Cost-Effectiveness of the Mindfulness-Based Stress Reduction Methodology

The conflicting challenges of increased patient demand and decreased health care resources require a partial shift in responsibility from the health care system back to the individual. Our objective was to see if participation in a group program (mindfulness-based stress reduction (MBSR)) that reduces stress and fosters self-care impacted health care utilization. We did a prospective study of 1730 patients participating in an MBSR program comparing their health care utilization for 1- and 2-year pre-/post-periods with three different matched comparison groups. In both pre-intervention periods, cases had higher overall costs, numbers of physician claims, and utilization of lab facilities when compared with all three comparison groups. Participation in an MBSR program resulted in consistent decreases in utilization across all outcome variables at the 1-year pre/post interval. These decreases were significantly different than the patterns shown by the matched comparisons. Assuming 1500 MBSR participants (close to the number in the "closest" match) times an average savings of $250 would result in $375,000 in savings. These differences disappeared at the 2-year pre/post interval with the exception of laboratory utilization. Our findings suggest that mindfulness training is effective for short-term reductions in health care use among a group of complex and heavy users. Anecdotal reports suggest MBSR participants stop their formal mindfulness practice within months of completing the program. It may well be that continuing the formal practice of mindfulness is a necessary prerequisite for maintaining the reductions in health care utilization.