A checkup of sorts for the Hawaii Medical Service Association's health promotion and prevention program shows people who participate in it generally save money and enjoy better health than nonparticipants.

That's the gist of an independent review of HMSA's HealthPass initiative, a program that is free to most of the insurer's members and features an annual health assessment, screenings and counseling by health professionals. About 52,000 people are enrolled in HealthPass, which HMSA touts through invitations mailed around members' birthdays and through employers.

The study by HealthMedia Inc. of Ann Arbor, Mich., found the program lowered overall healthcare costs by about $6.8 million, improved health and helped people make lifestyle changes. An examination of 3,700 people who'd been with the program for four years found most with cholesterol problems lowered their readings. There were favorable results for people with high blood pressure, glucose, sedentary lifestyles, too much stress and cigarette smoking.

"I've found the advice to be good and the testing to be useful," said Kenji Sumida, a 76-year-old Kailua resident who has participated in the HealthPass program for a decade.

Sumida has sought counseling on how to control cholesterol and dieting. His wife also is enrolled.

"I've always believed preventative care is just as important as getting treated after you get sick," Sumida said.

Some of the HealthPass program's success may be due to attracting people who are more interested in their health. Caryn Ireland, vice president of HMSA's Integrated Services Inc. unit that oversees the program, said people who come in may be more motivated than others to take care of themselves, but that at the same time the program generally appeals to people who have greater health risks than the general population.

"They might be more health conscious, but not healthier," Ireland said. People enrolling in the program fill out a questionnaire online or at the offices and get their body mass index measured along with glucose and cholesterol. These factors are then reviewed with a health professional who can recommend ways to take care of problems or make referrals to physicians.

The program can also identify other tests that should be taken such as mammograms or bone-density exams.

"Really, what it's all about is starting to engage more people in health," Ireland said.

The HealthMedia study found that has produced a $505 savings in healthcare costs in 2005 for people who had been in the program for a year. The healthcare costs for the member were $2,658 versus the $3,163 they were estimated at if the person didn't participate in the program.

The report also estimated that for every dollar invested by HMSA in HealthPass there is a $2.40 return in savings.

"With education, motivation, and the right tools, you can succeed in making changes that will have a positive impact on your well being and reduce your healthcare costs," said Victor Strecher, HealthMedia chief science officer in a press statement.

"The true causes of death are not heart disease, cancer and stroke. They are cigarette smoking, poor diets, sedentary behavior and stress."

Reach Greg Wiles at gwiles@honoluluadvertiser.com.