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In 2012, 28% of large U.S. employers hosted on-site medical clinics, and 39% will have them by 2014, a Towers Watson survey found. The figure in 2011 was 23%.

Consultants and health-care providers are advising employers to add chronic-disease management—from regular blood and glucose tests to nutrition and lifestyle coaching—to their clinic

Though less than half of all the patients were compliant with their blood pressure medication regimens, the patients who got the feel-good phone calls were 17% likelier to be adherent, the study found. These good-feelings exercises may be especially helpful for patients who don't trust the medical system, Dr. Ogedegbe says.

The number of people enrolled in health savings accounts (HSA) has more than tripled in the last six years from 4.5 million people in January 2007 to 15.5 million in January 2013, according to America's Health Insurance Plans, a trade association that represents health insurers.

In the future, Cohen said he expects to see several options used more widely to lower costs, such as rewards for low cholesterol or keeping diabetes under control, incentives to join gyms and benefits for participating in healthy lifestyle programs.

The data also shows that businesses could save money while providing their employees with more choices, he said. Some of those choices, such as closed-network programs or single primary-care physician-based programs, have been avoided in the past because the common wisdom is that people don't like being limited by what doctors they may see.

Most in the Pioneer group achieved quality improvements, but only 18 produced cost savings.

It remains to be seen whether it functions profitably or not," said Alan Miller, chief executive of Universal Health Services, which operates more than 200 hospitals, behavioral health facilities and outpatient centers."There has been a lot of discussion of moving away from fee- for-service to something like this, but we are a long way from there," Miller said.

The big opportunity for cost savings lies in getting preventive care for people before they land in the hospital with illnesses such as heart disease, diabetes and asthma,