Executive Summary: Certified Athletic Trainers Deliver ROI in Occupational Work Settings

By Craig Halls, MBA, LAT/ATC, CEES

A Report from the Clinical/Industrial/Corporate Athletic Trainers’ Committee



A penny saved is a penny earned. The adage is true with certified athletic trainers working in the industrial and commercial settings. Certified athletic trainers (ATCs) working full-time in occupational settings provide a measurable, positive return on investment for each dollar spent on athletic training programs, no matter the size of the company, according to a new survey by the National Athletic Trainers’ Association (NATA). Certified athletic trainers (ATCs) greatly influenced decreases in company health care costs through a stunning variety of programs designed to meet the needs of their occupational athletes. The 2003 NATA survey helps substantiate long-standing anecdotal evidence that on-site occupational athletic training programs add value to the corporation. This value is evidenced by decreases in frequency, severity, and overall cost of workers’ compensation claims for musculoskeletal disorders, and increases in worker productivity through fewer lost or restricted workdays. Both workers and companies benefit from wellness and fitness programs offered by certified athletic trainers. Respondents, who were primarily human resource or safety managers, recommend employing two ATCs per 1,000 employees.

Survey highlights:

  • 100 percent of companies report that the certified athletic trainer provides a positive return on investment (ROI).
  • Of companies that track ROI,
    • 30 percent indicate the ROI is at least $7,
    • 83 percent indicate the ROI is more than $3.
  • 94 percent of companies indicate the severity of injuries has decreased by at least 25 percent.
  • Almost two-thirds of the companies indicate that the certified athletic trainer has helped to decrease restricted workdays and workers’ compensation claims for musculoskeletal disorders (MSDs) by more than 25 percent.
  • 50 percent of companies report that the number of injuries has decreased by at least 50 percent.
  • Almost half of the companies that utilize certified athletic trainers to provide on-site physical rehab indicate that health care costs have decreased by more than 50 percent.


The purpose of the Industrial Athletic Trainers’ survey sponsored by the National Athletic Trainers’ Association was to determine the baseline cost/benefit numbers for athletic trainers working in occupational settings. The primary objectives of the survey were to determine return on investment for occupational athletic training programs and the most-common corporate profiles for future employment opportunities for ATCs. Another primary objective was to gain basic information on how athletic training programs run on-site by companies provide a return on investment through improved employee productivity and positive impact on health care costs. Secondarily, the survey determined what types of services were offered by certified athletic trainers to occupational athletes.


Employment outlook for ATCs in the industrial and corporate setting appears positive through 2010. The market segment has had strong growth over the past five years. According to the survey, 12 companies reported that they would hire additional ATCs within three years, with eight and nine companies reporting that they would hire additional ATCs within five and 10 years respectively. Some companies reported that they would hire certified athletic trainers in all categories. ATCs were full-time employees by a wide margin (63%). The second most-favored option was optimizing ATCs on an outreach basis (25%). The remaining ATCs were either independent contractors or part-time employees. A wide variety of services are offered by occupational ATCs, which is a professional strength of those in the athletic training profession. The variety of programs offered is reflective of the wide range of capabilities, and diverse training and education of ATCs. Injury prevention was the most cited and highest rated service, with 31 companies (97%) reporting that it was very important or important to their programs. Wellness programs were offered by 26 companies, and 25 companies offered physical conditioning, ergonomics and education/outreach training. Twenty-four companies offered rehabilitation services, 22 offered fitness services, and nutrition and safety programs were offered by 20 companies. Nine companies had medical case management, and seven companies had work hardening programs. Nine companies offered nine different ongoing services, and five companies each offered seven or eight different services. Four companies offered six programs, and three companies offered 11 programs. The remaining companies offered from three to five different programs concurrently.


Of the 32 respondents, 31 (97%) say their athletic training programs provided a positive impact on the company’s health care costs. The other company did not know whether results were positive or negative. In particular, 30 out of 32 respondents (94%) reported that the individual ATC himself or herself provided a positive return on investment. This affirms that the ATC’s education and training in injury prevention, assessment, treatment and rehabilitation are ideally suited for occupational settings. Of the respondents that tracked specific dollar figures, 100 percent reported positive ROI. The results were:

  • 3 companies reported ROI in the $1-$3 range (per $1 invested)
  • 6 companies reported ROI in the $3-$5 range (per $1 invested)
  • 3 companies reported ROI in the $5-$7 range (per $1 invested)
  • 1 company reported ROI in the $7-$10 range (per $1 invested)
  • 4 companies reported ROI of greater than $10 (per $1 invested)
  • The remaining survey respondents did not track this information.

Twenty-four companies (75%) provided on-site rehabilitation services. The other eight companies did not provide this service, so ROI tracking on this issue was not applicable. The decreased health care costs by providing rehabilitation services on-site were significant. Four companies reported a 0-25 percent decrease in health care costs. Three companies in each of the following categories reported decreased health care costs: 26-50 percent decrease, 51-75 percent decrease and 76-100 percent decrease.


Incident rate: Twenty-eight of 32 respondents (88%) noted that occupational ATCs helped the company decrease the incident rates for musculoskeletal injuries and illnesses. Four companies did not track the information. Of those that specified a percent of decrease, 38 percent reported a 51-75 percent decrease in incidence rate. Twenty-five percent of the companies reported either a 0-25 percent decrease or 26-50 percent decrease in incidence rate. Twelve percent of the companies reported 76-100 percent decrease in incidence rate. Severity rate: Twenty-two (69%) of 32 respondents noted that the individual ATC helped decrease the company’s severity rate for musculoskeletal injury and illness. Two companies reported no decrease in severity rates and eight companies did not track the information. Fifty percent (8 companies) reported a 26-50 percent decrease in severity rates. Thirty-one percent (5 companies) reported a 51-75 percent decrease in severity rates. The final three companies reported either the highest or lowest category of decrease. Worker productivity and decreased lost or restricted workdays are important issues in manufacturing, industrial and other corporate settings. Twenty-one (66%) of 32 companies reported a decrease in restricted workdays. Of those reporting a specific percentage, all 15 companies reported a decrease, ranging from 0 to 75 percent decrease. Workers’ compensation claims were also decreased with 75 percent of the total companies reporting. Of those reporting specific percentages, 37 percent reported a 0-25 percent decrease in workers’ comp claims related to musculoskeletal injuries. Thirty-two percent of companies reported a 26-50 percent decrease, and 26 percent reported a 51-75 percent decrease. One company reported a 76-100 percent decrease. This information was tracked through the use of OSHA logs, workers’ comp premiums and internal cost analysis. The types of companies responding to the survey include: aerospace products, automotive manufacturing, beverages, carbonless/thermal paper, chemicals/plastics, disability management, drugs/medical manufacturing, energy/electricity, entertainment, health care, logistics/warehousing and less-than-truckload freight. Representative titles are: health/worksite promotion director, operations health manager, director of safety and security, fitness director, medical directory, safety/ergo training manager, division risk manager and personnel manager.


The greatest number of certified athletic trainers was employed by companies with 2,501-5,000 employees (9 respondents for 28% of employer category). Interestingly, seven (7) companies (22%) employed between 101-500 employees. Two employer size categories tied for the third largest size (511-1,000 and 1,001-2,500 employees). Five companies (16%) in each the 101-500 and 1,001-2,500 employee categories tied for third. Four companies (13%) employed fewer than 100 people, and two (6%) companies employed more than 5,000 people. Of the 32 respondents, the mean number of ATCs per company was 5.5, and the mode was 1 (at 12 companies). The mean number of ATCs employed per facility was 1.35. The mode was one (representing 23 companies). Human resource managers noted that about two (mean 1.9) ATCs per 1,000 employees were ideal. The mode of ATCs per 1,000 employees was 1-2 (18 companies using this figure).


The survey was e-mailed to National Athletic Trainers’ Association members who listed industrial or corporate as their primary work setting. Members in this category without e-mail addresses were sent the survey via U.S. mail. Only U.S. members were sent the survey. A total of 460 surveys were sent, 378 by e-mail and 82 by postal service. A total of 75 surveys were received, which is a 16 percent response rate. However, only 32 surveys were usable, which equals to 7 percent. The response rate on usable surveys was lower than usually received by NATA because the survey audience was not the actual member. NATA members received the survey with a request that it be filled out by the person responsible for the financial and/or human resource aspects of the athletic training program, which was usually the human resource manager or safety manager. This means that a person less vested in the results of the success of the survey was responsible for completing it. However, a 16 percent response rate is very acceptable, and the survey is valid as a trend indicator and reliable industry segment sample. About the author Craig Halls, MBA, LAT/ATC, CEES Corporate Wellness Site Manager, Appleton Papers, Inc. Halls is the Corporate Wellness Site Manager at Appleton Papers where he manages an on-site physical rehabilitation center and directs the corporate ergonomic programs. He is a 1996 graduate of UW-Milwaukee where he received his Bachelor of Science in Human Kinesiology. He is a nationally certified athletic trainer and a licensed athletic trainer in Wisconsin, where he also serves as the Chair for the Industrial Committee of the Wisconsin Athletic Trainers’ Association. Additionally, Halls has obtained his MBA and is a Certified Ergonomic Evaluation Specialist. About NATA: Certified athletic trainers (ATCs) are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses that occur to athletes and the physically active. The National Athletic Trainers' Association represents and supports the more than 30,000 members of the athletic training profession through education and research. www.nata.org. NATA, 2952 Stemmons Freeway, Ste. 200, Dallas, TX 75247, 214.637.6282; 214.637.2206 fax. Contact Cate Brennan Lisak, director of external marketing, for more information. Industrial ATC survey_final_Feb03_draft2_ch_cbl_sf Apr10.03

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