Financial Incentives Increase Likelihood of Wellness Program Participation

Incentives tied to uptake of telephone health coaching

New research shows that when employers offered financial incentives, employees were 33 times more likely to participate in telephone health coaching and did so sooner than employees without incentives. Telephone health coaching: one-on-one phone calls with a personal health coach: is one of many employee wellness programs that employers and insurers can offer today. With all that goes on in the workplace, employee wellness programs can sometimes go unnoticed; however this new research shows that adding an incentive can drastically change participation numbers, thus leading to a potential increase in overall health and a decrease in costs for health plans.

The findings were presented on Nov. 7, 2014, at The Obesity Society (TOS) Annual Meeting in Boston

“While the jury is still out about whether workplace wellness programs improve health, the programs have great potential,” said lead author Jason Block, MD, TOS member and assistant professor at Harvard Medical School’s Department of Population Medicine. “Our goal was to evaluate what motivates people to participate in these programs and what strategies companies and insurers can use to get everyone involved. Our data show that financial incentives clearly work to motivate participation in a health coach program.”

From Oct. 2010 to July 2013, researchers led by Block gathered data on adult members of one nonprofit health plan. They compared the uptake of a telephone health coaching program among the 16,961 members who received financial incentives to the 974,782 members who did not. Their research found that during the nearly three-year follow-up period, 10% of the members with incentives began using the telephone health coaching, whereas only 0.3% of those without the incentives did so.

Financial incentives were also strongly associated with how long it took members to begin using the program. Members who used the telephone health coaching typically had six to seven interactions with a coach over an average duration of four months, where they discussed their lifestyle, assessed their health situation and concerns, and worked to develop specific health goals.

“The idea of using employer incentives to participate in health coaching is relatively new,” says Eric Finkelstein, PhD, MHA, an associate research professor in the Duke Global Health Institute at Duke University. “This research gives us a solid foundation to build upon. The next step is to measure changes in these participants’ health behaviors and identify long-term success.”

Advice for Employers

TOS offers advice for companies looking to implement their own programs and encourages them to focus on incentives for participation rather than penalties. In a TOS position statement released in 2013, TOS members examined the research in the area and made recommendations for employers when developing these programs, including:

1. Structure programs to reward employees for engaging in healthy habits.
2. Avoid the use of Body Mass Index (BMI) as a basis for financial penalties or incentives.
3. Ensure incentive programs are matched with health plans that cover evidence-based obesity treatment programs and medications.
4. Focus programs on overall wellness for all employees rather than only those affected by obesity or overweight.
5. Create a supportive workplace environment that provides opportunities for healthy behaviors, such as healthy food options in the cafeteria and vending machines.

“Tackling obesity in the workplace requires a holistic approach with a focus on supporting employees in their health journey,” continues Finkelstein. “Getting it right means workplaces that are encouraging healthy activities, employee cafeterias with healthy options, leaders who model healthy behavior, and health plans that cover a wide range of treatments for obesity and overweight.”

The full abstract of this study is available here.

Learn more about CBIA’s Healthy Connections wellness program here.