Incentives and Wellness Program Participation

Employers continue to rely on wellness programs to help control spending and improve worker health and productivity.  These programs only work, if they do at all, if employees participate.  Companies have come up with a variety of incentives and penalties to encourage participation and an Employee Benefit Research Institute paper analyses the effect of these incentives.   (EBRI Brief)   The report looked at one large employer, which began offering a financial incentive for completing health risk assessments and participating in biometric screening; and compared the characteristics of those who participated in the wellness offerings before the incentive’s introduction with those who first participated after availability of the incentive.  The incentive was a $20 monthly discount off of health insurance premium contributions.  Prior to the introduction of the incentive, 75% of employees had participated in the health risk assessment and 29% in the biometric screening.  After the incentive an additional 24% completed the HRA and 65% more did the biometric screening.  Looking at the group that first participated after the incentive, they were older, more likely to be male, had higher incomes, and had higher rates of diabetes, high blood pressure and high cholesterol.  Specialist use was greater among this group but primary care visits were lower.  Drug use was also higher, but rates of use of other categories of health services was roughly the same. Overall the group that participated after the incentive was introduced were less healthy, indicating they could benefit from closer attention to their health and health care.

Health risk assessments and biometric screenings are a common part of wellness programs.  About half of employers are now using incentives to encourage participation and the incentives can be quite large.  The EBRI research suggests that the incentives are leading employees who may need to pay more attention to their health, and who may have higher costs, to participate.  This would indicate that incentives are a good thing both for the employers and the workers.  And the incentive in this case was relatively small.  A higher incentive might have an even greater impact.