About Wellness Corporate Solutions

Monday, May 11, 2009

Incentives and Wellness Program Participation Rates

In its latest issue, the American Journal of Health Promotion published an interesting study regarding incentives and corporate wellness programs. It's an important issue for us, because we often advise clients that incentives drive participation rates. Some choose to pay their employees a nominal amount for being screened--usually less than $50. Others offer reduced health care premiums. 

Not surprisingly, the study showed that offering an incentive did increase participation rates. But the the authors also examined two additional elements: the strength of the communication strategy used to promote the program, and the level of overall commitment from management, something they called worksite culture. Effective communications and a robust culture of wellness magnified the results of any incentive offered.

Some key points from the study:
  • Nearly 50% of employers use incentives to encourage participation in their wellness programs.
  • A cash incentive under $100 resulted in the most dramatic increase in participation.
  • A strong culture of wellness, combined with a benefits-related incentive, resulted in the highest mean participation rate: 69.4%.

2 comments:

Anonymous said...

Biometric criteria can damage participation rates:

Wellness programs are now widespread in both the public and private sector, created to achieve cost-savings and improve employee health. The programs should be designed for broad participation. As Feifei Wang, PhD, expresses, “Most of the wellness programs reach only a small portion of the target population.”
Wellness program advisors express a consensus on strategies to build effective plans. Most importantly, they believe that a target population should be the source of ideas concerning the development of program activities and incentives. Every participant should be awarded incentives in an individualized, non-competitive manner. Appropriate rewards may be time off; reduced health insurance co-payments; recreational equipment or facilities; and discounts for recreational health activities.
A wellness program that rewards individuals only on narrow criteria as body mass, blood pressure, and cholesterol is flawed. According to the Texas Department of State Health Services, any wellness program should avoid rewards for biometric data and competitive incentives.
A program that only rewards participants with a “normal” BMI below 24.9 excludes participants. Currently, about 55% of Americans exceed BMI 25. If they perceive that attaining BMI 24.9 is unrealistic, individuals from whom costly medical risks arise will reject the program.
Historically, the range of “normal” BMI extended to 25.8 for women and 26.4 for men. Steven Halls, MD, estimates that “normal” BMI for men should extend to 27. Furthermore, increased medical and drug costs begin at BMI 27, according to a large-scale study by Feifei Wang, PhD, et. al. The steepest increases in costs are below BMI 19 and above BMI 30.
Medical cost increases are approximately 4% per BMI from 27 to 45. Drug cost increases are estimated at 7% per BMI unit. Therefore, any improvement saves money and should be rewarded.



Blood pressure levels provide another example. Lowering the average blood pressure of participants may be a noble goal. However, requiring a participant to achieve a blood pressure reading less than or equal to 120/80, perceived as a “normal” standard, is not helpful. Prehypertension, blood pressure between 120/80 and 140/90, may affect one-third of the population. However, medical studies indicate that prehypertension is misdiagnosed in up to 43% of patients due to errors such as variations in readings and the elevated pressure created by “white coat” syndrome, measuring in a clinical setting.
According to Laura P. Svetkey, MD, changes in diet and exercise can lower blood pressure 7 points; weight loss of ten pounds can lower systolic pressure another 4 points. Therefore, an attainment criteria of 120/80 forces health care providers to become drug pushers, increasing health care costs and endangering the health of patients with pressure readings only slightly above “normal.”
Therefore, any successful wellness program will reject specific biometric criteria. The attainment of improved health among the members of a group is dependent on the infusion of ideas and participation from the bottom to top of an organization, not unfunded mandates from aloof comptrollers on high.

Joseph said...

You should know the rates of the incentives and corporate wellness programs you participate in.

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