By Simon Powell
Oct. 10, 2013
The Affordable Care Act has expanded the ability of self-insured employers to offer wellness incentives to their employees as part of health plan design. Companies are now frequently rewarding employees $1,500, or even $3,000, for getting to a healthy weight, quitting smoking, and/or getting their biometrics into a healthy range. As you evaluate whether wellness incentives are appropriate for your population, and determine what type of incentives will work best, it’s helpful to look across the pond to identify what types of programs are working in the UK and globally.
Recent research from the UK’s National Health Service (NHS) has demonstrated that financial incentives can positively improve behaviors that impact long-term health, including smoking, weight, and physical activity.
Positive financial incentives can help women give up smoking during pregnancy. A Tayside, Scotland program paid pregnant women up to $1,050 in weekly $20 grocery vouchers for each week they abstained from tobacco. These cash incentives were found to be significantly more effective than other intervention strategies in inducing pregnant women to stop smoking. The cash incentives were cost-effective, too; a similar scheme in Sheffield, England found that every £1 (English pound) spent incentivizing women to stop smoking would save the NHS £4 in future health care bills.
Similar results have been found to induce weight loss with cash incentives. A weight loss incentive study developed by NHS Eastern and Coastal Kent in 2007, challenged slimmers to lose between 15-30 pounds and paid them for doing so. Overall, 67 percent of 401 participants lost weight, an average of 18 pounds, after three months in the program.
Finally, recent research has found that activity can be encouraged in the same way. A study in Northern Ireland offered contactless “loyalty cards” to allow about 400 governmental workers to monitor physical activity levels. After a week where existing habits were measured, the office workers could use their cards to register their attendance of the office gym or to swipe at brightly-colored posts along a number of different woodland and riverside walks and runs near their offices. Half of the workers were simply encouraged to monitor their activity. The other half were rewarded with gift vouchers for local shops depending on the activities chosen, their frequency and even on the speed increases shown on their runs. The study concluded that both sets of workers increased their activity during the study. The non-incentivized workers averaged an extra 30 minutes of moderate to vigorous physical activity a week, but the average incentivized worker had increased their activity by a full hour, doubling that of their non-incentivized peers.
NICE, the U.K. clinical body that evaluates the efficacy and cost-effectiveness of NHS programs, examined these studies in 2010 and concluded that alongside other interventions, financial incentives should be supported providing among over provisos that they are only offered to people who are committed to changing their health behavior and that their progress is monitored throughout.
These studies show that there is tremendous potential to use positive incentives to induce behavior change. But, the incentive schemes need to be carefully designed to induce change. By providing ways to measure the improvements in the short term, as with the activity loyalty cards, and by incentivizing the long term benefits, as with the smoking abstention studies, organizations can help individuals make the changes they would otherwise struggle to achieve.
Employers can use these modern collaborative tools to create fun, focused activities to help spur employees into taking an interest in their health and acting to improve it. Programs such as weight loss challenges can allow staff to work together toward their own goals, improving their health and company morale at the same time.
Simon Powell is global client program director at HealthyWage, which provides financial incentives for those looking to lose weight. Based in London, U.K., he helps firms across the US design and implement weight loss incentives for their employees. He may be reached at www.healthywage.com.