The Impact of Alternative Incentive Schemes on Completion of Health Risk Assessments
ABSTRACT The biggest challenge for corporate wellness initiatives is low rates of employee participation. We test whether a behavioral economic approach to incentive design (i.e., a lottery) is more effective than a direct economic payment of equivalent monetary value (i.e., a grocery gift certificate) in encouraging employees to complete health risk assessments (HRAs).
Employees were assigned to one of three arms. Assignment to a treatment arm versus the nontreatment arm was determined by management. Assignment to an arm among those eligible for treatment was randomized by office.
A large health care management and information technology consulting company.
A total of 1299 employees across 14 offices participated.
All employees were eligible to receive $25 for completing the HRA. Those in the lottery condition were assigned to teams of four to eight people and, conditional on HRA completion, were entered into a lottery with a prize of $100 (expected value, $25) and a bonus value of an additional $25 if 80% of team members participated. Those in the grocery gift certificate condition who completed an HRA received a $25 grocery gift certificate. Those in the comparison condition received no additional incentive.
HRA completion rates.
Logistic regression analysis.
HRA completion rates were significantly higher among participations in the lottery incentive condition (64%) than in both the grocery gift certificate condition (44%) and the comparison condition (40%). Effects were larger for lower-income employees, as indicated by a significant interaction between income and the lottery incentive.
Lottery incentives that incorporate regret aversion and social pressure can provide higher impact for the same amount of money as simple economic incentives.
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ABSTRACT: To provide insight on the feasibility and utility of implementing a broad based incentive program for health within the Military Health System (MHS). Published studies, articles, and information on the use of financial incentives in the military setting and to promote healthy behaviors were reviewed. Health care costs in the MHS have more than doubled over the past decade. The high prevalence of modifiable risk behaviors such as tobacco abuse, physical inactivity and obesity and their associated chronic diseases are accounting for a significant percentage of the growth. One evidence-based approach to address this issue would be the implementation of a broad based incentive program for health whereby all MHS beneficiaries would be eligible to receive some type of financial remuneration for meeting positive personal health metrics (e.g. not smoking or a normal body mass index). This approach if designed appropriately has the potential to have a high level of acceptance within the current beneficiary population since financial incentives are already used widely in the military to help meet overall manpower requirements. The use of a MHS wide financial incentives program to instill healthy behaviors in beneficiaries' may be an effective means to curb rising healthcare cost.Preventive Medicine 07/2012; 55 Suppl:S113-5. DOI:10.1016/j.ypmed.2012.06.022 · 2.93 Impact Factor