Health and Wellness Incentives in 2012: Participants Have to Hit Clinical Marks

Thursday, September 13th, 2012
This post was written by Patricia Donovan

health incentives

Incentives in 2012: Rewarding Risk Assessment, Lifestyle Change

Showing up isn’t enough any more to earn a cash- or benefit-based incentive for health improvement, say respondents to HIN’s fourth annual Health & Wellness Incentives survey. Instead, employers and health plans are rewarding measurable achievements in health behavior change &#151 weight loss, smoking cessation, BMI reduction or other lifestyle changes that reduce an individual’s risk of developing or exacerbating a chronic (and costly) illness.

“That’s the future of population health management,” concurs Patricia Curran, principal in Buck Consultants’ National Clinical Practice. “Companies have developed incentive programs, but they’ve found that awarding incentives just for participating is not necessarily achieving the outcomes they want. Just taking the health risk assessment and the biometric screenings isn’t getting the results.”

While completion of a health risk assessment (HRA) remains the most heavily incented health improvement activity for the fourth consecutive year, according to two-thirds of survey respondents, more companies are incentivizing the lifestyle behavior changes of weight loss (57 percent) and smoking cessation (51 percent) than 2011’s favored activities of preventive screenings and participation in on-site wellness.

This makes sense, says Ms. Curran. “They’re making participants toe the mark. They have to meet certain health goals, and they’re going to be measuring that effort. They’re going to incentivize individuals for meeting those goals going forward. It’s a new trend — making people more aware of the importance of these health goals. [Companies] really want to see people getting results, so they’re going to be targeting things like weight management, tobacco cessation, BMI.”

In other survey findings, the use of texting to communicate incentive program details doubled in the last year, from 7 to 14 percent. Social networks and health portals also gained favor for this purpose. At the same time, more are relying on the more traditional communication modalities of work site flyers and table cards, a trend that has risen steadily from 61 percent in 2009 to 68 percent in 2011 to 84 percent this year.

“You have to leverage the right tools and techniques matched to those consumers or their preferences,” notes Jay Driggers, director of consumer engagement at Horizon Blue Cross Blue Shield. A key area of study for Driggers’s consumer engagement team is behavioral economics, which he refers to as “the carrots and the sticks, things that will motivate people to change their behavior or to do something.” Incentives fall into this category, he says.

The survey also identified a 2 percent increase in the awarding of incentives via contests and drawings, a practice reported by 57 percent of 2012 respondents. “In most cases, I think a lottery can be a cheaper option that will drive more participation than a one-to-one reward,” suggests Driggers, who recently outlined Horizon’s approach to consumer engagement in its patient-centered medical home initiative.

Other 2012 survey results:

  • The number of respondents reporting incentives program ROI of between 3:1 and 4:1 has doubled in the last 12 months, from 2.6 percent in 2011 to 5.3 percent this year. Program ROI of between 2:1 and 3:1 remained constant at 14 percent from 2011 to 2012.
  • The use of biometric screening to identify participants for incentive-based programs rose slightly in 2012 to 40 percent, up from 36 percent in 2011. Opt-in or self-registration remains the top identification tool, at 62 percent.
  • Group incentives lost some favor this year, in use by just 23 percent, versus 36 percent of 2011 respondents.
  • In new survey data this year, 20 percent extend eligibility for health and wellness incentives to domestic partners.

For more survey highlights, download the executive summary of Health & Wellness Incentives in 2012: Rewarding Risk Assessment, Lifestyle Changes. A detailed analysis of these metrics, including year-over-year trends, is provided in 2012 Healthcare Benchmarks: Health & Wellness Incentives.

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