My last blog post -- about the New Year’s resolutions many of us make but fail to keep -- examined American’s general lack of health and argued that financial incentives hold the greatest promise for improvement.
I discussed a study which found that men who were offered financial incentives for weight loss lost significantly more weight than those who weren’t. While many of the men weren’t able to keep it off long-term, the study shows the promise and potential of even relatively small financial incentives.
Hours after publishing the post, I received a press release from Welltok, a company that operates a wellness platform for Colorado state employees. In just six months after the state launched its health incentive program, Café Well, a third of state employees (roughly 10,000) were participating in the wellness program in some form. About 5,000 employees completed a risk assessment, which is up more than six times the amount who completed the assessments in years past.
Why the improvement?
Financial incentives.
Under the program, state employees receive $10 a month off their health insurance premiums by completing the assessment. They can also earn an additional $10 off their premiums by completing other wellness activities, such as a smoking cessation or walking program, according to a Business Insurance article.
The Colorado initiative is sponsored by UnitedHealthcare and Kaiser Permanente, which provide health insurance for Colorado state employees.
"We are pleased to partner with the State of Colorado and Welltok to provide an engaging platform that offers a variety of opportunities to be healthy at work," said Eric France, MD, Kaiser Permanente chief of population care and prevention services. "This program helps create and promote a culture of total health -- something that's in our Kaiser Permanente DNA. Employees can motivate each other to make positive changes that can ultimately result in a healthier workforce."
Employers have operated employee wellness programs for some time, but increasingly, they are providing small financial incentives for employees who complete certain wellness activities.
I believe this is one of the best ways to improve population health -- at least until incentives can be rolled out on a larger scale than through individual employers. A caring, engaged physician is important, but, as they say, money talks. O,r in this case, leads to real results.
Some argue that financial incentives are unfair to the most at-risk workers, making insurance more expensive for those that need it most –- the least healthy workers. (A 2013 Wall Street Journal article does a nice job of illuminating both sides of the incentive argument.) However, it’s important to note these programs don’t incent only for health, but also for taking steps toward health. So, while a non-smoking employee at a healthy weight would receive an incentive, so too would an overweight smoker who is enrolled in a program to stop smoking, eat healthier, or move more.
Perhaps it speaks to the state of our nation when we have to pay people to improve their health -- something we'd assume most people would desire to do regardless of external incentives. Yet, we know this isn't the case, and our national health expenditures show it. To rein in costs, perhaps the answer is dolling out a little money to save a lot more.