Financial incentives tied to health insurance premiums did not promote significant weight loss in the workplace, according to a new study published in the journal Health Affairs.
Many employers use health insurance premium adjustments to target health outcomes, and the Affordable Care Act increased the proportion of premiums that can be used as penalties or rewards from 30 percent to 50 percent, the study notes. However, there has been little evaluation of the effectiveness of this approach. In October, Aetna claimed that it is possible for a wellness initiative to show a positive return on investment in one year, but doubts remain about whether or not these incentive programs truly work.
In the study, which took place from 2013 to 2015, participants were asked to lose 5 percent of their body weight, and each was assigned to one of four study groups. The first group would receive the $550 in the form of 26 biweekly premium discounts beginning the following year, the second group was told that once participants met their weight target, they would immediately begin receiving the $550 premium discount, and in the third group, participants who reached their daily goal were entered into a lottery in which they could win financial rewards. At the end of the year, none of the groups had reached their 5 percent weight loss goal, and overall, weight was generally unchanged.
"In many programs, effectiveness has been assumed rather than tested," the authors wrote. "However, an important insight from other work is that the effectiveness of incentive programs typically depends not just on the size of the incentive but also on how it is deployed and in what context."
The study also found that employer premium adjustments typically involve future rewards and have the downside of being bundled with larger amounts of money such as an employee's paycheck. Also, they found evidence that immediate gratification may be more motivating than rewards in the future and that mental accounting strongly affects how money is perceived.
Employees involved in workplace wellness programs have been skeptical about whether their personal information will trickle back to their employer and be used against them, FierceHealthPayer has reported.
To learn more:
- here is the study (subscription may be required)