Study reveals premium-based financial incentives not enough to motivate obese workers to lose weight

Study reveals premium-based financial incentives not enough to motivate obese workers to lose weight

Philadelphia, United States – A new study published by researchers from the Perelman School of Medicine at the University of Pennsylvania reveals that premium-based financial incentives are not enough to motivate employees to lose weight and adopt a healthy lifestyle.

To promote health and wellness in the workplace, many employers have introduced programs to help workers make healthy lifestyle choices including offering financial incentives in the form of reduced health insurance premiums to help encourage success. However, the research team’s findings revealed that three types of incentive programs using either health insurance premium adjustments or lottery-based financial incentives were not effective in promoting weight loss among workers.

The study suggests that employers promoting weight reduction and other healthy lifestyle choices through workplace wellness programs should test incentive designs different from premium-based financial incentives.

“More than 80 per cent of large employers use financial incentives for health promotion,” said Mitesh Patel, MD, assistant professor of Medicine and Health Care Management at Penn’s Perelman School of Medicine and the Wharton School.

“Many use health insurance premium adjustments, but these incentives are often delayed and, even when they aren’t, they are typically hidden in paychecks along with other deductions and payments. That makes them less noticeable.

“Our findings suggest that employers should consider testing designs alternative to the $550 premium-based incentives used in this study.”

The researchers involved more than a hundred participants to enroll in a workplace wellness program and were given a weight loss goal equivalent to five percent of their weight at enrollment. They were randomly assigned to a control arm with no financial incentive for achieving the goal, or one of three intervention arms, each offering an incentive valued at $550. Two of these arms used health insurance premium adjustments, either delayed until the beginning the following year, or taking effect in the first pay period after achieving the goal. The third group were entered into a lottery incentive. Twelve months later, no significant changes were seen in average weight loss for participants in all of the groups.

“Though participants in our study didn’t experience significant weight loss, that doesn’t mean that all incentive programs are ineffective, only that we need to move to more creative designs that might better leverage predictable barriers to behavior change,” said David Asch, MD, MBA, a professor of Medicine and Health Care Management and director of the Penn Center for Health Care Innovation.

The Affordable Care Act contains a provision allowing employers to use up to 30 percent of health insurance premiums as penalties or rewards, which totals around $1,800 for the average employee.

The authors say incentive amount alone may not be enough to influence lifestyle modification. Instead, effectiveness of incentive programs typically depends in part on how the incentive is deployed and in what context.

“There is often a presumption that the size of the rewards is all that matters. In reality, incentive systems vary in effectiveness according to how well they are designed.” Said Kevin Volpp, MD, PhD, professor of Medicine and Health Care Management and director of the Penn Center for Health Incentives and Behavioral Economics. “In this case, premium adjustments had little impact on weight and the lottery incentives we used were constrained by having to do weigh-ins in workplace settings. That made sustained engagement and behavior change more challenging.”

The study has been published this month on Health Affairs.