By their very definition, incentives serve as motivation to elicit specific actions.

When used by employers as part of a medical management program—particularly wellness and disease management—incentives are proven to significantly raise participation rates, leading to improved member health, increased productivity, reduced health care spending and, ultimately, positive returns on their investment.

The challenge is determining how to structure an incentive program to deliver the desired results.

Studies and our experience have shown that incentives of $50 per employee per month, or $600 per employee annually, yield participation levels of 75 percent or better when the member answers the call. In other words, with the right incentive, you can lead a horse to water, and you can expect him to drink, at least three-fourths of the time.

Successful medical management programs target high-risk plan members with medical conditions or lifestyle behaviors that drive costs for employers. When implementing an incentive program, however, it is wise to cast a wider net.

Although it might seem counterintuitive to offer incentives to employees who are already healthy, it's important to engage the entire member population. Doing so deepens the pool from which you can identify candidates with chronic conditions or emerging lifestyle risks who would benefit from one-on-one coaching from a registered nurse or behavior-change specialist.

Remember, about 75 percent of those you engage will agree to participate. So if you are able to reach a larger percentage of the overall population, your participation rate will increase proportionately. Plus, even the healthiest of plan members can benefit from learning more about how the decisions they make can influence their personal health and well-being.

Consider a plan structure with a primary incentive that appeals to the total population, complemented by a secondary incentive used to target the at-risk population. Primary incentives often are distributed in the form of premium reductions or additional dollars applied to an employee's paycheck, a health savings account or as part of a value-based benefit plan.

These incentives typically are used to motivate members to complete clinical health risk assessments and biometric health screenings, both of which help identify individuals for potential coaching intervention.

These at-risk or high-risk individuals are candidates for secondary incentives. They may have a chronic medical condition, such as diabetes, heart disease or asthma. They may have a higher likelihood of developing complications during pregnancy. Or they may have one or more lifestyle risks, such as obesity, tobacco use or a lack of physical activity.

Secondary incentives can encourage these members to work with a health coach toward managing their medical condition or making health sustainable changes to their behavior.

Their participation may be required in order to remain eligible for premium reductions, or they may receive secondary incentives in the form of gift cards or reduced or waived copayments or coinsurance for:

Therapeutic class medications used to treat chronic diseases
Diabetic supplies
A newborn's inpatient stay following delivery
Nicotine replacement therapy gum or patches
Weight loss or fitness club memberships

Our experience shows that, on average, more than 80 percent of those who enroll in coaching will complete the process, equipping them with healthy habits and techniques that are sustainable for a lifetime.

When combined with an effective medical management plan, the right incentives will help employers move employees' personal wellness forward, move their corporate health culture forward, and reduce their plan costs long-term.

Chris Galanos is vice president, customer solutions—care management, at United Health Care.

Instant Insights /

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