In 2019 health care costs—including premiums and out-of-pocket costs for employees and dependents—are estimated to reach nearly $15,000 per employee, a number that has continues to increase each year. Given that more than 80 percent of all large US employers offer corporate wellness programs, which often leverage incentives to encourage healthy behaviors, one would think are health expenses would be in check.
Just because an employer has a wellness program does not necessarily mean they have an overarching wellness strategy. Therein lies the problem—while incentives can be powerful drivers of healthy behavior change, their successful implementation requires a comprehensive wellness strategy, which is a delicate balance of both art and science.
Companies without a clear strategy often approach wellness offerings in a haphazard manner, deciding to add interventions when annual surveys of employee wellness or biometric screenings shed light on a new concern for the population. This piecemeal approach to wellness adds unnecessary complexity through the incorporation of disjointed vendors, and leads to internal confusion among employees, and in turn, low participation rates in the program. There is a need for a comprehensive wellness strategy from the get-go with a consolidated and holistic ecosystem of health and wellness features to address the unique needs of employees.
While incentives are an essential component of behavior change, one should not lose sight of what is being incentivized: health. So how can an employer maximize the power of incentives?
A championed culture of health
Corporations must make every effort to champion health and wellness to make it a part of the company culture—through actions such as offering healthy snacks in the office, hosting walking meetings, offering standing or treadmill desks, and encouraging the use of the stairs rather than the elevator.
Successful wellness programs also feature wellness champions who act as ambassadors within the company and are the go-to people for questions about wellness programming and events. These champions should be diverse across job areas and levels of an organization, educated about the program, passionate about promoting challenges and participation, and available to offer peer support. A culture of health and wellness facilitates increased organizational visibility and awareness of incentives.
Visibility and awareness
Incentive visibility is a function of access, communication, and corporate championing. Individuals need to have ready access to the resources that best suit their health and wellness needs. Wellness programs will only be set up for success when employees have a clear understanding of what exactly is required of them to meet various incentives. This is best achieved by having in place excellent corporate communication to ensure people have an awareness of the benefits, which will also be facilitated through the culture of health that is instilled across an organization.
Incentives should be rooted in a combination of clinical, behavioral, and data science principles to drive behavior change. Clinical science serves to identify the greatest drivers of risk within a population. Data science should identify individuals with those risk characteristics as well as the activity patterns of successful participants, serving as a potential roadmap for others. And behavioral science principles, such as loss aversion, present bias, framing, financial incentives, and pre-commitment, are the tools that ensure that an overwhelming majority, including high-risk individuals who would most benefit from a health and wellness program, are drawn into the program to benefit from well-framed health information and incentives to encourage healthier behaviors.
Sustainable behavior change
In order to drive behavior change, wellness goals should be achievable by everyone and must incentivize individuals to engage in healthy behaviors on an ongoing basis. Incentive structures that are predicated on single activities alone, such as completing a health assessment or getting a biometric screening, often lead to individuals completing those activities and then disengaging upon accomplishing that task. When there is little incentive to sustain healthy behaviors, individuals tend not to do so. It is essential that programs are incentivizing sustainable behavior change through a combination of activities and outcomes.
It is important that companies not only assess employee health to understand the most pressing health issues within their workforce, but also measure and report on the health of their employees on an ongoing basis, elevating employee health as a primary pillar of corporate success.
While there is no one recipe for developing the perfect incentive structure, we do know that there is an art and a science to harnessing the maximum value from incentives. As with any leading artist or scientist, the best solutions require creative thinking that resonates across unique individuals and their workplaces.
It is important to remember that incentives are a facilitator rather than an end in their own right, and we should not lose sight of the fact that we are leveraging incentives with a view towards optimizing health. As our days fill up with a never-ending list of priorities, health sometimes falls from view. It is the role of smart incentives in a health-centric ecosystem to ensure that health is always on the agenda.