Mary Imboden, Ph.D.

Director of Research, Health Enhancement Research Organization (HERO)

We all need a little motivation sometimes to make the right decision for our health. That’s why an estimated 78 percent of large employers offer incentives that are designed to help employees take the first steps toward a healthier lifestyle through participation in corporate health and well-being initiatives. 

Incentives can take a variety of forms — from rewards for completing health screenings to prizes for reaching specific health goals — but a new study from the Health Enhancement Research Organization (HERO) suggests effective implementation of incentives requires careful consideration and a commitment to well-being that stretches beyond individual incentives to include the broader workplace culture. 

Effective incentives

The HERO study, which is among the first to measure the impact of incentive design on both participation and workplace health outcomes at the organization-wide level, identified four primary approaches to incentives:

Outcomes-focused incentives encourage participants to reach health-related outcomes; participation-focused incentives encourage participation in health behavior change interventions; combination incentives focus on a mix of outcomes and participation; and participation-to-outcomes incentives begin with a focus on participation but shift over time to focus on outcomes. 

Not surprisingly, there were meaningful differences in the amount of incentives associated with each design. Outcomes-focused employers offered the greatest maximum incentives at an average of $1,526, while average incentive values for combination design were half that amount. Participation-focused and participation-to-outcomes designs had much lower incentive amounts, offered at $449 and $538, respectively. 

Employers that want to know which approach will yield the best outcomes in the least amount of time should consider these additional findings from the HERO study:

1. Outcomes-focused incentive approaches were best at driving participation in health screenings — though their effectiveness waned over time — but worst at encouraging employees to pursue behavior-change interventions. 
2. Participation-focused approaches fared second worst at driving participation in behavior-change interventions and were worst at convincing employees to complete health screenings.  
3. Combination incentive approaches were associated with the highest workplace culture scores, and high participation in health assessments and behavior change interventions over time. This approach was also associated with the greatest reduction in population levels of cholesterol and blood pressure, as well as significant improvement in glucose.
4. Participation-to-outcomes incentive approaches were found to have the highest participation in health behavior change interventions and participation remained steady over time. This approach also revealed the greatest improvement in population level glucose risk. 

While incentives are not a magic bullet for improving employee health, they can be highly effective when offered in a thoughtful and strategic way, and within a culture that supports employee health through consistent and comprehensive communications, and leadership support at all levels.