Incentives Bring Needed Participants to Wellness Programs

An EBRI analysis found individuals who first completed a health risk assessment after an employer offered a financial incentive had greater health risk than those completing it pre-incentive.

Financial incentives appear to be a crucial factor in bringing unhealthy workers into workplace wellness programs, according to an analysis by the Employee Benefit Research Institute (EBRI).

Using administrative data from a large employer that provided anonymous participant information, EBRI analyzed the impact financial incentives had on the first-time participants in the employer’s wellness programs. EBRI found that in general, individuals who first completed a health risk assessment (HRA) or biometric screening in the two or three years after financial incentives were offered were less healthy than early adopters. Moreover, prevalence rates of diabetes, high blood pressure and high cholesterol were all higher in the post-incentive groups than in the pre-incentive groups.

Individuals who first completed the HRA post-incentive had greater health risk than those first completing it pre-incentive. Employees first completing the HRA post-incentive were more likely than those completing it pre-incentive to be at risk for high blood pressure, inadequate exercise, high glucose, unhealthy nutrition, smoking, and unhealthy weight.

“Our findings paint a vivid picture of who responds to wellness-program financial incentives. They indicate incentives have a strong impact at bringing in the kind of people who really need the program,” says Paul Fronstin, director of EBRI’s Health Research and Education Program, and co-author of the study report.

The analysis found older men were most likely to respond to incentives. Among employees who first completed an HRA post-incentive, 82.4% were male, versus 70.2% pre-incentive, and the gender comparison was similar for biometric screenings. Late adopters also tended to be older: Among those first completing an HRA post-incentive, the mean age was 50, compared with 45 among the pre-incentive group. For biometric screenings, the average age was 48.7 versus 46.4 for the post- and pre-incentive cohorts, respectively.

Visits to specialists were higher for the post-incentive cohorts. Prescription drug utilization was higher as well among post-incentive HRA completers (17 fills per year), compared with pre-incentive HRA completers (14.2 fills per year), and also greater for post-incentive biometric screening completers. In large part, individuals who first completed HRA and biometric screenings after the financial incentives were introduced were less likely to consume preventive care, and they were less likely to have visited a primary care provider.

Late adopters of biometric screening also had worse biometric values. More than one-third (35.2%) of post-incentive biometric screening completers was obese compared with about one-quarter (26.3%) of pre-incentive completers. Further, 50.3% of post-incentive biometric screening completers were pre-hypertensive, compared to 45.8% of early adopters.

The full report, “Financial Incentives and Workplace Wellness-Program Participation,” is published in the March 2015 EBRI Issue Brief, online at