Cancel Sign In. Please purchase a SHRM membership before saving bookmarks. OK Join. An error has occurred. From Email. To Email. Send Cancel Close. Post a Job See All Jobs. HR Daily Newsletter News, trends and analysis, as well as breaking news alerts, to help HR professionals do their jobs better each business day.
Since limited employee engagement is regarded as an important obstacle to program success, employers are using incentives to increase employee engagement, as the RAND Employer Survey and other surveys suggest. Modest incentives also seem to increase participation in and impact of lifestyle management programs.
The use of incentives tied to health standards remains uncommon. The RAND Employer Survey shows that nationally, only 10 percent of employers with 50 or more employees that offer a wellness program use any such incentives, and only 7 percent link the incentives to premiums for health coverage. For this subset, maximum incentive amounts average less than 10 percent of the employee premium for health care coverage.
The one health risk factor for which results-based incentives are more common and involve higher amounts is smoking, as suggested by both the RAND Employer Survey and our case studies. We need to caution that our survey results may be subject to response bias, as some characteristics of respondents and nonrespondents differed significantly.
Further, both the external and internal validity of the results based on the CCA data may be limited. The database represents a convenience sample of employers with long-standing commitment and substantial investment into wellness programs, implying that results may not be generalizable to all employers. As with any nonexperimental design, we cannot fully rule out that unobservable differences between program participants and nonparticipants have influenced our results.
For example, differential motivation may have contributed to our estimated effect on health behaviors, such as exercise and smoking. Finally, the limited variation in incentive use among the employers in the CCA database prevents us from reaching definite conclusions regarding the effect of incentives on wellness program participation, health behaviors, and outcomes.
This project represents the most comprehensive analysis of worksite wellness programs to date, and it evaluates current program participation, program impact, and the role of incentives. It also helps us to identify priority areas for future research:.
Long-term impact of wellness programs. Given the long latency between health risks and development of manifest chronic diseases, a much longer follow-up period will be required to fully capture the effect of worksite wellness programs on health outcomes and cost.
Design of programs. Research is needed on program design features that are most likely to achieve wellness goals. Smoking cessation is an area where additional research could inform program development. A more granular look at different program components would provide valuable insights into the determinants of program success. For example, such analyses could compare the differential effects of modalities for program delivery e.
Research into the relative impact of individual-level and workforce-level interventions could help to increase program efficiency. Impact on a broad range of measures. Future studies should look at a broader range of outcomes, in particular work-related outcomes and health-related quality of life. Work-related outcomes, such as absenteeism, productivity, and retention, are of critical importance to employers as they directly affect business performance.
Contextual factors that modify program impact. Contextual factors will influence the effectiveness and cost-effectiveness of workplace wellness interventions. Employer characteristics, such as workplace culture and leadership support, might modify the effect of wellness programs. Understanding the role of such modifying factors should be considered for future research. Similarly, we need to understand better how employee demographic characteristics drive decisions about program uptake and how those factors interact with financial incentives.
Effect of financial incentives. Thus, comprehensive evaluation of the intended and unintended effects of such incentives and different incentive amounts may require a prospective or even experimental study.
In addition, there is limited information on the differential impact of different incentive types e. Final rules regarding incentives for nondiscriminatory wellness programs in group health plans are being contemporaneously published with this article Federal Register , Although Incentives that are not offered through group health plan coverage would not be subject to these requirements, other nondiscrimination and privacy laws may still apply with respect to employer practices relating to wellness programs operated outside the group health plan context.
National Center for Biotechnology Information , U. Journal List Rand Health Q v. Rand Health Q. Huang , Kristin R. Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Short abstract This article investigates the characteristics of workplace wellness programs, their prevalence, their impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs.
Abstract This article investigates the characteristics of workplace wellness programs, their prevalence, their impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. Study Objectives and Research Approach This article addresses the requirements of m 1 of the Public Health Service Act and answers the following research questions: What are the characteristics and prevalence of current workplace wellness programs?
What is the evidence for program impact? In the past 10 years, WellSteps has helped hundreds of clients set up and manage well-being incentive plans. Some of these have been a huge successes and others—not so much. The goal of the wellness program is to help employees adopt and maintain healthy behaviors. It is best when employees are internally motivated to be healthy. But sometimes employees get stuck in unhealthy habits and they need help adopting and maintaining healthy behaviors.
The best way to do this is to provide small incentives, such as gift cards, to randomly selected employees who successfully complete different aspects of the wellness program.
We have great published scientific evidence that this incentive approach works. It is the incentive approach that WellSteps recommends to all of our clients. Employees can qualify for a drawing if they complete a personal health assessment, biometric screening, a behavior change campaign, or a challenge. All employees do not get an incentive for completing the target behavior because that leads to entitlement. Instead, they earn the chance to win—sort of like the lottery, only not as big.
Just having a chance to win is fun and is sufficient to motivate most employees. For example, if a company with employees has complete a behavior change campaign, all employees are entered to win a small number of gift cards, prizes, or event tickets. These small gifts given immediately upon program completion make the program more fun, create the opportunity for vicarious reinforcement, and provide substantial motivation to participate at very little cost. Employers get even greater adoption of employee health behavior with a benefits-based incentive plan.
Without the safe harbor, these practices would violate the ADA by treating some individuals with disabilities less favorably than individuals without those disabilities. Many of the insurance practices the safe harbor permitted at the time of the enactment of the ADA, such as denying health coverage for individuals with pre-existing conditions or charging some individuals in group health plans more than others because of their health conditions, are now unlawful under the Affordable Care Act.
The safe harbor provision does not apply to employer wellness programs, since employers are not collecting or using information to determine whether employees with certain health conditions are insurable or to set insurance premiums. The final rule adds a new provision explicitly stating that the safe harbor provision does not apply to wellness programs even if they are part of an employer's health plan. As noted above, the ADA allows employers to make disability-related inquiries for example, by asking employees to complete a HRA and require medical examinations that are part of a voluntary employee health program.
The final rule retains the requirement in the proposed rule that an employee health program -- including any disability-related inquiries or medical examinations that are part of such a program -- must be "reasonably designed to promote health or prevent disease. A wellness program that asks employees to answer questions about their health conditions or have a biometric screening or other medical examination for the purpose of alerting them to health risks such as having high cholesterol or elevated blood pressure is reasonably designed to promote health or prevent disease.
Collecting and using aggregate information from employee HRAs to design and offer programs aimed at specific conditions prevalent in the workplace such as diabetes or hypertension also would meet this standard. However, asking employees to provide medical information on a HRA without providing any feedback about risk factors or without using aggregate information to design programs or treat any specific conditions would not be reasonably designed to promote health or prevent disease.
A wellness program also is not reasonably designed to promote health or prevent disease if it exists merely to shift costs from the employer to employees based on their health or is used by the employer only to predict its future health costs. Like the proposed rule, the final rule lists several requirements that must be met in order for an employee's participation in a wellness program that includes disability-related inquiries or medical examinations to be considered voluntary.
Specifically, an employer:. Additionally, in order to ensure that an employee's participation is voluntary, an employer must provide a notice that clearly explains what medical information will be obtained, how it will be used, who will receive it, and the restrictions on disclosure.
Finally, an employer must comply with the incentive limits explained below. In some cases. To the extent that an employer already clearly provides the information required by this rule, such as in a brochure or email that describes the details of the wellness program, an employer does not have to create a new notice.
However, where an employer does not provide employees with the detailed information about what medical information will be obtained, how it will be used, who will receive it, and the restrictions on disclosure, an employer must revise existing communications or create a new notice to comply with this rule. The EEOC will provide a sample notice on its website that satisfies the necessary requirements. This rule applies only to wellness programs that require employees to answer disability-related questions or to undergo medical examinations in order to earn a reward or avoid a penalty.
It would not apply, for example, to a wellness program that simply requires employees to engage in a certain activity such as attending a nutrition or weight loss class or to walk a certain amount every week in order to earn an incentive. However, the ADA requires employers to provide reasonable accommodations that allow employees with disabilities to participate in such programs.
For example, an employer would have to provide a sign language interpreter for an employee who is deaf and wants to attend a smoking cessation class, materials in an accessible format such as in Braille or large print for an employee who is blind, or an alternative to a program that requires a certain amount of walking for an employee who uses a wheelchair. If a wellness program is open only to employees enrolled in a particular plan, then the maximum allowable incentive an employer can offer is 30 percent of the total cost for self-only coverage of the plan in which the employee is enrolled.
The employer also could offer the same level of incentive if it offered only one group health plan but allowed any employee to participate in the wellness program regardless of whether he or she is enrolled in the health plan.
0コメント