Since its original release in the 1890s, the Swiss Army knife has sold more than 90 million units and featured more than 800 different tools. No doubt, employers would love to have a similarly enduring and ubiquitous way to cut health costs and achieve greater wellness program outcomes.

It's not by coincidence, then, that Sonic Boom has dubbed its wellness incentive management system the "Swiss Army knife of incentive administration." While it remains to be seen whether WIMS can compare to the timeless utility of having scissors, corkscrew and a nail file all in one, Sonic Boom founder Danna Korn is confident.

"The thing about WIMS is it's so highly customizable, it's almost hard to describe. It provides members with one page [via the Sonic Boom website or embedded within a company intranet] with the ultimate reward they're working toward - say, a health care premium reduction of 5% - and it also shows them what they have to do to get there, like take a biometric screening, a health risk assessment, a certain amount of steps on a pedometer. Some employers even like to add performing a philanthropic activity," she says.

WIMS allows employers to merge all incentives - across all benefit types and all vendors - onto one platform. So, if an employee visits his doctor for a preventive care exam, logs onto his health plan site to take a health risk assessment, does an hour of volunteer work in his community and gets 10,000 steps on his pedometer in the process, WIMS provides one place for him to put that information and claim all of his wellness incentives at once.

"It can be self-reported or integrated through other vendors so it's validated," Korn says. "Or, it can be what we call semi-validated, where we ask them to provide a name and a date. For instance, if [an employer requires] a member to have a preventive care exam, we'd ask them to provide the name of the physician and the date they saw that physician; that's semi-validated."

She adds that WIMS isn't just applicable to health benefits and health improvement programs. The model can support other benefit plans that employers want to incentivize.

"If you have benefits that are being underutilized, like dental vision or an EAP that you're paying for but people aren't using, if you put those things into the WIMS program you'll see utilization skyrocket - phones are ringing off the hook," says Korn.

She also claims that administration with WIMS is "effortless. We take the data from all the vendors and integrate it into the WIMS page [so that] people see their real-time feedback."


What's wrong with water bottles?

Despite her enthusiasm about the system, WIMS can't do all the work, Korn is quick to point out. She emphasizes that unless employers have well-conceived and well-designed incentive programs to start with, no platform will help them achieve the cost-saving results companies are after.

"The type of incentive we like to see is what we call a 'modified carrot' approach," she explains. "The way that works is saying, 'Health care costs are out of control and we have to raise health care premiums by 5%. But the good news is you can earn back that 5% by doing all the right things. And here's the WIMS program to show you what all those right things are.' That's where we provide the menu of opportunities for people to earn back that 5%."

She continues: "We love when our clients reward on biometric outcomes. So, we can take say, five different metrics, integrated through biometric vendors and they can reward people for meeting healthy standards. That's great accountability. Water bottles, things like that, are great for day-to-day engagement. But we ask clients to provide something really meaningful on the table - things like health care premium reductions, HSA/HRA/FSA contributions, even paid-time off - things that are really meaningful to [employees]."

Still, she notes that rewarding employees who make an effort to improve health - even if they don't quite hit wellness targets - is an important piece of the incentives puzzle. "You can't just reward the people who meet the standards; you have to make sure you give people the chance to do the right things even if they're not quite all the way there," she says. "If you don't meet all the standards, then you need to take part in health coaching or something like that."


'Carrots don't work'

In light of health care reform, which provides for even greater investments in employer-sponsored wellness programs, Korn believes "we're in an exciting time, because there are a lot of changes going on. But I think the bigger picture in what's happening in the wellness world right now is that employers are seeing this as a business imperative, that a healthier workforce is a more productive workforce and finally starting to say we need to hold people accountable for this."

She adds that with greater employee accountability should come different terminology. "I like the term 'earn-centives' instead of incentives, so that people have to do the right things to get that health care premium reduction or see some sort of reward.

"When we started, everyone was all about carrots: 'We don't want to penalize people! We only want to reward them!' We were in that camp, too, I gotta say. But as things have changed in the wellness world, and we've realized that carrots don't work very well; we believe it's time to face facts. People respond more to the idea of loss aversion," says Korn.

Putting it bluntly, she says: "Why should employers have to bear the entire burden without asking employees to be accountable for their own health improvement? Employers are finally willing to use more of a stick approach, and that's cool."


U.S. employers rely on incentives to drive wellness participation

Survey findings from Aon Hewitt show increased interest in linking incentives to a result over program participation.

Most employers (84%) say they now offer incentives for participating in a health-risk questionnaire and almost two-thirds (64%) offer an incentive for participation in biometric screenings.

Just over half (51%) of the survey respondents provide incentives to employees who participate in health improvement and wellness programs.

The use of monetary incentives, in particular, has increased dramatically over the past year. In 2012, 59% of employers used monetary incentives to promote participation in wellness and health improvement programs, up from 37% in 2011. The use of monetary incentives for participating in disease/condition management programs almost tripled in 2012 to 54% from 17% in 2011.

Of companies with incentives, 58% offer some form of incentive for completing lifestyle modification programs, such as quitting smoking or losing weight. About one-quarter offer incentives for progress toward meeting acceptable ranges for biometric measures.

Despite increased employer interest in tying incentives to results, the survey shows room for improvement. More than 80% of employers provide an incentive to complete a health questionnaire, yet less than 10% provide an incentive to address the results of the questionnaire. Additionally, more than 60% of employers provide an incentive to complete biometric screening, but less than 10% provide an incentive to take any action.

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