All at once or one at a time: Designing wellness incentives that work

Employers everywhere are launching wellness programs in the hope that this focus will lower their medical costs and keep their employees healthy. The challenge, however, is getting employees to participate and be engaged in the process of wellness so they actually take a stake in their own health.

Wellness is the key to keeping benefit costs in check, sick days to a minimum and productivity high - but getting employees to participate in these programs isn't easy.

The first step in any wellness program is getting employees to complete a health risk assessment. An HRA gives employees the data they need to identify their own health risks and take action on them.

It also provides the employer with an overall snapshot of their population, and what types of health risks exist in it, allowing employers to then develop a full wellness plan targeted at reducing these health risks.

To get employees to take an HRA, employers tend to offer incentives. Incentives can range from reduced health insurance premiums to cash or gift cards.

But while many employers offer incentives for employees to take the HRA, few offer incentives for continued participation in the wellness program after the HRA is taken.

Employers want employees to want to be healthy and to participate in wellness programs to achieve this goal - without the employer having to offer an incentive for the employees to do so. But let's be realistic.

Unfortunately, our society indicates that most employees are not going to continue with a wellness program unless there is some incentive for them to do so. Most wouldn't even take the HRA if their employer didn't provide an incentive.

The challenge becomes how to design an incentive that keeps employees engaged and participating in the entire wellness process.

Not all at once

I believe the best way to keep employees involved in the wellness program is to not offer your incentive all at once. If you offer $100 to take the HRA but nothing further, you'll have employees take the HRA and nothing more.

Instead, why not design your incentive plan to allow employees to receive rewards for completing certain milestones within the wellness program, thus creating an incentive for them to continue participating in and become engaged in the entire wellness process?

To take on this approach, you'll first want to set a standard menu of wellness milestones you want your employees to complete. You'll then need to decide if you want to have your incentive paid out at each milestone reached, or if you want it to pay it upon completion of all milestones.

Some examples of wellness milestones to include in your program may be:

* Employee's completion of the HRA.

* Spouse/domestic partner's completion of the HRA.

* Employee completing annual wellness visit.

* Spouse/domestic partner completing annual wellness visit.

* Employee going through company wellness fair, including biometric screenings.

* Employee completing tobacco cessation program.

* Spouse/domestic partner completing tobacco cessation program.

For the incentive, rather than giving employees cash or gift cards, try tying the incentive to lowering their out-of-pocket medical expenses.

Do this by either lowering their payroll contributions or by depositing money into a health reimbursement account they can use to offset deductibles, coinsurance or copays. Either of these approaches allows you to link your wellness program directly to your medical plan.

You'll need to decide if you want to limit the incentive to only those who participate in the medical plan, or if you want to provide an alternative incentive to those who do not participate in the medical plan but participate in the wellness program.

For example, if you go with the lower payroll contribution approach, you could offer the reduction amount as extra money in the paycheck of those employees who do not participate in your medical plan but who do complete the wellness program.

If you go with the health reimbursement account approach, you could allow employees to use the health reimbursement account funds to reimburse medical expenses from their other coverage.

Designing your wellness program this way does involve some administrative work. You'll need to keep track of the milestones each employee meets and process either the lower payroll deductions or the health reimbursement account deposits.

This will likely involve the use of a third-party administrator - especially if you use the health reimbursement account approach - because you'll need someone to process the claims.

Despite the additional administrative work, designing your wellness program this way can lead to greater employee participation and long-term engagement in the entire program - which is what all employers are after. -C.Y.


Contributing Editor Christy Yaccarino is a benefits manager for Ambrose Employer Group in New York City. She can be reached at christy.barr@juno.com.Follow EBN on: Twitter | Facebook | LinkedIn | Podcasts

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