While there is still much discussion about whether and how incentives really work for engaging employees in wellness programs, most companies still plan on increasing the dollar value of the incentives they offer. That’s according to a survey of 139 employers from Fidelity and the National Business Group on Health released last week to analyze the growth of health-improvement programs in the workplace, which usually entail condition-management services (e.g., managing insulin treatments), lifestyle-management services (e.g., weight-loss advice) and health-risk management services (e.g., onsite flu shots).

The survey finds that almost three out of four (73%) companies used incentives in 2011 to engage employees in health-improvement programs and the average incentive value was $460. That figure has steadily increased from an average of $430 in 2010 and $260 in 2009. According to the study, employers used different types of incentives including cash, gift cards and contributions to health savings accounts. The majority (57%) agreed that incentive-based programs had a better than expected success rate at increasing employee participation.

"Incentives have come a long way from a free t-shirt and a water bottle," says Adam Stavisky, senior vice president of Fidelity business consulting. "As companies have increased their commitment and investment in health-improvement programs, they have made their incentives more enticing.”

More are also requiring their employees participate in health-improvement programs. Last year, 5% of companies required their workers to complete biometric testing (e.g., cholesterol screening) or be excluded from coverage. That number is expected to nearly double in 2012 to 9%. Likewise, 7% of companies required completion of a health-risk assessment last year. This year, 10% of companies will require it.

"Employers are increasingly expecting employees to take steps to improve their health, conditioning even access to health benefits on meeting certain requirements," says Helen Darling, NBGH president and chief executive officer. "This isn't surprising given how much control employees can have over their own health and how much poor health habits cost employers."

Incentives aside, funding for health-improvement programs held steady with the average employer spending $169 per employee on health-improvement programs in 2011, comparable to $154 in 2010 and up from $108 in 2009.

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