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Do Financial Incentives Encourage Weight Loss?

Offering people a little extra green seems to be a golden way to help them lose weight, according to a new Mayo Clinic study.

The study found that participants who received financial incentives of as little as $20 a month for losing weight were more likely to continue with a weight-loss program than participants who didn’t receive the cash.

“I was surprised that it didn’t take a whole lot of money to motivate behavior change,” says Dr. Steven Driver, lead author of the study.

Weight loss financial incentiveThe study’s findings were presented at the American College of Cardiology’s annual meeting in March 2013. The report may have implications for employer wellness programs designed to improve employee health and drive down health insurance costs.

Modest incentives, major results

The study looked at 100 participants over a one-year span. All had a body mass index – calculated by measuring a person’s weight and height – of at least 30, which the federal Centers for Disease Control and Prevention (CDC) defines as “obese.”

Participants were divided into four groups and given a goal of losing 4 pounds a month until reaching a set goal weight. Two groups of participants either received $20 a month for hitting their goal, or had to pay $20 a month to a bonus pool for failing to achieve the target. (Participants in the incentive groups who finished the study were eligible to win the pool through a lottery process.)

The other two groups of participants received no incentives.

The study found that participants in the incentive groups were more likely to complete the program than participants with no incentives (62 percent to 26 percent) and also had a better rate of average weight loss (9.08 pounds, compared with 2.34 pounds).

Experts see America’s rising obesity rate as a prime contributor to the rising cost of health care costs and, by extension, higher health insurance premiums.

Driver says the study shows that even modest financial incentives – along with a healthy dose of weight-loss education – can help people stick to their weight-loss regimen.

“I think these types of incentives work best to achieve the kind of behavior change people wish they could achieve anyway,” he says.

Ninety-two percent of employers with at least 200 workers offered some type of wellness program in 2009, according to a study sponsored by the U.S. Department of Labor and the U.S. Department of Health and Human Services. Fifty-three percent of these programs targeted weight loss as a main goal.

Despite such widespread use of these programs, employee participation remains low. The government study cites one survey that found that less than one-fifth of eligible employees participate in wellness programs.

Driver says the Mayo study shows that wellness programs work when employees have the right motivation and do not feel they’re being forced into joining. “It really needs to be a partnership with the employees,” he says.

Reaction to the study

Several earlier studies also have found that offering incentives to employees boosts participation in wellness programs, at least in the short term, says Jerry Noyce, president and CEO of the Health Enhancement Research Organization (HERO), a nonprofit that focuses on employee health management research, education, policy, strategy and leadership.

However, he adds, the Mayo study is the first to look at such efforts over a longer period of time.“They followed these folks for 12 months,” Noyce says. “That’s a longer study than has been done prior to them.”

For that reason, Noyce finds the Mayo results to be significant, although he adds that more research needs to be done before concluding that incentives keep people participating over longer periods of time.

Noyce’s organization has done extensive research on employer-sponsored wellness programs. He says companies that build a strong, supportive environment around these programs yield the best results. For example, such companies may offer places where employees can walk or run, or healthy food offerings in the company café.

In addition, these companies make employee health a priority, and communicate that message from the top leadership, down through middle management to the employees. For example, they may designate “wellness champions” – people who believe in the program and get co-workers involved, Noyce says.

It’s also critical for companies to measure success. Benchmarks might include high rates of employee participation, lower health insurance costs or lower rates of employee absenteeism.

Lower health insurance costs?

A survey by the International Foundation of Employee Benefit Plans found that nearly 40 percent of employers that offer wellness programs said they do so as a means of controlling health insurance costs.

Wellness programs can help cut health insurance costs for some employees, says Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade association for the health insurance industry.

“Sometimes an individual may get a lower premium for participating in a general wellness program,” she says.

However, Pisano says her group doesn’t have data showing a direct link between participation in wellness programs and widespread reduction of health insurance costs for either employers or employees.

Employer efforts to cut the health insurance costs of employees may get a boost, thanks to federal health care reform. Now, a number of state and federal laws place limit the use of incentives – including lower premium costs – by employers through wellness programs.

The federal health care reform law raises the limit to 30 percent of the cost of health care coverage beginning in 2014. In addition, the law gives discretion to the heads of three federal agencies – Labor, Health and Human Services and Treasury – to increase the reward to up to 50 percent of the cost of coverage.

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