Effects of a reimbursement incentive on enrollment in a weight control program.
OBJECTIVE
The objective was to examine the effect of offering a reimbursement incentive on the percentage of inquirers who enrolled in a weight control program and on weight loss and program attendance among enrollees.


METHODS
We used a sequential control-intervention design to observe how inquirers of the University of Alabama at Birmingham EatRight Lifestyle Program responded to an enrollment incentive for potential 50% ($150) reimbursement of the total program fee if they attended 10 of 12 classes and lost at least 6% of their current body weight. Inquirers had to be adults with a BMI >or=30 kg/m(2), seeking information about a weight control program, and informed of the program cost. Outcomes included proportion of inquirers enrolled, overall number of classes attended, and weight loss.


RESULTS
Of the 401 people who inquired during the study periods, 24.5% and 25.0% enrolled in the intervention and control periods, respectively. There was a trend toward higher attendance in the intervention group, compared with the control group; there were no differences in percentage of weight loss. The odds of attending >or=10 classes were 2.4 times as high, and both losing >6% body weight and attending >or=10 classes were three times as high in the intervention subjects compared with controls, although non-significant.


CONCLUSIONS
The potential of earning a performance-based reimbursement incentive did not affect enrollment in the EatRight Lifestyle Program. Performance-based incentives may be an ideal mechanism for extending coverage of weight-loss interventions by insurers because of limited financial risk and improved adherence.
Butsch
W Scott
WS
Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 439, 1675 University Blvd., Birmingham, AL 35294-3360, USA.
Ard
Jamy D
JD
Allison
David B
DB
Patki
Amit
A
Henson
C Suzanne
CS
Rueger
Miriam M
MM
Hubbert
Katherine A
KA
Glandon
Gerry L
GL
Heimburger
Douglas C
DC
D000328:Adult; D000407:Alabama; D019985:Benchmarking; D019468:Disease Management; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics* / Q000628:therapy*; D010349:Patient Compliance; D010358:Patient Participation / Q000706:statistics & numerical data*; D012052:Reimbursement, Incentive / Q000191:economics*; D016896:Treatment Outcome; D015431:Weight Loss