title: Wellness incentives, equity, and the 5 groups problem.
abstract: Wellness incentives are an increasingly popular means of encouraging participation in prevention programs, but they may not benefit all groups equally.  To assist those planning, conducting, and evaluating incentive programs, I describe the impact of incentives on 5 groups: the "lucky ones," the "yes-I-can" group, the "I'll-do-it-tomorrow" group, the "unlucky ones," and the "leave-me-alone" group. The 5 groups problem concerns the question of when disparities in the capacity to use incentive programs constitute unfairness and how policymakers ought to respond.  I outline 4 policy options: to continue to offer incentives universally, to offer them universally but with modifications, to offer targeted rather than universal programs, and to abandon incentive programs altogether.
authors.affiliation: Center for Health Incentives, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104-6021, USA. schmidth@mail.med.upenn.edu
authors.forename: Harald
authors.initials: H
authors.lastname: Schmidt
mesh_terms: D006291:Health Policy; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D054625:Healthcare Disparities; D006801:Humans; D009042:Motivation; D014481:United States
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