title: Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.
abstract: Employers commonly use adjustments to health insurance premiums as incentives to encourage healthy behavior, but the effectiveness of those adjustments is controversial. We gave 197 obese participants in a workplace wellness program a weight loss goal equivalent to 5 percent of their baseline weight. They were randomly assigned to a control arm, with no financial incentive for achieving the goal, or to one of three intervention arms offering an incentive valued at $550. Two intervention arms used health insurance premium adjustments, beginning the following year (delayed) or in the first pay period after achieving the goal (immediate). A third arm used a daily lottery incentive separate from premiums. At twelve months there were no statistically significant differences in mean weight change either between the control group (whose members had a mean gain of 0.1 pound) and any of the incentive groups (delayed premium adjustment, -1.2 pound; immediate premium adjustment, -1.4 pound; daily lottery incentive, -1.0 pound) or among the intervention groups. The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both.
authors.affiliation: Mitesh S. Patel (mpatel@upenn.edu) is an assistant professor of medicine at the Perelman School of Medicine and of health care management at the Wharton School, and a faculty member at the Leonard Davis Institute Center for Health Incentives and Behavioral Economics (CHIBE), all at the University of Pennsylvania; and a staff physician at the Crescenz Veterans Affairs (VA) Medical Center, all in Philadelphia.
authors.forename: Mitesh S
authors.initials: MS
authors.lastname: Patel
authors.affiliation: David A. Asch is a professor of medicine, medical ethics and health policy, and anesthesiology and critical care medicine at the Perelman School of Medicine and of health care management and operations, information, and decision at the Wharton School, and a member of the faculty at CHIBE, all at the University of Pennsylvania; executive director of the Penn Medicine Center for Health Care Innovation; and a staff physician at the Crescenz VA Medical Center, all in Philadelphia.
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
authors.affiliation: Andrea B. Troxel is a professor of biostatistics and associate director of the Division of Biostatistics in the Department of Biostatistics at the Perelman School of Medicine; and director of Biostatistics at CHIBE, all at the University of Pennsylvania.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.affiliation: Michele Fletcher is associate vice president of human resources at the University of Pennsylvania Health System, in Philadelphia.
authors.forename: Michele
authors.initials: M
authors.lastname: Fletcher
authors.affiliation: Rosemary Osman-Koss is director of employee benefits at the University of Pennsylvania Health System.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Osman-Koss
authors.affiliation: Jennifer Brady is a manager of employee health and well-being at the University of Pennsylvania Health System.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brady
authors.affiliation: Lisa Wesby is Way to Health research operations manager at CHIBE.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wesby
authors.affiliation: Victoria Hilbert is a project manager at CHIBE.
authors.forename: Victoria
authors.initials: V
authors.lastname: Hilbert
authors.affiliation: Jingsan Zhu is assistant director of data operations at CHIBE.
authors.forename: Jingsan
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Wenli Wang is a biostatiscian at CHIBE.
authors.forename: Wenli
authors.initials: W
authors.lastname: Wang
authors.affiliation: Kevin G. Volpp is a professor of medicine at the Perelman School of Medicine and of health care management at the Wharton School; vice chairman for health policy in the Department of Medical Ethics and Health Policy; and director of CHIBE, all at the University of Pennsylvania; and a staff physician at the Crescenz VA Medical Center.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
mesh_terms: D000328:Adult; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D050177:Overweight / Q000191:economics / Q000517:prevention & control*; D011322:Primary Prevention / Q000458:organization & administration; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000191:economics* / Q000379:methods; D017132:Workplace
keywords: Employer-Based System < Insurance; Health Promotion/Disease Prevention; Organization and Delivery of Care