What Works?

Wellness Incentives - What Works

The use of incentives to improve employee health behavior has skyrocketed in recent years. According to a new employer survey conducted by Fidelity Investments and the National Business Group on Health (Business Group), nearly nine-out-of ten employers indicated that they currently offer wellness-based incentives (86%), compared to 73% in 2011 and only 57% back in 2009.1

But, one may raise the obvious question, “do these incentives actually work?  The limited research results suggest that the use of incentives increases participation levels in health promotion activities. However, the use of incentives for changing employee health behaviors long term is promising but much more research is needed. For example, an incentive of up to $750 for quitting smoking for up to one year was effective, nearly tripling long-term smoking cessation rates.2


How Much of an Investment and What is Return on Investment?

What is the price point that increases program participation for companies that want to use of incentives to improve employee health behavior? Sorry, that too needs much more investigation. For example:

  • HRA participation rates increased by 1.58 percent for every $20 of incentive value in a 2009 study.3
  • Another study concluded that HRAs participation would increase by 7 percent for each $100 increase in incentive value, achieving a maximum 100 percent participation with a $700 incentive.4
  • Including an incentive level of $200 into a health plan is claimed to raise HRA participation rates to almost 90% (compared to rates between 20% and 40% without the use of incentives).5
  • Studies suggest that financial rewards worth more than $450 have little additional effect on rates of participation in wellness programs.6


Your Best Bet

Company culture and the use of multi levels of promotional techniques are two key factors for success for health promotion initiatives at the worksite. For example, researchers studying 124 employers who used incentives for HRA completion reported a substantial reduction in the cost for incentives needed when they used a “blast” technique for promoting the event. Employers who promoted the event ten or more times using several different promotional mediums needed only a $40 incentive compared to employers who achieved the same results but needed a $120 incentive when advertising the program only one to three times.7

So your best bet to maximize your incentive program participation and decrease the expenses for your incentives would be to promote your event as often as you can and use as many avenues to get the word out as possible.


1. http://www.businessgrouphealth.org/pressroom/pressRelease.cfm?ID=207

2. K. Volpp et al., “A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation.”

3. E. L. D. Seaverson et al., “The Role of Incentive Design, Incentive Value, Communications Strategy, and Worksite Culture on Health Risk Assessment Participation,” American Journal of Health Promotion 3, no. 5 (2009): pp. 343–352

4. G. d’Andrea and M. Dermer, Impact of Incentive Values on Participation in Comprehensive Wellness and Health Risk Assessment Interventions, November 2009, http://www.incentone.com/index.php?option=com_smartformer&Itemid=173.

5. M. O’Donnell, “Financial Incentives for Workplace Health Promotion: What Is Equitable, What Is Sustainable, and What Drives Healthy Behaviors?”, American Journal of Health Promotion 26, no. 5 (2012): pp. iv-vii.

6. Seaverson EL, Grossmeier, J, Miller TM, Anderson DR, “The Role of Incentive Design, Incentive Value, Communications Strategy, and Worksite Culture on Health Risk Assessment Participation.” American Journal of Health Promotion, 2009 May-June;23(5):343-52. See also Serxner, S, Anderson DR, Gold, D, “Building Program Participation: Strategies for Recruitment and Retention in Worksite Health Promotion Programs.” American Journal of Health Promotion. 18:1-6, iii, 2004.

7. Taitel MS, Hau”e V, Heck D, Loeppke R, Fetterolf D. Incentives and other factors associated with employee participation in health risk assessments. J Occup Environ Med 2008;50(8):863-72.

Group of employees