An Employer Health Incentive Plan for Advance Care Planning and Goal-Aligned Care.

One strategy to promote workforce well-being has been health incentive plans, in which a company's insured employees are offered compensation for completing a particular health-related activity. In 2015, Providence Health & Services adopted an Advance Care Planning (ACP) activity as a 2015-2016 health incentive option. More than 51,000 employees and their insured relatives chose the ACP incentive option. More than 80% rated the experience as helpful or very helpful. A high proportion (95%) of employees responded that they had someone they trusted who could make medical care decisions for them, yet only 23% had completed an advance directive, and even fewer (11%) had shared the document with their health care provider. The most common reason given for not completing an advance directive was that health care providers had never asked about it. These findings suggest that an insured employee incentive plan can encourage ACP consistent with the health care organizations' values and strategic priorities.

The Impact of Specialized Telephonic Guides on Employee Engagement in Corporate Well-Being Programs.

Employer-sponsored well-being programs have been growing in popularity as a means to control rising health care costs and increase workplace productivity. Engagement by employees is necessary for these programs to achieve their desired effects. Extrinsic motivators in the form of incentives and surcharges are commonly introduced by employer program sponsors to promote meaningful engagement. Although these may be successful in achieving a degree of engagement, individuals benefit by being intrinsically motivated as they modify behaviors and improve short- and long-term well-being. Telephonic guides equipped with motivational interviewing and other behavioral strategies to improve engagement may bridge the gap between extrinsic and intrinsic motivation. The objectives of this study are to determine characteristics associated with employee utilization of these guides when offered and to compare subsequent program engagement rates between utilizers to a propensity score matched group of employees who were not offered the service. The data were retrieved from a well-being program provider's database. The study examined 166,258 employees across 35 employers. It found utilizers were older, proportionally more female, in the manufacturing industry, incented to use the guide service, offered a larger incentive for program participation, had healthier self-reported behaviors, and had a higher perception of their employer's focus on well-being. The study found that guide utilizers were significantly more likely to engage in telephonic coaching, digital coaching, and activity tracking up to 6 months. The study's findings suggest telephonic guides using a range of behavioral techniques are an effective strategy to drive well-being program engagement.

Outcome-based and Participation-based Wellness Incentives: Impacts on Program Participation and Achievement of Health Improvement Targets.

OBJECTIVE: This study examined whether worksite wellness program participation or achievement of health improvement targets differed according to four incentive types (participation-based, hybrid, outcome-based, and no incentive). METHODS: The study included individuals who completed biometric health screenings in both 2013 and 2014 and had elevated metrics in 2013 (baseline year). Multivariate logistic regression modeling tested for differences in odds of participation and achievement of health improvement targets between incentive groups; controlling for demographics, employer characteristics, incentive amounts, and other factors. RESULTS: No statistically significant differences between incentive groups occurred for odds of participation or achievement of health improvement target related to body mass index, blood pressure, or nonhigh-density lipoprotein cholesterol. CONCLUSIONS: Given the null findings of this study, employers cannot assume that outcome-based incentives will result in either increased program participation or greater achievement of health improvement targets than participation-based incentives.