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Influence of Incentive Design and Organizational Characteristics on Wellness Participation and Health Outcomes.

OBJECTIVE
To explore how changing incentive designs influence wellness participation and health outcomes.


METHODS
Aggregated retrospective data were evaluated using cluster analysis to group 174 companies into incentive design types. Numerous statistical models assessed between-group differences in wellness participation, earning incentives, and over-time differences in health outcomes.


RESULTS
Four incentive design groups based on requirements for earning incentives were identified. The groups varied in support for and participation in wellness initiatives within each company. All four design types were associated with improved LDL (p < .01), three with improved blood pressure (p < .001), and two with improved fasting glucose (p < .03). No incentive plan types were associated with improved BMI, but designs predominantly focused on health outcomes (e.g., Outcomes-Focused) exhibited a significant increase over time in BMI risk.


CONCLUSION
Incentive design and organizational characteristics impact population-level participation and health outcomes.