Employers Offer Incentives for Shaping Up
by Suzanne Hadley Gosselin on 04/09/2008 at 12:00 PM
My company's health and wellness department is about to start the spring fitness challenge "Walk it Off!" For $5, employees can participate in the challenge from May to July and qualify to win major prizes. I've participated in past challenges and have always appreciated my company's interest in my health.
The Newsweek article "Dieting for Dollars" examines the trend among companies to monitor employee health habits and reward those who shape up.
In an effort to rein in mounting health-care costs (employer health insurance premiums increased an average of 6.1 percent last year, more than twice the rate of inflation), hundreds of employers are using financial rewards and, increasingly, penalties, too, to persuade employees to take demonstrable steps to improve their health and reduce their health insurance costs, and absenteeism in the bargain.
Companies have good reasons for doing this. Not only can such "persuasion" reduce health-care costs. Increased health among employees is proven to increase productivity.
The economic impact goes beyond health-care costs. A survey of nearly 29,000 workers, published in the Journal of Occupational and Environmental Medicine in 2003, found that health-related lost productivity time-from missed days, reduced work hours, and so-called presenteeism (going to work sick and being markedly less productive)-costs employers nearly $226 billion a year, or about $1,685 per employee. Improve employees' behavior, the thinking goes, and you can improve their health and productivity and lower the costs of health care.
I had never heard the term "presenteeism," but I've certainly witnessed a lot of it this winter. (Think: the person hacking in the cubicle next door.) Who knew you put such a big price tag on employees going to work sick. Many companies are encouraging employee health by offering monetary rewards to workers who complete health assessments, quit smoking and lose weight. But this kind of "encouragement" may have its limits.
If financial rewards aren't enough to convince employees to change their behavior, employers could find themselves in an awkward position. Can they require participation in health improvement programs? Should employees be punished if they join a program but don't achieve optimal results? Can employees who refuse to stop smoking or to lose weight be fired? "It's a really slippery slope," says Peter Cappelli, director of the Center for Human Resources at the University of Pennsylvania's Wharton School of Business. "There are big legal and ethical issues with pushing employees to change their behavior."
However, the results of health incentive programs are good. Some studies published in the American Journal of Health Promotion found that work site health promotions could reduce medical and absenteeism costs by 25 to 30 percent over the course of three to four years. And who doesn't appreciate the nudge to be a healthier person -- even if it's coming from work? I like to walk anyway. Prizes are just icing on the (rice) cake.
1. Amir Larijani said the following at 12:20 PM on Apr 9:
Suzanne: I'm all in favor of such constructive incentives to get people to take care of themselves.
Where I work, employee health insurance is very expensive for two reasons:
(1) There is no compelling incentive for employees to take care of themselves, as they all pay the same premiums. Ergo, a 400-pounder will pay the same premium as a fitness nut like me. (exception: smokers pay a slightly higher premium)
(2) Employees and retirees are in the same group, and there is no incentive for retirees to take care of themselves.
Add to that the fact that I'm in one of the more obese states in the union, and that translates to a cost born by everyone.
Being the libertarian that I am, I'm all for people making their own choices in life. I'm also for people bearing the cost of their choices.
On the other hand, I support the rights of employers--which often bear the burden of adverse employee health--to create incentives for people to take the right initiatives for their own health.
2. Keb said the following at 3:14 PM on Apr 9:
Weight/BMI by itself shouldn't be the only measure of physical fitness. People can be healthy or unhealthy at a much bigger range of sizes than media hype and the BMI standard indicate. There are fitness buffs who are overweight but healthy and skinny people who live on junk food and video games.
Companies should certainly encourage healthy habits and make them easily attainable by their employees, but we should be careful that it does not become a stigma based on looks alone that results in people not being hired or promoted to do work they are well qualified to do, simply because they do not match an ideal standard.
Personally, I think that health insurance should be entirely divorced from employment. Instead, it should be easily available to people to purchase independently, at a price and with benefits that people will value enough to do so.
3. Jeni said the following at 3:38 PM on Apr 9:
Incentives for improving health at work are nice. I like them. I think that the hard part is how "health" is determined. A person who spends 2-3 hours a day in the gym working out shouldn't set the standard for good health for all of mankind.
4. B.M. said the following at 4:50 PM on Apr 9:
I think companies that create incentives for improving employees health and wellbeing should be commended! In response to Jeni's comment, in a country where obesity is becoming "normal" I hardly think there's much danger of people "who [spend] 2-3 hours a day in the gym" becoming "the standard for good health." Those people are few and far between, and I have never gotten the impression that companies promoting healthy lifestyles in the employees are pushing them to spend hours a day in the gym.
5. Kelly said the following at 6:39 PM on Apr 9:
"Presenteeism" is a difficult concept. I hate coming to work when the people around me are sick. I know I will inevitably catch it as well.
But if I have a cold? I'll still show up to work, for the following reasons:
(1) I don't get paid if I'm absent
(2) With a mild illness, I get SO BORED staying at home all day (even if I don't feel the best, my brain is still active!)
If only we could work from home when we're sick. But I guess that would get totally abused. I know I'm less productive when I'm not at 100% but I more than make up for it when I'm feeling better again.
6. KJ said the following at 7:17 PM on Apr 9:
A few years ago the school where I was teaching had a weight-loss contest where teachers/staff who participated were assigned to teams and had weekly weigh-ins, with the team losing the most combined weight named as the winner. Coincidentally, I was working on walking more for fitness and was frequently seen briskly walking in the halls after school. The result: everyone wanted me on their team. I declined politely because (a) I didn't care about losing weight at that point and (b) unfortunately, whenever I begin exercising, I gain several pounds (muscle, presumably) first, so a 4-6 week contest would only cause my team members unnecessary anger! It was frustrating to me that the only thing that mattered was losing the maximum number of pounds during the contest; whether you did that by eating nothing but grapefruit and raw spinach or whether you did that by making healthy choices was inconsequential. A contest that rewarded healthy choices (additional exercise, wiser food choices, etc.) would have made more sense.
7. Lynne said the following at 8:05 PM on Apr 9:
The best employee program I've seen was one my husband participated in. He was part of an inner city health ministry. Quarterly, you met with one of the health educators to set your health goals. For each quarter you achieved your goals (as reported by you and the health ed) you received an extra day of vacation. If you succeeded 4 quarters in a calendar year, you received a bonus day, meaning you could earn up to a week of vacation each year.
But, even with great program support (there was a workout facility on the premises), people still did not opt in. Just goes to show, you can lead a horse to water, but you can't make him drink.
8. Louise said the following at 8:31 PM on Apr 9:
When I was in my mid-twenties the company I began working for offered $250.00 cash to anyone who successfully quitted smoking.
I had successfully quit a few years prior, but after I heard that one I seriously considered starting again and quitting again!
:)
9. Sarah22 said the following at 9:11 PM on Apr 9:
I think any arena in life that encourages a healthy lifestyle is a positive thing. I do agree with those who have concerns about how you measure good health.
As a 22 year old I know a lot of girls from highschool who work out 5 to 6 times per week and physically look very fit however they bing drink 3 to 4 times per week and eat a lot of junk, their main concern is looks not actual good health. I have always struggled with my weight and I am currently working on getting in shape again after a year long bout with cancer/cancer treatments/etc. and if you stood me alongside the girls I just spoke about they look much healthier but I'm not convinced that they are as I don't drink, I eat healthy and I exercise daily. There are a lot of obese people who are unhealthy, that's true, but there are also a lot of "fat skinny people".
Sorry, I guess I probably went off on a tangent but the whole topic of measuring one's health based on weight alone really incenses me sometimes...
10. Deidra said the following at 10:57 PM on Apr 9:
I think it's a good idea, but it's also a very slippery slope. Overweight/obese people are already ostracized or verbally eviscerated by there "supposedly" unhealthy choices. (I say supposedly because many people assume when they see fat that that person's diet consists of Big Macs & Cokes which is stupid.) Because a person looks "fat" they are automatically assumed to be unhealthy.
You have to be very careful here, because the lay public just sees the outside, but that person who is 20 pounds overweight by BMI standards (don't even get me started on BMI), may actually be healthier when you check blood pressure, cholesterol, and blood glucose in comparison with supposedly "healthy" looking skinny person. There are many people who assume that because they have a flat stomach that they are healthy. Not so.
Look at sumo wrestlers. Very fat by American standards, but they are some of the healthiest people out there. There fat is on the outside, not visceral fat wrapped around their organs.
Making healthy choices is a good thing. But only looking at a person's waist size is dangerous, and you run the risk of ostracizing people because you sit there thinking how much better you are than them because you fit the current accepted BMI standards.
11. Amir Larijani said the following at 5:16 AM on Apr 10:
Keb says:
I absolutely agree with that. And that would allow companies to charge individuals premiums based on their individual risks.
Sure, there would be some abuses. But for the most part you would see a lot more shopping, a lot more options in coverage, and a lot more incentives for health maintenance.
12. Melissa D. said the following at 6:46 AM on Apr 10:
My health insurance has an incentive program that "rewards" you for exercising and/or logging your food intake to get a reading of fat/calories/vitamins, etc. I have received a free mp3 player, a stainless steel thermos, and most recently, a tent. The program helps me get to the gym more frequently.
13. NeedACatchyName said the following at 10:24 AM on Apr 10:
I had never heard of an employer doing anything to encourage fitnesses until I read this article. But then I got an email today saying that my employer is now encouraging employees to take a short walk (30 minutes or so) during the afternoon if they aren't too busy. So now that I have permission to get outside for a little bit during the day while on company time, I think I'll probably take them up on their offer. When you think about it, it's a really good idea, since bored employees tend to waste at least that much time surfing the internet* during the middle of the day, so it's not like you're losing any productive time if they replace their web surfing with walking. Plus if people know that they can take a thirty minute break away from their desk if their schedule permits, then that provides an incentive to get your work done early enough so that you'll have the time to take the break.
* Yes, I'm fully aware of the irony that I'm posting this from work. :)
14. John Bates said the following at 7:12 AM on Apr 17:
Health Promotion and Employee Wellness Programs are the only meaningful way to tame the ever-increasing cost of health care. That said, it's the incentives that will encourage people to make the necessary changes to improve their health and well-being.
If people were intrinsically motivated to be healthy then 2/3's of the US population would not be overweight / obese. My grandfather used to say that there are two ways to get a person to do something...1.) to use a "carrot" and / or 2.) to use a "stick".
Being healthy is much more difficult than being unhealthy. It's going to take both "carrots" and "sticks" to get people to change.