Benefits & Compensation News

Study: Lotteries the best way to boost health risk assessment participation

It’s not uncommon for employers to offer generous incentives to every employee who fills out a health risk assessment. But new research suggest there’s a much better way to use incentive money to spark participation in this area.

Instead of simply giving each and every staffer who fills out an HRA the same monetary reward, what would happen if you enrolled them in a lottery in which only a few winners split all the incentive cash?

That question was answered by Wharton health care management professor Kevin Volpp, who along with three co-authors conducted a study on health risk assessments and incentives. Their findings were published recently in the American Journal of Health Promotion.

According to Volpp, the study was looking “to get higher rates of completion for the same amount of money.”

Greater risk, larger incentive

The study consisted of 1,299 eligible employees in the 14 offices of an anonymous company. In 2007, the company’s participation rate was just 27%. So, in 2008, the firm offered a $25 cash reward to all employees who filled out the health risk assessment questionnaire. Result: Participation rates climbed to 49%.

The following year, a lottery was added to the mix to see if it would bolster participation even further.

Here’s how it worked: Workers who were selected to participate in the lottery were put into teams of four to eight. Then, these individuals were told that anyone on their team who completed the health risk assessment before the lottery drawing would receive a prize of $100 if their team was selected. However, if the team got 80% or more of its workers to fill out the health risk assessment, they’d all get $125 if they won the lottery.

For comparison purposes, the study included two other groups as well. The first group was only promised the original $25 cash reward for completing the health risk assessment; the other was eligible for the cash incentive, as well as a grocery gift certificate.

Both of those groups also received an email explaining the assessment process, as well as the rewards they stood to gain for completing it in a timely manner. Then, they received weekly email reminders for the next four weeks.

A 20% higher participation rate

By far, the lottery incentive garnered the greatest participation from employees. Sixty-four percent of the employees in the lottery group completed the HRA questionnaire, compared to the 44% of those in the group that received the cash andgrocery incentive and 40% of the employees in just the cash reward group.

So why was the lottery incentive model so effective? In a large part because of the human emotion of regret, says Volpp. “When people become aware of the fact that they could easily win a fairly substantial reward, they anticipate that if they don’t win that reward, they are going to be disappointed in themselves for not having done what they needed to do,” says Volpp.

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