Employers want their employees to be responsible for their health—and they want it so badly that the number of companies using financial incentives and penalties for participation in health programs is rapidly on the rise, according to a survey of companies by Towers Watson.

The use of financial rewards in health management programs increased by 50 percent between 2009 and 2011. And by 2012, four in five companies plan to offer some type of financial reward to individuals who participate in their health management programs.

Additionally, the use of penalties more than doubled from 2009 to 2011, rising to 19 percent from 8 percent, and is expected to double again by 2012 when more than a third (38 percent) of respondents plan to have penalties in place. While just 12 percent of U.S. respondents report they currently reward (or penalize) based on outcomes (such as target BMI or cholesterol levels), an additional 16 percent are planning this achievement-based approach for 2012.