The new rage in wellness is building outcomes-based programs which, depending on how you look at it, either provide an incentive to those that take care of their health or penalizes those who are unhealthy.

For those not familiar with this concept, this incentive is offered (most often a discount in their insurance premium) for achievement of a certain health standard. You may get a $100 annual discount for having healthy levels of cholesterol, $100 for having healthy levels of glucose, $100 for healthy blood pressure, and so on. By building in such a strong incentive, companies are able to drive very high levels of program engagement; often more than 90 percent of eligible employees. Many in the wellness field applaud this trend, because we are fed up with the days of offering health programming only to see 20 percent of the population show up to participate. Even more infuriating is when you realize that most of that 20 percent are your healthiest employees that are coming to prove to each other which of them are the most fit.

There are other reasons this approach is gaining popularity at such a rapid rate (a recent Towers Watson study showed the use of penalties for health outcomes more than doubled from 2009 to 2011, rising from 8 percent to 19 percent, and is expected to double again by 2012). It is one of the only ways to provide a "thank you" to the 80 percent of the population that maintain their health well enough to only take 20 percent of your health care expenditures. It's also one of the only ways to provide a goal to the individualized portion of your wellness initiative that stresses achievement over activity. In many cases companies are also using it as a funding mechanism to help pay for programs that can help the employees get healthier; programs that in many cases could not fit into the budget otherwise.