Cash beats wellness program in health screening smackdown

A team of researchers may have created the theoretical framework for a new kind of health screening promotion program: Pay the employees at least $75 to get screened once, then sit back and hope that many will continue to get screened every year.

Damon Jones of the University of Chicago and two economists at the University of Illinois Urbana-Champaign — David Molitor and Julian Reif — included the $75 payment strategy in a study based on the University of Illinois at Urbana’s own employee wellness program.

Jones and colleagues analyzed the formation of good health habits by looking at how likely university employees who came in for basic health screening in one year were to return for screenings in later years.

Statistical analysis shows that simply offering a cash incentive of $75 or more to get employees to come in for screening in 2016 was the only variable studied that had much effect on whether the employees got screened in 2018, the researchers report.

Even the wellness program’s own communication efforts had little effect on whether the employees came in for screenings in the second and third years.

“These findings have practical implications for health policy,” the researchers write. “The results suggest that initial monetary incentives can lead to lasting changes in health-related behaviors.”

The history

The economists have posted their analysis in a working paper the National Bureau of Economic Research website.

A working paper is an academic paper that has not yet gone through a full peer review process.

The authors of the paper are members of a team that has been causing wellness program advocates stress since 2018.

Related: Time to pull the plug on wellness programs?

The researchers have studied different wellness program strategies, participation incentives and effects by offering some employees access to comprehensive wellness, such as access to weight management classes and a walking program, and simply offering some other employees health screening sessions.

The screenings tested for health indicators such as height, weight, blood pressure, cholesterol levels and blood sugar levels.

The researchers also used a random strategy to offer some employees cash incentives at levels of $0, $75, $100, $125 or $200.

In earlier papers, the researchers found the university wellness program had little measurable effect on the participants’ wellness.

Study details

When the researchers paid employees who were screened in 2016 to get screened again in 2017, that had a big effect on whether they got screened in 2018, but it led to no increase in the odds that they would get screened in 2018.

For workers who received a financial incentive and got screened in 2016, for example, the first-year financial incentive increased the percentage who got tested the first time by 12 percentage points to about 28 percentage points.

Completing the first-year screening increased the percentage who got tested in the third year by about 33 percentage points, no matter what the people screened in the first year did in the second year, according to the researchers.

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