Study: Financial Incentives Increase Use of Health Coaching

By Stephen Miller, CEBS Nov 12, 2014

When employers offered financial incentives, employees were 33 times more likely to participate in telephone health coaching, and they did so sooner than employees without incentives, new research finds.

“Our goal was to evaluate what motivates people to participate in these programs and what strategies companies and insurers can use to get everyone involved,” said lead author Dr. Jason Block, assistant professor at Harvard Medical School’s Department of Population Medicine, in a news release announcing the findings. “Our data show that financial incentives clearly work to motivate participation in a health coach program.”

The study, Do Financial Incentives Promote Uptake of Telephonic Health Coaching within a Health Plan?, was published in November 2014 by The Obesity Society, a nonprofit that encourages research on the causes, treatment and prevention of obesity. (The full study abstract, provided by The Obesity Society, is shown in the box below.)

From October 2010 to July 2013, researchers led by Block gathered data on adult members of one nonprofit health plan. They compared the uptake of a telephone health-coaching program among the 16,961 members who received financial incentives to the 974,782 members who did not. Their research found that during the nearly three-year follow-up period, 10 percent of the members with incentives began using the telephone health coaching, whereas only 0.3 percent of those without the incentives did so.

Financial incentives were also strongly associated with how long it took members to begin using the program. Members who used telephone health coaching typically had six to seven interactions with a personal health coach over an average duration of four months, where they discussed their lifestyle, assessed their health situation and concerns, and worked to develop specific health goals.

In a position paper, The Obesity Society recommends that wellness plan sponsors ensure that incentives are matched with health plans that cover evidence-based obesity treatment programs and medications, and focus on overall wellness for all employees, rather than only those affected by obesity.


Study: Do Financial Incentives Promote Uptake of Telephonic Health Coaching Within a Health Plan?

Authors: Jason Block, Dennis Ross-Degnan, Matthew Gillman, Sheryl Rifas-Shiman, Renata L. Smith, Ken Kleinman

Background: Employers increasingly offer financial incentives to employees for participation in wellness activities. Whether these incentives lead to health promotion activities is unclear. In a nonprofit health plan, we examined the impact of monetary incentives on uptake of telephone health coaching.

Methods: The health coach program began in October 2010, and any health plan member was eligible to work with a coach. Employers began offering incentives to work with a coach in 2011. Using records on health plan members, health coach encounters, and employer incentives, we gathered data on all adult health plan members from October 2010 to July 2013 (N=991,743). For this analysis, we compared uptake of coaching among the 16,961 members who received incentives v. the 974,782 members who did not, adjusted for demographics. Using first contact with a health coach as the outcome, we used survival analysis to examine the association of receiving an incentive with coaching uptake.

Results: Among members, mean age was 42.6 years, 52% were female, and 89% were White. During the 2.75-year follow-up period, 4,898 members worked with a coach, including 1,693 among the 16,961 with incentives (10%) and 3,205 among the 974,782 without (0.3%). In 2011, 2012, and 2013, being offered an incentive was strongly associated with time until uptake of health coaching (Hazard ratios 6.9 [95% CI 5.7, 8.4], 80.8 [74.5, 87.6], and 7.1 [5.0, 10.1]). Other important predictors of uptake included minority race, older age, and female gender.

Conclusions: Providing coaching incentives was strongly associated with uptake of telephone health coaching in a nonprofit health plan.

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.

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