by Dean Witherspoon   Dean's profile on LinkedIn  

It’s really a poor long-term motivator for lifestyle change. Here’s why:

  • Money gets spent on bills, fast food, gas, and other consumables. Once it’s gone, there’s no visible reminder of the accomplishment.
  • Over time, cash incentives are viewed as part of normal compensation. The first year it’s a novelty, a chance for a few extra dollars. But then there’s not a lot of motivation to do more, and the money is expected.
  • Once in place, systems are hard to change without upsetting those who liked them in the past — there’s nothing more demotivating than money out of your pocket. So if the program isn’t working, you have to up the ante to get them to buy in.
  • It’s difficult to recognize or celebrate the awarding of money tastefully and without making some people feel slighted.
  • You hire and pay people for the contribution they make to the organization, not their percent body fat. It’s important they understand unhealthy behaviors hurt the bottom line, but don’t muddle the issue by paying for anything other than their contribution.
  • Be careful about jumping on the disincentive bandwagon or a pay-me-now and pay-me-later incentive model. All it takes is a change in leadership and you’re starting over — no matter how good your data.

Health is a personal responsibility. Recognizing individuals for taking that responsibility seriously can be a very positive thing, but paying people to get healthier (or penalizing people for taking it less seriously) is fraught with peril. Proceed at your own risk.


# Jamila Brown 2015-10-05 18:57
I read the white paper you reffered to in the previous comment. I understand that creating an enviroment condusive and supportive to change would allow someone who is intrinsically motivated to flourish. What are some effective principals or techniques that would move a population towards intrinsic motivation? We are already doing most of the things listed, in my organization. One aspect mentioned that would be hard for us to improve is the amount of autonomy some positions have, being that we are a hospital, and patient care is a priority. When we market/promote our programs, we try to focus on the individual and how they can benefit- not just from the outcome, but how the experience affects their lives. If we didn't tie an incentive to some programs, we would not have half the participation and could not sustain them. Are you suggesting we measure/justifi y our programs in different ways? Any suggestions would be helpful. Thanks, Jamila Brown
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# Dean Witherspoon 2015-10-06 14:33
Hi, Jamila. Great questions and comments. Obviously, not knowing your workplace and population as well as you do, I'm not sure how helpful this will be, but here goes... autonomy, connectedness, meaning, and purpose are all values your hospital's management needs to buy into -- without it, a supportive environment doesn't exist. It really is the foundation and needs to be part of every supervisor's responsibility to foster in their teams. When people feel valued and safe at work, it allows intrinsic motivation to be possible. As to what to measure, keep in mind our goals (typically) are health and quality of life, not wellness program participation. In my opinion, that's what we should all be focused on. In a supportive environment with outstanding wellness services focused on well-being, carrots and sticks only impede progress, not enhance it. Here's an excellent book on the topic: The Best Place to Work: The Art and Science of Creating an Extraordinary Workplace. Good luck.
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# Dean Witherspoon 2015-09-30 14:08
Hi, Linda. Here's an excellent white paper on the topic which includes multiple studies highlighting human motivation for health behavior change:
And you're mistaken about the Fed government requiring states and states requiring health plans to offer member incentives. The ACA has rules health plans and employers must follow IF they offer cash incentives, but there is no requirement to offer them.
The alternatives that work better are compelling wellness services that make people WANT to engage because they offer the promise of making life better -- also covered in the white paper.
Thanks for taking time to comment.
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# Linda 2015-09-30 11:59
Where is the research or surveys to back up the claim that cash rewards don't work as a health incentive? I would love to see the published data. As you may know, the Federal government requires the States, who require the health plans to offer member incentives, which is often a gift card. My experience is that this works well at promoting quality scores that are measurable. Show me the research that this is a bad idea so I will be convinced and give me some alternatives that work better.
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