Does worker qualify for incentive? Be objective

The near future of health promotion and illness prevention programs is relatively clear in one aspect: In large part, they will be based on metrics such as body mass index and nicotine levels.

"These will be followed by an annual evaluation program which examines differences in the baseline assessment data for each individual," says Susan Kennerly, RN, PhD, associate professor and deputy director of the occupational health nursing program at the College of Nursing at University of Cincinnati (OH).

Objectively measurable signs can demonstrate that an employee qualifies for a particular incentive. "As we get smarter about this down the road, we will find that certain type of incentives work and others don't," adds Paul Papanek, MD, MPH, chairman of the board for the San Francisco, CA-based Western Occupational Environmental Medical Association.

Health risk assessments, which are relatively low-cost, may be the "low hanging fruit" when it comes to getting results from incentives. "We know that just the act of filling it out correlates with healthy behaviors," says Papanek. "Just having to check off 'yes' or 'no' makes people more likely to comply."

This could take the form of asking the workforce to fill out a questionnaire voluntarily, then having an occupational health professional follow up on the risk factors identified for that person. Based on this information, occupational health can work with the insurer to learn what benefits are available to help the worker.

Other incentives may require employees to log onto a website periodically to record visits to the gym. "Sure, there are a certain percentage of cheaters. But if you are even 50% effective in increasing the fitness level of employees, that's huge in terms of preventing cardiovascular risks," says Papanek. "You don't have to be perfect to be effective."