Health Policy$ense

Employers Take Note: Premium-Based Incentives For Weight Loss Don't Work

Randomized Trial Finds No Effects For Employees

A new study casts doubt on the effectiveness of reducing health insurance premiums as a way to encourage employees to lose weight. LDI Senior Fellow Mitesh Patel and his team, in a randomized controlled trial, test the effectiveness of a $550 incentive in promoting weight loss in obese employees. They found no difference in weight loss over the course of one year between the control group and three different kinds of incentive programs.

It didn’t matter if the incentive was set up to provide premium discounts in the subsequent year, or in the same year, or even as part of a daily lottery.  About 20% of people in each of the groups were able to lose 5% of their body weight in a year (the goal); the rest, practically nothing.

This may come as no surprise to people who have struggled, mightily, to lose weight and keep it off.  But it may be surprising to the many employers who offer these typical incentives and assume that they work. The fact that premium adjustments are often delayed or bundled into paychecks likely contributes to their ineffectiveness. Patel and colleagues suggest that employers use insights from behavioral economics to design and test different incentive structures. While financial incentives have shown great promise in workplace wellness programs (see, for example, this recent study on smoking cessation), the amount and type of financial incentive that can promote workplace weight loss—if one exists—remains elusive.