Will Wellness Incentives Work In Health Care?

Last year the average incentive paid to participants in an employer-sponsored wellness program was a little over $300 a year. Some employers paid a lot more- one paid $4,000 to employees just to complete an HRA- and some less, but the overall average increased over the previous year.

A lot of dollars are being thrown at employees to get them involved. Why is it that still only 11% of the employees actually are?

Daniel Pink’s new book “Drive; The Surprising Truth About What Motivates Us” provides an interesting perspective.

Pink delivers his argument from a historical perspective and simply comes to the conclusion that the way individuals were motivated in the past no longer applies today. He describes the historical way we have tried to motivate individuals as Motivation 2.0. Motivation 2.0 assumed “the way to improve performance, increase productivity, and encourage excellence is to reward the good and punish the bad.” It was the old carrot and stick model.

The carrot and stick model worked fine when the actions you were trying to change were repetitive and measurable and there was no consideration of external forces influencing an individual. If you produced more widgets, you were paid more. If you didn’t meet your quota, you might not have the job for much longer. The measurements were simple.

Pink argues that our culture no longer works that way. The dynamics of the workplace and the characteristics of our demographics are dramatically changing. He believes that we are moving toward Motivation 3.0. Motivation 3.0 “concerns itself less with the external rewards to which an activity leads and more with the inherent satisfaction of the activity itself.” Individuals don’t always respond to the carrot and the stick approach any more.

Individuals are looking for more in their lives (including their work) than they ever have before. Pink believes motivation to take action at any level is based upon an individual’s desire for three things: 1. Autonomy- the desire to direct our own lives; 2. Mastery- the urge to get better and better at something that matters; and 3. Purpose- the yearning to do what we do in the service of something larger than ourselves

Focusing on material incentives (money and gifts) may sometimes work to achieve short-term results but will probably not work to achieve the real goal of engagement and active participation. Actually, Pink cites examples where the carrot and stick approach worked in reverse. In health care, engagement and participation of the individual consumer is crucial. We can’t get much lower engagement than where we already are.

Getting employees engaged in this new health care world will require more than a carrot and stick approach. It will require creating the culture around the individual that meets their personal requirements of feeling they are in control of their lives (autonomy), continually improving their health because they know it matters (mastery), and participating because they know its not just about themselves (service).

Pink writes, “In our offices and our classrooms we have way too much compliance and way too little engagement. The former gets you through the day, but only the latter will get you through the night.”

If we can move to Motivation 3.0 in health care maybe we’ll have more than 11% of the individuals engaged in sponsored programs and we won’t have to pay $4,000 to get someone to complete an HRA.

Be Well.