Wellness Incentives, Equity, and the Five Groups Problem

Wellness Incentives, Equity, and the Five Groups Problem

The study's author, 2009–10 Commonwealth Fund Harkness Fellow Harald Schmidt, characterized employees as belonging to one of five groups: "the lucky ones," whose behavior is effortlessly compatible with wellness goals; "the yes-I-can" group, who welcome the opportunity to join an incentive program; "the I'll do-it-tomorrow" group, who may want to change behavior but choose not to for a variety of reasons; "the unlucky ones," who are unable to meet the criteria of specific incentives; and "the leave-me-alone" group, who may qualify for incentives but decide not to accept them.

Schmidt identified a number of inequities across the groups. For example, some people may receive benefits even if their behavior runs counter to the spirit of the program (e.g., those who eat in unhealthy ways and never exercise but still have favorable body mass index values). Others may face strong medical or societal constraints that make it harder to meet targets—for instance, some people with genetic mutations will always be obese, regardless of how much they exercise or diet. In other cases, people may find healthy food unavailable or unaffordable or have insufficient time to prepare it, or they may lack access and time for exercise in a safe environment.

http://www.commonwealthfund.org/Publications/In-Brief/2012/Jan/Wellness-Incentives.aspx