The Washington State Health Care Authority kicked off its Health Counts Program in July 2006 and in the 3 years hence has seen promising results.
There has been an increase in participation by WSHCA employees between the ages of 18 and 39, significant changes in self-reported lifestyle behavior and an increase in self-reported preventive care from the approximately 8,700 participants who took its health risk assessment (HRA) multiple years, said Michele Ritala, senior health policy analyst at WSHCA.
The Health Counts program saw changes among self-reported behaviors, including a decrease in the percent of employees who have two high health risks, from 14 percent to 13 percent, and employees who have three or more health risks, from nine percent to eight percent.
Health Counts reported an increase in healthy behaviors, including an increase from 60 percent to 69 percent in moderate physical activity at least five days a week. The program also saw an increase in self-reported preventive care, including an increase in employees getting flu shots, from 46 percent to 59 percent.
HRAs are mostly used to drive segmentation of which member should be offered what services in a behavioral change program, said Liz Boehm, a Forrester Research analyst. Employer groups and payers are now reporting changes in people’s health behavior through their HRA data-driven programs, she said.
Health Counts switched from a cash-based to a gift card-based incentive in 2008 and saw a 59 percent increase in participation from 2007 to 2008, which validates the direct correlation between the rate of HRA completion and the size of the incentive to complete it, according to Boehm.
“Employers are putting incentives in their programs because they recognize that incentives are needed to drive healthier lifestyle decisions,” said Kimberly Hanson, vice president of sales for Hallmark Insights, which provides business incentives solutions.
HRAs need “bandwidth” early in a program and then require re-engagement to keep participation up, which require an introduction of incentives in the beginning and then a tweak of those incentives, Hanson said.
Ritala agreed, saying, “You need to start with carrots.”