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The Association Between Incentive Designs and Health Assessment or Biometric Screening Completion

Heltemes, Kevin J., MPH; Pelletier, Kenneth R., PhD, MD; Ippolito, Andrea C., MPH; Do, Diana C., MPH; Boylan, Brandon C., MS

Journal of Occupational and Environmental Medicine: April 2019 - Volume 61 - Issue 4 - p e146–e149
doi: 10.1097/JOM.0000000000001556

Objectives: To identify statistically significant predictors for completing a Personal Health Assessment (PHA) or biometric screening from attributes of incentive designs.

Methods: A cross-sectional study was conducted that included 426,694 members from 56 employer groups who required a PHA or screening as part of their incentive during 2016.

Results: Incentive designs that combine high-value with immediate disbursement can relatively increase employee PHA participation by as much as 66% over plans with low-value and delayed disbursement (56.7% vs 34.1%, P < 0.001). Surcharge component was a significant predictor of PHA completion (P < 0.001); similar predictors were found for screening completion.

Conclusions: This study identified several significant predictors of PHA or screening completion, including: monetary value, time to disbursement, disbursement method, and frequency. Our findings are consistent with prior research in human behavior responses to positive reinforcement.

American Specialty Health, Indiana (Mr Heltemes, Dr Pelletier, Ms Ippolito, Ms Do, Mr Boylan); University of California San Francisco (UCSF) School of Medicine, San Francisco, California (Dr Pelletier).

Address correspondence to: Kevin J. Heltemes, MPH, American Specialty Health, 12800 N. Meridian St. Carmel, IN 46032 (

Clinical significance: Our findings are consistent with prior research indicating responses to positive and immediate reinforcement improves the likelihood of taking action. Understanding the factors that motivate behaviors, such as completing an assessment, is important in establishing individuals’ risk profiles in order to build tailored interventions to mitigate health risks.

Funding for this study was provided by American Specialty Health, a Musculoskeletal Health Solutions Company.

The authors declared no conflicts of interest with respect to the research, authorship, and/or publication of this article. All authors are employees of American Specialty Health, Inc., which is developing products related to the research described in this article, and the work was done as part of their employment with American Specialty Health.

Copyright © 2019 by the American College of Occupational and Environmental Medicine