Worksite Wellness: A Field Experiment on Participation Incentives & Selection into Wellness Programs

 描述（由申请人提供）：在美国，工作场所健康是一个快速增长的，价值60亿美元的行业。几乎所有提供健康福利的200名或更多员工的公司也提供健康计划。为了鼓励人们接受医疗保险，《平价医疗法案》允许雇主对参加工作场所健康计划的人给予高达医疗保险费用50%的经济奖励。然而，几乎没有严格的证据表明工作场所健康的有效性，部分原因是这些计划的自愿性质意味着参与者可能会因与健康计划的因果关系无关的原因而不同于非参与者。在这个项目中，我们试图通过实施工作场所健康的随机对照试验来克服这一障碍。我们还将提供这些计划的分配效果的第一次分析。这将使我们能够确定他们是否有效地将成本转移到不健康的，这可能发生，如果这些计划差异吸引健康的员工。我们将在一个大的大学校园里实施我们的随机实验。它将包括初步调查和健康风险评估，然后是一系列可选的健康活动，如体重管理和娱乐课程。第二次调查和健康风险评估将在一年后进行。我们将试验性地改变提供给参与者的财政激励和健康计划补贴。我们还将一些员工分配到一个对照组，既不接受健康风险评估，也不参加健康活动。在目标1中，我们将比较接受大激励的个人与接受小激励的个人的参与情况，以记录这些激励如何影响参与水平。在目标2中，我们将比较这些相同个体之间先前存在的健康指标，以估计激励措施如何影响参与的构成。在目标3中，我们将比较参与者与对照组的结果，以估计工作场所健康对员工健康和福祉的因果影响。最后，在目标4中，我们将比较财政激励与健康计划补贴的有效性。我们的项目的主要贡献是使用随机对照试验来建立工作场所健康计划对健康，医疗利用和福祉的影响的因果估计，并提供这些计划的分布效应的第一个措施。

 DESCRIPTION (provided by applicant): Workplace wellness is a rapidly growing, $6 billion industry in the United States. Nearly all firms with 200 or more employees that offer health benefits also offer a wellness program. To encourage take-up, the Affordable Care Act allows employers to financially reward participation in workplace wellness programs by up to 50 percent of the cost of health insurance coverage. Yet, there is little rigorous evidence available on the effectiveness of workplace wellness, partly because the voluntary nature of these programs means that participants may differ from nonparticipants for reasons unrelated to the causal effects of the wellness program. In this project we seek to overcome this barrier by implementing a randomized control trial of workplace wellness. We will also provide the first analysis of the distributional effects of these programs. This will allow us to determine whether or not they effectively shift costs onto the unhealthy, which can occur if these programs differentially attract healthy employees. We will implement our randomized experiment on a large university campus. It will consist of an initial survey and health-risk assessment, followed by a set of optional wellness activities such as weight-management and recreation classes. A second survey and health- risk assessment will take place one year later. We will experimentally vary the financial incentives and wellness program subsidies offered to participants. We will also assign some employees to a control group that neither receives a health-risk assessment nor participates in wellness activities. In Aim 1 we will compare participation among individuals who receive large incentives to individuals who receive small incentives to document how those incentives affect the level of participation. In Aim 2 we will compare preexisting health measures among those same individuals to estimate how incentives affect the composition of participation. In Aim 3 we will compare outcomes among the participants to outcomes among the control group to estimate the causal effect of workplace wellness on employee health and well-being. Finally, in Aim 4 we will compare the effectiveness of financial incentives with that of wellness program subsidies. The primary contribution of our project is the use of a randomized controlled trial to establish causal estimates of the effect of workplace wellness programs on health, medical utilization, and well-being, and to provide the first measure of the distributional effectsof these programs.