The Impact of Wellness Programs and Incentives on Preventive Services

描述（由申请人提供）：雇主和健康计划越来越相信健康计划是增加获得预防服务和促进健康行为的重要工具。特别令人感兴趣的是如何将财政激励措施纳入这些方案，以进一步鼓励健康促进和预防。我们建议研究的影响，以促进预防保健和健康的金融激励措施，通过检查最近的大型公司，通过同一个大型健康保险公司提供保险覆盖的计划。这种准实验提供了在实际公司产品的背景下而不是在外部有效性有限的受控实验室环境中研究健康计划的机会。健康保险公司提供的早期健康计划包括健康风险评估，以及健康教练计划和疾病管理计划（“标准健康”）。随后，健康保险公司推出了健康计划，将标准健康产品与现场生物识别筛查和财务激励相结合，这些激励措施与投保人为改善健康而采取的行动明确挂钩（“健康+财务激励”）。在不同的公司中，这些财务激励的规模和类型存在自然的差异。我们的研究将利用保险公司推出的健康+财务激励计划提供的自然实验。我们将实证估计这些健康+财政激励计划的倾向，以及他们的财政激励的结构，影响健康风险评估率，预防服务利用率和健康促进行为。我们提出了一项多年的研究，我们观察注册之前和之后，他们提供了新的健康+财政激励计划，以及注册谁提供标准的健康计划。通过这种独特的准实验设计，我们的研究可以指导财务激励设计，以加强健康计划，改善健康促进和预防活动。最近的医疗保健改革法（病人保护和平价医疗法）明确促进健康计划的健康计划。这项研究可以告知健康计划是否提供了金钱奖励的健康行动产生更大的成功，在促进预防保健比那些没有提供。此外，它可以告知如何构建健康计划的激励措施，以鼓励更多的参与。 公共卫生相关性：本研究的目的是揭示健康计划在改善预防保健和促进健康的有效性，通过检查公司通过其员工健康计划提供的计划。具体来说，我们试图确定的影响， 健康计划，结合健康风险评估，生物识别筛查和一系列财政激励措施。了解健康计划背景下的财务激励措施对于了解如何更有效地鼓励参与健康促进和预防计划至关重要。

DESCRIPTION (provided by applicant): There is growing belief among employers and health plans that wellness programs represent an important tool to increase access to preventive services and promote healthy behavior. Of particular interest is how financial incentives can be incorporated into these programs to further encourage health promotion and prevention. We propose to study the effects of financial incentives to promote preventive care and wellness by examining recent programs offered by large firms that provide insurance coverage through the same large health insurer. This quasi-experiment affords the opportunity to study wellness programs in the context of actual firm offerings rather than in controlled laboratory environments with limited external validity. Early wellness programs offered by the health insurer included health risk assessments in combination with wellness coaching programs and disease management programs ("standard wellness"). Subsequently, the health insurer introduced wellness programs that combine the standard wellness offerings with on-site biometric screening and financial incentives that are explicitly tied to actions taken on the part of enrolles to improve health ("wellness+financial incentive"). Across firms there is natural variation in the size and type of these financial incentives. Our study will take advantage of the natural experiment provided by the insurer's introduction of the wellness+financial incentive program. We will empirically estimate the propensity of these wellness+financial incentive programs, as well as the structure of their financial incentives, to affect rates of health risk assessment, preventive services utilization, and health-promoting behaviors. We propose a multi-year study where we observe enrollees before and after they are offered the new wellness+financial incentive programs, as well as enrollees who are offered standard wellness programs. Through this unique quasi-experimental design our research can guide financial incentives design to enhance wellness programs and improve health promotion and prevention activities. The recent health care reform law (the Patient Protection and Affordable Care Act) explicitly promotes health plan wellness programs. This study can inform whether wellness programs offered with monetary rewards for health actions yield greater success in promoting preventive care than those offered without. Further, it can inform how to structure incentives for wellness programs to encourage greater participation. PUBLIC HEALTH RELEVANCE: This study is designed to shed light on the effectiveness of wellness programs in improving preventive care and promoting health, by examining programs offered by firms through their employee health plan. Specifically we seek to identify the effect of wellness programs that combines health risk assessment, biometric screening and a range of financial incentives. Understanding financial incentives in the context of wellness programs is critical to understanding how to more effectively encourage participation in health promotion and prevention programs.