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. 2018 Mar;131(3):293-299.
doi: 10.1016/j.amjmed.2017.09.024. Epub 2017 Oct 9.

Effect of Health Plan Financial Incentive Offering on Employees with Prediabetes

Anita D Misra-Hebert  1 , Bo Hu  2 , Phuc H Le  3 , Michael B Rothberg  3
Affiliations

Effect of Health Plan Financial Incentive Offering on Employees with Prediabetes

Anita D Misra-Hebert et al. Am J Med. 2018 Mar.

Abstract

Background: Prediabetes may be improved or reversed with lifestyle interventions. A worksite wellness program offering financial incentives for participation may be effective in improving the health of employees with prediabetes. We studied the effect of employee health plan financial incentives on health outcomes for employees with prediabetes.

Methods: We conducted a retrospective cohort study using electronic medical record data from January 2008 to December 2012. Our study participants were employees with prediabetes and propensity-matched non-employees with prediabetes and commercial health insurance, all receiving care within one health system. Exposures included fixed annual financial incentives for program participation and later a premium discount divided between program participation and achievement of goals. We used longitudinal linear mixed models to assess yearly changes in glycosylated hemoglobin (HbA1c), weight, and low-density lipoprotein cholesterol in employees versus non-employees. We also compared outcomes of employees by ever- versus never- program participant status.

Results: Our study population included 1005 employees and 1005 matched non-employees. The yearly reduction in HbA1c for employees versus matched non-employees did not differ in 2008-2010 but was greater in 2010-2012, when incentives were tied to program participation as well as achievement of goals (-0.10% vs -0.08 %, respectively; P for difference in change [DIC] = .01 from 2010 to 2012). Analyses from both periods showed that employees lost more weight per year than matched non-employees (-1.85 vs -0.21 lb [1 lb=0.45 kg] from 2008 to 2010; P for DIC < .001 and -2.35 vs -0.65 lb from 2010 to 2012; P for DIC < .001). Employees who participated in disease management lost more weight than those who did not (-2.14 vs 0.79 lb yearly before 2010 and -2.82 vs -0.91 after January 1, 2010, P for DIC < .01 and < .001, respectively).

Conclusion: A worksite wellness program offering health plan financial incentives for participation and outcomes was associated with improvements in weight and HbA1c.

Keywords: Employee health; Incentive plans; Prediabetes.

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Conflict of interest statement

Conflict of Interest: ADM-H has received grant funding from the Merck Investigator Studies Program and Novo Nordisk, Inc., both unrelated to this study.

Figures

Figure
Figure
Employee disease management program participation rates, 2008–2012. Programs: diabetes, hyperlipidemia, hypertension, weight.
See this image and copyright information in PMC

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References

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