With all of this nudging to get workers to take better care of themselves, employers are quite aware of the fine line they walk between offering support for healthy choices and making inappropriate demands, experts say. Wellness programs don't work if people think their employer is trying to get them to do things they don't want to do.
"I've seen extreme concern and fear over issues around discrimination when you start doing things like rewarding for certain amounts of weight loss or biometric screens," says Josh Klapow, chief behavioral scientist at Birmingham, Ala.-based ChipRewards Inc., which develops health incentive programs.
But will this new focus on results actually make employees more healthy? Some experts have their doubts. Pruitt, for one, thinks that rewarding people for an outcome without reinforcing all the steps needed to get there isn't likely to be effective. "There is a real lack of understanding among very smart people that there is a science of human behavior," she says.
Klapow agrees that by shifting rewards from participation to outcomes, employers are making a huge assumption that people will be able to figure out and engage in all of the behaviors that lead to the desired outcome. He argues that a successful program would reward people for every necessary step along the way to a goal.
His prescription for a stop- smoking program, for example: "Give points for enrolling, points for every time you participate in class, points for graduating, points for reporting nicotine-free," he says. Sure, give the most points for passing a nicotine breathalyzer — but don't save all rewards for just the breathalyzer.
All agree that figuring out the best way to motivate employees to get healthy and thereby cut costs is going to take time — and trial and error. "I think this is an evolutionary process, and some companies are more mature in that process than others," Thompson says.