Incentives - are they the solution or the distraction in EHM?

For many years, we have been asked to demonstrate the ROI of health management programs. Specifically, identify the financial investment in employee health management programs and show the savings reaped from the investment. Recently financial incentives have been at the top of discussions because of their "power" in motivating individuals to participate in programs. Furthering this dialogue is health reform, allowing employers to increase the percent of health benefits that can be offered as incentives from 20% to 30%, and possibly 50% in the future.  Based on the state of the market and our interest in responding to the ROI request, many are asking the question "What is the best incentive to offer to engage participants and afford the best outcome in health programs?"

I would challenge those responding to that question and ask why we are trying to answer this question? In all of my experience over the years, no one program design has fit more than one company, because each company has it's own set of unique program goals, culture, leadership support, resources and policies. So, what would make us think we could identify one incentive amount, type, or design as the "gold standard." 

I think we should be asking different questions entirely: What barriers exist that are preventing people from prioritizing their health? How is the health of an employee woven into an organization's policies, performance reviews, manager evaluations, leadership commitment? What is the organization's opportunity to achieve greater performance, retention, growth, culture, etc.?  Identifying success measures and assigning value to these as a "return" is a worthy conversation. 

Finally, let's not focus all of our attention on an incentive and assume this component is the success or failure of the program. An incentive is only the "coupon" that gets you to walk in the store, let's try to achieve loyal customers and integrate programs so well that prioritizing health is easy, rewarding and an expectation within the organization's culture.