Way to Health

UPHS Weight Loss

Premium-based financial incentives to promote workplace weight loss

Jan 1, 2016

Mitesh S. Patel, MD, MBA, MS Mitesh S. Patel, MD, MBA, MS
David A. Asch, MD, MBA David A. Asch, MD, MBA


Employers commonly use adjustments to health insurance premiums as incentives to encourage healthy behavior, but the effectiveness of those adjustments is controversial.

Intervention and Design

They gave 197 obese participants in a workplace wellness program a weight loss goal equivalent to 5 percent of their baseline weight.

Intervention - They were randomly assigned to a control arm, with no financial incentive for achieving the goal, or to one of three intervention arms offering an incentive valued at $550. Two intervention arms used health insurance premium adjustments, beginning the following year (delayed) or in the first pay period after achieving the goal (immediate). A third arm used a daily lottery incentive separate from premiums.

Way to Health Use

Findings and Conclusions

At twelve months there were no statistically significant differences in mean weight change either between the control group (whose members had a mean gain of 0.1 pound) and any of the incentive groups (delayed premium adjustment, −1.2 pound; immediate premium adjustment, −1.4 pound; daily lottery incentive, −1.0 pound) or among the intervention groups.

The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both.

Publications and Press

  • Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.