When a health insurance provider charged its obese customers higher prices for coverage as incentive to work out, it earned results. Although it was a controversial practice, a study finds that it was effective. Five thousand steps per day on the pedometer goals were met by enrollees who were offered discounts for achieving exercise goals.
According to a joint study by the University of Michigan Health System and Stanford University, health insurance enrollees exercised more to save money. People were given the incentive to pay 20 percent less by meeting fitness goals as participants in a walking program where their steps were tracked online.
"There are ethical debates around the idea of forcing someone to be personally responsible for health care costs related to not exercising, but we expect to see more of these approaches to financially motivate healthier behaviors," Caroline R. Richardson, senior author and assistant professor in the U-M Department of Family Medicine, said. Richardson is also an investigator with the VA Center for Clinical Management Research and a member of the U-M Institute for Healthcare Policy and Innovation.
Researchers evaluated a group of 6,548 individuals that were under the health insurance program offered by Blue Care Network. Using WalkingSpree, a pedometer based fitness program, the enrollees' steps would be tracked. The participants were rewarded with insurance discounts as long as their walking goals were met.
After one year, almost 97 percent of the enrollees met or exceeded the 5,000 steps per day average walking goal on the pedometer. Some participants who were resistant to the walking program at first, found it to be "coercive".
"Our evaluation of Blue Care's incentivized program showed a surprisingly high rate of people who enrolled in the Internet-mediated walking program and stuck with it - even among those who were initially hostile to the idea. Wellness interventions like this clearly hold significant promise for encouraging physical activity among adults who are obese."
Blue Care Network created a stir when it introduced its financial incentive program in the U.S., one of the largest-scaled efforts. Enrollees who were obese were required to enroll in a fitness program to qualify for lower out-of pocket health insurance costs. Fitness program choices included Weight Watchers and the pedometer based program, WalkingSpree.
"Our findings suggest that incentivized wellness programs are acceptable to many individuals and that these programs encourage healthy behaviors," lead author Dr. Donna Zulman. Zulman is an Instructor in the Division of General Medical Disciplines at Stanford University and research investigator at the VA Palo Alto Health Care System. Findings from the study were published in Translational Behavioral Medicine.
