The Impact of Alternative Incentive Schemes on Completion of Health Risk Assessments

The authors looked at different ways to encourage employees (N=1299, 81% female, mean age 41) at a health care management and IT consulting company to complete Health Risk Assessments (HRAs); specifically examining whether a lottery is more effective than a direct payment of equivalent monetary value (i.e. a gift certificate). There was a control group in addition to these two treatment arms.The authors cite inspiration from the Dutch postal code lottery for their design, which incorporates regret aversion. In their lottery, employees were divided into teams of 4-8 and one team was randomly selected as the winner each week. Each member of the winning team who had completed the HRA prior to the time of the drawing would win $100. If at least 80% of the members of the team completed the HRA, the prize would increase to $125.Results showed significantly higher HRA completion for the lottery group (64%) than the gift certificate group (44%) and the control (40%). Effects were larger for lower-income employees.