New ethics guidelines for health incentives

Incentive programs are increasingly popular carrot or stick programs offered by employers or health insurance companies that encourage people to adopt healthy behaviors.

Strategies to improve people’s habits — such as paying people to take their medicines or giving them a gym membership if they quit smoking — are catching on from employers and health insurance companies. But programs like these come with a number of possible ethical pitfalls. From WHYY’s health and science desk, Kerry Grens reports on new ethical guidelines published yesterday.

Incentives are offered to people to improve their health, and to save money for whoever’s footing the medical bills. There’s no standard format for how these programs work, and the American College of Physicians saw the possibility for doing it wrong. For example, a person may lose an incentive for missing a healthy eating goal. But he may live in a neighborhood with no grocery stores.

ACP president-elect Virginia Hood says the ethics policy should guide employers or insurance companies crafting incentive programs.

Hood: So we don’t want to punish people merely because they have a disease or don’t have as healthy lifestyles as somebody may think is ideal for them.

Hood says incentives can be done right. But there are few studies backing up the efficacy of these programs. Kevin Volpp is the director of the Center for Health Incentives at the University of Pennsylvania.

Volpp: One of the most important things is whatever is done, the impact needs to be very carefully measured. There’s a lot of programs like this that are being implemented by employers and being implemented by various other entities but the incremental impact isn’t really being carefully studied.

The new health insurance law that passed this year includes provisions for employers to try incentives to improve health and save money on medical bills.

Hood says organizations should base programs on those that are known to work, or do them for the sake of research.