When a 2014 portion of the Affordable Care Act comes into effect, employers will be able to use financial rewards and penalties to encourage healthier behaviors. Last week the Obama administration released its final rulesregarding these employer-based wellness programs.
Still, critics are concerned that an annual premium adjustment isn't likely to change behavior, and will just end up penalizing those with poorer health.
According to Dr. Kevin Volpp, Director of theCenter for Health Incentives and Behavioral Economics at the University of Pennsylvania, it isn't as simple as just paying someone for doing the right thing. People tend to respond to immediate, short-term rewards (e.g. the satisfaction of eating one more piece of pizza) more readily than to delayed consequences (weight gain). The science of "behavioral economics" has found that when people are offered immediate incentives and penalties to do the healthy thing, they are more likely to make the right decision, sort of like having a swear jar for healthy living.
But not all incentives are created equal, and some behaviors are harder to change (e.g. quitting smoking) than others (taking your kid for a routine check up). The impact of an incentive depends a lot on how it is framed, and the context in which it's offered.