Hello WikiWIT collaborator,
WikiWIT stands for Wiki Wellness Incentive Calculator. “Wiki” is a Hawaiian word meaning quick. It has entered mainstream culture through the pioneering efforts of Wikipedia, which set the audacious goal of working to “compile the sum of all human knowledge” through a collaborative effort in which users supply the content. We hope to capture that spirit within the health promotion community to refine WikiWIT. Future elements of WikiWIT will be released based on insights provided by the collective health promotion community.
We are seeking input in the six major areas listed below. Click on the “+ “symbol, for more details and specific questions and in each area.
Thank you for helping us improve WikiWIT. We look forward to ongoing collaborations.
Michael P. O’Donnell, MBA, MPH, PhD
Part I of WikiWIT has three major components:
1) Equations to determine the amount of incentives;
2) Guidelines for establishing cut points or health standard to earn incentives;
3) Funding options to guide the extent to which program costs and incentive costs should be shared between employer and employee.
Question #1: Do these four components cover the major issues involved? What, if any, new components should be added?
Focus of Equations. Seven equations are provided in the equations section of WikiWIT. These are organized into sets for participation, biometric outcomes and tobacco use.
Question #2: Do these equations cover the full scope of the issue? Is it important to provide a set of equations for Health-Contingent Activity Only incentives, or is it appropriate to think of Activity Only elements as Reasonable Alternative Standards flowing from the Outcomes? What other sets of equations are important to add?
The equations include factors reflecting employers’ levels of priorities relative to morale, cost equity, and behavior change and their confidence that the wellness program will enhance morale and that they can develop, manage and communicate the incentive program effectively. They also include factors representing the differential medical cost for those who do and do not have the risk factors, as well as the amount required to persuade an employee to perform a simple behavior.
Question #3: Are these the most important factors to include in the equations? Which if any should be removed? Which new ones, if any, should be added?
The numerators in all the equations represent values from the literature about medical cost differentials, or the amount required to nudge an employee to pursue a specific behavior. The values of the numerators also reflect the maximum value of the equations. The numerators and multiplier represent employer priorities and levels of confidence. The impact of the denominator and multiplier is to reduce or not change the value of the equation, never to increase it. The two elements of morale are in the multiplier rather than the denominator to allow them to have more impact on the value of the equation than any of the other employer factors, and to allow those two elements of morale to directly influence each other.
Question # 4: Does this structure combine the factors in the most appropriate ways? If not, what structure might be more appropriate?
Each of the factors includes a modifier variable to allow the user to assign a greater or lesser value to any of the factors. The default value for all of the modifiers is 1, which makes all of the factors have equal value.
Question #5: Should the modifiers be retained or deleted? Should the default values be 1, or should the factors be weighted based on findings in the literature or any other reason?
Three different rationales are suggested for setting the cut points for the health standards that must be met to earn the incentives. These are the inflection point at which the medical costs for the risk factor are lowest, the optimal level from a health perspective, based on clinical standards, and slightly above the clinical standards.
Question #6. Should other approaches be considered?
Question #7: Do these nine options reflect the full range of options? Is not, what are other important options? Are the ratings for fiscal sustainability, cost equity and employee morale reasonable for each of the options? If not how should they be modified? What other major factors should be considered?
Collaborators are encouraged to identify studies from the scientific literature that measure the items below. For published work, please provide complete citations, including authors, publication name, volume, issue and pages and article title. For unpublished findings, please tell us how we can access the details.
Differences in medical costs among participants and non-participants in HRAs.
Question #8. What studies should we consider?
Differences in medical costs among participants and non-participants in health screenings
Question #9. What studies should we consider?
Differential medical costs for BMI, blood pressure, glucose, Hemoglobin A1C and cholesterol
Question #10. What studies should we consider?
Cut points in medical costs for BMI, blood pressure, glucose, Hemoglobin A1C and cholesterol
Question #11. What studies should we consider?
Participation rates in HRAs, health screenings and other wellness programs based on different levels of financial incentives
Question #12. What studies should we consider?
Readers are also encouraged to share data from practical experience or the practice literature on participation rates in HRAs, health screenings and other wellness programs based on different levels of financial incentives
Question #13. What studies should we consider?