A recent article in the Boston Globe has set me to thinking about how and whether financial incentives really influence how people behave.
Two Harvard graduates are exploring whether a fine-based system will motivate people to meet their fitness goals at the gym. Briefly, their company will pay for selected participants to join one of several local gyms. In return, the members agree to work out 4 times/week. If they fail to follow-through in any one week, they owe the gym $25. If members leave the program (for any reason than injury or illness), they pay $75. The benefits of the program are twofold: members are motivated to continue their New Year's fitness goals beyond Jan 3rd and the participating gyms collect an additional revenue stream. The downside is that if members keep working out, the gyms may have to employ more people or provide more space and equipment, which becomes more costly. To keep their idea financially viable, the company supplying the memberships is currently exploring the possibility of earning referral fees and revenue-sharing affiliate programs with additional gyms.
This concept is an interesting spin on an incentive known as "P4P4P," or pay for performance for patients--a model that provides immediate financial incentives for patients who give up unhealthy behaviors such as smoking, overeating, teen pregnancy, or physical inactivity. Data from large-scale employee studies suggest that P4P4P shows considerable promise in changing these undesirable behaviors, although it is not clear whether the effects extend after the financial compensation has ended.
But this new gym model, which flips the P4P4P model upside down, has intriguing possibilities. Perhaps the company could provide paid memberships to attend weight-loss or smoking cessation classes and fine those who don't complete the program. I wonder which incentive program would be more successful--payment for success or fines for failure to achieve? And in this time of healthcare reform, maybe this approach should be considered among insurers and healthcare providers?
