Employee wellness is not a new idea, but new ideas from digital health companies like Castlight Health and Fitbit, as well as incumbents like UnitedHealthcare, are reimagining and reinvigorating the space.

At a panel at the Personal Connected Health Alliance’s Innovation Leaders Summit at HIMSS18 (moderated by yours truly), Castlight Health President Derek Newell, Fitbit Health Solutions Chief Operating Officer Amy McDonough, and UnitedHealthcare Vice President of Emerging Products Paul Sterling discussed the evolving space and how wearable technology is leading to record engagement and motivation for employee populations.

“Connected devices are interesting to people,” Sterling said. “They’re interesting gadgets. Our objective is to leverage that interest, that momentum, that enthusiasm people have for these capabilities and transition it to a meaningful health tool. [UnitedHealthcare] Motion is a baby step along a long path. We’ve paired this technology along with a rigorous but achievable concept and are incentivizing people to participate.”

UnitedHealthcare’s Motion program, a collaboration with Qualcomm, pays users $4 a day to meet health and wellness goals, as measured by trackers like Fitbits, Samsung devices, and, soon, as he announced at the show, Apple Watches. They can put that money toward other healthcare expenses. 

“The best incentive design is to give an employee a subsidy to buy a biometric device, have them start tracking something — steps, sleep, activity, whatever — and then give them rewards where they can buy other things that will improve their health, like gym memberships, 401K, all of these things,” Newell said. “That’s a virtuous cycle of creating daily behavior that’s incredibly helpful.”

While the question is often phrased as which is better, intrinsic or extrinsic motivation, panelists all agreed that well-designed programs should include both. They should also give rewards quickly, rather than making the individual wait a year. And rewards should be as personalized as possible.

“You still run into this problem of employers having this incredibly paternalistic attitude about what rewards I can get,” Newell said. “And if you limit the choice of rewards, which is what all employers want to do, you’re going to limit engagement, you’re going to limit enthusiasm, because there is intrinsic and extrinsic motivation and if I can use the same currency to get different things, I’m going to be more motivated. It’s not just the immediacy of the reward that’s important, it’s the choice architecture of the reward.”

Finally, McDonough added, any wellness program that succeeds needs to have a culture fit with the organization employing it.

“In terms of financial rewards and other rewards and incentives, this is probably an obvious statement but the more integrated it is into the culture, whether that’s the culture of the individual and who they surround themselves with every day or the culture of the organization, the more effective it’s going to be longterm,” she said. “And I think it’s always a combination of some intrinsic motivators, that you have to be in a state of readiness for change. But a financial motivation program that’s well-designed, like the Motion program, where it’s based in science and gives you these motivations throughout, the research really shows that [the financial incentive] doesn’t even have to be a super meaningful number. What it has to do is tie closely into the culture of the program.”