Employers could get better results in their wellness programs if they focused more on the immediate gratification, according to a group currently researching the role of behavioral economics in these programs.

Kevin Volpp and Mark Pauly, professors at the University of Pennsylvania's Warton School, call this approach "P4P4P": pay for performance for patients. Too often, they say, employers' wellness programs have had major incentive-related design flaws that hampered results.

. . . "Our human nature is a combination of rationality and irrationality. It is best to design a program that uses both approaches," Pauly said. "The rational thing is to be conscious of your mortality and doing something about it, but that is hard for many people. In some ways, life is too short to be rational all the time."

Others are talking about behavioral economics' role in wellness programs, too. . . . "What employers have learned is that they have not provided the right incentive" in wellness programs" said Paul Fronstin, director of health research and education at the Employee Benefit Research Institute. Some employers, he said, have "just thrown a wellness program out there with the 'We will build it and they will come' mentality."

Experts point these ideas for employers to consider when designing a program:

• Money often motivates people to participate
• A reward should materialize soon
• Consider making [incentives] competitive

. . . Incentives do help drive near-term participation "but, when you take them away, most people rebound to their old behavior," said Kathy Harte of Hewitt Associates. . . . For something to become a long-term lifestyle change, the motivation has to shift from an external factor, such as a material reward, to an intrinsic motivation, [according to Barry Hall of Buck Consultants.] Employers can help by creating a "culture of health" in their organizations, he said.

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