Motivational tools

Cash may be king, but it shares the throne when it comes to efforts to get employees to reduce their cholesterol levels.

A program that combines education and monthly calls from a nurse proved just as effective as cash incentives in a recently completed study among northern Nevada workers.

Information about effective motivational tools is critical to folks who run benefits programs that emphasize wellness.

"Wellness always has been a big topic for people who run health plans, but quantifying results has always been problematic," says Randy Waterman, risk and benefits manager for the City of Sparks.

In the cholesterol study, The Nevada Health Care Coalition a group of major employers joined with Saint Mary's Health Network and Integrated Health and Wellness in the study of 171 employees.

The employees, all of whom had high levels of LDL so-called "bad cholesterol" were broken into three groups.

Members of one group were told they'd get $100 if they reduced their cholesterol level by 15 percent in six months.

They could use any strategy they wanted.

A second group, meanwhile, was offered free classes in cholesterol control developed by Saint Mary's Health Plans and received monthly calls from a Saint Mary's nurse.

The third group got no special support or incentives.

On average, members of the group that received cash incentives lowered their cholesterol by 18 points.

The group receiving education and calls from nurses posted the same results.

The average reduction in the group left to its own devices was about five points.

Dr.Michael Bloch of Saint Mary's Risk Reduction Center, the medical director of the study, said researchers wanted to pay special attention to low-cost methods of reducing health risks.

The cost per participant whether they received cash or education was about $150.

And Waterman, one of about 20 City of Sparks employees to participate in the study, said the finding that cash is an effective motivational tool is promising.

"It's really simple to administer," he said.

The payoff for a modest investment in cholesterol reduction programs can be dramatic for health plan administrators.

Bloch said a 15 percent reduction in cholesterol levels for a decade can lead to a 30 percent reduction in the risk of heart attacks and strokes.

And with the cost of coronary bypass surgery topping $40,000, the dollar savings can be substantial.

Saint Mary's health and wellness unit now is developing a cholesterol-reduction program centered on the education and follow- up calls from nurses that was used in the just-completed studies.

Employers who purchase that program will be encouraged to further sweeten the deal with cash incentives, Bloch said.

Next, he said, researchers want to learn more about effective incentives for a couple of challenging wellness issues tobacco use and obesity.

The researchers also hope to do follow-up to learn how well participants in the first study stick with their improved cholesterol levels as months pass.

Waterman, part of the group that received education and nurses' calls, thinks he'll see some long-term benefits from his participation.

"I met my goal," he said."And it gave me some lasting skills such as reading labels."