Mayo: Money Talks When it Comes to Losing Weight

A little cash goes a long way, even when the topic is wellness and shedding a few pounds.

Details from a recent study:

Weight loss study participants who received financial incentives were more likely to stick with a weight loss program and lost more weight than study participants who received no incentives, according to Mayo Clinic research.

Previous studies have shown that financial incentives help people lose weight, but this study examined a larger group of participants (100) over a longer period (one year), says lead author Steven Driver, M.D., an internal medicine resident at Mayo Clinic. One hundred healthy adult Mayo employees or their dependents, ages 18-63 with a body mass index of 30 to 39.9 kg/m2, were assigned to one of four weight loss groups: two with financial incentives and two without. An adult who has a body mass index — a calculation determined by using weight and height — of 30 or higher is considered obese, according the Centers for Disease Control and Prevention.

All participants were given a goal of losing 4 pounds per month up to a predetermined goal weight. Participants were weighed monthly for one year; previous financial incentive studies followed patients for 12 and 36 weeks. Participants in the incentive groups who met their goals received $20 per month, while those who failed to meet their targets paid $20 each month into a bonus pool. Participants in both incentive groups who completed the study were eligible to win the pool by lottery.

Study completion rates for the incentive groups were significant compared with the non-incentive groups: 62 percent versus 26 percent. In the incentive groups, participants' mean weight loss was 9.08 pounds, compared with 2.34 pounds for the non-incentive groups.

"The take-home message is that sustained weight loss can be achieved by financial incentives," Dr. Driver says. "The financial incentives can improve results, and improve compliance and adherence."

Researchers found that even participants in the incentive group who paid penalties were more likely to continue their participation in the study than those in the non-incentive groups, Dr. Driver says.

Senior study author Donald Hensrud, M.D., preventive medicine expert at Mayo Clinic and medical editor of The Mayo Clinic Diet, says obesity continues to be a major concern in the United States because extra weight contributes to many conditions, such as heart disease and diabetes.

"Traditional therapies are not working for a lot of people, so people are looking for creative ways to help people lose weight and keep it off," Dr. Hensrud says. "The results of this study show the potential of financial incentives."

Businesses Disapprove of Incentive “Border War” in KC

When an Illinois company, for example, moves to Indiana because of high tax rates or other business climate concerns, most consider that a good thing. When Missouri and Kansas battle over Kansas City area organizations, some businesses view it as wasteful spending on tax incentives. Governing reports:

Seventeen prominent business leaders, including top officials with Hallmark and Sprint Nextel, recently wrote a letter to the governors of Kansas and Missouri, asking them to put an end to the “economic border war.”

“Because of our unique bi-state community, too often these incentives are being used to shuffle existing business back and forth across the state line with no net economic benefit or new jobs to the community as a whole,” the business leaders wrote.

The fact that the business community has come out against this practice hasn’t moved politicians to stop devoting scarce tax dollars to it. Kansas Gov. Sam Brownback denies that his state is “poaching” companies and is unapologetic about seeking new employers wherever they may be found, including just over the border in Missouri.

Sly James, the new mayor of Kansas City, Mo., says it’s time his city makes a move. His predecessor, Mark Funkhouser, was opposed to using tax incentives to lure businesses. (Funkhouser is a Governing contributor.) That opposition, James argues, handed Kansas an advantage. “The days of sitting back and watching it happen are over,” James told reporters at an economic development event. “Mutually assured destruction only works if both sides are armed.”

But some residents agree that their region should be presenting a united front. When a company’s interested in relocating, says Jeff Kaczmarek, the president of the Greater Kansas City Chamber of Commerce, there’s a “well worked out protocol” for banding together. If a company is moving in from Seattle or Denver, there’s no squabbling about which jurisdiction is going to try to lure it. “Everybody agrees that the best approach is a regional approach,” Kaczmarek says.

It’s only when a company is already established in the area that the bidding wars take place, it seems. “Money that goes to bribing some company to move 10 miles across some obsolete political border is money wasted,” says Richard C. Longworth, author of a book about heartland economics in the global era.

It may happen everywhere, but the practice of throwing tax dollars at companies has become so prevalent around Kansas City that it has, in fact, generated some new business. Realtors are benefiting by helping companies find short-term leases, which have become fashionable because businesses know they may be moving in the near future to take advantage of new incentives.

Throw Away Those Prescription Pads!

I’ve written a few stories for BizVoice magazine on electronic medical records during my tenure here at the Chamber. Over the last few years, I’ve asked three different physicians (our longtime doctor moved too far away and the first choice apparently skipped the bedside manner/communicate with your patients class in medical school; thus, three family docs) about their use of EMRs.

The paraphrased responses, in no particular order: not using them and don’t ever plan to; been using for about a year but it’s been a painful transition; and they are the greatest thing in the world. The latter seemed particularly efficient as she zipped off a prescription to the pharmacy while we were wrapping up our conversation.

E-prescribing is the focus of a new national report. According to the Center for Studying Healthy System Change, few doctors were e-prescribing advocates or using the advanced features that are available. The caveat is that the survey represents 2008 use, a year before federal incentives before put into place and prior to additional government emphasis on all things electronic in health care delivery.

Here’s a portion of the study release and link to the full report.

Even when physicians have access to e-prescribing, many do not routinely use the technology, particularly the more advanced features the federal government is promoting with financial incentives, according to a new national study released today by the Center for Studying Health System Change (HSC).

Slightly more than two in five office-based physicians reported that information technology (IT) was available in their practice to write prescriptions in 2008, the year before implementation of federal incentives, according to the study funded by the Robert Wood Johnson Foundation (RWJF). And, among physicians with e-prescribing capabilities, about a quarter used the technology only occasionally or not at all.

The study also found that  fewer than 60 percent of physicians with e-prescribing capability had access to three advanced features included as part of the Medicare and Medicaid incentive programs—identifying potential drug interactions, obtaining formulary information and transmitting prescriptions to pharmacies electronically—and less than a quarter routinely used all three features.

“Adoption of e-prescribing remains low, particularly among the half of all physicians who work in solo or two- to five-physician practices, said study author Joy Grossman, Ph.D., an HSC senior researcher. “And, among physicians with e-prescribing capabilities, many do not use the technology routinely, and even fewer use advanced e-prescribing features routinely.”


Get Employees Back on Track

A recent article by Forbes asks an intriguing question about what motivates employees more – incentives vs. recognition. You can read the entire article for elaboration on each question (below) that companies should ask themselves:

It takes two to tango. These days, however, many chief executive officers worry they may be dancing alone with their employees standing idle on the sidelines. The recession has pummeled employee engagement, and poor employee morale has left CEOs feeling out of step with their workforce. What can you do to get your workers moving again? How do you capture their hearts and give them back the drive to do their very best?

Two tools are often prescribed to CEOs by their human resources experts: incentive programs and recognition programs. Incentive programs are contests usually limited to a specific group within a company, such as sales, in which employees compete to win some prize. By contrast, recognition programs acknowledge and reinforce the accomplishments of the majority of employees. They are more about long-term goals and values.

When and how these two approaches are best used can get confusing. As a CEO who has dealt with incentives and recognition for more than a decade, I offer five questions for you to ask to help you determine which may work best for you.

  1. Is your company morale in a state of emergency?
  2. Do you know what really motivates your employees?
  3. Do you just need to hit a quarterly target or deadline?
  4. Are you trying to motivate your entire workforce or just your star performers?
  5. Are you and your team committed to making employee engagement both an art and a science?

Pay to Learn: Which Side are You On?

Education reform is a good thing. Trying new things when the same old efforts fail generally makes a lot of sense. Innovation to improve student performance and graduation rates is something to applaud — for the most part.

But what about paying students for their accomplishments? Not pizza parties and "no homework for a day" passes, but cell phones and cold, hard cash. Below are two excerpts from a Governing magazine article. It’s an interesting read. Personally, I fall much closer to the second camp and give the programs under way in some big cities "A’s" for intentions and much lower scores for fairness and long-term impact.

“It’s been outstanding for us,” says Laverne Nimmons, the principal of P.S. 335. “The students took to it immediately.” Nimmons sees cash incentives not only as an academic motivator for students but also a ticket out of poverty. “When you get into wealthier, upper-middle class families, you get parents who reward their children for good grades. They pay for after-school programs or private tutors to help improve their grades.” Those are luxuries that Nimmons’ students can’t afford. “These are children in an impoverished community. There are no rewards. With this program, we’re just trying to create a level playing field.”

Opponents of incentives programs, including experts in education and child psychology, say bonus money won’t change students’ study habits in any lasting way. In fact, they argue, the incentives may backfire and hurt student performance in the long run. Others are simply uncomfortable with the social implications of paying some students to learn but not others. “It becomes a condescending situation,” says Heather MacDonald, an author who has written about education for the Manhattan Institute. “I just find it troubling that half of society is paying the other half to do something the first half already knows it should be doing. Who is in the paying class and who is in the paid class? How do you explain to one group of students that they should value education for its own sake while some of their classmates are getting money for the exact same thing?”