This applied study offers empirical evidence to help employers increase their employees' participation in health risk assessments.

Physical activity provides numerous health benefits, including reducing risk factors that contribute to the leading causes of morbidity and mortality. Many employers offer incentives to employees to motivate engagement in wellness program activities. Two incentive designs to reward employees for achieving step goals were evaluated. This study used a retrospective design and the study population consisted of benefit-eligible employees at American Specialty Health ages 18 to 65 years who completed a health assessment and biometric screening during 2011 (N=396) or 2012 (N=500). A total of 320 employees participated in both years. During 2011, the incentive goal was 500,000 steps per quarter. By comparison, a 3-tier step goal plan was implemented in 2012 (ie, 400,000; 650,000; or 900,000 steps/quarter). The prevalence of participants in the step program was 64.7% in 2011 and 72.8% in 2012. The percentage of employees who reached at least 1 quarterly incentive increased from 36.3% in 2011 to 51.4% in 2012. Average steps/day was higher in 2012 (mean [M]=3573, standard deviation [SD]=3010) compared to the same employees in 2011 (M=2817, SD=2654) (P<.001). The findings suggest that a tiered incentive design may be an effective population approach to engage employees in physical activity. A multitier incentive design offers participants choices for goal setting and may help shape behavior toward what may be perceived as a difficult goal to achieve. (Population Health Management 2016;19:88–94)