????溫科勒指出，機構內部文化和信任度是健康方案最重要的元素。公司在實施與健康行為有關的獎勵或懲罰措施時必須提供相關的信息、干預和方案，使員工有可能實現健康目標。依據員工個性、健康風險和其他因素所制定的個性化方案獲得成功的可能性更大，但是也更難以管理。

????推高醫保成本并導致疾病風險主要有八種風險，它們包括吸煙、靜態生活方式、不健康飲食、過量飲酒、缺乏預防性檢查、病人不遵醫囑、睡眠不足和不良的壓力管理。溫科勒說，公司應評估員工的最大風險和成本，并從此處著手，而不是同時應付這八種風險。

????然而，不要以為公司會用花花綠綠的手冊和人事講座這種老套的手法來推出新的方案。美國大公司在這方面各顯其能。溫科勒表示：“那些成功促使雇員改變行為方式的公司所采用的是營銷策略，而不是傳統的人事福利溝通?！?/p>

????越來越多的公司采用競賽和游戲等有趣的方式來鼓勵員工實現健康目標。翰威特的研究發現，在接受調查的公司中，22%的企業愿意將健康方案與游戲理念進行結合。

????博斯沃思稱，Keas公司認為懲罰難以改變個人的行為。該公司找到了一種成功的模式，它將有趣的、基于社會性獎勵的方式與游戲、可實現的目標、健康習慣培養以及支持健康目標的小型同事團隊相結合。Keas在佛羅里達州一家醫院開展的一項案例研究顯示，46%的參與者增加了新鮮農產品的攝入量，并加大了運動量；16%的員工降低了壓力水平；30%的員工減掉了一定的體重。

????全球企業挑戰賽同樣超越了金錢獎懲的范疇。在這項賽事中，各公司員工組成的團隊在虛擬環境中進行環球競走比賽。比賽從5月23日開始，前16周是啟動階段，接下來是9個月的后續賽程。挑戰賽總裁兼創始人格蘭?萊斯利表示，“獎金并不能激發人們的責任感，實際上還會產生不利作用。”

????在前幾年的挑戰賽結束時，參賽者的體重平均下降了9.9磅；66%的人表示壓力得到了緩解；在血壓偏高的參賽者中，54%的人把血壓降到了不那么危險的水平。挑戰賽網站上的信息顯示，參與這項賽事的公司包括培生集團（Pearson）、華納兄弟（Warner Brothers）和勞斯萊斯（Rolls Royce）。

????怡安翰威特的調查顯示，絕大部分美國公司（83%）已通過激勵政策來鼓勵員工參與健康計劃。與健康行為有關的獎懲制度預計會越來越多，而且最終會以具體指標為依據。

????考利說：“很多人都會覺得這樣做有點不近人情。而真正不公平的是現在的體制，目前所有參與醫保的人都在承擔不正常肥胖所帶來的醫療保健成本。”（財富中文網）

????譯者：翔

????Culture and level of trust within an organization are the most important elements of a wellness program, according to Winkler. Rewards or penalties around healthy behavior must be give in the context of information, interventions, and programs that make it possible for employees to reach their health goals. Programs that are personalized to the workers' personalities, health risks, and other variables are more likely to be successful -- but are also harder to administer.

????Eight primary risks can drive up health care costs and lead to diseases: smoking, sedentary lifestyle, unhealthy diet, excessive alcohol use, lack of preventive screenings, patient non-compliance, inadequate sleep, and poor stress management. Rather than tackle all eight at once, an employer should assess where the greatest risks and costs exist among their employees and go from there, Winkler says.

????But don't expect the same old glossy brochures and HR-speak as new programs roll out. Organizations are getting creative. "Employers that have had success in connecting with people to change behavior have used marketing tactics as opposed to traditional HR benefits communications," notes Winkler.

????Rather than simply threatening or bribing employees, a growing number of employers are launching competitions and gaming applications that encourage achieving health goals in a fun way. The Hewitt study found that 22% of employers surveyed are interested in incorporating gaming concepts into their wellness programs.

????Keas believes that penalties don't work in changing individuals' behavior, says Bosworth. Rather, the company has found success through a fun and social rewards-based approach that combines games, achievable goals, healthy habit building, and small coworker teams that support health goals. A case study Keas conducted at a Florida hospital found that 46% of employee participants improved their fresh produce intake and exercise, 16% improved their stress level, and 30% lost a modest amount of weight.

????Also going beyond monetary rewards or penalties is the Global Corporate Challenge, in which teams of employees compete in their virtual progress walking around the world, with a 16-week jump-start period beginning May 23 and another nine months of follow-up. "Payment doesn't encourage personal responsibility; it actually compromises it," argues GCC president and founder Glenn Riseley.

????At the end of previous years' challenges, participants lost an average of 9.9 pounds; 66% reported decreased stress; and of those with high-risk blood pressure, 54% had reached low-risk levels. Past participants include Pearson, Warner Brothers, and Rolls Royce, according to the GCC web site.

????The vast majority of American companies, 83% according to Hewitt's survey, already offer incentives for participating in wellness programs. Expect more to expand those rewards and penalties to cover healthy behaviors and eventually to rest on specific results.

????"A lot of people will feel that it's somehow mean to do this," says Cawley. "What's not fair is the current system where everybody else in the health insurance pool is subsidizing the health care costs of the morbidly obese."