Purpose: To examine wellness programs with financial incentives and their effect on disparities in preventive care.
Design: Financial incentives were introduced by 15 large employers, from 2010 to 2013.
Setting: Fifteen private employers.
Subjects: A total of 299 436 employees and adult dependents.
Measures: Preventive services and participation in financial incentives.
Analysis: Multivariate linear regression.
Results: Disparities in preventive services widened after introduction of financial incentives. Asians were 3% more likely and African Americans were 3% less likely to receive wellness rewards than whites and non-Hispanics, controlling for other factors.
Conclusion: Federal law limits targeting of wellness financial incentives by subgroups; thus, employers should consider outreach and culturally appropriate messaging.
Keywords: employer wellness incentives; health disparities; preventive medicine.