By Jill Brown - October 17, 2012

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Aetna Inc. has an offer for its work force: $300 for each year they stave off obesity.

The insurer has targeted a wellness incentive program for weight management to its 35,000 employees — not an easy group to design health interventions for, according to Nancy Novo Lusignan, benefits manager of employee wellness and work/life programs at Aetna. “That’s 35,000 employees who are all constantly telling us what we should be doing because they’re all experts,” she quipped.

Lusignan reported on the program’s results today at the National Business Group on Health’s 2012 Conference on Health, Productivity, and Human Capital in Washington, D.C.

The program targets metabolic syndrome, which is not a condition but a cluster of five risk factors: elevated blood pressure, glucose and triglyceride levels, larger waist circumference and low levels of HDL (so-called “good”) cholesterol. Metabolic syndrome is present in 60% of people considered to be obese, 22% of those who are overweight and 5% of those at a healthy weight. Each risk factor increases average medical costs by 24%, she said.

Aetna grants a $300 premium credit to each employees, spouse or partner who gets a voluntary screening and demonstrates that he or she is in the healthy range for three of the five areas. There is an “out,” Lusignan added; patients can get a physician’s affidavit if it is medically inadvisable to achieve reductions in one or more of the risk factors.

In 2010, the baseline year, participation was 67%, with 88% of those passing and receiving the premium credit. But in 2011, participation fell to 57.5%, with 90% of those passing. Target glucose levels were achieved by the highest percentage — 95% for both 2010 and 2011 — while waist circumference (of fewer than 40” for men and 35” for women) was passed by the lowest percentage — 62% in 2010 and 66% in 2011.

Lusignan speculates that enrollees who suspected they were out of range did not bother to be tested the second year and said Aetna is working on ways to reach out to them to encourage more screening. Those who are identified as at higher risk are referred to disease management and coaching programs.

What do you think — do intervention programs like this one help enrollees manage their weight? Is it fair to pay people to keep risk factors under control?