More than half of 2,000 U.S. employers responding to a recent survey are providing incentives to employees who participate in health improvement and wellness programs. According to Aon Hewitt's 2012 Health Care Survey, 59 percent used monetary incentives to promote participation in such programs, compared to only 37 percent in 2011. While the first step is getting employees to participate, many companies are struggling to see actual results. Fifty-eight percent of employers offering initial incentives also offer them for completing lifestyle modification programs.

Besides the obvious humanitarian implications of healthier employees, employers stand to save $700 per employee by impacting three out of eight risks and behaviors which Aon believes directly influence 15 chronic conditions accounting for 80 percent of total costs for all chronic illnesses worldwide. Chronic medical conditions the risks and behaviors lead to include diabetes, back pain, obesity, coronary artery disease, high cholesterol and asthma. These 8 risks and behaviors include:

• Poor diet
• Insufficient sleep
• Poor stress management
• Smoking
• Physical inactivity
• Excessive alcohol consumption.

To change employee behavior, companies also must associate rewards with program outcomes instead of basic enrollment. Employees have to have a sense of accountability after they see the results of health questionnaires and biometric screenings. There is still room to improve. Even though more than 80 percent of employers provide incentives to complete health questionnaires, less than 10 percent use incentives to motivate behavior change.