In an earlier posting on “The Challenge of Authentication” (Jan 7, 2008), I noted the importance of authenticating the participation, behavior changes, health improvements, and economic gains achieved by employees in order to make employee health management work better for employers.  The payment of incentives without methods to ensure that employees deserve them would be an open invitation to gaming of the system, and underperforming EHM initiatives.

But authentication is equally important to employees, themselves.  For example, if employees sense that they can gain incentives, or even if it is only other less honest employees who do so, without making the necessary effort, that can reduce their motivation to invest time and effort in achieving real change.  As a result, they will not achieve, or at least achieve less than optimal results for themselves, in terms of personal health and life quality, as the normal “side effects” of improving their health behaviors.

For example, if they do not actually quit smoking, but merely report that they have, in order to gain a few hundred dollars in incentives, they will gain those dollars, but miss the greater financial gains available from not having to buy increasingly expensive tobacco products.  These gains can easily amount to a thousand dollars and more in avoided expenditures, which could be tracked and recorded in their personal EHM record of accomplishments.

Qualifying for incentives without having to achieve actual changes in behavior, health status, or productivity and performance at work will also cheapen the value of the incentives, themselves.  Since the impact of extrinsic incentives tends to diminish with time, from being perceived as a reward for “good behavior” to merely an entitlement, gaining incentives without actually having to work for them will surely reduce their impact even further.

But the worst impact of being able to gain incentives without authentic effort and accomplishment is likely to be that employees who do so will not actually experience any personal gains except for the incentives, themselves.  They will almost automatically have less respect for their employers, who have allowed them, or even their peers, to fool them into paying for nothing.  And they will not experience the personal benefits of better health, or the psychological benefits of achieving actual change.

As is described by Chip Conley in his book PEAK: “How Great Companies Get their Mojo” from Maslow Jossey Bass 2007, employees can be motivated, at least minimally, by motives related to their needs for survival and belonging.  But to engage them at higher levels of productivity and performance, their needs for success, achievement, self-actualization and personal transformation are more powerful.  Emotional competencies  are where the full value of human capital tend to lie, and will not be engaged without employees feeling that they are really accomplishing something for themselves, their family, and even something larger, rather than merely winning a reward.

Gaining rewards without actual behavior and health status changes will also not even gain employees the respect of their peers, except for the grudging respect given to those who successfully cheat.  And it may even diminish the pride their peers gain from real achievement, once all realize that rewards can be won without it.  By contrast, real achievement, authenticated for all to recognize, can gain the respect of others, and is more likely to do so than inauthentic accomplishments.

For firms that still operate in what has been called “theory X” management, where it is believed that employees have to be commanded and controlled, do not really want to work, and have to be “conditioned” by extrinsic cues and rewards in order to do anything, the idea of authentication will fit well.  But it is equally important in theory Y managed organizations, where it is accepted that people are naturally motivated to work, enjoy controlling their own environments and achieving personal goals.

While “transactional” leadership (theory X) is still the dominant mode, in spite of strong and long-established evidence that “transformational” leadership works far better (theory Y), authentication is essential in both, though operates differently in each.  It is the prospect and satisfaction of achieving personal and social, not merely organizational goals that drive employees to invest their best efforts, whether it is in their work responsibilities or EHM.

It is employees’ unique and normally unrecognized personal goals and values that will drive the greatest engagement and effort in EHM.  This includes idiosyncratic aspirations and dreams that employers normally know nothing about, and it is not necessary that they know what they are for individuals.  But if employees are encouraged and enabled to set their own goals, and to track their own progress toward and achievement of these goals, they will gain that much greater a sense of self-esteem, self-confidence, and self-actualization as a result.

Achievement of even social goals can be a source of motivation beyond self-actualization.  Employees who invest in fitness by walking or biking to work will automatically also be contributing to “saving the planet” by reducing vehicle emissions that contribute to global warming.  Some may, if invited, agree to donate some of their employer-paid incentives, or personal savings from such cheap forms of “transportation” to work to causes they deem important, giving both incentives and personal savings another dimension of value.

Such authentic investments and accomplishments can work equally well at the team level, if employees are joined in team efforts and incentive schemes.  Such joint efforts will enlist the added motivations of social/peer pressure and support in promoting effort and achievement, as well as adding the impact of competition to authenticated efforts and achievements.  They can also enable employers to achieve their goals with lower overall incentive payouts, reducing their costs and thereby improving their return on investment.

While extrinsic incentives are often essential or at least helpful in initial stages of EHM strategies and initiatives, they lose impact, or have to be increased over time in order to retain impact.  And they always add to the size of the “costs” denominator or offset to ROI levels.  In contrast, personal and social motivations can continue to be as strong as ever over time, as long as employees know they are making progress toward or maintaining such goals.

Personal and group recognition will only have meaning if it is meaningful to employees, and if they know they deserved it by achieving authentic improvements.  Just as employees can be motivated by a company mission such as “To restore people to full life and health” (Belken pacemaker firm), they can be motivated by personal and social goals where progress toward them through EHM can be authenticated.   If the U.S. Army recruiting slogan “Be All You Can Be” can work to enlist people in an unpopular war, authentication of personal and team progress toward becoming all they can be through EHM should be at least as effective for employees.

In many cases, employers can enable employees to authenticate their own efforts, through devices such as pedometers to track walking or running efforts.  Progress toward weight loss and blood pressure or sugar level reductions can be authenticated by scales or home testing devices.  It has been frequently demonstrated that employees who are able to keep track of their “scores” or effort in some way are significantly more likely to persist in their efforts, so authentication works in that mode as well.

If employers are able to empower employees to authenticate their own effort and progress, as well as monitor both for their own purposes, they should be able to achieve far more, as well as be more confident in their achievements.  While simply believing that progress is being made may be enough in the early implementation of EHM efforts, having authenticated progress, achievement, and value will tend to enable employers and employees, both, to better manage their efforts and investments.