According to the 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care, in 2014, 22% of companies adopted outcome-based incentives (other than for tobacco), and that figure is expected to reach 46% by 2015 if companies follow through with their plans. Two-thirds of companies also use financial incentives to encourage participation in wellness activities, and 22% of those companies (especially best performers) design these as penalties. And many employers are putting much greater amounts at stake. On average, employees who complete all available wellness activities can earn nearly $50 per month. Increasingly, employers are embracing wellness as a family issue: Nearly 40% of companies extend wellness incentives to spouses, up from 34% in 2013. At these companies, employees and their spouses together can earn nearly $100 per month for completing all the requirements of the wellness program.