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Potentially preventable death, disabling injury, and serious illness are very common secondary to work in production agriculture in Nebraska and elsewhere. The traditional approach to farm safety has consisted largely of education designed to prevent traumatic injury. While education is of critical importance, additional incentives may be needed to reduce fatal and non-fatal events to an acceptable level. The Certified Safe Farm concept was developed in collaboration with two Nebraska health insurance companies. The program consists of combining an on-farm safety assessment and occupational health screening with an education program. The incentive to complete this program is to be eligible for a reduction in health insurance premiums, which are a large expense for farmers. A Certified Safe Farm pilot program was established in a northeast Nebraska farm community with no prior occupational heath services for farmers. A local nurse practitioner received agricultural health training and a local farmer was trained to perform the on-farm safety assessments. Eleven farms were enrolled in the program in the first year. While all passed the safety assessment process, a number of important safety problems were identified. Also, a surprising number of current health problems and risk factors for future illness were found. It is hoped that successful participation in the Certified Safe Farms program will be used in the future to offer Nebraska farm families reductions in their health insurance premiums.