A new comprehensive landscape analysis of Medicaid health behavior incentive programs gathers together many challenges and potential solutions in the latest issue of Health Affairs. In 2017-2018 the team interviewed 80 key-informant stakeholders and searched the literature.
The most common incentive type offered by programs was gift cards or vouchers, including cash, Visa gift cards, specific venue gift cards, and vouchers for things link gym memberships. Since incentives are typically built on existing infrastructure, evaluations of impact are quite limited.
“Adoption is partly driven by the recognition that health outcomes are often affected more by behavior choices than by health care services.”Vulimiri et al. 2019
- Higher value incentives are usually related to greater behavior change
- Stakeholders want external evaluators, such as local academics or commercial groups, engaged earlier in program design and implementation
- Future studies should measure durability of effect after incentives end to assess sustainability
- Technology infrastructure requires high upfront costs, so long-term cost-effectiveness should be evaluated
This study leaves me wondering: Do physicians need to be incentivized to offer patients incentives for health-promoting behaviors?
Madhulika Vulimiri, William K. Bleser, Robert S. Saunders, Farrah Madanay, Connor Moseley, Hunter F. McGuire, Peter A. Ubel, Aaron McKethan, Mark McClellan, and Charlene A. Wong. Engaging Beneficiaries In Medicaid Programs That Incentivize Health-Promoting Behaviors. Health Affairs. 38, NO. 3 (2019): 431–439. DOI: 10.11377/hlthaff/2018.05427.