Financial incentives for preventative care
Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).
- This strategy can help residents access health services. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
- Investments in this strategy are SLFRF-eligible as long as they are designed to assist populations or communities disproportionately impacted by COVID-19.
Program overview
Encouraging patients to adopt preventative care: Financial incentives can be used to encourage patients to take preventative care measures to address a range of health issues. They have been shown to increase uptake of preventative care, including cancer screenings, sexually transmitted infection testing, annual physicals, vaccinations, regular prenatal appointments, and early diabetes detection. Preventative care can also include behavioral interventions such as smoking cessation, weight loss, lower blood pressure, and lower cholesterol.
Interventions targeted at vulnerable populations: Preventative care financial incentives are generally directed toward low-income and high-risk patients. Eligibility may include income level, pre-existing diseases or predisposition toward certain diseases, or external risk factors such as homelessness and drug use. Most commonly, financial incentive programs are targeted toward patients relying on public insurance, such as Medicaid. Patients are generally invited to participate in programs by their medical providers, insurers, or community health centers.
Implemented by states: Typically, financial incentive programs are administered at the state level by Departments of Health and Human Services. Funding is sourced from Medicaid or State Children’s Health Insurance Program (CHIP) budgets. State leaders need to establish funds within these public insurance programs for use as incentives. At times, the federal government has also offered grant funding to individual states in order to implement incentive programs for Medicaid beneficiaries.
Flexibility in form of incentive: Depending on the program, incentives can be delivered to patients as gift cards, debit cards, mailed checks, cash, or points to be redeemed from a rewards catalog. Depending on how the program is structured, patients can receive incentives immediately after appointments or after check-ins after regular intervals (e.g., quarterly) for patients who continue to meet the established criteria.
- Strategies
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Increasing access to health care
- Cost per Participant
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Not available
Multiple studies with rigorous designs demonstrate that patient financial incentives for preventative care are a well-supported strategy to increase the uptake of preventative care services.
- This assessment is based on evidence from a 2018 research synthesis.
Use data to identify participants and target outreach efforts: Often, incentive programs are developed for individuals on Medicaid or who have specific medical conditions. In order to identify individuals who are eligible to participate in the program, administrators should utilize available medical data (e.g., Medicaid claims or electronic health records). Partnerships with local Community Health Centers and nonprofit organizations can also help identify eligible participants. This can allow for a more targeted marketing campaign to recruit participants.
Build on existing programs: New incentive interventions are easiest to implement when they build upon existing initiatives, relationships, or contracts. For example, partnering with a local nonprofit organization that has connections to the target population can ease the burden of recruitment. Similarly, partnering with existing Community Health Centers or medical homes that serve eligible patients (e.g., those receiving Medicaid) can reduce start-up costs and time.
Make services accessible: In order for incentive programs to be effectively utilized, preventive care measures must be accessible to the patient population served. As such, programs should connect participants with transportation services, provide reimbursement for public transit costs, identify virtual health care providers, or distribute medical products and incentives through the mail to prevent unnecessary trips.
Ensure culturally appropriate programs for the target population: Incentive programs should be adapted to address community priorities and preferences. For example, if a program is providing incentives in the form of gift cards, it is important for providers to select gift cards that patients will be interested in using. Behavioral interventions should also be designed with a cultural lens, such as ensuring that healthy recipes in a weight loss program include versions of traditional foods in a given culture.