Patient Care Management and Rewards Program
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Aaron E. Henry Community Health Services Center
Mississippi Delta
Diabetes and Cardiovascular Disease Risk Factors
Rural, nonprofit primary health care organization
African Americans |
PROJECT
Patients receive cash incentives for positive health behaviors and health outcomes.
Nurses lead a comprehensive care management program which includes a cash incentive program for uninsured patients suffering from either hypertension or diabetes. The patient-centered program focuses on education and self-management. Patients who show positive health outcomes (weight management, aerobic activity and medication adherence) receive financial incentives. Financial rewards up to $408 are distributed on a quarterly basis for one year.
To promote the maintenance of healthy behaviors, 40 percent of the total reward earned is withheld from the patient until the program is completed.
RATIONALE
A care management program that includes patient-focused incentives has the potential to improve standards of clinical care, while also reducing health care costs. This program incorporates health coaching, care support service delivery and direct financial incentives. Cash incentives for uninsured patients have the potential to promote wellness behaviors and a healthy lifestyle, which in turn may improve clinical outcomes and reduce overall health care costs. Uninsured patients may be particularly responsive to this type of reward system, due to the economic challenges they face.
Furthermore, large financial incentives may be more motivating than small ones. In addition to the financial incentives, patient education information and self-management tools are provided to encourage healthy lifestyle changes such as medication adherence, weight loss and increased physical activity.
EVALUATION PLAN
Funded by Finding Answers in 2009.
Uninsured patients with either diabetes or hypertension are being randomized into either the control group or one of seven intervention groups representing all combinations of incentives for weight loss, exercise and/or medication adherence. Each behavior category group that the patient is placed in has the potential to reward that patient with separate cash incentives: patients placed into multiple behavior change groups have the potential to receive larger incentives than those placed in
fewer groups. The program is lasting for one year. Researchers are examining a variety of health behavior outcomes, including weight loss, physical activity and self-reported medication adherence. Researchers are also tracking blood glucose levels, blood pressure and cholesterol levels. The study is examining whether patients receiving larger incentives show a greater improvement than patients receiving smaller incentives. Researchers are also evaluating the overall cost effectiveness of the program by tracking inpatient and outpatient health care expenditures.
Principal Investigators:
- William L. Booker, MD (Medical Director, Aaron E. Henry Community Health Centers)
- Ashish J. Abraham, MD, MBA, MHSA (Chief Executive Officer, Altruista Health)
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