Patient-Directed Financial Incentives
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CIGNA Healthcare
Mid-Atlantic
Hypertension
Health Services Company
African Americans, Latinos, Asians |
PROJECT
Patients are offered financial incentives to make an appointment with their doctor.
Patients are sent a letter with hypertension education materials, a wallet-size blood pressure health record, and an offer to receive a $15 gift card if they visit their doctor within the next two months.
A second mailing goes to patients who have not scheduled an appointment within four months of the first mailing. Participating physicians receive a letter introducing the initiative and its goals, educational materials on plain language communication with patients, and a copy of the materials being sent to their patients. The prepaid debit cards are mailed to patients as soon as a claim for the doctor visit is received by the health plan.
RATIONALE
Insured, low-income minority populations may be motivated to visit their physician and improve their hypertension self-management through financial incentives. These incentives may be effective even if the amount is relatively small, especially if the incentives offset barriers to care such as the costs of transportation and childcare. By motivating patients to see their physician, this study may improve both short- and long-term health outcomes. Encouraging patients to make an appointment with their doctor and providing education materials can potentially help convince a patient that he or she has an active and important role in his or her own health. This increased motivation may improve health outcomes by increasing disease self-management behaviors, treatment adherence, and physician-patient communication.
EVALUATION PLAN
Funded by Finding Answers in 2009.
Eligible members with hypertension are being randomized into one of three groups: one receives educational materials only; a second group receives both educational materials and an offer for the $15 incentive; and a third group (a control group) receives their usual care. Blood pressure levels and related measures (including cholesterol levels, body-mass index and medication adherence) are being collected at six- and 12-month follow-up periods. Formative evaluation methods are being used to gain a deeper understanding of the processes through which the incentive programs work or do not work. These evaluations include semi-structured interviews with CIGNA managers and administrators and participating study physicians, as well as focus groups with patient participants and brief patient telephone surveys. These formative evaluations are exploring the feasibility and sustainability of the incentive program on a larger scale.
Principal Investigators:
- Kathryn Pierce, BSN, MBA (Director of Clinical Quality, CIGNA HealthCare)
- Laurie Martin, ScD, MPH (Associate Policy Researcher, RAND Corporation)
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