Fewer Care Gaps and Healthier Choices: How Incentive Programs Can Help

By HMS
Oct. 2, 2019

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Financial incentives have been making inroads into the healthcare arena for several years. These programs are popular with health plan members and they often lead to positive results because they motivate individuals to manage chronic diseases more carefully, schedule preventive screenings, participate in well visits, and more.

A recent report published by the Centers for Medicare and Medicaid Services (CMS) highlighted the value of incentives in action:

  • In 2017, teams analyzed Medicaid Incentives for Prevention of Chronic Diseases (MICPD) State Minimum Data Set (MDS). This revealed that program participants used preventive services significantly more when they received a financial incentive to do so. Individuals in diabetes prevention, weight management, and diabetes management programs in Minnesota, Montana, and New York, attended significantly more diabetes prevention program classes when they received an incentive.
  • Medicaid beneficiaries were also surveyed about incentives. Around three quarters strongly agreed that they were happy with the incentives overall, close to three quarters (73%) strongly agreed that the incentives were fair, and over three quarters (78%) indicated that they liked getting incentives for taking good care of their health. In general, respondents felt that incentives positively impacted their health understanding and behaviors.
  • The majority of beneficiaries felt that incentives provided them with several important benefits. They felt encouraged to make lifestyle changes to improve their health, had learned ways to take better care of their health, and had a better understanding of their health issues. They also felt that incentives helped them set goals and then work toward them.

Research has found that the design of incentive programs matter – programs that incorporate behavioral economics principles tend to be more effective. Another important consideration is the methodology which forms the foundation of the incentive program. Many solutions simply send out gift cards or other rewards without insight into member claims.

HMS’ Eliza Solution for Incentives uses a fundamentally different approach. Eliza enables plans to communicate with every member about incentives related to various health-related activities. Eliza’s access to claims data takes incentives to the next level, by identifying members’ propensity to engage in healthy behaviors. This enables health plans to send additional messages to individuals who need extrinsic motivation to “do the right thing.” It’s like using a microphone to speak directly with members.

Incorporating an incentive program into your health plan can make a meaningful difference when closing gaps for quality measures, health risk assessment (HRA) completion, and more. It’s important to remember, however, that not all incentive solutions are created equal. Solutions that leverage claims data and that are integrated into a full member engagement platform are more likely to generate member satisfaction, as well as meaningful outcomes.

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