[EQ] Paying the Patient: Improving health using financial incentives

Paying the Patient: Improving health using financial incentives

 

Karen Jochelson UK King’s Fund, December 2007

 

Available online at: http://www.kingsfund.org.uk/publications/other_work_by_our_staff/paying_the.html

PDF: http://www.kingsfund.org.uk/document.rm?id=7298

 

“…..The paper identifies programmes based on positive incentives that reward individuals directly for a desired behaviour or outcome and those based on negative incentives that discipline an individual by withdrawing a reward. It finds that financial incentives are effective in encouraging people to perform clearly defined, time-limited, simple behavioural tasks, such as keeping appointments, and also in encouraging participation in lifestyle programmes, but that the healthier behaviour is not maintained. Financial incentives are not effective when the behaviour change required is complex, for example, giving up smoking….”

 

“…..Internationally, new models of health care are emerging that rely on financial incentives to encourage individuals to become more responsible for their health. PruHealth and Discovery, health insurers based in England and South Africa respectively, offer clients reduced premiums if they participate in health-promoting activities such as exercise or screening programmes. The company believes that its members are healthier, and make fewer health claims as a result. Definity Health, part of the US UnitedHealth Group, rewards members who successfully manage chronic conditions with credits for health care.

 

German social insurance companies reward members who take part in health screening or have a healthy lifestyle, with points redeemable for retail goods, cash or reduced premiums (Schmidt 2007). Incentive schemes are also emerging for the very poor. In the United States, recent changes to insurance and welfare law have led to new Medicaid programmes, which reward participation in health screening or disease management programmes with small financial payments that recipients can use to buy health-related products, and at least one programme offers both the incentive and a threat of reduced health benefits if individuals fail to comply.

 

The idea is that incentives will encourage healthier lifestyles and reduce health care costs (Greene 2007; Rudowitz and Schneider 2006; Silow-Carroll and Alteras 2007). In several Latin American and Caribbean countries, the poorest families receive a ‘co-responsibility’ payment in return for participating in antenatal and child health care programmes and ensuring their children attend school; this has extremely positive results for children’s health outcomes…”

 

 

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