Aaron E. Henry Community Health Services Center
Mississippi Delta
Diabetes and Cardiovascular Disease Risk Factors
African American

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.

Summary Results

Offering patient financial incentives in a clinic with a strong care management program failed to improve the incentivized clinical outcomes of weight loss, medication adherence, or physical activity.

Publications

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)