Engaging Beneficiaries In Medicaid Programs That Incentivize Health-Promoting Behaviors

• Published in: Health Affairs Vol. 38; no. 3; pp. 431 - 439
• Main Authors: Vulimiri, Madhulika, Bleser, William K., Saunders, Robert S., Madanay, Farrah, Moseley, Connor, McGuire, Hunter F., Ubel, Peter A., McKethan, Aaron, McClellan, Mark, Wong, Charlene A.
• Format: Journal Article
• Language: English
• Published: Chevy Chase The People to People Health Foundation, Inc., Project HOPE 01-03-2019
• Subjects: Addictions; Addictive behaviors; Beneficiaries; Blood pressure; Chronic illnesses; Consumers; Cost control; Diabetes; Disease management; Disease prevention; Gift cards & certificates; Government grants; Government programs; Health behavior; Health care policy; Health education; Health promotion; Immunization; Incentives; Interest groups; Interviews; Medicaid; Monetary incentives; Participation; Personal health; Pregnancy; Prevention; Preventive medicine; Primary care; Program evaluation; Qualitative research; Responsibility; Smoking cessation; Stakeholders; Systematic review; Waivers
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2018.05427

Medicaid programs are increasingly adopting incentive programs to improve health behaviors among beneficiaries. There is limited evidence on what incentives are being offered to Medicaid beneficiaries, how programs are engaging beneficiaries, and how programs are evaluated. In 2017-18 we synthesized available information on these programs and interviewed eighty policy stakeholders to identify the rationale behind key program design decisions and stakeholders' recommendations for beneficiary engagement and program evaluation. Key underlying program rationales included improving the use of preventive services and promoting personal responsibility. Beneficiary engagement strategies emphasized meeting members where they are and offering prizes or services customized for certain groups. Stakeholders recommended collaborating with external evaluators to design and conduct robust evaluations of incentive programs. Finally, stakeholders recommended aligning beneficiary incentives with provider incentives and other payment reforms through the use of common meaningful measures to streamline program evaluation.