A long, healthy life seems ample motivation for patients to maintain their health, but that's not always the case. So, hospitals and health plans are testing reward programs similar to those run by sandwich shops and airlines to provide an extra boost of encouragement.
Jersey City Medical Center rewards patients who have chronic conditions with points for attending doctors' appointments, picking up prescriptions and such. Patients exchange the points for gift cards or products, and even score discounts on gym memberships or health options at local restaurants.
Life can get hectic, and the LibertyHealth system hospital wanted a way to keep its customers engaged as part of its accountable care organization, says Susan Walsh, M.D., accountable care organization medical director. "People have very busy lives, and the point system is really just to push health a little bit higher on everybody's day-to-day priority list," she says.
Health plans are testing similar strategies to keep members engaged. UnitedHealth entices its employees to live healthfully by rewarding them points for getting health screenings or hitting biometric targets. Those can be cashed in for premium reductions of up to $1,200 per family the following year, according to a study in Health Affairs. And Humana compensates members with points for everything from donating blood to learning CPR for use in their online "mall."
Key to the approach is tailoring to individuals, whether they're already healthy or slimming down, says Jeff Blunt, spokesman for the HumanaVitality. A health screening, complete with a member's "Vitality Age," provides a starting point.
"It gives them a frame of reference for how healthy they're living and what it actually means in their lives, and it's a wake-up call for a lot of folks," he says.
Such programs have shown early success. Jersey City Medical Center studied 200 patients who had been part of the program for at least one year. In comparing the number of ED visits they had the year before entering the program with the number they experienced in the first 12 months of the program, these patients reduced inappropriate emergency department visits anywhere from 13 to 31 percent, depending on the condition. UnitedHealth showed improvements in all health measures, and a lower growth rate in costs, worth about $107 million compared with industry averages.
But experts caution that reward programs are just a small piece of the puzzle. It's important that hospitals present patients with a mix of both monetary and more "intrinsic" rewards, like trophies or badges, says Chris Delaney, founder and CEO of patient engagement measurement company Insignia Health. Material rewards should be given out intently, so a patient can't fall back into old habits. Plus, hospitals should tie them to outcomes rather than just starting a process.
Rewards effectively steer patients toward healthier lifestyles, but maintaining them requires a richer mix of strategies, says Trissa Torres, M.D., senior vice president of the Institute for Healthcare Improvement. With all the obstacles to wellness, problematic patients need a supportive environment and a health coach to help them stick to a plan, she says.
"We have to find ways to either decrease those barriers or help people overcome them," Torres says. "If an incentive can be something to get you started down the road, then I think it can have a role. But ultimately, I think it's a fairly minor role."