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Financial incentives for patients: preventive care

Evidence Rating

Scientifically Supported

Health Factors

Financial incentives such as payments, vouchers, and tickets for prize drawings can be used to encourage patients to undergo preventive care such as screenings, vaccinations, and other brief interventions. Personal incentive programs are usually offered through the public sector and typically offer incentives to low income individuals ().

Expected Beneficial Outcomes (Rated)

  • Increased preventive care

Other Potential Beneficial Outcomes

  • Increased adherence to treatment

  • Reduced drug and alcohol use

  • Improved prenatal care

Evidence of Effectiveness

There is strong evidence that financial incentives increase preventive care among low income and high-risk populations (). Effects appear strongest for brief, infrequent behaviors such as attending an appointment, and for rewards that are large or delivered soon after the patient completes a target behavior ().

Financial incentives have been shown to improve patients’ participation in vaccination programs, screening for various cancers, and adherence to treatments for tuberculosis and sexually transmitted infections (). Incentives can also reduce drug use in the short-term () and increase prenatal care for pregnant teenagers ().

Impact on Disparities

Likely to decrease disparities

Implementation Examples

The Affordable Care Act authorizes grants to states to provide incentives to Medicaid beneficiaries who participate in prevention programs, adopt healthier behaviors, and improve their health. State programs must help beneficiaries quit using tobacco, lose weight, lower cholesterol or blood pressure, or avoid or manage diabetes (CMS-MIPCD).

Implementation Resources

CMS-MIPCD - Centers for Medicare & Medicaid Services (CMS). Medicaid incentives program for the prevention chronic diseases model.

Citations - Evidence

* Journal subscription may be required for access.

Sutherland 2008* - Sutherland K, Christianson JB, Leatherman S. Impact of targeted financial incentives on personal health behavior: A review of the literature. Medical Care Research and Review. 2008;65(6 Suppl):36S–78S.

Marteau 2009* - Marteau TM, Ashcroft RE, Oliver A. Using financial incentives to achieve healthy behaviour. BMJ. 2009;338:b1415.

Citations - Implementation Examples

* Journal subscription may be required for access.

CMS-MIPCD - Centers for Medicare & Medicaid Services (CMS). Medicaid incentives program for the prevention chronic diseases model.

Date Last Updated

Apr 26, 2013
  • Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
  • Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
  • Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
  • Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
  • Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
  • Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results.