Financial incentives alone aren’t enough to drive behavioral change in patients and providers, says this piece in HealthcareDIVE.
Among the observations: “Behavioral economics suggests patients respond more strongly to incentives that are apparent immediately. In this study, incentives were somewhat hidden. For the delayed {insurance} premium adjustment group, the financial benefit wouldn’t be apparent for months. Even for the immediate premium adjustment group, incentives were distributed with regular paychecks. To make a program like this more effective, researchers suggested sending a separate check to participants along with a progress report. The incentive is salient when it is distinct from regular compensation, according to researchers.
“Another principle of behavioral economics suggests individuals react more strongly to incentives when they are framed as losses rather than gains. In a separate CHIBE study, published March 2016 by Annals of Internal Medicine, this theory held up.
“In this study, participants in a workplace wellness program were tasked with walking 7,000 steps per day over a 26-week period. Participants were …divided into four study groups. A control group received no financial incentive, a lottery group that offered a possible prize averaging $1.40 each day the goal was achieved, a gain group that received $1.40 for every day the goal was reached, and a loss group in which participants were given $42 at the start of each month with the catch that they would have to return $1.40 for each day the goal was not reached.
“Results to the study showed that the gain group and the lottery group performed similarly to the control group. Participants in these groups achieved the daily goal around 30% to 35% of the time. Participants in the loss group, on the other hand, achieved the daily goal 45% of the time.”
“The principle of loss aversion applies to providers the same as it applies to patients. Authors of the Annals of Internal Medicine article point to the Massachusetts General Physicians Organization (MGPO) incentive program as an example. This quality improvement program issued advance incentive payments so that it would feel like a loss to not receive the payments in subsequent years. {A}n October 2013 article in Health Affairs asserted the application of loss aversion helped to drive the program’s eventual success.”
“People generally care about how they compare to their peers and providers are no different. For instance, Dean Clinic in Wisconsin found that providers were more likely to change their behavior when monthly performance reports identified physicians within a department compared to when they released anonymous rankings. ”
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