Money is a powerful motivator and improving patient adherence is a long-sought goal by the healthcare industry. A University of Pennsylvania Hospital System project to reduce Medicare costs in the long term has received $4.8 million to offer financial incentives for people recovering from a heart attack to take the full course of their medications.
It is part of a remote-monitoring study to improve patient engagement beyond office visits and hospital stays. Dr. David Asch, who applied for the project funding with Dr. Kevin Volpp, both of the Penn Medicine Innovation Center, said: “We want to find new ways to help people stay on track with their care. So many of our health outcomes depend on … what we do when we are at home or at work, and whether we take our medications, exercise and follow healthy diets.”
According to a Penn spokeswoman, this is how it will work:
Patients enrolled in the new study will be assigned a two-digit number (say, 42). Each day, a staff person will randomly select a number between 00 and 99. If 42 comes up and it is a patient’s number, he will receive $50. If a 4 comes up in the first place (e.g., 41, 43, 47) the patient gets $5. If a 2 comes up in the second place (e.g., 02, 72, 92), the patient gets $5. But he will only get these awards if he took his medication the day before. (His medication bottles, received at discharge, will send electronic signals that notify his doctors if he has taken his medication or not).Advertisement
Financial incentives paired with the excitement of winning (or losing) a lottery. Financial incentives have been proven to positively impact adherence in lifestyle choices like losing weight and quitting or reducing smoking. Studies like this show how serious these incentive programs are getting as the components of the Affordable Care Act, like reduced reimbursements for preventable readmissions for certain chronic illnesses, move closer to implementation.
The financial incentives for medication adherence project is one of 81 innovation awards projects developed as part of the Affordable Care Act. This project is expected to save $2.7 million.
Pharmaceutical companies are looking at this area as well. Boston Medical Center is sponsoring a financial incentives for medication adherence study in collaboration with Pfizer and The National Bureau of Economic Research, according to ClinicalTrials.gov. People with diabetes, hypertension and hyperlipidemia will be the focus of the eight-month study, which is scheduled to start this month. Patients will be asked if they want to participate in the study during their regularly scheduled appointment with their primary care physician if they have high blood sugar levels one year after being diagnosed with diabetes.
Patients in one group will get $40 in cash each month when they pick up their medications for diabetes, hypertension and hypercholesterolemia at the pharmacy on time. Patients in a second group will get the $40 when they get their meds on time and will get an additional $100 for each percentage point of decrease in their hemoglobin A1c over the course of the study, according to the website. There will also be a control group.