As someone who has seen firsthand the challenges of closing care gaps at scale from the payer perspective, I’ve turned from a skeptic to a believer in using rewards to close care gaps.
Closing care gaps is one of the most pressing challenges for health plans seeking to improve quality and manage costs. Medication nonadherence alone contributes to 125,000 preventable deaths annually and costs the healthcare system up to $300 billion each year. Add in missed screenings, unmanaged chronic conditions, and social barriers, and the problem grows exponentially.
Traditional engagement tools like wellness apps and remote monitoring often fail to reach members who lack intrinsic motivation or face significant social risk factors. These tools rely on self-directed action, which can feel out of reach for members juggling the demands of chronic illness or systemic challenges.
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Daily rewards: A proven strategy for engagement
Personalized daily rewards programs have emerged as a game-changer, blending advances in AI and behavioral science to close care gaps in a cost-effective and scalable way. By offering tailored incentives for actions like medication adherence, preventive screenings, and chronic condition management, these programs motivate members to take the small daily steps that add up to significant health improvements.
Recent research and case studies have shown plans using personalized rewards programs closed more care gaps compared to those using traditional engagement methods.
Addressing SDOH and long-term ROI
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What sets personalized rewards apart is their ability to address social determinants of health (SDOH). By providing incentives that can be used for essentials like groceries, transportation, or utilities, these programs help remove barriers to care and create a pathway to better health.
The ROI is also undeniable. Research has found significant results in improving outcomes for Medicaid members leveraging reward technology. Members using this type of technology increase medication adherence and incur significantly reduced costs compared to non-participants. Programs like these also reduce costly ER visits and hospitalizations while improving quality metrics such as Star Ratings.
A personal perspective
As someone who once relied on these programs as a health plan CEO, I bring a unique perspective to my role as COO. I understand the skepticism some may have when they first hear about “paying members to engage in their care.” But I’ve seen the results — in lives improved, care gaps closed, and dollars saved.
Conclusion
Personalized daily rewards programs are more than a tool for closing care gaps — they’re a catalyst for change in how health plans engage with their members. By addressing both motivation and social barriers, these programs not only improve health outcomes but also advance equity, strengthen communities, and reduce healthcare costs.
Photo: erhui1979, Getty Images
John Snyder is the Chief Operating Officer (COO) of Wellth, a science-backed and award-winning behavioral change company that helps people create sustainable healthy habits. As COO, he oversees Wellth’s operations, growth strategies and business development.
John has 40+ years of executive leadership experience with both health systems and health plans. Before joining Wellth, he was CEO of Sanford Health Plan (SHP), serving members in rural areas across the Midwest. Under his leadership, SHP strengthened its integrated partnership with the Sanford provider system, becoming an invaluable partner in the organization’s approach to value-based care. Prior to SHP, John was the CEO of Health Alliance Medical Plans in Illinois. Before that, he served as Executive Vice President and System COO for Carle Health System, and as COO for Carle Foundation Hospital for over 22 years.
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