​ Incentives for Medicaid Patients Will Encourage Healthier Habits and Lower Costs

Making incentives available will encourage healthier behavior and thus lower health care costs due to the reduction in chronic disease development. Health care costs have been on the rise due to the increase in poor outcomes of patients with chronic diseases (Blumenthall et al., 2013). Shroeder (2007) states in a lecture, “health is influenced by factors in five domains – genetics, social circumstances, environmental exposures, behavioral patterns, and health care” (p. 1221). Shroeder’s statement helps explain Foraker et al. (2011) study that Medicaid recipients have a higher chance of developing chronic disease and progress into clinical comorbidity and rehospitalization. This position paper will explain the theory behind incentives, present evidence that incentives promote healthy behavior, introduce initiatives that the Centers for Medicare & Medicaid Services (CMS) are implementing through the Medicaid Incentives for the Prevention of Chronic Disease (MIPCD) grant program, and lastly address components of incentive design to encourage greater utilization of incentives.

According to the CMS (n.d.a), Medicaid provides health coverage to pregnant women, parents, seniors and individuals with disabilities where eligibility is based on income, calculated in relation to a percentage of the Federal Poverty Level. Socioeconomic disparity such as low income and low education level is linked to wide range of health problems (Adler & Newman, 2002). Shroeder (2007) suggests “the single greatest opportunity to improve health… lies in personal behavior” (p. 1222).

“Stronger motivational forces are necessary for most people to make a change. This is where incentives come into play” (Hall, 2008, p. 13). People continue unhealthy behavior ...

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...Retrieved from http://innovation.cms.gov/initiatives/MIPCD/MIPCD-The-States-Awarded.html

Foraker, R.E., Rose, K.M., Suchindran, C.M., Chang, P.P., McNeil, A.M., & Rosamond, W.D. (2011). Socioeconomic status, Medicaid coverage, clinical comorbidity and rehospitalization or death following an incident heart failure hospitalization: ARIC cohort (1987-2004). Circulation: Heart Failure (4)3, 308-316. doi: 10.1161/CIRCHEARTFAILURE.110.959031

Greene, J. (2011). Using consumer incentives to increase well-child visits among low-income children. Medical Care Research and Review (68)5, 579-593. doi: 10.1177/1077558711398878

Hall, B. (2008). Health incentives: The science and art of motivating healthy behaviors. Benefits Quarterly (24)2, 12-22.

Shroeder, S.A. (2007). We can do better – Improving the health of the American people. New England Journal of Medicine (357)12, 1221-8.