Featured Articles                                                   January 2011, Vol. III, No. 9
More Meaningful Rewards Could Improve Smoking Cessation Rates

Reward programs, known as contingency management, are perceived positively by participants and can increase rates of successful smoking cessation, according to researchers at RTI International. Researchers examined how participant characteristics, perceptions and behavior are influenced by contingency management interventions, which offer rewards such as money or vouchers to participants for successfully quitting smoking.

The researchers found that participants perceive incentives for successfully quitting smoking as motivating, but that smokers' preferences for rewards are varied. They suggest that identifying rewards that are most meaningful to the smoker attempting to quit would help increase the cessation rate. The review also showed that reward programs may lead to greater withdrawal symptoms initially for participants, such as craving for cigarettes. They noted that these symptoms tend to decrease at a greater rate over time compared with non- incentive group participants. The authors suggest that this may occur because contingency management participants are motivated by the reward and thus have greater focus on the symptoms presenting potential challenges to success.

According to the U.S. CDC, while almost half of smokers attempt to quit each year, only about 5 percent are successful. This further indicates the need for tailored, consumer- focused smoking cessation programs, such as those that can be provided using a contingency management approach.

"According to the review, contingency management interventions have the flexibility to adapt to individual preferences and needs, which leads to greater participation and likelihood of successful cessation," said the researchers. "Thus, contingency management provides an important framework for addressing the need for consumer-focused smoking cessation interventions."

Get more information here.

Quotable: Incentivizing Physicians and Patients

"Our members have an incentive program tied to wellness, in which we try to get them to adopt healthy lifestyles. As they do that, they are provided with monetary incentives. We are also looking at programs to incentivize physicians for doing certain things as well. We plan to align those two initiatives so that the physician can be active in supporting the member in acquiring those lifestyle patterns or habits that we hope they will adopt. For example, physicians should prescribe exercise. Data now shows that’s very effective for a physician to actually write a prescription for exercise rather than just mentioning it. The prescription should include how much exercise the person needs to do and which activities they might be able to do — and have that discussion about the benefits to the patient. If we’re incenting the member to increase their exercise, at the same time, we would develop incentives for the PCPs to have those conversations with the individual."
                                        — Dexter Shurney, Vanderbilt University and Medical Center

Learn more about health and wellness incentives.

Interest in Behavior-Changing Financial Incentives Declines in 2010

The overall percentage of people who think getting a financial incentive would be extremely or very useful for choosing a more effective treatment decreased from 61 percent in 2009 to 55 percent in 2010, according to a new report released by the Employee Benefit Research Institute (EBRI). Similarly, the percentage of people who had an interest in using high-quality provider networks that offer lower cost-sharing incentives dropped from 45 percent in 2009 to 42 percent in 2010.

Despite the overall drop, young people, minorities and low-wage workers are still more likely to find financial incentives extremely or very useful, EBRI found. There was no significant difference between women and men and no difference found in education level. Among other findings in the report:

  • Younger individuals were more likely than older ones to report that incentives to choose the most effective treatment would be extremely or very useful. Sixty-two percent of persons under age 45 reported that they would find incentives useful, compared with 52 percent of 45-64 year olds and 41 percent of individuals age 65 and older.

  • Among those who reported that their health status had gotten worse during the past five years, about 18 percent reported that they did not think that a lower cost- sharing incentive to choose more effective treatments would be useful. In contrast, about 9 percent of individuals whose health status had gotten better in the last five years did not think that a lower cost-sharing incentive to choose more effective treatments would be useful.

  • Individuals who reported that they had not experienced an increase in either premiums or cost sharing were more likely than those who had to report that lower cost sharing would not be a useful incentive to choose a more effective treatment. Similarly, those experiencing a cost increase were more likely than those who had not to report that they would be interested in lower cost sharing as it relates to using a limited network of high-quality providers.

    Read the full article here.

Nurse Advice Line Reduces Avoidable ER Use
More than a third of healthcare organizations have launched nurse advice lines to reduce avoidable ER use and direct patients to the most appropriate care venue, according to a July 2010 survey by the Healthcare Intelligence Network. The staffing and operation of Optima Health's nurse advice line is influenced by many factors, explains Patricia Curtis, director of operations, clinical care services for Optima Health. Curtis describes the distinct responsibilities of the LPNs and RNs who staff the advice line as well as the diverse needs of the member populations who call the advice line.

Listen to the podcast here.

New Chart: Top 5 Occasions to Boost Medication Adherence

Medication adherence programs can improve patient care and lower healthcare costs by more effectively managing chronic medication utilization. We wanted to see at which points in care organizations were most heavily focused on improving medication adherence.

Click here to view the chart.

Tying Incentives to Participation

Question: How can an organization create an incentives program that encourages participation?

Response: It traditionally relates to either a monthly or an annual number that individuals will see. It’s usually a premium-based reduction. For the employer, their decision about premiums in any given year is whether or not they really to use the premium in a reduction or the premium to incent participation in their program. Some are overt and some are less overt about the law of large numbers. The fundamentals of health insurance are based on a law of large numbers and that insurance only works if everyone is in the game at a certain level. We know in any given year that those who are healthier and are paying a bit more than they would’ve needed are the ones that are going to offset the costs of the people who are sicker that year and actually didn’t pay as much as they need. That’s how it works. In these premium-adjusted designs, they know that not everyone is going to take advantage of a premium reduction and that in effect the overall premium differential between participants and non-participants can help pay for the costs of the program.

(Dr. Paul Terry, president and CEO of StayWell Health Management.)

Learn more about incentives and participation.

HCH Readers Save 10% on Coaching Resource

In 2010, healthcare reform moved from rhetoric to reality with the passage of the Patient Protection and Affordable Care Act (PPACA). The 2011 Healthcare Benchmarks Yearbook: Metrics, Measurements and Innovations — HIN's second annual compilation of performance benchmarks in key areas of healthcare activity and growth — delivers all-new actionable data compiled in 2010 on nine trend-bending PPACA initiatives. This 425-page resource delivers more than 23,000 data points from 1,000 responding healthcare organizations in an easy-to-use binder format. This resource contains more than 400 graphs and tables documenting adoption, activity and ROI in nine key healthcare areas, frequently drilling down to the perspectives of hospitals, health plans and employers.

HealthCoach Huddle subscribers should use ordering code HCH to purchase this product at a special price!

Get more information on our 2011 Healthcare Benchmarks Yearbook.

2010 Performance Benchmarks in Tobacco Cessation

This white paper summarizes results of the Healthcare Intelligence Network’s second annual Tobacco Cessaton & Prevention e-survey conducted in November 2010, revealing the efforts of 84 healthcare organizations to curb these trends, including program availability, program components and reimbursement trends.

Download complimentary white paper here.

Take HIN's e-survey on Healthcare Case Management in 2011.

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