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Home / News & IndustryManaged Care Insight and Analysis
Updated: June 3, 2008
AHRQ Releases Consumer Financial Incentives Guide For Employers

The Agency for Healthcare Research and Quality released a new guide to help employers, private health plans, the federal government and state Medicaid agencies as they consider consumer financial incentives as part of a strategy to improve the quality of healthcare and get better value for what they spend on services.

Consumer financial incentives are either a reward offered to influence patients to behave in a particular way, or, less often, a penalty for failing to do so. By using financial incentives, healthcare purchasers hope to encourage patients to take actions that either may improve the results of their treatment – such as selecting a high-quality physician, reducing or eliminating high-risk behaviors and using preventive services – or may reduce costs by eliminating unnecessary emergency room visits and decreasing preventable hospitalizations.

Using incentives to promote better value in healthcare is one of the four cornerstones of the Department of Health and Human Services’ Value-Driven Care Initiative, which has a goal of providing consumers with the information necessary, and the incentive, to choose healthcare providers based on value.

The decision guide was developed by a team of researchers led by Dr. R. Adams Dudley, an associate professor with the Institute for Health Policy Studies at the University of California, San Francisco, in partnership with representatives of the purchaser and consumer communities.

Dudley said, "A number of strategies to improve quality – public report cards and provider incentives in addition to consumer financial incentives – all start with performance measurement. To the extent that measures are aligned across these strategies, they can reinforce each other."

The decision guide consists of an evidence summary organized around a series of 21 questions that purchasers need to consider when implementing consumer financial incentives. They span incentive design and implementation decisions.

The guide reviews the application of incentives to five types of consumer decisions, including selecting a high-value provider, selecting a high-value health plan, deciding among treatment options, reducing health risks by seeking preventive care, and reducing health risks by decreasing or eliminating high-risk behavior.

In addition to a summary of the evidence base, the guide includes examples of consumer financial incentives currently being offered, criteria for selecting performance measures, elements to enable patients to participate in medical decision making and in managing their chronic diseases, and characteristics that increase the likelihood that a consumer will respond to financial incentives.

Address: Agency for Healthcare Research and Quality, 540 Gaither Rd., Suite 2000, Rockville, MD 20850; (301) 427-1364, www.ahrq.gov.


  This article was taken from:
The Executive Report on Managed Care

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