Internal Medicine–Primary Care Program, Massachusetts General Hospital, Boston, USA.
Health Aff (Millwood). 2013 Mar;32(3):497-507. doi: 10.1377/hlthaff.2012.0431.
In September 2011 the Centers for Medicare and Medicaid Services awarded $85 million in grants to ten states to test financial incentive programs to encourage healthy behavior among Medicaid enrollees with chronic diseases. There is little published evidence about the effectiveness of such incentives within the Medicaid program. We evaluated the available research from three earlier Medicaid incentive programs and found mixed results. On the one hand, in Florida only about half of the $41.3 million in available credits was "claimed" by enrollees between 2006 and 2011. On the other, Idaho's incentive program was credited with improving the proportion of children who were up-to-date on well-child visits. Our findings suggest that Medicaid incentive programs should be designed so that enrollees can understand them and so that the incentives are attractive enough to motivate participation. Medicaid incentive programs also should be subject to rigorous evaluation to more clearly establish their effectiveness.
2011 年 9 月，医疗保险和医疗补助服务中心向 10 个州拨款 8500 万美元，以测试财政激励计划，鼓励慢性病医疗补助受助人采取健康行为。关于医疗补助计划中此类激励措施的有效性，相关文献很少。我们评估了之前三个医疗补助激励计划的现有研究，发现结果喜忧参半。一方面，2006 年至 2011 年间，佛罗里达州约有一半的 4130 万美元可用积分被受助人“领取”。另一方面，爱达荷州的激励计划被认为提高了及时接受儿童健康检查的儿童比例。我们的研究结果表明，医疗补助激励计划的设计应使受助人能够理解计划内容，并且激励措施要有足够吸引力来激励参与。此外，还应严格评估医疗补助激励计划，以更清楚地确定其有效性。
