Financial Incentives for Medicaid Beneficiaries With Diabetes: Lessons Learned From HI-PRAISE, an Observational Study and Randomized Controlled Trial
| Autor: | Rebecca Rude Ozaki, Robin Arndt, Chuan C Chinn, Dongmei Li, Zi Wang, Timothy J. Halliday, Ritabelle Fernandes, Christina M. B. Wang, Misha Morioka, Timothy B. Frankland |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Health (social science) media_common.quotation_subject Health Status 030209 endocrinology & metabolism Health Promotion Pacific Islands Hawaii law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Financial analysis medicine Diabetes Mellitus Humans 030212 general & internal medicine Praise Empowerment Reimbursement Incentive media_common Randomized Controlled Trials as Topic Motivation Medicaid Public Health Environmental and Occupational Health Middle Aged United States Observational Studies as Topic Incentive Family medicine Pacific islanders Observational study Female Psychology |
| Zdroj: | American journal of health promotion : AJHP. 32(7) |
| ISSN: | 2168-6602 |
| Popis: | Purpose: The Hawaii Patient Reward and Incentives to Support Empowerment (HI-PRAISE) project examined the impact of financial incentives on Medicaid beneficiaries with diabetes. Design: Observational pre–post study and randomized controlled trial (RCT). Setting: Federally qualified health centers (FQHCs) and Hawaii Kaiser Permanente. Participants: The observational study included 2003 Medicaid beneficiaries with diabetes from FQHCs. The RCT included 320 participants from Kaiser Permanente. Intervention: Participants could earn up to $320/year of financial incentives for a minimum of 1 year. Measures: (1) Clinical outcomes of change in hemoglobin A1c (HbA1c), blood pressure, and cholesterol; (2) compliance with American Diabetes Association (ADA) standards of diabetes care; and (3) cost effectiveness. Analysis: Generalized estimating equation models were used to assess differences in clinical outcomes. General linear models were utilized to estimate the medical costs per patient/day. Results: Changes in clinical outcomes in the observational study were statistically significant. Mean HbA1c decreased from 8.56% to 8.24% ( P < .0001) and low-density lipoprotein decreased from 106.17 mg/dL to 98.55 mg/dL ( P < .0001). No significant differences were found between groups in the RCT. Improved ADA compliance was observed. No reduction in total health cost during the project period was demonstrated. Conclusion: The HI-PRAISE found no conclusive evidence that financial incentives had beneficial effect on diabetes clinical outcomes or cost saving measures. |
| Databáze: | OpenAIRE |
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