Financial Incentives for Care Gaps: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 8,042
- 试验地点
- 1
- 主要终点
- Proportion of care gaps closed
研究概览
简要总结
This project seeks to understand how individuals respond to financial incentive programs for wellness care. In a randomized controlled trial among customers with care gaps, the investigators will experimentally compare the impacts of incentives for gap closure (gift cards), information on existing gaps (mailers), and no intervention. The research objectives are to assess how responsive individuals are to incentives for, and to information about, existing care gaps; and to assess spillovers from incentives onto other care. In addition, impacts on downstream utilization will be studied, which may be impacted if financial incentives are effective at increasing wellness visits.
详细描述
Setting and sample:
The study will be conducted among individuals enrolled in an insurance plan offered by an insurance company in the state of Nebraska.
The sample will include a subset of individuals eligible for a program designed to improve delivery of care by incentivizing individuals and their dependents to fill "care gaps" - gaps in recommended care.
Interventions:
The design will entail two overarching interventions for each incentivized care gap: Incentives, and Information Only. In addition, there will be a control that receives neither.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Prevention
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Is a partner organization member in the region of study
- •Has a care gap in one of the six target areas
排除标准
- •Participating in another select high-intensity wellness intervention provided by the partner organization
研究组 & 干预措施
Control: W34
Members receiving the Control intervention for the W34 (3- to 6-year-old well visit) gap will not receive a mailer.
Information only: W34
Members receiving the Information Only intervention for the W34 care gap will receive a mailer informing them of that gap, but not of financial incentives for closing the care gap.
干预措施: Information (Behavioral)
Incentives: W34
Informational W34 mailer and incentive to close gap
干预措施: Financial Incentives (Behavioral)
Incentives: W34
Informational W34 mailer and incentive to close gap
干预措施: Information (Behavioral)
Control: LSC
Members receiving the Control intervention for the LSC (lead screening in children) gap will not receive a mailer.
Information only: LSC
Informational LSC mailer and incentive to close gap
干预措施: Information (Behavioral)
Incentives: LSC
Members receiving the Incentives intervention for the LSC care gap will receive a mailer informing them of the gap and eligibility for a gift card if they close the gap.
干预措施: Financial Incentives (Behavioral)
Incentives: LSC
Members receiving the Incentives intervention for the LSC care gap will receive a mailer informing them of the gap and eligibility for a gift card if they close the gap.
干预措施: Information (Behavioral)
Control: IMA
No mailer for IMA (immunizations) gap
Information only: IMA
Informational IMA mailer
干预措施: Information (Behavioral)
Incentives: IMA
Informational IMA mailer and incentive
干预措施: Financial Incentives (Behavioral)
Incentives: IMA
Informational IMA mailer and incentive
干预措施: Information (Behavioral)
Control: CDC
No mailer for CDC (clinical diabetes care) gap
Information only: CDC
Informational CDC mailer
干预措施: Information (Behavioral)
Incentives: CDC
Informational CDC mailer and incentive
干预措施: Financial Incentives (Behavioral)
Incentives: CDC
Informational CDC mailer and incentive
干预措施: Information (Behavioral)
Control: CCS
No mailer for CCS (cervical cancer screening)
Information only: CCS
Informational CCS mailer
干预措施: Information (Behavioral)
Incentives: CCS
Informational CCS mailer and incentive
干预措施: Financial Incentives (Behavioral)
Incentives: CCS
Informational CCS mailer and incentive
干预措施: Information (Behavioral)
Control: AWC
No mailer for AWC (adolescent well-care visit) gap
Information only: AWC
Informational AWC mailer
干预措施: Information (Behavioral)
Incentives: AWC
Informational AWC mailer and incentive
干预措施: Financial Incentives (Behavioral)
Incentives: AWC
Informational AWC mailer and incentive
干预措施: Information (Behavioral)
结局指标
主要结局
Proportion of care gaps closed
时间窗: 18 months, from the date of randomization until December 31, 2019
Care gap closure for all care gaps. A care gap is considered closed for an individual or dependent who had not received recommended care (i.e. who had a care gap) at the time of enrollment at the time they receive the recommended care. For example, if a dependent child has not received lead screening (LSC) at the time of enrollment, the LSC care gap is considered closed once the child receives a lead screening.
Proportion of care gaps closed
时间窗: 6 months, from the date of randomization until end-of-year (i.e., December 31, 2018)
Care gap closure for all care gaps. A care gap is considered closed for an individual or dependent who had not received recommended care (i.e. who had a care gap) at the time of enrollment at the time they receive the recommended care. For example, if a dependent child has not received lead screening (LSC) at the time of enrollment, the LSC care gap is considered closed once the child receives a lead screening.
次要结局
- Health care expenditure during study - Total claims(6 months, from the date of randomization until end-of-year)
- Health care expenditure following study - Total claims(12 months, from December 31 2018 - December 31 2019)
- Outpatient visits during study(6 months, from the date of randomization until end-of-year)
- Prescriptions during study(6 months, from the date of randomization until end-of-year)
- Outpatient visits following study(12 months, from December 31 2018 - December 31 2019)
- Inpatient visits during study(6 months, from the date of randomization until end-of-year)
- Inpatient visits following study(12 months, from December 31 2018 - December 31 2019)
- Prescriptions following study(12 months, from December 31 2018 - December 31 2019)