Christopher Whaley1, Neeraj Sood2,3, Michael Chernew3,4, Leanne Metcalfe5, Ateev Mehrotra4. 1. RAND Corporation, Santa Monica, California, USA. 2. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA. 3. National Bureau of Economic Research, Massachusetts, USA. 4. Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA. 5. Health Science Center, The University of Texas at Tyler, Texas, USA.
Abstract
OBJECTIVE: Many employers have introduced rewards programs as a new benefit design in which employees are paid $25-$500 if they receive care from lower-priced providers. Our goal was to assess the impact of the rewards program on procedure prices and choice of provider and how these outcomes vary by length of exposure to the program and patient population. STUDY SETTING: A total of 87 employers from across the nation with 563,000 employees and dependents who have introduced the rewards program in 2017 and 2018. STUDY DESIGN: Difference-in-difference analysis comparing changes in average prices and market share of lower-priced providers among employers who introduced the reward program to those that did not. DATA COLLECTION METHODS: We used claims data for 3.9 million enrollees of a large health plan. PRINCIPAL FINDINGS: Introduction of the program was associated with a 1.3% reduction in prices during the first year and a 3.7% reduction in the second year of access. Use of the program and price reductions are concentrated among magnetic resonance imaging (MRI) services, for which 30% of patients engaged with the program, 5.6% of patients received an incentive payment in the first year, and 7.8% received an incentive payment in the second year. MRI prices were 3.7% and 6.5% lower in the first and second years, respectively. We did not observe differential impacts related to enrollment in a consumer-directed health plan or the degree of market-level price variation. We also did not observe a change in utilization. CONCLUSIONS: The introduction of financial incentives to reward patients from receiving care from lower-priced providers is associated with modest price reductions, and savings are concentrated among MRI services.
OBJECTIVE: Many employers have introduced rewards programs as a new benefit design in which employees are paid $25-$500 if they receive care from lower-priced providers. Our goal was to assess the impact of the rewards program on procedure prices and choice of provider and how these outcomes vary by length of exposure to the program and patient population. STUDY SETTING: A total of 87 employers from across the nation with 563,000 employees and dependents who have introduced the rewards program in 2017 and 2018. STUDY DESIGN: Difference-in-difference analysis comparing changes in average prices and market share of lower-priced providers among employers who introduced the reward program to those that did not. DATA COLLECTION METHODS: We used claims data for 3.9 million enrollees of a large health plan. PRINCIPAL FINDINGS: Introduction of the program was associated with a 1.3% reduction in prices during the first year and a 3.7% reduction in the second year of access. Use of the program and price reductions are concentrated among magnetic resonance imaging (MRI) services, for which 30% of patients engaged with the program, 5.6% of patients received an incentive payment in the first year, and 7.8% received an incentive payment in the second year. MRI prices were 3.7% and 6.5% lower in the first and second years, respectively. We did not observe differential impacts related to enrollment in a consumer-directed health plan or the degree of market-level price variation. We also did not observe a change in utilization. CONCLUSIONS: The introduction of financial incentives to reward patients from receiving care from lower-priced providers is associated with modest price reductions, and savings are concentrated among MRI services.
Authors: Sunita Desai; Laura A Hatfield; Andrew L Hicks; Anna D Sinaiko; Michael E Chernew; David Cowling; Santosh Gautam; Sze-Jung Wu; Ateev Mehrotra Journal: Health Aff (Millwood) Date: 2017-08-01 Impact factor: 6.301
Authors: Christopher Whaley; Neeraj Sood; Michael Chernew; Leanne Metcalfe; Ateev Mehrotra Journal: Health Serv Res Date: 2021-08-09 Impact factor: 3.734