We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Impact of Financial Incentives on Health Outcomes and Costs of Care among Medicaid Beneficiaries with Diabetes in Hawai'i.
- Authors
Fernandes, Ritabelle; Chinn, Chuan C.; Dongmei Li; Halliday, Timothy; Frankland, Timothy; Ozaki, Rebecca Rude
- Abstract
The Hawai'i Patient Reward And Incentives to Support Empowerment (HIPRAISE) project, part of the Medicaid Incentives for Prevention of Chronic Diseases program of the Affordable Care Act, examined the impact of financial incentives on Medicaid beneficiaries with diabetes. It included an observational pre-post study which was conducted at nine Federally Qualified Health Centers (FQHCs) between 2013 to 2015. The observational study enrolled 2,003 participants. Participants could earn up to $320/year in financial incentives. Primary outcomes were change in hemoglobin A1c, blood pressure, and cholesterol; secondary outcomes included compliance with American Diabetes Association (ADA) standards of diabetes care and cost effectiveness. Generalized estimating equation models were used to assess differences in clinical outcomes and general linear models were utilized to estimate the medical costs per patient/day. Changes in clinical outcomes in the observational study were statistically significant: mean hemoglobin A1c decreased from 8.56% to 8.24% (P < .0001); mean systolic blood pressure decreased from 125.16 to 124.18 mm Hg (P = .0137); mean diastolic blood pressure decreased from 75.54 to 74.78 mm Hg (P = .0005); total cholesterol decreased from 180.77 to 174.21 mg/dl (P < .0001); and low-density lipoprotein decreased from 106.17 to 98.55 mg/dl (P < .0001). Improved ADA compliance was also observed. A key limitation was a reduced sample size due to participant's fluctuating Medicaid eligibility status. HI-PRAISE showed no reduction in total health cost during the project period.
- Subjects
UNITED States; HAWAII; MONETARY incentives; HEALTH outcome assessment; PEOPLE with diabetes; MEDICAID beneficiaries; PREVENTION of chronic diseases; MEDICAL care costs
- Publication
Hawaii Journal of Medicine & Public Health, 2019, Vol 78, Issue 1, p19
- ISSN
2165-8218
- Publication type
Article