Cash Incentives Can Encourage Primary Care Visits

A randomized controlled trial experiment published in Health Affairs, “Small Cash Incentives Can Encourage Primary Care Visits By Low-Income People With New Health Care Coverage,” reports small cash incentives to low-income patients with new health care coverage promotes primary care visits, which may result in a reduction of costs overall. Researchers with the Colorado School of Public Health at CU Anschutz found subjects in the $50 and $25 incentive groups were more likely to see a primary care provider (77% and 74%) compared to the $0 group (68%). Only 61% of participants in the control group received care.

To determine if a cash incentive could encourage patients to make an initial visit to a primary care provider, investigators studied low-income subjects in Virginia living 100% below the federal poverty level who were newly covered by a primary care program. Participants were divided into four groups where three groups (1228 participants) were given a baseline survey by telephone and then either $50, $25 or $0 to visit their provider within six months. The control group (414 subjects) did not receive an incentive or contact from the researchers.

Designed to help inform policymakers considering Medicaid expansion, this economic experiment also suggests interactions with a health care program coordinator who can assist low-income enrollees through the system may encourage primary care visits without further cash incentives since more people in the $0 incentive group sought and received care than the unpaid group.