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Want Medication Compliance? Reward Your Patients

By John Commins  
   April 25, 2018

An Express Scripts survey finds a strong majority of people with chronic diseases want some sort of reward for staying on their medications.

Apparently, the prospect of improved health is not motivation enough to keep some people on their medications regimens.

A new survey from Express Scripts finds that strong majorities of people with chronic diseases want a reward for taking their medications.

Two-thirds of the 800 chronically ill adults polled say they are more likely to take better care of their health and adhere to their medications when rewarded for their efforts. Those numbers vaulted to 88% for adults ages 18 - 34.

By some estimates, medication noncompliance costs about $300 billion each year in the form of increased downriver care costs, such as complications that require emergency department visits.

Given the potential savings and improved healthcare outcomes, and the popularity of rewards programs with patients, the idea is being vigorously pursued by Express Scripts, says Kyle Amelung, a senior clinical consultant with the company.  

"We have seen this in healthcare in a number of different areas, particularly in wellness programs that incentivize people to stop smoking or exercise or be mindful of their health," Amelung says.

"We are taking it a step further," he says. "We want to reward people with chronic conditions for becoming more health literate. We want to reward them for tracking biometrics like blood pressure and blood glucose, and we want to reward them for sticking on their medication."

Personal financial rewards were cited as the overwhelming preference by 82% of respondents while charitable contributions were chosen by 3%.

"Behavioral science has shown us that incentives are the one thing that can increase this behavior," Amelung says. "Even if you showcase the possible negative outcomes that can occur from non-adherence, most people just aren't incentivized to take care of their health for one reason or another."  

While he didn't provide specific numbers, Amelung says the rewards program, which is subsidized by fees charged to providers, is generating about $2 in savings for every $1 spent, a ratio they hope to improve upon.

Amelung says Express Scripts hasn't found a one-size-fits-all "silver bullet" approach to medication adherence, but a rewards program they've launched through its Mango Health app shows potential.

"About 80% of U.S. adults use a smart phone, so if we can use that to encouraged improved clinical behavior, and that is a win-win for everybody," Amelung says.

The app asks patients to report daily on key metrics, such as blood pressure or blood glucose, and in exchange they build up rewards points. Each week, there's a raffle with gift cards at retailers such as Starbucks, Amazon, and Whole Foods.

"This encourages people to go in there every day, state what their biometrics are, how adherent they are to their medications, and they can win these gift cards that are applicable to their daily lives," Amelung says.

While 60% of the patients who access Mango Health are aged 50 or older, Amelung says the app – and the rewards -- are particularly popular with younger adults.

"This younger generation has been on cell phones pretty much their entire lives and they understand the rewards that can come through them and how the technology can help them live a healthier lifestyle," he says.

John Commins is a senior editor at HealthLeaders.


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