The lure of rewards points is strong, as credit card companies will tell you. Use your credit card and points build up to be redeemed for gift cards, reductions on gasoline, even cash. One New Jersey hospital is using a rewards points program in the hopes of more effectively managing chronic disease patients.
Jersey City Medical Center’s Wealth from Health, started in 2012, focuses on patients with 13 chronic conditions. Patients from the hospital can sign up or can be referred by nurses, care managers or social workers to the voluntary program.
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Participants earn reward points by doing things like picking up prescriptions on time or watching Internet programs that engage patients in improving their health. When patients earn enough points, they earn gift cards from online retailers. Community businesses offer discounts if participants order healthier options like a vegetable pizza instead of meat pizza or salad instead of French fries.
“If someone has to pick their kid up from school and their medications are ready, they will get their kid,” said Susan Walsh, Jersey City’s medical director. “If they get 10 points for it, they will leave 15 minutes early to get their medication, and then pick their child up from school.”
Unlike many other wellness programs, Walsh said Jersey City is focusing on chronic disease management instead of working with people who are young and healthy and want to stay that way.
The hospital originally allotted $1.2 million for the rewards program and then quadrupled its funding after the first year. The budget for the program is mainly spent on personnel and incentives.
To date, 500 people have enrolled in the program. Participants decreased their usage of the emergency room anywhere from 13 percent to 31 percent depending upon the disease studied. Walsh said they need “critical mass” to get meaningful measurements of the program’s effectiveness and plan to look at indicators including disease progression, quality of life and compliance with care plans.
While Jersey City Medical Center is still in the early stages of its program and assessing its return on investment, others have had success with similar rewards programs.
Insurer UnitedHealth Group instituted a similar program. In an August Health Affairs article, UnitedHealth shared the impacts of the program after having it in practice for three years.
The Rewards for Health program was created to engage UnitedHealth employees in their own healthcare. Payers, the UnitedHealth authors pointed out, are in a good position to take on this effort because of their ability to use data to understand areas where there is need.
UnitedHealth employees were eligible to earn points by performing activities like undergoing a screening, meeting a biometric target or enrolling in a coaching program. The points could then be turned in for up to $1,200 per family in health premium reductions.
In the first year, 76 percent of employees who signed up earned at least some points. Twenty-seven percent earned the most points possible. During the second year, 82 percent enrolled and 36 percent earned the highest rewards.
The company said it saw results including increases in wellness visits, screenings and eye exams for diabetics, identification of 7,200 people at high-risk for disease, health coaching for 40 percent of people above body mass index targets and 4.5 percent average weight loss for those individuals.
The study also reported that UnitedHealth Group’s employee healthcare costs grew lower than industry averages by approximately $107 million over the three years the program was in place.
On the surface, it seems that rewards programs are effective, but looks may be deceiving, cautioned Ithaca College consumer psychologist Michael McCall.
They can be expensive – he noted that rewards programs in the hotel industry are usually hotels’ most expensive costs after labor – and without proper measurement, organizations don’t really know if they’re achieving what they set out to do.
For instance, can a hospital prove that reduced ER usage is due to its rewards program, or know whether or not the programs are truly incenting customers to be healthier?
Patients might, for example, pick up their medications and get the rewards points for doing so, but may never take the medication, or eat a salad for dinner but follow it up with a huge serving of dessert.
“It may be that people are trying to get the points instead of changing behaviors,” McCall said. “They want to avoid getting people working for rewards instead of for the process they are intending.”