An economic experiment to inform policymakers considering Medicaid expansion shows small cash incentives to low-income people with new health care coverage can promote primary care visits that may significantly reduce costs overall. The study, by Dr. Cathy Bradley, professor of health systems, management and policy at the Colorado School of Public Health shows a potential for cost savings for a very small amount of money.
[Photo: Dr. Cathy Bradley]
“Access to primary care does not necessarily mean a visit will occur,” Dr. Bradley said. “Establishing a primary care relationship with an initial visit helps prevent chronic conditions, avoids hospitalizations and use of emergency departments and provides better care to the patient.”
In a randomized controlled trial with subjects in Virginia living 100 percent below the federal poverty level, researchers studied low-income adults newly covered by a primary care program to determine if a cash incentive could encourage them to make an initial visit to a primary care provider. Among four total participant groups, three were given a baseline survey by telephone and then either $50, $25 or $0 to visit their provider within six months. A control group received no incentive or contact from the researchers.
The findings also suggest that interaction with a healthcare program coordinator who assists low-income enrollees through the system may also encourage primary care visits without further cash incentives.Colorado