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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Patient Financial Incentives for Preventive Care

Approach. Support the use of patient financial incentives for preventive care.

Source. Robert Wood Johnson Foundation's What Works for Health (WWFH) Database

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Overview. Financial incentives such as payments and vouchers are often used to encourage patients to undergo preventive care such as screenings, vaccinations, and other brief interventions.

Evidence. Scientifically Supported. There is strong evidence that financial incentives increase preventive care among low income and high-risk populations (Bradley 2017, Mehrotra 2014, Kane 2004*, Stone 2002*, Briss 2000*, Jepson 2000*, Giuffrida 1997*, Seal 2003*, Slater 2005*). Patients are most likely to attend appointments or receive services such screenings or testing if incentives include reduced out-of-pocket costs, free services (Briss 2000*, Stone 2002*, Jepson 2000*, Slater 2005*), or a large reward (Bradley 2017, Haukoos 2005*, Kane 2004*, Giuffrida 1997*). Read more in theĀ WWFH database report. Read more about WWFH's evidence ratings. (*Links to citations can be accessed through the WWFH database).

Target Audience. Patients.

Outcome. Percent of women, ages 18 through 44, with a preventive medical visit in the past year.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support the use of patient financial incentives for preventive care,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of clinics offering financial incentives for preventive care services.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of clinics offering financial incentives for preventive care services.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of women who report increase in motivation to access preventive care service with financial incentive.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women who report increase in motivation to access preventive care service with financial incentive.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


 

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.