| Goal of incentive |
Decision timing |
Health status |
Examples |
| Select a high value health plan or provider network |
During open enrollment |
Distribution between the healthy and ill reflecting
underlying enrollee population |
- Premium-tiered health plans.
|
| Select a high value provider |
Varies—usually at the point-of-care |
Patient is usually ill or needing service |
- Point-of-care tiered health plans.
- High-deductible health plans with savings account options.
|
| Select a high value treatment option |
At the point-of-care |
Usually when the patient becomes ill, sometimes before |
- Tiered drug benefits.
- High-deductible health plans with savings account options.
- Consumer incentives for disease management.
- Consumer incentives for preventive care.
|
| Reduce health risks by seeking care |
Ongoing |
Varies—the patient has a high-risk condition |
- Consumer incentives to comply with recommended care (e.g., prenatal care).
|
| Reduce health risk by changing lifestyle |
Ongoing |
Varies—the patient has a lifestyle factor that increases
health risks |
- Consumer incentives to encourage certain health behaviors (e.g., smoking cessation, weight loss).
|