Skip Navigation U.S. Department of Health and Human Services www.hhs.gov
Agency for Healthcare Research Quality www.ahrq.gov
www.ahrq.gov

Consumer Financial Incentives: A Decision Guide for Purchasers

Final Contract Report (continued)

References

1. Wharam JF, Landon BE, Galbraith AA, et al. Emergency department use and subsequent hospitalizations among members of a high-deductible health plan. JAMA 2007;297(10):1093-102.

2. Kaiser Family Foundation. Prescription drug trends fact sheet; June 2006 Update. Available at: http://www.kff.org/rxdrugs/3057.cfm. Accessed April 30, 2007.

3. Personal communication with Mark Cauthen, Risk Supervisor, City of Colorado Springs; June 11, 2007.

4. Jin GZ, Sorensen AT. Information and consumer choice: the value of publicized health plan ratings. J Health Econ 2006;25(2):248-75

5. Mukamel DB, Weimer DL, Zwanziger J, et al Quality report cards, selection of cardiac surgeons, and racial disparities: a study of the publication of the New York State cardiac surgery reports. Inquiry 2004;41(4):435-46.

6. Beaulieu ND. Quality information and consumer health plan choices. J Health Econ 2002;21(1):43-63.

7. Scanlon DP, Chernew ME, McLaughlin, Solon G. The impact of health plan report cards on managed care enrollment. J Health Econ 2002;21(1):19-41.

8. Wedig GJ, Tai-Seale M. The effect of report cards on consumer choice in the health insurance market, J Health Econ 2002;21(6):1031-48.

9. Chernew M, Scanlon DP. Health plan report cards and insurance choice. Inquiry 1998;35(1):9-22.

10. Dafny L, Dranove D. Do report cards tell people anything they don't already know? The case of Medicare HMOs. NBER Working Paper 2004;1142

11. Chernew ME, Gowrisankaran G, Scanlon DP. Learning and the value of information: evidence from health plan report cards. NBER Working Paper 2001 Nov;8589.

12. Dranove D, Kessler D, McClellan M, Satterthwaite M. Is more information better? The effects of “report cards” on health care providers. J Political Econ 2003;111:555-88.

13. Arora R, Singer J, Arora A. Influence of key variables on the patients' choice of a physician. Qual Manag Health Care 2004;13(3):166-73.

14. Cutler DM, Huckman RS, Landrum MB. The role of information in medical markets: an analysis of publicly reported outcomes in cardiac surgery. Am Econ Rev 2004;94(2):342-6.

15. McNamara P. Provider-specific report cards: a tool for health sector accountability in developing countries. Health Policy Plan 2006;21(2):101-9.

16. Hibbard JH, Peters E. Supporting informed consumer health care decisions: data presentation approaches that facilitate the use of information in choice. Annu Rev Public Health 2003;24:413-33.

17. Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Aff 2005;24(4):1150-60.

18 Newhouse JP. Consumer-directed health plans and the RAND Health Insurance Experiment. Health Aff 2004;23(6):107-13.

19. Keeler EB, Brook RH, Goldberg GA, et al. How free care reduced hypertension in the health insurance experiment. JAMA 1985;254(14):1926-31.

20. Brook RH, Ware JE Jr, Rogers WH, et al. Does free care improve adults' health? Results from a randomized controlled trial. N Engl J Med 1983;309(23):1426-34.

21. Bozic KJ, Smith AR, Hariri S, et al. The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics. Clin Orthop Relat Res 2007;458:202-19.

22. Dumbleton JH, Manley MT. Metal-on-metal total hip replacement: what does the literature say? J Arthroplasty 2005;20(2):174-88.

23. Learmonth ID. Total hip replacement and the law of diminishing returns. J Bone Joint Surg Am 2006;88(7):1664-73.

24. Bozic KJ, Morshed S, Silverstein MD, et al. Use of cost-effectiveness analysis to evaluate new technologies in orthopaedics. The case of alternative bearing surfaces in total hip arthroplasty. J Bone Joint Surg Am 2006;88(4):706-14.

25. Mendenhall S. Hip and knee implant review. Orthop Net News 2007 Jan;1-16.

26. Rowe J, Robinson JC. Consumer-directed health insurance: the next generation. Interview by James C. Robinson. Health Aff 2005;Supplement Web Exclusives:W5-583-90.

27. Kane RL, Johnson PE, Town RJ, Butler M. Economic incentives for preventive care. Rockville, MD: Agency for Healthcare Research and Quality; August 2004. Evidence Report/Technology Assessment 101. AHRQ Publication No. 04-0024-2.

28. Cranor CW, Bunting BA, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc 2003;43(2):173-84.

29. Hey K, Perera R. Competitions and incentives for smoking cessation. Cochrane Database Syst Rev 2005;2:CD004307. DOI: 10.1002/14651858.DC004307.pub2.

30. Guiffrida A, Torgerson D. Should we pay the patient? Review of financial incentives to enhance patient compliance. Br Med J 1997;20:703-5.

31. Klesges RC, Glasgow RE, Klesges LM, et al. Competition and relapse prevention training in worksite smoking modification. Health Educ Res 1987;2(1):5-14.

32. Koffman DM, Lee JW, Hopp JW, Emont SL. The impact of including incentives and competition in a workplace smoking cessation program on quit rates. Am J Health Prom 1998;13(2):105-11.

33. Windsor RA, Lowe JB, Bartlett, EE. The effectiveness of a worksite self-help smoking cessation program: a randomized trial. J Behav Med 1988;11(4):407-21.

34. Donatelle RJ, Prow SL, Champeau D, Hudson D. Randomised controlled trial using social support and financial incentives for high risk pregnant smokers: Significant Other Support (SOS) program. Tob Control 2000;9(Suppl III):iii67-iii69.

35. Emont SL, Cummings KM. Using a low-cost, prize-drawing incentive to improve a recruitment rate at a work-site smoking cessation clinic. J Occup Med 1992;34(8):771-4.

36. Gottlieb NH, Nelson A. A systematic effort to reduce smoking at the workplace. Health Educ Q 1990;17(1):99-118.

37. Jeffery RW, Forster JL, French SA, et al. The Healthy Worker Project: a work-site intervention for weight control and smoking cessation. Am J Pub Health 1993;83(3):395-402.

38. Stitzer ML, Bigelow GE. Contingent payment for carbon monoxide reduction: effects of pay amount. Behav Ther 1983;14:647-56.

39. Follick MJ, Fowler JL, Brown RA. Attrition in worksite weight-loss interventions: the effects of an incentive procedure. J Consult Clin Psychol 1984;52(1):139-40.

40. Wing RR, Jeffery RW, Pronk N, Hellerstedt WL. Effects of a personal trainer and financial incentives on exercise adherence in overweight women in a behavioral weight loss program. Obes Res 1996;4(5):457-62.

41. Dey P, Foy R, Woodman M, Fullard B, Gibbs A. Should smoking cessation cost a packet? A pilot randomized controlled trial of the cost-effectiveness of distributing nicotine therapy free of charge. Br J Gen Pract 1999;49(439):127-8

42. Hughes JR, Wadland WC, Fenwick JW, et al. Effect of cost on the self-administration and efficacy of nicotine gum: a preliminary study. Prev Med 1991;20(4):486-96.

43. Jeffery RW, Forster JL, Baxter JE, et al. An empirical evaluation of the effectiveness of tangible incentives in increasing participation and behavior change in a worksite health promotion program. Am J H Promot 1993;8(2):98-100.

44. Fisher E, Wennberg D, Stukel T, et al. The implications of regional variations in medicare spending. Part 2: Health outcomes and satisfaction with care. Ann Intern Med 2003;138(4):289-321.

45. Promoting consumerism through responsible health care benefit design. Washington, DC: National Business Coalition on Health; 2006.

46. UnitedHealth premium designation program; summary of methodology. Minnetonka, MN; 2007.

47. Robinow, A. Consumer incentives; strong examples in action: patient choice health care. Presented at the National Business Coalition on Health/Leapfrog Group/Bridges to Excellence meeting, advancing Value-Driven Health Care: The Third Annual Incentives and Rewards Symposium. Philadelphia, PA: Buyers Health Care Action Group; 2007 May 15.

48. Briesacher B, Kamal-Bahl, Hochberg M, Orwig D, Kahler KH. Three-tiered-copayment drug coverage and use of noonsterodial anti-inflmammatory drugs. Archives of Internal Medicine. 2004; 164:1679-84.

49. Huskamp HA, Deverka PA, Epstein AM, et al. The effect of incentive-based formularies on prescription-drug utilization and spending. N Engl J Med 2003;349(23):2224-32.

50. Huskamp HA, Dverka PA, Epstein AM, et al. Impact of 3-tier formularies on drug treatment of attention-deficit/hyperactivity disorder in children. Arch Gen Psychiatry 2005;62:435-41.

51. Joyce GF, Escarce JJ, Solomon MD, Goldman DP. Employer drug benefit plans and spending on prescription drugs. JAMA 2002:288(14):1733-9.

52. Kamal-Bahl S, Briesacher B. How do incentive-based formularies influence drug selection and spending for hypertension. Health Aff 2004:23(1):227-36.

53. Schneeweiss S, Walker AM, Glynn RJ, et al. Outcomes of reference pricing for angiotensin-converting-enzyme inhibitors. N Engl J Med 2002:346(11):822-9.

54. Schneeweiss S, Soumerai SB, Maclure M, et al. Clinical and economic consequences of reference pricing for dihydropyridine calcium channel blockers. Clin Pharmacol Ther 2003;74(4):388-400.

55. Adams AS, Soumerai SB, Ross-Degnan D. Use of antihypertensive drugs by Medicare enrollees: does type of drug coverage matter? Health Aff 2001;20(1):276-86.

56. Goldman DP, Joyce GF, Escarce JJ, et al. Pharmacy benefits and the use of drugs by the chronically ill. JAMA 2004;291:2344-50.

57. Piette JD, Heisler M, Wagner TH. Cost-related medication underuse among chronically ill adults: the treatments people forgo, how often, and who is at risk. Am J Pub Health 2004;94(10):1782-7.

58. Tseng C, Brook RH, Keeler E, et al. Cost-lowering strategies used by Medicare beneficiaries who exceed drug benefit caps and have a gap in drug coverage. JAMA 2004;292:952-60.

59. Federman AD, Adams AS, Ross-Degnan D, et al. Supplemental insurance and use of effective cardiovascular drugs among elderly Medicare beneficiaries with coronary heart disease. JAMA 2001;286:1732-9.

60. Gibson TB, Mark TL, McGuigan KA, et al. The effects of prescription drug copayments on statin adherence. Am J Manag Care 2006;12:509-17.

61. Dormuth CR, Glynn RJ, Neumann P, et al. Impact of two sequential drug cost-sharing policies on the use of inhaled medications in older patients with chronic obstructive pulmonary disease or asthma. Clin Ther 2006;28:964-78.

62. Piette JD, Heisler M, Wagner TH. Problems paying out-of-pocket medication costs among older adults with diabetes. Diabetes Care 2004;27:384-91.

63. Piette JD, Wagner TH, Potter MB, Schillinger D. Health insurance status, cost-related medication underuse, and outcomes among diabetes patients in three systems of care. Med Care 2004;42:102-9.

64. Gibson TB, Ozminkowski RJ, Goetzel RZ. The effects of prescription drug cost sharing: a review of the evidence. Am J Manag Care 2005;11(11):730-40.

65. Mojtabai R, Olfson M. Medication costs, adherence and health outcomes among Medicare beneficiaries. Health Aff 2003;22(4):220-9.

66. Tamblyn R, Laprise R, Hanley JA, et al. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA 2001;285(4):421-9.

67. Heisler M, Langa KM, Eby EL, et al. The health effects of restricting prescription medication use because of cost. Med Care 2004;42(7):623-5.

68. Dudley, RA, Rosenthal, MB. Pay for performance: a decision guide for purchasers. Rockville, MD: Agency for Healthcare Research and Quality; 2006. AHRQ Publication No. 06-0047. Available at: http://www.ahrq.gov/qual/p4pguide.htm. Accessed October 3, 2007.

69. Rosenthal MB, Dudley RA. Pay-for-performance: will the latest payment trend improve care? JAMA 2007;297(7):740-4.

70. McGlynn EA. Identifying, Categorizing, and evaluating healthcare efficiency measures. Prepared for the Agency for Healthcare Research and Quality, Rockville, MD, under Contract 282-00-0005, Task Order 21; 2007.

71. Kennedy J, Coyne J, Sclar D. Drug affordability and prescription noncompliance in the United States: 1997-2002. Clin Ther 2004;26(4):607-14.

72. Safran DG, Neuman P, Schoen C, et al. Prescription drug coverage and seniors: findings from a 2003 national survey. Health Aff 2005;Web exclusive W5:152-66.

73. Soumerai SB, Pierre-Jacques M, Zhang F, et al. Cost-related medication nonadherence among elderly and disabled Medicare beneficiaries : a national survey 1 year before the Medicare drug benefit. Arch Intern Med 2006;166(17):1829-35.

74. Wilson IB, Rogers WH, Chang H, Safran DG. Cost-related skipping of medications and other treatments among Medicare beneficiaries between 1998 and 2000. Results of a national study. J Gen Intern Med 2005;20(80):715-20.

75. Mojtabai R, Olfson M. Medication costs, adherence and health outcomes among Medicare beneficiaries. Health Aff 2003;22(4):220-9.

76. Kennedy J, Morgan S. A cross-national study of prescription non-adherence due to cost: data from the joint Canada-United States survey of health. Clin Ther 2006;28:1217-24.

77. Piette JD, Heisler M. The relationship between older adults' knowledge of their drug coverage and medication cost problems. J Am Geriatr Soc 2005;54:91-6.

78. Bann CM, Berkman N, Kuo TM. Insurance knowledge and decision-making practices among Medicare beneficiaries and their caregivers. Med Care 2004;42:1091-9.

79. McCall N, Rice T, Sangl J. Consumer knowledge of Medicare and supplemental health insurance benefits. Health Serv Res 1986:20:633-57.

80. McCormack LA, Uhrig JD. How does beneficiary knowledge of the Medicare program vary by type of insurance. Med Care 2003;41:972-8.

81. Garnick DW, Hendricks AM, Thorpe KE, et al. How well do Americans understand their health coverage? Health Aff 1993;12(3):204-12.

82. Marquis MS. Consumers' knowledge about their health insurance coverage. Health Care Financ Rev 1983;5(1):65-79.

83. Hibbard JH, Jewett JJ, Engelmann S, Tusler M. Can Medicare beneficiaries make informed choices? Health Aff 1998;17:181-93.

84. Uhrig JD, Bann CM, McCormack LA, Rudolph N. Beneficiary knowledge of original Medicare and Medicare managed care. Med Care 2006;44(11) :1020-9 .

85. Meredith LS, Humphrey N, Orlando M, Camp P. Knowledge of health care benefits among patients with depression. Med Care 2002;40:338-46.

86. Shrank WH, Fox SA, Kirk A, et al. The effect of pharmacy benefit design on patient-physician communication about cost. J Gen Intern Med 2006;21:334-9.

87. Alexander GC, Casalino LP, Tseng C, et al. Barriers to patient physician communication about out-of-pocket costs. J Gen Intern Med 2004;19:856-60.

88. Sofaer S, Kreling B, Kenney E, et al. Family members and friends who help beneficiaries make health decisions. Health Care Financ Rev 2001:23:105-21.

89. Cihak J. When you're 64; what consumers don't know about Medicare. Issue Brief. Oakland, CA: California Health Care Foundation; 2006. Available at: http://www.chcf.org/documents/insurance/WhenYoure64MedicareIssueBrief.pdf. Accessed October 3, 2007.

90. Public opinion on Medicare Part D - the Medicare prescription drug benefit. Kaiser Public Opinion Spotlight. Washington, DC: Kaiser Family Foundation; 2006. Available at: http://www.kff.org/spotlight/medicarerx/index.cfm. Accessed October 3, 2007.

91. O'Connor AM, Legare F, Stacey, D. Risk communication in practice: the contribution of decision aids. Br Med J 2003;327(7417):736-40.

92. Hibbard, JH, Peters, E. Supporting informed consumer health care decisions: data presentation approaches that facilitate the use of information in choice. Annu Rev Pub Health 2003;24:413-33.

93. Fraenkel L, McGraw, S. What are the essential elements to enable patient participation in medical decision making? J Gen Intern Med 2007;22(5):614-9.

94. DeMonaco HJ, von Hippel E. Reducing medical costs and improving quality via self-management tools. PLoS Med 4(4): e104; Available at http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040104&ct=1. Accessed October 3, 2007.

95. Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econometrica 1979;XLVII:263-91.

96. Personal communication with Elizabeth H. McNamee, St. Luke's Health Initiatives, Phoenix, AZ; May 9, 2007.

97. Navigator™ by Tufts Health Plan Benefit Summary. Watertown, MA: Commonwealth of Massachusetts, Group Insurance Commission; 2007 March. Available at: http://www.tuftshealthplan.com/pdf/GIC%20Benefit%20Summary_0307_final.pdf. Accessed on October 11, 2007.

98. Hibbard JH, Stockard J, Tusler M. Does publicizing hospital performance stimulate quality improvement efforts? Health Aff 2003;22(2):84-94.

99. Mehrotra A, Grier SA, Dudley RA. The relationship between health plan advertising and market incentives: evidence of risk selective behavior. Health Aff 2006;25(3):759-65.

100. Dudley RA, Frolich A, Robinowitz DL, et al. Strategies to support quality-based purchasing: a review of the evidence. Rockville, MD: Agency for Healthcare Research and Quality; 2004. Technical Review 10. AHRQ Publication No. 04-0057.

101. de Brantes F. Best practices and lessons learned in provider rewards: evidence to date. Presented at the National Business Coalition on Health/Leapfrog Group Bridges to Excellence meeting, Advancing Value-Driven Healthcare. Philadelphia, PA; 2007 May 15.

102. Shaller D, Sofaer S, Findlay SD, et al. Consumers and quality-driven health care: a call to action. Health Aff 2003;22(2):95-101.

103. Robinson JC. Theory and practice in the design of physician payment incentives. Milbank Q 2001;79(2):149-77.

104. Sofaer S, Firminger K. Patient perceptions of the quality of health services. Annu Rev Pub Health 2005;26:513-59.

105. Hibbard JH, Sofaer S, Jewett JJ. Condition-specific performance information: assessing salience, comprehension, and approaches for communicating quality. Health Care Financ Rev 1996;18(1):95-109.

106. Barry MJ, Fowler FJ Jr, Mulley AG Jr, et al. Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care 1995;33(8):771-82.

107. Iglehart JK. Changing health insurance trends. New Engl J Med 2002; 347:956-62.

108. Herzlinger RE. Let's put consumers in charge of health care. Harvard Bus Rev 2002;80(7):44-55.

109. Zucker D, Hopkins RS, Sly, DF, et al. Florida's "truth” campaign: a counter-marketing, anti-tobacco media campaign 2000: J Pub Health Manage Pract 2000;6(3):1-6.

110. Williams AF, Wells JK, Reinfurt DW. Increasing seat belt use in North Carolina. In: Hornik RC, ed. Public health communication: evidence for behavior change. Mahwah, NJ: Lawrence Erlbaum; 2002. p. 85-96.

111. Hanson DJ. Social norms marketing is highly effective. Alcohol Problems and Solutions. Potsdam, NY: National Social Norms Research Center; 2003. Available at: http://www2.potsdam.edu/hansondj/YouthIssues/1093546144.html. Accessed October 3 2007.

112. Nielsen-Bohlman L, Panzer AM, Kindig DA, eds. Health literacy: a prescription to end the confusion. Washington, DC: National Academies Press; 2004.

113. Harmon-Jones E, Mills J, eds. Cognitive dissonance: progress on a pivotal theory in social psychology. Washington, DC: American Psychological Association; 1999.

114. Gladwell M. The tipping point: how little things can make a big difference. New York: Little Brown; 2000.

115. Strombom BA, Buchmueller TC, Feldstein PJ. Switching costs, price sensitivity and health plan choice. J Health Econ 2002;21(1):89-116.

116. Hibbard JH, Mahoney E, Stock R, Tusler M. Does increasing patient activation result in improved self-management behaviors? A further validation of the Patient Activation Measure (PAM). Health Serv Res 2005;40(6 Pt 1):1918-30.

117. Greene J, Hibbard J, Tusler M. How much do health literacy and patient activation contribute to older adults' ability to manage their health? Washington, DC: AARP Public Policy Institute; June 2005. PPI Publication 2005-05. Available at: http://assets.aarp.org/rgcenter/health/2005_05_literacy.pdf. Accessed October 3, 2007.

118. Levinson W, Kao A, Kuby A, Thisted RA. Not all patients want to participate in decision making: a national study of public preferences. J Gen Intern Med 2005;20:531-5.

119. Dohan D, Schrag D. Using navigators to improve care of underserved patients. Cancer 2005;104(4):848-55.

120. Clanton M, Freeman H. Patient navigator program reduces cancer health disparities. NCI Cancer Bulletin 2004 Aug 17;1(33):1-2. Available at: http://www.cancer.gov/ncicancerbulletin/NCI_Cancer_Bulletin_081704/page3. Accessed October 7, 2007.

121. Burack JH, Impellizzeri P, Homel P, Cunningham JN Jr. Public reporting of surgical mortality: a survey of New York State cardiothoracic surgeons. Ann Thorac Surg 1999;68(4):1195-200.

122. Werner RM, Asch DA. The unintended consequences of publicly reporting quality information. JAMA 2005;293(10):1239-44.


Return to Contents

Current as of November 2007
AHRQ Publication No. 07(08)-0059


Internet Citation:

Final Contract Report. Consumer Financial Incentives: A Decision Guide for Purchasers. AHRQ Publication No. 07(08)-0059. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/value/incentives.htm


 

AHRQ Advancing Excellence in Health Care