Financial incentives for improving adherence in diabetes: Phase II


Katherine Baicker, Amitabh Chandra, Elizabeth Rourke


Currently, approximately 139 million adults in the U.S. have diabetes mellitus, hypertension, or hypercholesterolemia, accounting for $250.6 billion dollars in direct and indirect costs, not including the costs associated with hypercholesterolemia. A large portion of these costs are negative consequences from long-term poorly-controlled diabetes and hypertension. The microvascular complications include blindness, renal failure (ultimately requiring dialysis), and neuropathic pain. The macrovascular complications include stroke, heart attack, and amputation of the lower extremities.

This intervention is a randomized trial of financial incentives in improving two types of health behaviors. The first is to improve adherence to physician-prescribed medication for diabetes, hypertension, and hypercholesterolemia. The second is to improve attendance at provider visits. The key idea behind financial incentives is that it may be a vehicle to increase the salience of future benefits at the time of making decisions today.