Hawaii Patient Reward And Incentives to Support Empowerment
| Status: | Completed |
|---|---|
| Conditions: | Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/17/2019 |
| Start Date: | May 2014 |
| End Date: | September 2016 |
A Randomized Incentive-Based Diabetes Self-Management Study (Hawaii Patient Reward And Incentives to Support Empowerment Project)
The purpose of this randomized controlled trial (RCT) study is to examine the extent that
financial incentives when combined with diabetes evidence-based practices, improve
self-management and biometric measures for adult diabetic Medicaid recipients with an HbA1c
of ≥ 6.5 at enrollment. The study will also evaluate the cost-effectiveness of the program.
Specific Aims:
1. Evaluate whether financial incentives for completing American Diabetes Association (ADA)
recommended tests, exams, health education, biometric outcome goals, and vaccinations
will improve primary biometric outcomes.
2. Evaluate whether financial incentives for completing ADA recommended tests, exams,
health education, biometric outcome goals, and vaccinations will improve diabetes
patients' self-management as assessed by Summary of Diabetes Self-Care Activities
Measure (SDSCA) and 36-Item Short Form Health Survey (SF36v2).
3. Evaluate the extent to which financial incentives for healthy behaviors reduce the cost
of health care utilization.
financial incentives when combined with diabetes evidence-based practices, improve
self-management and biometric measures for adult diabetic Medicaid recipients with an HbA1c
of ≥ 6.5 at enrollment. The study will also evaluate the cost-effectiveness of the program.
Specific Aims:
1. Evaluate whether financial incentives for completing American Diabetes Association (ADA)
recommended tests, exams, health education, biometric outcome goals, and vaccinations
will improve primary biometric outcomes.
2. Evaluate whether financial incentives for completing ADA recommended tests, exams,
health education, biometric outcome goals, and vaccinations will improve diabetes
patients' self-management as assessed by Summary of Diabetes Self-Care Activities
Measure (SDSCA) and 36-Item Short Form Health Survey (SF36v2).
3. Evaluate the extent to which financial incentives for healthy behaviors reduce the cost
of health care utilization.
Diabetes is the seventh leading cause of death in the United States (OECD 2013). It is also
known that certain populations are at greater risk for diabetes. In Hawaii, diabetes
disproportionally affects Native Hawaiians and Pacific Islanders as they are three times more
likely to be diagnosed with diabetes. In addition, in 2010 the U.S. Department of Health and
Human Services Office of Minority Health reported that Native Hawaiians/Pacific Islanders in
Hawaii were 5.7 times as likely as Caucasians living in Hawaii to die from diabetes(Office of
Minority Health, 2010).
In order to address the challenges that chronic diseases impose on individuals and the health
care system the Centers for Medicare & Medicaid Services (CMS) is assessing the impact of
incentivizing patients to increase self-care and disease management. Previous studies have
demonstrated that monetary incentives have been associated with an improvement in behavioral
outcomes, most notably when the incentive is received immediately following the targeted
behavior (Volpp, K.G., et.al., 2008; Mitchell, M.S., et.al., 2013). Cahill et al. (2008)
showed that economic incentives were tied to smoking cessation and led to a decrease in
relapse within a year. Our study seeks to build on these findings and determine whether
financial incentives may provide a way to improve diabetes self-management.
Data:
Electronic data (Labs, Outcomes) - January 1st, 2013 through December 31, 2015 Electronic
data (Claims) - January 1st, 2011 through December 31, 2015
known that certain populations are at greater risk for diabetes. In Hawaii, diabetes
disproportionally affects Native Hawaiians and Pacific Islanders as they are three times more
likely to be diagnosed with diabetes. In addition, in 2010 the U.S. Department of Health and
Human Services Office of Minority Health reported that Native Hawaiians/Pacific Islanders in
Hawaii were 5.7 times as likely as Caucasians living in Hawaii to die from diabetes(Office of
Minority Health, 2010).
In order to address the challenges that chronic diseases impose on individuals and the health
care system the Centers for Medicare & Medicaid Services (CMS) is assessing the impact of
incentivizing patients to increase self-care and disease management. Previous studies have
demonstrated that monetary incentives have been associated with an improvement in behavioral
outcomes, most notably when the incentive is received immediately following the targeted
behavior (Volpp, K.G., et.al., 2008; Mitchell, M.S., et.al., 2013). Cahill et al. (2008)
showed that economic incentives were tied to smoking cessation and led to a decrease in
relapse within a year. Our study seeks to build on these findings and determine whether
financial incentives may provide a way to improve diabetes self-management.
Data:
Electronic data (Labs, Outcomes) - January 1st, 2013 through December 31, 2015 Electronic
data (Claims) - January 1st, 2011 through December 31, 2015
Inclusion Criteria:
1. Clinically diagnosed with diabetes mellitus
2. 18 years of age or older
3. Medicaid recipient
4. At recruitment has an HbA1c level of ≥ 6.5
5. At recruitment is receiving care coordination at Kaiser Permanente Hawaii
Exclusion Criteria:
1. Current pregnancy - gestational diabetes
2. End-stage Renal Disease
3. Does not speak English
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