Using incentives to improve patient compliance
Dr. Murat Kalayoglu, founder and chief science officer at HealthHonors, on how providing patients with customized incentive plans can increase adherence rates and cut costs.
By on Feb 9, 2010Dr. Murat Kalayoglu, founder and chief science officer at HealthHonors, on how providing patients with customized incentive plans can increase adherence rates and cut costs.
Its complicated; thats the one thing everyone can agree on about patient compliance. Its complicated to understand why patients deviate from medication plans and its complicated to figure out how to motivate them to return. Its complicated to the tune of millions of dollars in lost profits and tens of thousands of lost lives and failed health plans every year.
From this complexity, however, HealthHonors, based in Braintree Massachusetts, has woven a surprisingly elegant solution: customized incentives. The companys software looks at patterns of how people engage, identifies how those patterns vary, and then determines the right mix of reinforcements for each individual. We started off with the speculation that the reason a lot of existing programs to improve medication adherence havent worked well is because they treated people as a single entity, says Dr. Murat Kalayoglu, founder and chief science officer at HealthHonors. They assumed that people in general behave the same way and thus respond well to the same incentives.
Different incentives for different patients
The truth is, of course, that people respond to incentives very differently. Where money might motivate one person, an appeal to competition, community, or common sense might motivate the next. Kalayoglu and his team used behavioral economicsthe study of how psychological factors influence financial decisionsto build Dynamic Intermittent Reinforcement (DIR), a software program that gleans such preferences from patients as they casually engage with an online interface.
The software in essence creates a personal reinforcement plan for each and every individual in order to maximize engagement and minimize costs, says Kalayoglu.
Heres how it works. Whenever a patient takes a pill, theyre encouraged to log onto a website and confirm theyve taken their medication as scheduled. Then they receive a quick educational message followed by a notification of whether theyve received points. Sometimes theyll receive 100 points, sometimes 500, sometimes zero. The points are redeemable for disease-specific health rewards. For instance, an asthmatic patient might be able to redeem points for a peak flow meter, an inhaler kit, or a book on asthma. Points are also redeemable to reduce existing co-pay benefits. In other words, your co-pay benefit level depends on your level of engagement.
Keep it simple
From the consumer standpoint, its amazingly simple, says Kalayogluand effective. In trial and commercial environments, HealthHonors has shown increases of anywhere between 33 to 56 percent in sustained adherence to targeted behaviors, while lowering incentive budgets.
In HealtHonorss first controlled study, of 200 diabetes patients over a nine- to 12-month period, the firm found an A1C reduction of a full point with those who used the DIR software, compared to an A1C increase in those who did not. In 2008, AstraZeneca became the first major pharma firm to implement HealthHonorss software to increase adherence among customers.
The data have been so good across the board that weve been asked to increase the engagement of consumers beyond medication adherence, says Kalayoglu. For example, our software is now used to drive engagement with taking surveys, signing up to a website, doctors appointment remindersanything that a brand is interested in getting the customer interested in.
Relationship management
HealthHonors recently signed a non-exclusive partnership with McKesson and in the first quarter of 2010 will launch a performance-based benefit design program with the LoyaltyScript co-pay card. It also has reached an agreement with Kaiser Permanente.
Thats the beauty of this kind of software, says Kalayoglu. It becomes very powerful as an add-on on top of existing relationship management strategies. We can complement everything a brand is trying to get consumers to do, and ultimately help them to do it better.