Current Evidence on Health Behavior Incentives in the Medicaid Program

In recent years, many state Medicaid programs and Medicaid managed care organizations (MCOs) have implemented beneficiary incentive programs for health behaviors. These programs typically use financial incentives like gift cards, prizes, reduced premiums or copays, or penalties to promote specific health behaviors like losing weight, going to preventive visits, getting vaccinations, or quitting smoking.

States report multiple motivations for trying these programs: instilling personal responsibility in entitlement programs, encouraging people to engage with their health, or incentivizing specific behaviors that affect long-term health and Medicaid costs.1–3 Health behavior incentives have been embraced by both conservative and liberal policymakers as one of many tools in a state’s toolbox as they work to improve health and lower Medicaid costs. Yet there is a need for strategies that can help these programs improve, given the nascent state of many programs and the mixed (but limited) evidence about impact on health outcomes.