Pay them and they will come: Cash incentives get patients to visit a primary care physician

Male doctor in white lab coat
Offering patients small financial incentives could pay off big. (Getty/Saklakova)

Small cash incentives are one way to get low-income people who have just gotten healthcare coverage into the doctor’s office.

A study, published in Health Affairs, found those incentives encourage patients to make a visit to their primary care provider—in what is seen as a small cost that might mean big savings to the healthcare system.

A visit to the primary care doctor can save money if it keeps people from developing health problems, going to the emergency room for treatment or waiting too long for care, leading to hospitalization.

If the use of primary care is shown to reduce overall healthcare use and improve health in this high-cost population, cash incentives may be a cost-effective way to steer low income patients away from more expensive services and help them establish a relationship with a primary care provider,” the study authors wrote.

Offering cash incentives may be particularly effective for patients newly offered healthcare coverage, said the authors, Cathy J. Bradley, associate director for population health sciences at the University of Colorado Cancer Center, and David Neumark, professor of economics at the University of California, Irvine.

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In a randomized, controlled trial, the researchers gave patients $10 to complete a baseline survey during an interview and then randomly assigned them to receive an incentive of $50, $25 or $0 to visit their primary care provider within six months of enrolling in a community-based primary care program established by the Virginia Commonwealth University Medical Center, a safety-net provider.

Patients offered $50 and $25 incentives were more likely to see a primary care provider (77% and 74%) compared to patients not offered a cash incentive (68%).

Researchers included a control group with people who were not offered a cash incentive and also were not contacted by a healthcare program coordinator to offer information about their primary care provider and how to schedule a appointment.

The effects of the intervention to offer incentives were about twice as large when compared to patients who got $50 or $25 incentives and visited their provider and the proportion in the control group (61%). So, even the effort to reach out to new patients, without any financial incentive, made a difference.