IN THE STATES: Indiana Leads the Way on Prevention

We all know you can earn rewards for frequent flying. But what about for routine trips to your doctor?

Emphasizing primary care and preventive services is a key goal of health reform and many contend the savings from such programs can help finance a health care overhaul (and make us a healthier country). Yet, the details of how these savings might be realized are less clear.

Indiana is one state to find some answers. Contributing to a statewide effort to improve population health, Managed Health Services, one of three Medicaid plan administrators in Indiana, now offers the CentAccount Healthy Rewards Program. Participants accrue dollars on a CentAccount Mastercard debit card as a bonus for participating in appropriate  preventive care services -- in the appropriate care settings. LIke the doctor's office, not the E.R.

For example, a patient will earn $15 for seeing a primary care physician within the first three months of joining, and can get additional money if they get certain screenings, for instance for cervical cancer or chlamydia. (which can cause complications in pregnant women and their newborns.) They earn $10 each time they take their newborn baby to the doctor's office for a recommended checkup.. The money on the card can then be used to pay for health-related items at participating grocery and convenience store, including over-the-counter medicines, diapers, and bottles.

Pat Rooney, president and CEO of Managed Health Services, recently told the AP, "What we're trying to do is promote the healthy behavior and make sure the people are getting the right things that they need." Rooney contends that "Just getting people in to see their primary care doctor is always a challenge with this population."

Realigning incentives is a central goal of reform. As we've written before, small changes can have a big impact on personal behavior, health, and system savings. Often, the return on investment from primary care and prevention depends on how you define these programs. The results from Indiana's initiative expand our definition and refine our discussion of such efforts.