State Medicaid programs are increasingly seeking ways to encourage beneficiaries to adopt lifestyle and other behavioral changes that lead to improved health. The Affordable Care Act created new opportunities for states to implement grant programs; Indiana, Iowa, and Michigan have included a healthy behavior incentive program as part of Section 1115 demonstration waivers expanding eligibility to the new adult group.
Research on whether healthy behavior programs improve health outcomes, regardless of the source of health insurance coverage, is mixed. The relatively few studies that have examined the effectiveness of healthy behavior incentives in Medicaid have found that Medicaid enrollees were more likely to participate in one-time or short-term activities rather than changing long-term behaviors, and providing incentives immediately after completion of an activity was more effective than delayed distribution.
This issue brief focuses on the use of healthy behavior incentives in Medicaid, including the legal authorities, incentive structure, and the effect of these efforts on behavior.