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Financial Incentives for Care Gaps: A Randomized Controlled Trial

Last registered on August 21, 2018
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Pre-Trial

Trial Information

General Information

Title
Financial Incentives for Care Gaps: A Randomized Controlled Trial
RCT ID
AEARCTR-0003249
Initial registration date
August 19, 2018

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
August 21, 2018, 12:23 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
United States of America
Region

Primary Investigator

Name
Ariel Zucker
Affiliation
UC Santa Cruz
Contact Primary Investigator

Other Primary Investigator(s)

PI Name
Joseph Doyle
PI Affiliation
MIT
Contact Investigator

Additional Trial Information

Status
In development
Start date
2018-08-01
End date
2021-12-31
Keywords
Health
Additional Keywords
JEL code(s)
Secondary IDs
Abstract
This project seeks to understand how individuals respond to financial incentive programs for wellness care. In a randomized controlled trial among customers with HEDIS care gaps, we will experimentally compare the impacts of incentives for gap closure (gift cards), information on existing gaps (mailers), and no intervention. The research objectives are to assess how responsive individuals are to incentives for, and to information about, existing care gaps; and to assess spillovers from incentives onto other care. In addition, impacts on downstream utilization will be studied, which may be impacted if financial incentives are effective at increasing wellness visits.
External Link(s)

Registration Citation

Citation
Doyle, Joseph and Ariel Zucker. 2018. "Financial Incentives for Care Gaps: A Randomized Controlled Trial." AEA RCT Registry. August 21. https://doi.org/10.1257/rct.3249-1.1
Former Citation
Doyle, Joseph and Ariel Zucker. 2018. "Financial Incentives for Care Gaps: A Randomized Controlled Trial." AEA RCT Registry. August 21. https://www.socialscienceregistry.org/trials/3249/history/203134
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2018-08-30
Intervention End Date
2018-12-31

Primary Outcomes

Primary Outcomes (end points)
Care gap closure at end of year and 18 months for all care gaps
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Health care utilization
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We randomly offer individuals one of two overarching interventions for each incentivized care gap: Incentives, and Information Only. In addition, there will be a control that receives neither.
Experimental Design Details
The design will entail two overarching interventions for each incentivized care gap: Incentives, and Information Only. In addition, there will be a control that receives neither. Treatment groups for each care gap will be cross-randomized.

-Incentives. Members receiving the Incentives intervention for a given care gap will receive a mailer informing them of that gap, and that they are eligible for a gift card if they close that care gap.
-Information Only. Members receiving the Information Only intervention for a given care gap will receive a mailer informing them of that gap, but without any incentives. 

-Control. Members receiving the Control intervention for a given care gap will not receive a mailer. 

All eligible individuals will be “made whole” following the intervention period, regardless of treatment status; i.e. members will be compensated for filling incentivized care gaps regardless of whether they were informed of their eligibility to do so. The size of the payment for filling each care gap will be determined by the partner according to usual business practices.

The Incentivized Care Gaps for 2018 are: W34, LSC, IMA3, CDC Eye Exam and/or CDC Hba1c Screening, CCS, and AWC. 

Randomization Method
Random assignment to two treatment and comparison groups for each care gap was generated on a computer using the partner’s software.
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
1
Sample size: planned number of observations
Approximately 8500 individuals with care gaps as of intervention date.
Sample size (or number of clusters) by treatment arms
Gap 1: 1696 per treatment group
Gap 2: 22 per treatment group
Gap 3: 358 per treatment group
Gap 4: 141 per treatment group
Gap 5: 208 per treatment group
Gap 6: 44 per treatment group
Gap 7: 460 per treatment group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
To be determined upon receipt of data
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
MIT Committee on the Use of Humans as Experimental Subjects
IRB Approval Date
2018-05-17
IRB Approval Number
1805348624
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
March 31, 2019, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
December 31, 2020, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
17,581 care gaps among 8,042 members
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
17,581 care gaps among 8,042 members (care gaps were randomized independently)
Final Sample Size (or Number of Clusters) by Treatment Arms
Control: 2461 care gaps Information: 2430 care gaps Incentives: 2452 care gaps
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials