Sara Ratner

Sara Ratner

By Sara Ratner, senior vice president of compliance and corporate systems, RedBrick Health

It’s no secret—improving the health of beneficiaries with chronic conditions is essential to lowering avoidable healthcare costs and improving quality of life. Treating chronic diseases accounts for 86 percent of our nation’s healthcare costs1.

In our work with employers, we’ve seen that employees who participate in wellness initiatives—condition-specific or not—can improve their health. Can wellness programming also move the needle for Medicare and Medicaid populations? And if so, how to best engage them?

There are many levers to drive engagement and one is the use of rewards and incentives. At RedBrick, we believe the lessons we’ve learned can be actively adapted to support those with Medicare Advantage and managed Medicaid plans. While these populations can be uniquely distinct and challenging, it is possible to apply strategies and incentive philosophies that effectively engage these populations.

Effective incentive designs can help get participants in programs that start them on the path to better health, reducing both behavioral and biometric risk factors and the medical costs associated with chronic conditions. We’ve seen their impact as we’ve helped employers implement hundreds of incentive designs and analyzed what models work best for different populations.

Though there is no “one size fits all” approach, we’ve been able to quantify the engagement levels associated with different incentive levels, and work to determine which approach best meets client objectives. Whatever the rewards model, the framework should consider:

  • Compliance Requirements. It is important to be mindful of the various laws and regulations that govern incentives to the Medicare and Medicaid population to ensure compliance.
  • Value amount. Within the compliance requirements, the optimal reward size and type depend on both population and individual attributes, as well as program objectives that may be in place.
  • Frequency. Evidence suggests that frequent, small (but meaningful) rewards often outperform larger (but distant) rewards2.
  • Form. Data on reward preferences and demographics can help clients determine what reward is most effective for their audience.

At RedBrick, we’ve seen that a research-backed approach to incentive design can help to engage people, change health behaviors and reduce healthcare costs, especially among those with chronic conditions. And we believe these lessons learned can be actively adapted to support those with Medicare Advantage and managed Medicaid plans.


For more information, contact us for a copy of our position paper, Medicare And Medicaid: Lowering Costs and Generating ROI with Rewards.


1 Centers for Disease Control and Prevention. Chronic Disease Prevention and Health Promotion. [Online]. 2015.

2 Volpp, K., Asch, D., Galvin, R., & Loewenstein, G. (2011). Redesigning Employee Health Incentives—Lessons from Behavioral Economics. New England Journal of Medicine, 365, 388–390. doi:10.1056/NEJMp1105966