At Mount Sinai, monetary incentives drive medication adherence

By Jonah Comstock
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Mount Sinai Health System is trying a new way to get high-risk patients to take their medications: financial incentives. Supported by a grant from Health 2.0 and the New York City Economic Development Corporation, the New York health system has enrolled 12 patients in a pilot with startup Wellth.

“What I’m so impressed with is a lot of companies go out and say ‘We want to make this and this is going to solve that problem,'” Jill Carroll, an IT project manager at Mount Sinai, told MobiHealthNews. “What [Wellth] did is they said ‘Here’s a really big problem we want to solve’ and they did a ton of research and they were really utilizing research that’s been done in behavioral economics.”

Carroll will be sharing lessons learned from the pilot at the Digital and Personal Connected Health Conference, a one-day event on March 5th in Las Vegas.

With Wellth’s technology, patients can earn a few dollars a day for taking their pills on time, which can add up to a significant amount over a few months. At Mount Sinai, for example, patients can earn $50 for one month of adherence. To report their adherence, they simply snap a photo with their phone’s camera of the pills in hand.

“The first person they selected [for the pilot] had been very noncompliant and just after a week or two, the staff was super excited because this person had adhered to their plan every single day,” Carroll said.

There are some tricks to the platform based on the startup’s behavioral economics research. For one thing, rather than seeing a monetary total tick up as they report their adherence, users see a pool of money that depletes when they miss a dose.

“People have money deducted rather than added to their balance because they found that loss avoidance is a stronger incentivizer than rewards gains,” Carroll said.

The app is also designed with the intended audience, not necessarily a tech-savvy demographic, in mind.

“They tried to make this absolutely as user friendly as possible,” Carroll said. “The population that we’re working with is the kind of population that is on Medicaid or Medicare, … it’s not highly educated, most of them are low income, and we still see a lot of success with them, so I think it’s a really well-designed program.”

Carroll’s session “My Doc Paid Me to Do It: Incentives as a Better Route to Adherence” will be held at 4:00 p.m. on March 5th at the Wynn Hotel in Las Vegas. Register here.