Covid-19 Taught Us Health Care Incentives Are the Right Approach And We Need More

In 2015, Pitcher Max Scherzer signed a 7-year, $210M contract with the Washington Nationals. This mammoth deal had an added $500,000 incentive for each Cy Young Award he brought back to the District. A man with the nickname “Mad Max” likely doesn’t need much to incite his competitive drive, but he has won two Cy Youngs over the course of his contract. I’m not saying the incentive drove the victories, but there is a reason they were built into the contract.

Incentives work.

Last month, Governor Hogan announced that using vaccination records, the MD State Lottery will give away $40,000 a day through July 3 to the vaccinated population using a random number generator. Then, on July 4, a final drawing will award one winner a grand prize of $400,000.

From the chance to win $400,000 in Maryland to $1,000,000 in Ohio, states across the country are offering rewards for getting vaccinated. Maine residents were offered a choice between a free park pass, a hunting or fishing license, or an L.L. Bean gift card. Residents of New Jersey, a shot and a beer; Connecticut, free drinks at 100 restaurants. And the list goes on. Any one of these rewards for saving a life — perhaps your own — is a very good deal.

Refusing an injection for an infectious disease isn’t just risky for the individual, but it reverberates throughout the community. When my son Henry was recovering from a bone marrow transplant and was finally well enough to leave the hospital, he was still immune-compromised. There was very little that posed a greater risk to Henry than someone in his school or our neighborhood or the hospital where he continued to visit as an outpatient, who refused to be vaccinated to prevent measles, pertussis, or the flu. While becoming ill might mean a few days in bed or even worse for the non-vaccinated, any one of those diseases would be deadly for Henry.

Incentivizing adults to make good health care decisions isn’t new. For years, pharmacies have offered coupons to customers in exchange for flu shots. Employers dangle big incentives, like cash bonuses, paid days off, and gym memberships to encourage workers to lose weight. Health care providers offer patients free Uber rides to encourage on-time appointment arrival.

I have seen first-hand the impact of incentivizing kids to adhere to their medical procedures. As COVID-19 raged, one program became the first pediatric initiative to demystify complex and scary medical procedures, incentivize young patients to adhere to their doctor-ordered medical plans, and reward children for completing their procedures. Since 2020, the program has helped kids undergo 14 particularly challenging medical procedures (e.g., MRI, lumbar puncture, IV placement, and COVID-19 testing) at hospitals across the country.

Less than one year later, nearly 1,200 of our nation’s youngest, most vulnerable patients are undergoing previously terrifying procedures like MRIs, COVID testing, lumbar punctures, and IV Placement/Blood Draw without anxiety, or even the need for sedation, thanks to the initiative. At the cost of less than $50 per child, this is a small price to pay to reduce short- and long-term trauma while increasing adherence to doctor-prescribed procedures, reducing complications due to resistance to recommended care, and achieving significant cost savings throughout the health care system.

Every day, young hospital patients are traumatized at the prospect of getting an injection, having a needle placed in their vein, or the force of a syringe that penetrates layers of muscle to access the port into which flows their life-saving medicines. And all of this takes place in rooms filled with unfamiliar people and towering medical equipment. Their reaction, quite understandably, is to resist care. They cry. They squirm. They attempt to run away. This suffering is eased, and adherence to medical plans increases when kids are incentivized, comforted, and have a positive patient experience.

Whether it’s a superhero action figure in exchange for the successful completion of an MRI or a chance to win $40,000 in exchange for a life-saving COVID vaccine, incentives work.