Monte Sinai’s Health System is testing a new model aiming to let high-risk patients assume their medications through the distribution of economic incentives.
Thanks to contributions from Heath 2.0 and New York City Economic Development Corporation, the New York Health System has enrolled 12 patients for a pilot project with the startup Wellth.
Through the Wellth technology, patients can gain some dollars/day if they regularly take the prescribed medications, which in certain cases reach a significant amount in few months. In Monte Sinai test, for example, patients can gain up to 50 dollars/month if they adhere to the therapy. To demonstrate their adhesion, patients have to simply take a photo of pills in hand using the their mobile and the Wellth app.
The first person selected for the test had been very defaulting in the past; two weeks later, the personnel was very satisfied because, thanks to the incentives, this person was adhering to their plan every single day, as reported by Jill Carroll, IT project manager of Monte Sinai.
Wellth platform is based on behavioural economy researches executed by the startup. Incentives are distributed not every time the patient take a photo, so increasing his credit, but on the contrary starting from a global sum and deducting the relevant amount any time the patients does not accomplish the therapy.
This choice comes from the study that safeguarding a credit is a stronger incentive than gaining a recompense step by step. The application has been designed to be very user-friendly and usable from uncultured people too or with a familiarity with the new technologies.
Wellth is a startup supplying a platform for insurances and health systems, aimed to improve the therapy adherence of high-risk patients suffering of heart pathology, diabetes type 2, asthma and COPD. Insurance companies and Health organizations offer incentives to patients in the form of 50 dollars- gift cards within Amazon if they engage to follow the prescribed therapy and, in case of heart suffering, if they control their weight every morning. If they skip a measurement or a therapy, the system automatically deducts two dollars/day, so reducing the value of their gift card.
Wellth declares a reduction of 40% of Hospital readmissions, a result verified in a study published on Journal of the American College of Cardiology, regarding a clinical trial on 88 patients, shared in intervention group and check group.
A study made by researchers of University of Pennsylvania, (as shown in the figure above) demonstrated that diabetics who received scale, blood pressure and glucose indicators, after 3 months less than 50% still uses those devices, percentage which decreases to 30% after 6 months. Giving them only 1,40 dollars/day for 3 months, the patients’ adherence to devices has doubled.
In respect to the hospitalization costs, especially in the United States, 50 dollars for each risk-patient can be a valid investment. At the first sight, paying a person for taking care of himself could seem bizarre and ethically questionable; but the American pragmatism repays the result: what is the problem?