The Behavioral Science Behind Rewards and Gap Closure

Motivating members to complete recommended screenings, tests or follow-up visits can be an uphill battle, especially when the benefits of those actions feel distant or abstract. That’s one thing every health plan has in common. While some members respond well to education and outreach alone, others need a more tangible nudge to take action, which is where incentives come in.  

Thoughtfully designed rewards programs can bridge the gap between intention and action, giving members an immediate reason to engage in their care while driving measurable improvements in outcomes.  

The behavioral science behind inaction

Changing health-related behaviors can include a range of actions such as becoming more physically active, eating better and healthier foods, getting annual checkups, completing screenings and staying up to date on vaccinations.  

Let’s look at the phases of behavior change and different types of motivation to understand where and why people don’t take the desired action.

• Phase 1: Adoption. This is when people start thinking about and trying new behaviors. As people try to create a new habit, the action is often inconsistent.
• Phase 2: Maintenance. This is when sticking with the behavior over time becomes the real test. Success isn’t just about making a change but about making it last with consistency. For some habits, like healthy eating and exercise, consistency means frequent action. For others, like vaccinations or screenings, it means taking action at the right time, even less often. In almost every case, consistency is the key to lasting behavior change.

At the same time, motivation is the foundation for both initiating and sustaining new behaviors. Self-determination theory describes different types of motivation on a spectrum as follows:

• Amotivation: No motivation to act.
• Extrinsic motivation spectrum: Spans from being driven by external rewards to being driven by more internal values and aspirations.  
• Intrinsic motivation: Driven by personal values and internal satisfaction.

On this spectrum, the closer someone is to intrinsic motivation, where actions align with personal values, the more likely they are to sustain behavior over time and the closer someone is to amotivation, the likelihood of changing behavior decreases.  

The moral of the story: perceived immediate benefits are critical to the early stages of establishing a new behavior pattern. Without immediate results and benefits, it’s easy to lose motivation, especially with long-term goals.  

In the early phases of behavior change before the behavior becomes more internalized, instant gratification and immediate rewards can help people move in the right direction. This is because most health behaviors require long-term effort before the benefits become obvious. For example, the benefits of annual checkups or vaccinations may not be felt right away or even at all. Sometimes the benefits can feel insignificant, for example avoiding an instance of flu after a flu shot can go unnoticed. People naturally seek immediate gratification; therefore, distant rewards and benefits are less motivating than immediate ones.

Rewards as a tool to address inaction

Immediate rewards, especially financial incentives, are tied to extrinsic motivation and can nudge members to adopt a new behavior such as scheduling their screenings or vaccination which ultimately helps close the care gaps. Incentive theory shows that external rewards can bridge the gap between the effort and the perceived delayed benefits of actions, providing instant gratification that keeps people moving forward.  

And while rewards administration in healthcare is undoubtedly valuable, how rewards are delivered plays an important role in their effectiveness. Research shows that small, frequent incentives for healthy actions such as annual checkups or medication adherence that can be delivered and redeemed right away are more effective than rewards that are less visible, such as those hidden in paychecks or insurance premiums.  

Rewards program ease-of-use is critical to success. Rewards done wrong can create friction. Friction can occur if incentives are hard to redeem, require too many steps, have incentives that are of little or no practical value to the member, or the reward simply takes too long to be delivered.  

When done right, rewards can encourage members to take action, especially when the health benefits of their actions aren’t immediately felt or seen.  

Make sure you’re avoiding these three reward program pitfalls.  

Why Healthmine rewards  

Plans in all lines of business and of all sizes partner with Healthmine to administer member-centric rewards programs that prioritize gap closure in key measurement areas.  

Members in our rewards programs are 93% more likely to close care gaps and continue to do so.  

Across all of our reward programs, plans are seeing significant improvement on specific health actions:

• 39% improvement on flu shot completion  
• 53% more preventive provider visits  
• 68% increase in breast cancer screenings  
• 152% increase in cervical cancer screenings  
• 63% increase in colorectal cancer screenings

But not all rewards programs deliver this kind of impact. Success comes from having the right framework and the right partner. Our incentive programs are tailored to your plan’s needs with:

• End-to-end reward fulfillment for faster delivery, happier members, fewer calls and complaints and stronger gap closure.  
• Relevant incentives so your members receive gift cards to the retailers they actually want.
• Targeted programming to say goodbye to blanket rewards. Connect rewards to the actions that matter most to your members health care and your performance.
• Consolidated budget management for consistency across quality and risk teams without added administrative burden.  

With Healthmine, incentives are not just one-off rewards — they drive meaningful results. Let us show you how we’re building strategic incentive programs for our partners. Contact us today.

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