Abroad, some experiences have already shown that cash rewards and other incentives can help people take care of their own health and help reduce healthcare costs.
A systematic review of the international literature points to three findings.
They raise vaccination rates, encourage physical activity and screening uptake.
The effect is especially strong in vulnerable groups, where economic and motivational barriers are highest.
When prevention is rewarded, uptake rises.
Programmes in several countries, run by health insurers and public services, show that rewarding healthy habits goes hand in hand with measurable health results.
Vitality, Discovery Health’s rewards programme, involves 2.5 million people who earn points for exercise, screening and healthy habits. The most active members have a lower hospitalization rate (20.7% vs 22.2% among inactive members) and lower health costs: the dose-response relationship holds across hundreds of thousands of members.
The National Steps Challenge, a national programme, rewards people who reach physical activity targets with points that can be turned into shopping vouchers. In the third edition (2017–2018), among 696,907 adults who signed up, daily steps rose by about 1,580 compared with the initial period and were still about 930 higher in the maintenance phase.
Source: Yao et al., Journal of the American Heart Association, 2022 ↗
The Give it up for baby scheme combined stop-smoking support with a weekly £12.50 credit, spendable in supermarkets, linked to abstinence verified with a breath test. Among the 383 women who took part, 54% of quit attempts were smoke-free at four weeks and 17% three months after giving birth. Evaluation without a control group.
The Health Models programme offered cash incentives, from $10 to $75, for attending appointments, achieving or maintaining viral suppression and using support services. Among 2,076 patients at three specialist clinics, the share with a suppressed virus rose from 58% at enrolment to 83% after twelve months. Before-and-after study without a control group.
Today only 35.8% of Italians aged 50–69 (about 17.9 million people) take part in free colorectal cancer screening. What would happen if uptake rose?
Out of 100 people invited, 36 get screened today. With +10% uptake, it would be 46.
Uptake from 35.8% to 45.8% · additional life-years and savings compared with today, estimated over 10 years
