Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr George discusses the importance of health plans that use incentives to encourage healthy individual behaviors, a trend that recently has been gaining popularity. Last summer, West Virginia began the implementation of such a plan that reduces Medicaid benefits for patients who do not sign and conform to a personal responsibility contract.1 The plan provides enhanced benefits for patients who fulfill these requirements (eg, medication adherence, keeping appointments, avoiding unnecessary emergency department visits). The West Virginia plan is the first large-scale incentive plan to be implemented, but many smaller private incentive systems also exist.2 National surveys show increased public support for tailoring health care plans to individual behavior and charging higher premiums for individuals with unhealthy lifestyles.3
Gostin LO. Using Law to Facilitate Healthier Lifestyles—Reply. JAMA. 2007;297(18):1981-1983. doi:10.1001/jama.297.18.1982-b