Fact Sheet

Encouraging Healthy Behaviors by Expanding Beneficiary Rewards & Incentives in Medicare Advantage

In 2014, CMS issued guidance to permit Medicare Advantage to offer rewards and incentives, as has been allowed in commercial insurance. These non-benefit rewards and incentive programs are designed to encourage healthy behaviors in beneficiaries and enhance the value of integrated care. Rewards and incentives are typically focused on early intervention and prevention and may include rewards for visiting your primary care doctor, receiving the flu shot, or losing weight. If the programs are structured correctly, these incentives result in better health outcomes and behavioral changes that last after the rewards are offered.