Consumer knowledge and engagement in Florida Medicaid's Enhanced Benefits Reward$ program

Background: The Florida Medicaid program recently implemented the Enhanced Benefits Rewards Program to encourage beneficiary empowerment and self-management The Enhanced Benefits Reward$(EBR) program offers financial incentives to enrollees who participate in healthy behaviors. Our research objective is to evaluate the extent to which different population groups within the Medicaid program have heard about and then engaged in an EBR activity. Study Design: We conducted an analysis of consumer surveys of adult (18-64)beneficiaries in Florida (n=4,456). Beneficiaries were asked if they have heard about EBR and whether they have engaged in an activity to receive credit. Bivariate and logistic regression analyses were conducted. Principal Findings: Sixty-eight percent of the respondents have heard about EBR. Of those who indicated that they heard of EBR 67% engaged in an activity. Relative to individuals in poor health, those who reported excellent health were 1.41 times (95% CI: 1.12, 1.78) and those in good health were 1.39 times (95% CI: 1.1, 1.76) more likely to have heard about EBR. Other statistically significant associations include race (whites were 1.34 times (95% CI: 1.19, 1.51) more likely than blacks); eligibility category (those with SSI were 36 percent less likely compared to those with TANF (OR: .64 95% CI:.53;.76)); language (English speakers compared to Spanish speakers were 1.46 times more likely (95% CI:1.23, 1.74)); plan type (individuals in HMOs compared to provider service networks (PSNs) were 1.29 times more likely (95% CI:1.16, 1.43)); and having a personal doctor (those without were 26 percent less likely compared to those with a personal doctor (OR: .74 95% CI: .62;.86)). Of those who heard about EBR, whites relative to blacks were 1.19 times likely to engage in an activity (95% CI: 1.03; 1.38). Also, English speakers compared to Spanish speakers were 3.2 times more likely engage (95% CI:2.5; 3.98); those with SSI relative to TANF recipients were 26 percent less likely to engage (OR: .74 95% CI .58;.93)) and those without a personal doctor were 33 percent less likely to engage (OR:.66 95% CI .53; .81) in an activity. Conclusions: Knowledge of and engagement in the EBR program is not uniform across groups of beneficiaries. Certain groups, notably those who are black, non-English speakers, receive SSI, and without an identifiable personal doctor are less likely to benefit from the incentive program. Program development of incentive programs should incorporate specialized strategies for educating and engaging certain groups of individuals.