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The wellness incentives and navigation project: design and methods.

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The Wellness Incentives and Navigation (WIN) project tests interventions for Medicaid beneficiaries with behavioral health conditions. This pragmatic trial aims to improve health outcomes through personalized support and incentives.

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Area of Science:

  • Public Health
  • Health Services Research
  • Behavioral Health

Background:

  • 35% of non-elderly US adult Medicaid enrollees have behavioral health conditions.
  • Individuals with serious mental illness face 2-3x higher mortality rates due to lifestyle factors.
  • 61% of Medicaid beneficiaries with behavioral health conditions also have co-occurring chronic physical health conditions.

Purpose of the Study:

  • To test the effectiveness of incentives for Medicaid beneficiaries participating in prevention programs.
  • To improve health risks and outcomes by promoting healthy behaviors.
  • To present the unique design of the Wellness Incentives and Navigation (WIN) trial.

Main Methods:

  • A three-year randomized pragmatic clinical trial comparing interventions to usual care.
  • 1250 Medicaid individuals with co-occurring conditions or serious mental illness randomly assigned to intervention or control groups.
  • Intervention includes personal navigators, motivational interviewing, and a flexible wellness account.

Main Results:

  • Primary outcomes include physical and mental health quality-of-life (SF-12), BMI, blood pressure, LDL-C, and HbA1c.
  • Outcomes will be assessed via patient-reported outcomes, health care claims, and electronic health records.
  • A comparison group was recruited to assess internal validity.

Conclusions:

  • The WIN trial's design is presented to aid future community-based randomized pragmatic trials.
  • The study aims to reduce cardiovascular risk in a vulnerable Medicaid population.
  • This research is registered under NCT02440906.