Beliefs related to health care incentives: Comparison of substance use disorder treatment providers, medical treatment providers, and a public sample

This study surveyed substance use disorder (SUD) treatment providers, medical treatment providers, and a public sample about beliefs regarding health care incentives to explore differences among the groups and across health disorders for which research has demonstrated incentives improve outcomes. Six hundred participants (n = 200/group) completed the Provider Survey of Incentives. The study found between group differences for positive and negative beliefs. The public sample was highest on the positive beliefs subscale (M = 3.81), followed by SUD (M = 3.63) and medical treatment providers (M = 3.48; F_{(2, 597)} = 20.09, p < .001). The medical treatment providers were highest on the negative beliefs subscale (M = 2.91), compared to the public sample (M = 2.77) and SUD treatment providers (M = 2.65; F_{(2, 597)} = 7.521, p < .001). Endorsement of incentives to treat medical disorders was similar across the groups, with obesity the most endorsed disorder. In contrast, endorsement of incentives to treat SUDs differed across groups, except for smoking. The SUD treatment providers were almost twice as likely as the public sample (OR = 1.81, 95% CI = 1.27–2.59) and the public sample almost twice as likely as the medical treatment providers (OR = 1.74, 95% CI = 1.24–2.47) to endorse the use of incentives to treat more SUDs. Medical treatment providers were also the least likely to endorse incentives to treat both legal and illicit substance use. These findings suggest that incentive programs have good acceptability among SUD treatment providers and the public, but medical treatment providers are less accepting of incentive programs. This study provides evidence that incentive-based interventions are acceptable to the public and is the first to document specific objections that individuals disseminating incentive interventions will most likely face when introducing them in medical settings.