Behavioral Spillovers from Targeted Health Incentives: Unintended Consequences and Opportunity Costs

Most studies focus on the direct effects of incentives (e.g., BEECON trial, Ramos-Gomez et al., 2020; Stecher et al., 2023), but little is known about how incentivizing one behavior influences others. For example, does incentivizing regular dental visits cause people to neglect other preventive care, or vice versa? This research would use multi-arm randomized controlled trials or natural experiments to track not only the incentivized outcome but also a range of related and unrelated health behaviors. The approach would build on the observation that incentives can have unintended consequences—either crowding out or catalyzing other behaviors—an area rarely measured in insurance design studies. Understanding these spillovers could help design holistic incentive strategies that maximize net health benefits, rather than optimizing for one metric at the expense of others.

References:

1. Family monetary incentives as a value-based care model for oral hygiene: rationale and design of the BEhavioral EConomics for Oral health iNnovation (BEECON) trial.. F. Ramos-Gomez, Justin S. White, H. Lindau, T. Lin, T. Finlayson, Jenny X. Liu, S. Gansky (2020). Journal of Public Health Dentistry.
2. Combining Behavioral Economics–Based Incentives With the Anchoring Strategy: Protocol for a Randomized Controlled Trial. Chad Stecher, Sara A. Cloonan, S. Linnemayr, J. Huberty (2023). JMIR Research Protocols.