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Adventures in Sleep

Positive Rewards

Published April 24, 2013 2:43 PM by Penny Mehaffey

I was thinking about our insurance plan last night just before drifting off to sleep.

This year we have some new incentives for trying to live healthier lifestyles.

For example, if we keep up with our preventive visits or attend the gym 6 times a month then we are awarded extra funds loaded on our HSA card.  I think that's a pretty good deal, not so sure I can make it 6 times a month to the gym though. I am trying. I am encouraged.

And so I was wondering what if we incentivized CPAP users  too?  Instead of threatening to take away the equipment if usage falls below the set amount of time, why don't we award users for the total time used?  I mean, the goal is to get people acclimated to and using CPAP or whatever the therapy is. It seems to me this approach would foster goodwill on the patient's behalf since the first encounter would include instructions for how to obtain the "reward" instead of the threat of losing the equipment if not compliant. Rewards, however small, are still rewards. I am not saying we should "break the bank" for the system to work. But why set them up to fail? I am definitely in favor of positive reinforcement. Over and over studies have shown it works well. So link the desired outcome with a small reward. 

Yet our go-to response is usually the negative choice. It seems all we hear are negatives from the insurance industry, Medicare and Medicaid. Cuts and losses of coverage, things covered last year are no longer covered this year. And then there's the new rule about patient education and loss of payments if a patient is readmitted for an illness and it's determined they were not educated about their illnesses, meds, treatments, etc.  WHAT?? Good grief. I am a nurse and can't count the amount of time I have spent with patient's "educating" them, hoping they would take their meds and check their blood sugars and keep those dressings changed.  Was the benefit of good outcomes incentive enough for them?

And sometimes, a lot of the time, you can tell even as you're speaking that what you're saying is not going to happen at home, like good sleep hygiene or even a set bedtime for children. And now it seems I am backed into a corner because the reward of good health is not enough, but neither is the threat of removing equipment.  And at what level should a reward system be implemented?

Why do these things pop into my head when I am trying to sleep?
posted by Penny Mehaffey

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    Adventures in Sleep
    Occupation: Sleep technicians
    Setting: Various sleep facilities
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