For this controlled trial, we randomly divided our sample population of 2,324 diabetics into four groups and sent each a different type of letter from the Oklahoma Health Care Authority. To track and compare the responses of the different groups, we analyzed Medicaid claims data for each patient over the next year, noting payments for physician visits, blood tests and filled prescriptions. By the end of our one-year analysis period, the control group had caught up with the nudge recipients (not surprising in a population of diabetics, who are likely to have medical checkups over an extended period). There was no longer a significant difference in the number of prescriptions filled, whether as the result of physician visits or renewals of existing prescriptions. So it seems that the value of the nudge is actually in prompting recipients to act more quickly – which should have a positive effect on long-term health outcomes, particularly when extended across a population of millions.




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