UCLA Studies Participant Payment

A critical challenge that clinical trial researchers face is patient drop out. Why patients fail to complete studies can be attributed to a variety of reasons, and delays in compensation can often be one of them.   UCLA knew that its trials were being affected by payment issues, but wanted to examine whether or not the mechanism for patient reimbursement impacted patient retention. To that end, the University conducted a study that randomly divided trial participants into two groups: one that received money orders and one that received Greenphire’s ClinCard, a reloadable debit card and software platform. The purpose of this study was to assess a more effective means to engage study participants in follow-up activities, was more effective in keeping study participants engaged in follow-up activities, and to determine any cost savings associated with either payment method.    As part of the study, participants were asked to complete two interviews: a baseline interview at the beginning of the study and a follow-up interview after the study was completed. The baseline interview was conducted as soon as the participant consented to be in the study for background and demographic context. The follow-up interview, which was conducted six months later over the phone, assessed the participants’ experience and satisfaction with the payment system they were assigned to. During the study, participants were asked to call researchers at the beginning of each month for the ensuing five months to update their locator information- even if nothing had changed. Completing a call resulted in a $10 payment issued immediately via ClinCard or by money order that arrived within one to three weeks by mail.   The study consisted of 303 participants from the Los Angeles area. Of those, 151 subjects participants were enrolled into the Rechargeable Incentive Cards (RIC) arm and 152 were enrolled into the money order control arm.    Results   The survey indicated broad acceptance and positive feedback for ClinCard, with scores showing a greater preference for the reloadable debit card than money orders. The survey indicated there was a slight preference for ClinCard over cash payments.   Overall, RIC participants made 40% of the possible five calls, whereas control participants made 30%.   At the six-month follow-up, 98% of participants had activated their debit cards – all but 2% participants. The survey results noted:

• 92% of users indicated they had no difficulties using the card

• 6% indicated they experienced some difficulties

• 2% indicated they had not used their cards yet

To measure how participants perceived the RIC method relative to other potential payment methods, they were asked questions using a 3-point scale--worse (1), the same (2), or better (3). RIC participants showed a decided preference for the RIC method over grocery cards with a mean of 2.9 and cash payments, at 2.3.   In addition to ClinCard receiving a strong preference from participants and positively impacting participation, the amount of staff time devoted to tracking and paying participants was decreased by 39.8 minutes, which equaled a savings of $14 per subject for staff costs.   Time logs were kept for payment activity including delivery payment delivery and the cost of payment – price per money order and setup costs for debit cardsClinCards. The cost team assigned values to tracking, locating and executing payments by using a combination of observational data and contact logs. The cost team used payroll records to calculate hourly rates, and found the time devoted to RIC per subjects was 34 minutes vs. 74 minutes for money orders.   The UCLA study found that the payment mechanism for clinical trial participants did matter. Using Greenphire’s ClinCard produced an increase in patient engagement and reduced staff time devoted to participant tracking and payments. ClinCard also provides an online portal that automates alerts for appointments in a patient’s native language, keeping them engaged throughout the study.  

Zach Hales

, Greenphire, ClinCard Product Manager