Service Credit Banking in Managed Care

Service credit banking programs seek to help elderly people remain healthy, independent, and in their homes by enlisting volunteer caregivers to provide supportive services, such as transportation, medication monitoring, shopping and light housekeeping. As an incentive, each caregiver receives credits that can be redeemed for similar volunteer services.

The Service Credit Banking in Managed Care program, which ran from 1992 to 1999, tested the efficacy of the service credit banking concept.

The program helped fund and develop a prototype pilot project, the Rocky Mountain Health Maintenance Organization in Grand Junction, Colo., and five replication projects at other managed care organizations.

Key Results

  • Ultimately, most of the service credit banking projects at the managed care organizations were unable to meet either of the challenges that prompted RWJF to launch the program: financial sustainability and information management.
  • Facing decreasing profits and, in some cases, organizational upheaval, four of the five managed care organizations abandoned their service credit banking projects.
    • Two ceased providing Medicare coverage altogether, and a third substantially scaled back its coverage.
    • Only the Rocky Mountain Health Maintenance Organization and Blue Shield of California maintained their service credit banking operations beyond the end of 1999.
  • The program did not determine whether earning service credits is a meaningful incentive for volunteers or whether service credit banking programs can produce savings that offset their administrative costs.