Policyholders' adherence to preventive health programs: What factors explain this?

Summary The aim of the health system reforms implemented in recent years in most countries has been to shift the focus from curative medicine to preventive medicine. In a context of budgetary constraints, these reforms aim in particular to stimulate a market for prevention in order to reduce risks and improve the efficiency of healthcare expenditure. The National Interprofessional Agreement (ANI) implemented since 2016 in France, which requires private sector companies to offer supplementary health insurance to their employees is part of this context. The conditions of this agreement, in fact, provide that part of the contributions be invested by insurance companies and mutual insurance companies in prevention programs ensuring personalized monitoring of the insured in their lifestyle and health. The adherence of policyholders to these services, often free of charge and attached to the complementary health insurance offer, is one of the key factors of the success of this preventive health policy. Based on the results of a survey conducted in 2016 among a sample of policyholders of a French mutual insurance group, we study the determinants of the intentions of the policyholders surveyed to participate in such a service offer. Beyond the socio-demographic determinants regularly highlighted by studies on the demand for prevention, we are more specifically concerned with the effect of behavioral biases on the one hand, and the possible induced effect of medical follow-up on participation in prevention programs on the other. While our econometric results tend to moderate the influence of the role of curative medicine on participation in prevention programs, they do reinforce the very significant influence of behavioral biases.