In Open Forum Infectious Diseases, David Wohl and colleagues, including Harsha Thirumurthy, assess the feasibility of two strategies for financially incentivizing adherence to Hepatitis C (HCV) care among patients with substance use disorders. Previous research has shown that, although rates of a sustained response to the virus (SVR) surpass 90%, patients experiencing substance use disorders may struggle to adhere to HCV care. The authors randomly assigned participants to either a fixed or lottery-based monetary incentive for attending clinic appointments, adhering to medications, and achieving SVR. They found that 100% of participants in the lottery group and 86% of participants in the fixed group completed 12 weeks of therapy. Furthermore, 93% in the lottery arm and 92% in the fixed arm achieved SVR, and both groups achieved high levels of appointment attendance and medication adherence. These findings suggest that financial incentives may be useful to support HCV treatment adherence in patients with substance use history.