University of Pennsylvania LDI CHI | Center for Health Incentives at the Leonard Davis Institute of Health Economics | Home of the UPHS Innovation in Healthcare Financing Center & Penn CMU Roybal P30 Center on Behavioral Economics and Health

 Source: WHYY Radio, April 16, 2012

CHIBE investigator Judith Long and colleagues compared measures of diabetes control among three groups of diabetic veterans at the Philadelphia VA Medical Center. One group received usual care, one group received a financial incentive plus usual care, and one group received usual care plus they were matched with a peer mentor who contacted them once a week. On average, the peer mentored group had better diabetes control after six months than the group that received usual care, or the group that received financial incentives. Though more research is needed, it seems that peer mentors are an inexpensive, beneficial addition to the healthcare physicians can provide diabetic patients during an office visit.  

Source: Robert Wood Johnson Foundation Blog, April 4, 2012

The Robert Wood Johnson Foundation recently announced that they are supporting a number of research projects testing simple interventions that may have widespread impact on complex problems. The initiative titled "Applying Behavioral Economics to Perplexing Problems In Health and Health Care" received administrative support from LDI CHIBE. Eight innovative proposals were selected to be funded through the initiative and teams will convene next year to share their findings.

Source: The Wall Street Journal, May 1, 2012

Gaming techniques are an increasingly popular new way to improve health behaviors. A number of workplace programs are using competitive videogame-style techniques to motivate employees to eat healthier and exercise more. Kevin Volpp notes that there is not a lot of peer-reviewed evidence out there that these gaming techniques actually achieve sustained improvement in health outcomes.

Source: MedCity News, April 23, 2012, LDI Health Economist, April 25, 2012

Kevin Mahoney's "Big Ideas Challenge" sought ideas for innovative ways to improve patient care from Penn staff. Ten ideas were chosen out of over 1,750 to be presented at a town hall meeting next month. Future innovation tournaments will focus on more targeted issues. 

Christian Terwiesch described this as "the American Idol phenomena" because "you have thousands of potential innovations but don't know which ones would ultimately create the kind of value that really moves the needle on patient experience." He also pointed out that the winning ideas will be refined into effective business plans.

Source: AAMC Reporter, April 2012 

In an interview with the AAMC Reporter about his book "Smart Medicine," Bill Hanson discusses how technological advances make health care more efficient and less costly. He suggests that the traditional model of medical education is already over and that the new model is moving toward a more team-based approach leaning heavily on easily accessible information.

Source: Risk & Insurance, April 13, 2012

Kevin Volpp was cited in an article that raised a number of questions about employer wellness incentives. He cautions that financial incentive designs are not well understood and non-financial factors need to be taken into account when designing these types of programs. 

Source: Philly.com, April 4, 2012

A new campaign has nine medical societies making recommendations against dozens of unnecessary medical tests in order to cut costs and avoid anxiety and risky follow-up procedures in patients. Mark Pauly believes that insured patients might not question the need for tests that they are not paying for directly. He says "the way to get them to do it is to give them a stake in the outcome."

Source: USA Today, April 2, 2012

Will the rising popularity of employer wellness programs lower health care costs? In an interview with USA Today, Kevin Volpp comments that we don't know how effective incentives are. The evidence shows that these programs work best when participants are offered choices and rewards are given immediately.

Source: NPR Radio, March 28, 2012

A controversial organ donation technique places possible donors on a heart-lung machine called ECMO, before their hearts stop beating. In an interview with NPR radio, Scott Halpern comments on the ethical concerns surrounding this technique stating that "the problem is, it's not at all clear that donors after circulatory determination of death are truly dead."

Source: NBC News - The Grio, March 27, 2012

Judith Long comments on her study that showed improved glucose control among African-American males through peer mentoring. She noted that "peer mentoring may be particularly effective in minority communities where there is a history of distrust in the system" and that "compared to whites, African-Americans are more likely to trust information from community contacts then they are from health care providers."

Source: Chattanooga Times Free Press, March 25, 2012, The Tennessean, January 12, 2012

In an interview regarding workplace wellness programs, Harald Schmidt offered that in order for a program to be truly effective, it needs to look at several factors including better health, cost savings and participation. He also commented that since programs are becoming more common, we ideally should expect to see health improvement and not just cost savings and improved productivity.

Source: Penn Medicine News, March 19, 2012; LDI Health Economist, March 20, 2012; New York Times, March 22, 2012

A study recently published in Annals of Internal Medicine found that peer mentoring improved diabetes control among African American Vets. Judith Long, Principal Investigator of the study, commented in a New York Times article that "peer mentoring is an inexpensive, easy and patient-centered way we doctors can support healthy behaviors outside of our offices." Kevin Volpp adds that that their study "raises the possibility that a more informal, flexible means of providing one-on-one peer support through peer coaches or mentors could potentially provide larger benefits at low cost."

Source:  Reuters, March 15, 2012

Scott Halpern and colleague Jason Wagner commented in the Archives of Internal Medicine on a research study done in Canada that showed no difference in patient mortality rates among patients referred to a medical emergency team at three hospitals when intensive care units (ICUs) were full and had to turn some patients away than when they were not.  Overcrowding of ICUs with patients who do not need critical care is common, and, says Halpern, "it's much easier to transfer a patient to an intensive care unit whether or not they will benefit from it than it is to have a difficult discussion about the end of life...Work needs to be done to better understand how commonly ICU beds are not available, and how often that affects patients who could benefit from ICU admission."


 

Source: Science in Action, March 16, 2012

A study conducted at Clark Park Farmers' Market by Alison Buttenheim collected SNAP (Food Stamp) payments through an easy electronic point-of-sale system. This easier method of payment increased fresh produce sales to SNAP recipients by 38 percent during the study; however, farmers' markets would not be able to break even on sales if they paid the costs associated with this system. Buttenheim hopes this study will "inform policymakers about the specific mechanisms driving SNAP redemptions and about the need for subsidies for wireless POS technology at farmers' markets."

Source: WHYY Newsworks, March 15, 2012

Mark Pauly discusses the evolution of the health insurance mandate idea and its current purpose. He also offers up some predictions about the Supreme Court hearing later this month.

Source: LDI Health Economist, February 2012

Mark Pauly, Janet Weiner, Daniel Polsky and David Grande took part in a panel discussion of the PBS documentary's content. They commented on the barriers that have prevented the innovative techniques highlighted in the documentary from being adopted by the rest of the country.

Source: Association of University Programs in Health Administration

LDI Senior Fellow Mark Pauly has been named the 2012 winner of the William B Graham Prize for Health Services Research. The award program is funded by the Baxter International Foundation and administered by the Association of University Programs in Health Administration (AUPHA). The prize includes $50,000 which will be split between Pauly and an institution of his choice to continue and expand his research. The prize will be awarded at the AUPHA Annual Meeting on May 31st in Minneapolis. Pauly is the Bendheim Professor of Health Care Management at Penn's Wharton School.

Source: The New York Times, February 14, 2012

While most conservatives now oppose the idea of an individual mandate, Mark Pauly reveals that his views remain the same. His influential paper calling for an individual mandate in 1991 is cited.

Source: The New York Times, February 13, 2012

Kevin Volpp's study on the impact of incentives on completion of health risk assessments is cited as an example of how lotteries can serve as effective motivators toward better health. 

Source: The Record, February 3, 2012

Mark Pauly weighs in on an article discussing the effects of for-profit hospitals on the quality of health care. He offers that even though people may not like the idea of for-profit hospitals, it may be the only way to get a hospital in their community