A study lead by Mitesh Patel, published in Annals of Internal Medicine, gave 281 overweight and obese participants a goal of 7,000 steps per day for 13 weeks. Participants were randomized to one of three incentive groups with daily feedback, a gain incentive ($1.40 for each day goal was met); lottery incentive (daily eligibility if goal was achieved); or loss incentive ($42 allocated monthly upfront and $1.40 removed each day goal was not achieved) or a control group with daily feedback. They found that financial incentives framed as a loss were most effective for achieving physical activity goals.
The Philadelphia Inquirer featured an article on the FIELDS program, highlighting their current studies and recent publications. FIELDS is " the country's only program devoted to applying the principles of behavioral economics, in essence the study of how people make choices, to end-of-life care," says director Scott Halpern.
The "Behavioral Insights for Health Innovation" (BIHI) initiative between CHIBE and nonprofit behavioral science lab ideas42 will give practitioners and policymakers tools to apply powerful and cost-effective solutions inspired by behavioral science, putting BIHI at the forefront of America’s drive for low-cost innovation and improved health outcomes. The new collaboration will also include a spotlight series of pieces taking a closer look at behavioral solutions to pressing challenges and issues that our healthcare system faces, ranging from over-prescription of pharmaceuticals to smoking cessation to diabetes prevention. This initiative is supported by the Robert Wood Johnson Foundation.
Source: LDI News, May 11, 2016
NEJM Catalyst has appointed national "Lead Advisors" and a committee of "Thought Leaders" in three areas of healthcare delivery. Kevin Volpp was chosen as the Lead Advisor for the Patient Engagement core and David Asch and Scott Halpern were chosen as two of the seven Thought Leaders. The core participated in the NEJM Catalyst Event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania on February 25, 2016.
Source: Medical Express, May 9, 2016
A study published in JAMA Internal Medicine, led by Mitesh Patel, found that a change to prescription default options in electronic medical records immediately increased generic prescribing rates from 75 percent to 98 percent. Patel commented "Our results demonstrate that default options are a powerful tool for influencing physician behaviors but that they have to be well-designed to achieve the intended goals."
Source: JAMA Pediatrics, May 9, 2016
A JAMA viewpoint article authored by Alison Buttenheim and David Asch identifies several interventions that use behavioral economics to increase vaccine acceptance. These interventions recognize common biases as well as people’s tendency to respond to social cues and salient information.
Two new studies led by Jalpa Doshi have found evidence that cost-sharing arrangements are associated with significant reductions in access to specialty drugs. Both papers are published online in the American Journal of Managed Care.
In the first study, the team conducted a review of the literature and found evidence that high out-of-pocket costs were generally associated with lower use of specialty drugs. In the second study, the team examined Medicare claims data and found that “Part D” (prescription drug plan) co-insurance policies for specialty drugs seem to be reducing or delaying use of a lifesaving class of leukemia therapies.
Source: NEJM Catalyst, March 25, 2016
Where do we draw the line between improving people’s health behavior in the direction that we want, versus leaving them happy with what they have? Kevin Volpp, David Kirchhoff, and Wendy Wood discuss how much providers should let patients drive what happens (patient-centered care), and when it might make sense to be more paternalistic. This segment is taken from the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health
Source: NEJM Catalyst, March 7, 2016
As Lead Advisor for the Patient Engagement theme on NEJM Catalyst, Kevin Volpp kicks off an ongoing series of articles, case studies, interviews, and other contributions from leaders dedicated to improving patient engagement.
His first blog post discusses patient engagement and behavioral insights. He summarizes that the key to designing a better health care system is to recognize that what patients want is to be healthy, not consume health services.
Source: NEJM Catalyst, March 7, 2016
A lot of incentives programs don’t work, but they can if they’re designed just a little bit better, says David Asch. He and NEJM Catalyst’s Tom Lee sat down to discuss how financial incentives really can work to engage people in healthy behavior, and Asch discusses how things have changed since publishing several key articles in The New England Journal of Medicine.
Mitesh Patel, David Asch and Kevin Volpp authored an Op-Ed in The New York Times about the effectiveness of workplace wellness programs based on recent research they've published. Their research suggests that financial incentives can work well for employee wellness programs, but only if they are separated from insurance premiums.
Source: Medscape, March 3, 2016
An article published in the Journal of Clinical Oncology, authored by Eric Ojerholm, Scott Halpern and Justin Bekelman, explores what defaults are, why they work, and how they could be used to improve quality and value in oncology. The article includes three examples in which a default option could be useful clinically.
CHIBE hosted a free web event, produced by NEJM catalyst focused on improving the quality and value of health care through patient engagement. Ten preeminent business and clinical experts with in-depth knowledge of psychology, habit formation, behavioral economics, social marketing, and benefit design (several from CHIBE) shared their perspectives on ways to change patients’ health behavior that are scalable and usable across a wide range of clinical contexts.
Source: 2ser Radio, February 24, 2016
A radio station in Sydney Austrailia interviewed Kevin Volpp about the intricacies of monitoring people's behaviour and effectively implementing change using financial incentives, particularly in relation to obesity.
Dan Polsky of LDI and Kevin Volpp of CHIBE will lead a four-year project to develop and test algorithms aimed at predicting adverse health events in real time. The project, Smarter Big Data for a Healthy Pennsylvania: Changing the Paradigm of Healthcare is funded by the Commonwealth Universal Research Enhancement (CURE) program, and will examine the use of the algorithms in the hospital, at home, and in the community.
Jalpa Doshi, Pengxiang (Alex) Li, and colleagues have been announced as the first-place winners in the “PAN Challenge: Balancing Moral Hazard, Affordability and Access to Critical Therapies in the Age of Cost Sharing” launched by the Patient Access Network (PAN) Foundation in collaboration with the American Journal of Managed Care (AJMC). The competition called for papers addressing how federal cost sharing policies affect the ability of individuals with chronic and rare diseases to have affordable access to critical therapies and what policy solutions are likely to improve access.
Their paper titled “High Cost Sharing and Specialty Drug Initiation under Medicare Part D: A Case Study in Newly Diagnosed Chronic Myeloid Leukemia Patients “ won the first prize of $10,000. More importantly, the paper will be published in a special AJMC supplement and presented at a Cost Sharing Roundtable convened at the Kaiser Family Foundation Barbara Jordan Conference Center in Washington D.C. next month.
Source: Forbes, January 19, 2016
An alumni of Leonard Davis Institute's Summer Undergraduate Minority Research (SUMR) Program, Aaron Schwartz, was named to Forbes "30 Under 30" list. Aaron is a graduate of Swarthmore College and is now a medical student at Harvard. His research focuses on algorithms to determine how much is being spent on medical services that don't make patients much healthier. His work has been published in Health Affairs, JAMA Internal Medicine, and the New England Journal of Medicine.
Sources: The New York Times, January 18, 2016
A New York Times Op-Ed column authored by Harald Schmidt, PhD, discusses the practice of employers and health plans incentivizing women to get mammograms. Since the pros and cons of getting a mammogram can be complicated, depending on age and risk profiles, he suggests that employers and health plans should instead offer incentives that reward the use of online decision aids which are based on the best available scientific evidence. In short, he writes "Don’t pay women to get mammograms — pay them to use a tool to decide whether they should get mammograms."
Sources: CBS News, US News & World Report, TIME, Fox News, Philly.com, Penn Medicine News, HealthDay, Medical News Today, WebMD, Medical Daily, Doctors Lounge, Medical Xpress, Capital Wired, NewsMax, International Business Times, January 14, 2016
An article published in Pediatrics by lead author Christina Roberto, PhD, found that warning labels on sugar-sweetened beverages may deter parents from purchasing them. Roberto commented that "Some states have introduced bills requiring SSBs to display health warning labels, but to date, there is little data to suggest how labels might influence purchasing habits, or which labels may be the most impactful." She notes that their findings are similar to those from studies that examined the effects of tobacco warning labels, which have been shown to encourage smoking cessation.
The Washington Post published a write-up of Mitesh Patel and colleagues' past work on wearable technologies. While a lot of people are interested in the potential for wearables to transform health behaviors, there hasn't been much evidence yet that these devices do that, says Patel. There is also little understanding of how the health community can get wearables into the hands of the patients who need them most. Patel also offered some guidelines for how people or organizations can best use activity trackers.