Center for Health Incentives and Behavioral Economics News Archive

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"Loss Incentive" Motivates Employees to Take More Steps

Sources: The New York Times, Forbes, TIMEPhiladelphia Inquirer, Reuters, FortuneMedpage Today, Newswise, STAT, ACSHLDI Blog, Penn Medicine, February 16, 2016; Penn Current March 24, 2016

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.

Tags: Mitesh Patel

Warning Labels May Discourage Teens from Purchasing Sugary Drinks

Source: Forbes, New York Daily News, Philly.com, U.S. News & World ReportKnowledge@Wharton Radio, Times of India, American Heart Association, Nutrition Insight, Penn Medicine News, Health Day, Daily Mail, Healthy Food America, PreventObesity.Net, ElEconomista.es, Pourqui DocteurAJMC, India TV News, Medical Xpress, Beverage Daily, September 8, 2016

Teens are more than 15 percent less likely to say they would purchase soft drinks and other sugary drinks that include health warning labels, according to a new CHIBE study conducted by Christina Roberto, PhD and Eric Van Epps, PhD of the Psychology of Eating and Consumer Health Lab. The study, published in the American Journal of Preventive Medicine, is among the first to examine how warning labels on sugary drinks influence teens, and builds upon research published by the team earlier this year which showed that parents were less likely to select sugary beverages for their kids when labels warning about the dangers of added sugar – which can contribute to obesity, diabetes and tooth decay – were present.


CHIBE Forges Research Partnership with National University of Singapore

Source: Penn LDI eMagazine, August 2016

Penn LDI reports: "In a new international partnership, the University of Pennsylvania's LDI Center for Health Incentives and Behavioral Economics (CHIBE) and the National University of Singapore (NUS) will jointly conduct a series of behavioral economics studies.

CHIBE Director Kevin Volpp said 'The similarity between the issues faced in Singapore and in the US in terms of switches in provider payment toward value and concerns about the role of non-communicable diseases such as obesity and diabetes as a major driver of health costs and poor outcomes is remarkable. We are excited about the possibility of this collaboration.'

The new CHIBE/NUS project will launch a number of pilot studies in various areas of population health including better management of diabetes, medication adherence, the promotion of healthier lifestyles, and the use of wearable monitoring devices for chronic disease management."


Patients More Likely to Take Medications When Refills are Synced

Source: Kaiser Health News, Science Daily, Specialty Pharmacy Times, Long-Term Living Magazine, The BulletinPenn Medicine News, August 8, 2016

A CHIBE study published today in Health Affairs found that a refill synchronization program – in which patients received all prescription refills at the same time – increased medication adherence by an average of three to five percent compared to a control group. Researchers found that refill synchronization had the greatest impact on patients who were least likely to take their medication before the intervention, increasing medication adherence in this subgroup by nine to thirteen percent over the control group. “The logistical challenges involved with keeping track of remaining pills and obtaining timely refills and renewals are magnified for patients who need to take multiple medications, and often create an obstacle to medication adherence,” said lead author Jalpa A. Doshi, PhD. The results of the study suggest that syncing prescription refills may be an effective strategy for reducing these obstacles.


Conditions Worse Than Death as Rated by the Seriously Ill

Source: The Economist, WHYY, WBUR, Fox News, Philly.com, Medscape, LDI Health Policy$ense, Live Science, August 1, 2016

Research from CHIBE's Fostering Improvement in End-of-Life Decision Science (FIELDS) program was highlighted in The Economist after the publication of a JAMA Internal Medicine article entitled, "States Worse Than Death Among Hospitalized Patients with Serious Illnesses."

The magazine wrote: "Asking people approaching, or threatened with death, how they feel about it, and the moment at which they would like it to come, is a welcome development. Both sides of the doctor-assisted-dying debate should pay attention to it."


Ordering Food in Advance Leads to Healthier Choices

Source: New York Times, Consumer Reports, Science Alert, New York Magazine, July 25, 2016

The New York Times profiled CHIBE's study, "Advance Ordering for Healthier Eating? Field Experiments on the Relationship Between the Meal Order–Consumption Time Delay and Meal Content," recently published in the Journal of Marketing Research.

CHIBE Postdoctoral Fellow Eric VanEpps told the Times, "If a decision is going to be implemented immediately, we just care about the immediate consequences, and we discount the long-term costs and benefits. In the case of food, we care about what’s happening right now – like how tasty it is – but discount the long-term costs of an unhealthy meal.”


Employee Exercise Increases with Competition and Financial Incentives

Source: Live Science, Penn Medicine News, July 15, 2016

A new CHIBE research study published in American Journal of Health Promotion found that comparing performance to average peers and offering financial incentives was the most effective method for increasing physical activity among teams of employees. "Many employers are using workplace competitions and financial incentives to encourage physical activity and other healthy behaviors among their employees," says Mitesh Patel, MD, MBA, MS, lead author of the study. The research team's findings demonstrate that these efforts can be successful when behavioral economics principles are applied.


Using Science to Make Good Health Choices

Source: NPR. July 7, 2016

NPR health news featured research that can raise the odds of making positive behavior changes. Kevin Volpp discusses the use of commitment contracts and Katherine Milkman's "temptation bundling" concept was also mentioned.


Kevin Volpp Comments on IBC Workplace Walking Study

Source: Reuters, July 7, 2016

Researchers at Independence Blue Cross compared workplace walking programs with and without "enhanced" features and found participants in the enhanced programs logged more steps, lost more weight and reported more improvement in energy and mood. Kevin Volpp commented that "it’s hard to know which part of the program was really the key ingredient to improvement. The challenge with these interventions is to disentangle the pieces of the intervention, to figure out which components, like feedback and incentives, had an impact.”

Tags: Kevin Volpp

Heather Schofield Study Shows Muslims Less Productive During Ramadan

Source: The Economist,  July 2, 2016

An Economist article discussing Ramadan's negative economic effect on Muslim countries mentions Heather Schofield's research suggesting that Muslims are less productive during Ramadan. The study found  that fasting by Indian agriculture workers led to a 20-40% drop in productivity when the holy month fell in the planting or harvesting season. Office workers are said to put off meetings and decisions until after Ramadan, during which trading activity tends to decline on stockmarkets in the Middle East.


Shivan Mehta Comments on Text Messaging Study

Source: The Wall Street Journal, June 30, 2016

Shivan Mehta, Associate Chief Innovation Officer at the Center for Healthcare Innovation, commented on a study conducted in Australia that suggests text messages could reduce one’s odds of a second heart attack. Mehta noted that the length of the Australian study was important because earlier studies have been conducted over a period of three months or less and the first six months after a heart attack are a high-risk period during which new health habits are formed. He also commented that the Australian study targeted multiple risk factors concurrently—smoking, exercise, diet and general cardiovascular awareness, rather than focusing on a single behavior.

Tags: Shivan Mehta

Financial Value of Wearable Devices

Source: Money Magazine, June 22, 2016

Money Magazine’s Get Healthy, Get Wealthy issue features Kevin Volpp's research on the role wearable fitness devices play in motivating people to start or improve an exercise routine. Wearable devices can be helpful if they spark an exercise habit, Volpp says, but “once the novelty wears off, many people stop using them.”

Tags: Kevin Volpp

“Traffic-light” and Numeric Calorie Labels Cut Calorie Consumption

Sources: Penn Medicine NewsUS News & World Report, Huffington Post, CBS Philly, Tech Times, New Hampshire Voice, June 17, 2016

A recent study published in the the Journal of Public Policy & Marketing by CHIBE Postdoctoral Fellow Eric VanEpps and colleagues at Carnegie Mellon University, involving online workplace lunch orders, found that each of three types of calorie labeling conditions – numbers alone, traffic lights alone, or both labels together – reduced calories ordered by about 10 percent, compared to orders involving no calorie labels. “The similar effects of traffic light and numeric labeling suggests to us that consumers are making decisions based more on which choices seem healthier than on absolute calorie numbers,” VanEpps said.


CHIBE and CHOP Partner to Address Juvenile Diabetes through Way to Health Platform

Source: Bench to Bedside (CHOP), June/July 2016

Researchers from CHIBE and the Children's Hospital of Philadelphia (CHOP) are collaborating with the goal of improving teens' glycemic control through behavioral economics. Their research has been made possible through the use of CHIBE's innovative Way to Health platform. CHOP reports: "The platform automates many of the research functions necessary to perform these sorts of behavioral economic randomized controlled trials using devices such as wireless activity trackers and other mobile health applications." 

Tags: Mitesh Patel

Volpp and Asch Receive AcademyHealth Article of the Year Award for "Effect of Financial Incentives on Lipid Levels"

Source: AcademyHealth, June 14, 2016

AcademyHealth Announced their 2016 Annual Research Meeting Award Recipients. Kevin Volpp and David Asch received the Article-of-the-Year Award for "Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial."

The Article-of-the-Year Award recognizes the best scientific work that the fields of health services research and health policy have produced and published during the previous calendar year. The award-winning article provides new insights into the delivery of health care and advances the knowledge of the field. 


Nudging Physicians Toward Value: Incentives in the Era of MACRA-Economics

Source: Commonwealth Fund, June 2, 2016

On June 2, 2016, The Commonwealth Fund, Healthcare: the Journal of Delivery Science and Innovation, and The University of Pennsylvania hosted an event at the National Press Club, in Washington, D.C., that explored how leading policymakers, health system executives, and payers are crafting innovative incentive programs to support value-based models of care. The event, MACRA-Economics: Nudging Physicians Toward Valuefocused on programs at three regional health systems—Advocate Healthcare in Chicago, Baptist Health System in San Antonio, and Partners HealthCare in Boston—and consider how insights from behavioral economics are shaping new models of provider incentives. Speakers from Penn were Ezekiel Emanuel, M.D., Ph.D. and Amol Navathe, M.D., Ph.D. 


Making End-of-life Care More Scientific

Source: Philadelphia Inquirer, May 22, 2016

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.


CHIBE Partners with ideas42 for "Behavioral Insights for Health Innovation" Initiative

Sources: ideas42, Yahoo.com, May 17, 2016

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.


Volpp, Asch and Halpern Lead New 'NEJM Catalyst' Advisory Committee

 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.


Changing EHR Default Options Increases Generic Prescribing

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."