In a perspective published this week in the New England Journal of Medicine, David Asch argues that lowering the cost of health care requires lowering the cost of medical education. Asch and co-authors write "if we want to keep health care costs down and still have access to well-qualified physicians, we need to keep the cost of creating those physicians down by changing the way that physicians are trained. From college through licensure and credentialing, our annual physician-production costs are high, and they are made higher by the long time we devote to training."
A recently published study estimated that a $9,648 incentive per living donor would increase the number of kidneys available for transplant by 5%. In an accompanying editorial, Peter Reese suggested that it is time to conduct a study which would look into a limited trial of offering incentives for organ donation. He also commented that financial incentives that are legal and less controversial than direct payment should also be explored.
At the annual two-day Penn-CMU Roybal Center for Behavioral Economics and Health retreat at Cape May's Congress Hall, CHIBE conducted an experiment exploring how innovation tournament methodology might be applied to the scholarly research process. The theme was to identify ways to increase enrollment in behavioral economic studies. Two winning ideas each were awarded $10,000 in funding to further pursue their hypotheses. Kevin Volpp commented that the innvoation tournament "worked out really well with a lot of energy and team building that generated many ideas that were quite good."
The Institute of Medicine announced 70 new members during its 43rd annual meeting. Karen Glanz, professor of epidemiology and nursing and affiliated faculty at CHIBE, was among those elected. The statement notes that, "Election to the IOM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service."
In an interview with NPR, Kevin Volpp spoke to how employers are increasingly recognizing the fact that the health habits of their employees are one of the top challenges to affordable benefits coverage. Companies commonly incentivize their employees by lowering insurance premiums for healthy outcomes. Kevin commented that "the ideal program really does provide people with much more in the way of ongoing, frequent feedback. And, rewards that happen in the present, not just in the future."
The Robert Wood Johnson Foundation announced the grantees of their second year of the "Applying Behavioral Economics to Perplexing Problems in Health and Health Care" initiative, which received administrative support from LDI CHIBE. Six projects that proposed innovative solutions to reduce the utilization of low value services in health care will be funded. All grantees of this initiative will present their projects at the RWJF conference in November.
Traditional weight loss programs are facing stiff competition from programs and mobile apps that embrace newer technologies. Katie Milkman's research helps explain the popularity of these mobile apps by demonstrating how people can "get hooked" on healthy habits when they are paired with an engaging activity such as listening to a thrilling audio book. Kevin Volpp adds that many people still like the format of the traditional weight loss programs, so their challenge is to "morph their business model in ways that allow them to retain their core customer base while at the same time attract customers for whom the new [technologies] are appealing."
A recent study conducted by Scott Halpern and Jason Wagner dispels the notion that resource-strained ICUs will ration critical care resources and negatively affect patient care. They found that when ICUs were at their busiest, patients were discharged more quickly, without affecting patient outcomes. This study was published in the October issue of Annals of Internal Medicine.
Source: CNN, September 26, 2013
A study published in the Journal of Health Economics found that only 14% of people that were polled could identify basic health terms. They study's author, George Loewenstein, commented on why this is a huge issue, stating "we know from other research that people make disastrously bad insurance choices because they don't understand this basic language."
The University of Pennsylvania is collaborating with the Vitality Institute, who focuses on reducing chronic disease risk, in order to to further research and best practices to improve health. The first three areas of focus will be weight loss, smoking cessation and medication adherence. By using behavioral economics, Kevin Volpp says "we can design more effective approaches to help people get healthier by better understanding how people's emotions and thoughts affect their decisions."
The Summer 2013 issue of Penn Medicine Magazine features a story titled "How to Get People to Live Healthier," which focuses on the behavioral economics research being conducted by Kevin Volpp and other colleagues at CHIBE.
In response to low participation rates in their wellness program, Penn State is switching from carrots to sticks. Starting January, they will charge a $100 monthly surcharge to employees that haven't filled out their health screening forms and gotten a physical exam. Harald Schmidt says that unfortunately, due to lacking reporting requirements, it is difficult to learn from the range of natural wellness incentive experiments that employers conduct.
Source: New York Times, August 10, 2013
Part of the solution to keeping patients adherent to medications that are of high benefit to them is to offer them free of cost. However, people still neglect to take their medicines even if they are free, so a more creative solution is warranted. Several studies under the direction of Kevin Volpp use GlowCaps to remind patients to take their medication. They also offer financial incentives in the form of lotteries that people can only win if they take their medications.
Source: Reuters, August 10, 2013
In response to the rapidly growing employer wellness-based incentive program market, Weight Watchers is planning to commit more resources to it's workforce division. This division, called Health Solutions, partners with corporations to create incentive programs with Weight Watchers. Although the market appears to be growing, employers are not required to report participation in these programs, so it is hard to gather exact data, said Harald Schmidt.
The August Issue of Medical Ethics Advisor brings up the key ethical issue of whether responses to obesity should focus on societal level, individual level or both. Harald Schmidt spoke about how “we need action at both the social and individual level, but we must take care not to penalize people unduly.”
Scott Halpern has been named an Institute of Medicine (IOM) Anniversary Fellow for a two-year term during which he will serve on an expert study committee and participate in other health and science policy work. He is one of four Anniversary Fellows that were selected for their professional qualifications, reputations as scholars, professional accomplishments, and relevance of current field expertise to the work of the IOM.
Penn State employees that do not participate in a new health program titled "Take Care of Your Health" will be charged a $100 a month surchage. Kevin Volpp and Mark Pauly were both interviewed for their critiques on the new program. Kevin Volpp offered that "a penalty-type program doesn't engender warm feelings among the employees that the employer is looking out for their best interests and is just trying to help them." Mark Pauly commented that "it's a pipe dream that it will save Penn State money."
Source: CBS News, July 19, 2013
CBS News covered a story about a recently published study in the American Journal of Public Health. The study, led by Julie Downs, supplemented menu labelling with calorie intake recommendations and found that people who were given the calorie guidelines ate an average of 49 more calories more than those who did not receive the guidelines. Downs commented that "the bigger issue is that asking people to do math three times a day every day of their lives is a lot," She also added "because it's not like we make a decision about what to eat just once. It's a lot of decisions. And if you add a cognitive [mental] burden on top of that it's a lot to ask."
Source: Knowledge@Wharton, July 17, 2013
Creators of "connected-health devices" are facing several challenges including FDA guidelines and engagement among high-risk populations. The Way to Health platform, managed by Kevin Volpp and David Asch, has successfully tested several devices to improve engagement among people that are at high risk. Kevin Volpp believes that technology is an enabler, but the key challenge is changing people's behavior.
The Philadelphia Inquirer recently covered a story on Penn's research partnership with Independence Blue Cross. They will be collaborating on several studies under the direction of Kevin Volpp. One study utilizes GlowCaps, electronic pill bottles that remind patients to take their medicine, which allow the study teams to track medication adherence 24 hours a day.