A recent Health Affairs article, authored by David Asch and Peter Ubel, offers psychological explanations for why it is difficult for clinicians to "'de-innovate,' or give up old practices, even when new evidence reveals that those practices offer little value." To overcome the resistance to de-innovation, Asch and Ubel recommended that the task force's guideline development committees be made up of medical experts from a wide variety of domains with different clinical expertise so that they can cancel out each other's conformation bias.
Kevin Volpp's work has earned him the 2015 Matilda White Riley Award, issued by the National Institutes of Health Office of Behavioral and Social Sciences Research (OBSSR). The Matilda White Riley Award is given in recognition of an outstanding behavioral or social scientist whose research has contributed to both the deepening of knowledge and its application in a manner that furthers NIH’s mission of improving health. The 8th Matilda White Riley Award and Lecture will take place June 23, 2015, as part of the celebrations of the 20th Anniversary of OBSSR.
Sources: New York Times, Wall Street Journal, Washington Post, Reuters, NBC News, CBS News, Fox News, The Guardian, Los Angeles Times, TIME, The Philadelphia Inquirer, Huffington Post, US News & World Report, Business Standard, NPR, ABC, Tech Times, Yahoo Finance, The Business Journals, Knowledge@Wharton, LDI Health Economist, May 13, 2015
A study led by Scott Halpern, recently published in the New England Journal of Medicine, compared five smoking cessation techniques in 2,538 employees of CVS, along with their friends and relatives. The study found that many more people signed up to a program that offered them an $800 reward than one that threatened them with losing a $150 deposit and only offered a $650 reward. However, those in the penalty program were twice as likely to quit.
"We found that those programs that first required people to deposit $150 of their own money were less acceptable to people than programs that were pure rewards," Halpern said.
"However, among those who would have accepted either program, the deposit-based programs were twice as effective as the rewards-based programs and five times more effective than the standard of care which was provision of free access to behavior modification therapy and nicotine replacement therapy."
Cass Sunstein, director of The Program on Behavioral Economics and Public Policy at Harvard Law School, compared the penalty program to taxes in an editorial for the New England Journal of Medicine.
Based on the results, "CVS Health is rolling out a campaign called '700 Good Reasons,'" Halpern said. "Instead of requiring a $150 deposit, it will require a $50 up-front deposit. If people are abstinent at 6 and 12 months, they'll not only get their $50 back but get an additional $700. Because they'll still have some skin in the game, it should be fairly effective."
Scott Halpern has been elected to membership in the American Society For Clinical Investigation (ASCI), a century-old medical honors society that supports the research work of physician-scientists. New members were announced and inducted by the ASCI Council at the organization's annual meeting in Chicago. Nomination and election to ASCI membership is based on the career accomplishment of "meritorious original, creative and independent investigations in the clinical and allied sciences of medicine."
Justin Bekelman, MD, Assistant Professor of Radiation Oncology at the medical school and CHIBE affiliated faculty member, will receive $11.9 million for a five-year study comparing the short and long-term effects of Proton versus Photon radiation therapy for patients with stage II or III breast cancer.
A consortium of 20 academic and community practice radiation therapy centers and related professional groups will conduct a randomized clinical trial in which 1,716 patients with stage II and II breast cancer involving lymph nodes under the arm or above the collarbone will receive after-surgery Proton or Photon therapy. Patients will be followed to determine differences in subsequent heart problems, cancer control and health-related quality of life measures.
At the Translational Science 2015 annual meeting, The Association for Clinical and Translational Science and The American Federation for Medication Research presented awards to investigators with outstanding contributions of investigators and educators in the field. Kevin Volpp was the recipient of the Distinguished Investigator Award for Career Achievement and Contribution to Clinical and Translational Science for Translation from Clinical Use into Public Benefit and Policy.
John Hancock Insurance Company announced a new program being operated through a partnership with Vitality, a global wellness company that works with insurers throughout the US. The new program rewards insurers points for continuously sharing wellness data. Achieving different levels of points lead to discounts on annual life insurance premiums. Kevin Volpp commented that the program “...changes the paradigm of life insurance, in some sense, it tries to change your insurance into less of a passive vehicle that pays the bills if something happens, into a more active vehicle to get people to lower their risk.”
In an interview at the 2015 AGA Tech Summit, David Asch discusses how physicians can incorporate the principles of behavioral economics into their practices to improve patient care.
A new study published in JAMA by Meredith Case, Holland Burwick, Kevin Volpp and Mitesh Patel is the first to compare the accuracy of smartphone apps to wearable devices when measuring physical activity. The researchers tested 10 smartphone apps and devices and found that the smartphone apps were just as accurate as the devices at tracking steps. "Our findings suggest that smartphone apps could prove to be a more widely accessible and affordable way of tracking health behaviors,” says Patel.
A paper published in the New England Journal of Medicine by LDI Executive Director Dan Polsky and co-authors at Penn and the Urban Institute provided the first evidence that the Medicaid “fee bump” succeed in its goal of improving primary care availability for growing numbers of Medicaid patients. In a 10-state study before and after the pay bump, primary care appointment availability improved 7.7 percentage points for Medicaid patients, while remaining unchanged for privately insured patients.
A JAMA Viewpoint article authored by Mitesh Patel, Kevin Volpp and David Asch describes why wearable devices alone don't drive behavior change. They offer that the potential health benefits depend more on the design of the engagement strategies than on the features of their technology.
Source: LDI Health Economist, January 2014
CHIBE's 2014 Behavioral Economics and Health Symposium took place in November at The Wharton School's Huntsman Hall. The symposium brought together academic, business and government experts from around the country to discuss the field's latest findings and trends. Speakers ranged from a member of the White House Social & Behavioral Sciences Team and top executives from PCORI and AHRQ to leading researchers from universities including Penn, Stanford, Harvard and Carnegie Mellon.
A new study led by Justin Bekelman in the Journal of Clinical Oncology found that hormone therapy plus radiation reduced cancer deaths by nearly 50 percent in men aged 76 to 85 compared to men who only received hormone therapy. Bekelman advises patients and their physicians to "carefully discuss curative treatment options for prostate cancer and reduce the use of hormone therapy alone.”
A study published in JAMA by lead investigator Mitesh Patel examined national death and readmission rates after the 2011 ACGME duty hour reforms went into effect. Patel reported that “some hoped that by shortening intern shifts from 30 hours to 16 hours, less fatigued residents would lead to less medical errors and improved patient outcomes. Yet, others were concerned that shorter shifts would increase patient handoffs and leave less time for education, thereby negatively affecting patient outcomes. These results show that in the first year after the reforms, neither was true.”
A study published in JAMA authored by researchers Justin Bekelman and Zeke Emanuel found that two-thirds of women treated for early-stage breast cancer in the U.S. receive longer radiation therapy than necessary. The vast majority of women who undergo lumpectomies receive six to seven weeks of radiation therapy, despite multiple randomized trials and professional society guidelines showing that three weeks of radiation is just as clinically effective, more convenient, and less costly.
A Harvard Business Review article by David Asch and Kevin Volpp encourages the adoption of behavioral economics approaches for wellness programs. Specific suggestions for implementation include: smaller incentives that are easy to find, constructing teams whose success depends on each member achieving a goal and turning repetitive activities into a daily game.
Researchers led by Dr. Peter Reese found that a US policy that puts previous kidney donors at the top of the transplant list is working. The organ donors had much shorter waiting times for a transplant and received higher-quality kidneys than non-donors. "After transplant, their survival is excellent compared with similar people who were not organ donors," Reese added.
Troy Brennan, Chief Medical Officer at CVS, recently spoke at an LDI health policy seminar about the impact of CVS' decision to stop selling tobacco and their strategies moving forward. These including expanding the in-store Minute Clinics, developing close ties with physicians, developing medication adherence services and favoring new health care related services and products in the front of the store.
A study lead by Mitesh Patel found that physicians prescribe less brand name drugs when generics are the default choice in electronic health records. “Not only was changing the default options within the EHR medication prescriber effective at increasing generic medication prescribing, this simple intervention was cost-free and required no additional effort on the part of the physician,” said Patel
An announcement from the NIH relayed that funds would be renewed funds for 11 Edward R. Roybal Centers for Research on Applied Gerontology. The announcement states "the centers have been innovative models for moving promising social and behavioral research findings out of the laboratory and into programs and practices that can be applied every day to improve the health and well-being of older people." CHIBE is one of the 11 Roybal Centers funded for renewal.