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.
Source: NPR. July 7, 2014
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.
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.”
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, 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.
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.”
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.
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.
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 Value, focused 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.
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.