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.
George Loewenstein was quoted in a New York Times article about steps for avoiding public hysteria during the Ebola crisis. He offers that “the system often flips from one extreme to another, from ignoring risks altogether and then overreacting.”
Kevin Volpp and David Asch were two recipients of the Penn Medicine Awards of Excellence. The awardees exemplify the profession's highest values of scholarship and teaching, innovation, commitment to service, leadership, and dedication to patient care.
This year, the 7th annual Penn-CMU Roybal Center Retreat returned to Cape May, New Jersey on September 11th and 12th. The Roybal Retreat brings together academic experts from CHIBE and Carnegie Mellon University's Center for Behavioral Decision Research (CBDR) in Pittsburgh. The Retreat took place at Congress Hall and featured several faculty presentations, an innovation tournament and a team-building scavenger hunt.
Source: Philly.com, September 28, 2014
A Philly.com article refers to Katherine Milkman's research on temptation bundling in an article about building better habits. Her research showed that students who were only permitted to listen to a selected "sticky" novel at the gym exercised more than the control group and the group that was allowed to listen to their selected novel when they exercised at home as well. Milkman describes this as harnessing a bad habit and using its motivational power for good.
In a recent Washington Post article, Alison Buttenheim sheds light on the disturbing trend of an increasing number parents opting out of vaccinating their children in California. She believes parents are spreading their ideas that vaccines are unsafe or ineffective through social networks and these social processes produce clusters of vaccine refusers. When like-minded parents are drawn to the same schools, it creates schools and communities where vaccine refusal is the norm.
Jason Karlawish, in an op-ed piece for The New York Times, asks "when should we set aside a life lived for the future and, instead, embrace the pleasures of the present?" He notes that the United States Preventive Services Task Force finds that after certain ages, the benefits of prevention are not worth the risks and hassles of testing, surgeries and medications. He suggests that a national investment in communities and services that improve the quality of our aging lives might help us to achieve not only life, but happiness.
Strategy+business recently conducted a video interview with Wharton Professor Katherine Milkman about motivating people to achieve their goals. The key to achieving our goals throughout the year, shes says, is leveraging fresh starts--moments when we wipe the slate clean and are motivated to work harder.
A Philadelphia Inquirer article authored by David Asch, Roy Rosin and Raina Merchant reflects on why the ALS ice bucket challenge went viral and what health systems working on topics ranging from vaccinations and colorectal screening can learn from the campaign.
CHIBE Faculty member Alison Buttenheim has received a grant from the National Institutes of Child Health and Human Development to investigate the vaccination status of children exempt from school-entry immunization mandates. Her research in vaccine hesitancy and refusal titled “Potential Effects of California’s New Vaccine Exemption Law on the Prevalence and Clustering of Exemptions" was recently published in the American Journal of Public Health.