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.
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.
CHIBE hosted a free web event, produced by NEJM catalyst focused on improving the quality and value of health care through patient engagement. Ten preeminent business and clinical experts with in-depth knowledge of psychology, habit formation, behavioral economics, social marketing, and benefit design (several from CHIBE) shared their perspectives on ways to change patients’ health behavior that are scalable and usable across a wide range of clinical contexts.
Source: 2ser Radio, February 24, 2016
A radio station in Sydney Austrailia interviewed Kevin Volpp about the intricacies of monitoring people's behaviour and effectively implementing change using financial incentives, particularly in relation to obesity.
Dan Polsky of LDI and Kevin Volpp of CHIBE will lead a four-year project to develop and test algorithms aimed at predicting adverse health events in real time. The project, Smarter Big Data for a Healthy Pennsylvania: Changing the Paradigm of Healthcare is funded by the Commonwealth Universal Research Enhancement (CURE) program, and will examine the use of the algorithms in the hospital, at home, and in the community.
Jalpa Doshi, Pengxiang (Alex) Li, and colleagues have been announced as the first-place winners in the “PAN Challenge: Balancing Moral Hazard, Affordability and Access to Critical Therapies in the Age of Cost Sharing” launched by the Patient Access Network (PAN) Foundation in collaboration with the American Journal of Managed Care (AJMC). The competition called for papers addressing how federal cost sharing policies affect the ability of individuals with chronic and rare diseases to have affordable access to critical therapies and what policy solutions are likely to improve access.
Their paper titled “High Cost Sharing and Specialty Drug Initiation under Medicare Part D: A Case Study in Newly Diagnosed Chronic Myeloid Leukemia Patients “ won the first prize of $10,000. More importantly, the paper will be published in a special AJMC supplement and presented at a Cost Sharing Roundtable convened at the Kaiser Family Foundation Barbara Jordan Conference Center in Washington D.C. next month.
Source: Forbes, January 19, 2016
An alumni of Leonard Davis Institute's Summer Undergraduate Minority Research (SUMR) Program, Aaron Schwartz, was named to Forbes "30 Under 30" list. Aaron is a graduate of Swarthmore College and is now a medical student at Harvard. His research focuses on algorithms to determine how much is being spent on medical services that don't make patients much healthier. His work has been published in Health Affairs, JAMA Internal Medicine, and the New England Journal of Medicine.
Sources: The New York Times, January 18, 2016
A New York Times Op-Ed column authored by Harald Schmidt, PhD, discusses the practice of employers and health plans incentivizing women to get mammograms. Since the pros and cons of getting a mammogram can be complicated, depending on age and risk profiles, he suggests that employers and health plans should instead offer incentives that reward the use of online decision aids which are based on the best available scientific evidence. In short, he writes "Don’t pay women to get mammograms — pay them to use a tool to decide whether they should get mammograms."
Sources: CBS News, US News & World Report, TIME, Fox News, Philly.com, Penn Medicine News, HealthDay, Medical News Today, WebMD, Medical Daily, Doctors Lounge, Medical Xpress, Capital Wired, NewsMax, International Business Times, January 14, 2016
An article published in Pediatrics by lead author Christina Roberto, PhD, found that warning labels on sugar-sweetened beverages may deter parents from purchasing them. Roberto commented that "Some states have introduced bills requiring SSBs to display health warning labels, but to date, there is little data to suggest how labels might influence purchasing habits, or which labels may be the most impactful." She notes that their findings are similar to those from studies that examined the effects of tobacco warning labels, which have been shown to encourage smoking cessation.
The Washington Post published a write-up of Mitesh Patel and colleagues' past work on wearable technologies. While a lot of people are interested in the potential for wearables to transform health behaviors, there hasn't been much evidence yet that these devices do that, says Patel. There is also little understanding of how the health community can get wearables into the hands of the patients who need them most. Patel also offered some guidelines for how people or organizations can best use activity trackers.
Sources: Penn Medicine News, US News & World Report, Philadelphia Inquirer, NPR, NPR Blog, Chicago Tribune, Kaiser Health News, WebMD, HealthDay, Medical Xpress, WDAM, Metro, Human Resource Executive, PhillyVoice, Health Affairs Podcast, January 6, 2016
A study led by Dr. Mitesh Patel, published in Health Affairs, revealed that three different types of incentive programs using either health insurance premium adjustments or lottery-based financial incentives were ineffective for promoting weight loss in a randomized trial using weight scales in the workplace. Authors note that the apparent failure of the incentives to promote weight loss suggests that employers encouraging weight reduction and other healthy lifestyle choices through workplace wellness programs should test incentive designs different from the typical premium-based financial incentives.
"Wearable Devices as Facilitators, Not Drivers, of Health Behavior Change," an article written by Mitesh Patel, David Asch and Kevin Volpp was named one of the top five most popular articles of 2015 by the Journal of the American Medical Association (JAMA). According to Altmetric, the article was viewed more than 40,000 times, covered by 15 news outlets, tweeted about by 992 Twitter users and mentioned on 58 Facebook pages.
NEJM Group announced the launch of NEJM Catalyst, an online resource that offers a combination of multimedia content, web events, expert panels, and new research. NEJM Catalyst articles, case studies, video talks and events are organized around key themes impacting health care today. Kevin Volpp will lead the NEJM catalyst theme, “Patient Engagement: Behavioral Strategies for Better Health" on February 25th, 2016.
Sources: JAMA, The Philadelphia Inquirer, CBS News, US News & World Report, HealthDay, Newsworks, MedPage Today, LDI, AJMC, UK News, Endocrinology Advisor, Food World News, Daily Mail, Yahoo Finance, Health Medicine Network, American Pharmacists' Association, Entertainmentwise, Health Insurance & Protection Daily, November 12, 2015.
A recent study led by Dr. David Asch and Dr. Kevin Volpp, published in JAMA, found that providing financial incentives to both primary care physicians and patients leads to a greater reduction in low-density lipoprotein (LDL) cholesterol in patients than paying only the physician or only the patient. This was the first study to test physician-only and patient-only incentives compared to incentives shared by patients and physicians. The study used the Way to Health Platform to enroll 340 physicians and 1,503 patients.
Source: Penn LDI October 9, 2015
A study led by Charlene Wong on young adults' experiences on HealthCare.gov recommended several tools that are now being implemented into the upgraded website. New tools include an out-of pocket total cost estimator, tools that allow consumers to see if their preferred providers or hospitals are in-network across all plans, and an improved window-shopping experience, which allows consumers to see what’s available to them before creating an account.