Under the Affordable Care Act, individuals will have to pay a penalty of $95 or 1% of their income (whichever is higher) for not having health coverage. The question is whether that amount is enough of a penalty, since health coverage can cost thousands of dollars. Kevin Volpp offers that this modest penalty could work better than most people think, because of a phenomenon known as loss aversion which refers to people's tendency to strongly prefer avoiding losses to acquiring gains.
A Way to Health study published in this weeks Annals of Internal Medicine, conducted by PI's Jeff Kullgren and Kevin Volpp, found that offering CHOP employees a competitive group financial incentive was more effective for weight loss than an individual incentive. Co-author David Asch comments “our study demonstrates that how one offers the incentive is critically important. A lot of employers, insurers, and health care institutions are rolling out incentive programs now, and with a little design help they can make those programs much more effective.”
Incentivizing patients to seek higher value medical services may be crucial to the success of the accountable care organization model. David Asch offers that the most effective incentive designs take into account the timing and delivery of incentives.
The New England Journal of Medicine featured two perspective essays about the smoker hiring ban by two groups of Penn researchers. David Asch, Kevin Volpp and Ralph Muller highlight the reasons an employer would want to implement a no-smoking policy for new hires in their article "Conflicts and Compromises in Not Hiring Smokers." The opposing article, written by Harald Schmidt, Kristin Voigt and Ezekiel Emanuel, points out the ethical issues behind the ban in their article "The Ethics of Not Hiring Smokers."
Source: LDI News, March 28, 2013
Graduate student and CHIBE trainee Nora Becker was named one of the winners of the Leonard Davis Institute's William L. Kissick Health Policy Research Award. Becker was acknowledged for her work as co-author on the paper "The Impact of Two Incentive-Based Health Interventions on Stages of Change and Patient Activation Measure Scores." The Health Policy Research award is given to students who have done meritorious research in the field of health economics.
This week's cover story of New York Times Magazine profiled Adam Grant, a Wharton professor and affiliated faculty member at CHIBE. He is known as a "rising star" in the field of organizational psychology. Along with being given tenure at age 30, he is also the highest-rated professor at Wharton.
Source: New York Times, March 12, 2013
A day before it was supposed to go into effect, the courts ruled against New York's proposed soda ban. Kevin Volpp offers that the proposed law is a nudge because it makes it less convenient to buy larger amounts of soda and it is also implicitly a tax by raising the relative cost of an ounce of soda. He also commented that the soda ban is a slippery slope because it could worry people that similar bans might be applied to many other types of items such as potato chips.
Source: NPR, March 7, 2013
There has been an explosion of interest in workplace wellness programs that offer financial incentives, according to Kevin Volpp, in an interview with NPR. He commented on the results of a recent study conducted at the Mayo Clinic that offered financial incentives in the form of lotteries and deposits. In this study, the incentive group lost an average of 9 pounds, which Volpp considers to be promising, but may not make a big difference in their health.
High-value care has recently been emphasized as an important goal of health care reform efforts. In an article published in the New England Journal of Medicine, Lisa Rosenbaum explains that creating value to physicians means reducing overuse of unnecessary tests, while for patients, creating value means enhancing their experience and paying attention to processes that matter to them. Rosembaum calls for a view that encompasses both patients and physician perspectives of "high-value care"
In an interview with Southern California Public Radio, Kevin Volpp spoke about workplace wellness programs and how they are using outcome-based incentives to a much greater degree. This means that workers will pay more for health insurance if they fail to get in better shape. This is supported by the new healthcare law, under which employers can impose larger financial penalties starting next year.
Kevin Volpp was a recent guest on the Kojo Nnamdi show, a radio show based in Washington, DC that highlights news, political issues and social trends. He spoke about using economic incentives to get employees motivated to join employer wellness programs. He noted that it is not the just size of the reward that makes a program effective most, rather it depends on how simple the system is, the salience of the rewards and frequency of feedback.
Source: USA Today March 3, 2013
Jonah Berger, assistant professor of marketing at Wharton, recently published a book about why certain stories get shared, e-mails get forwarded, or videos go viral. In an interview with USA Today, Jonah describes that his book, Contagious: Why Things Catch On, is all about is how word of mouth and social influence more generally drive people to talk about and share things and drive those things to become popular.
Eighty percent of large employers in the US are using financial incentives for health behaviors. Kevin Volpp offers that sweepstakes are an effective incentive mechanism to get employers more bang for their buck, that is, get higher rates of completion for the same amount of money.
A number of health systems, including Penn Medicine, are instituting policies to hire only non-smokers in order to provide a healthier environment for their patients while saving on employee health insurance. Kevin Volpp agreed that not hiring smokers is one way for employers to lower their future health costs.
As a part of the Affordable Care Act, the total cost of health benefits is now printed on W-2 forms. This is meant to make employees aware of the full cost of their health benefits. Kevin Volpp offers that a once-a-year reminder of this may not be ineffective since it does not tell consumers how they can lower these costs.
Source: Medcity News, February 6, 2013
Kevin Volpp and David Asch's CMMI project was cited as one of the five ways that Independence Blue Cross is improving patient centered care. The collaboration between IBX and the Penn Medicine Innovation Center is designed to increase medication adherence for patients who were admitted for acute myocardial infarction.
A new study comparing different types of advanced directives conducted by Scott Halpern finds that while most seriously ill patients prefer comfort-oriented care, the default option that was checked on their advance directive dramatically influenced their choice. Halpern comments that this finding makes sense because patients can't be expected to have deep-seated preferences about choices that are rarely encountered and difficult to contemplate.
Source: New York Times, January 10, 2013
In a recent op-ed by New York Times columnist David Brooks on the importance of behavioral economic approaches to informing public policy, work by CHIBE researchers Kevin Volpp, George Loewenstein and Leslie John in contributing to a recent the book on the behavioral foundations of public policy was highlighted with description of a weight loss study we conducted that was published in JAMA in which people trying to lose weight were made eligible for daily sweepstakes and lost three times as much weight as those who were in a control group.
Based on a 2009 IOM report recommending protected sleep periods for residents who work up to 30 hours, Kevin Volpp and colleagues wanted to evaluate the feasibility of a 5 hour protected sleep period for interns. The results show that a protected period of sleep for interns is feasible and can result in an increase in overnight sleep duration and improved alertness the next morning. The study was the first to show that protected sleep periods may provide a reasonable alternative to the intern duty hour reduction that went into effect in July 2011.
Source: Forbes, November 26, 2012
A recent study sponsored by Aetna showed that waiving drug co-pays for heart-attack patients only resulted in a a small improvement in adherence. Kevin Volpp offers his thoughts stating "we need serious rethinking about what happens when medication is dispensed." Volpp and others are experimenting with approaches that offer incentives to patients for taking their medications.