At the RWJF/Donaghue/CHIBE Conference on Applying Behavioral Economics to Perplexing Problems in Health and Health Care, attendees competed in an innovation tournament to identify testable ideas that leverage behavioral economic principles to help make people healthier by working with commercial entities. The winning team addressed the issue of texting while driving by proposing an app that could be installed onto a cell phone to send reminders not to text while driving. The top three teams won Amazon gift cards.
Kevin Volpp explains how lotteries are an effective tool for getting employees to complete heath risk assessments. "Lotteries are designed to take advantage of both the fact that people are not good at estimating probabilities and that they can anticipate the regret they would feel if they don't win something they could have easily won," he says.
In response to the recent change in CVD treatment guidelines, Jason Karlawish authored an Op-Ed in the New York Times, noting that new numerically driven guidelines are "a revolutionary shift. Once upon a time, medicine was a discipline based on the nuanced diagnosis and treatment of sick patients. Now, Big Data, networked computers and a culture obsessed with knowing its numbers have moved medicine from the bedside to the desktop (or laptop). The art of medicine is becoming the science of an insurance actuary. "
Katherine Milkman's recent research evaluates a concept she coined as "temptation bundling." The study coupled listening to audio books such as "The Hunger Games" with going to the gym and found that “attendance rates increased meaningfully and significantly with access to the temptation bundling program, suggesting that temptation bundling creates value.” Kevin Volpp adds that further research could also look at how employers and insurers can use temptation bundling as a way to encourage healthier living.
University of Pennsylvania health care management professors Mark Duggan, Dan Polsky and Ezekiel Emanuel took to the stage to examine the future of the ACA at a Wharton School Lifelong Learning forum in Washington.
In a perspective published this week in the New England Journal of Medicine, David Asch argues that lowering the cost of health care requires lowering the cost of medical education. Asch and co-authors write "if we want to keep health care costs down and still have access to well-qualified physicians, we need to keep the cost of creating those physicians down by changing the way that physicians are trained. From college through licensure and credentialing, our annual physician-production costs are high, and they are made higher by the long time we devote to training."
A recently published study estimated that a $9,648 incentive per living donor would increase the number of kidneys available for transplant by 5%. In an accompanying editorial, Peter Reese suggested that it is time to conduct a study which would look into a limited trial of offering incentives for organ donation. He also commented that financial incentives that are legal and less controversial than direct payment should also be explored.
At the annual two-day Penn-CMU Roybal Center for Behavioral Economics and Health retreat at Cape May's Congress Hall, CHIBE conducted an experiment exploring how innovation tournament methodology might be applied to the scholarly research process. The theme was to identify ways to increase enrollment in behavioral economic studies. Two winning ideas each were awarded $10,000 in funding to further pursue their hypotheses. Kevin Volpp commented that the innvoation tournament "worked out really well with a lot of energy and team building that generated many ideas that were quite good."
The Institute of Medicine announced 70 new members during its 43rd annual meeting. Karen Glanz, professor of epidemiology and nursing and affiliated faculty at CHIBE, was among those elected. The statement notes that, "Election to the IOM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service."
In an interview with NPR, Kevin Volpp spoke to how employers are increasingly recognizing the fact that the health habits of their employees are one of the top challenges to affordable benefits coverage. Companies commonly incentivize their employees by lowering insurance premiums for healthy outcomes. Kevin commented that "the ideal program really does provide people with much more in the way of ongoing, frequent feedback. And, rewards that happen in the present, not just in the future."
The Robert Wood Johnson Foundation announced the grantees of their second year of the "Applying Behavioral Economics to Perplexing Problems in Health and Health Care" initiative, which received administrative support from LDI CHIBE. Six projects that proposed innovative solutions to reduce the utilization of low value services in health care will be funded. All grantees of this initiative will present their projects at the RWJF conference in November.
Traditional weight loss programs are facing stiff competition from programs and mobile apps that embrace newer technologies. Katie Milkman's research helps explain the popularity of these mobile apps by demonstrating how people can "get hooked" on healthy habits when they are paired with an engaging activity such as listening to a thrilling audio book. Kevin Volpp adds that many people still like the format of the traditional weight loss programs, so their challenge is to "morph their business model in ways that allow them to retain their core customer base while at the same time attract customers for whom the new [technologies] are appealing."
A recent study conducted by Scott Halpern and Jason Wagner dispels the notion that resource-strained ICUs will ration critical care resources and negatively affect patient care. They found that when ICUs were at their busiest, patients were discharged more quickly, without affecting patient outcomes. This study was published in the October issue of Annals of Internal Medicine.
Source: CNN, September 26, 2013
A study published in the Journal of Health Economics found that only 14% of people that were polled could identify basic health terms. They study's author, George Loewenstein, commented on why this is a huge issue, stating "we know from other research that people make disastrously bad insurance choices because they don't understand this basic language."
LDI Executive Director and Senior Fellow Dan Polsky is quoted in a Knowledge@Wharton article that analyzes the U.S. deficit's decrease to the lowest level since 2008. Polsky notes that will some elements the drive the deficit are one-time shots, there is evidence that some recent declines in health care costs could be longer lasting.
FIELDS Director Scott Halpern has been named an Institute of Medicine (IOM) Anniversary Fellow for a two-year term during which he will serve on an expert study committee and participate in other health and science policy work.
According to IOM President Harvey Fineberg, this year's four Anniversary Fellows were selected for their professional qualifications, reputations as scholars, professional accomplishments, and relevance of current field expertise to the work of the IOM. The IOM provides nonpartisan, evidence-based guidance to national, state and local policymakers, academic leaders, health care administrators and the public
The University of Pennsylvania is collaborating with the Vitality Institute, who focuses on reducing chronic disease risk, in order to to further research and best practices to improve health. The first three areas of focus will be weight loss, smoking cessation and medication adherence. By using behavioral economics, Kevin Volpp says "we can design more effective approaches to help people get healthier by better understanding how people's emotions and thoughts affect their decisions."
The Summer 2013 issue of Penn Medicine Magazine features a story titled "How to Get People to Live Healthier," which focuses on the behavioral economics research being conducted by Kevin Volpp and other colleagues at CHIBE.
In response to low participation rates in their wellness program, Penn State is switching from carrots to sticks. Starting January, they will charge a $100 monthly surcharge to employees that haven't filled out their health screening forms and gotten a physical exam. Harald Schmidt says that unfortunately, due to lacking reporting requirements, it is difficult to learn from the range of natural wellness incentive experiments that employers conduct.
Source: New York Times, August 10, 2013
Part of the solution to keeping patients adherent to medications that are of high benefit to them is to offer them free of cost. However, people still neglect to take their medicines even if they are free, so a more creative solution is warranted. Several studies under the direction of Kevin Volpp use GlowCaps to remind patients to take their medication. They also offer financial incentives in the form of lotteries that people can only win if they take their medications.