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.
Source: Reuters, August 10, 2013
In response to the rapidly growing employer wellness-based incentive program market, Weight Watchers is planning to commit more resources to it's workforce division. This division, called Health Solutions, partners with corporations to create incentive programs with Weight Watchers. Although the market appears to be growing, employers are not required to report participation in these programs, so it is hard to gather exact data, said Harald Schmidt.
The August Issue of Medical Ethics Advisor brings up the key ethical issue of whether responses to obesity should focus on societal level, individual level or both. Harald Schmidt spoke about how “we need action at both the social and individual level, but we must take care not to penalize people unduly.”
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. He is one of four Anniversary Fellows that were selected for their professional qualifications, reputations as scholars, professional accomplishments, and relevance of current field expertise to the work of the IOM.
Penn State employees that do not participate in a new health program titled "Take Care of Your Health" will be charged a $100 a month surchage. Kevin Volpp and Mark Pauly were both interviewed for their critiques on the new program. Kevin Volpp offered that "a penalty-type program doesn't engender warm feelings among the employees that the employer is looking out for their best interests and is just trying to help them." Mark Pauly commented that "it's a pipe dream that it will save Penn State money."
Source: CBS News, July 19, 2013
CBS News covered a story about a recently published study in the American Journal of Public Health. The study, led by Julie Downs, supplemented menu labelling with calorie intake recommendations and found that people who were given the calorie guidelines ate an average of 49 more calories more than those who did not receive the guidelines. Downs commented that "the bigger issue is that asking people to do math three times a day every day of their lives is a lot," She also added "because it's not like we make a decision about what to eat just once. It's a lot of decisions. And if you add a cognitive [mental] burden on top of that it's a lot to ask."
Source: Knowledge@Wharton, July 17, 2013
Creators of "connected-health devices" are facing several challenges including FDA guidelines and engagement among high-risk populations. The Way to Health platform, managed by Kevin Volpp and David Asch, has successfully tested several devices to improve engagement among people that are at high risk. Kevin Volpp believes that technology is an enabler, but the key challenge is changing people's behavior.
The Philadelphia Inquirer recently covered a story on Penn's research partnership with Independence Blue Cross. They will be collaborating on several studies under the direction of Kevin Volpp. One study utilizes GlowCaps, electronic pill bottles that remind patients to take their medicine, which allow the study teams to track medication adherence 24 hours a day.
Kevin Volpp and Scott Halpern discuss how insights from behavioral economics can improve the health of the population. Volpp offers that interventions that combine telemedicine and behavioral nudges can strengthen traditional care approaches while Scott Halpern speaks to decision fatigue and the importance of framing.
Source: Financial Times, June 20, 2013
The use of penalties for employee non-participation in wellness programs has more than doubled in the US from 2009 to 2011. Penalties to drive reductions in smoking or obesity raise ethical questions, says Harald Schmidt. “In principle there would be nothing wrong if it was equally easy for all to comply with conditions,” he says. “But because that’s questionable for smoking, just as for obesity, real fairness issues are raised.”
On a 6ABC news segment covering the lung transplant waiting list rule, Scott Halpern offered his thoughts on the ramifications of the decision to overturn the current rule that keeps children under 12 from qualifying for adult lungs. He commented that we may not "want judges making medical decisions any more than we want doctors deciding Supreme Court cases" and pointed out that “every child under the age of 12 who gets an adult lung, that’s someone else, probably a child who is 13 or 14, who is not getting that lung.”
The Penn Medicine Center for Innovation along with the Chief Medical Information Officer and Network Development Office convened the recent University of Pennsylvania's first annual "Connected Health Symposium" on April 3rd to explore the latest technological developments in the field of medicine. A video report comprised of all presentations from this event can be viewed here.
Source: The Atlantic, June 3, 2013
The Obama administration recently released its final rules on employment-based wellness programs. In an interview with The Atlantic, Kevin Volpp offers that not all incentive programs are created equal and that the impact of the incentive depends on the context in which it is offered and how it is framed.
It would be wrong to assume that the findings of a newly-released two-year study of Medicaid outcomes in Oregon is conclusive evidence of the worth -- or lack of worth -- of Medicaid, according to health economist Dan Polsky. He was one of four top University of Pennsylvania health policy experts who cautioned that the study's findings have been the subject of sensational headlines that present a less-than-accurate picture.
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."