In the News

Category Archives: In the News

Penn Current: Taking steps to improve activity-tracking results

By | In the News

“… Patel, who has spearheaded several studies about activity trackers since their advent, partnered with Humana between 2014-15 for the largest study of its kind, totaling approximately 4.5 million people who had access to the HumanaVitality wellness program, which incentivized continued use with financial rewards of as much as 25 cents to 40 cents per day. Remarkably, during the two-year monitoring period, only 1.2 percent of the sample—or, 53,245 people—activated a tracking device.

But the study also offers good news about trackers with its insights into the habits of those who did use them, even after six months had passed. Eighty percent of those who signed up continued to use the trackers after six months; to boot, though only .1 percent of the elderly in the sample population activated their device, 90.4 percent of those people—more than any other demographic—sustained use. Individuals younger than 34 were the least likely to stick with it.

Patel says the findings are useful for designing future health tracking programs and informing insurance companies, not to mention medical practitioners, who to focus on in the future.

‘Really, the goal of that study was to look at what people are using, in general, and then see what demographics an employer might want to think about,’ he says. ‘Maybe they do want to offer extra promotions to target the elderly.’

Patel, who is a part of the world’s first-ever behavioral design team in a health system, says the study data suggests that the design and framing of incentives are crucial in persuading people to be more active. Access to the technology and financial incentives alone, he concluded, may not be enough.

‘One challenge is most of these incentives are designed under the standard economic approach: “You lose weight, be active, get your metric screening, then we’ll pay you. We won’t give you cash; it’ll come as a deduction in your health insurance premium, which you’ll never see because it’s tied to your bi-weekly paycheck and shunted to your bank account through direct deposit,”‘ Patel says. ‘It’s hidden; it’s delayed. These are all things we know from behavioral economics are not very motivating to people.’

In essence: Build it and, in reality, they may not come.

‘These are behavioral issues, not technological ones,’ adds David Asch, executive director of the Penn Medicine Center for Health Care Innovation, which collaborates with the Nudge Unit. ‘Everyone already knows seatbelts save lives and smoking kills, but people still smoke and still people get into a car without buckling up. Behavioral economics recognizes that people don’t always act in their own rational best interest. The key observation of behavioral economics is not just that people sometimes behave irrationally, but that they do so in highly predictable ways. It is the predictability of these decision errors that allow us to design strategies to overcome them. That’s what has me optimistic.'”

Read the rest of the article at Penn Current.

The Washington Post: Need A Medical Procedure? Pick The Right Provider And Get Cash Back

By | In the News

“‘… If insurance plans were serious about saving money, they would have been doing this stuff years ago,’ said Josh Archambault, a senior fellow at the Foundation for Government Accountability, a limited-government advocacy group based in Naples, Fla., that promotes such ‘right-to-shop’ laws. ‘This starts to peel back the black box in health care and make the conversation about value.’

Still, some economists caution that shop-around initiatives alone cannot force the level of market-based change needed. While such shopping may make a difference for individual employers, they note it represents a tiny drop of the $3.3 trillion spent on health care in the U.S. each year.

‘These are not crazy ideas,’ said David Asch, professor of medicine, medical ethics and health policy at the Penn Medicine Center for Health Care Innovation in Philadelphia. But it’s hard to get consumers to change behavior — and curbing health care spending is an even bigger task. Shopping incentives, he warned, ‘might be less effective than you think.’

If they achieve nothing else, though, such efforts could help remove barriers to price transparency, said Francois de Brantes, vice president at the Health Care Incentives Improvement Institute, a nonprofit that designs benefit programs. ‘I think this could be quite the breakthrough,’ he said.”

Read the rest of the article at The Washington Post.

Healthcare IT News: Innovation is much more than just using new tech

By | In the News

“Innovation is one of the most sought-after things in healthcare, but it’s also one of the most poorly understood, according to experts presenting at the Digital and Personal Connected Health conference Monday at HIMSS18.

‘The term innovation loses so much meaning, and one of the meanings that it gets is “It’s innovation if it uses products designed by Apple,”‘ David Asch, MD, executive director at the Penn Medicine Center for Health Care Innovation, said in his keynote address. ‘Many of us love Apple products because of the design, but I’ve heard too many people say “We’re doing innovation because we’re using iPads.”‘

Even outside of Apple, the assumption that all innovation needs to be technological is a problematic one.

‘I think technology for technology’s sake is a mistake,’ Luis Castillo, president and CEO of Ensocare, said on a leadership panel. ‘If you’re automating a bad process it’s still a bad process.’

Instead, Asch said, innovation needs to be undertaken the way hospitals take on research.

‘Innovation is like research,’ he said. ‘It’s hypothesis-driven, it’s falsifiable and it’s highly disciplined.’

One problem that many organizations have innovating is they don’t recognize that step one is to identify the problem.

‘Often we are solving for the wrong problem, and if we solved for the right problem we might be in a better position to address our customers’ needs,’ Asch said. ‘Until you identify the problem you fundamentally want to solve, you can innovate in the wrong direction.’

Read more at Healthcare IT News.

Healthcare Analytics News: CMS is Leading the Way Toward Bundled Payments. Should It Be?

By | In the News

“The irony of Price’s objection to mandatory payment bundles—that they are ‘experiments’—is the reason why many in healthcare like them. Doctors are scientists, and scientists experiment. ‘The beauty of the mandatory bundle for joint and cardiac procedures is that you basically have a randomized trial where you can see [whether] bundles increase the volume of procedures, [whether] hospitals are able to save money, and [whether] quality is maintained,’ Ezekiel Emanuel, MD, told HCA in an interview. ‘You get real data.’

Emanuel, the founding chair of the Department of Bioethics at the National Institutes of Health and vice provost for global initiatives at the University of Pennsylvania, takes credit for working behind the scenes to launch the OCM, and he has also published studies and opinion letters regarding the efficacy of the joint replacement bundles.

‘What happens with voluntary?’ he asked. ‘Who is going to participate? Someone who thinks they’re going to succeed. It’s not a random sample, and it doesn’t get those people who are sitting on the sidelines waiting, the [major for-profit health systems]. You’ve got to get those people to play the game.’

To Amol Navathe, MD, PhD, that self-selection problem is troubling. A colleague of Emanuel’s at the University of Pennsylvania, the healthcare economist has studied bundled payments for years. Hospitals that choose to participate in bundled payment programs are most often high-volume, nonprofit, and urban. Few safety-net or for-profit hospitals have done the same.”

Read more at Healthcare Analytics News.

The Atlantic: People Don’t Actually Know Themselves Very Well

By | In the News

“When Donald Trump tweeted that he was a ‘very stable genius,’ he was accused of lacking self-awareness by journalists and comedians. But the truth is that no one has perfect self-awareness—you probably believe more than a few things about yourself that are false.

Whether it’s in trying to land a job or impress a date, people spend a staggering amount of time making claims about themselves. It makes sense: You’re the only person on Earth who has direct knowledge of every thought, feeling, and experience you’ve ever had. Who could possibly know you better than you? But your backstage access to your own mind sometimes makes you the last person on Earth others should trust about it. Think of it like owning a car: Just because you’ve driven it for years doesn’t mean you can pinpoint when and why the engine broke down.

Sixteen rigorous studies of thousands of people at work have shown that people’s coworkers are better than they are at recognizing how their personality will affect their job performance. As a social scientist, if I want to get a read on your personality, I could ask you to fill out a survey on how stable, dependable, friendly, outgoing, and curious you are. But I would be much better off asking your coworkers to rate you on those same traits: They’re often more than twice as accurate. They can see things that you can’t or won’t—and these studies reveal that whatever you know about yourself that your coworkers don’t is basically irrelevant to your job performance.”

Read the rest of the article at The Atlantic.

USA Today: Financial shortcuts to avoid and use when saving and investing for retirement

By | In the News

“Investors often use rules of thumb or cognitive shortcuts that simplify decisions. In the world of behavioral economics, these rules or shortcuts are known as heuristics. But investors are sometimes blind to the mistakes they might be making when they use rules of thumb and shortcuts.

So, what are some heuristics that investors should use and which ones should they avoid?

Bury your head in the sand. Likewise, pay no attention to the ups and downs in the markets. ‘Practice ostricity,’ says George Loewenstein, a professor of economics and psychology at Carnegie Mellon University and co-director of the Center for Behavioral Decision Research. ‘Don’t monitor your investments’ ups and downs.’

Others agree. ‘Don’t think much about fluctuations, even big ones,’ says Sunstein.

Don’t put all your eggs in one basket. Use the diversified portfolio heuristic. ‘Have a good mix of equities, bonds, cash; err on the conservative side if it brings you peace of mind; and use index funds,’ says Sunstein.

For his part, Loewenstein also recommends picking an investment strategy — a target-date mutual fund is a good option — and then adhering to it mindlessly. And remember, above all else, ‘it’s all about how much you put aside; not how you invest it,’ he says.

Retirees might also consider playing it safe given their time horizon. ‘In retirement, of course, your time horizon is shorter than it used to be, so it makes sense to invest in safe, less volatile alternatives: bonds instead of stocks, mutual funds instead of individual stocks, and so on,’ says Angner.”

Read more at USA Today.

The Baltimore Sun: Lured by high payouts, Marylanders turn $30 lottery ticket into top seller

By | In the News

“… But experts say there is no winning formula in the long run. They say the $30 ticket may present players better chances than lower-priced games, but the odds are still with the lottery.

‘I suppose at one level it is a better deal,’ said George Loewenstein, a professor of economics and psychology at Carnegie Mellon University. ‘But depending on how often one plays, you are getting into amounts that can start to make a dent in an average family’s take-home income, potentially detracting from more important expenditures.'”

Read more at the Baltimore Sun.

Medpage Today: Key to Reducing Opioid Prescribing: Default to Fewer Pills

By | In the News

“Reducing opioid prescribing as well as the number of opioid pills patients receive can be done with the help of system defaults, M. Kit Delgado, MD, MS, said at an event on safe opioid prescribing sponsored by the Duke Margolis Center for Health Policy.

At the end of an effort to reduce unnecessary opioid prescribing at their institution, ‘if anything, patients’ ability to manage pain was better … People were having improved pain outcomes,’ said Delgado, assistant professor of emergency medicine and epidemiology at the University of Pennsylvania in Philadelphia, at the event here Thursday…”

Read the rest at Medpage Today.

Dark Daily: Recent Study Looks at How Consumers Use Wearables That Generate Biometric data and Whether Such Data Might Be Valuable for Physicians and Medical Laboratories

By | In the News

“… With the popularity of activity trackers on the rise, researchers are examining their usage patterns to determine how the devices are being utilized, their target market, and ways to encourage sustained use of the gadgets.

A recent article published in Annals of Internal Medicine provided insight regarding who is using this type of wearable device, how activity trackers are being employed, and the length of time consumers will maintain their usage.

The research was spearheaded by Mitesh Patel, MD, Assistant Professor of Medicine and Health Care Management, Perelman School of Medicine and the Wharton School, University of Pennsylvania. He believes this is the largest study of its kind to evaluate the usage of wearable fitness trackers.

‘Many people are excited by the potential of using activity trackers to monitor healthy behaviors, but there is very little evidence on who is using them and whether or not use is sustained over time,’ Patel stated in a Penn Medicine news release. ‘We found that, though use grew over time, it really varied depending on individual characteristics like age and income. We also found that once someone started using an activity tracker, sustained use at six months was high at 80%.'”

Read more at Dark Daily.

The Atlantic: Why Amazon Pays Some of Its Workers to Quit

By | In the News

“… When I talked to Katherine Milkman, a professor at the Wharton School at the University of Pennsylvania, she brought up a similar idea, from the realm of social psychology. She talked about the mental pressure humans feel to resolve cognitive dissonance—if people have two conflicting beliefs, they’ll try to rationalize one to make it fit with the other. In this case, workers may dislike their jobs at Amazon, but if they turn down The Offer, it means they passed on a chance to quit. It’s likely that they’ll then try to convince themselves that they actually like working at Amazon, Milkman said. To pick a more extreme example of this phenomenon, when people join a cult that says the world is going to end on a certain date and then it doesn’t end, they tend to end up believing more strongly in the cult, because they can’t put up with the cognitive dissonance between what they believe and what actually happened.

Milkman also brought up ‘escalation of commitment,’ another concept studied by behavioral economists. The idea is that when people put a lot of money or effort into something and it appears to be going badly—perhaps they bought a stock and the share price is tanking—they often double down on their commitment. ‘They say, “I want to see this turn around—I don’t want it to turn out badly,”‘ Milkman said. When employees see that they’ve lost $5,000 by not taking The Offer, they might mentally recommit to the company, trying to do better at their jobs and enjoy them more.”

Read the rest of the article at The Atlantic.