Earlier this month, our founding partner, the Leonard Davis Institute of Health Economics, celebrated 50 years of research with a symposium drawing together some of the brightest minds in health policy. At a panel focused on the potential for behavioral science to influence health care, CHIBE Director Kevin Volpp, MD, PhD joined External Advisory Board member Robert Galvin, MD, Internal Advisory Board member Barbara Kahn, PhD, MBA, MPhil and renowned Duke University behavioral economist Peter Ubel, MD to outline behavioral solutions that address premature mortality in the United States. The panel, moderated by Internal Advisory Board member David Asch, MD, MBA highlighted the ways in which health care delivery systems and employers can leverage behavioral insights to promote health.
Humans have bounded rationality in predictable ways. In his talk, Dr. Volpp described program designs that take advantage of our typical decision errors to help make it easier for individuals to engage in healthier behaviors. Policies such as changing the default prescription option in electronic health records to a generic medication and using an enhanced active choice automatic refill program for prescriptions can boost health while cutting down on unnecessary costs.
Another area ripe for behaviorally-informed policy change is menu presentation of health information. Dr. Ubel explained that the location of calorie labels impacts how we eat in often unexpected ways. When calorie information is placed on the side of the menu where we begin reading (left for English, right for Hebrew), we curb our consumption. In another experiment, Dr. Ubel found that surcharges for unhealthy menu items are much less effective at shifting our eating habits than labels listing those same foods as “unhealthy” or approaches that combine the labels and the surcharges.
Dr. Kahn described the many exciting ways in which Amazon has been transforming retail. She highlighted principles that could be applied to health care, including the importance of both minimizing pain points and creating experiences that exceed expectations. Dr. Kahn also described ways in which data can be seamlessly collected about a person’s preferences, and how this creates many ready opportunities for personalization that could be applied in health care settings.
After years of experience working directly with CEO’s to develop employee health policies, Dr. Galvin brought a unique perspective to the panel. Workplace wellness programs can place employers in an uncomfortable role, while at the same time, employees frequently have little interest in getting healthier. Dr. Galvin suggests that, in addition to focusing on benefit design, employers should carefully consider environmental changes to the workplace that promote a healthier lifestyle. This can include behaviorally-informed placement of healthier foods on the work site and the incorporation of standing desks or other movement that disrupts sedentary jobs. Employers are already comfortable making work sites safer and “greener,” so making these environments healthier is a logical next step.
Improving the relatively poor health outcomes of the United States will take time. However, small, behaviorally-informed changes in our offices, restaurants and health care policies can contribute to producing significant improvements.