CHIBEblog

Aug 16 2016
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What Do Hospitalized Patients Say Would Be Worse Than Death?

By CHIBEblog

Survey says… In caring for hospitalized patients with serious illnesses, and in evaluating interventions designed to help them, clinicians and researchers often focus on death as the primary outcome to be avoided. We tend to pay less attention to avoiding other outcomes that may be equally or more unacceptable to some patients. Between July 2015 and March 2016, Anna Buehler, Scott Halpern, and I asked 180 patients with serious illnesses who were hospitalized at the Hospital of the University of Pennsylvania to rate a series of single-dimension health states on a 5 point Likert scale with options of worse than…

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May 19 2016
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an immunization for a child

Applying Behavioral Economics to the Thorny Issue of Vaccine Acceptance

By CHIBEblog

The Theory and Practice Can insights from behavioral economics inform creative approaches to increasing vaccination rates, and help prevent outbreaks of vaccine-preventable diseases? In a JAMA Pediatrics Viewpoint, LDI Senior Fellows Alison Buttenheim and David Asch suggest how to apply behavioral economic principles to the thorny issue of vaccine acceptance, and discuss the challenges in doing so. Buttenheim and Asch suggest vaccine interventions that leverage default and omission biases, increase the salience of vaccine-preventable diseases, and make vaccination social and the benefits immediate. Each of these suggested approaches come with caveats about what could go wrong in putting them into…

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Mar 07 2016
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Patient Engagement and Behavioral Insights—What People Want Is Health

By CHIBEblog

In 2004, Blockbuster Video had a market capitalization of more than $5 billion, with 9,000 stores nationwide staffed by 60,000 employees. In 2010, the company declared bankruptcy before being dissolved. Like many once-proud firms before it, Blockbuster was a victim of its inability to recognize that emerging technologies had enabled a seismic shift in what consumers were demanding — in Blockbuster’s case, the convenience of being able to pick movies from the comfort of their own homes via Netflix. Many companies in many industries have made this same mistake, focusing on what they can easily produce instead of what their…

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Feb 27 2016
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harrison kalodimos headshot

NEJM Catalyst Event Tackles Patient Behavior Change

By CHIBEblog

How can physicians empower patients? Editor’s note: Last week, NEJM Catalyst and the University of Pennsylvania Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute (LDI CHIBE) hosted a live event and webcast on “Patient Engagement: Behavioral Strategies for Better Health.” In it, event Chair Kevin Volpp described the successful health system of the future that would feature  value-based provider payments and insurance benefit design, new and improved patient choice environments, and incentives for healthy behaviors.  Above all, the system would meet patients where they are, not where we think they should be. Panels discussed the formation…

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Feb 25 2016
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Using Bribes–er, Incentives–to Change Children’s Eating Habits

By CHIBEblog

Study: 25 Cents Increases Lunch Intake of Fruits and Vegetables “Can I have dessert?” “Did you eat all of your vegetables?”  This is a common dinner conversation in our house and probably for most other families.  Whether we call it bribery or not, parents bribe their kids in small ways every day.  Eating more vegetables in exchange for a little dessert.  Cleaning a bedroom in exchange for more time on a computer or video game.  Good behavior to play with friends. New research asks the question whether bribing kids to eat more fruits and vegetables can change their eating habits…

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Feb 16 2016
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Move It Or Lose It

By CHIBEblog

Mitesh Patel Study Sheds Light on Employee Incentives The latest study by LDI Senior Fellow Mitesh Patel and colleagues adds to our growing understanding of how best to frame financial incentives to encourage healthy behaviors, and employer wellness managers should take note. Patel and colleagues’ randomized control trial, published today in the Annals of Internal Medicine, shows that financial incentives framed as a loss (upfront rewards that are reduced when goals aren’t achieved) are most effective in increasing physical activity among overweight and obese adult employees of a major university (ok, it’s Penn). That’s the good news if you’ve set…

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Jan 05 2016
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Employers Take Note: Premium-Based Incentives For Weight Loss Don’t Work

By CHIBEblog

Randomized Trial Finds No Effects For Employees A new study casts doubt on the effectiveness of reducing health insurance premiums as a way to encourage employees to lose weight. LDI Senior Fellow Mitesh Patel and his team, in a randomized controlled trial, test the effectiveness of a $550 incentive in promoting weight loss in obese employees. They found no difference in weight loss over the course of one year between the control group and three different kinds of incentive programs. It didn’t matter if the incentive was set up to provide premium discounts in the subsequent year, or in the…

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Oct 30 2015
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Amol Navathe

Physician Incentives – Making Performance Measures Meaningful

By CHIBEblog

How can we redesign physician incentives to improve their impact on behavior and performance?  Recently, the Commonwealth Fund published a round-up of expert views on reforming physician incentives, and one of the experts was LDI Senior Fellow Amol Navathe, MD, PhD. Navathe, a physician, health economist, and engineer, studies how to apply behavioral economic principles to physician financial and non-financial incentives. At a recent retreat, he described ongoing research on physician pay-for-performance measures; you can watch an excerpt here. And below is Amol’s Q & A from the Commonwealth Fund’s October 2015 issue of “Transforming Care“, reproduced here with permission.  Q:…

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May 28 2015
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Taking the Science of Financial Incentive Programs to a New Level: An Interview With Scott Halpern

By CHIBEblog

Last week, Scott Halpern, Kevin Volpp and colleagues published a groundbreaking study in the NEJM demonstrating that financial incentives work in helping employees quit smoking, and that the design of the incentives matters. The article prompted widespread media coverage, as did the announcement by study partner CVS Health that, next month, it will launch a financial incentive program for all its employees who use smoke or use tobacco of any kind. You can read an excellent summary of the study by Aaron Carroll on The Incidental Economist, and watch Dr. Volpp explain the study on Knowledge@Wharton. I posed a few…

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Mar 23 2015
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Healthy Nudges in the School Lunch Line

By CHIBEblog

In an online commentary in JAMA Pediatrics, Mitesh Patel and Kevin Volpp comment on a new school-based randomized trial that tested whether increased food palatability, combined with choice architecture, improved the diet of elementary and middle school children. The intervention had two phases: first, schools were randomized to a control or to receive a chef’s visit twice a week for seven months. After three months, schools were again randomized to a “choice architecture” intervention that included preferential placement of fruits, vegetables, and milk, and promotional signage and packaging. The result after seven months? Healthier food choices and consumption increased with…

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