Kevin Volpp in JAMA – Price Transparency Not a Panacea for High Health Care Costs

In a JAMA editorial, Kevin Volpp, MD, PhD, discusses whether price transparency helps lower the cost of health care when pricing of services is a choice tool for deciding on a health care plan.

Responding to a new study by Desai et al in the same May 3, 2016 issue of JAMA, Volpp says “there was no evidence that health spending declined in the settings where transparency tools were offered” and suggests consumers might benefit from employers providing context with cost. “(I)n the absence of credible information presented simultaneously on quality, many patients may likely assume that higher price means higher quality.”

Volpp concludes “it is not surprising that price transparency tools that offer patients as consumers information on relative prices fail to lower the rate of spending, given that this information is often offered without accompanying data about quality and for services that would exceed the deductibles of patients. Perhaps by providing meaningful relative information on price and quality and focusing on services with prices lower than a patient’s deductible, such tools could succeed in driving patients to choose higher-value services.”

Dr. Volpp is a UPenn PRC Director and principal investigator, along with founding the Center for Health Incentives and Behavioral Economics (CHIBE).

Team-based Goals Enhance Incentives to Increase Physical Activity

 

 

In the March 15, 2016 issue of Journal of General Internal Medicine,  UPenn PRC Director Kevin Volpp, MD, PhD, UPenn PRC researcher David Asch, MD, MBA, and co-authors reported on a study to compare the effectiveness of individual versus team-based financial incentives to increase physical activity.

304 employees from a Philadelphia-based organization formed 76 four-member teams. Participants received daily feedback on a daily 7,000 step goal during intervention and follow-up periods. A participant on a winning team was eligible for a $50 award if he/she met the goal (individual incentive), a $50 award only if all four team members met the goal (team incentive), or a $20 award if he/she met the goal individually and $10 more for each of three teammates that also met the goal (combined incentive.)  The control group received no other incentive. For the three financial incentive groups, every-other-day drawings were held during the intervention period.

Participants in the combined incentive group achieved their goal 35 percent of the time, nearly double the success rate for the control and team incentive groups (18 and 17 percent, respectively), and still higher than the average success rate for participants rewarded based on individual performance (25 percent). Compared to the control group, participants receiving the combined incentive had 1,446 more steps per day.

“The findings of our study shed light on how financial incentive programs can be used to change people’s behavior towards better health, and how physical activity interventions and wellness programs can be better designed,” said senior author Kevin G. Volpp, MD, PhD, a professor of Medicine and Health Care Management, and director of the Penn Center for Health Incentives and Behavioral Economics. “People are accountable to themselves but also to others and, in this vein, it may not be surprising that the incentive that provided rewards based on individual and was most effective.”

 

Read more here:

http://link.springer.com/article/10.1007/s11606-016-3627-0

Do Financial Incentives for Increasing Physical Activity Work?

In the February 16, 2016 issue of Annals of Internal Medicine,  UPenn PRC Director Kevin Volpp, MD, PhD, UPenn PRC researcher David Asch, MD, MBA, and co-authors reported on a study to test the effectiveness of offering financial incentives to increase physical activity among overweight and obese adults.

Participants were divided among three groups. Researchers found the most powerful incentive was the possibility of losing money that would be taken away if a 7,000-step daily goal was not met.  This finding suggest a new approach which may be helpful to the most sedentary overweight and obese.

Read more here:

http://annals.org/article.aspx?articleid=2491916

http://mobile.philly.com/beta?wss=/philly/health/sportsmedicine&id=368872741

 

 

CHIBE – NEJM Catalyst Web Event: Behavioral Strategies for Better Health. Feb. 25, 2016

On Thursday, February 25,  NEJM Catalyst produced a live web event titled Patient Engagement: Behavioral Strategies for Better Health. Hosted by the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, the event provided expert insight and real-world examples on ways to improve the quality and value of health care through patient engagement.

The event featured eleven preeminent business and clinical experts, with in-depth knowledge of:

  • behavioral psychology
  • habit formation
  • behavioral economics
  • social marketing

 

Experts shared their perspectives on ways to change patients’ health behavior across a wide range of clinical contexts. In addition to scalable, actionable ideas on how to motivate patients to take an active role in optimizing their health.

“As health care leaders and clinicians see more and more how the pressures to improve patient outcomes are driving health care organizations’ interests, it’s important to think broadly about how we influence patient behavior and how that helps to keep people healthy,” said Kevin Volpp, MD, PhD, Director of the Center for Health Incentives and Behavioral Economics; Vice Chairman for Health Policy, Medical Ethics and Health Policy; and Professor of Medicine, Medical Ethics and Health Policy and Health Management, Perelman School of Medicine and the Wharton School, University of Pennsylvania, UPenn PRC Director, and Lead Advisor for NEJM Catalyst.

 

 

 

 

 

 

Philadelphia Inquirer Tracks Incentives Research

The Philadelphia Inquirer: Feb. 16, 2016

The latest in a series of studies from behavioral economists at the University of Pennsylvania reported an example on Monday: promising people a monthly pot of money to increase their physical activity, but then deducting some every day they missed the goal led to a 50 percent jump in successful days – far better than simply paying them to exercise more.

More than 80 percent of large employers offer some kind of incentive to get workers to take up healthier habits, on the theory that this will improve well-being and reduce health-care costs.

But the trend has grown faster than research into what works best. Commonly offered “hidden” incentives, such as lower insurance premiums the next year, don’t “engage” employees enough for them to change their lives, said Mitesh S. Patel, lead author of the new study and one of 50 faculty, along with UPenn PRC Director, Kevin Volpp, MD, PhD, affiliated with Penn’s Center for Health Incentives and Behavioral Economics.

 

 

 

 

 

 

Wearable Fitness Devices Do Not Drive Health Behavior Changes

In the February 5 edition of The Journal of the American Medical Association,  UPenn PRC Director Kevin Volpp, MD, PhD, and Penn colleagues, Mitesh Patel, MD, MBA, MS, and David Asch, MD, MBA, discuss the efficacy of wearable fitness devices, such as Fitbit,  in a Viewpoint article. Volpp et al note that these devices appear to have more durability as facilitators for individuals already motivated to change their health behaviors than as motivators for people seeking to create new, healthier habits.

“Although wearable devices have the potential to facilitate health behavior change, this change might not be driven by these devices alone. Instead, the successful use and potential health benefits related to these devices depend more on the design of the engagement strategies than on the features of their technology. Ultimately, it is the engagement strategies—the combinations of individual encouragement, social competition and collaboration, and effective feedback loops—that connect with human behavior.”

 

http://jama.jamanetwork.com/article.aspx?articleid=2089651

Kevin Volpp. MD, PhD, advisor to new healthcare information platform

Kevin Volpp, MD, PhD is a theme leader for NEJM Catalyst, a new collaborative platform that brings together health care executives, clinician leaders, and clinicians to share innovative ideas and practical applications for enhancing the value of health care delivery.

NEJM Catalyst provides information about practical innovations, insights from experts in the health care field, and leaders from provider organizations. It contains unbiased and objective content and articles, and an exchange of ideas and perspectives from across the health care community. The platform, from the NEJM Group that includes the New England Journal of Medicine, features live web seminars, daily blogs, white papers, case studies, video presentations, a digital newsletter, and the exchange of ideas. Advisors for live seminars will be editors of a NEJM sub journal and will facilitate dialogue to get the pulse of the community and then deliver pertinent information.

The four theme areas are:

  • the new healthcare marketplace
  • patient engagement
  • care redesign
  • leadership

Theme leaders were selected because each “has successfully implemented a change in his or her own organization,” according to NEJM.

Theme leaders include:

  • Dr. Volpp, who is Professor of Medicine and Health Care Management at the Wharton School of the University of Pennsylvania
  • Amy Compton-Phillips, MD, Executive Vice President, Chief Clinical Officer, Providence Health Services
  • Leemore Dafny, PhD, Professor of Strategy and Director of Health Enterprise Management at the Kellogg School of Management, Northwestern University
  • Stephen Swensen, MD, Medical Director for Leadership and Organization Development, Mayo Clinic College of Medicine

 

 

In JAMA Viewpoint, UPenn PRC Director Kevin Volpp, MD, PhD, discusses complexities in physician motivators

In the Dec. 1, 2015 issue of JAMA, UPenn PRC Director Kevin Volpp, MD, PhD, joins Timothy J. Judson, MD, MPH, University of California/San Francisco, and Allan S. Detsky, MD, PhD, University of Toronto, in discussing the complexities of determining the right mix of physician motivators to achieve the “value goal” in health care.  Noting “in the context of health care, it is generally more difficult to determine quality. Health care comprises both amenities, which can be easily seen, and technical proficiency, which is difficult for a non-expert to assess,” Volpp and co-authors explore how extrinsic and intrinsic motivators can be effective or ineffective, depending on several factors.

 

Read the paper here.

 

UPenn PRC Director, Kevin Volpp, MD, PhD, speaking @ Quality Talks about how health behaviors affect health outcomes

Kevin Volpp, MD, PhD, UPenn PRC Director, founding Director of the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute (LDI CHIBE) and Professor of Medicine at the University of Pennsylvania, spoke at the National Committee for Quality Assurance (NCQA) Quality Talks about the science of motivation, health care providers as “choice architects” for their patients and how health behaviors affect health outcomes.

The video is no longer available.

 

Preliminary Data Show that Electronic Pill Bottles Help People Remember to Take Their Medication

David Asch, MD, MBA, UPenn PRC investigator

An ongoing project headed up by the PRC’s Kevin Volpp and David Asch was cited in a Washington Post article. The study focuses on how behavioral economics can be an effective strategy for increasing medication adherence.  Researchers at Penn gave 1,000 patients with heart disease “electronic pill bottles” that would light up and beep and notified a designated friend or relative (as well as their doctor) to remind the patient if they didn’t comply within a few days.  Those who took their medications became eligible for a lottery to win a cash prize.  Preliminary data suggest a big improvement in adherence compared with a control group.

Read the article in the Washington Post, by Lenny Bernstein, here.

Nudging Students Towards Healthier Food Choices: An Editorial by UPenn PRC Director Kevin Volpp

In an editorial in JAMA Pediatrics, UPenn PRC Director Kevin Volpp, MD, PhD, and Mitesh Patel, MD, MBA, MS examine the value of a behavioral economics approach to research addressing the need to improve nutrition for and lower obesity in children in the U.S.

Behavioral economics is a field that recognizes that individuals do not always behave rationally when making decisions. When choosing what to eat, children are particularly influenced by the environment in which food is presented. Choice architecture is the application of behavioral economic principles to the design of environments in which decisions are made. While there is a significant opportunity to nudge students toward healthier food choices, there is a lack of rigorous evaluation of such interventions in real-world settings.

Despite numerous efforts to improve the food consumption of America’s youth, rates of obesity among school-aged children have not changed over the past decade. Strategies that are most likely to encourage healthier food choices are those that reflect individuals’ rational preferences (e.g., making food taste better) and apply insights from behavioral economics to better design choice architecture.

Read the article here.

Patel MS, Volpp KG. Nudging Students Toward Healthier Food Choices—Applying Insights From Behavioral Economics. JAMA Pediatr. 2015;169(5):425–426. doi:10.1001/jamapediatrics.2015.0217

UPenn PRC Director Dr. Kevin Volpp Receives 2015 ACTS Distinguished Investigator Award

Kevin Volpp, MD, PhD, was presented with the 2015 Association for Clinical and Translational Science (ACTS) Distinguished Investigator Award for Career Achievement and Contribution to Clinical and Translational Science. Above all, the award honored his expertise in translation from clinical use into public benefit and policy. As a result, Dr. Volpp was given the prestigious award at the organization’s sixth annual meeting in Washington, D.C.

Volpp, director of the UPenn PRC, is a professor of Medicine and Health Care Management. He is the director of the Center for Health Incentives and Behavioral Economics in the Leonard Davis Institute of Health Economics, in addition to vice-chair of health policy in the Department of Medical Ethics and Health Policy. These positions are held within Perelman School of Medicine at the University of Pennsylvania.

Read more here.