JULY 2017
The Healthy Nudge
Welcome to The Healthy Nudge. Each month, we'll get you up to speed on the latest developments in policy-relevant health behavioral economics research at CHIBE. Want more frequent updates? Follow us on Twitter @PennCHIBE and visit our website.
  Bringing CHIBE's Insights to AcademyHealth
CHIBE faculty joined health services researchers across the nation at the AcademyHealth Annual Research Meeting in New Orleans June 25-27th, presenting research on topics such as the use of wireless pill bottles to measure medication adherence, social incentive-based gamification to increase physical activity and strategies to reduce low-value care. LDI eMagzine provides a recap of Penn posters at the conference, including CHIBE's.
Wisdom in Crowds
  A recently published study by Damon Centola, PhD finds that when people talk to each other they can make smarter decisions together than on their own.
Calorie Miscalculations 
Individuals purchasing high-calorie sugary beverages in fast food restaurants greatly underestimate the amount of total calories they have purchased in their meal compared to those who do not purchase such drinks, according to a new study by Christina Roberto, PhD.

Blog Spotlight
Charlene Wong, MD, MSHP reports from AcademyHealth on her study - one of the first examining financial incentives targeted at behavior change in young adults.
HERO Webinar with Kevin Volpp, MD, PhD & Mitesh Patel, MD, MBA, MS  
07/12 @ 1 PM
Register here.
In The News

  • Stat
    We're Making it Hard to Have a Good Death

  • Healthcare Finance
    Healthcare industry should employ behavioral economics to change outcomes, increase financial success

  • MedPage Today
    Triple Attack on Drug Nonadherence Still Fails in Post-AMI Setting

  • The Today Show
    The 1 mistake we all make when it comes to serious decisions

  • Penn News
    Six Research Projects at Penn Bolstered Through Quartet Pilot Competition Funding

  • Philly Voice
    Penn Medical School Alum Confronts What 'No One Wants to Talk About' in New Podcast

  • Knowledge@Wharton
    How Anticipating Future Variety Curbs Consumer Boredom

  • Fierce Healthcare
    Two out of Three U.S. Adults Have Not Completed an Advance Directive

 CHIBE Profile
Dr. Mark Mugiishi is the Executive Vice President and Chief Health Officer of the Hawaii Medical Service Association (HMSA). HMSA has partnered with CHIBE's Dr. Amol Navathe,  Dr. Kevin Volpp and Dr. Ezekiel Emanuel on a study to improve patient engagement and health metrics, as well as a payment transformation project.

How does behavioral economics play a role in HMSA member consumer engagement?

We've been working closely with Drs. Volpp, Navathe, and Emanuel to design provider reimbursement models and a system of care that would leverage behavioral economic principles to optimize consumer engagement. This includes a pilot for a joint provider member incentive to improve A1c values for members needing help with blood sugar control. We've also more recently begun working with the CHIBE team to help us think through how plan benefit designs might be altered to drive optimal use of health benefits. Finally, we are leveraging the power of the smartphone to drive consumer behavior by launching an "all-your-health-in-one-place" app (Sharecare) that implements behavioral tools that are critical to engaging consumers.

In what ways does HMSA’s payment transformation initiative change primary care provider payment in Hawaii? Have any other states moved in a similar direction already?

We've completely re-engineered how our primary care providers are reimbursed. Payment transformation moves us almost completely away from the volume-based fee-for-service (FFS) payment model to a global monthly payment that allows providers the flexibility to care for their patients without constraints of FFS billing. This global payment is affected by panel size, panel risk, quality performance, and total cost of care.  First and foremost, we are now paying for value (access, quality, and resource utilization) rather than volume of service.  In addition, by providing more stable revenue, we are furthering our goal of a creating a sustainable community health system that prioritizes the well-being of patients. 

We believe that primary care is so foundational to health that it was important to start payment transformation there. As far as we know, no other state has made these kinds of large scale changes to primary care reimbursement. 

How could other insurance providers learn from the experience of HMSA in applying behavioral economics to health care? Are there any ‘lessons learned’ you’d like to share? 

Change is hard for most, and perhaps harder still when it comes to changing a revenue methodology that's been in place for decades. Those who embraced the change and ran with the new model have unsurprisingly been the most successful in the pilot. Good communication, proper message framing, and multiple opportunities and avenues to understand the new payment model were important.  It was also critical that we phased in the program, allowing for time to learn from and respond to feedback from providers before expanding the program to its current scope. At present, 93% of our primary care providers and 98% of our membership are benefiting from payment transformation.

New Publications
    The Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania conducts behavioral economics research aimed at reducing the disease burden from major U.S. public health problems. Originally founded within the Leonard Davis Institute of Health Economics, our mission is to inform health policy, improve healthcare delivery and increase healthy behavior.
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