The Healthy Nudge
August 2020
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.
How to address patient fear
graphic of doctors with masks
To ensure that patients seek needed health care services during the COVID-19 pandemic, health care systems can use a few behavioral tactics to counteract patients' fear. Framing information in the right way about health risks, using social comparisons, and leveraging defaults can be useful. Read the NEJM Catalyst commentary "To Re-Open Health Care, Leaders Should Address Patient Fear" by Joshua M. Liao, MD, MSc; Peter J. Pronovost, MD, PhD; and CHIBE Associate Director Amol S. Navathe, MD, PhD.
Do physician incentives increase patient medication adherence?
Medication pills
A new study examined the impact of financial incentives for physicians to potentially help increase patient medication adherence in diabetes medication, antihypertensives, and statins. CHIBE Director Kevin Volpp, MD, PhD, and Director of the Roybal Pilot Program George Loewenstein, PhD, and colleagues found that physician incentives of $50 per patient in each drug class was not effective for increasing patient adherence. "Additional research is warranted to disentangle whether physician effort is not responsive to these types of incentives, or medication adherence is not responsive to physician effort," the study authors wrote. Read the Health Services Research paper here.
Nudging toward cardiovascular health
heart model
A new paper by Mitesh Patel, MD, MBA, MS, a member of CHIBE's leadership team, and Dr. Patel's colleagues explores how behavioral economics principles can inform the delivery of primary and secondary cardiovascular prevention interventions. Some of the key behavioral economics principles they discuss include bounded rationality, prospect theory, choice architecture, loss aversion, and social norms. Check out the paper in Current Treatment Options in Cardiovascular Medicine here: A Nudge Towards Cardiovascular Health: Applications of Behavioral Economics for Primary and Secondary Cardiovascular Prevention.
Implementation Science and Behavioral Economics in Cancer Care
A $4.9 million grant has been awarded to the Perelman School of Medicine to use behavioral economics and implementation science to improve cancer care, and CHIBE is proud that two CHIBE-affiliated faculty members Rinad Beidas, PhD, and Justin Bekelman, MD, will serve as PIs alongside Robert A. Schnoll, PhD, on this program. The National Cancer Institute is funding the work through a P50 grant over five years. This team (which also includes CHIBE's Alison Buttenheim, PhD, MBA, David Asch, MD, MBA, Frank Leone, MD, MS, Brian Jenssen, MD, MSHP, and Mitesh Patel, MD, MBA, MS) will seek out ways to encourage clinicians and centers to adapt their behavior and use evidence-based approaches. In addition, CHIBE’s Karen Glanz, PhD, MPH, Carmen Guerra, MD, MSCE, Roy Rosin, MBA, and Kevin Volpp, MD, PhD, will serve on the Internal Executive Committee. Read more in the Penn Medicine press release.
CHIBE Aids City of Philadelphia with Contact Tracing
CHIBE Director Kevin Volpp, MD, PhD, and CHIBE-affiliated faculty member Carolyn Cannuscio, ScD, are leading Penn Medicine's efforts to work with the City of Philadelphia on contact tracing, leveraging both traditional methods and digital strategies. Read this Q&A and letter from Jonathan A. Epstein, MD, William Wikoff Smith Professor of Cardiovascular Research and Executive Vice Dean and Chief Scientific Officer at Perelman School of Medicine, to learn more.
CHIBE Members Appointed to National Committee on the Equitable Allocation of COVID-19 Vaccines
Two CHIBE members have been appointed to an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine and the National Academy of Medicine to provide a framework for the equitable allocation of vaccines for the coronavirus. CHIBE Associate Director Alison Buttenheim, PhD, MBA, and CHIBE-affiliated faculty member Daniel Polsky, PhD, MPP, are two of the 17 members of the committee. This committee will work together to develop guidance for policymakers in the domestic and global health communities when a COVID-19 vaccine has been created. Read more on our blog.
CHIBE Q&A: Vanessa Madden, BSc Hons
vanessa madden headshot
Read CHIBE’s Q&A with Vanessa Madden, BSc Hons, Assistant Director for Project Management at the Palliative and Advanced Illness Research (PAIR) Center.

What projects are you working on now?
The two clinical trials that have my focus right now are both large pragmatic trials with external health systems, in keeping with the [PAIR] Center’s focus to conduct real-world research in the settings where most Americans receive their care. The first study partners with Ascension to understand the effectiveness of inpatient palliative care, by changing the default ordering system for consult services from opt-in to opt-out. The second study is a smoking cessation trial across four health systems, with recent additional funding to understand the dual adverse impacts of COVID-19 and systemic racism on the willingness and ability of older, underserved individuals to engage with preventative health care services.

What do you find rewarding about your work?
Now, more than ever, I’m proud to see the real-world impact of our Center’s work on the larger community. Not long after we started seeing a surge of critically ill patients in Philadelphia, one of our team members shared a slide that said: “What do you want to be during COVID-19?” with an emphasis on growth opportunities. In that spirit, our faculty led several initiatives this spring to help guide the health system response to the pandemic, from prediction modeling to emergency preparedness, crisis management and resource allocation, clinician wellness, and family communication plans. It was immensely rewarding to see our prior work be immediately useful to front-line clinicians. I’ve been reflecting a lot recently on how critical care is such a team-based endeavor and that the team at PAIR has always been my favorite thing about coming to work, albeit over BlueJeans nowadays!

What drew you to the field of palliative care?
Like many people, I’m drawn to the holistic nature of palliative care and the extra layer of support that it provides to seriously ill patients and their families when they need it most. During my time at the University of Florida, I helped to lead a statewide evaluation of a pediatric palliative care program and was constantly humbled by both the strength of families and the dedication of hospice providers. I feel very fortunate to have been able to continue working in this field in Philadelphia, and am especially proud to be involved with the establishment of our Roybal Center in partnership with Genesis HealthCare. In recent years my mother has battled a progressive illness, receiving respite from a nursing home, and so on a personal level I truly appreciate the commitment of organizations such as Genesis to scholarship to improve care services for their long-term residents.
EVENT: Population Health Science Research Workshop
PHS workshop logo
The Population Health Science Research Workshop is back! Sponsored by the Leonard Davis Institute of Health Economics and Boston University School of Public Health, this virtual workshop on December 11 will bring together scholars from economics, epidemiology, demography, sociology, and related disciplines to present papers on topics related to population health. This year's theme is Health Equity in the Age of COVID-19, and the call for papers is now open. CHIBE's Atheendar Venkataramani, PhD, MD, MPhil, is one of the lead organizers of this event. Find more details and the submission form here.
Selected Media Coverage
Selected New Publications
CHIBE's COVID-19 Research Projects and Media
CHIBE has launched a website showcasing all of the ways in which CHIBE faculty are involved in the response to COVID-19. Read about their research projects and activities, find media coverage, and resources. If you have a project to share with us, email us here.
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 health care delivery, and increase healthy behavior.