The Healthy Nudge

December 2023

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. See our 5 top stories below.

1) Why are nonprofit hospitals focused more on dollars than patients?

A New York Times article written by CHIBE Associate Director Amol Navathe, PhD

"How do we get hospitals to refocus on their communities rather than on profits? Through their boards of directors. Their role is to tell hospital executives what to focus on and prioritize. And you would think that focusing on the mission would be the top priority, though boards aren’t doing this consistently. ... A good first step is to reform how boards reward hospital executives to accomplish the mission. Instead of paying leaders to pursue conventional financial goals, executives’ compensation should be tied to metrics reflecting the mission." Read more in The New York Times.

2) Out-of-pocket costs for long-acting antipsychotics among Medicare patients with schizophrenia

A Psychiatric Services paper led by CHIBE Associate Director Jalpa Doshi, PhD

This study found that most Medicare beneficiaries with schizophrenia qualified for full low-income subsidy and faced minimal out-of-pocket costs for both oral antipsychotics and long-acting injectables. The remainder (i.e., partial low-income subsidy and non-low-income subsidy beneficiaries) faced substantial out-of-pocket costs, both per prescription and annually. Read more in Psychiatric Services.

3) A “Food Is Medicine” approach to disease prevention: Limitations and alternatives

A JAMA Viewpoint written by Alyssa J. Moran, ScD, MPH, RD, and CHIBE Associate Director Christina Roberto, PhD

"We need to focus on changing food industry behavior to ensure that unhealthy foods are not ubiquitous and not as cheap and heavily marketed while ensuring that our existing nutrition assistance programs are accessible and health promoting. We already know that investing in these interventions can make a real and sustained difference in people’s lives." Read more in JAMA.

4) Appropriate statin prescriptions increase sixfold with automated referrals

A Penn press release featuring CHIBE-affiliated faculty member Alexander C. Fanaroff, MD, MHS

"The odds of prescribing the appropriate dose of statins—a medicine used to lower 'bad' cholesterol levels—increased sixfold when automated referrals were made to pharmacy services, instead of relying on traditional prescribing methods." Read more in this Penn press release.

5) Financial incentives for reduced alcohol use and increased isoniazid adherence during tuberculosis preventive therapy among people with HIV in Uganda

A Lancet Global Health paper led by Gabriel Chamie, MD, MPH, featuring CHIBE Associate Director Harsha Thirumurthy, PhD, et al

"Escalating financial incentives contingent on recent alcohol abstinence led to significantly lower biomarker-confirmed alcohol use versus control, but incentives for recent isoniazid adherence did not lead to changes in adherence. The alcohol intervention was efficacious despite less intensive frequency of incentives and clinic visits than traditional programs for substance use, suggesting that pragmatic modifications of contingency management for resource-limited settings can have efficacy and that further evaluation of implementation is merited." Read more here.

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Awards

Congratulations to Kevin B. Mahoney, MBA, University of Pennsylvania Health System CEO and CHIBE External Advisory Board Member, who was named to the Philadelphia Business Journal’s 2023 Most Admired CEOs list.

Events

Division of Health Policy and CHIBE Research Seminar: Wendy De La Rosa, PhD

December 14, 2023, Noon to 1 PM, Hybrid

Wendy De La Rosa, PhD, Assistant Professor of Marketing at the Wharton School, will discuss the role of budgeting strategies on benefit-seeking. Attendees may attend in person at 1104 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, or virtually through the Zoom link here. More details can be found here.

Job Opportunities

Postdoctoral Fellow

The Behavioral Economics and Global Health Insights (BEGIN) Lab at the University of Pennsylvania is seeking a Postdoctoral Fellow who can support ongoing research projects and conduct original research on a wide range of topics in global health. Co-directed by Professors Alison Buttenheim and Harsha Thirumurthy, the mission of the BEGIN Lab is to seek innovative solutions to persistent challenges that limit healthy lifespans globally. In pursuit of these solutions, the BEGIN Lab’s projects include the design and evaluation of behavioral, structural, and policy interventions that have the potential to advance health for all. Supported by grants from the US National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation, the BEGIN Lab’s projects take place in Kenya, India, South Africa, and Uganda and are focused on both communicable and non-communicable diseases. Apply here.

Project Manager

The Division of Health Policy is seeking a highly motivated Project Manager B (PM-B) to be responsible for the day-to-day research operations for a new program in which we plan to test the effects of utilizing behavioral economic principles to increase healthy food purchasing behavior among an urban population at high-risk of ASCVD and food insecurity across Penn Medicine. The PM-B will be responsible for oversight of all grant activities for this study including management of day-to-day research activities, IRB and regulatory requirements and the training and supervision of research staff. The PM-B will be responsible for managing and tracking study budgets as well as managing the timely submission of grant reporting to the sponsors. The PM-B will meet regularly with study leadership (internal and external) to provide study updates but will function independently in carrying out most responsibilities. Apply here.

Health Economics Postdoctoral Fellowship

The Postdoctoral Fellow will join The Parity Center, based in the Department of Medical Ethics and Health Policy in the Perelman School of Medicine. This new interdisciplinary team of experts will be led by Amol Navathe, MD, PhD, as Center Director, and will include Paula Chatterjee, MD, MPH; Austin Kilaru, MD, MHSP; Kristin Linn, PhD; Ravi Parikh, MD, MPP; and Eric Roberts, MA, PhD, as Associate Directors. The aims of The Parity Center are to advance the redesign of payment and policy to promote health care equity; build partnerships with payment and delivery organizations to translate and test in real world settings; and train future leaders who can address payment-related drivers of inequity. Apply here.