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Submitted URL: https://dx.doi.org/10.1377/hlthaff.2012.1163
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LOGIN TO YOUR ACCOUNT Email or Remote login Password Forgot password? Keep me logged in New User CREATE A NEW ACCOUNT Email Returning user Can't sign in? Forgot your password? Enter your email address below and we will send you the reset instructions Email Cancel If the address matches an existing account you will receive an email with instructions to reset your password. Close REQUEST USERNAME Can't sign in? Forgot your username? Enter your email address below and we will send you your username Email Close If the address matches an existing account you will receive an email with instructions to retrieve your username CHANGE PASSWORD Old Password New Password Too Short Weak Medium Strong Very Strong Too Long PASSWORD CHANGED SUCCESSFULLY Your password has been changed * For Authors * For Subscribers * Subscribe * Renew * 0 Cart * Login * SearchSearchADVANCED SEARCH * COVID-19 * Topics FEATURED TOPICS Affordable Care Act Health Equity Considering Health Spending ADDITIONAL TOPICS COVID-19 Resource Center Leading to Health Social Determinants of Health View All Topics * Journal ISSUES October 2022, Disability & Health September 2022, Nurses, Care Delivery, Pharmaceuticals & More August 2022, Spending, Payment & More View Issues Archive FEATURED ARTICLE SERIES Age-Friendly Health Considering Health Spending Leading to Health Narrative Matters View All Article Series ADDITIONAL JOURNAL CONTENT Ahead of Print Collected Works Theme Issues View Journal Homepage * Forefront FEATURED TOPICS Considering Health Spending Following the ACA Global Health Policy ADDITIONAL TOPICS AND SERIES GrantWatch Elsewhere@Health Affairs COVID-19 View All Forefront Series View Most Recent Forefront Articles Forefront FAQs View Forefront Homepage View Forefront Archive * Podcasts FEATURED PODCAST SERIES A Health Podyssey This Week Narrative Matters Pathways View All Podcasts * Events FEATURED EVENTS Professional Development: Disability, Health, And Accessibility In Health Services Research Policy Spotlight: One-On-One with Dave Chokshi Journal Club: Personal Care Aides: Assessing Self Care Needs and Worker Shortages in Rural Areas Health Affairs Briefing: Disability & Health: The View From Main Street Health Affairs Briefing: Disability & Health Virtual Symposium ADDITIONAL EVENTS CONTENT View Upcoming Events View All Events * Briefs * * SearchSearchADVANCED SEARCH * For Authors * For Subscribers * * * * ANALYSIS & COMMENTARY Health AffairsVol. 32, No. 7: States, Medicaid & Countdown To Reform ANALYSIS & COMMENTARY BEHAVIORAL ECONOMICS HOLDS POTENTIAL TO DELIVER BETTER RESULTS FOR PATIENTS, INSURERS, AND EMPLOYERS * George Loewenstein , * David A. Asch , and * Kevin G. Volpp Affiliations 1. George Loewenstein ( gl20@andrew.cmu.edu ) is a professor of economics and psychology at Carnegie Mellon University, in Pittsburgh, Pennsylvania, and director of behavioral economics at the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute, University of Pennsylvania, in Philadelphia. 2. David A. Asch is a member of the Center for Health Equity Research and Promotion at the Philadelphia Veterans Affairs Medical Center. He is also a professor at the Perelman School of Medicine and the Wharton School and director of the Center for Health Care Innovation, all at the University of Pennsylvania. 3. Kevin G. Volpp is a member of the Center for Health Equity Research and Promotion at the Philadelphia VA Medical Center. He is also a professor at the Perelman School of Medicine and the Wharton School and director of the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute, all at the University of Pennsylvania. PUBLISHED:July 2013No Accesshttps://doi.org/10.1377/hlthaff.2012.1163 About * Details * Exhibits * References * Related * View article * View Full Text * View PDF * Permissions Share Share on * FacebookFacebook * TwitterTwitter * LinkedInLinked In * RedditReddit * EmailEmail Tools * Add to favorites * Download Citations * Track Citations * Permissions View article * View Full Text * View PDF ABSTRACT Many programs being implemented by US employers, insurers, and health care providers use incentives to encourage patients to take better care of themselves. We critically review a range of these efforts and show that many programs, although well-meaning, are unlikely to have much impact because they require information, expertise, and self-control that few patients possess. As a result, benefits are likely to accrue disproportionately to patients who already are taking adequate care of their health. We show how these programs could be made more effective through the use of insights from behavioral economics. For example, incentive programs that offer patients small and frequent payments for behavior that would benefit the patients, such as medication adherence, can be more effective than programs with incentives that are far less visible because they are folded into a paycheck or used to reduce a monthly premium. Deploying more-nuanced insights from behavioral economics can lead to policies with the potential to increase patient engagement and deliver dividends for patients and favorable cost-effectiveness ratios for insurers, employers, and other relevant commercial entities. TOPICS * Patient engagement * Premiums * Co-payments * Health insurance benefit design * Pharmaceuticals * Affordable Care Act * Health care providers * Payment * Cost-effectiveness * Costs and spending Please enable JavaScript to view the comments powered by Disqus. * Details * Exhibits * References * Related ARTICLE METRICS Citations: Crossref 120 -------------------------------------------------------------------------------- Recommended Articles * Health Benefits In 2022: Premiums Remain Steady, Many Employers Report Limited Provider Networks For Behavioral Health Oct 2022 | Gary Claxton et al. * Patients Receive Flexible And Accessible Care When State Workforce Barriers Are Removed Aug 2022 | Bianca K. Frogner * Can Alternative Payment Models And Value-Based Insurance Design Alter The Course Of Diabetes In The United States? Jun 2022 | Sabrina Wang et al. * Identifying And Exploring Bias In Public Opinion On Scarce Resource Allocation During The COVID-19 Pandemic Oct 2022 | Ari Ne’eman et al. -------------------------------------------------------------------------------- History Published online 1 July 2013 -------------------------------------------------------------------------------- Information Project HOPE—The People-to-People Health Foundation, Inc. -------------------------------------------------------------------------------- ACKNOWLEDGMENTS All three authors have consulted for VAL Health, a health consulting company. George Loewenstein and Kevin Volpp have consulted for CVS Caremark and have done research with support from Humana, CVS Caremark, Discovery, and Weight Watchers. The opinions expressed are those of the authors and not the Department of Veterans Affairs. -------------------------------------------------------------------------------- PDF download -------------------------------------------------------------------------------- REFERENCES * 1 Special issue: new era of patient engagement . Health Aff (Millwood) . 2013 ; 32 ( 2 ). Google Scholar * 2 Bodenheimer T , Chen E , Bennett HD . Confronting the growing burden of chronic disease: can the U.S. health care workforce do the job? Health Aff (Millwood) . 2009 ; 28 ( 1 ): 64 – 74 . Go to the article, Google Scholar * 3 Towers Watson . Performance in an era of uncertainty: 2012, 17th annual Towers Watson/National Business Group on Health employer survey on purchasing value in health care [Internet]. New York (NY) : Towers Watson ; 2012 [cited 2013 Jun 12 ]. Available for download from: http://www.towerswatson.com/en/Insights/IC-Types/Survey-Research-Results/2012/03/Towers-WatsonNBGH-Employer-Survey-on-Value-in-Purchasing-Health-Care Google Scholar * 4 Newhouse JP , Insurance Experiment Group . Free for all? Lessons from the RAND Health Insurance Experiment . Cambridge (MA) : Harvard University Press ; 1993 . Google Scholar * 5 Hsu J , Price M , Huang J , Brand R , Fung V , Hui R , et al. Unintended consequences of caps on Medicare drug benefits . N Engl J Med . 2006 ; 354 ( 22 ): 2349 – 59 . Crossref, Medline, Google Scholar * 6 Baicker K , Mullainathan S , Schwartzstein J . Behavioral hazard in health insurance [Internet]. Cambridge (MA) : National Bureau of Economic Research ; 2012 Oct [cited 2013 May 28 ]. (NBER Working Paper No. 18468). Available from: http://www.nber.org/papers/w18468.pdf Google Scholar * 7 Chernew ME , Shah MR , Wegh A , Rosenberg SN , Juster IA , Rosen AB , et al. Impact of decreasing copayments on medication adherence within a disease management environment . Health Aff (Millwood) . 2008 ; 27 ( 1 ): 103 – 12 . Go to the article, Google Scholar * 8 Choudhry NK , Fischer MA , Avorn J , Schneeweiss S , Solomon DH , Berman C , et al. At Pitney Bowes, value-based insurance design cut copayments and increased drug adherence . Health Aff (Millwood) . 2010 ; 29 ( 11 ): 1995 – 2001 . Go to the article, Google Scholar * 9 Choudhry NK , Avorn J , Glynn RJ , Antman EM , Schneeweiss S , Toscano M , et al. Full coverage for preventive medications after myocardial infarction . N Engl J Med . 2011 ; 365 ( 22 ): 2088 – 97 . Crossref, Medline, Google Scholar * 10 Volpp KG , Loewenstein G , Asch DA . Choosing wisely: low value services, utilization, and patient cost sharing . JAMA . 2012 ; 308 ( 16 ): 1635 – 36 . Crossref, Medline, Google Scholar * 11 Pear R . Employers get leeway on health incentives . New York Times . 2013 May 29 . 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