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Kevin volpp

Sanjay V Desai, David A Asch, Lisa M Bellini, Krisda H Chaiyachati, Manqing Liu, Alice L Sternberg, James Tonascia, Alyssa M Yeager, Jeremy M Asch, Joel T Katz, Mathias Basner, David W Bates, Karl Y Bilimoria, David F Dinges, Orit Even-Shoshan, David M Shade, Jeffrey H Silber, Dylan S Small, Kevin G Volpp, Judy A Shea
Background Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians. Methods We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off between shifts. Measures of educational experience included observations of the activities of interns (first-year residents), surveys of trainees (both interns and residents) and faculty, and intern examination scores...
March 20, 2018: New England Journal of Medicine
Zirui Song, Amol S Navathe, Ezekiel J Emanuel, Kevin G Volpp
The United States is simultaneously moving toward value-based payments for populations and precision medicine for individuals. During this evolution, innovations in payment and delivery that enhance tailoring of treatments to individuals while improving the value of care are needed. We propose one such innovation that would allow physician payment and patient cost sharing to better reflect the value of care by allowing the appropriateness of a service for a given patient in a given clinical situation to play a more meaningful role in the design of such incentives...
March 2018: American Journal of Managed Care
Judd B Kessler, Andrea B Troxel, David A Asch, Shivan J Mehta, Noora Marcus, Raymond Lim, Jingsan Zhu, William Shrank, Troyen Brennan, Kevin G Volpp
BACKGROUND: Poor medication adherence is common and limits the effectiveness of treatment. OBJECTIVE: To investigate how social supports, automated alerts, and their combination improve medication adherence. DESIGN: Four-arm, randomized clinical trial with a 6-month intervention. PARTICIPANTS: A total of 179 CVS health employees or adult dependents with CVS Caremark prescription coverage, a current daily statin prescription, a medication possession ratio less than 80%, and Internet access...
March 15, 2018: Journal of General Internal Medicine
Mitesh S Patel, Kevin G Volpp, Roy Rosin, Scarlett L Bellamy, Dylan S Small, Jack Heuer, Susan Sproat, Chris Hyson, Nancy Haff, Samantha M Lee, Lisa Wesby, Karen Hoffer, David Shuttleworth, Devon H Taylor, Victoria Hilbert, Jingsan Zhu, Lin Yang, Xingmei Wang, David A Asch
PURPOSE: To evaluate the effect of lottery-based financial incentives in increasing physical activity. DESIGN: Randomized, controlled trial. SETTING: University of Pennsylvania Employees. PARTICIPANTS: A total of 209 adults with body mass index ≥27. INTERVENTIONS: All participants used smartphones to track activity, were given a goal of 7000 steps per day, and received daily feedback on performance for 26 weeks...
January 1, 2018: American Journal of Health Promotion: AJHP
Kevin G Volpp, Harlan M Krumholz, David A Asch
No abstract text is available yet for this article.
March 7, 2018: JAMA Cardiology
Eric M VanEpps, Andrea B Troxel, Elizabeth Villamil, Kathryn A Saulsgiver, Jingsan Zhu, Jo-Yu Chin, Jacqueline Matson, Joseph Anarella, Patrick Roohan, Foster Gesten, Kevin G Volpp
PURPOSE: To identify whether financial incentives promote improved disease management in Medicaid recipients diagnosed with hypertension or diabetes, respectively. DESIGN: Four-group, multicenter, randomized clinical trials. SETTING AND PARTICIPANTS: Between 2013 and 2016, New York State Medicaid managed care members diagnosed with hypertension (N = 920) or with diabetes (N = 959). INTERVENTION: Participants in each 6-month trial were randomly assigned to 1 of 4 arms: (1) process incentives-earned by attending primary care visits and/or receiving prescription medication refills, (2) outcome incentives-earned by reducing systolic blood pressure (hypertension) or hemoglobin A1c (HbA1c; diabetes) levels, (3) combined process and outcome incentives, and (4) control (no incentives)...
January 1, 2018: American Journal of Health Promotion: AJHP
Mitesh S Patel, Kevin G Volpp, David A Asch
The final common pathway for the application of nearly every advance in medicine is human behavior. No matter how effective a drug, how protective a vaccine, or how targeted a therapy may be, a clinician usually has to prescribe it, and a patient accept and use it as directed, for it to improve..
January 18, 2018: New England Journal of Medicine
Leslie K John, Andrea B Troxel, William S Yancy, Joelle Friedman, Jingsan Zhu, Lin Yang, Robert Galvin, Karen Miller-Kovach, Scott D Halpern, George Loewenstein, Kevin Volpp
PURPOSE: To test the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally available weight management program. DESIGN: A randomized trial tested the impact of employer subsidy: 100%; 80%, 50%, and a hybrid 50% subsidy that could become a 100% subsidy by attaining attendance targets. TRIAL REGISTRATION: NCT01756066. SETTING AND PARTICIPANTS: Twenty three thousand twenty-three employees of 2 US companies...
January 2018: American Journal of Health Promotion: AJHP
Meredith B Rosenthal, Andrea B Troxel, Kevin G Volpp, Walter F Stewart, Thomas D Sequist, James B Jones, AnneMarie G Hirsch, Karen Hoffer, Jingsan Zhu, Wenli Wang, Amanda Hodlofski, Darra Finnerty, Jack J Huang, David A Asch
While financial incentives to providers or patients are increasingly common as a quality improvement strategy, their impact on patient subgroups and health care disparities is unclear. To examine these patterns, we analyzed data from a randomized clinical trial of financial incentives to lower low-density lipoprotein (LDL) cholesterol levels in patients at risk for cardiovascular disease. Patients with higher baseline LDL experienced greater cholesterol reductions in the shared incentive arm (0.23 mg/dL per unit change in baseline LDL, 95% CI [-0...
May 1, 2017: Medical Care Research and Review: MCRR
Christian Terwiesch, David A Asch, Kevin G Volpp
No abstract text is available yet for this article.
December 5, 2017: Annals of Internal Medicine
David A Asch, Kevin G Volpp
No abstract text is available yet for this article.
October 3, 2017: Annals of Internal Medicine
Mitesh S Patel, Emelia J Benjamin, Kevin G Volpp, Caroline S Fox, Dylan S Small, Joseph M Massaro, Jane J Lee, Victoria Hilbert, Maureen Valentino, Devon H Taylor, Emily S Manders, Karen Mutalik, Jingsan Zhu, Wenli Wang, Joanne M Murabito
Importance: Gamification, the application of game design elements such as points and levels in nongame contexts, is often used in digital health interventions, but evidence on its effectiveness is limited. Objective: To test the effectiveness of a gamification intervention designed using insights from behavioral economics to enhance social incentives within families to increase physical activity. Design, Setting, and Participants: The Behavioral Economics Framingham Incentive Trial (BE FIT) was a randomized clinical trial with a 12-week intervention period and a 12-week follow-up period...
November 1, 2017: JAMA Internal Medicine
Jonathan Skinner, Kevin G Volpp
No abstract text is available yet for this article.
September 12, 2017: JAMA: the Journal of the American Medical Association
Judy A Shea, Aderinola Adejare, Kevin G Volpp, Andrea B Troxel, Darra Finnerty, Karen Hoffer, Thomas Isaac, Meredith Rosenthal, Thomas D Sequist, David A Asch
OBJECTIVES: Clinical trials are increasingly testing the effectiveness of paying patients' financial incentives for achieving desired clinical outcomes. Some researchers and providers are concerned that patient financial incentives will harm the doctor-patient relationship. How patients feel about these approaches, and these trials, is largely unknown. This study examined patients' perceptions of a compound behavioral and financial incentive intervention used in a large multicenter trial to lower low-density lipoprotein cholesterol (LDL-C), including their perceptions of benefits and challenges and the study's effect on patients' relationship with their primary care physicians (PCPs)...
June 2017: American Journal of Managed Care
Hengchen Dai, David Mao, Kevin G Volpp, Heather E Pearce, Michael J Relish, Victor F Lawnicki, Katherine L Milkman
Expanding on evidence that interventions to improve health are more effective when informed by behavioral science, we explore whether reminders designed to harness behavioral science principles can improve medication adherence. We conducted a randomized controlled trial with 46,581 U.S. participants with commercial or Medicare Advantage insurance from Humana. Participants were randomly assigned to one of four experimental conditions. Participants in the usual care condition only received standard mailings that the insurer usually sends...
July 24, 2017: Preventive Medicine
Shivan J Mehta, Jordyn Feingold, Matthew Vandertuyn, Tess Niewood, Catherine Cox, Chyke A Doubeni, Kevin G Volpp, David A Asch
Behavioral economic approaches could increase uptake for colorectal cancer screening. We performed a randomized controlled trial of 2245 employees to determine whether an email containing a phone number for scheduling (control), an email with the active choice to opt in or opt out (active choice), or the active choice email plus a $100 incentive (financial incentive) increased colonoscopy completion within 3 months. Higher proportions of participants in the financial incentive group underwent screening (3.7%) than in the control (1...
November 2017: Gastroenterology
Kevin G Volpp, Andrea B Troxel, Shivan J Mehta, Laurie Norton, Jingsan Zhu, Raymond Lim, Wenli Wang, Noora Marcus, Christian Terwiesch, Kristen Caldarella, Tova Levin, Mike Relish, Nathan Negin, Aaron Smith-McLallen, Richard Snyder, Claire M Spettell, Brian Drachman, Daniel Kolansky, David A Asch
Importance: Adherence to medications prescribed after acute myocardial infarction (AMI) is low. Wireless technology and behavioral economic approaches have shown promise in improving health behaviors. Objective: To determine whether a system of medication reminders using financial incentives and social support delays subsequent vascular events in patients following AMI compared with usual care. Design, Setting, and Participants: Two-arm, randomized clinical trial with a 12-month intervention conducted from 2013 through 2016...
August 1, 2017: JAMA Internal Medicine
George L Anesi, Scott D Halpern, Michael O Harhay, Kevin G Volpp, Kathryn Saulsgiver
In efforts to combat tobacco dependence, most smoking cessation programs offer individuals who smoke the choice of a target quit date. However, it is uncertain whether the time to the selected quit date is associated with participants' chances of achieving sustained abstinence. In a pre-specified secondary analysis of a randomized clinical trial of four financial-incentive programs or usual care to encourage smoking cessation (Halpern et al. in N Engl J Med 372(22):2108-2117, doi: 10.1056/NEJMoa1414293 , 2015), study participants were instructed to select a quit date between 0 and 90 days from enrollment...
December 2017: Journal of Behavioral Medicine
Theresa Gamble, Bernard Branson, Deborah Donnell, H Irene Hall, Georgette King, Blayne Cutler, Shannon Hader, David Burns, Jason Leider, Angela Fulwood Wood, Kevin G Volpp, Kate Buchacz, Wafaa M El-Sadr
Background/Aims HIV continues to be a major public health threat in the United States, and mathematical modeling has demonstrated that the universal effective use of antiretroviral therapy among all HIV-positive individuals (i.e. the "test and treat" approach) has the potential to control HIV. However, to accomplish this, all the steps that define the HIV care continuum must be achieved at high levels, including HIV testing and diagnosis, linkage to and retention in clinical care, antiretroviral medication initiation, and adherence to achieve and maintain viral suppression...
August 2017: Clinical Trials: Journal of the Society for Clinical Trials
Jonathan S Skinner, Kevin G Volpp
No abstract text is available yet for this article.
May 16, 2017: JAMA: the Journal of the American Medical Association
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