Kevin Volpp

• Mark V. Pauly, Lawton R. Burns, David A. Asch, Kevin Volpp, Flaura Winston, Mary Naylor, Ralph Muller, Rachel Werner, Seemed Like a Good Idea: Alchemy versus Evidence-Based Approaches to Healthcare Management Innovation (Cambridge, UK: Cambridge University Press, 2022)
• Katherine L. Milkman, Linnea Gandhi, Sean F. Ellis, Heather N. Graci, Dena Gromet, Rayyan S. Mobarak, Alison Buttenheim, Angela Duckworth, Devin Pope, Ala Stanford, Richard H Thaler, Kevin Volpp (2022), A Citywide Experiment Testing the Impact of Geographically Targeted, High-Pay-Off Vaccine Lotteries, Nature Human Behaviour. https://doi.org/10.1038/s41562-022-01437-0 Abstract

  Lotteries have been shown to motivate behaviour change in many settings, but their value as a policy tool is relatively untested. We implemented a pre-registered, citywide experiment to test the effects of three high-pay-off, geographically targeted lotteries designed to motivate adult Philadelphians to get their COVID-19 vaccine. In each drawing, the residents of a randomly selected ‘treatment’ zip code received half the lottery prizes, boosting their chances of winning to 50×–100× those of other Philadelphians. The first treated zip code, which drew considerable media attention, may have experienced a small bump in vaccinations compared with the control zip codes: average weekly vaccinations rose by an estimated 61 per 100,000 people per week (+11%). After pooling the results from all three zip codes treated during our six-week experiment, however, we do not detect evidence of any overall benefits. Furthermore, our 95% confidence interval provides a 9% upper bound on the net benefits of treatment in our study.

• Mitesh Patel, Katherine L. Milkman, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, M. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Seung Hyeong Lee, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin Volpp, Angela Duckworth (2022), A Randomized Trial of Behavioral Nudges Delivered through Text Messages to Increase Influenza Vaccination Among Patients with an Upcoming Primary Care Visit, American Journal of Health Promotion, 37 (3), pp. 324-332. Abstract

  Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza
  vaccination rates.
  Design: Randomized, controlled trial.
  Setting: Two health systems in the Northeastern US between September 2020 and March 2021.
  Subjects: 74,811 adults.
  Interventions: Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that
  varied in their format, interactivity, and content.
  Measures: Influenza vaccination.
  Analysis: Intention-to-treat.
  Results: Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were
  White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination
  rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points
  or 6.1% (P = .005). The top performing text message described the vaccine to the patient as “reserved for you” and led
  to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P < .001) in vaccination relative to control. Three of the top five
  performing messages described the vaccine as “reserved for you.” None of the interventions performed worse than
  control.
  Conclusions: Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased
  influenza vaccination rates and could be a scalable approach to increase vaccination more broadly.

  Related
  Links
• Harsha Thirumurthy, Katherine L. Milkman, Kevin Volpp, Alison M. Buttenheim, Devin G Pope (2022), Association Between Statewide Financial Incentive Programs and COVID-19 Vaccination Rates, PLoS One, 17 (3). Abstract

  To promote COVID-19 vaccination, many states in the US introduced financial incentives ranging from small, guaranteed rewards to lotteries that give vaccinated individuals a chance to win large prizes. There is limited evidence on the effectiveness of these programs and conflicting evidence from survey experiments and studies of individual states’ lotteries. To assess the effectiveness of COVID-19 vaccination incentive programs, we combined information on statewide incentive programs in the US with data on daily vaccine doses administered in each state. Leveraging variation across states in the daily availability of incentives, our difference-in-differences analyses showed that statewide programs were not associated with a significant change in vaccination rates. Furthermore, there was no significant difference in vaccination trends between states with and without incentives in any of the 14 days before or after incentives were introduced. Heterogeneity analyses indicated that neither lotteries nor guaranteed rewards were associated with significant change in vaccination rates.

• Katherine L. Milkman, Linnea Gandhi, Mitesh Patel, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Jake Rothschild, Jonathan E. Bogard, Ilana Brody, Christopher F. Chabris, Edward Chang, Gretchen B. Chapman, Jennifer E. Dannals, Noah J. Goldstein, Amir Goren, Hal E. Hershfield, Alexander Hirsch, Jillian Hmurovic, Samantha Horn, Dean Karlan, Ariella Kristal, Cait Lamberton, M. Meyer, Allison H. Oakes, Maurice Schweitzer, Maheen Shermohammed, Joachim H. Talloen, Caleb Warren, Ashley Whillans, Kuldeep N. Yadav, Julian J. Zlatev, Ron Berman, Chalanda N. Evans, Rahul Ladhania, Jens Ludwig, Nina Mazar, Sendhil Mullainathan, Christopher K. Snider, Jann Spiess, Eli Tsukayama, Lyle Ungar, Christophe Van den Bulte, Kevin Volpp, Angela Duckworth (2022), A 680,000-Person Megastudy of Nudges to Encourage Vaccination in Pharmacies, Proceedings of the National Academy of Sciences, 119 (6). 10.1073/pnas.211512611 Abstract

  Encouraging vaccination is a pressing policy problem. To assess whether text-based reminders can encourage pharmacy vaccination and what kinds of messages work best, we conducted a megastudy. We randomly assigned 689,693 Walmart pharmacy patients to receive one of 22 different text reminders using a variety of different behavioral science principles to nudge flu vaccination or to a business-as-usual control condition that received no messages. We found that the reminder texts that we tested increased pharmacy vaccination rates by an average of 2.0 percentage points, or 6.8%, over a 3-mo follow-up period. The most effective messages reminded patients that a flu shot was waiting for them and delivered reminders on multiple days. The top performing intervention included two texts delivered 3 d apart and communicated to patients that a vaccine was “waiting for you.” Neither experts nor lay people anticipated that this would be the best-performing treatment, underscoring the value of simultaneously testing many different nudges in a highly powered megastudy.

• Katherine L. Milkman, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Predrag Pandiloski, Yeji Park, Aneesh Rai, Max Bazerman, John Beshears, Lauri Bonacorsi, Colin Camerer, Edward Chang, Gretchen B. Chapman, Robert Cialdini, Hengchen Dai, Lauren Eskreis-Winkler, Ayelet Fishbach, James J. Gross, Samantha Horn, Alexa Hubbard, Steven J. Jones, Dean Karlan, Tim Kautz, Erika Kirgios, Joowon Klusowski, Ariella Kristal, Rahul Ladhania, George Loewenstein, Jens Ludwig, Barbara Mellers, Sendhil Mullainathan, Silvia Saccardo, Jann Spiess, Gaurav Suri, Joachim H. Talloen, Jamie Taxer, Yaacov Trope, Lyle Ungar, Kevin Volpp, Ashley Whillans, Jonathan Zinman, Angela Duckworth (2021), Megastudies Improve the Impact of Applied Behavioural Science, , 600 (), pp. 478-483. Abstract

  Policy-makers are increasingly turning to behavioural science for insights about how to improve citizens’ decisions and outcomes. Typically, different scientists test different intervention ideas in different samples using different outcomes over different time intervals. The lack of comparability of such individual investigations limits their potential to inform policy. Here, to address this limitation and accelerate the pace of discovery, we introduce the megastudy—a massive field experiment in which the effects of many different interventions are compared in the same population on the same objectively measured outcome for the same duration. In a megastudy targeting physical exercise among 61,293 members of an American fitness chain, 30 scientists from 15 different US universities worked in small independent teams to design a total of 54 different four-week digital programmes (or interventions) encouraging exercise. We show that 45% of these interventions significantly increased weekly gym visits by 9% to 27%; the top-performing intervention offered microrewards for returning to the gym after a missed workout. Only 8% of interventions induced behaviour change that was significant and measurable after the four-week intervention. Conditioning on the 45% of interventions that increased exercise during the intervention, we detected carry-over effects that were proportionally similar to those measured in previous research. Forecasts by impartial judges failed to predict which interventions would be most effective, underscoring the value of testing many ideas at once and, therefore, the potential for megastudies to improve the evidentiary value of behavioural science.

• Katherine L. Milkman, Mitesh Patel, Linnea Gandhi, Heather N. Graci, Dena Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, M. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin Volpp, Angela Duckworth (2021), A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment, Proceedings of the National Academy of Sciences, 118 (20). 10.1073/pnas.2101165118 Abstract

  Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.

• Colman Humphrey, Dylan Small, Shane T. Jensen, Kevin Volpp, David A. Asch, Jingsan Zhu, Andrea B. Troxel (2019), Modeling Lottery Incentives for Daily Adherence, Statistics in Medicine, 38 (15), pp. 2847-2867.
• Maguire Herriman, Kevin Volpp, Maurice Schweitzer (2019), Beyond ‘Rub Some Dirt on It:’ The Need for an Intervention to Prevent Sports Injuries, Journal of American Medical Association Pediatrics, 173 (3), pp. 215-216.
• Christian Terwiesch, Kevin Volpp, David A. Asch (2017), Reimagining Provider Visits as the New Tertiary Care, Annals of Internal Medicine.
• All Research from Kevin Volpp »

Current Courses

• HCIN6020A - Behavioral Economics And Decision Making

  Behavioral economics is a relatively new field at the intersection of economics and psychology that builds on the observation that people tend to make predictably irrational decisions, and that those patterns can be used to shape personally and socially beneficial behaviors. This course offers an introduction to behavioral economics and its applications in health and health care. We will examine the foundations of the field, then consider: • The structure of choice environments and how people are influenced by how choices are framed. • Strategies for supercharging incentive programs. • The use of social incentives and social comparisons to achieve better physician performance. The course will conclude with an exploration of how behavioral economics can be used to shape health policy, and the important question of when a “nudge” becomes a shove. This is a multi-term course. To earn course credit, students must successfully complete both HCIN6020A in the Fall and HCIN6020B in the Spring. Students who complete both parts will receive a single grade and earn 1 CU total.

  HCIN6020A001

  HCIN6020A002

Past Courses

• HCIN6020A - Behavioral Economics

  Behavioral economics is a relatively new field at the intersection of economics and psychology that builds on the observation that people tend to make predictably irrational decisions, and that those patterns can be used to shape personally and socially beneficial behaviors. This course offers an introduction to behavioral economics and its applications in health and health care. We will examine the foundations of the field, then consider: • The structure of choice environments and how people are influenced by how choices are framed. • Strategies for supercharging incentive programs. • The use of social incentives and social comparisons to achieve better physician performance. The course will conclude with an exploration of how behavioral economics can be used to shape health policy, and the important question of when a “nudge” becomes a shove. This is a multi-term course. To earn course credit, students must successfully complete both HCIN6020A in the Fall and HCIN6020B in the Spring. Students who complete both parts will receive a single grade and earn 1 CU total.

• HCIN6020B - Behavioral Economics

  This course is a continuation of HCIN6020A, Behavioral Economics and Decision Making. In the final weeks of the course, you will focus on structuring incentive programs, utilizing social forces to shape behavior, and applying behavioral economics in workplace and policy settings. As a final project, you will design a behavioral intervention plan, with a funding request, to address poor health metrics. Students must successfully complete HCIN 6020A in the Fall term before taking this course. Students will receive a single letter grade and earn 1 CU total for HCIN 6020A and 6020B.

• HCIN6050 - Applying Behavioral Econ

  Analyze a case, define a behavioral economics intervention, sketch a behavioral roadmap, and write a proposal for the intervention.

• HCIN6080 - Health Insurance Dsgn & Value

  This is a 6-week, 1 cu, online course that pairs two complementary course topics. In the first 3 weeks, you will study Health Insurance and Benefit Design with David Asch, MD, MBA and Kevin G. Volpp, MD, PhD. In the final 3 weeks, you will study Driving Value in Health Care with Lee Fleisher, MD. Strategies for Health Insurance and Benefit Design: Recent efforts to increase the amount of health produced through health insurance benefits relative to the cost have utilized a number of strategies. These have included high deductible health plans, price transparency, value-based insurance design, simplifying health plan designs, and providing incentives geared to influencing utilization. In this course, we will discuss some of the main challenges facing health insurers, efforts to reduce growth in entitlement spending, and research that uses on the effectiveness of different strategies to modify behavior through the use of incentives embedded within health insurance design. This course will emphasize both understanding and practical applications of this knowledge through a combination of lectures and interviews with expert practitioners. Following completion of this course, students will have a deeper understanding of some of the tradeoffs inherent in the approaches insurers are taking to provide greater value and health improvement for their beneficiaries. Paired with Driving Value in Health Care. We explore methods for analyzing value drivers and survey strategies to improve value (defined as quality over cost) in a health care system. Most policy experts agree that by focusing on value, we can align incentives for different groups within the health care system to address our most pressing problems. This course gives you the tools to do that by examining topics including the determinants of value, methodologies for understanding value drivers, and real-world examples of improving value through quality improvement. Through your work, you will identify gaps in quality, track inefficiencies in the patient experience, and ultimately build a persuasive presentation focused on reducing low-value care.

• HCMG6530 - HCMG Field App Project

  This course focuses on leadership and management issues in health care organizations while providing students with a practice setting to examine and develop their own management skills. Each team acts as a consultant to a healthcare organization which has submitted a project proposal to the course. The teams define the issue and negotiate a contract with the client organization. By the end of the semester, teams present assessments and recommendations for action to their clients and share their experience and key lessons learned in a final presentation to their classmates.

• HCMG8990 - Independent Study

  Arranged with members of the Faculty of the Health Care Systems Department. For further information contact the Department office, Room 204, Colonial Penn Center, 3641 Locust Walk, 898-6861.

• HPR9900 - Hpr Thesis I

  Each student completes a mentored research project that includes a thesis proposal and a thesis committee and results in a publishable scholarly product. Prerequisite: Course only open to Masters of Science in Health Policy Research students.

• HPR9901 - Hpr Thesis II

  Each student completes a mentored research project that includes a thesis proposal and a thesis committee and results in a publishable scholarly product. Prerequisite: Course only open to Masters of Science in Health Policy Research students.

• Article-of-the-Year Award, "Effect of Financial Incentives on Physicians, Patients, or Both on Lipid Levels", Academy Heath Annual Meeting, Boston, MA, 2016 Description

• Philadelphia Business Journal Innovation Award, 2012
• Elected to Association of American Physicians (AAP), 2012
• Elected to Institute of Medicine, National Academy of Sciences (IOM), 2012
• British Medical Journal Group Awards for "Translating Research into Practice" for work on Financial Incentives and Smoking Cessation implemented by General Electric nationally for 152,000 employees January, 2010
• Society of General Internal Medicine Outstanding Research Paper of the Year for Volpp KG, Troxel AB, Pauly MV, et al. New England Journal of Medicine; 2009; 360:699-709, 2010
• Time Magazine Most Significant Advances in Health 2009 A-Z. Work descibed under "I" for "Incentives", 2009
• Elected to American Society of Clinical Investigation (ASCI), 2008
• Alice S. Hersh New Investigator Award, AcademyHealth, for "exceptional promise for future contributions to health services research", 2007
• Best Paper Award - AcademyHealth Annual R esearch Meeting (with A Rosen, P Romano, P Rosenbaum, J Silber) - "Impact of ACGME Duty Hours on Mortality Among Patients in VA Hospitals" - one of three highest rated abstracts our of about 1700 submitted., 2007
• John Thompson Award from Association of University Programs in Health Administration (AUPHA) for outstanding accomplishments in health services research as a junior investigator, 2006
• Society of General Internal Medicine Outstanding Junior Investigator Award, 2006
• Presidential Award for Early Career Scientistis and Engineers (PECASE) - recognized at White House by President Bush with highest honor given by US government for early career scientists, 2005
• World Economic Forum - chosen to serve on Global Advisory Council on Behavior, 1970
• Association for Clinical and Translational Science (ACTS) Distinguished Investigator Award for Translation from Clinical Use into Public Benefit and Policy. "Award for Career Achievement and Contribution to Clinical and Translational Science", 1970
• Matilda White Riley Award For Contributions to Social and Behavioral Science, 20th anniversary of the Office of Social and Behavioral Sciences Research, NIH, 1970

Knowledge @ Wharton

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