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Ongoing Research
“Pilot Trial of Lottery to Improve Warfarin Adherence”
Kimmel / Volpp / Loewenstein
Aetna Foundation
This is a 2-arm randomized controlled trial with 100 subjects testing the effectiveness of financial incentives in improving warfarin adherence.
“Financial Incentives for Smoking Cessation”
Volpp PI / Pauly Co-PI
Centers for Disease Control and Prevention
This project involves process evaluation, business case, and assessment of external validity of a large employer-based study of financial incentives for smoking cessation that was also CDC-funded.
“Impact of Treatment Profitability on Hospital Responses to Financial Stress”
Volpp PI / Lindrooth Co-PI
Robert Wood Johnson Foundation HCFO Program
This research involves the assessment of differences in profitability among hospital service lines and their relationship to hospital outcomes.
“A Randomized Trial of Interventions to Improve Warfarin Adherence”
Kimmel / Volpp Joint PIs
National Heart Lung Blood Institute
Pilot data from a study funded by the Aetna Foundation has shown that delivery of a lottery-based financial incentive was feasible and may be associated with substantial improvement in adherence. This larger phase III study is powered to evaluate the effectiveness and cost effectiveness of incentives and reminders for warfarin adherence.
“Financial Incentives for Weight Loss”
Volpp PI / Loewenstein Co-PI
United States Department of Agriculture (USDA) and Hewlett Foundation
This randomized controlled trial is testing two different types of deposit contract incentives in achieving weight loss over an 8 month period. Earlier work by our group has shown greater weight loss in both deposit contract and lottery incentive groups relative to a control group.
“Impact of Resident Work Hour Rules on Errors and Quality”
Volpp PI / Silber Co-PI
National Heart Lung Blood Institute
This research involves analysis of the effect of ACGME work hour rules on errors and quality in non-VA teaching hospitals.
“Collaboration to Reduce Disparities in Hypertension”
Kimmel / Volpp Joint PIs
Commonwealth of Pennsylvania/Pfizer, Inc.
Randomized controlled trial testing the impact of reducing copayments for patients with poorly controlled blood pressure from $8 per medication per month to $0 or $0 to -$8 on blood pressure control.
“Payment for Living Kidney Donation: An Undue or Unjust Inducement?”
Halpern PI / Reese Co-PI
This research aims to test empirical assumptions about human decision-making with respect to kidney donation among urban community members and those being evaluated for kidney donation at a large city hospital. The influences of the risk of kidney donation, the payment to be offered, and the recipient of the kidney (family member vs. anonymous recipient) on the subjects’ willingness to donate will be evaluated.
“Financial Incentives in Surveys of Healthcare Providers: Lotteries versus Guaranteed Payments”
Halpern PI / Cannuscio and Volpp Co-PIs
Greenwall Foundation Faculty Scholar Award in Bioethics/Medical Education Research Grant from the University of Pennsylvania,
LDI CHI Pilot Project
This study will evaluate the relative efficacy of guaranteed payments (either up-front or conditional on response) vs. lotteries (in which respondents are entered into a random drawing for a larger reward) in increasing healthcare provider response to surveys. This study comprises 3 independent randomized trials of actuarially equivalent payments and lotteries.
“A Randomized Clinical Trial of Default Options in Advance Directives for the Elderly”
Halpern PI
Submitted for funding to NIH
Patients 65 or older with terminal lung diseases will be randomized to receive 1 of 3 advance directives which differ in terms of default framing or ‘usual care.’ Preference for a plan of end-of-life care focused on comfort rather than life extension will be assessed.
“The Paradox of Declining Female Happiness”
Stevenson / Wolfers Joint PIs
This research is exploring changes in women's subjective well-being over time and in relation to changes in objective measures. Findings may help guide public policy.
“Women’s Education and Family Behaviour: Trends in Marriage, Divorce and Fertility”
Stevenson / Isen Joint PIs
This research examines how marital and fertility patterns have changed along racial and education lines for men and women.
“Do Antidepressants Put People Back to Work? A Cross-Country Analysis of the Relationship Between Access to SSRIs and Long-Term Unemployment”
Stevenson / Ludwig / Marcotte / Norberg Joint PIs
SSRIs represent a technological advance that has changed the experiences of workers in the labor market, possibly reducing spells of unemployment.
“Impact of Medicaid Prescription Copayments in Patients with Schizophrenia”
Doshi PI
NIH/NIMH
This project aims to understand whether and how Medicaid prescription copayment changes impact (a) antipsychotic medication use, choice, adherence and (b) other non-drug health care service use and costs in patients with schizophrenia.
“Impact of Prescription Coverage and Cost-Sharing on Statin and Antihypertensive Use in the Elderly”
Doshi PI
American Heart Association
This study aims to examine the relationship between prescription cost-sharing and (a) statin and antihypertensive use and (b) intermediate health outcomes among elderly. The study will use data from, retiree plans, VA, and a national survey.
“Impact of Medicare Part D Cost-Sharing on Cardiovascular Medication Adherence”
Doshi PI
Pfizer, Inc.
This study aims to evaluate the impact of Medicare Part D cost-sharing features on statin and antihypertensive use.
“Impact of the Medicare Modernization Act (MMA) of 2003 on Medicare Part B Drug Utilization and Spending”
Doshi PI
Leonard Davis Institute of Health Economics
This project will examine the impact of the MMA 2003 on Part B drug use and expenditures, both overall and among subgroups of beneficiaries using Part B covered biologicals for conditions like rheumatoid arthritis and cancer.
“Market Competition and the Quality of Home Health Services”
Polsky PI
The goal of this project is to establish the relationship between competition and quality in the home health industry and the relationship between competition and the market-based reform of the Home Health Quality Initiative (HHQI). This project will test whether competition improves quality, whether HHQI improves quality, and whether HHQI is more likley to improve quality in more competitive markets.
“CEA in CTN: Bup/Nal Treatment for Opioid Addicted Youth”
Polsky PI
The National Drug Abuse Treatment Clinical Trials Network (CTN), as a network of community treatment providers, provides a ready platform for researching innovative strategies for the treatment of drug abuse and addiction. This research involves a comprehensive cost-effectiveness analysis of an ongoing clinical trial studying buprenorphine/naloxone-facilitated rehabilitation for opioid dependent adolescents/young adults.
“Regulation of the Provision of Health Incentives”
Madison PI
This project is examining the regulation of the use of financial incentives to encourage healthy behaviors.
“Charitable Fundraising”
Loewenstein PI / Cryder Co-PI
Hewlett Foundation
In collaboration with organizations such as the Red Cross, United Way, and the Carnegie Mellon Development Office, this project is exploring different ways to increase charitable giving, volunteering and blood donations. Specifically, the project explores a variety of different ways of increasing the tangibility to donors of the benefits produced by their donations.
“Improving the effectiveness of IDAs (Individual Development Accounts)”
Loewenstein PI / Haisley and Loibl Co-PIs
Foundation Support
Randomized trials to test different ways to use ideas from behavioral economics to increase the effectiveness of IDAs, targeted savings plans intended to help low income individuals meet savings goals for purposes of education, house purchases or business development by typically providing a 1-1 or larger match of the saver’s deposits. People asked to deposit smaller amounts more frequently might end up saving more.
“Behavioral Economics of Privacy”
Loewenstein PI / Acquisti and John Co-PIs
Dominant theories proposed by economists and psychologists assume that people have stable, coherent, attitudes toward privacy, but this research has found that people are extremely inconsistent in their concern about privacy. A large number of field and laboratory studies have found that people are often protective of their privacy in situations in which there is no need to be, and even more often not concerned about privacy or even motivated to reveal information in situations in which caution would be warranted.
“Ostrich Effect”
Loewenstein PI / Seppi, Sicherman and Utkus Co-PIs
This research studies investors' tendency to 'put their head in the sand' and deliberately avoid getting information about the value of their holdings when the market is down, but to look much more frequently when the market is up. The project has diverse implications that are being explored for other situations, including decisions about when to seek out medical information.
“Conflict of Interest”
Loewenstein PI / Cain and Moore Co-PIs
A conflict of interest is a situation in which an individual faces a conflict between a primary professional responsibility, such as a physician's responsibility to promote the health of his or her patients and a secondary personal interest, which often involves money or career advancement. Most lay people as well as academics have typically viewed conflicts of interest through the lens of corruption; those succumbing to conflicts of interest are assumed to put make a deliberate decision to put self-interest before professional responsibilities. This research proposes an alternative perspective, according to which succumbing to a conflict of interest is often the result of unconscious, unintentional, bias. A related line of research is focusing on the limitation of disclosure as a remedy for the problems caused by conflicts of interest.
“Payments to Physicians”
Abrams PI - LDI CHI Pilot Project
There is concern in the medical community that payments to physicians by pharmaceutical companies may distort prescribing behavior, whether through a conscious or unconscious mechanism. By combining a proprietary dataset covering 80 million individual prescriptions with payment data collected by state agencies the goal of this research is to produce the first empirical estimates of the relationship between pharma payments and prescription choice.
“The Impact of Advertising on Prescribing Behavior”
Abrams PI
Billions of dollars are spent annually on pharmaceutical advertising, presumably with the intent of influencing physician pharmaceutical choice. This paper seeks to precisely estimate the extent of that influence. This research uses a difference-in-difference framework, comparing physician prescribing behavior before and after a local advertising blitz, with physicians in similar regions where there is no change in advertising expenditures.
“When Docs Snooze Do You Lose? Medical Resident Work Hours and Patient Outcomes”
Abrams PI
In 2003, a national 80-hour weekly work limit was imposed on medical residents for the first time. The frequently stated motives were to improve patient outcomes and resident effectiveness, but at the time, little was known about how to optimally balance the tradeoff between resident fatigue and patient handoffs. This study makes use of a natural experiment in which New York State imposed a similar work hour limit in 1989. Using a difference-in-difference and triple differences methodology with CMS data, the investigator has been able to estimate that the New York rule change decreased 180-day mortality rates by 6-11%.
“Frailty Models for Quality of Life in Oncology (statistical methods)”
Troxel PI
This project involves the development of new statistical models that facilitate the joint analysis of quality-of-life (QOL) data and clinical outcomes in oncology trials. A frailty models is a type of random-effects model for failure-time data that allows correlated events; estimation of this kind of model in the context of QOL allows for both the estimation of the correlation between length and quality of life and its adjustment when obtaining estimates of treatment or other intervention effects.
"Concepts of Late-life Brain Health and Disease"
Karlawish PI
This research involves examining the clinical and policy implications of changing concepts of late-life brain health and disease.
"Awareness of Cognitive Deficits and Quality of Life"
Karlawish PI
The aim of this research is to measure the impact of awareness of cognitive deficits on self-reported quality of life.
"Behavioral Economics and Aging"
Karlawish PI
This line of research is examining the implications of the psychology and neurology of aging on theories of behavioral economics with attention to the clinical, ethical and policy issues