Delivery Innovation

The search for new and innovative ways to deliver health care more efficiently and effectively. 

Built Environment Assessment: Multidisciplinary Perspectives

Apr. 19, 2016

Karen Glanz, Susan Handy, Kathryn Henderson, Sandy Slater, Erica Davis, Lisa Powell

In SSM Population Health, Karen Glanz and colleagues examine how different disciplinary perspectives can contribute to environmental context-based assessment related to obesity.  The authors also make recommendations for encouraging effective advances in built-environment assessment. A multidisciplinary team of experts convened in 2013 to discuss how their respective disciplines can collaborate to integrate environmental assessment to prevent obesity. There has been significant progress in collaboration across key disciplines that contribute to studies of built environments and...

Choosing Wisely in Emergency Medicine: A National Survey of Emergency Medicine Academic Chairs and Division Chiefs

Mar. 14, 2016

Brandon Maughan, Jill Baren, Judy Shea, Raina Merchant

In Academic Emergency Medicine, Brandon Maughan and colleagues, including Judy Shea and Raina Merchant, assess whether leaders of academic emergency medicine departments are aware of the Choosing Wisely campaign, and their attitudes about the campaign. The Choosing Wisely campaign seeks to promote collaboration and communication between patients and physicians regarding the appropriateness of common tests and procedures. For this study, the researchers used a web-based survey of emergency department chairs and division chiefs to examine awareness of the campaign, anticipated...

Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care

Feb. 17, 2016

Ezekiel Emanuel, Peter Ubel, Judd Kessler, Ralph Muller, Amol Navathe, Pankaj Patel, Robert Pearl, Meredith Rosenthal, Lee Sacks, Aditi Sen, Paul Sherman, Kevin Volpp

In Annals of Internal Medicine, Ezekiel Emanuel and colleagues, including Judd Kessler, Ralph Muller, Amol Nayathe, and Kevin Volpp, discuss several principles of behavior economics, including inertia, loss aversion, choice overload, and relative social ranking. Designing physician incentives based on behavioral economics principles can improve their effectiveness through better alignment with performance goals. The study includes anecdotal examples of successful incentive programs that apply behavioral economics principles. Though the effectiveness of behavioral economic-based...

Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial

Research Brief
Jan. 15, 2016

To whom should financial incentives be targeted to achieve a desired clinical or health outcome—physicians or patients? Using insight from behavioral economics, a research team led by LDI Senior Fellows David Asch and Kevin Volpp sought to determine whether physician financial incentives, patient incentives, or shared physician and patient incentives are more effective in promoting medication adherence and reducing cholesterol levels of patients at high risk for cardiovascular disease. Though physician and patient incentives are becoming more common, they are rarely combined, and effectiveness of these approaches is not well-established. This study offers insight into what incentive structure leads to the greatest impact on health promotion. 

Cost Differences After Initial CT Colonography Versus Optical Colonoscopy in the Elderly

Nov. 19, 2015

Hanna Zafar, Jianing Yang, Katrina Armstrong, Peter Groeneveld

In Academic Radiology, Hanna Zafar and colleagues, including Peter Groeneveld, compare differences in total Medicare costs among asymptomatic elderly patients in the year after initial computed tomographic colonography (CTC) or initial optical colonoscopy (OC). In 2009, the Centers for Medicare and Medicaid Services stopped covering CTC screening among asymptomatic individuals based on the scarcity of data regarding differences in outcomes and costs between patients who received CTC and OC. Zafar and colleagues performed a retrospective cohort study of asymptomatic Medicare...

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