A powerful, simple, nudge has been discovered by researchers at Wharton’s Leonard Davis Institute — it’s directly paying people to be healthy.

Readers of Health Populi should already know about P4P, pay-for-performance, being adopted in Medicare and by other payers to incent health providers to provide health care that demonstrates health outcomes.

In this health citizen-facing version, call it “pay-for-performance-for-patients,” P4P4P.

Kevin Volpp is the Wharton professor who’s been studying how to move health consumers toward healthier behaviors. He’s written articles for journals like, “Asymmetric Paternalism to Improve Health Behaviors” in JAMA. His logic trail follows the Sunstein and Thaler Nudge principles of libertarian paternalism.

His research has found the following:

  • 9.4% of smokers who were offered $750 in incentives to quit smoking were able to remain smoke free for 18 months, compared with just 3.6% of smokers who tried to quit without financial incentive
  • Dieters who could earn money by loosing weight lost more pounds more quickly than those who weren’t offered a monetary reward
  • Patients who regularly forget to take their medication and have the chance to win an average of $3 per day in a daily lottery pushes many of them to remember to take their daily doses.
Volpp has uncovered some nuances across different populations, which are discussed in more detail in Wharton’s June 24, 2009, publication of Knowledge at Wharton.
Health Populi’s Hot Points: I’ve been doing a lot of speaking with large health plans, employer coalitions, and life sciences companies these past few months, and the Nudge concept is getting a lot of traction in those quarters as well as in the Obama Administration, where Cass Sunstein is now employed in a health regulatory capacity.

This week, The National Business Group on Health recognized 63 of the 2009 Best Employers for Healthy Lifestyles. These firms, NBGH says, “create healthy workplaces and help employees and their families make wise choices about their health and well being.”

These Best Health-Cos include several retailers (Hannaford, Walmart, Meijer and Target), health companies (Boehringer-Ingelheim, CVS Caremark and Cardinal Health), and General Mills.

It’s heartening to see smarter health plan design targeting wellness and productivity, along with the refinement in the Art of Nudging, gaining traction among employers. Here’s one targeted, strategic way to lower health costs in an era where employers are facing between 9 and 11% cost increases for the 2010 health planning horizon.

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