Peter Ubel Again Nudges Payment Reform

New, in Annals of Internal Medicine:
Emanuel EJ, Ubel PA, Kessler JB, Meyer G, Muller RW, Navathe AS, et al. Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care. Ann Intern Med. 2016;164:114-119. doi:10.7326/M15-1330 [Full Text]

In case you missed it, this paper first appeared online November 24, 2015. It’s in print now, in the current issue of the Annals of Internal Medicine, the section on “Medicine and Public Issues.”

Emanuel et al discuss the use of behavioral economics to design systems that incentivize high value care. Their perspective emphasizes the need to examine the science of human motivation. They provide principles and likely uses for behavioral economics, for example, providing social ranking to improve performance. However, they leave us with four issues — the problem of too many metrics, the quandary about individual or practice group distribution, the concern of being too cost conscious, and the unknowns about appropriate size of incentives, all familiar to practicing clinicians.

One co-author, Dr. Peter Ubel, a physician and behavioral scientist, is a well known faculty member of Duke General Internal Medicine. Recently we posted another publication by Ubel, his JAMA Viewpoint titled “Value Promotion in Health Care: The Importance of Symmetry.” The JAMA publication raised concerns about misguided congressional efforts to promote the use of high-value healthcare services, without doing anything to reduce the use of low value ones.

You can read more about Dr. Ubel’s publications and his opinions from his blog: “Health, Bioethics, and Behavioral Economics."

Also, follow @PeterUbel on Twitter.

 

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