Can Behavioral Economics Help Healthcare?
The NIH and AHRQ are spending $15M to find out.
Comparative effectiveness research in healthcare, or studies on the relative cost and benefit of specific diagnostics and treatments, is a hot topic. Doing this type of research will empirically determine, for example, if there is any clinical benefit to a more expensive or frequent diagnostic imaging technique.
Doing the research is one thing, getting providers to use it in delivering care is another. And that will be a big problem. To help solve the problem, the National Institute of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ) are offering $15M in grant money to purse clinical trials on Using Behavioral Economics Research for Nudging Comparative Effectiveness Research.
Here is the purpose of the grant as specified in the executive summary:
“This NIH Funding Opportunity Announcement (FOA), supported by funds provided to the NIH and AHRQ under the American Recovery & Reinvestment Act of 2009 (“Recovery Act” or “ARRA”), Public Law 111-5, invites applications proposing clinical trials using the principles of behavioral economics to enhance the uptake of the results of comparative effectiveness research (CER) among health care providers in their practice. For this FOA, applicants must propose controlled trials that randomize units (whether individuals or clusters such as practices, hospitals, or larger units) to conditions, resulting in a randomized clinical trial (RCT) or cluster randomized trial (CRT). Research to foster the uptake of CER is seen to be necessary given the surprisingly modest behavioral response of health care providers and health care systems to information concerning treatments or procedures judged to be superior in CER trials. An additional possible benefit is that some behavioral economic interventions to promote the uptake of CER (e.g., those that rely on manipulating a provider’s default options) could be more cost effective than conventional approaches including some pay for performance schemes (P4P). For the purposes of this FOA, the definition of comparative effectiveness research will adhere to that adopted by the Federal Coordinating Council given at http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. Behavioral economics refers to the interdisciplinary efforts involving cognitive and social psychologists, decision scientists, and other social scientists together with economists to model economic decision-making and consequent actions. The approach is inclusive, since at its heart it tries to take into account what is known about how people actually make decisions rather than relying on the assumption that economic agents are fundamentally rational in the sense of expected utility theory (see, e.g., Kahneman and Tversky’s (1979) work on Prospect Theory and Kahneman’s (2003) Nobel lecture). It is hoped that this line of research will lead to significantly greater consideration of CER by health care providers and therefore enhance the quality of the nation’s health.”
