Tuesday, February 28, 2012

Our aversion to loss is greater than our desire for gain

At the American College of Preventive Medicine conference, I heard Dr. Kevin Volpp who is a Professor of Medicine and Health Care Management; Director, Center for Health Incentives and Behavioral Economics, at the Leonard Davis Institute,  and Director, Penn CMU Roybal P30 Center in Behavioral Economics and Health Education at the University of Pennsylvania. Dr. Volpp's academic credentials include: a PhD, University of Pennsylvania (Wharton) 1998; MD, University of Pennsylvania 1998; AB, Harvard College, 1989.

Dr. Volpp talked about the role of behavioral economics in understanding and influencing patient behavior.   From his talk, I gleaned one of the most significant insights I have had in over a year.

The impetus for me to start MDPrevent was my learning that Medicare was implementing coverage for the Annual Wellness Visit. This made me ecstatic because this was the first time that Medicare was going to pay a doctor to focus on disease prevention instead of treatment.  What got me even more excited was that it was not going to cost the patient a penny. It was essentially free to the patient and not subject to the deductible and co-payment as are most Medicare services. This news just rocked my world.

So over the past few months since opening the doors at MDPrevent, I have been informing the local Medicare population that there is new free benefit available to them that could change their lives and help them prevent, delay, and even mitigate the development and severity of deadly chronic diseases such as heart disease, diabetes, cancer, stroke, and some forms of dementia.

The response has been less than expected. Although we have already performed over 500 patient visits, I had expected there to be a stampede of demand. MDPrevent is providing a free service that can have a dramatic effect on one's life. Seniors in Florida are known heavy consumers of health care services and this service can spare them unnecessary pain and suffering. I thought this was the right message given my twenty years of experience taking care of 5 million seniors and working with their families for service approvals, the same families that have since turned 65. I couldn't figure it out. Why aren't more seniors taking advantage of this amazing service? According to Medicare, around 5% of eligible seniors took advantage of the service in 2011, the first full year of implementation. That means 95% missed out. Why was this happening? I was dumbfounded. Then I heard Dr. Volpp speak.

Dr. Volpp said that people have more of a risk and loss aversion than a gain motivation. In other words, people are more concerned about losing something than they are interested in gaining something. The light blub went off in my head.

By marketing the new service as free, I have been sending the wrong message. The connotation of free suggests little value. The old adage, "you get what you pay for" comes to mind.  Seniors aren't appreciating the value of this service and it's a shame. It is a wonderful service and MDPrevent provides it as well if not better than anyone in the country. MDPrevent's medical professionals give each patient as much time as needed to thoroughly review all aspects of health history and lifestyle, including a comprehensive review of diet and supplement usage, and then make recommendations on proper usage as appropriate.

While Medicare pays about $175 for this service the first year and about $110 each year thereafter, I think the service's potential effect on one's short term and long term health is priceless.

Therefore, my message has changed from come get your free service to don't lose out on a wonderful and valuable service that has a value of $175.

Will the new messaging make a difference? Only time will tell.

I openly offer this insight because I want as many seniors as possible to benefit from this incredible service across the country.

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