Author Archives: Lori Melichar

Six Ideas for Reducing the Use of Low-Value Health Care

Oct 17, 2013, 8:00 AM, Posted by Lori Melichar

Lori A. Melichar Lori Melichar, director

Two years ago, my colleagues and I knew very little about how to use behavioral economics to improve health care decisions. Today, we know more. We also know how much there is to learn and do in this field.

That’s why we’re excited to announce six new grantees who will continue to build on the work we’ve funded over the last two years to apply principles from behavioral economics to challenges in health care.

The new grantees are as follows:

  • Amber Barnato and Rebecca Sudore, University of Pittsburgh and University of California, San Francisco, Consumer-directed financial incentives to increase advance care planning among Medicaid beneficiaries
  • Jeremiah Schuur, Brigham and Women's Hospital, Inc., Decision Fatigue in the Emergency Department and the Use of Hospital Services
  • Jeffrey Kullgren, University of Michigan Medical School, Decreasing Overuse of Low-Value Health Care Services through Physician Precommitment
  • Mark Vogel and Scott Halpern, Genesys Health System and University of Pennsylvania, BEACON -  Behavioral Economics for Advanced Care OptioNs
  • Richard Frank and Abigail Friedman, Harvard Medical School, Behavioral Experiments in Improving Medicare Coverage Choice
  • Mark Schlesinger and Rachel Grob, Yale University and University of Wisconsin – Madison,  Precommitment, Provider Choice, and Forgoing Low-Value Health Care

If you’re curious about why we’re funding these particular projects at this specific moment in time, read on.

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Weighing the Pros and Cons of Making Proposals Public

Aug 8, 2013, 8:00 AM, Posted by Lori Melichar

Lori A. Melichar Lori Melichar, director

“Information wants to be free.” That’s the mantra of Internet culture, which is increasingly indistinguishable from culture at large. What does this cultural shift mean for a foundation seeking to fund innovation? Specifically, what does it mean for Pioneer?

My colleague, Nancy Barrand, and I have been thinking about this a lot lately. Clearly, the existence of this blog, and of our website and various social media channels, are all proof that we share more information outside the walls of this Foundation than we ever did before. But we still keep one part of our process under lock and key: proposal review.

Each year, thousands of organizations submit proposals to RWJF, and only the fraction of them that receive funding are ever shared publicly. This is less a comment on the quality of the ideas than it is on the specificity of our funding strategy, and, of course, the fact that our budget is finite. Increasingly, we’ve wished we could share the ideas we don’t fund with a wider audience, so they could benefit from the collective intelligence of our growing network.

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Grantee Spotlight: Nicholas Christakis

Jul 24, 2013, 8:00 AM, Posted by Lori Melichar

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We at Pioneer are fortunate to work with grantees who consistently challenge our thinking and open us up to new ways of looking at the world. Nicholas Christakis, MD, PhD, MPH is no exception. We recently watched a talk of his on Edge.org titled A New Kind of Social Science for the 21st Century (which we highly recommend), and found ourselves brimming with questions. His answers were as provocative as the talk itself, so we thought we'd share them. Read the Q&A.

Video: Larry Smarr on the Health Data Exploration Project

Jun 10, 2013, 8:00 AM, Posted by Lori Melichar, Steve Downs

As we set forth on the Health Data Exploration project, we're being guided by a wonderful set of advisors. Here's a quick video post from one of them, Larry Smarr, the director of Calit2.  Larry's a pioneer who's exploring the frontiers of quantified self, as you can see from the extraordinary talk he gave at TEDMED earlier this year.

Health Data: Let's Go Exploring

May 29, 2013, 8:00 AM, Posted by Lori Melichar, Steve Downs

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Think about it for a moment. When you consider what you "know" about health, where does that knowledge come from? While we all have our sources—doctors, friends, news articles—our knowledge at its core is derived from research. And that research is built on a foundation of data.

Data about health typically come from several types of sources: clinical data, gleaned from electronic health records or chart pulls, and billing and claims data, which are byproducts of the health care process; and public health surveillance data, which are specialized collections about particular topics or populations. All of these sources can then be supplemented, at a considerable cost, by original data collection efforts specific to a particular study.

These different types of data are like pieces of a jigsaw puzzle; when assembled, they create a more complete picture of health.

But a piece of the puzzle is missing.  Or it has been up till now.

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