Good news: health costs as little as $3 a day. At least, that's all it took in one recent study for several patients to forgo bad behaviors that put their health at risk.

Each year, more than 40% of premature deaths in the United States result from unhealthy behaviors such as smoking, overeating or failing to take medications as prescribed. Physicians routinely struggle to get patients to give up their bad habits for the sake of their long-term health, yet 20% of Americans still smoke, and 71% are either overweight or obese.

"We know that people in the short term have a lot of trouble changing their behavior in ways that is in their long-term best interest," says Kevin Volpp, Wharton professor of medicine and health care management, and a professor at the University of Pennsylvania School of Medicine. "People aren't very good at making these tradeoffs between immediate gratification and delayed and often intangible benefits, such as good health 10 years from now."


Volpp -- with collaborators Mark V. Pauly, Wharton professor of health care management; George Loewenstein, professor of economics and psychology at Carnegie Mellon University; and others -- may have found an answer to this problem: cash.

As director of Penn's Center for Health Incentives, part of the Leonard Davis Institute of Health Economics, Volpp is in perpetual pursuit of carrots that will lure patients away from lethal behaviors. In a series of ongoing studies, Volpp has found evidence that money can motivate some patients to stop smoking, lose weight or keep up with their daily medication.

A smoking-cessation study led by Volpp, "Financial Incentives for Smoking Cessation," published in the New England Journal of Medicine and conducted among employees at General Electric, found that 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.

Another Volpp-led study, "Financial Incentives for Weight Loss," published in the Journal of the American Medical Association, found that dieters who could earn money by losing weight lost more pounds more quickly than those who weren't offered a monetary reward. And a small preliminary study of patients who regularly forgot to take their medication, titled "A Test of Financial Incentives to Improve Warfarin Adherence," found that the chance to win an average of $3 per day in a daily lottery pushed many of them to remember to take the daily dose.