Two Blues discuss healthy behavior change, rewards, loss aversion, and regret theory

By Aditi Pai
07:19 am

ServeitUpPremera Blue Cross Director of Member Engagement Neal Sofian and Blue Shield of California Senior Wellness Program Manager Ritu Riyat introduced ways in which their respective health plans are incentivizing patients and providing meaningful data to improve their everyday life at a mobile health conference last week in Boston.

Sofian takes issue with the one size fits all approach to a lot of wellness programs because "there's not one thing that's the critical thing to know". Rather, he sees a need for many different strategies for improving health, each benefiting a different type of person.

His team's new product, Serve It Up helps consumers create shopping lists and identify which products are healthier choices. Serve It Up includes a rewards system that compensates shoppers for choosing healthy options, a coupon finder for healthy groceries and a social sharing mechanism that enables users to share shopping lists and recipes with like-minded shoppers.

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"Serve It Up is saying we recognize how people operate: They are at the grocery store 200 times a year so why not start where people are, at the grocery list?" Sofian said. "Which means it starts at the dining room table or the kitchen table when you're making your weekly shopping list."

Notable prizes within the program include -- on the high end -- tickets to a Seattle Seahawks football game.

In her presentation, Ritu Riyat of Blue Shield of California described the program Wellvolution, which launched in 2008. Wellvolution arose out of her group's dissatisfaction with the previous model -- a basic "complete an HRA, answer a few questions about fruits and vegetable consumption, possibly receive a $50 gift card and in the end making little to no impact."

After looking at multiple different programs and testing them out herself, Riyat chose a program that she felt provided consumers with some of their "basic human needs".

"We all want a sense of belonging, we want to be recognized, we want to take the path of least resistance, we want the easy way," Riyat said.

She aimed for the program to be rewarding, easy, social, and fun. Instead of linking incentives to cash, the program links incentives to health insurance benefits. The outcomes of the program are set so that if someone doesn't meet the requirements of the program, they are still rewarded for participating. To make the program easy, Riyat designed it so that people make fewer choices.

"We are all social beings," Riyat said. "We wanted to leverage this as a strategy within our Blue Shield population by working with innovative partners like ShapeUp and MeYou Health to launch team-based step challenges as well as social platforms where employees can connect with other colleagues as well as friends and family members."

Within the trial year of the program, participants completed over 175,000 challenges and had a 90 percent retention rate, she said.

To tackle fitness, Riyat's team launched Walkadoo, in partnership with MeYou Health, this year. Walkadoo is a physical activity platform that uses a device made by Fitlinxx Pebble and has a step goal based on your current walking patterns and activity level.

Six months into the program, half the company is participating -- almost 2,500 participants -- and of those 70 percent wear the devices daily, Riyat said. As a group, they have walked over 800 million steps thus far.

This year, Riyat and her team are working with VAL Health to improve Blue Shield of California's existing program, Healthy Lifestyle Rewards, with a new rewards engine. The new rewards program is based on regret theory, defined as a decision made when anticipating loss and choosing another option as a result. The improvements to the Healthy Lifestyle Rewards program, which were tested on an unspecified client population, Riyat said, increased participation while lowering the amount of money the health insurance company had to spend on the program.


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