What healthcare plans can learn from casinos

Harvard Business School professor and economist Gary Loveman discussed how strategies from the world of gaming could help health plans better engage their members with technology.
By Laura Lovett
02:54 pm
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Healthcare has a few lessons it can learn from the casino world, according to Gary Loveman, a professor at Harvard Business School.  

Loveman’s somewhat unconventional career path has given him experience in both the insurance world and the healthcare industry; he previously served as the president of Aetna’s Consumer Health and Service division and held the CEO position at Caesars Entertainment Corporation for over a decade. 

While the two industries seem to be quite different, they both have to do with human behavior and motivation, he said. And although the healthcare world hasn’t quite gotten the hang of engaging customers like the gaming world, with digital tools, Loveman said the future is promising. 

“I think this is an opportunity like nothing I have ever seen before, where the potential for the resolution for this paradox is the greatest I’ve ever seen," Loveman said during a presentation at the BrightInsight Ecosystem event in Boston last week. "People want to be healthier. People in their orbit want them to be healthier. There is a tremendous commercial upside to getting people healthier. ... The challenge is just to unlock their native desire to do better in the system that surrounds them.”

The gaming world has succeeded in getting clients to come through its doors and gamble, while the medical world has so far struggled with patient compliance. 

“Why is it the same people who would trample Caesars Palace to get their dinner for $5 cheaper at 7 o’clock, or who would respond to a mailer I would send them to get their room in Las Vegas for $10 less than it was yesterday, not take their medicine when it keeps their arteries moving clearly, or when it keep their ambulation more comfortable, or [when] it does these other vital things their physicians told them was the case?” Loveman asked. 

Every person who steps into the gambling den will be worth a certain amount for the casino, he said. Similarly, healthcare plans associate each patient with the potential cost of their treatment.

“If you had come to see me in Las Vegas and you had visited me just one time, I would have immediately estimated how much you were worth as a customer,” Loveman said. “I would have been able to do that with surprising precision by knowing your age, your gender, where you lived, what game you played or what activities you did at Caesars Palace.”

One of the keys to reaching customers is understanding motives, but so far health plans have fallen short when applying this methodology to patients.

“Based on what your upside was as a customer, I would try to build that business with you over time,” he said. “Who does that in healthcare? If you are a person whose health is way below its potential and [an insurer] is paying a lot more than they need to and you are suffering a lot more than you need to — who is out to capture that? Nobody.”

The gaming industry is constantly trying to figure out the best way to reach a client until they engaged in a desired behavior. 

“Once we knew you were worth a certain amount, somebody who worked for us was going to keep at it over and over again. So why doesn’t this happen in healthcare?" He asked. "At Aetna people would ask all the time, 'What is the cost of the flu?'”

He said that for an elderly patient, that cost could be at least $50,000, maybe even $75,000, if it meant the flu led to a stay in the intensive care unit. With this in mind, it could be worthwhile for a health plan to spend a bit more than usual to convince the patient that a flu shot is worthwhile.

“If we have to send you out in a limousine and a marching band to give you that flu shot, it’s worth it,” Loveman said. “If you were a commercial business, that is exactly what you would do.”

The second lesson the gaming industry could teach healthcare has to do with making customers feel like a winner. In the healthcare world many patients don’t feel successful, and this causes them to not come back for care. 

“If you have a device on your wrist and all it tells you is you haven’t closed a circle since the Carter Administration, [or that] you haven’t stood up since the last time you got a beer, why would you put a device on your arm that constantly tells you that every goal that has been set for you, you are missing. Nobody does that,” he said. “The goal is not to put up positive reinforcement for people who don’t need it. The goal is to find reinforcement for people who do need it, for whom their interaction with healthcare is constantly disappointing.”

While some consumer gadgets might not be the best way to get patients to care, technology could be a way to help meet people where they are, as well as an easy way to figure out a customer’s motives. 

“It’s got to be easy. It’s got to be convenient. It’s got to be available when the patient needs it so they don’t have to take off work, they don’t have to drive across down, or pay $45 to park,” he said. “What is needed is a trusted engagement tool that is data-driven, that encourages people to find a path to improve their health, that is consistent with their interests, that is informed by their decisions and is personalized to their interests.”

It’s not just the insurance industry that could take advantage of digital tools that help customize to patients. 

“Biopharma and the medical device world have a very exciting future — we are talking about personalization, we are talking about precision medicine, both directed at the notion [that] we will find solutions tailored to the needs of the individual in a way that allows them to pursue their health in a constructed fashion,” he said. “In so doing, remember this is a consumer. This is a person that will respond more favorably to things they find encouraging and hopeful, and less responsive to things they find discouraging and defeatist.”

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Focus on Patient Experience

In May, we'll talk to the thought leaders and first-movers reimagining how and where — Hint: outside their perimeter — and report on how they're to activate if not delight the people they treat.