GuideWell Using Behavioral Science to Influence Healthy Decisions

People make decisions about the same information in different ways, depending on how the information is presented. Consider yogurt. You likely chose the one labeled “80% fat free” over the one labeled “contains 20% fat,” although they have the same meaning. Here’s another common preference—we’re more likely to make choices with immediate benefits over those that will pay off in the future.

Last year, we partnered with Professor George Loewenstein, co-director for Behavioral Decision Research at Carnegie Mellon University, to apply behavioral science techniques at GuideWell

Behavioral science uses psychology and economics to determine why people make the choices they make. At GuideWell, we’re investing in behavioral science as an innovative tool to help us build stronger, more trusted customer relationships. We want to make it easier for our customers to make choices that enhance their health and well-being.

“Behavioral economics has been leveraged in financial and other domains but in health care--an area that’s very ripe for it--it hasn’t been leveraged yet because it’s new,” said Dr. Svetlana Bender, director of behavioral science and analytics at GuideWell. “There’s so much opportunity (to integrate behavioral science) and you can literally see the connection between the interventions that you design and the outcomes that we see with our members.”

We have some early positive results we’d like to share about two initiatives aimed at Medicare Advantage members.

Initiative #1: How Can We Get More Members to Properly Take Their Medications?

If people would just take their medications as prescribed, also known as medication adherence, it could save up to $289 million in avoidable health care costs each year. With Professor Loewenstein’s guidance, our Behavioral Science and Medicare Pharmacy teams recently collaborated with Walgreens pharmacists on a pilot program in south Florida. The On-Time Delivery Program targeted Medicare Advantage members who were not medication adherent to deliver medicine to their homes. These members were eligible for free medication yet failed to request a refill or didn’t pick up a refill they requested due to lack of transportation, a busy schedule or just delaying to act.

Pharmacists were given different versions of scripts—some with behaviorally-tailored messaging—to follow when they called targeted members to encourage enrollment in the On-Time Delivery Program. After four months in the program, over 75% of enrolled members became adherent. Walgreens has expanded a similar program to other parts of Florida and the Behavioral Science and Pharmacy teams are exploring ways to pilot similar program with other retail pharmacies in Florida.

Initiative #2: How Can We Get More Members to Get Screened for Colon Cancer?

Colorectal cancer is the third most common cancer worldwide, according to the American Cancer Society. It is also the second most lethal cancer, although early screening tests are effective at identifying polyps that can be removed before they become cancerous. For our Fit Kit campaign, we mail cancer screening tests directly to Medicare Advantage members’ homes.

The Medicare and Behavioral Science teams conducted a pilot with 13,564 members to test the effectiveness of behavioral science messaging with the Fit Kit instructions. The revised instructions did not include a deadline for returning the kits. Instead, members were urged to complete the screening “today.” The objective was to reduce the tendency to procrastinate, or to not take the test at all because they missed the deadline. We also highlighted a colonoscopy as an alternative, yet less convenient method for screening.

As a result, the 30-day Fit Kit return rate for those who received the behaviorally-tailored instructions was 11.6% higher relative to those who received the standard communication. In addition, the revised instructions were associated with more care gap closures compared to the standard communication, and both communication where better than no communication at all.

These are just a couple of examples of how we are implementing behavioral science techniques into our work processes. Bender says understanding the factors that drive our customers’ health decisions allows us to tailor solutions that can ultimately lead to improved health outcomes.

“If we do explain to them member about the advantages and use the behavioral interventions to engage with them, they are more likely to engage with us, and that way we can improve their health and keep them out of the ER," said Bender. "It’s a win-win for everybody.”

About the Author

Latondra Steele

After a 20-year hiatus, Latondra recently relocated back to the Sunshine State and now works as an internal communications consultant at Florida Blue. As a true communications explorer, she enjoys helping people and organizations say the right things to the right people at the right time. She has a BS in Journalism from Florida A&M University and a MS in Communications from Purdue University. You can follow her on Twitter at @ Steele_I_Rise, especially if you’re a guinea pig owner!