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The Business of Behavior Change[When Success Depends on Doing]

Joshua Klapow, Ph.D.

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Are You in the Business of Behavior Change?

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• Husband, Brother, Son, Father• Clinical Psychologist, Chief Behavioral Scientist• Radio Co-Host (Insert Shameless Plug Here)

I Am

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• Dog owner

I Am

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• Responsible for revenue flow?• Responsible for provider productivity?• Responsible for customer acquisition and retention? • Responsible for market differentiation? • A parent?• A significant other?• A pet owner?• Ever make a New Years Resolution?

Are you In?

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The Common Denominator

BEHAVIOR

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Source: Oliver Wyman

• When does a patient become a consumer? (is a provider a consumer?)

• When is a consumer a patient?

• Can we understand patients better by understanding them as consumers? (providers?)

Patient to Consumer? Consumer to Patient?

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Transparent Consumer Markets

The line between health care and self-care is blurred

Data is accessible for every aspect of our life

The line between health system market and retail consumer market is blurred

Methods to engage are no longer dictated solely by market type (i.e. health, retail, financial)

Source: Oliver Wyman |

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Health Care: A Personalized Market

• The individual becomes the center of the “universe”

• Individual actions drive engagement across markets

• What someone does or doesn’t do on any given day is quantified

• How can this be unified?

Source: Oliver Wyman |

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The Common Denominator

BEHAVIOR

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• Outcomes define success.

• Behavior drives outcomes.

• The collective behavior of the population decides the game.

• Individuals must behave in certain ways to produce certain outcomes.

Behavior

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Behavioral Science: An empirical approach to understanding, evaluating and changing human behavior.

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What is Behavioral Science?

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• Human behavior is not random; it is explainable, predictable and lawful.

• Behavior can be influenced using scientific principles.

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Why turn to Behavioral Science?

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Influencing Behavior

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Behavior Change is Everywhere in The Popular Press

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• Learning Theories (Skinner/Pavlov)

• Health Belief Model (Rosenstock)

• Theory of Reasoned Action (Ajzen & Fishbein)

• Social Cognitive Theory (Bandura)

• Transtheoretical Model (Prochaska & DiClemente)

• Information/Motivation/Behavioral Skills Model (Fisher & Fisher)

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Models of Behavior Change

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Learning Theory: A Quote to Consider

“…behavior is followed by a consequence, and the nature

of the consequence modifies the organisms tendency to repeat the

behavior in the future.”- B.F. Skinner

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Diving Deeper Can Shed Light

CUE

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Are You Ready For The Secret Behavior Change Ingredient?

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How Can We Generally Think About Behavior Change?

P =Probabilityof Behavior Change

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Why Do We Need to Remember C4 = P?

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Kids

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Co-Workers

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Health

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Meet Sheila

Female, Over 40

Family Hx of Cancer

Diabetes

How can the 4 Cs be leveraged to help Sheila (Cost, Consequences, Culture, Communication) ?

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One Solution

Cost (behavioral): Complete 16 diabetes education program

Consequence: Free meds (cessation)/HRA dollars

Communication: Home mailer with program overview & email when signing up

C

P

C

C

C

Probability: Of Program Completion

Culture: Benefit shift to cdhp/healthcare provider

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Where’s Sheila? What Happens When We Scale?

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- Merchandise- Gift cards- Real-time travel- Activities & events

- Notifications- Virtual badges - Achievements

- Discounts- Special offers- Savings & benefits

- Premium reduction- HRA / HSA / FSA

contributions

- Annual exams- Preventive screens- Condition management

- Note Eligibility changes- Populate EMR data-QI Actions

- Onsite health events- Remote participation- Medical purchases- Grocery purchases

- Self-reported activity- Quiz completion- Evaluator reporting

Cost (Behavioral )

Data Consequence

Behavior Change @ Scale

Consequence schedule

Communications: Text, email, secure message, web portalCulture: Benefit design, union/non-union, industry (healthcare)

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Sheila @ Scale

Claims (Behavioral Cost)

HSA Contribution (Consequence/Culture)

Web Portal and Secure MessageCommunication)

The science does not change. We need technology to enable the science.

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Behavior is the Center of our Health Universe

Behavioral science combined with effective technology can improve our efforts to move the needle on critical issues facing our society and our organizations.

Source: Oliver Wyman |

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“When you die, it does not mean that you lose to cancer, you beat cancer by how you live, why you live, and in the manner in which you live.”

Stuart Scott (1965-2014)

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