Price Transparency: The Time is Now.

Though it is sometimes hard to see through the thick haze of government-imposed health reform, the US is also on a parallel path toward market-based healthcare consumerism.

Free-market solutions have taken a back seat to politics for the past few years, but the journey which began with the introduction of high deductible health plans a decade ago, continues today.

brill.pill9.inddThe essence of a free market is one that features consumer choice, broad access, open competition and price transparency. The reality is that none of these are in place in healthcare today.

The area of price transparency, however, is now on a fast track toward broader market acceptance and increasing consumer usage.

Here are five notable events or trends to note which support the continued expansion of the price transparency in healthcare:

1. Published data. One seminal moment occurred in May of last year, when CMS released data from 3,300 hospitals that listed the average prices they charged Medicare in 2011 for the 100 most common inpatient services. They followed this up a month later with information on pricing for 30 common outpatient procedures.

2. Major article. These data releases followed Steven Brill‘s epic Time Magazine article that appeared in March. “Why Medical Bills are Killing Us” highlights numerous examples of outrageous pricing scenarios and their impact on patients. For healthcare insiders, it wasn’t breaking news, but it did bring significant media coverage to the issue for the general public.

3. Vendor companies well capitalized.
There are at least a couple dozen start-up firms specializing in this area, including Castlight Health, Change Healthcare and ClearCost Health. MedCity News recently reported the amount of investment firm input into the start-ups at over $400 million since 2010.

4. Health plan price tools.
Health insurers have been actively pursuing this area and most offer some sort of price comparison resource to their members. In fact, Catalyst for Payment Reform notes that 98% of health plans do offer an online price comparison resource – yet only 2% of members who have such resources actually use them.

5. Higher deductibles.
Over the past few years, many consumers have become responsible for a larger portion of their medical bills. Kaiser Family Foundation reported that in 2013, 38% of those with employer health coverage had deductibles of $1,000 or more, compared with just 10% in 2010. And the impact of health reform will drive many more insured to higher deductibles.

The Wall Street Journal recently published a front page article on this topic as well, lending further credence to this important trend.

We’re definitely on a path toward broader availability of price information for consumers.

This is a big step forward in the continuing move toward healthcare consumerism in the US market… stay tuned…!

Note: Later this month, I’ll have the privilege of moderating a panel discussion on Price Transparency at the HR Executive Health and Benefits Leadership Conference in Las Vegas. Joining the panel will be Clayton Nicholas of Change Healthcare, Chris Santas of ClearCost Health and Scott Matthews of Castlight Health. Each of their companies has been working to help bring a greater degree of consumerism to healthcare, by helping individuals make smarter healthcare decisions.

This is an important time for this burgeoning healthcare service. Employers and health plans are increasingly promoting the use of price transparency tools and resources. We expect a full house with many great questions and equally insightful responses. The panel is scheduled for Tuesday, March 18 at 1pm.

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Consumer Segmentation: The Right Route to Better Engagement…?

Chances are, you’ve received some kind of “Dear Resident” direct mail solicitation in the past week or two. And, unless it featured a coupon or something of real or perceived value, you probably tossed it into the can.

In a way, that’s how many health and well-being improvement programs are introduced. Limited personalization, broad message, same story for all. They usually fall flat, which is the main reason for today’s all-too-common participation incentives.

Consumer_segmentation_healthcentric_health_well-being_improvementBut now, taking a page from the consumer marketer’s playbook, many employers, health plans and vendors are exploring segmentation as a way to gain richer insights about their populations to deliver more tailored messages and interventions.

Consumer segmentation goes beyond traditional methods of claims-based stratification and risk-identifying algorithms. It incorporates geo-demographic coding, attitudinal and lifestyle factors, buying habits and other inputs.

Various types of personality assessment are also emerging – and this is an area to keep an eye on.

By knowing more about the key characteristics of end users, sponsors are better able to craft the outreach and interactions and better influence health behavior change.

Consumer product marketers have long used strategic segmentation to fine-tune their target audience definition, optimize media selection, and generate differentiating ideas for creative development. This deeper understanding leads to more persuasive and effective advertising and marketing campaigns.

With the implementation of segmentation for health promotion, there’s a higher likelihood of achieving far better one-to-one interactions that will lead to more positive actions.

Here is a thumbnail of some of the major players in consumer segmentation:

- The Futures Company offers their Living Well segmentation. They identify six unique consumer segments, which differ in their health challenges and health engagement, enabling insightful profiles and the opportunity for impactful and targeted communications and programs. These segments can be generated either by secondary data or through self-administered questionnaires.

- Nielsen features PRIZM, probably the oldest established segmentation methodology (1971). They utilize 66 unique segments based on socioeconomic levels, which take into account characteristics such as income, education, occupation and home value, and carry intriguing identifiers such as Blue Blood Estates, Crossroads Villagers and Shotguns & Pickups. These segments are further grouped into 11 Lifestage Groups and 14 Social Groups.

- Experian has Mosaic, a household-based consumer lifestyle segmentation system that classifies all US Households and neighborhoods into 71 unique segments and 19 overarching groups. Mosaic also defines 10 categories of insights around dimensions such as who we are, where we live, how we get by and how we live our lives.

- FICO uses Segmentation Models for custom analytic engagements. They work with customers to understand key metrics and develop measures of customer value. Their approach is to analyze customer-provided data and append FICO inputs to provide insights on each segment.

Each of these firms has something a bit different to offer, and each can provide valuable insights into your specific populations.

As noted above, consumer segmentation can be a powerful strategic tool, but it also needs to be utilized with clear objectives, the ability to deliver relevant communications messaging and tailored interventions to each segment, and the systems in place to measure impact in an accurate and timely manner.

It is commonly believed that the closer we can get to 1:1 marketing, the more effective we are likely to be.

Strategic segmentation of your population can be an important step toward achieving this.

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Closing the Engagement Gap: Selling Employees on Health and Wellness

Dossia_logo_FinalDavid Goldsmith and the team at Dossia recently invited me to present a webinar to their customers and industry colleagues on engagement strategy.

Participant engagement is a significant issue for many of their customers (WalMart, Intel, AT&T, Pitney Bowes,BP, etc.) and they are each searching for solutions that fit their populations.

In thinking through the overall aim of employee health and wellness initiatives, it really boils down to these four areas: lower costs, stronger culture, healthier people, and better performance.

It struck me that “this is not rocket science” (or shouldn’t be) and that got me thinking about rocket science, and its potential relevance to health and wellness.

dossia-engagement-frank-hone,wellness,employee-health,well-being-strategyWhen President Kennedy in 1961 set forth the ambition of putting a man on the moon and returning him safely to the earth by the end of the decade, NASA was mobilized to achieve an enormous mission.

And, when Neil Armstrong set foot on the moon on July 20, 1969, that historic dream was realized.

The accomplishment provides several strong lessons related to accomplishing audacious goals. But, in looking to draw parallels about government actions related to health and wellness, there are no meaningful analogs. Government has no substantial role in helping to ensure better health and wellness outcomes.

In fact, the single stakeholder group with the most to gain from having healthier people is employers. This is both a responsibility and a burden and we are continually reminded of just how hard it can be.

Health behavior change is difficult, and probably more challenging than most employers realize. Despite the fact that the industry continues to evolve, many employees are simply not “buying” into the wellness programs being offered.

The main problem is that we as an industry don’t do a great job of “selling” it.

So what can we learn from “Brand Owners” who must work every day to win the hearts and minds of their target consumers, and how can we translate these learnings toward achieving engagement success?

well-being-strategy, effective-engagement, employee-wellness, frank-honeIn sharing examples of brands such as the Ford F-150, the AT&T 4G LTE wireless network, and Fidelity Investments’ “Personal Economy” pitch, it was noted that their ubiquitous advertising messages (at least during NFL games), provide “moments of engagement” designed to lead to a single purchase decision.

And while each of these brand categories have fairly long purchase cycles, their messages are also intended to reinforce the decision and build loyalty.

The correlation to health-related engagement may not be direct, but the principles have relevance.

In translating to our world, we need to consider the following:

First, we need to do more to define what we mean by engagement. This much-cited, but undefined term needs clarity. In our work, we consider engagement to be a “means to an end,” which feeds into the second point.

We need to be clearer about our objectives and what we indent to accomplish with health and wellness initiatives. Part of the reason that today’s critics are having a field day with this space is because we haven’t applied enough business discipline. Having specific and attainable goals is the right starting point.

And third, we need to be practical about what can be accomplished in a given timeframe. This applies to both program goals and individual-level behavior change. We must set realistic goals based on available budget and resources and recognize that it takes time and sustained effort to achieve meaningful and long-lasting change.

Of course, engagement in the employer setting is different from brand marketing in many ways:

– We are marketing into a “closed” environment in that only employees (and dependents) are involved
– The target market is all employees and we expect (or hope) that the total universe will participate
– Price is absent, and in fact, we are often paying them
– Privacy is a big issue and can be very difficult to overcome in many settings
– Wellness is not the main event; job performance comes first

A final difference is that is that health and wellness is basically a daily “purchase decision.” The choices we make each and every day accumulate to improvement (or not), so reinforcing positive steps is critical for long-term success.

Seven Marketing Principles That Can Help Drive Engagement

In applying lessons from marketing, here are seven key principles that employers and their vendor and health plan partners should consider as you look to do more with engagement and health behavior change:

1. Dig deeper for more consumer insight. Regularly conduct market research with your people to better understand what’s working and what’s not.We recently ran a series of focus groups for one customer that was switching vendors and wanted to know what changes would lead to improved outcomes. The insights from listening to employees in structured sessions were invaluable in helping to make productive changes to their approach.

2. Consider consumer profiling. We’re all aware that one size does not fit all, so find ways to personalize interactions.We’re working with one customer now on using personality assessments to profile individuals and enable stronger coaching interactions.

3. Deliver better and more targeted communications. Consumers respond to messages that talk to their style.With proper segmentation, outreach can be tailored to the individual and their particular needs. One of our customers is currently developing an automated rules engine that will do just that.

4. Provide stronger context around health and wellness.
We need to tell the whole story to our audience with emphasis on why we want you healthier.Companies like Humana, Florida Power and Light and Kimberly-Clark are among those that stand out in this area.

5. Conduct your own engagement assessment. It’s important to go beyond the reports. Dig deeper to identify your own gaps and opportunities for improvement. We’re working with a customer today that is committed to optimizing performance in this area – it’s not easy but it is a critically important undertaking.

6. Focus on end-to-end strategic integration with clear and transparent process flows. Working with vendor and health plan partners, customers need to ensure the overall system is working optimally, and that gaps and “leaks” are minimized. Quality methods from manufacturing and production have real relevance here (e.g. Deming).

7. Use business discipline in all planning, delivery and measurement. We need to treat Health and Wellness like it is a line of business, and have sufficient resources, realistic metrics, and a long-term perspective.

As noted earlier, this is not rocket science, but it is sure challenging to achieve meaningful success. With a marketer’s mindset, thought, you can explore new and different ways to sell health and wellness to your people. So, be a marketer, and make a difference…!

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Dossia Webinar – Closing the Engagement Gap: Selling Employees on Health and Wellness


Will this year bring better engagement for health and well-being improvement?

Seems like that is the eternal hope for those of us in the industry. We all know that health behavior change is hard. Too often, the efforts to overcome rational and emotional barriers to change are insufficient.

Dossia_logo_FinalWe recently wrote about the opportunity to infuse more consumer marketing into the engagement process, and we’ve been advocating for the Chief Engagement Officer role as a means of unifying strategies and tactics.

We’ll be talking about some key aspects of this whole area in next week’s webinar, sponsored by Dossia. See below for details, and join us if you can.

Closing the Engagement Gap: Selling Employees on Health and Wellness

Dossia WebinarWednesday, January 22, 2014
1:00 PM – 2:00 PM EST
Register Now
Sponsored by Dossia

If employee health improvement is so important, then why is it so hard?

We all know that to achieve meaningful engagement we need to have leadership endorsement, effective communications, relevant incentives, and a supportive culture.

– Then why the Engagement Gap?
– What’s missing in our planning and execution?
– What more can we do with our tools and resources to close the gap?

In this second in our series of webinars on new models for consumer engagement, industry thought leader Frank Hone looks at what employers, providers and others can learn from the world of consumer products marketing and advertising.

As Chief Engagement Officer at Healthcentric Partners, Inc., Frank explains how to think differently about the challenge at hand and build strategies designed for success. He applies his health behavior change experience from a career in advertising and his recent role as Director of Sustainable Engagement at Healthways.

Frank Hone
Chief Engagement Officer
Healthcentric Partners
Blog: Well-Being Strategy
Book: Why Healthcare Matters
917 375-7716

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Beyond Marketing: How Engagement is Different

beyond-marketing-engagement-for-health-behavior-changeHealth behavior change is hard.

Scores of well-meaning employee health improvement initiatives and interventions fall short because they fail to effectively engage their intended populations.

This has been an industry conundrum for years, despite the influx of “pay for participation” incentives.

As employers and their vendor and health plan partners seek to do better at connecting their programs to their people in 2014, we see three areas where added emphasis should improve engagement:

Business Discipline – Employers need to apply the same sort of rigor to health and wellness as they put toward company operations and deliverables in their lines of business
Strategic Process – Program owners need the ability to see the full array of cross-functional flows and interactions to ensure more effective operations and more integrated participant interactions
Consumer Marketing- In developing annual plans, there is great opportunity to incorporate more strategic and tactical marketing principles that help convey value and drive desired actions and results

While each of these can contribute greatly to better engagement, the third point helps introduce the theme of this piece: Marketing. We see the need to infuse the participation pitch with better marketing ideas and experiences to raise help awareness and generate action. But there are differences between marketing and engagement.

Marketing is a well-established discipline that has helped build brands, accelerate sales, and foster consumer loyalty for decades.

Engagement for health and well-being improvement is still new. It’s not even well defined by our industry, but we do know we need more of it to bring about better outcomes.

And not just for employees, but increasingly for health plan members, health system patients, and other consumer constituents in the healthcare arena.

So, while we advocate the infusion of consumer marketing, we also want to draw some distinctions between Marketing and Engagement – as well as highlight several gaps to be filled. Here are a number of areas where we contrast the two:

1. Business Objectives. Marketers develop detailed annual business targets, while Engagement too often lacks sufficient strategic planning and forward thinking.

2. Target Audience. Marketing targets a particular demographic segment, while Engagement needs to be personalized to individuals and their particular needs.

3. Consumer Insights. Marketers rely on formal consumer research to inform their strategies, while Engagement gets by on ad-hoc feedback and occasional surveys.

4. Communications. Marketing uses coordinated advertising and promotional campaigns, while Engagement needs to deliver multi-modal messaging, reminders and updates; create positive connections; and stimulate action.

5. Desired Actions. Marketing is intended to raise brand awareness and interest that leads to sales, while Engagement encourages participation and health behavior change.

6. Budget Levels. Marketing budgets are based on annual P&L projections, while Engagement investment is far more discretionary and often insufficient.

7. Incentives. Marketing uses incentives to initiate trial and compete on price, while Engagement has had to rely on payments to force participation.

8. Metrics.
Marketing fields Awareness, Trial and Usage surveys and tracks sales, while Engagement monitors participation levels, completion of specific actions, and health outcomes, though reporting is rarely thorough.

9. Ownership. Marketing is led by professional marketing teams, while Engagement is often overseen by HR and Benefits professionals with limited experience in behavior change.

10. Expertise. Marketers generally have MBAs and deep practical experience, while Engagement teams too often learn on the fly.

While some of these critiques are harsh, they are intended to illustrate that we have a long way to go toward achieving real engagement success. There is definitely a lot to learn from consumer marketing, but we must also factor in the unique challenges of health behavior change.

In my own experience with direct-to-consumer (DTC) advertising of prescription drugs many years ago, we also drew in many lessons from general consumer advertising but had to the draw the line at a point because,

- The ultimate “sale” involved a mix of physician, pharmacist and managed care plan
- Regulatory restrictions created unique challenges for copy development
- Consumers each have unique decision pathways relative to their disease state and symptoms – with many rational and emotional barriers to overcome

These learnings helped strike the balance between directly adopting consumer marketing methods and modifying to meet market conditions.

Nevertheless, for health and well-being improvement, we do need more consumer marketing to help generate insights, elevate engagement and bring about meaningful health behavior change, but we do need to forge our own path.

This is one reason we see the Chief Engagement Officer role as essential to help lead the health and well-being improvement area.

The opportunity for positive change is huge. But we need to supplement the massive implementation efforts for affordable and accessible health insurance with equal efforts to improve engagement and elevate personal responsibility for one’s own health and well-being.

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Where is the Urgency About Engagement…? Five Problem Areas to Address

We find it curious and concerning that for all the effort and expenditure that go into employee health behavior change initiatives, the element of urgency to improve engagement is just not there.

When I went to work at Healthways as their Director of Sustainable Engagement back in 2009, there was broad agreement across the enterprise that engagement was an important issue that had to be addressed. From the sales and account teams, I’d hear:

· We need more engagement
· Our engagement isn’t what it should be
· The customer isn’t happy with the engagement levels

Engagement-Urgency-Well-Being-StrategyThere was clearly a problem, but the idea of engagement was amorphous.

What did we really mean by engagement…?

The concept of engagement is still not well defined – it is vague and open to many interpretations, as it has broad scope and is inclusive of many actions and behaviors. Like marketing, it is a balanced mix of art and science.

We see engagement as a means to an end, and that end is health behavior change. This puts a premium on doing more to specifically define program objectives.

Our view is that effective engagement incorporates critical elements of strategic process, behavioral economics, effective communications and timely measurement. It links business purpose to overall performance.

Yet, engagement improvement efforts too often lack priority and urgency. We see five key problems as being deterrents here:

Problem #1 – Engagement efforts are too sporadic
The industry has made good strides in designing smart programs to help change health and lifestyle behavior. But the emphasis is too often on a given intervention or action rather than on more of a continuous and sustainable process of change. Engagement intent needs to begin further upstream to set the stage for interactions and interventions. Then they can then occur more naturally and ideally, without the need for incentives. Transparency of purpose helps people understand the rationale and end benefits of participation.

Problem #2 – Integration is lacking
Many internal departments and external vendors must coordinate effectively in their care management and wellness efforts. Each of these entities need to understand the overall aim of the initiatives as well as their specific roles. There needs to be more accountability and better peripheral vision to smartly string together their activities and hand-offs. And, there needs to be an orchestrator to bring it all together – the Chief Engagement Officer.

Problem #3 – Reporting isn’t actionable
Most customers have no idea about the success of many efforts until it’s late. There’s not nearly enough real-time reporting to make timely and necessary adjustments in communications and outreach. We need to see regular updates on enrollment and participation levels. This can allow for promotion to modulate up or down as needed to achieve goals. Reporting is an industry-wide challenge that needs some real attention.

Problem #4 – Marketing is missing
The employee health management field has its roots in disease management and much of that clinical mindset remains. But, as organizations continue to evolve toward total population solutions and consumer-centric approaches, marketing has to have a bigger role. Consumer insights, marketing strategies and smart tactics are critical in delivering the behavior change story and its rationale.

Problem #5 – It’s not due tomorrow
Most decision-makers will nod their heads at the above points. And then move on to address something else that has to get done today. Contrast that with the open enrollment buzz at most companies right now. The urgency to “get it done” and meet that deadline is palpable. That same sort of urgency needs to be instilled into developing effective engagement strategies and delivering impactful outreach. There needs to be better business discipline, more dedicated resources, and accountability for results.

When Dan Pink introduced his thesis at the opening of Drive, he noted that there are decades of research about what motivates behavior change, and noted that “for too long, there’s been a mismatch between what science knows and what business does.”

That is what needs to happen with engagement strategy – business knows how to address issues of process and promotion, it just isn’t getting it done well enough to effectively improve engagement and produce measurable results.

Are you ready for a stronger and better engagement strategy? Let’s get together and work on ways to get your initiatives moving on the right track. Call today to get started…!

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The Time is Now for the Chief Engagement Officer

Engagement around health behavior change remains a hot topic.

the-time-is-now-chief-engagement-officer-frank-hone-well-being-strategyAnd that won’t change anytime soon.

There’s certainly been a lot of talk about it, and some well-intentioned actions to help address it.

We’ve seen an array of smart developments, from mobile apps and social wellness to outcomes-based incentives and behavioral economics. Vendors, health plans and sponsors are putting forth good efforts to drive better consumer engagement for health improvement.

But we have to ask:

– To what end…?
– How effective has it been…?
– Is it delivering sustainable health behavior change…?

We see too many engagement efforts that are fragmented, nonaligned, short-lived.

We believe that engagement should be viewed as a means to an end. And while it may be good to have more of it, it also needs firm direction and clear intention. It needs strategic purpose at its core.

Here’s where the Chief Engagement Officer comes in.

The area needs a point person to provide strong leadership and dedicated ownership.

The role would incorporate aspects of business discipline, strategic process and consumer marketing. It would be geared to helping individuals through their own decision pathways would emphasize participant interactions and relationship-building.

It will need to address the rational and emotional barriers to change and articulate the consumer value proposition that will result from positive shifts in attitudes and actions. It has to embrace the process of behavior change, disrupt inertia and reinforce healthy habits.

In defining the scope for the Chief Engagement Officer role, we see that it would encompass the following:

1. Strategic Intent. Owning and defining the overarching approach to achieving the specific business objectives for behavior change and having the authority to execute against these goals.

2. Behavioral Science. Understanding and applying the knowledge of how people make choices, incorporating consumer insights and behavioral economics.

3. Segmentation and Tailoring. Defining relevant population segments at the macro level and providing personalized communications tailoring at the micro level.

4. Targeting and Delivery of Effective Messaging. Leading the design, development and delivery of communication stimuli that inform, educate, encourage and reinforce health behavior change.

5. Organizational Integration. Ensuring that all related disciplines, vendors and business units are strategically and operationally aligned toward achieve specific, defined goals.

6. Measurement and Refinement. Constant monitoring of metrics with the view to making midstream modifications when appropriate, and delivering accurate and meaningful data and updates on a regular basis

7. Continuous Improvement. Always seeking to apply lessons learned, share best practice and strive for better design, process, delivery and outcomes.

These seven areas are essential to the success of any consumer health behavior change initiative. They also need to be effectively integrated to produce successful outcomes.

The Chief Engagement Officer role will provide the business discipline and strategic oversight necessary to unify and orchestrate appropriate actions.

We see the adoption of this approach as an important undertaking for any company involved in health behavior change and we view its potential as significant in our evolving consumer-centric health care world.

Here’s to the future Chief Engagement Officers…!

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Engagement Learnings From the Healthcare.gov Fumble

Obamacare continues to make headlines across the country, and not for good reasons. No matter one’s view on the merits of government’s expanded role in healthcare, it’s clearly off to a bad start.

healthcare-gov-engagement-mess-learningsThe failed launch and continued problems of healthcare.gov shed light on an array of engagement-related concerns and issues.

This experience provides many lessons for those of us that spend time and effort to design, develop and deliver employee health and well-being improvement initiatives.

And while it may not be a true apples to apples comparison, there are valuable learnings to be gleaned from observations made over the past month.

Beyond the glaring technology failure, we also note other mistakes relative to consumer engagement. Here are 10 takeaways that can be helpful for those involved with employee health and well-being improvement:

1. Clear strategic direction
A well-defined and fully-articulated strategy is the essential starting point for any meaningful health behavior change initiative. With regard to the healthcare.gov roll-out, the Wall Street Journal recently headlined an article Health Site Stymied By Lack of Direction which highlighted the absence of a cohesive overarching plan in its critique. Strategic clarity needs to be at the core.

2. Right resources
This is a big challenge for employee health and wellness – too many don’t have the proper level or amount talent. We’ve learned a bit about the government contractors behind the site development, and have to ask, where are the folks that brought us Amazon or Travelocity or Google? When the goal is creating a seamless and smart web consumer experience, we should bring on those with expertise in doing so. Right people lead to right results.

3. Manage expectations
For both management and for employee participants, it’s best to under-promise and over-deliver – doing things right and coordinating across multiple vendors and departments usually takes longer than we think. Unfortunately, the federal government was stuck on the October 1 launch - political will required that date to be firm, regardless of consequences. Smart testing and “soft” launches can help work out unseen bugs.

4. Build a smart selling proposition to attract your audience
We are often “selling the invisible” when promoting wellness, and it takes the right sort of effort to effectively position, package and promote our story. Health reform is banking on selling the unnecessary to the unconcerned. Saying that premiums could be about the same price as your monthly cell phone bill is a weak attempt to “speak the language” without a meaningful “reason why.” Effective consumer marketing is essential, and needs to be based on a desirable value proposition.

5. Do your homework on consumer insight
Further to the above point, knowing more about the intended audience will help with both program design and setting expectations. With health reform, we have to ask – where will the market demand come from? Those who want and need health insurance will diligently pursue the application process, while the young and healthy (upon which the premise of the plan is based), won’t be bothered to buy, despite the threat of penalties. Know your market, and gear messages and metrics to their profiles.

6. Break down the silos
Creating an atmosphere of integration requires shared goals, clarity of roles and dependencies, and good peripheral vision. This was absent at CMS, as internal departments and external vendors operated in their own worlds, expecting that things would come together in the end – and they didn’t. Employers need to have a master integrator (e.g. Chief Engagement Officer) to help ensure coordination of efforts.

7. Consumer experience
The health and wellness arena has begun to move beyond the clinical mindset toward being more fully consumer-centric in outreach and intervention efforts. With healthcare.gov, the consumer experience is fully lacking. Smart sites let people shop before having to plunk down their credit card (e.g. enter all their personal data). Requiring full registration as step one was a mistake. Consumers expect efficiency online – don’t make it hard for them.

8. Local market support
While headquarters staff may lead the wellness charge, the truism that “all healthcare is local” also applies to the workplace, where wellness champions amplify efforts and rally participants. Government navigators were supposed to be fanned out across the country helping to drive health insurance enrollment, but their numbers have been low and efforts limited by the technical problems. Wellness champions need the right training, staff levels, and resources to succeed.

9. Test small, then expand
Not everything is ready for prime time when it comes out of the design and development phase. The contractors that testified on Capitol Hill stated that the testing time for healthcare.gov was vastly insufficient for an undertaking of its scope. When trying something new, begin with a segment of the population or a regional office, and then go broad.

10. Scenario planning
We don’t do enough of this with employee health and wellness programs – it is unlikely that everything will unfold as designed, so be flexible and prepared with back-up approaches. Healthcare.gov assumed that all would work well with the site roll-out and had to scramble to massively expand telephone access and paper applications. Keep Murphy’s Law at hand, “Anything that can go wrong, will go wrong” – it may not always be true, but it is a helpful reminder to stay prepared for the unexpected…

We’re only at the beginning of this new health reform experience. We can expect to see more valuable lessons for all as efforts to enroll the uninsured in the individual market continue…

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Strategy + Integration + Engagement = Recipe for Success

Employee health and wellness continues to grow in importance and sophistication. Established vendors are fine-tuning their offerings while newer players are making waves with innovative angles.

We’re seeing lots of activity with challenges and competitions, gaming and social wellness platforms, and different ways to win incentives and rewards.

recipe-for-success-healthcentricThese newer offerings can do a pretty good job at generating interest – even some excitement – and often succeed in getting individuals to sign up for something fun. Unfortunately, most of these ideas are tactical in nature, generally limited in duration, and don’t necessarily connect to bigger picture initiatives.

Separately, the industry is in the midst of a firestorm of sorts with critics vocally slamming many of the practices of suppliers, consultants and supporters.

Some of the criticism is warranted. Wellness programs don’t always produce stellar results. But rather than blame wellness, it’s time to take a new look at how we design, develop and deliver programs in the workplace.

With more and more employers now on the wellness bandwagon, they are tending to look to industry norms and best practice for guidance on how to proceed. It’s been well documented that most successful initiatives include the following:

•Smart program design
•Strong leadership endorsement
•Effective communications outreach
•Relevant incentives and reinforcement
•Supportive environment and culture

Few would argue as to the importance of these areas, and most wellness leaders work diligently to ensure that each are smartly addressed.

But even with these factors in place, there is significant opportunity to do more. We see the need to weave in three essential components to round out the mix and maximize the investment value.

1.Strategy. A solid and sustainable health and wellness programs needs smart strategy. There is too much reliance on bright and shiny tactical elements and not nearly enough on the fundamental rationale for why the programs are being offered, how they are designed, when they are delivered, and how much impact they create. Doing this better may require a different mix of wellness leaders, with more emphasis on business discipline and accountability.

2.Integration. A good wellness program should be run like a brand marketing campaign. Focusing on the end user, all communication, information, interaction and intervention elements need to be aligned and sequenced so they comes across as a seamless story to the consumer. This burden falls to the wellness leadership team or primary vendor, and it requires mapping out the user experience to identify gaps and opportunities. Too many initiatives are “multi-silo” and lead to inefficiencies and lost opportunities.

3.Engagement. Current the hottest topic in employee health and wellness, engagement will actually improve naturally if the first two ingredients are properly implemented. But to really heighten impact, we must know the population better. Having a system or methodology to collect feedback and uncover consumer insights will help to generate deeper understanding of the population and could also identify segmentation opportunities. This can lead to tailored messaging and program variation to address certain segments, and potentially, even individual personality profiles.

These three ingredients help complete the recipe. They add necessary flavor and spice to help make the overall entire entrée more palatable and rather delicious.

But they are not just “additives” – they are essential to ensuring the human capital investment in health and wellness is properly resourced, allocated and delivered.

Companies with true commitment to success will find that it comes naturally to blend in these ingredients, and they will help to produce positive behavior change and meaningful outcomes.

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Mad Men at HERO Forum 13: Communications for Health Behavior Change

“So what does consumer advertising have to do with health behavior change?”

This was the main theme of a recent talk given at HERO Forum 13, and the answer is actually quite a bit, if you’re willing to step outside the traditional views of how we approach health promotion in the workplace.

The premise of the talk is that we can learn a great deal about how to be persuasive with our communications if we understand how advertisers do what they do in developing strategy, identifying target markets, creating the brand story, delivering the campaign, and measuring the results.

Behavior Change Challenges

Human behavior change is one of life’s great mysteries, and made more difficult when put in the context of employee wellness programs. The work of changing habits toward improved health involves a whole host of rational and emotional barriers that hold people back; regardless of how hard we push. And in the corporate environment, we have the added burden of privacy concerns that can get in the way of effective outreach.

Over the past few years, we’ve seen an array of ways to address this including the increased use of incentives, behavioral economics and “small steps” interventions to help nudge people on the path toward better well-being. Each of these can help address one or more of the barriers – but all of them need good strong communications to help package and frame them properly.

One of the inherent obstacles for corporations is that much of their internal communications outreach is “compliance” oriented, whereas in attempting to change behavior, the key is to be persuasive.

Insights from Consumer Advertising

Don Draper This is where advertising comes in to play. For many decades, advertisers have worked on various ways to get into the heads of their buying audience to identify the triggers that will help get them to buy the advertised brand.

At one point in time, ad agencies employed legions of psychologists and human behavior experts to explore the underlying drivers of purchase decisions. This led one author to write about “The Hidden Persuaders,” a 1958 expose on the supposed devious efforts of advertising as a subliminal influence.

Whether or not the Mad Men of the 50′s used subversive techniques is immaterial to the fact that advertising has truly shaped our culture. It has guided us in our entertainment interests, dining and drinking preferences, automobile choices, and so much more. Some would even argue that it has helped to support some of the many bad habits and negative lifestyle choices we are now trying to reverse.

So it’s only fitting to draw some insights and lessons learned from this experience to help turn around our sedentary ways and nutritional shortcomings.

There are many good parallels between consumer advertising and employee health engagement. They each are intended to move us toward the sponsor’s goal; they each need focused strategic emphasis; they each must deliver messaging intended to deliver on business objectives; and they each have to address the process of change that individuals experience when shifting their habits.

Lessons from DTC Advertising

And while these parallels to consumer advertising are quite valid, the connection with direct-to-consumer (DTC) advertising of prescription drugs is actually stronger.

With DTC, consumer health behavior change is the object, and the messaging must help drive prospective patients through their individual decision pathway and also through the sometimes complex maze of the healthcare system.

DTC has had a long and interesting history – from the early days of experimentation and physician backlash, to consumer confusion of advertised brands with no indication in the mid-90s, to the full-scale branded commercials filled with previously unstated (at least in audio format) contraindications, warnings and side effects.

This 30 year experience of marketing pharmaceutical brands to the consumer is filled with cautionary experiences of failure balanced with a handful of outstanding successes.

There’s a lot to be learned about how to – and how not to – craft and deliver consumer messages promoting health behavior change from the DTC experience

Here are a few highlights to close with:
• It’s not about a single impactful message, but about how to stimulate behavior change through a process of smart communications that help lead to action
• Ensure that messages are strategically-driven, tailored to the audience, and designed to achieve desired objective
• Work to develop engaging creative that is delivered with enough reach and frequency though the right channels
• Establish a long-term plan, which should have multiple stages and be flexible enough for modifications, as needed
• Accommodate Continue reading

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