EveryMove blog

Tandem is Gaining Traction [Infographic]

By Russell Benaroya

I'm excited to share that we're starting to get some results on Tandem.  The infographic below shows the results of a usability study that was performed by a third party for an upcoming launch.  Progress! These engagement results are notable given pretty paltry industry statistics.

Tandem is designed to make it easy and fun to improve your health while giving customers the ability to offer programs and incentives that are tailored to your needs, interests, and goals.  We will keep improving on these metrics but early signs are positive.

Thanks for all the support.  If you're interested in learning more about your health plan or employer being on Tandem shoot James an email at james.andrews@everymove.com.

Posted on April 5, 2016 09:54 PM


What are your health goals? Who do you want to reward you? What is the reward?

By Russell Benaroya

I'm excited to present this survey we put out to our community to get a better sense of their goals and who and how they are interested in being rewarded.  With our launch of Tandem we have created a very flexible way for any types of sponsors to deliver rewards and incentives for a whole range of health related activities.  These could be lifestyle related or more specific to managing your health in the health system.  Examples include:

  • Visiting your physician
  • Getting your flu shot
  • Enrolling in a prevention program (e.g. diabetes)
  • Getting a screening
  • Using telehealth services
What other health related activities would you want your employer, health plan or physician to acknowledge with an incentive?  What would be motivating for you?

Posted on March 30, 2016 04:51 PM


[Infographic] The Value of Creative Consumer Retention

By Russell Benaroya
As you saw last week I wrote a post looking at the opportunities for health insurance plans to keep selling once they have a member join their health plan.  When I say "selling", I mean getting offers and services in front of people that will actually improve their health.  I mean being very clear on the value proposition of the service that's being provided and doing what you can as a health plan to make sure members are experiencing the best of it.  I put together this neat infographic to reinforce my point.    Enjoy.

Posted on March 29, 2016 08:02 PM


Health plans that build a culture of sales can improve the health of their members

By Russell Benaroya

It's All About Sales in Healthcare - Created with Haiku Deck, presentation software that inspires

Health insurance is partly a game of hardcore sales and then a game of mitigating risk.

I had the opportunity this week to attend a Medicare Sales and Marketing conference in Nashville, TN and realized the other side of healthcare – customer acquisition.  Most of us don’t see this side because most health insurance selling is shielded from the consumer and sold through brokers.  But Medicare sold through health plans (Medicare Advantage or Medicare Supplement) is different.  It’s direct to the individual and quite honestly, it’s pretty exciting.    There are 55 million Medicare beneficiaries today and 10,000 people are enrolling daily.  It’s huge. And health plans are all over it.

The gloves are off to acquire Medicare eligible consumers and short of knocking door to door (which you can’t do), all tactics (subject to disclosures) are on the table.  There are TV advertisements, a ton of direct mail (the #1 customer acquisition strategy), paid search, promoted social marketing, call centers, outsourced sales organizations, sponsorships, and seminars.  Health plans are willing to pay around $1,500 to acquire a new member and about half of that will go to commission related payments.  This is sales and these sales organizations are cranking.  I’d expect nothing less when competing for a scarce resource.  Get out there and sell.  Get what’s yours.  Go!  It’s all about revenue.

But then something really strange happens once that member is sold.  All of a sudden the relationship with the health plan changes from selling to silence and it’s uncomfortable.  Maybe the implied talk goes something like this:

Consumer:  “Okay, I purchased your health insurance now please don’t bother me.”
Health Plan.  “They purchased our health insurance product so let’s not bother them”

Why the passive aggressive stance?  Well it’s partly due to a general distrust of health plans and partly because members aren’t clear what’s expected of them so they get defensive/annoyed when you ask them to do things.   

But isn’t this when the real sales should begin, when health plans start working to make sure that they are inducing new customers to do what they’re supposed to which would actually result in reducing everyone’s expenses?  By working to keep members engaged, compliant and healthy, health plans will improve retention and that will save them the $1,500 to acquire a new customer next year.  If a health plan applied the same energy to selling an existing customer as they do to trying to sell a new one we would have a much healthier relationship with our health plan and probably be healthier.  Here are some ideas for how a health plans can “sell” their existing customers:

Hi, my name is Elizabeth and I will be your care navigator this next year.   Companies like Accolade are eating health plan’s lunch by building teams of people that help individuals navigate their benefits.  They have proven to lower costs.  When I sign up for insurance I should be introduced to a named person who will be my representative throughout the period.  I may not call on them but I know they are there.  18% of Medicare Advantage members switched to other health plans last year.  That’s not insignificant.  Their #1 reason was their dissatisfaction in the help they received in understanding their coverage.  Do these things:
  • Help me schedule my appointments
  • Offer some training webinars/seminars
  • Give me a chance to meet “my navigator person” in person
  • Let me connect with them over phone, text or email
Here is your personalized roadmap for optimal prevention this yearIf you need me to do something, let me know.  Don’t be bashful about telling me I need to go get a screening or see my physician.  Heck, the health plan is taking financial risk for my health so they should feel entitled to call me and make sure I’m doing the right thing for me and them.  Health plans need to know what kind of risk they just purchased because they get paid more when they know.  They should do what they need to do to find out.

Have you considered upgrading your supplementary benefits or purchasing a life insurance plan?  If I could benefit from other products, tell me.  Why not try and sell me on a catastrophic health policy, life insurance, or more comprehensive dental or vision.  I’m not going to find out about it on my own and if you’ve built some trust then I’m going to take your advice.  Don’t screw me or I’m leaving but if you have a valuable service to provide where the perceived value is more than the cost, I’m in.

We pride ourselves on benefits that are cool, different…and you’ll use.  Health plans often use programs like Silver Sneakers (a senior gym membership network) as an enticement to join them.  It’s a dated program but it works.  That’s what a lot of people care about and would stay with their health plan because of it.  The problem is that every health plan has Silver Sneakers so it’s not differentiated.  What about unique benefit programs with:
  • Grocery stores
  • Ride sharing companies (Uber)
  • Travel (Expedia)
  • Ecommerce (Amazon)
  • Fitness classes (Classpass)
  • Select premium mobile apps
Now we’re talking.  Now this gets interesting.

We have been conditioned to get very sensitive when talking about financial matters and health as if it’s taboo and you can’t put a price on it.  Until an individual become a member of the health plan it’s okay but once on the inside then we start using terms like patients which changes everything.  People aren’t patients.  They are people who entered into a financial transaction where each party has responsibilities and obligations.  Selling takes on a different form but make no mistake that health plans that continue “selling” will not only be more financially successful but they will improve the health of their population.

Posted on March 24, 2016 03:34 PM


End of the Line for Health Risk Assessments? What's Next?

By Russell Benaroya

Register today for one of the most exciting and actionable webinars of the year that impacts virtually every health plan and employer.  Andrew Sykes, a nationally recognized actuary (trust me, he’s entertaining) will be the guest on the inaugural EveryMove webinar scheduled for March 23rd at 10am Pacific Time.  The title of the Webinar is: 

While health risk assessments are still widely used to benchmark individual risk and determine the best course for prevention, they are fraught with error and haven’t necessarily yielded a return on investment.  So what’s a better option?   Reserve your spot today for March 23rd at 10am Pacific / 1pm Eastern to learn:

  • Why HRAs don’t work, and may even leave individuals LESS likely to change health habits.
  • How new behavioral influence methods help people create sustainable healthy habits.
  • How hyper-personalization drives engagement.
  • Why you’ll never want to roll out a traditional HRA again, when you see what’s possible instead.

 Russell Benaroya, CEO of EveryMove, will be hosting.


Posted on March 10, 2016 04:27 PM


Poor Digital UX is Expensive in Healthcare

By Russell Benaroya
It’s no mystery that healthcare has been considerably behind the times in keeping up with modern day consumer software experiences.  When you think about your primary technology interactions with healthcare today it probably consists of your:
  • Health insurance portal.  Yes, you have access to it even if you didn’t know.
  • Employer wellness portal.  Yes, it’s that thing you go to once per quarter to make sure you check enough boxes to get your $50 gift card.
  • Physician portal.  That blue and white circa 1996 experience where you can see some of your lab results and theoretically exchange secure and cryptic emails with your physician.
And generally speaking, these are experiences for the more progressive among us.  Of course I’m setting this up here because it really is a much bigger problem than health plans, employers and physicians realize.  When you stretch people’s mental capacity to navigate poor user experience it has the dual effect of degrading the customer’s perception of your value and reduces the follow-through of the intended behavior.   So what’s the big deal?  Does it really matter?  We know solutions aren’t optimal but hey, that’s healthcare, right?  Wrong.  Here are three reasons why poor user experience matter to everyone:
Poor experience increases friction. Friction increases effort.  Effort increases time.  Time is money.  And that financial burden gets pushed down to each of us. 
Where’s the Money?  When it’s too hard to figure out how to pay a bill (or what it’s for or why it’s so much money) we set it to the side and choose not to pay it (I may have implicated myself here).   That’s a pretty big deal as millions of consumers have the upfront cost burden today with both their premiums (individual market) and deductibles (high deductible health plans). 
The Result:  Billions of dollars of working capital due to past due transactions that ultimately get transferred into premiums to the consumer.
The Solution:  Simplify the payment process through mobile payments, Health Saving Account integration, predictive pricing (transparency), and collection at the time of care (tighter provider / health plan data integration).
Out of Sight.  Out of Mind.  If I need to go to my health insurance or physician portal to see that it’s time for my flu shot or annual physical I’m in big trouble.  If there is a new service like telehealth, I'm unlikely to hang out on my health plan portal to learn about it.  Further, if I’m going to build a rapport with my physician I don’t want to have to go into a separate email system to ask if I need 250mg or 500mg of Niacin only to forget that I sent it from there and get frustrated that I didn’t get a response.   
The Result:  Health plans will lose out on impacting risk adjustment, utilization, retention and quality measures.  Physicians signing value based contracts will have little visibility into their population.  Employers that want to measure action, not box checking, will be disappointed.  Consumers aren’t aware of what they need to do and don’t act.
The Solution:  Provide an easy way for people to set up their preferences at the time of enrollment and then show up in a way that works for that person.  For many people, that may be a more invisible interface for interactions via text or push messaging on mobile.    Portals display information.  Invisible interfaces trigger and acknowledge action in a welcomed way.
Portals display information.  Invisible interfaces trigger and acknowledge action in a welcomed way.
Lack of Empathy.  The subtle message to the consumer when we force them to use antiquated user experiences is that we don’t really care and that they are really data points and not people.  It’s why companies like Oscar Healthcare get so much recognition because they lead with empathy. 
The Result:  Poor customer experience = poor retention.
The Solution:  Just ask!  When we ask individuals what they want to achieve and how they want to engage we can learn a bit.  It will drive personalization and tailored interactions.  It will also allow for more authenticity and some self-deprecation. 
Let’s be clear that the biggest loser here is the individual.  Poor experience increases friction. Friction increases effort.  Effort increases time.  Time is money.  And that is financial burden getting pushed down to each of us.  So when we are talking about ways to improve the customer experience through consumer technology there are very real economic reasons to doing so.  And the answer isn’t putting more content behind a portal.  It may be getting rid of most of that portal after all.

Posted on March 1, 2016 05:49 PM


Why Guaranteed Issue Creates a "Guaranteed Issue"

By Russell Benaroya

What is guaranteed issue?  Guaranteed issue prohibits insurers from charging differentials based on health status and requiring them to offer coverage to any purchaser.  What this means is that anyone can buy insurance at an established price regardless of their health status.  The risk in guaranteed issue is the adverse selection death spiral where only people that need to use the insurance buy it.  That’s why regulations require that everyone have insurance or face a penalty.

The government put in place three pillars designed to stabilize the market.  The Kaiser Family Foundation explains this in terrific detail but here is the summary:

  • Risk Adjustment:  Redistributes funds from health plans that have low risk to health plans that have higher risk enrollees.  The idea is that health plans shouldn’t be penalized because they got a bunch of high risk members (i.e. adverse selection).
  • Risk Corridors:  Limits losses beyond an allowable range with the idea of encouraging health plans to keep premiums down.  The government would step in and manage payments to reduce big swings in the initial years of healthcare reform.  This has not worked.  If you read my post “Insurance Co-ops and the Risk Corridor – Land of the Lost” you would see that insurers asked for $2.87 billion while only $362 million was available for payout.  The result?  Half of the co-ops set up for the Exchange are out of business and more are falling (see the recent news on Moda).
  • Reinsurance:  Provides payments to plans that enroll higher cost individuals.  The idea is to protect against rising premiums by capping risk for high cost enrollees. 
Risk adjustment is designed to be a permanent fixture of the Exchange.  Risk Corridors and Reinsurance are temporary and to be phased out in 2016 which is going to be a big problem for consumers and definitely result in higher premiums and create a “guaranteed issue” in the pocketbooks of consumers and small business (pun intended). 

So what’s the problem?  Guaranteed issue (and the elimination of most dollar limits) creates tremendous challenges for organizations in the business of insuring risk.  More to the point, there is so little information shared with health insurers that they are literally “flying blind” in figuring out how to engage the right people.  They have no idea.  As such, they spend more administrative dollars in outreach but to no avail and they don’t have the systems to tie back and know whether the dollars they spent actually yielded engagement of any material kind.

Less information in the market creates risk and that risk gets priced and passed to the consumer.  There is so much uncertainty in the Exchange that premiums will absolutely need to rise dramatically without the government capping risk.  On the flip side, health plans don’t want to get priced out of the market by being too expensive but those efficient market forces may not play out.  The result may be unsustainable pricing pressure that puts the current insurance Exchange in jeopardy.

One way to address this is to have the government be the re-insurer of very high risk cases.  In other words, extend the Reinsurance program beyond 2016 and make it foundational to the individual marketplace.  When someone signs up on the Exchange with a rare enzyme disorder that costs $3 million /year in medication that is going to have to get paid by a health insurer whose hands are tied.  In these cases, is it reasonable that the government would reinsure and act as a stop loss for the health plan for these outlier situations? 

Another way to address this is to have every new member that joins the Exchange be required to get an annual health exam in order to activate their new insurance plan.  In that case, every member would have a primary care physician they are connected to with results that will help the health plan determine how to best support that individual.  Is this unreasonable?  Isn’t the primary care physician the very best starting point for every insured member?

I want the insurance exchanges to work.  They can work.  There needs to be more opportunities for the health plan to build an early relationship with each member so they can spend their resources wisely to serve each member’s needs most appropriately.  Guaranteed issue is creating a guaranteed issue but it can be solved through a regulatory extension of Reinsurance and a mandatory physician evaluation at the beginning of each plan year.

What other ways can we address the problem?

Posted on February 5, 2016 08:39 PM


EveryMove Launches Tandem

By Russell Benaroya

Today we launched Tandem to give individuals more ways to earn incentives from their health plan.  We consistently heard from customers over the last year that while fitness is the “universal prescription”, there are other areas they want to encourage individuals to take action.  These could be things like (i) seeing a primary care physician; (ii) using a new telehealth tool; (iii) getting a flu shot; (iv) enrolling in a care management program; and (v) more.  Delivering this level of flexibility is critical if we are going to deliver a more personalized approach to prevention.  And we are.

We are on a mission to improve the lives of 10 million people in 10 years and Tandem expands our capability to hit our goal and make a greater impact.  We’re not abandoning fitness by any means but it is becoming one of many different programs that a sponsor can build incentives around.   Are we excited?  Absolutely!  We are creating the first personalized "recipe list" of actions for individuals that will have a direct impact on lowering their healthcare costs.    

So what does this mean?  It means that if your health plan or employer are offering programs through Tandem you can access Tandem.  Programs and incentives are specifically designed by the customer for their given population.  Our other product, EveryMove Fit, is what you have experienced to date, a free consumer fitness tracking application that brings together all of your connected fitness data and community into one place!

We have been unwavering in our mission at EveryMove and we look forward to continuing to build solutions that create an environment where prevention in healthcare is valued.  Thank you for being a part of that journey.

Interested in learning more?  You can check out the press release here.  If you'd like a demo of Tandem, request one at www.hellotandem.com.

Posted on January 19, 2016 03:35 PM


The Traditional Health Assessment is Dead

By Russell Benaroya

I have a good friend, Andrew Sykes, who is a well-respected wellness actuary.  I’d say he is one of the sharpest guys in healthcare I have met and he is an advisor for our company.  We spend a lot of time talking about the consumerization of healthcare and how personalization is an imperative to align the right interventions to the right people at the right time.    The prevailing wisdom has been to first assess a person, figure out a bit more about them, and then propose something they should do.  The problem with the traditional assessment is that it is fraught with error.  Andrew Sykes wrote an article a few years back articulating why he believes this is the case and I wanted to share the high points.

What is a health risk assessment?  A health assessment typically consists of about 5-10 pages of questions that cover topics around exercise, eating, alcohol, biometrics, and more.  Many of you have probably filled one out (when you are going to get $100+ from your employer most likely).  Here are the problems with traditional assessments according to Andrew Sykes:

1.  Health assessments paint a biased picture of the population.  Most people that fill out health assessments are healthier than average so the data is skewed.  It is more worthwhile to just assume that your population maps to the general population of healthcare prevalence (why wouldn’t they?) and focus the attention (and incentive dollars) on programs.

2.  We have really poor memories.  I can’t even remember what I did yesterday so when the assessment asks questions about my physical activity or my nutrition I am likely going to recollect myself in a much better state (oh, of course I work out 5 days/week).  We have hindsight bias and wishful memories.

3.  We know we’re being observed.  We know the assessment is going to be collected and reviewed by someone, somewhere.  As a result, we alter our behavior because we are being observed.  And we know what the right answer should be so we’re inclined to overestimate our health too.  There is a term for this called the Hawthorne Effect.  Asking fewer questions with more frequency in a less intrusive way can glean more accurate information.

4.  We are programmed to misreport.  As humans we are already biased to misreport because anything less than “getting a good grade” is failure.  As a result, we tell “white lies” on health assessments that we skim through in as little time as possible. When the reports come back that we’re actually healthier than we really are, it only exacerbates the problem.

5.  Health assessments focus too much on risk factors, not health habits.  Health assessments ask questions to smoke out high risk individuals for intervention but that’s not how health assessments are marketed.  They are marketed to promote positive health drivers.  Improving health isn’t about merely being “not sick” but rather helping make someone their best selves.  If a health assessment is actually going to be useful, its content should be squarely focused on improving health drivers like exercise, nutrition and sleep.

6.  Health assessments actually drive up healthcare costs.  Health assessments give people a “free pass” to go visit their physician and get prescription medications which drive up healthcare costs.  Most people do not learn about the results from their health assessment and fundamentally change their behavior.  By going to the doctor with some new information, individuals can work to “treat” their health risks rather than reverse them with a change in lifestyle.

The traditional health assessment is dead.  Let’s stop spending money on it as soon as possible.  It’s not enough to say that it’s a good year over year benchmark because people aren’t truthful and healthcare is not getting improved because of the assessment.  There is a better way.  Learning about individuals is a process, not a 5-10 page questionnaire.  It is a process that directly accompanies engagement in actions and programs designed to improve health, not just treat the health risk. 

Posted on November 9, 2015 02:30 PM


Wearable Tech and Healthcare Week in Review -- Week of November 2, 2015

By Russell Benaroya

Summary: With health tracking platforms like Apple's HealthKit seeing increasing takeup, insurers are getting interested in the possibilities the devices represent. While health and fitness tracking platforms have long been popular with runners and quantified selfers, the arrival of Apple's HealthKit has caused a new group to get interested: insurers. Read more on this upcoming trend in this article from Jo Best. 

Summary: There’s some news for those who were questioning Fitbit’s entry into Corporate Wellness area. Reportedly, the number of businesses who started monitoring their employees’ wellbeing with Fitbit’s trackers have increased significantly in the last four months, when the program first started to take shape. Fitbit shares were up as much as 5%, as wearable device maker takes on 20 new enterprise customers in the third quarter, including Barclays PLC. Read more in this article from Smith Dalton.

Summary: The Consumer Electronics Association (CEA) this week released a set of voluntary guidelines for use by organizations designing tools and devices based around health and wellness. Providing consumers with clear, straightforward information on security is especially important as many remain wary about the privacy of their health information. Read more in this article from Katie Dvorak.

Summary: The success of Apple's ResearchKit platform in the clinical trial space has caught the attention of the U.S. Food and Drug Administration. In an Oct. 29 notice published in the Federal Register, the FDA is seeking input on how mHealth technology might be used to improve clinical trials. The agency is particularly interested in how healthcare providers and other parties are using consumer-generated data, how they're reaching out to consumers, and whether the data being collected is useful and reliable. More in this article from Eric Wicklund.

Summary: The smartphone has graduated from simply being a communication device to one that is capable of being used as a health tool in our daily lives. A veritable digital health revolution is brewing, with a plethora of health apps coming to market that go beyond simply tracking your daily steps and caloric burn. Nonetheless, while many companies and tech giants (eg, Apple and Google) are growing this niche, many health care practitioners are still trying to deduce how to use such data for daily practice and patient care. More in this paper published by Timothy Dy Aungst and Steven Khov on Pharmacy Times.

Summary: It should come as no surprise that we're losing the battle to improve global wellness.  But, there are rays of hope. As digital technologies like the Web and mobile have gained in popularity, some have used these tools to nudge people to engage in healthier behaviors. Read more in this article from Fard Johnmar.

Posted on November 9, 2015 12:10 AM