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Using Technology to Educate and Engage

In a tough market, UnitedHealth Group believes continuous innovation will help make it part of the solution rather than part of the problem.
By Ira Ozer
 
With healthcare costs rising steadily on both the employer and employee side, many people think the system is spiraling out of control and can’t be fixed. But this is far from the truth. UnitedHealth Group (UHG) is making a concerted effort to be part of the solution rather than part of the problem.
 
Serving more than 75 million individuals, UHG is one of the largest insurance and wellness management companies in the U.S. Its two major divisions, UnitedHealthcare and Optum, employ 77,000 people who work in six business units. In each of these businesses, there’s an innovation team that works to design and implement new products, services and efficiencies, all aimed at improving the quality of healthcare and driving down costs.  
 
Robert Plourde, Vice President of Corporate Innovation, says the key is to focus on root causes, noting that the U.S. spends as much as 10 times more on disease management than it does on prevention. “It’s critical for healthcare providers to educate people and provide them with the tools, incentives and coaching they need to actually implement the behavioral changes necessary to adopt healthier lifestyles,” he says, adding that ample information is available, but very few people take the time to seek it out.
 
Consequently, UHG has pioneered exciting ways to educate people about their health needs, specific diseases and courses of action by using technology and “gamification” techniques, along with incentives, to both engage and encourage them to take the necessary actions.    

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Enterprise-Wide Social Wellness
In the fall of 2010, UHG piloted an enterprise-wide “social wellness” program using what it called the ShapeUp platform, in which employees enrolled in a 12-week challenge to lose weight, increase the number of steps they walked and increase the amount of time they exercised daily. To participate, employees input their progress in the online platform, encouraged others to join them and compete together, and invited others to join as well.
 
The results: the social reinforcement and team-based structure drove 30% of employees to engage and participate. More importantly, 70% were first-time wellness users, and 40% were at high risk for obesity-related diseases. Overall, participants lost 25 tons of excess weight and recorded more than 1 billion steps. On average, individual participants exercised 30 minutes daily, lost 3.7 pounds and reduced their body mass index (BMI) by 0.6%, with some achieving dramatic and life-saving results.
 
Then, in November of 2010, OptumHealth launched “OptumizeMe,” a health and wellness platform that allows users to create a series of challenges using mobile apps, social interaction, recognition, intrinsic rewards and extrinsic rewards for goal achievement.

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Motivation Through Gamification 
According to Karl Ulfers, Vice President of Consumer Solutions for OptumHealth Care Solutions, it’s critical to help people navigate the system so they can learn about their specific conditions and health issues, find the right doctors and give them tools to help take the necessary actions, such as losing weight to reduce hypertension and diabetes risk.
 
Ulfers explains that because many people don’t have immediate access to their computers while at work, a restaurant, recreational activities, or while exercising, OptumHealth will be launching a new mobile coaching experience in December of this year that incorporates elements of gaming. As people take actions to improve their health – eating the correct foods, drinking water as directed, etc. – they’ll earn “badges” and unlock levels that will provide them with more features and functionality. For example, if they earn a bronze badge, they’ll be able to post on their friends’ walls and see more content (including articles and videos) and receive surprise rewards, such as congratulations from celebrities.
 
The OptumizeMe system also includes a “loyalty engine,” which awards points for participating, learning and accomplishing required outcomes. In one case, if a participant’s BMI is below a targeted number, they will earn points; if it’s above, they can still earn points, but only by taking remedial training and coaching.  

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Rewards And Relationships

 

Although this platform is designed and managed by OptumHealth, it’s customized for and sold by the 1,700 payers, providers and employers who are their customers. Award points can be used for insurance premium reductions, incentive merchandise, travel packages, or retail gift cards, depending on the goals and objectives of a particular program sponsor. Some employers believe that offering their employees reduced premiums is more motivational and will result in greater participation and better results (e.g. save $300 for taking the specified actions), while others believe that tangible incentives have greater perceived value, especially merchandise items and gift cards that relate to health and wellness (such as branded athletic gear and apparel).
 
Sweepstakes are also used as a promotional tool to generate interest and awareness for specified activities such as taking a Health Risk Assessment (HRA) or Biometric Screening. Ulfers believes that OptumHealth has experienced high participation rates because people are motivated by the “aspirational” travel and merchandise prizes that are being offered.  
 
In addition, UHG deploys devices that help improve wellness, such as kiosks that allow employees to test their weight, blood pressure and body fat at work in order to keep themselves on track and tie in to workplace education, coaching and support groups. UHG is also partnering with consumer electronics companies that are bringing products to market that are designed to help people get more fit, as well as with nonprofit health-related organizations and community groups to improve health and wellness education.
Building A Culture
In addition to encouraging all of its employees and channel partners to participate in health and wellness programs, UHG fosters a culture of innovation ad engagement that allows everyone to submit ideas for new products and processes, both individually and in teams. Participants can submit ideas in writing, via email, using an online community collaboration platform and even over the phone to reps who forward them to the appropriate reviewers.
 
And it doesn’t stop there, because if an idea is accepted the initiator can choose to become the “idea champion” to bring it forward – in some cases, even as their new full-time position. This culture of wellness, recognition and innovation drives passion, empowerment and engagement – and that comes from the top, because the company’s CEO promotes the program, issues challenges (such as a recent one to focus on childhood obesity) and recognizes top ideas and implementation teams at formal recognition events.
 
Erin Carnish, Senior Vice President of Innovative Health and Technology Solutions for OptumHealth Care Solutions, heads a team that’s focused on developing next-generation solutions to drive medical cost savings. She explains that while there are certain generalities that apply to the population as a whole, healthcare education, treatment and management for people with specific diseases must involve customized programs that are sensitive to their unique needs, while at the same time complying with strict privacy regulations.
 
OptumHealth also continuously gathers insights from patients and physician panels covering various specialties to improve its solutions. Carnish notes that they recently conducted focus groups with employees of a large retailer to learn why they visited the E.R. as their primary source of medical treatment. They learned it was because many of them couldn’t get to regular doctors for scheduled appointments. Acting on this information, “virtual doctors” were made available in the employee break room, which allowed the employees to explain their condition via a video conference and then get the proper treatment immediately or be directed to the most appropriate healthcare provider for their needs.
 
The division is taking this idea further, working on a program with doctors and other healthcare providers to provide an online scheduling service that will allow members of all groups, not just this retailer, to find the right type of doctor for their needs. 
Cutting Waste, Increasing Care
OptumHealth is also launching a major initiative to create a system of Health Advisors who will work in conjunction with people, much like financial advisors, to assess their needs, help direct them to education and providers and coach them to make the recommended behavior changes to live a healthier lifestyle. This cuts out wasted visits to inappropriate providers and maximizes the time of specialists who can help with specific conditions.
 
In 2010, OptumHealth piloted a program in its Golden Valley, MN, location to integrate all employer healthcare and wellness best practices. This included adding a gym with a variety of exercise classes; making thematic design changes, such as painting some of the office walls and common areas with the GOh! program logo and green color; adding motivational messaging throughout the building, especially in the stairwells; adding a ping-pong table and other equipment to the break room to encourage physical activity; introducing a nurse or other health professional as each employee’s wellness “concierge” to coach and guide them; revamping the menu in the cafeteria to eliminate foods with high fat and calories and replace them with fresh, whole foods that have high nutritional value; and coordinating monthly educational and fitness events.  
 
Their key objectives are to lower healthcare costs, change the way employees use the healthcare system, provide an environment where a healthy lifestyle is easy to achieve, and improve employee health with a comprehensive onsite health management solution.
 
The results have been outstanding. Some highlights:
  • medical savings increased 35 times over the prior year
  • wellness program engagement rose from 7% to 22%
  • employee engagement scores increased by 6 points
  • 31% of employees say their workplace productivity has increased
  • 67% say that they are placing a higher priority on improving their health.

The healthcare system might seem broken, but United Health Group is one of many companies leading the charge to fix it through continuous innovation and enterprise engagement.  

Ira Ozer, CPIM, is President of Engagement Partners, an enterprise engagement consulting and solutions company. He can be reached at 914-238-2220 or iraozer@engagementpartners.com

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