February 2023

The Humanity of Behavioral Design

by Jennie Byrne, MD, PhD

 

Although few things are more human than healthcare, we at Belong Health find ourselves concerned by the impersonal nature of the healthcare industry at large. To us, our members aren’t numbers and symptoms on a chart — they’re people with fears, hopes, families, friends, and ambitions. Shouldn’t healthcare treat them as such? Fortunately, behavioral design — the science of how people think, feel, and behave — embraces this natural complexity of the human condition. It recognizes people are irrational, passionate, dynamic, and unique. And so do we. 

In fact, we love the science of behavioral design so much, it’s central to everything we do — including creating processes, workflows, and communication plans that build trust with each of our members. Systems that fully support them as the wonderfully irrational people they are. 

The Value of Behavioral Design

What is Behavioral Design? Put simply, it’s the study of that pesky gap between what people say they’ll do and what they’ll actually do. Thoughtful, thorough examinations of this gap — followed by implementation of operational solutions with which to bridge it — are invaluable in nearly every industry, including ours. 

When applied to care management for dual-eligible special needs (D-SNP) members, behavioral design works wonders in the following ways: 

  • Offering Nudge Interventions – Nudge interventions are small changes to an environment or decision-making process that can influence behavior without limiting choice. When a D-SNP member needs a bit of a reminder to take a medication or schedule a check-up, nudge interventions can come to the rescue. 
  • Appealing to Social Norms – Care management services can influence behavior by highlighting what is typical or expected for a particular population. For D-SNP members, for example, it might be helpful to know the percentage of people within their respective communities who have received recommended screenings. 
  • Simplifying Choice – Behavioral design helps curb against decision overwhelm by simplifying choices. In the realm of care management, this could mean presenting D-SNP members with a limited number of options for care plans, using accessible and region-specific language to describe those plans, and working alongside each member as they make their respective decisions. 
  • Motivation Design – With the help of motivation design — by way of fun rewards, points systems, and interactive tools — care management naturally becomes more dynamic and enjoyable for D-SNP members. Clear incentives and a sense of ownership over their own progress can often make a world of difference in the achievement of health outcomes. 
  • Personalization – Through personalization, care management can be expertly tailored to the unique and often complex needs of every D-SNP member. Customized care plans or reminders, based on a blend of personal needs and preferences and expert advice, equips every member with the best possible path to health.  

Building Trust

Trust is earned when people and organizations do what has been expected and promised. Belong uses behavioral design as a key method of building and sustaining trust with our members.  

In this spirit, we go to great lengths to personalize our communications by doing extensive “homework” that lets us get to really get to know every member — not solely via their ailments or needs but also via their joys and passions. We remember details about their lives. We ask, and we celebrate, what is meaningful to them. Along every step of the healthcare journey, we learn every member’s personal preference. Would they like to work with a provider of a particular gender? Would they prefer we addressed them in a particular way? 

No matter the nature of the member engagement, we always go beyond a simple “check-the-box” phone call. Our care management teams regularly exceed the industry standard. This is why our commitment to behavioral design is critical to our success. 

Normalizing Improvement 

We’ve found one of the most outstanding benefits of behavioral design is the useful framework it allows for constant iteration and improvement of our process. We are never satisfied with recognizing something works “well enough.” Instead, we lean into a scientific behavioral design process that identifies key factors of our successes. Simultaneously, we look to improve our workflows, communications, and outcomes. 

One exciting example of this normalization of improvement is embodied in our “welcome call,” refined through behavioral design. This welcome call isn’t just useful for onboarding and engaging members — it provides key information on how we can best smooth our own processes and remain most effective for the members as we meet them. 

Thanks to fluid and interpersonal onboarding processes like these, our members stay engaged with their care management teams, complete lengthy risk assessments, and frequently call us for help before impulsively heading to the emergency room with a medical question or concern. 

Addressing the Central Challenge of Clinical Care Management 

Despite its many benefits, clinical care management is not without its complexities. For us, it presents the unique challenge of finding a way to individualize a patient’s experience while simultaneously preserving our commitment to equitable services. We are steadfast in providing the same high standard of care to every member yet also making that care so personalized and unique that it could never be confused for a cookie-cutter, one-size-fits-all approach. 

That’s one reason why behavioral design is so crucial for our work. It empowers us with consistent population tools. It guides us towards humanistic and individualized connections with every member. Additionally, its scientific method generates hypotheses that regularly challenge our own assumptions with reliable data. In short, it steers us clear of the dreaded sunk cost fallacy — a sense we must continue down a specific care path simply because we’ve already invested our time, money, and reputation in exploring it.  

We have a better way: the creation of systems that recognize human individuality — and avoid a natural tendency to persist with behaviors that simply aren’t working. 

Enriching the Patient Experience

Every day, our work folds together the expertise and clinical skills of care managers with workflows that recognize and celebrate patient individuality. Our equitable processes prevent members from falling through the cracks of a frequently fractured healthcare system. 

Across a complex landscape of healthcare processes and offerings, invaluable offerings like these remain among our key differentiators. By baking behavioral design into every layer of our process from the day we opened our doors, Belong Health has learned to thrive in complexity, to catch human errors early, and to iterate more quickly. 

In today’s constantly evolving healthcare ecosystem, and in the throes of an ongoing global pandemic, that capacity for adaptation is more vital than ever. I am confident we are poised to bend and iterate to fit these tumultuous times. Ironically, our unique capacity for change positions us – today and tomorrow — as a valuable constant for every one of the unique members and communities we’re so humbled to serve.