Do it different. Make a difference.
            Bryce Williams
          October 30, 2012


              @brycecwilliams



                page 1
two roads converging




 Source: D. Ornish, M.D.



                           page 2
living longer, living sicker


             U.S. Smoking Trends (1965-2006)                            U.S. Obesity Trends (1971-2006)

60%                                                        50%

50%
                                                           40%

40%
                                                           30%
30%
                                                           20%
20%

                                                           10%
10%

0%                                                         0%
      1965                            1990     2006              1971                            1990            2006
                           Men       Women                              18-29 Yrs   30-44 Yrs   45-64 Yrs   65+ Yrs




 Source: CDC Health, United States

                                                  page 3
wellness 1.0

 risk identification
 information transfer
 marginal impact




                        page 4
information rich, knowledge poor
quantity of global digital data, exabytes

1,000 (kilo)                   7,910
1,000,000 (mega)2,720          2015
        1,227
130 2008 (giga)  2010
1,000,000,000
 2005
1,000,000,000,000 (tera)
1,000,000,000,000,000 (peta)
1,000,000,000,000,000,000 (exa)
1,000,000,000,000,000,000,000 (zetta)
1,000,000,000,000,000,000,000,000 (yotta)
Source: EMC/IDC Digital Universe Study, 2011

                                               page 5
wellness 2.0 makes it…

                  Rewarding




        Easy                    Real




                Wellness 2.0




       Social                  Iconic




                     Fun




                    page 6
make it rewarding: the basics
I.       forget cash…link to benefits…seize the 20%


II.      embrace outcomes…show compassion


III. perfect is the enemy of the good

                   BMI & Mortality Risk                                            Health Risks & Costs
                                                           $6,000

                                                           $5,000

                                                           $4,000

                                                           $3,000

                                                           $2,000

                                                           $1,000

                                                               $0
                                                                           Low Risk            Med Risk              High Risk

                                                                        Medical/Pharma     Absence    Workers Comp    S-T Disabilit y


Source: Bray et al. West J Med 1988;149:429–41.            Source: Wright, Beard, Edington. JOEM. 44(12):1126-1134, 2002.


                                                  page 7
make it rewarding: behavioral economics
           Weight Watchers Participation (1Q)

600
                                                   Behavioral Economics


500

400

300
                            Reimbursement
200

100   Discount




  0
      2009           2010                   2011        2012
                            page 8
make it rewarding: social cohesion
              CalPERS - Social Incentives

100%

  80%

  60%

  40%

  20%
Traditional
Incentives
    0%

                       DPH       CalSTRS   SCO
                             page 9
make it easy




    Putting fruit in
   attractive bowls
    doubled sales!

                                        Putting salad bar
                                         near checkout
                                          tripled sales!




Source: Wansink et al, NY Times, 2010


                                                  page 10
page 11
make it social: the basics




                 page 12
page 13
Source: Massive Health; Christakis et al, NEJM, 2007
make it social: shape up shield




                 page 14
shape up shield: trends

               1400

               1200

               1000
Participants




                                                         social wellness is:
                800
                                                          “sticky” - significant
                                                         alumni retention
                600
                                                          “viral” – strong newbie
                400                                      adoption

                                                          “popular” – one
                200                                      program = 40% of BSC
                                                         employees
                  0
                      SUS1   SUS2        SUS3     SUS4

                              Alumni   Newbies



                                        page 15
shapeupshield: week 2 vs. week 8
             35                                                 Insight: marked increase in physical
                                                                activity as the challenge progressed
             30

             25
# of Teams




             20

             15

             10

             5

             0
                  <10,000   10,000-   20,000-   30,000-    40,000-   50,000-   60,000-   >70,000
                            19,999    29,999    39,999     49,999    59,999    69,999

                                            Steps/I ndiv idual/Week

                                                Week 2        Week 8
                                                 page 16
shapeupshield: team performance
                               700,000

                                                                      Insight: top teams consistently employed
                               600,000                                behavioral best practices (goal setting, group
                                                         Turned On
Cumulative Steps/Participant




                                                                      activities, peer coaching, loss aversion)
                               500,000


                               400,000


                               300,000


                               200,000


                               100,000
                                                                                                    Tuned Out

                                    0
                                         1   8   15   22 29   36 43   50 57       64 71   78 85   92 99 106 113 120 127

                                                                                 Team #
                                                                       page 17
shape up shield: high performance


       Teams Averaging >10K Steps/Day                      Avg Steps/Day - "Winning" Team

18                                              18000

15                                              15000

12                                              12000

 9                                                  9000

 6                                                  6000

 3                                                  3000

 0                                                     0
        1Q2011                   1Q2012                      1Q2011                   1Q2012




                                          page 18
by
                                                                                                                       to lead 1 in
                                                                                                                   Way ple! # n
                                                                                                                       m
                                                                                                                   exa ical Pla reat
                                                                                                                    Med unt! G
                                                                                                                         o
                                                                                                                    Disc
                                                                                                                     job!



           HR - total                HR - components                                   companywide
    2012 medical plan discount
                                                                                          2012 medical plan discount
                                               wellness 
                                              assessment     100%
                                                              85%
                                        90%                   70%
                                                              55%

              92%                                             40%




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                                                                                             2011 health day off

                                              wellness       100%
                                               goals & 
              71%                             programs
                                                             80%

                                        89%                  60%

    HR – by location                                         40%

                                                             20%
                              93%
  SF
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OTHER
                              67%                visit                    Sh
                              100%
                                        72%        page 19
connectedness & health



        Illness
     Wellness
               page 20
let’s face it…
  we love…




 we hate…


                 page 21
gamification & the hype curve




Source: Gartner, Inc.
                        page 22
make it fun




              page 23
daily challenge: research
                                     Engagement & Social Connection




Source: Poirier, J & Cobb, N; J Med Internet Res 2012

                                                        page 24
daily challenge: early returns
                                  60,000 Challenges
                                  90% Retention
                                  2/3 w/ >1 “Friends”
                                  1/4 w/ >8 “Friends”




                 page 25
make it iconic: brand anti-matter




                 page 26
page 27
make it iconic: brand matters




                page 28
make it iconic




                 page 29
make it real: engagement matters
90%


75%


60%


45%


30%


15%


0%
      2004       2005    2006      2007       2008   2009    2010    2011

             Wellness Assessment     Biometrics      Health Goals/Program
                                    page 30
better choices; better outcomes
low risk employees


                                             73%




            58%
             2008    2009             2010   2011



                            page 31
better choices; better outcomes
regular exercise


                                            56%




             42%
             2008   2009             2010   2011



                           page 32
make it real: outcomes matter
smoking


          12%

                  9%
                                   8%
                                         6%     6%
          2008   2009             2010   2011   2012



                        page 33
make it real: outcomes matter
hypertension


               24%    24%




                                10%    10%
               2009   2010      2011   2012



                      page 34
improving financials


         million annual cost savings



                           per employee



                   ROI
                 page 35
bryce.williams@blueshieldca.com
Follow on Twitter @brycecwilliams




               page 36

Gmd wellvolution webinar_103012

  • 1.
    Do it different.Make a difference. Bryce Williams October 30, 2012 @brycecwilliams page 1
  • 2.
    two roads converging Source: D. Ornish, M.D. page 2
  • 3.
    living longer, livingsicker U.S. Smoking Trends (1965-2006) U.S. Obesity Trends (1971-2006) 60% 50% 50% 40% 40% 30% 30% 20% 20% 10% 10% 0% 0% 1965 1990 2006 1971 1990 2006 Men Women 18-29 Yrs 30-44 Yrs 45-64 Yrs 65+ Yrs Source: CDC Health, United States page 3
  • 4.
    wellness 1.0 riskidentification information transfer marginal impact page 4
  • 5.
    information rich, knowledgepoor quantity of global digital data, exabytes 1,000 (kilo) 7,910 1,000,000 (mega)2,720 2015 1,227 130 2008 (giga) 2010 1,000,000,000 2005 1,000,000,000,000 (tera) 1,000,000,000,000,000 (peta) 1,000,000,000,000,000,000 (exa) 1,000,000,000,000,000,000,000 (zetta) 1,000,000,000,000,000,000,000,000 (yotta) Source: EMC/IDC Digital Universe Study, 2011 page 5
  • 6.
    wellness 2.0 makesit… Rewarding Easy Real Wellness 2.0 Social Iconic Fun page 6
  • 7.
    make it rewarding:the basics I. forget cash…link to benefits…seize the 20% II. embrace outcomes…show compassion III. perfect is the enemy of the good BMI & Mortality Risk Health Risks & Costs $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 Low Risk Med Risk High Risk Medical/Pharma Absence Workers Comp S-T Disabilit y Source: Bray et al. West J Med 1988;149:429–41. Source: Wright, Beard, Edington. JOEM. 44(12):1126-1134, 2002. page 7
  • 8.
    make it rewarding:behavioral economics Weight Watchers Participation (1Q) 600 Behavioral Economics 500 400 300 Reimbursement 200 100 Discount 0 2009 2010 2011 2012 page 8
  • 9.
    make it rewarding:social cohesion CalPERS - Social Incentives 100% 80% 60% 40% 20% Traditional Incentives 0% DPH CalSTRS SCO page 9
  • 10.
    make it easy Putting fruit in attractive bowls doubled sales! Putting salad bar near checkout tripled sales! Source: Wansink et al, NY Times, 2010 page 10
  • 11.
  • 12.
    make it social:the basics page 12
  • 13.
    page 13 Source: MassiveHealth; Christakis et al, NEJM, 2007
  • 14.
    make it social:shape up shield page 14
  • 15.
    shape up shield:trends 1400 1200 1000 Participants social wellness is: 800  “sticky” - significant alumni retention 600  “viral” – strong newbie 400 adoption  “popular” – one 200 program = 40% of BSC employees 0 SUS1 SUS2 SUS3 SUS4 Alumni Newbies page 15
  • 16.
    shapeupshield: week 2vs. week 8 35 Insight: marked increase in physical activity as the challenge progressed 30 25 # of Teams 20 15 10 5 0 <10,000 10,000- 20,000- 30,000- 40,000- 50,000- 60,000- >70,000 19,999 29,999 39,999 49,999 59,999 69,999 Steps/I ndiv idual/Week Week 2 Week 8 page 16
  • 17.
    shapeupshield: team performance 700,000 Insight: top teams consistently employed 600,000 behavioral best practices (goal setting, group Turned On Cumulative Steps/Participant activities, peer coaching, loss aversion) 500,000 400,000 300,000 200,000 100,000 Tuned Out 0 1 8 15 22 29 36 43 50 57 64 71 78 85 92 99 106 113 120 127 Team # page 17
  • 18.
    shape up shield:high performance Teams Averaging >10K Steps/Day Avg Steps/Day - "Winning" Team 18 18000 15 15000 12 12000 9 9000 6 6000 3 3000 0 0 1Q2011 1Q2012 1Q2011 1Q2012 page 18
  • 19.
    by to lead 1 in Way ple! # n m exa ical Pla reat Med unt! G o Disc job! HR - total HR - components companywide 2012 medical plan discount 2012 medical plan discount wellness  assessment 100% 85% 90% 70% 55% 92% 40% IT ea P S S BS H R l Fi B BU l C e g rp n ta ga s ar t e un s s s HC biometric  nc LG e S M gm tin C o a ti o at Op es nc z R PL To Le G F o ine ke or na in kM IS va d er C d us 2011 health day off Ad om screening or eB tw st ld Cu Ne ie Bi Sh 90% 2011 health day off wellness 100% goals &  71% programs 80% 89% 60% HR – by location 40% 20% 93% SF IT S S HR M ga l B BU l 67% e Ad in g rp n ta us ps B S r a te CP mt Fi s HC LP s nc z R LG S o r ce C o a ti o annual  es es To Le t G eB r O g an ke na in d in o kM IS d C ar Ne v e un 93% ea om EDH preventive  Fo 75% tw st ld Cu ie Bi OTHER 67% visit Sh 100% 72% page 19
  • 20.
    connectedness & health Illness Wellness page 20
  • 21.
    let’s face it… we love… we hate… page 21
  • 22.
    gamification & thehype curve Source: Gartner, Inc. page 22
  • 23.
    make it fun page 23
  • 24.
    daily challenge: research Engagement & Social Connection Source: Poirier, J & Cobb, N; J Med Internet Res 2012 page 24
  • 25.
    daily challenge: earlyreturns  60,000 Challenges  90% Retention  2/3 w/ >1 “Friends”  1/4 w/ >8 “Friends” page 25
  • 26.
    make it iconic:brand anti-matter page 26
  • 27.
  • 28.
    make it iconic:brand matters page 28
  • 29.
  • 30.
    make it real:engagement matters 90% 75% 60% 45% 30% 15% 0% 2004 2005 2006 2007 2008 2009 2010 2011 Wellness Assessment Biometrics Health Goals/Program page 30
  • 31.
    better choices; betteroutcomes low risk employees 73% 58% 2008 2009 2010 2011 page 31
  • 32.
    better choices; betteroutcomes regular exercise 56% 42% 2008 2009 2010 2011 page 32
  • 33.
    make it real:outcomes matter smoking 12% 9% 8% 6% 6% 2008 2009 2010 2011 2012 page 33
  • 34.
    make it real:outcomes matter hypertension 24% 24% 10% 10% 2009 2010 2011 2012 page 34
  • 35.
    improving financials million annual cost savings per employee ROI page 35
  • 36.