Overview of Wellvolution; Blue Shield of California's next generation wellness solution. The wellness 1.0 model, focused on risk identification and information transfer is broken. Our wellness 2.0 solution makes wellbeing rewarding, easy, social, fun, iconic and real. Employing rapid cycle prototyping and leading edge academic theories (e.g. behavioral economics, social cohesion, gamifcation, etc.) Wellvolution consistently delivers market leading engagement, health outcomes and financial returns. Our vision: do it different, make a difference!

1. Do it different. Make a difference.
Bryce Williams
October 30, 2012
@brycecwilliams
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2. two roads converging
Source: D. Ornish, M.D.
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3. 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
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4. wellness 1.0
risk identification
information transfer
marginal impact
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5. 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
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6. wellness 2.0 makes it…
Rewarding
Easy Real
Wellness 2.0
Social Iconic
Fun
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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.
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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
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9. make it rewarding: social cohesion
CalPERS - Social Incentives
100%
80%
60%
40%
20%
Traditional
Incentives
0%
DPH CalSTRS SCO
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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
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11. page 11

12. make it social: the basics
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13. page 13
Source: Massive Health; Christakis et al, NEJM, 2007

14. make it social: shape up shield
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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
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16. 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
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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 #
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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
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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
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21. let’s face it…
we love…
we hate…
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22. gamification & the hype curve
Source: Gartner, Inc.
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23. make it fun
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24. daily challenge: research
Engagement & Social Connection
Source: Poirier, J & Cobb, N; J Med Internet Res 2012
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25. daily challenge: early returns
 60,000 Challenges
 90% Retention
 2/3 w/ >1 “Friends”
 1/4 w/ >8 “Friends”
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26. make it iconic: brand anti-matter
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27. page 27

28. make it iconic: brand matters
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29. make it iconic
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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
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31. better choices; better outcomes
low risk employees
73%
58%
2008 2009 2010 2011
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32. better choices; better outcomes
regular exercise
56%
42%
2008 2009 2010 2011
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33. make it real: outcomes matter
smoking
12%
9%
8%
6% 6%
2008 2009 2010 2011 2012
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34. make it real: outcomes matter
hypertension
24% 24%
10% 10%
2009 2010 2011 2012
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35. improving financials
million annual cost savings
per employee
ROI
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36. bryce.williams@blueshieldca.com
Follow on Twitter @brycecwilliams
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