How Mobile Health Can Mend Your Bottom Line

Reposted with permission from the Benefitfocus blog. Benefitfocus is a RedBrick Health strategic partner.

To combat rising healthcare costs, many employers are working to engage their employees with strategic wellness initiatives. After all, when they’re successful, wellness programs can have tremendous results. According to a study conducted by the Harvard Business Review of 185 workers from a single organization, 57 percent of high-risk individuals were converted to low-risk status by the end of the company’s six-month wellness program. The result?—slashed medical claim costs of $1,421 per participant, or $6 in healthcare savings for every dollar the company invested in the program. Successful wellness programs like these are inspiring more organizations to invest in employee health and wellness, not only to cut costs but also to improve employee productivity and engagement.

RedBrick Health Mobile AppRallied by the achievements of wellness programs, many organizations are exploring avenues for additional healthcare savings and improved employee productivity. With the advent of new technology, the mobile health market provides numerous options for employers to complement their wellness strategies and provide more comprehensive care for their employees. Data from the 2014 Health Employer Survey on Purchasing Value in Health Care shows that nearly a third of high-performing companies adopted telemedicine in 2014, with 52 percent of employers projected to add it to their offerings by the end of 2015. While telemedicine generally results in auxiliary savings, organizations are finding value in using these solutions in tandem with a strategic wellness program to drive aggregate savings while providing employees convenient access to holistic healthcare services.

But mobile health isn’t just limited to telemedicine. Thanks to innovations in the industry, employers have a medley of opportunities available to engage their employees in their health. Conveniently accessible mobile apps provide services ranging from general diet and fitness tracking to premium amenities including clinical references, detailed graphics, nutrition plans, diagnostics and data analytics. As part of the “internet of things,” mobile health apps are able to collect and store usage data. As individuals take greater control of their health using mobile apps, employers benefit from unprecedented metric capabilities to track employee progress and further hone their wellness strategies in pursuit of organizational goals.

Mobile health apps are only becoming more prevalent in the marketplace as employers, employees and healthcare professionals realize their value. A survey by Research Now reveals that 46 percent of healthcare professionals plan to incorporate mobile apps into their practice over the next five years. Furthermore, market research firm Visiongain anticipates mobile health sales of over $10 billion globally by the end of 2015. The surge of mobile health services is fueled by decreased app costs, strengthened consumer trust in app services and significant professional endorsement. The above cited Research Now survey found that 96 percent of users believe their health apps help them to improve their quality of life, while 72 percent of healthcare professionals believe that health apps will effectively encourage patients to take more responsibility for their health. Innovations in mobile health are providing increased opportunities for employees to make more efficient use of their healthcare systems and become more responsible healthcare consumers – that’s good news for your bottom line.

As individuals make greater use of telemedicine and health apps, they are more likely to increase their knowledge and discover viable alternatives to costly emergency room and physician office visits. As health apps become more integral to individuals’ lives, employers can leverage these services to drive positive changes in employee health, reinforcing the directives of their overall wellness initiative—cutting costs and improving productivity.

Explore the innovative wellness strategies that can help you mend your bottom line and improve the health & engagement of your workforce!


Use Rewards to Engage Medicare and Medicaid Populations

Sara Ratner

Sara Ratner

By Sara Ratner, senior vice president of compliance and corporate systems, RedBrick Health

It’s no secret—improving the health of beneficiaries with chronic conditions is essential to lowering avoidable healthcare costs and improving quality of life. Treating chronic diseases accounts for 86 percent of our nation’s healthcare costs1.

In our work with employers, we’ve seen that employees who participate in wellness initiatives—condition-specific or not—can improve their health. Can wellness programming also move the needle for Medicare and Medicaid populations? And if so, how to best engage them?

There are many levers to drive engagement and one is the use of rewards and incentives. At RedBrick, we believe the lessons we’ve learned can be actively adapted to support those with Medicare Advantage and managed Medicaid plans. While these populations can be uniquely distinct and challenging, it is possible to apply strategies and incentive philosophies that effectively engage these populations.

Effective incentive designs can help get participants in programs that start them on the path to better health, reducing both behavioral and biometric risk factors and the medical costs associated with chronic conditions. We’ve seen their impact as we’ve helped employers implement hundreds of incentive designs and analyzed what models work best for different populations.

Though there is no “one size fits all” approach, we’ve been able to quantify the engagement levels associated with different incentive levels, and work to determine which approach best meets client objectives. Whatever the rewards model, the framework should consider:

  • Compliance Requirements. It is important to be mindful of the various laws and regulations that govern incentives to the Medicare and Medicaid population to ensure compliance.
  • Value amount. Within the compliance requirements, the optimal reward size and type depend on both population and individual attributes, as well as program objectives that may be in place.
  • Frequency. Evidence suggests that frequent, small (but meaningful) rewards often outperform larger (but distant) rewards2.
  • Form. Data on reward preferences and demographics can help clients determine what reward is most effective for their audience.

At RedBrick, we’ve seen that a research-backed approach to incentive design can help to engage people, change health behaviors and reduce healthcare costs, especially among those with chronic conditions. And we believe these lessons learned can be actively adapted to support those with Medicare Advantage and managed Medicaid plans.


For more information, contact us for a copy of our position paper, Medicare And Medicaid: Lowering Costs and Generating ROI with Rewards.


1 Centers for Disease Control and Prevention. Chronic Disease Prevention and Health Promotion. [Online]. 2015.

2 Volpp, K., Asch, D., Galvin, R., & Loewenstein, G. (2011). Redesigning Employee Health Incentives—Lessons from Behavioral Economics. New England Journal of Medicine, 365, 388–390. doi:10.1056/NEJMp1105966

Want engagement? Try starting with choice.

Phil Hadden

Phil Hadden

By Phil Hadden, Vice President, Business Development, RedBrick Health

Every day we’re deluged with information and offers vying for our attention. The Internet is teeming with content about our health. How do we make sense of it all and sort out the noise from what’s important?

Successful retailers like LL Bean, Amazon and Netflix have learned that personalizing a user’s experience and serving up relevant choices are keys to engaging shoppers —and keep them coming back. Consumers like to shop with companies who know what they like and show them options that relate to their tastes.

So why should health and wellness solutions be any different? By combining personalization and choice architecture we can provide guidance that taps each participant’s interests and motivations. Each one of us has different intrinsic motivations—like improving appearance, setting a good example for our kids, having more energy, or fitting into a smaller size—it’s these motivations that generate the energy to change. Aligning health improvement guidance with our inner motivations can unlock greater success.

To get better engagement and loyalty, try encouraging people to take small, achievable steps that overcome the inertia that makes it difficult to get started. If these steps align with their intrinsic motivations it’s even easier to make progress. Extrinsic rewards are great, to help people get started, but it’s achieving success—and the confidence that builds as we succeed—that keeps people going.

Once confidence builds, the next step is less scary, and with timely nudges you can keep people moving in a positive direction.

Health isn’t a destination; it’s a personal journey. Forming healthier habits—whether around lifestyle or around treatment adherence and self-care—doesn’t have to be hard. Everyone’s journey is different so be sure to offer relevant choices to help your members find the right path.

How one small thing can change your life

Sanna Yoder

Sanna Yoder

By Sanna Yoder, Senior Director, Content Strategy and Behavior Design, RedBrick Health

Set your alarm 15 minutes earlier and do some push-ups.

Put dinner on a smaller plate or bowl.

Ask your server to double the veggies.

Get some earplugs to block out your partner’s snoring.

Each of these tiny calls to action represents one small step from RedBrick Journeys®, the digital coaching program at the heart of RedBrick’s behavior change system. None of them requires much time or money, and none on its own is the key to health and longevity. But each one of these steps has changed the life of someone I know. And I have some theories about why.

It’s a social thing

My friend Jon surprised me at a school meeting not long ago when he thanked me for encouraging his morning strength-training routine. I was testing our Journeys social posting functionality; turns out he saw my Facebook post about setting your alarm early to exercise.

He took one small nudge from a friend and turned it into a healthy-habit trigger.

Psychologist Robert Cialdini would call this the power of “social proof,” where people tend to act in ways consistent with like-minded peers. In other words, consensus trumps cognition and makes changing behavior a whole lot easier.

You can read more about social proof in the author’s wisdom-packed volume, The Small BIG.1

By the way, triggers also play an important role in Jon’s new habit. An earlier alarm means he doesn’t even have to think about how and when to exercise. He can just get up and do. BJ Fogg of the Stanford Persuasive Tech Lab has a lot to say about triggers.

It’s about the commitment

Another friend marveled recently that she’s made a habit of dining on smaller plates since exploring our Unsupersize Your Meals Journey.

The smaller your plate, the fewer calories you take in over time. That’s regardless of how much food you actually have access to, according to Brian Wansink, author and director of the Cornell Food and Brand Lab and curator of

For my friend, a small step has become a habit in part because she was asked to commit. Core to the Journeys experience is this complete behavioral loop: You choose. You commit. You’re reminded. You complete. And for the right step at the right time—a habit is born.

It’s about seeing with fresh eyes

I am married to a wonderful guy who, bless his heart, snores. (Is there a Journey for that?) Bedtime Game Plan nudges Journeyers to check out the latest earplug technology at their local drugstore if noise is a sleep barrier.

Earplugs are not new. But familiarity had blinded me to opportunity until my Journey nudged me right down the ear care aisle of my local drugstore. The squishy silicon earplugs I found there have frankly changed the quality of my sleep—for good.

Cialdini and Fogg have much more to say on the subject of nudges like these. And RedBrick Journeys have thousands more ways to take tiny, life-changing actions. But the most important small step is the one that will make a difference for you.

What small step—in a Journey, suggested by a friend, or simply discovered—has made a big difference for you? Why did it work? Share it and help spread the power of small steps.


1 Martin, Steve; Goldstein, Noah; Cialdini, Robert. The Small BIG, New York: Hachette Book Group (2014).

Wansink, Brian. Mindless Eating – Why We Eat More Than We Think, New York: Bantam-Dell (2006).

Breaking good: Achieve the chemistry needed for lasting behavior change

Eric Zimmerman

Eric Zimmerman

By Eric Zimmerman, Chief Marketing Officer, RedBrick Health

Habits happen. We form them early and do them often. And because habits become well-ingrained patterns of behavior, they’re hard to break—even if your health depends on it.

Many times, it takes a “wake-up call”—a life event—to spur the action needed to break a bad health habit or establish a good one. A sudden illness, the birth of a child, a change of job—all introduce new motivations, as well as new behavioral cues.

But what about people wanting to make changes in their daily habit patterns without the backdrop of a major life change? What’s the success formula?

First, avoid the common pitfalls: focusing on big, abstract goals, thinking information leads to action, or blaming failure on lack of willpower.

If you want to help consumers break old habits and establish new ones:

  • Tap intrinsic motivations. Consumers tend to know which behaviors are healthy ones—but that doesn’t mean they’re motivated to do them. Instead of telling participants how to avoid a hypothetical future medical condition, ask “What really matters in your life? What would make things better for you?” Chances are their reasons don’t hinge on reducing health risk or bringing their biometric measures into an acceptable range. It’s more likely something that’s important to them, like boosting their energy, looking better or setting a healthy example for family. These intrinsic motivators are a much more powerful determinant of successful behavior change.
  • Encourage commitment to specific, small steps. Big abstract goals can be elusive and even discouraging. Breaking those abstract goals into small, achievable steps— especially within a choice framework—reduces the effort needed to make a move in the right direction. Make sure you include the necessary nudges to cue the new habit as it’s being formed. Once participants start to achieve small successes, it fuels their confidence and motivation to stay the course.
  • Let them choose. Traditional models tend to assess health risk, and then slot individuals into a modality based on their level of risk. High-risk individuals typically get phone coaching. Lower-risk individuals get lower-cost assistance like educational resources or online coaching. Instead, try putting the person back into the personalization. Let individuals select a modality based on their personal preference. We’ve applied this approach within the populations we serve and have observed profound effects. For example, we’ve learned that 80% of those with chronic illnesses, given the choice, opt to focus on a lifestyle issue rather than a condition. And when we let them, we end up doing three times as much condition-relevant coaching—by simply letting people start where they are ready.


And what about rewards? They certainly help create focus and initial engagement. However they likely aren’t enough—on their own—to create lasting habits. But, with the right behavior design, new habits happen.

What’s your habit-forming story? We’d love to hear it.

Is the definition of health engagement changing?

Karin Bultman

Karin Bultman

By Karin Bultman, Vice President of Market Development, RedBrick Health

In April 2015, we commissioned a survey to explore how buying patterns, program offerings and program design have adapted given the rapidly changing healthcare environment. This survey was a follow-up to a similar survey we sponsored in 2010. Our goal was to better understand benefits strategies around wellness and health management and how they relate to healthcare costs.

One of the things we were curious about was how employers are defining engagement. As wellness programs mature, is the definition of engagement evolving as well? Are employers looking for more than mere participation? And if the definition of engagement is evolving, how will this impact programs for employee health and well-being?
As it turns out, we did see the beginnings of a shift. While employers largely still define engagement in terms of participation, there is an increasing awareness of the importance of an attitudinal awareness of healthy living—and how this impacts employee health.

As part of our survey we asked respondents to characterize their organization’s definition of engagement in an open-ended response. They conveyed definitions of engagement that include employees:

  • Knowing their risk factors and take measures to maintain a healthy lifestyle.
  • Taking interest in learning how to have a better health lifestyle.
  • Paying attention to health messages and participating in healthy activities.
  • Working to improve quality of life through efficient health management.
  • Taking ownership of all aspects of health.


Given what we saw in the survey, and our experience in the day-to-day of employee health and well-being, we think it reasonable that over the next few years, the definition of engagement will continue to shift toward one that encompasses behavior change and improvement in health status. This continuing shift has ramifications for:

  • Which (and how many) programs employers should offer.
  • Reward program design.
  • Communications campaigns that need to reach all demographics and modalities.
  • Making getting healthy easy by leveraging social and community connections, and connected devices.
  • The link with health care delivery and how can wellness be part of the consumer and patient experience.


Yes, the definition of engagement seems to be maturing—and with this maturing will come the need to take a new look at the programs and options available to not only get employees on the path to wellness, but get them to a destination.

How does your organization define engagement? And is that definition changing?

See more survey results in our upcoming white paper, Employee Health Management Comes of Age, on

The seven key principles of health behavior change (and how technology empowers them)

Eric Zimmerman

Eric Zimmerman

By Eric Zimmerman, Chief Marketing Officer, RedBrick Health

This post was adapted from an article originally published by the Institute for HealthCare Consumerism (IHC).

I first cut my teeth as a wellness program coordinator during my internship at the Mattel toy company. It was truly the dark ages of technology. No Web. No smartphones. No social media. We scanned HRA questionnaires through optical readers and gave out printed reports. We delivered classroom educational programs and one-on-one counseling. We staged worksite challenges and tallied team data by hand into leaderboards.

Indeed, we lacked the high-tech tools that make up the modern wellness arsenal.

Fast forward to today. So much has changed. But let’s start with what’s stayed the same. Behaviors—inactivity, poor nutrition, inadequate coping skills, spotty treatment adherence, use of tobacco and other substances. What’s more, there’s greater financial responsibility in the face of an increasingly complex and still weakly coordinated healthcare system, driving the need for greater “healthcare consumerism.”

So is technology transforming the delivery of worksite wellness? Clearly it is. But not just because it lets us reach people faster and cheaper, or create cool stuff. It’s because we can put into practice powerful principles of behavior change in a more scalable and effective way—and make it more fun at the same time.

Here are seven key principles we use to guide the consumer experience, and how technology powers them.

  1. Know who you’re talking to, not just what you’re talking about. It’s not about educating or motivating, it’s about tapping existing motivation. Use technology to capture what moves each individual and use it in creating your experience.
  2. Get small. The classic educational paradigm teaches, encourages goal setting and relies on information to drive action. The new paradigm uses technology to get you to commit to very small steps. Why do small steps work? They help ensure success, which boosts confidence and creates momentum, moving you closer to your goal.
  3. Put the person back into the personalization. Don’t focus so much on tailoring content, but rather on using technology to give you a few relevant choices. Think Amazon, Netflix, Pandora. Get people active in the design of their own health journey.
  4. Give a nudge. This is where mobile technology shines. As people commit to each small step, use data-driven, automated triggers, tuned to individual preferences and schedules, to gently trigger desired behavior.
  5. Measure what works and iterate. Not all small steps are created equal. Use technology-captured performance data to tune experience. Enable the things that work—for individuals or groups of like individuals—to be served up more often.
  6. Make it social. You don’t need to create a new social network for health (though you can). The family dinner table can be a powerful network. Let people engage those who matter most—via Facebook, Twitter or simply email—with each step.
  7. Create fast feedback loops that reinforce. Humans don’t come with dashboards. Fortunately, an explosion of personal technology helps close that gap. Let people link to an array of personal devices—wearables, apps and smartphones—to essentially create a coach-in-your-pocket to reward and reinforce your progress.

Is it technology that’s making the difference? Yes, in that it’s powering smarter design based on a more informed view of how behavior works. Does it work? We’re seeing the rapid growth of a rich data set that suggests it does. And we’re just at the beginning.


Be mindful. It’s practical.

Sanna Yoder

Sanna Yoder

Part 2 of a 2-part series
By Sanna Yoder, Senior Director, Content Strategy and Behavior Design, RedBrick Health

In part 1 of our series, we introduced mindfulness as a practical solution to address the stresses of everyday life and discussed a few mindfulness practices. In this post, we’ll introduce a few additional mindfulness techniques, including one from Amit Sood, chair of Mayo Clinic’s Mind-Body Medicine Initiative.

Sood integrates elements from neurosciences, psychology, philosophy and spirituality to offer a scientific approach for stress management. His “Guide to Stress-Free Living1“ offers countless simple but profound exercises to reframe the stresses of daily life at work. He recommends a simple practice of joyful attention at least four to six times a day.

Here’s how it works: While your computer starts up, close your eyes and send an imaginary thank-you email to someone who’s helped you. While the traffic light is red, note of the shape and color of the cars around you. For just a few seconds, relax all your “frowning” muscles. Refocusing the mind, says Sood, helps cultivate flexibility of attention, allowing you to switch between a narrow focus and broad, relaxed attention at will.

At RedBrick, our coaches and our RedBrick Journeys® digital coaching program promote a practical approach to mindfulness that you and your employees can try right now with ideas like these:

  • Practice gratitude. Set a reminder for the same time each day to focus on three things you are grateful for.
  • Breathe. Take 4 square breaths: Breathe in to a count of four, then hold for a count of four. Breath out on four, then hold again for four. Repeat.
  • Visualize. For five minutes, close your eyes and visualize a vacation.
  • Simply wait. Next time you’re frustrated, pause 30 seconds before responding.
  • Start a meal mindfully. Take 10 deep breaths before lifting your fork.
  • Find a mindful app! Our own chief medical officer, Jeff Dobro, sets one of his smartphone apps to sound a calming chime at random times throughout his day.

Which one appeals to you most? Have you taken a “time out” today? If not, take one of these to your work group right now. Give them the immediate gift of a few moments of mindfulness—and over time, use these techniques to boost their resiliency.



1Sood, Amit, M.D., M.Sc. “The Mayo Clinic Guide to Stress-free Living.” Da Capo Press: Boston, MA. 2013.

Be mindful. It’s practical.

Sanna Yoder

Sanna Yoder

Part 1 of a 2-part series
By Sanna Yoder, Senior Director, Content Strategy and Behavior Design, RedBrick Health

No matter what the make-up of your population, there’s a cost-effective prescription for better health—one that may help lower blood pressure, reduce the effects of depression and anxiety and improve sleep. It may even help control cravings.1

It is called mindfulness, and it’s a practical solution to address the stresses of everyday life.

Mindfulness costs nothing but a few moments of time. It can be practiced anywhere. And while it can help employees feel better in the moment, it may even have a long-term impact, improving job performance, reducing turnover intention2 and increasing the resiliency of your work group.

But how do you “get mindful?” Or promote the practice in your work group? Do you have to carve out 20 minutes to sit and meditate? Do you need special training? Do you have to leave your desk or listen to a soothing voice? Do you have to close your eyes?

These are all valid aspects of being mindful, but sometimes, in the hectic pace of today’s workplace, they’re impossible. That’s why many mindfulness experts promote what author and scholar Karen Kissel Wegela calls informal mindfulness practices,3 or everyday activities that can support an attitude of mindfulness. Here are a few of her suggestions:

  • Simply pay attention to the sights, sounds, colors and movement around you in the moment.
  • Try neither too little nor too much.
  • Pay attention to what’s happening in your body.
  • Let go of distractions.

Rick Hanson, psychologist, best-selling author and senior fellow at UC Berkeley’s Greater Good Science Center, encourages a practice known as Taking in the good. Hanson asserts that the human brain is wired to be like Velcro® for bad experiences and Teflon® for good. It takes at least 20 to 30 seconds for a good experience to register, sink in and rewire the brain into feeling more relaxed, at peace, resilient and ready to take what comes. Focusing for 10, 15, even 20 seconds periodically throughout the day on a positive experience like feeling secure, feeling tenacious or expressing gratitude can reinforce the good.

Here’s a brief exercise from RedBrick Journeys® you can try right now:

Look at your cup of coffee—now imagine all the help that got it to you, from the farmer who grew the coffee beans to the artist who designed your mug.

A few seconds well spent. In part 2 of our series, we’ll take you through a few more mindfulness exercises you can use for an immediate impact on your day—or your work group.


See part part 2 here.



1National Institute of Health. “Meditation: What You Need To Know.” December, 2007. [downloaded from]

2Dane, E., and B. J. Brummel. “Examining Workplace Mindfulness and Its Relations to Job Performance and Turnover Intention.” Human Relations 67.1 (2013): 105-28. Web. 28 June 2015.

3Kissel Wigela, Karin. “Practice Mindfulness Without Meditating.” Psychology Today. Feb 18, 2010. [downloaded from]

Do outcomes-based rewards produce better outcomes?

Eric Zimmerman

Eric Zimmerman

By Eric Zimmerman, Chief Marketing Officer, RedBrick Health

A recent survey of employers with more than 500 employees confirmed what many of us expected to see—a continuing rise in outcomes-based incentives programs.1 Our own survey research shows a strikingly similar trend among employers with more than a thousand employees: Many are moving to outcomes-based designs.2

It seems like a logical assumption is being made here—outcomes-based models that tie rewards to key behavioral and biometric results are likely to produce better biometric outcomes.

But is there evidence to back up that assumption?

We recently reviewed the year-over-year program results of over 80 reward designs that reached nearly 500,000 individuals. We divided the sample into four reward design types:

  • Participation-based models that rewarded members with dollars or points for completing a health assessment, screening or other behavior, with no tie to a healthy result.
  • Partial outcomes-based models that rewarded points or credits for biometric measures within a healthy range (subject to the availability of reasonable alternative standards), and also for participation in healthy activities.
  • Outcomes-based models that penalized those whose biometrics were not within a healthy range and required them to “earn money back” through risk-matched reasonable alternative standard activities.
  • Programs where there was no incentive or punitive outcome.


Here’s what we found. Engagement levels were positively associated with improved biometric outcomes. So were reward levels. (In fact the two are highly correlated, so it’s likely the effect of rewards is really the lift they create in engagement.) However, we could find no statistical evidence that participants in outcomes-based models achieved better outcomes than those in other models.2 That’s not to say it isn’t there—we just didn’t see it in this large sample.

So the answer according to this analysis is no, outcomes-based designs do not produce better outcomes than participation-based designs. That may be a relief to those who’ve felt pressure to join the trend toward outcomes-based reward designs, but were concerned about backlash.

The takeaway: If you’re going to focus on one thing, focus on what gets you real engagement in your population, whatever that might be. It’s engagement that gets you results.



1Gene Baker, G., Dermer, M., & Wolfsen, Brad. (2015, April 29). 2015 bswift Benefits Study Preview: Wellness and Incentives [Webinar]. Retrieved from
2RedBrick Health, Analysis of results by reward design, 2013 to 2014.