Can Groupon Replace Health Insurance?

A recent article by BenefitsPro highlighted the growing trend of uninsured using daily deal sites for healthcare. You don’t need an article to know that this is on the rise – my inbox is regularly flooded with dental offers, skin care regiments, and other health services. In fact, the article says nearly 10% of daily deals last November were health or medical related.

There are certainly benefits to these deals. Consumers, especially those without insurance, have access to common healthcare procedures at a lower cost. As with any daily deal, businesses also benefit by using this as a platform to find and retain new customers.

Unfortunately, I see plenty of disadvantages that could hurt the customer in the long run. First, while customers clearly benefit from lower cost preventative services, many of the deals are for more expensive treatments or cosmetic procedures (e.g., laser eye surgery). These may require the customer to have screenings and a full understanding of the treatment. But with a ticking clock urging them to buy before the deal expires, some customers may make impulse decisions. Best case, they’re out several hundred dollars. Worst case, they put their health at serious risk.

Second, a doctor or center that agrees to discount services may not have a high degree of quality or experience. Clearly customers need to have the right expectations for what they’re getting, but there’s also a moral question of whether deal sites have the responsibility ensure their products meet certain standards.

Third, one benefit of insurance is that the provider can use data from doctors to track a patient’s health and proactively screen for any issues. When a consumer relies on Groupon, they are bypassing this system by running from doctor to doctor. Obviously this is tricky as is with the uninsured, but could be more so with these price sensitive customers.

That said, I think the daily deal model could work under the right circumstances. I could see something like this being valuable for the individual exchanges that will be created through the Affordable Care Act. Customers going through these exchanges will already be cost conscious, and, if the individual mandate stands, they will be forced to purchase insurance. A provider could partner with a daily deal site and promote offers targeted to its members that go above and beyond their coverage, providing more value to the customer. This type of arrangement could provide the oversight and quality assurance missing from daily deals today while not eliminating any of the benefits.

Do Studies Support Legislation To Reduce Childhood Obesity?

I recently ran across a couple interesting articles examining the relationship between junk food and childhood obesity, with implications on legislation. Somewhat surprising findings:

1) A study by the American Journal of Preventative Medicine found that fast food restaurants did not have the intended response to a ban on kid’s meal toys. The study was based in Santa Clarita, CA, the first city to pass this type of ordinance, and found that restaurants responded by eliminating the toys and promoting existing menu options rather than retooling meals to allow toys to remain on the menu. While there are a number of reasons to choose this strategy (e.g., long lead time to revamp menus, extra costs associated with toys), it demonstrates that the legislation failed to deliver more healthy meals. What will be interesting to see is the impact to sales and how much demand they toys accounted for.

2) Another recent study from Penn State took the blame for poor nutrition away from school and placed it on the home. The study showed that while access to junk food at schools rose between fifth and eighth grade, obesity rates among the students in the survey declined. This led the team to conclude that obesity was influenced less by school choices than by other factors. While this finding isn’t groundbreaking, it does bring into question investments being made to reduce junk food at schools and improve nutrition. If access at school has limited impact on obesity rates, would energy and resources be better spent on parent education and access to healthier foods at home?

You could argue these measures were successful because they eliminated a marketing gimmick targeted towards kids and reduced exposure to unhealthy foods. Some restaurants, potentially spurred by this type of legislation, are proactively taking new measures to improve kid’s meals (e.g., McDonalds will be automatically adding apples to Happy Meals starting in March). But these are great case studies on how legislation may not be an effective tool if businesses can work around the rules or the real issues are outside the scope of the law.

How Can Sex Games Lead To Safer Sex?

A recent ad campaign in Sweden managed to shatter a stigma by tapping into the male competitive spirit. To promote safe sex, an ad agency handed out 50k condoms, each with a QR code that installed an app to measure how good you are in bed. After instructing the user to put on the condom, the app measured various factors (e.g., sound, duration, rhythm), then uploaded the data to a central server. Users could then see their own performance and compare with others across the country.

You can call this crude or tacky (especially if you were an unwilling partner), but I think it’s brilliant. This ad agency was able to reach a captive audience by helping users to quantify something every guy wants to brag about, then giving them a semi-voyeuristic view into where they stack. Enabled by technology to collect and share this information, this campaign allowed the agency to attach a relevant message regarding safe sex and address a social issue.

Are there other groups of people or conditions that could benefit from a similar program? Could diabetics monitor how stable their glucose levels are then compare with other users? How about tracking Facebook or general computer usage to highlight behavior traits (e.g., user spends 30 mins per day updating statuses, 45 mins per day viewing friend profiles) and discourage people from spending so much time in front of the monitor?

How Can Fantasy Football Create Healthier Lifestyles?

A friend recently told me about a Biggest Loser-type challenge that he started with his family. They were inspired by his father, who recently had heart issues, and saw this as a way to collectively support his new health routine. Although it was spawned by an unfavorable situation, this is a great example of how group challenges can be used to change behavior:

1) Rallying Cause: Experiencing a powerful event or situation can provide the catalyst to start and maintain a healthier routine. In addition to triggering the new behavior, this story can help publicize the cause and reinforce the goal, similar to people who shave their head in solidarity with a cancer-stricken family member. Unfortunately, the majority of these triggers are negative events – are there positive motivators that can create the same sense of urgency?

2) Competition: Adding competitive elements keeps people motivated to stay on course and outperform. As much as I hate recent gamefacation trends, these social motivators can be valuable as long as the goals remain realistic and no one person gets too far ahead or behind to be a disincentive

3) Measurement: Like the Biggest Loser, my friend’s challenge is measured using weight loss. Having an easily quantifiable goal gives each of the participants a simple way to gauge their progress

The bigger question is how to scale these types of challenges up. The most successful model could be to align people with similar goals into small group challenges. A fantasy football model could work – a person can join a private or public challenge that is moderated by an individual, who puts various rules and tracking metrics in place. Tracking could be done by the individual or integrated with other existing apps (e.g., Nike+, Runkeeper) based on the challenge, and could include a reward system (e.g., Nexercise app). The best example of this model currently in development is Keas, a social health and wellness network, which is a little broader and primarily aligned with employers and employees.

Can the Healthcare Industry Improve New Year’s Resolutions?

The New Year brings an opportunity to reflect on the past 12 months and set goals for self-improvement. Most of us will dust off old resolutions given that most end in failure (almost 90% according to one study). Considering half of people will make a health resolution this year, there is a huge opportunity for healthcare companies to engage an unusually captive audience to keep them on the right path. I believe they can get involved in three ways:

1) Goal Setting: Using industry research or proprietary data, healthcare companies may be able to identify improvement areas, provide specific guidelines to set realistic targets, and clearly illustrate how achieving the goal will improve the consumer's life. For example, a health insurance company may use data to identify specific risk factors and potential behavior changes for a member (e.g., Patient X needs to lose weight based on BMI). Based on their research and Patient X’s profile, they can calculate the optimal amount of weight Patient X should lose over a year. Finally, by demonstrating the insurance premium savings and added life expectancy, Patient X may feel motivated to set these goals

2) Program Development: Users need to develop a realistic action plan and healthcare companies can help users create a timeline and provide advice. For example, after Patient X decides to lose weight, milestones can be set throughout the year (e.g., how much weight should be lost each month) and the company can provide advice on steps to take each month. While Patient X’s insurance company may not provide the services it recommends (e.g., gym memberships, health food providers), the company could partner and offer discounts with other suppliers

3) Program Tracking: Users also need an easy, unobtrusive way to track their progress. This tracking could be through a smart phone app or website, but would ideally be linked to the custom timeline and provide reminders / motivation to the user

The challenge with these solutions is that they require significant infrastructure and data, and ROI could be difficult to calculate. If this is appealing, however, a company could start with program tracking – there are some apps and websites dedicated to monitoring progress (e.g., Big Change). By partnering with one of these developers, a company could start helping customers achieve their existing goals and gradually roll out other features over time.