Insurers Are Plugging Into 'Gamification,' But Are Only Beginning to See Its Potential
Published in Health Plan Week, April 23 issue, copyright © 2012 by Atlantic Information Services, Inc. Reprinted with permission from Atlantic Information Services, Inc.
If UnitedHealth Group had its way, all of its members would own a Microsoft Xbox video game system and would use it every day. While promoting video games might sound like a way to grow couch potatoes, UnitedHealth and several other major insurers are using concepts behind popular video games to promote wellness, encourage exercise and boost social interactions between people -- and ultimately improve health outcomes and lower costs.
But health insurers have yet to harness the full potential of gaming for their members, says Kris Duggan, CEO of Menlo Park, Calif.-based Badgeville, which consults with companies and helps develop products for "gamification" efforts. Kaiser Permanente is one of its customers through its Avivia Health unit.
Bob Plourde, vice president of innovation and research and development at UnitedHealth, agrees and says that despite the excitement over using games to drive member behavior, insurers still have a long way to go and need to make significant investments if they are to achieve sustained results.
"If you look at the health care industry in general, it's not the most terribly exciting of times. People tend to check out very quickly. If we can get people engaged, more knowledgeable and get them to do activities, that's a huge win for us," he says.
UnitedHealth -- along with insurers such as Aetna Inc. and Humana Inc. -- is increasing its focus on gamification, which involves the use of game-design techniques, game thinking and game mechanics to encourage people to engage in certain behaviors. And while gamification has been used in other industries for some time, health insurers are only beginning to understand the potential.
Although the programs are in their incipient stages, at least one insurer has started to see positive results -- a decline in body mass index (BMI) for members using an exercise game -- through its gamification efforts.
"How can we take what is out there, like an Xbox Kinect, dance pads, Wii [and figure out] how can we use those technologies in a health or wellness type setting?" Plourde asks. "We're taking the psychology and the mechanics that have made the gaming space extremely successful. How can we take those mechanics and engage people in a very different way?" Kinect refers to the motion sensing input device that attaches to the Xbox console.
Plourde tells HPW that one of UnitedHealth's programs built around Xbox Kinect is known as JOIN, which is designed both for children who are obese or prediabetic, and for adults as a disease prevention and control program. With the game, in order to get a character on the screen to move, a person must actually run in real life.
In February, UnitedHealth collaborated with a local school district in the Houston area to give students the option to participate in a program that measures the potential impact of computer-based gaming, using Xbox Kinect, on physical activity and weight loss when combined with a weight management program. The insurer also has a mobile app for smartphones, called OptumizeMe, in which users can create and challenge each other to fitness competitions. The app tracks their progress and rewards them with virtual badges.
Humana is also using Xbox Kinect. The company has partnered with video game developer Ubisoft, which manufactures an exercise game for the system, to offer three workout games to members.
"Humana members are now able to seamlessly earn Vitality Points for exercising using Ubisoft's breakthrough fitness games," Shankar Ram, Humana's vice president of innovation, tells HPW. The points can be used for items including movie tickets, electronics and vacations. "This partnership marks the first time a fitness video game has been integrated with a health care solution in this way."
Aetna Sees BMI Decline
Aetna also is heavily engaged in gamification as it sees social interaction as a key to achieving positive outcomes, says Dan Brostek, head of consumer engagement at the insurer.
"Gamification works well when [a social element] is embedded in the game," he tells HPW. "When I can connect with what I'm doing within a social network, there's intrinsic value."
In 2010, Aetna launched Get Active!, a team-based fitness and nutrition program for employers that uses online social networking to encourage colleagues to work together to achieve health goals. The program allows participants to schedule group exercise opportunities, find colleagues with similar health interests, use online fitness and nutrition trackers and participate in team competitions.
Brostek says that 25 of its group plan sponsors offer it to employees, and results show that those employees that participated in Get Active! had a body mass index (BMI) reduction of 7.8 points compared with those who did not enroll in the program. A BMI of 30 or above is considered obese, while 18.5-24.9 is considered normal weight. Although gamification programs rely heavily on technology, Brostek says that doesn't mean it's only younger members who take advantage of the programs.
"When you look at the statistics on utilization of technology, social network, people that are Generation Y, Generation X, Baby Boomers, they are all embracing and utilizing these channels. Some of these experiences may be utilized more within certain demographics."
Plourde adds that his wife uses their family's Xbox system for her fitness program, making it more than just a standard entertainment device.
"If you looking at something like [getting a game device], it's a great way of getting into the household and engaging people," he says. "There are other opportunities to participate, such that those on Medicare or in retirement could potentially be used, such as with memory-type games."
While Plourde declined to say what UnitedHealth is spending on its gamification efforts, he says it's very important to the company. And in regard to getting Xboxes in the hands of members -- the lowest-priced Xbox system with Kinect retails for $300 -- he thinks that employers might help to shoulder some of that cost for employees. Also, Microsoft released in February a version of Kinect that connects to a personal computer that retails for $250 -- which could be more appealing to members, he adds.
Could Games Capture Key Data?
Duggan tells HPW his company has received a few calls from large health care companies asking it to create games. However, he says that the first step a health insurer must take when going into gaming is determining what they want to get out of it.
"Gamification is really about thinking through what we are really trying to achieve and how can we use human psychology, along with technology, to create those desired business outcomes," he adds.
Ultimately, gamification is about motivating people and driving behavior. For health insurers, games can lead to serious benefits, Duggan says. A game, for example, might encourage members to log prescription medications that they've taken. "Then the insurer wins and the patient wins. That doesn't [necessarily] require a game, but using psychological techniques."
In the future, Duggan envisions that insurers could use gamification for data mining since the games will generate a lot of data. "If there are things that are actionable from your data, you should make sure that your technology and your systems are in a place to support that." He adds that mining can be used to provide better service to consumers, as well as improved support and care.
And while access to a ton of data could leave insurers open to privacy issues, Duggan warns that any efforts in handling data should done legally and consistent with what members expect from their provider. "Track everything, but do it in a way that is consistent with personally identifiable information and best practices."