Increase Engagement in Diabetes Programs With Behavioral Economics   
Workspan Daily
November 21, 2022
Key Takeaways
  • Engaging employees. Diabetes is among the most prevalent health conditions that drive employer healthcare costs, and there are effective programs that can help prevent or better control this disease. However, employers often have trouble encouraging members to participate in these programs.
  • Higher costs. The cost of caring for individuals with diabetes is 2.3 times higher than non-diabetics, and over 20% of total U.S. healthcare spend is attributed to people with diagnosed diabetes.
  • Improving outcomes. Some suggestions to improve employee engagement and outcomes for members with diabetes or at risk of diabetes include providing easy access to affordable programs, crafting communication and using social networks.

Employers are expecting rising healthcare costs and report that cost management (67%) and affordability (42%) are their top priorities over the next three years.   

Diabetes is among the most prevalent health conditions that drive employer healthcare costs, and there are effective programs that can help prevent or better control this disease. However, employers often have trouble encouraging members to participate in these programs, which only save costs if they successfully engage members.  

The cost of caring for individuals with diabetes is 2.3 times higher than non-diabetics, and over 20% of total U.S. healthcare spend is attributed to people with diagnosed diabetes. Diabetic complications such as heart disease, nerve damage vision impairment and kidney failure represent large costs to health plan sponsors and productivity loss for employers. Most importantly, these complications lead to a significant decline in quality of life for diabetics.   

Employers are cognizant of these facts and a majority (70%) report that they will focus on metabolic syndrome and diabetes in the next three years as a means of improving member health.    

WTW has six suggestions for employers to increase program engagement, decrease risk and improve outcomes for their members with diabetes or at risk of diabetes.   

1. Provide Easy Access to High Quality, Affordable Programs  

Humans are conditioned by evolutionary biology to make decisions that take the smallest amount of energy. Employers can use choice architecture to make it easy for their members to participate in diabetes and metabolic syndrome programs.   

Employers can offer programs free of charge, and simplify enrollment with single sign-on, a QR code, or a single number to call for those who are more comfortable with phone versus digital methods. They can prioritize programs which provide complimentary supplies to decrease logistical roadblocks to test blood glucose, and they can offer a value-based formulary with no or low out-of-pocket costs for diabetic medications.   

Programs that allow virtual participation through asynchronous applications are more convenient and can increase engagement. Many diabetics also have high blood pressure or other chronic diseases. A single, integrated program offering that addresses multiple needs can simplify navigation.  

2. Communicate the Value of Participation   

Behavioral economics research shows that people hate losses more than they like gains, and employers can use this loss aversion to encourage initial and persistent participation in diabetes programs.  

For those enrolled in diabetes management programs, consistent engagement may be supported by communications that focus on the loss that is avoided through action. For example, employer or vendor communications can focus on avoiding the complications of unmanaged diabetes, including vision loss, nerve damage, heart disease and stroke. Communications can encourage members not to let the time they’ve already committed go to waste and avoid missing out on activities members love.   

3. Craft Communications That Leverage Optimism Bias   

People who qualify for diabetes prevention or management programs may think they can address their health issues on their own without an employer-sponsored program or professional help.   

Communications can point out that even the most successful people need help at times. Employer communications can also focus on positive messaging on accomplishments and milestones. For example, digital solutions that celebrate members throughout various milestones during a weight loss journey can encourage continued persistence.   

4. Utilize Stories to Motivate   

Compelling statistics that demonstrate the health and cost impact of diabetes diagnoses and complications alone don’t drive substantial behavior change; people are more moved to action by powerful stories than by impressive statistics.   

Both employer and vendor communications can take advantage of narrative preference by using storytelling to nudge members to engage in medical management programs. Communications can make it real by sharing a story about how a pre-diabetic member was empowered by a Diabetes Prevention Program to make lifestyle changes and has since avoided a diabetes diagnosis. Diabetes management programs can include stories around how a vendor helped a member manage diabetes and maintain their quality of life.

Communications that leverage data should clearly tie to the broader narrative.   

5. Use Social Networks to Nudge Behaviors    

People want to emulate the behaviors of their friends and those they respect, so an employer can report on how many colleagues have been helped or are currently engaged in a program. Successful programs often have a social media element that allows participants to share their success, and support or affinity groups can help encourage ongoing participation.   

Employers can encourage leaders who engaged in programs to share their successes to inspire employees to model their behavior.   

6. Appeal to Intrinsic Motivation to Drive Change   

Focus attention on the goals of individuals, which can be highly motivating. Within program design, members should be empowered to help craft their care plan and set goals in partnership with a coach or clinician. Coaches can help users to uncover their personal motivations for keeping diabetes in check.    

Employers can identify what really matters to members through surveys, focus groups and other data gathering methods. Craft communications to demonstrate how participating in employer-sponsored programs can help members achieve their goals.   

More member engagement in effective programs to address increases in obesity, metabolic syndrome and diabetes can lead to lower costs, less disability, and increased quality of life.  Investing in helping employees avoid or manage diabetes not only enhances employee wellbeing but can improve employers’ bottom lines.   

Employers should understand their employee population’s unique needs, challenges, and preferences, and apply behavioral economics to choose and communicate programs that will promote risk reduction, decrease the incidence of diabetes complications, and help control healthcare costs.    

Editor’s Note: Additional Content 

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