Gamification Ratchets Up Employee Engagement

On a mission to improve health literacy among its employees as a pathway toward improving health outcomes, Blue Cross and Blue Shield of Minnesota found a solution that not only engaged them, it turned some into "change prophets."

Blue Cross and Blue Shield of Minnesota's launch of an educational game to help its employees better understand their health insurance benefits outperformed the health plan's expectations and highlighted a new population that is instrumental in creating a successful internal messaging launch—employee champions.

Matt Marek, vice president of product and consumer experience for BCBS MN, says employee champions are a cross section of workers that have one thing in common.

"They want to make a difference; they want to be a change agent," he says. "They're almost like change prophets. It is a healthy mix of new and more tenured employees, but they're celebrating something they believe in."

The issue that stirred up BCBS MN employees' excitement was increasing health literacy. As documented by the Agency for Healthcare Research and Quality (AHRQ) and the Harvard School of Public Health, there is a significant correlation between health literacy and hospitalizations, ED use, and prescription adherence.

Essentially it boils down to this: the less a patient knows, the more expensive their healthcare is without the benefit of a better outcome.

BCBS MN's ultimate goal of improving health and health outcomes begins far earlier than when a member walks through the doors of a doctor's office or hospital. It starts, says Marek, with knowing when to utilize provider services.

"The problem is that [only] 20% of members and employees understand their benefits," he says.

Instead of sending out another round of memos explaining how insurance works or holding an employee meeting explaining insurance benefits, BCBS MN decided to give its 3,000 employees access to Healthcare University,  an interactive online program that uses videos, quizzes, and games to teach employees about their benefits and how to make more cost-conscious healthcare decisions.

"We've tried to educate our members," says Marek, echoing the sentiment of other employers who've attempted to increase the health literacy of their own workforce.

The tool, developed by Change Healthcare, a Brentwood, TN–based company that works with health plans to increase member engagement and reduce costs, awards points and badges to users who master a course on healthcare education.

"We were testing the theory, 'Can gamification change behavior?' " What they learned was that "Gamification is a great way to educate," says Marek.

For BCBS MN, the pilot curriculum included ten courses. Each begins with a 2–3 minute animated video. Users then answer a five-question quiz, which unlocks a game and leads to more subject areas, as well as points and badges that are made public on a leader board visible to BCBS MN members.

The program launched in February, so it is too early to tell if the games led to the ultimate goal of a behavior change, but Marek was encouraged to see employees beat every goal BCBS MN set for participation.

Out of 3,000 employees, 1,343 registered for Healthcare University. The 38% participation rate exceeded the health plan's goal of 20% registration.  "We were absolutely thrilled," says Marek. "I wasn't sure where we would land."

The communications strategy to launch the program was relatively simple – emails were sent, icons pushed out to employee desktops and a takeover of the company's intranet for several days.

The real key to getting employees registered was not in catchy graphics and slogans. It was all about people.  BCBS MN's CEO Michael Guyette set the tone for participation by registering and using the tool himself. Other leadership followed, as did employees, and this is where Marek says he saw the excitement for health literacy come alive. Some employees then "took it upon themselves to champion" the education portal. Marek says the internal encouragement was no surprise because he says the culture of BCBS MN is supportive.

"We didn't create employee champion groups before the pilot," he says. "Identifying employee champions is part of our culture. We've taken an active role in attempting to be more transparent with projects and encouraging people to be more involved."

In addition to blowing past its registration goal, BCBS MN also saw its users surpass the company's 30% completion rate of at least one subject buy double digits. Initial results saw 53% of users finish one subject, and 62% of users who completed one course went on to finish all of them.

Another key to its internal marketing campaign was timing. The pilot launched in February.

"We tied it into a time of year we thought would draw more attention," says Marek. "It is part of the reason, I think, healthcare is broken— open enrollment, benefit changes … it is all crammed together in the fall."

It's not clear if the animation, games, and creative content will eventually lead to consumers making better, more informed decisions about their healthcare. But the successful launch of the tool points to the importance of having a culture that supports the mission of an organization.

When employees see leadership "living the mission," pushing out a marketing message to employees can take on a life of its own, doing a lot of the legwork of posters and elevator wraps.

"The employee champions are important to the process," says Marek. "We got more bang for our buck."

BCBS MN is now reviewing how to reward behavior change, and considering whether to extend the healthcare education portal beyond its employees to its members in 2014.