Believing in Behavior Change
Hi. I’m Matt Wallaert and starting today, I’m Clover’s new Chief Behavioral Officer or CBO.
As you may have noticed, we don’t usually do a blog post every time we hire someone. After all, we grew our team by over 300 people last year to meet the needs of our members and develop our technology. But given that I’m the first CBO at Clover (and at any health insurance company, so far as I know), an introduction seems appropriate. Especially because the desire to employ a CBO is part of what makes Clover different from other health insurance companies.
“People can’t change” is one of those axioms you hear so often that it is easy to start believing it’s true. Certainly other health insurance companies seem to believe it. After all, think about the basic business model of health insurance: companies are paid premiums to insure the health of their members. In return, when members get sick, the insurance companies pay for their treatment. So being profitable is ultimately about ensuring that the cost of treatment is less than the total premiums.
However, if you believe people can change, that they have some control over their own health, then the natural thing to do as a health insurance company is help them be as healthy as possible. After all, by helping your members be healthier, they’ll need less treatment and you’ll have a better chance of staying profitable.
Yet that isn’t how you see most insurance companies behaving. They really only show up when people are already sick and their primary function is an economic transaction. To me, the implication of building a business that way is obvious: if traditional insurance companies know that healthier members are beneficial and they aren’t spending resources to help their members become healthier, then they must not truly believe their members can change and improve their health.
This lack of belief in people comes out in other ways as well. Have you ever talked to an insurance company about a claim and felt like they blamed you for being sick? That they treated you as though your illness was due to some sort of internal failing, as if you didn’t want to be healthy? Part of believing that people can’t change is the assumption they don’t want to change, or that they do and are simply too lazy.
I don’t believe that and neither does Clover. And science agrees: years of research have shown that people can change. But even though I am a scientist by training, I don’t want to introduce myself by throwing studies at you. Instead, let me tell you a story from my own life.
About two years ago, I put on about ten pounds. When I went for my annual checkup, my doctor said, “Matt, you really need to care more about your weight.” She assumed my weight gain was about my motivation, something internal to me, and that the reason I gained weight was because I didn’t care enough.
This is my son Bear. He’s about two years old. And he’s the reason I weigh a little more now.
Nothing about my desire to stay healthy changed. If anything, I want to be healthy more than I ever have before, because I now have this awesome kid who depends on me and insists I chase him around the park without getting tired.
What changed was my environment. I don’t sleep as much as I used to (teething!). My meals are more likely to be quick and not as healthy because they’re squeezed in between being a parent and a full-time CBO. And the exercise I used to get boxing regularly has fallen by the wayside. It’s hard to get to the gym and into the ring when there are other demands on my time.
Bear is what my doctor and my insurance company missed. While they were busy assuming an internal failure of motivation, I was facing a new world of external pressures. Recognizing that difference is a big part of what makes Clover different from other insurance companies. Understanding the complex context of health behaviors is the start of helping me, and anyone else, change them.
At Clover, we have a few core beliefs that inform how we choose to do business.
1) We believe that our members fundamentally want to be healthy.
2) We believe that being healthy, especially if it means changing your behaviors, can be hard.
3) We believe that if Clover makes it easier for people to be healthy, they will choose the behaviors that improve their health.
And that’s why we have a Chief Behavioral Officer. By training, I’m a behavioral scientist, a type of psychologist that specializes in the science of behavior change. Over the past 10 years, I’ve worked with startups and big companies, non-profits and governments. And I’ve designed dozens of products, programs, and services that have done everything from help people better manage their money to quit smoking.
At Clover, I’ll have three big jobs. The first is to help our members lead happier, healthier lives by creating interventions that help them change particular behaviors. For example, for a diabetic member who is struggling to control their sugar intake, I might work with our team to develop systems that make it easier to choose the right kinds of foods. For a doctor with a busy waiting room, I might find ways to make that waiting time more productive (and entertaining) so members are more willing to stay engaged and doctors can concentrate their time on delivering care.
The second is to help us work better internally, because when Clover works better, we can do better for our members. That can involve everything from how we set up our physical spaces to how we communicate and work with each other. There is a Teddy Roosevelt quote I love, “Far and away the best prize that life has to offer is the chance to work hard at work worth doing.” Part of my job at Clover is helping each of our employees do meaningful work.
Finally, I’ll spend part of my time teaching everyone at Clover (and beyond) about the basics of behavioral science so they can incorporate it into everything they do. Because changing how health insurance works isn’t the silver bullet that will motivate everyone to be as healthy as they want to be. We need many changes, both big and small, that members, providers, and Clover make together. And by teaching our members how to change their behaviors, they get to maintain better control over their health. They set the goals and decide how to accomplish them. Preserving that autonomy is an important part of how Clover chooses to operate.
I’ll be writing fairly regularly here on the Clover blog so you’ll hear more from me soon, but I want to end this post on an important note. Behavioral science has the capacity to bring about great positive change in the world. But some companies have used it to increase their profits by manipulating people to do things that aren’t in their best interest, like spending more money than they have or working longer than they should.
Part of my commitment to you in taking this role is to use behavioral science in a way that puts our members first, always. I believe the best way to do that is to be transparent. So I’ll be sharing what we’re trying, what is making an impact, and what isn’t. And I’ll be listening for your feedback. Feel free to email me at matt@cloverhealth.com or @mattwallaert on Twitter if you have questions, concerns, or want to share an idea. I believe good science starts with good conversation and I encourage you to start one with me.
And that’s it for my first post. Hopefully the reason for a Chief Behavioral Officer at Clover is now clear: we believe people want to change, that change is hard, and we can build an ecosystem of services that support making healthy changes. We know we’re the first health insurance company with a CBO but we’re comfortable with being first, because doing things differently is why so many people choose Clover. If you believe in change, I hope you’ll consider joining us.
