Assessing the Impact of myHealth Rewards New Hire Enrollment Emails

Study Overview
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Brief Summary
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The purpose of the study is to evaluate, prospectively, the potential impact, on myHealth Rewards wellness program enrollment prior to the 2019 November submission deadline, of sending different messages via email to Geisinger Health Plan (GHP) members who have just been hired.

Detailed Description
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The myHealth Rewards wellness program managed by GHP rewards those GHP members who carry their insurance through employment at Geisinger with reduced health insurance premiums over the course of the following year, if members register for the program and have their health measures on file by the enrollment deadline and are then able to meet their health goals by the respective due date. In spite of the potential savings to health plan members and the wellness program's potential to motivate engagement in healthy activities (with consequent improvement in health outcomes), about 23% of eligible existing GHP members did not enroll during the primary 2019 enrollment period, even after receiving promotional email communications and reminders. Therefore, the current study was developed to test whether a revised version of a standard welcome email is more effective than the standard email in increasing myHealth Rewards login and enrollment rates. The standard welcome email is what would typically be sent by GHP to encourage enrollment among new hires; it mentions the benefits of enrollment (maintaining good health and saving money on insurance premiums), the average premium savings, the ease of the registration process, and the deadline for registering and having health measures on file, plus it provides registration steps and hyperlinks for registering and finding free health screenings where health measures can be collected and registered at one convenient time and location. The loss frame email recommends that GHP members not throw away a precise monetary amount in savings by not participating and that they can therefore avoid missing out on substantial gains (i.e., savings) by taking action. It is hypothesized that, on average, the loss frame email will increase enrollment compared with the standard email, among this population of new hires for whom this is only the second time that they have been informed about myHealth Rewards. Findings will help inform how best to increase enrollment in a wellness program among health plan members who are new to the system.

Official Title
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Assessing the Impact of myHealth Rewards Program-related Communications on New Hire Enrollment

Conditions
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Health Promotion, Wellness Programs

Intervention / Treatment
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* Behavioral: Welcome email
* Behavioral: Loss frame


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any Geisinger new hire, regardless of benefits status, who started on or after July 1, 2019 and before November 30, 2019 Exclusion Criteria: Existing Geisinger employees hired prior to July 1, 2019 New hires who do not have an email address on file

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Standard welcome email<br>The standard welcome email mentions the benefits of enrollment (maintaining good health and saving money on insurance premiums), the average premium savings, the ease of the registration process, and the deadline for registering and having health measures on file, plus it provides registration steps and hyperlinks for registering and finding free health screenings where health measures can be collected and registered at one convenient time and location. | Behavioral: Welcome email<br>* Email<br>|
| Loss frame email<br>The loss frame email recommends that GHP members not throw away a precise dollar amount in savings (over $2,000) by not participating and that they can therefore avoid missing out on substantial gains (i.e., savings) by taking action. This intervention frames the status quo as a state from which recipients, via inaction, are slated to forfeit a sizable and precise monetary amount to which they should otherwise feel entitled (via loss aversion and the endowment effect). People tend to be risk-seeking in the domain of losses; therefore, this intervention is hypothesized to increase enrollment in the hope of achieving zero loss by meeting program goals, as opposed to a sure loss via inaction. | Behavioral: Welcome email<br>* Email<br>Behavioral: Loss frame<br>* Email<br>* Other names: Endowment effect;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of People Enrolled Within 7 Days | Enrollment in the myHealth Rewards program (yes/no) within 7 full days of the beginning of the intervention for each cohort (i.e., when the emails are first sent within each weekly new hire cohort). Data will be aggregated across cohorts, including the July 16 cohort and every subsequent cohort through the week prior to reminder emails scheduled to be sent out in October, 2019. | 7 days | 
| Number of People Who Logged in to the Program Within 7 Days | Logging into the myHealth Rewards program (yes/no) within 7 full days of the beginning of the intervention for each cohort (i.e., when the emails are first sent within each weekly new hire cohort). Data will be aggregated across cohorts, including the July 16 cohort and every subsequent cohort through the week prior to reminder emails scheduled to be sent out in October, 2019. | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prospect theory