A New Take on Engagement: Aetna and Apple Launch Attain

apple-aetna attain appOn Tuesday I had the pleasure to be at Aetna – CVS Health’s grand announcement for Attain, an Apple Watch-based app that will be released later this Spring. Aetna and Apple co-developed this application – Aetna providing the healthcare expertise and Apple its user interface chops.

Attain is yet another health, wellness and medication adherence app (as if we don’t have enough already) but with a few twists:

  • Initially, Aetna will promote Attain directly to members, bypassing employer HR departments.
  • It’s a watch-based app built on the theory of “Nudges” to change behavior(s).
  • Wellness goals will initially be set based on age, gender, weight. However, over time Attain will self-adjust and personalize health and wellness goals based on an analysis of member usage patterns to provide meaningful, attainable goals.
  • Attain with Apple Watch benefit is a “loss-framed incentive” program. Most wellness benefit programs are simple gain-incentive based.

How it works: Aetna members will be notified of the opportunity to buy an Apple Watch on a monthly payment plan. By using the Attain app on their watch and accumulating points, those points will be applied to paying down the monthly installment. Meet your monthly goals, and no payment needs to be made. Fall short, and the loss-framed incentive kicks in and the member must pay a portion of the monthly bill.

Note that both Aetna and Apple were very proactive and firm regarding the steps they will take to ensure the security and privacy of member health data. Aetna will continue to improve security, migrating to gesture-based authentication. Aetna will never use collected data for underwriting, nor will data be used or sold for secondary purposes. Apple, likewise, will only collect de-identified data for improving the app experience if the consumer opts in.

But there are a few areas where this initiative falls short:

  • There was no discussion as to how Attain will address chronic conditions such as hypertension, diabetes or mental health.
  • The event did not address how Attain might become a platform with open APIs and developer kit to enable others to build disease-specific modules for Attain.
  • Surprisingly, no mention of how Attain might alert a member to care gaps and assist in scheduling an appointment.
  • They also did not discuss how providers might be able to leverage Attain to better manage their patients in a value-based contract. (In a private discussion with an Aetna executive, he did state that they are working with some of their provider JV partners on the opportunity Attain may bring – but it’s early.)

While hoping for discussions on the above, it is clear that Attain is very much a v1.0 product and future enhancements, including the above, are likely if the app proves successful over course of this initial launch. In a recent report from Rand Europe, there is reason for hope.

Aetna has always been a leader among payers in experimenting with new ways to engage their members. No other payer comes close. I really like what Aetna and Apple are doing here together as it truly breaks the mold of traditional approaches and go-to-market strategy to engage members in their health. It is a great first step and truly representative of a healthcare organization seeking to improve the health of the population it serves.

In stark contrast is what we will all see in a couple of weeks at HIMSS’19. No health IT vendor has even come close to this level of commitment to patient/consumer engagement with such an easy-to-use, engaging app. And frankly, responsibility for this shortcoming does not rest solely with vendors, but also their provider customers. IT vendors typically build what their market desires (or demands). Despite all the talk of consumer/patient engagement, I’m calling bullsh*t on the providers and the vendors that serve them for not stepping up to the plate and taking consumer/patient health and wellness seriously and making the investments necessary to truly move forward in a meaningful way.

So providers and the vendors that serve you – what’s next? Please don’t tell me it is yet another scheduling app that just generates more revenue for you, or an easier way to pay co-pays, or a static filing box of medical records. Seriously, what’s next in the game plan to truly engage patients in a way that is reflective of expected 21st century customer experiences and is truly patient-centric?

Stay up to the minute.

Did You Know?

Payers Refocus Efforts on ROI for Member Engagement

cvrWhat a difference a year has made to the payer market. In late 2012 Chilmark Research published the first version of our Payer Benchmark report — detailing how leading payers were beginning to adopt emerging consumer technologies. We found a market where significant experimentation was occurring, but little if any broad, member wide deployments and a market still trying to understand social media.

This week we are releasing the next iteration of this report – Benchmark Report 2013: Payer Adoption of Emerging Consumer Tech – Payers Continue their Pursuit of the Digital Consumer. Based on the research I conducted for this report, I find it simply amazing to see how this market has shifted over the course of a single year.

For one thing, the traditional health insurance business model continues to erode, as the Affordable Care Act (ACA) has capped medical loss ratios (MLRs) and has completely stripped payers of their ability to underwrite based on health risk.

Meanwhile, payer-provider realignment is ongoing. Hospitals are partnering directly with employers or launching health plans that might compete with payers in the employer market. Likewise, some payers are acquiring providers to more closely align financial interests with healthcare services delivered.  All this bodes well for rising interest in payer-provider-aligned population health management and patient engagement technologies.

In addition, the ACA/Obamacare has come to be seen as inevitable, and Health Insurance Exchanges (HIX) are forcing payers to seek out new places in the minds of consumers and within the broader healthcare ecosystem —  with an increasing focus on engaging and retaining consumers.

Outside of healthcare, the consumer tech space continues to defy our expectations.  It is easy to see how in the past year that emerging, low-cost activity tracking technologies have spread far beyond early adopters.

These and other macro forces are pushing payers toward the digital consumer in ever more multi-faceted ways.  For example, payers have drastically pulled back from their flurry of experimentation in 2012, and are now focusing their efforts into fewer, more precise areas where they foresee strong potential for ROI.

One change from 2012 is the pull-back in creating mobile app versions of member service portals, as have health & wellness app launches. (This makes sense: in general, very few payer-launched or payer-owned mobile apps have gained any kind of significant traction, with iTriage as a notable outlier, and they already had good traction prior to acquisition by Aetna).


While payers may have pulled back from rapid experimentation along certain lines, this does not mean that they have given up on the digital consumer. To the contrary, we continue to see growing investment in payer-owned consumer platforms, biometric tracking initiatives, the next generation of social media, and more… all detailed in the report.

This report profiles an expanded set of payers as compared to the first edition, across commercial, Blues, and provider-aligned categories. These innovative payers are exploring the wild west of digital consumer engagement and learning as they go. The report describes their experimentation in detail, what initiatives are working and why, and where promising new territory might lie. Any organization that is looking to build-out a strategy that leverages consumer tech for member/patient engagement will find this report invaluable.

We hope our subscribers enjoy the read…as much as we enjoyed the research.