Understanding Key Behaviors in Health (6/8)

We add to our understanding of the Customer Segment by looking at Key Behaviors and how they affect our healthcare business models. Key Behaviors are the steps required from the User to complete their JTBD (job to be done). Why do we need this block called out for our healthcare business model canvas? Stick around and find out. I trust you will agree.

By the way, this will be a long post. We have a few objectives today:

• Defining the questions to ask for the Key Behaviors building block.
• Helping create healthcare Key Behaviors.
• Understanding how behavioral economics models can be applied.
• Understanding how behavior change models can be applied.
• Understanding how rewards and incentives can be applied.

What are Key Behaviors?

“Behaviors” are an entity’s (re)actions to stimuli within a system. In modelH, your Customer Segment is the entity, and your business model is the system. In healthcare, to understand what action you want performed by your Customer Segment, you must understand the Key Behaviors required by your business model. Behaviors are at the heart of any healthcare business model, but behavior change is tough to do. Try it yourself, and you will see. Too many Users think managing their health is either too difficult or too tedious. The result is poor health. For business models that rely on healthy customers to make a profit, this is a problem. For business models that drive behavior change, this is a bonus.

Either way, Users are humans, and as humans, they think and act irrationally at times. You can use this variable to elicit desired responses (Key behaviors). The key is to define and build the Key Behaviors into your business model using a systematic process. We are lucky that the well-developed science of behavioral design can guide us. Behavioral Design is the systematic understanding of how people think and make decisions, forming the basis for what interventions (Key Activities) are needed for behavioral change so that your Customer Segment can realize your complete Value Proposition.

The questions to ask on your business model canvas for Key Behaviors are as follows:

1. What Key Behaviors are required from the Customer Segment (Buyer & User) to complete their JTBD and realize the Value Proposition?
2. What negative Key Behaviors must be overcome by the User?
3. Which negative Key Behaviors result from your business model, and how can they be removed?
4. How difficult will adopting the Key Behaviors be for the Customer Segment?
5. Which of these Key Behaviors require stimulus from Key Influencers?
6. Which of these Key Behaviors are affected by Intermediaries and how?
7. What behavior change model(s) are you using to drive the Key Behaviors?
8. What behavioral economics models can be applied to your Customer Segment?
9. What behavior change models can be applied to your Customer Segment?
10. What rewards and incentives can be applied to your Value Proposition?

We can now dive deeper into this topic so you can add nuance to your business model. The modelH method for defining Key Behaviors is as follows:

1. Enumerate the Key Behaviors
2. Apply a Behavior Change Model
3. Build Behavior Triggers Into Your Key Activities
4. Reward and Reinforce the Key Behaviors

We will look at each in turn.

Enumerate the Key Behaviors

The critical first step in this process is to map out the Key Behaviors you can elicit, making your Value Proposition work. You can visualize the steps as user flows or journey maps. You can define what the User must do and what you and your business model must do to help the User start and finish their JTBD. This process will come in two forms — what you can directly influence and what must be indirectly influenced through others (Key Influencers). Keep in mind the User is affected by Intermediaries and Key Influencers, so both will have to be considered.

Key Behaviors hold a pivotal role in shaping the User’s journey, occurring before, during, and after they fulfill their JTBD. Some of these behaviors act as positive reinforcements to the steps, while unfortunately, many others yield the opposite result.

It’s widely accepted that behavior change is a prerequisite for creating favorable health conditions. But what about Customer Segments that are resistant to change? The refusal to change behavior is also a Key Behavior. Identifying controllable behaviors can help devise strategies to encourage Users in their JTBD. Similarly, defining uncontrollable behaviors can help guide Users in avoiding them. Grasping the intricacy of the behavior change required for the User to complete their JTBD is a crucial aspect of a realistic business model.

modelH Diagram — Key Behaviors

Understanding the principles of Behavioral Economics and the decision-making models people use is helpful and essential for your work in this area. Behavioral Economics studies humans’ decision-making process by weighing opportunity costs (and benefits) to calculate the right choice to yield the maximum benefit. This knowledge empowers you to make informed decisions in your business strategy.

Defining Key Behaviors in the Customer Segment of your business model will illuminate where large and small changes need to occur. It requires that you be honest about your business model and its effect on your Users. It would help if you focused on identifying any negative stimuli your business model creates or enables, particularly in the sense of shared value we so often advocate.

To drive the Key Behaviors, we need healthcare Users to act in the desired way and do so consistently. We must understand how they decide to buy and use the Value Propositions in our business models. You can use these principles in your Value Propositions to impact a Buyer’s purchase and a User’s usage decisions. Some examples of behavioral decision models are choice architecture, hyperbolic discounting, optimism bias, information avoidance, loss aversion, and more.

Apply a Behavior Change Model

Behavioral Change, a practical science, is about understanding how effectively human beings can take actions and sustain them relative to personal goals. Simply put, it’s about studying how we make and break habits — good and bad. When applied to healthcare business models, it empowers the User to perform the Key Behaviors necessary to complete their JTBD and realize the Value Proposition. Business models with this understanding can incorporate applicable behavior models into their Key Behavior block. This way, you can realistically assess the likelihood of your Customer Segment realizing their Value Proposition.

Once you have the Key Behaviors mapped out, the next step is determining how to get people to do the first behavior in the flow. If this first step is obstructive or unnatural for your User, figure out how to get the following one to happen. In a step-by-step manner, you should continue this process until the user flow has a reasonable chance of happening. The beauty of this approach is that Key Behaviors will not occur in one step but progress through stages to a successful change. Moreover, they will appear individually as each User is unique and affected differently by the change they enact. Certain types of people have a higher prevalence of sustaining change than others. Each behavior also requires a readiness to change before change can happen.

While there are several proven models for defining health behaviors, it’s important to remember that there’s no one-size-fits-all solution. Some Key Behaviors may be too complex for a particular model, while others may be too simple. But that’s the beauty of it — depending on the actions you’re trying to elicit, you may need to use more than one model. The key is to align your stimulus with the system, ensuring that your chosen behavior model is a good fit for the context and desired outcomes. This flexibility ensures a solution for every situation, giving you the confidence to tackle any behavioral change challenge.

Some of the more prevalent ones are shown in the list here:

• Expectancy Theory — Vroom
• Persuasive Design — Fogg
• Social Cognitive Theory / Self-Efficacy — Bandura
• Theory of Reasoned Action / Planned Behavior — Fishbein & Ajzen
• Transtheoretical Model / Stages of Change — Prochaska
• Hierarchy of Needs — Maslow

Build Behavior Triggers Into Your Key Activities

Once you understand the Key Behaviors on the User’s side of your business model, it is time to define the Key Activities that are needed. A future post will cover instructions on how to build these behavior triggers into your Key Activities.

Reward and Reinforce the Key Behaviors

It stands to reason that rewarding your Users for desired behavior makes good sense. As we pointed out, when correctly applied to a business model, the result can expedite the Key Behaviors you need from your Buyer/User so their JTBD is complete. Plus, the User realizes the fullness of your Value Proposition.

Rewarding Key Behaviors does not have to be cost-prohibitive. You can combine real/tangible financial and perceived/intangible incentives to create a low or no-cost reward model. There are many reward models to choose from:

• Key Partner (merchant) funded rewards as cash or coupons
• Discounts on purchases
• Rebates or cash back on purchases
• Multi-purchase discounting, such as 2-for-1 deals
• Gamification principles

How healthcare Users behave is highly complex and often counterintuitive. Humans have a bias towards short-term gain over long-term benefits. People frequently fool themselves into thinking they are healthier than they are or have more time to get healthy than they do. As stated above, the science of Behavioral Economics reminds us that while our Customer Segment’s choices may not be logical, their Key Behaviors are usually predictable. The science of Behavior Change can help you create business models that influence Users to take desired actions to compete with their JTBD and realize your Value Proposition. Rewards and incentives for your User’s Key Behaviors can expedite their JTBD completion.

Take time to incorporate these approaches into the Key Behaviors block in your business model canvas. Whether your business model is aimed at Patients, Providers, Payers, or Purveyors, defining the Key Behaviors and the Key Influencers required to enact them will ensure your Customer Segment can realize your Value Proposition in a timely and complete manner.

What is Next?

Next, we look at Key Influencers and how they affect our healthcare business models.

Interested in what I am doing and want to learn more? You can read all about modelH business model innovation for healthcare on Medium.

to your health,

- Kevin