Closing Care Gaps: An Evidence-Based Behavioral Science Approach
Wellth’s Behavioral Scientist breaks down ways to successfully engage members in preventive health behaviors and build lasting habits along the way.
November 4, 2022

By Sarah Watters, Wellth’s Behavioral Scientist

When was the last time you went to the dentist?

What about the doctor for your annual check-up? 

You’re not alone if you either can’t remember or realize you’re probably overdue. Completing these routine behaviors – closing these care gaps – isn’t as easy as it seems. There are multiple steps that need to be taken from booking an appointment to taking time off of work or other commitments, for example. That is, if we even remember that we’re “due” for these visits and screenings in the first place. 

People often have a number of care gaps – like A1c or kidney tests, cancer screenings, and medication reviews, to name a few – that they should complete in order to get a holistic picture of their health. Closing these care gaps is important for preventive health, but are also critical to how health plans perform on quality measures. However, due to a number of reasons (including fear of test outcomes) members may forget, put off, or avoid these visits.

How do we encourage people to complete these important behaviors?

Start small, but do it at scale. There is no one size fits all for addressing human behaviors, so it is crucial to engage with members on an individual level. Health plans benefit when they team up with member-centered digital health technology companies that can help bridge the gap between catering to an individual’s health needs and a health plan’s quality performance goals. It's often not enough, however, to be member-centered; this member-centricity needs to be paired with behavioral science to help make the leap from awareness to (ideally, repeated) action. That’s where innovative solutions like Wellth come in.

At Wellth, we leverage a member’s daily engagement to drive routine behaviors, and ultimately close care gaps. With over 90% of members engaging with Wellth every single day, the breadth of data that is collected from these check-ins provides contextual information that can help educate the member on the care gap, learn what relevant resources they might need to attend an appointment, and pinpoint just the right time to prompt them to make the appointment.

Let’s dig in a little deeper.  


We don’t ask members to close their care gaps without delicately orchestrating the lead up. 


In behavioral science, the Ostrich effect refers to our desire to bury our heads in the sand – so to speak – when we encounter something in which we’re unfamiliar. For example, we are less likely to get a colonoscopy or a mammogram, for instance, if we have little to no idea what it entails (coupled with some preconceptions of the process) – whereas if we know more about what exactly will happen, why, and how long it will take, we are more likely to act.  

Wellth makes sure that members know what particular care gap appointments, screenings, or visits entail prior to prompting them to complete these activities. We guide the member through what tests and questions to expect, and details around when, where, and how long the appointment should take – and whether they need someone to accompany them. This allows the member to adequately prepare and increases the likelihood that they will follow through on closing the care gap. 

Meet members where they are 

Typically, when the phrase “Meet members where they are” is used, what’s being implied is that the member’s individual needs and circumstances are being taken into account. These circumstances however, tend to be more general in nature (think things like demographic or diagnosis-related characteristics) which limit a health plan’s reach and engagement opportunity.  

At Wellth, through meaningful engagement on a daily basis, we are able to gain a more detailed view of our members’ lives and day-to-day situation, in order to create a tailored experience that addresses their individual health journey. By consistently showing up, the member is signaling to us that they’re on the right track, prioritizing their health and may be able to take on more. Relatedly, consistently showing up at daily check-ins brings a member greater awareness to items discussed above – like education around specific gaps. 

Listen and Support

By using Wellth as a proxy for communication with members, information can be relayed to members’ care teams and enable timely intervention to get the member support. Health plans are therefore able to establish a bi-directional relationship with members, building their engagement, trust, and satisfaction with their health care experience

Once members have demonstrated a mastery of their daily check-ins, we incorporate additional engagement within the Wellth program – such as responses to surveys and interactions with our dedicated support team. Both of which feed into our determination of a member's readiness to be asked to close a care gap. Self-reported overall health, for instance, gives us a window into how the member is feeling, social needs screening can tell us whether a member may need extra assistance, and other in-app nudges – all help to gauge how our care gap experiences and prompts unfold. 

When Wellth utilizes in-app surveys for social needs screenings, we are able to understand a member’s specific barriers and challenges to accessing care and therefore support them from a foundational level to be able to close their care gap. For instance, we may know from previous questions that a person might require transportation or a companion to particular appointments. Understanding our members through listening and supporting their needs leads to successful gap closure.

Positive feedback

Hey, great job, you! 

It’s important to round out a care gap closure experience through positive feedback. 

Positive feedback makes a strong association between an action and feeling good. At Wellth, this support ensures our members feel accomplished (and more likely to repeat the behavior in the future) – and that we’re here to support them along the way, because we are!

Long lasting habit formation relies on a cycle of cue-routine-reward: a timely cue, with a simple routine, and an immediate and effective reward. Rewards vary in type and value (intrinsic vs. extrinsic) to keep the pay-off fresh and valuable. Wellth’s positive feedback is grounded in behavioral science, and brings in elements of gamification, social support, and financial incentives.

The low-down on member incentives

Built on the foundation of behavioral science, reward incentives are a powerful part of Wellth’s approach to care gap closure for several reasons, such as:

  • They’re immediately provided.
  • They’re provided in a manner that the member is already familiar with and trusts.
  • They help members overcome any present bias getting in the way of completing a task.

Ultimately, incorporating member rewards can also offset the social drivers of health that limit members from completing their necessary health tasks to begin with. A recent Medicare Advantage partner program shows their members spending rewards on essential items such as groceries, fuel, personal care, and household items. 

Through these member incentives, health plans are making an impactful investment into members’ lives and communities, helping to address SDOH inequities. In addition, plans see a return on their investment with reductions in inpatient utilization, care gap closures, member retention, and more. 

"I'm glad that my health plan took interest in my health, and it gives me a little bit more interest in my own well-being. Before the program, I didn't really have a routine because I'm handicapped, so I don't get out much, but Wellth gives you something to do and look forward to. To be honest, the little bit of money from the incentives really helps to buy groceries…I really like the streaks in the app too because they help me stay on track and motivate me to do well…I have talked to people my age who are thinking about switching health care providers, and I give them my plan’s information and give them a five star review." -Wellth Member Feedback

Bridge the Gaps

Daily engagement means daily opportunities to present members with an idea, information, or a request – be it to show them where to find the most appropriate care for their needs, talking points to bring with them to their next annual wellness visit, or – as we discussed above – ask to complete an activity that is a key part of their care plan and, often, an activity driving important quality metrics.

Closing care gaps is not straightforward. We know this. We know it’s hard to complete those annual or bi-annual visits, even when we’re healthy and thriving. But, the Wellth toolkit – in particular, daily engagement coupled with an evidence-based behavioral science approach – successfully drives care gap closure even among members with complex health needs.