How Small Changes Can Yield Big Results For The Government

Transcript

AUDIE CORNISH, HOST:

What kind of messages do you ignore? What kind prompt you to do something? Those are questions that a small group of behavioral scientists have been quietly working on at the White House and some federal agencies since early last year. And today's their coming out party.

ROBERT SIEGEL, HOST:

They're called the Social and Behavioral Sciences Team and they issued their first annual report today explaining what they've been doing. To understand exactly what we're talking about, I made a trip to Fort Myer in Arlington, Va.

COLONEL GILLIAN: Colonel Gillian.

SIEGEL: This is an in-processing briefing. Soldiers new to Fort Meyer come here for all their HR concerns.

UNIDENTIFIED MAN: OK, and if you can date, print, sign there please.

SIEGEL: The Department of Defense saw this moment as a chance to get more soldiers enrolled in the Thrift Savings Plan. That's like a 401(k) for federal workers. Fewer than half of active-duty service members are enrolled in the plan. As military retirement benefits are scaled back, the government wants more people contributing to their own retirement savings, especially those who won't stay a full 20 years. Enter the Social and Behavioral Sciences Team. They worked with the staff at Fort Meyer to develop a presentation about the Thrift Savings Plan. Michael Clarence Richardson has given those presentations.

MICHAEL CLARENCE RICHARDSON: We gave them all the information. We gave them - they experienced - some of the senior leaders stood up and said, hey, young guys, go ahead and get it now because all these proposals that's coming up to the retirement system, you need to go ahead and get yourself enrolled because even if you don't stay a whole retirement, you already got money.

SIEGEL: It sounds like what you're doing is you're saying, look, here's a question. Now I'm going to tell you what the right answer is to the question.

RICHARDSON: Right, that's it, sir. That's it. That's it in a nutshell. Hey, go ahead and jump on it.

SIEGEL: The Fort Meyer presentations were just one part of the Social and Behavioral Science Team's work on military savings. The team's chair, Maya Shankar, told me that they also applied behavioral science to this problem - 140,000 service members had to re-enroll in the Thrift Savings Plan or they would lose the right to contribute.

MAYA SHANKAR: We redesigned the Department of Defense's business-as-usual letter to include clear action steps for enrolling. We also put a postscript into the email message. It turns out, research shows the postscript is the second thing the visual system looks at when we open a letter, open an email. So you can highlight key messages and key action steps in that particular location on a letter. And we redesigned the letter and then we tested the impact of the standard business-as-usual letter with the redesigned letter that used behavioral insights. And we found within a week that there is a 22 percent increase in re-enrollment rates for those who received the redesigned letter. The DOD immediately took those insights and brought them to scale for the remainder of the email outreach campaign so that everybody was able to benefit from those insights moving forward.

SIEGEL: When you say there was a 22 percent increase, it's from roughly what rate to what rate?

SHANKAR: Yeah, so in this particular case, it was from 23.5 percent to 28.7 percent. So this represented 3,770 service members who are re-enrolling as a result of the redesigned letter.

SIEGEL: Yes, and this, of course, gets to the unique scale of the federal government, which is that if you affect a change of 3 or 4 percent, on the one hand, one can say, well, you know, that's not earthshaking. On the other hand, it could be tens of thousands of people if it's the federal government, if not hundreds of thousands.

SHANKAR: That's exactly right. I mean, that's what makes the nature of our work so thrilling, which is the scale of impact that we can have from these very small tweaks that are very low-cost and very easy to implement within federal programs.

SIEGEL: In your team's report that was released today, you described several projects, some of which succeeded and some of them didn't. And I wanted to ask you about one that didn't, as you described it. It was the attempt to use peer pressure as a tool to discourage improper prescription of opioids and other controlled substances. Tell us what you did.

SHANKAR: The Center for Program Integrity at the Centers for Medicare and Medicaid studies sent letters to doctors simply notifying them of how their prescribing rates compared to that of their peers. So this is sort of similar to when you might receive an energy bill in the mail and it shows you how your energy consumption compares to that of your neighbors. We ran this and found that actually it didn't work and so right now it's sort of...

SIEGEL: You mean the doctors who prescribed a lot of these drugs and who received this letter, there was no change in their behavior from doctors who had not received this letter.

SHANKAR: That's correct. So it's compelling a re-evaluation of how can we better communicate with physicians? So we're thinking about the envelope. Are people even opening these letters?

SIEGEL: Well, you know, that's the question that I had. Did it look like an important personal communication or did it look like something with an automatic paid postage, you know, stamp on it that you receive dozens of in the mail?

SHANKAR: These are exactly the features that we're exploring in a follow-up pilot in which we try to figure out ways to get these letters in the hands of the physicians so that they can learn from the information and maybe change their prescribing patterns accordingly.

SIEGEL: How far can this go? How pervasive a role do you think behavioral sciences and behavioral economics can have in government actions and policies?

SHANKAR: Well, we think that government programs work best and Americans are best served when they are easy to access and when program information is presented clearly. I think the critical thing that behavioral science teaches us is that when programs are not designed in this way, the consequences for Americans are much larger than we might think. In example, every year, 20 to 30 percent of college-accepted high school graduates in urban districts fail to matriculate in college in the fall because they haven't filled out required college enrollment materials. And so this phenomena is known as summer melt. What research shows us and what the Social and Behavioral Sciences Team worked on is sending these students eight low-cost text messages that reminded them of these deadlines and provided them with more information and access to personalized links so that they could complete this information. Now, some might say, well, it's so straightforward and common sense to simply send students text messages, but this can make the difference between a student going to college or not going to college.

SIEGEL: What do you say to the cranky, complaining taxpayer who says what you're doing is you're pushing an unmotivated kid into assuming some college debts for something that he or she isn't interested in enough to actually follow through on?

SHANKAR: These are students who have applied to college, have gotten in and might not have access to the kind of professional assistance that a lot of people might have access to within their own schools or within their communities. And all we're doing is providing that sort of assistance so that students who want to go to college can actually go.

SIEGEL: Maya Shankar, thanks you very much for talking with us.

SHANKAR: Thank you so much for having me.

SIEGEL: Maya Shankar is chair of the administration Social and Behavioral Sciences Team, which issued its first report today. Transcript provided by NPR, Copyright NPR.