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Behavioral Insights team

Many of the most difficult and important problems in healthcare — problems that resist solutions but are important to improving health outcomes and/or offer a high potential return on investment — involve human behavior. Behavior change is an essential component in almost every healthcare intervention. Getting people to change their behavior isn’t always easy. But changing the way decisions are framed and choices are presented to people can help.


What is a Nudge Unit?

The Behavioral Insights team, also known as the Nudge Unit, uses insights from psychological science and behavioral economics to help Geisinger patients, providers and staff improve their decisions. “Nudges” are small changes in “choice architecture” — the way in which choices are presented to people making decisions — that improve the outcome for at least one stakeholder in the decision while not worsening the outcomes for other stakeholders. 

Nudges are transparent, easy to opt out of, and aligned with the welfare of the person being nudged. Typical nudges include:

  • Setting sensible default options, so that failing to make a decision doesn’t lead to a bad outcome
  • Altering the order of options in a set, so that the best ones are seen first
  • Describing options differently to make better ones more likely to be chosen
  • Presenting choices when the relevant information is most helpful to the decision-maker

Why nudge?

Nudges don’t eliminate any choices or substantially change the costs or benefits of choices for the decision-maker. They make better choices easier, but not mandatory, so they preserve freedom while helping to improve outcomes for Geisinger and for our patients.

The Behavioral Insights team designs, implements and rigorously evaluates nudges and other innovative behavioral interventions at Geisinger. We also investigate attitudes and reactions to those nudges.

How we work

  • Collaborating with partners across the health system and outside of Geisinger to diagnose the nature, extent and likely cause(s) of suboptimal behaviors
  • Designing and implementing interventions
  • Conducting A/B tests (pragmatic randomized controlled trials) to quickly and reliably determine which approaches yield the best outcomes

We measure our success via:

  • Increased engagement in healthy behaviors
  • Improved clinical outcomes
  • Reduced claims
  • Return on investment (or ROI) to the system

We also collaborate on grant writing and conducting grant-funded research with internal and external researchers.

Interested in working with us?

Click on the “Collaborate with us” button at the top right to submit an innovative intervention to the Steele Institute for Health Innovation.
You can also email us at BehavioralInsightsTeam@geisinger.edu.

Example projects

Below are just a few projects the Behavioral Insights team is currently working on:


Reducing waste

  • Changing electronic health record (EHR) lab order options to discourage repeat ordering of tests that only need to be performed once
  • Incorporating norm-based nudges encouraging staff to ask for point-of-service bill payments on outstanding balances
Increasing utilization

  • A/B testing EHR alert configurations to determine the most effective way to increase pediatric lipid screen orders and completions (randomizing patients to alerts)
  • A/B testing email timing strategies to increase enrollment in Geisinger’s online patient portal (myGeisinger)
  • A/B testing email content (loss framing, social norms, testimonials) to increase enrollment in an employee wellness program (myHealth Rewards)
  • A/B testing email content to increase use of Geisinger's mail-order and retail pharmacies, which save money for the patients and the health system
Closing care gaps

  • A/B testing reminder letters to encourage colorectal cancer screens with at-home test-kits or colonoscopies
  • A/B testing flu vaccination messages to patients at high risk or with existing appointments
  • A/B testing mailers to promote mammograms for older women
Implementing and evaluating programs

  • Implementing nudges in a mobile app for patients, their families and case managers that aims to increase the choice of a preferred post-acute care provider—and A/B testing our nudges
  • A/B testing different materials and nudges that promote a vegan (or plant-based) diet to patients with chronic conditions, with the goal of improving health and reducing healthcare spending
  • Evaluating the impact of a care-delivery program that aims to support at-risk mothers after delivery (Free2BMom)

Who we are:

Christopher Chabris, PhD – Faculty co-director (cognitive and behavioral scientist)
Michelle Meyer, PhD, JD – Faculty co-director (bioethicist and legal scholar)
Amir Goren, PhD – Program director (health outcomes researcher and social psychologist)
Maheen Shermohammed, PhD – Staff scientist (cognitive neuroscientist)
Henri Santos, PhD – Staff scientist (social and cultural psychologist)

Internal clinical advisors:

Bradley Flansbaum, DO (Internal Medicine)
Sandy M. Green, MD (Cardiology)
Chadd Kraus, DO, DrPH, MPH, CPE, FACEP (Emergency Medicine)
Thomas B. Morland, MD (Internal Medicine)
George R. Rohrer, MD (Family Medicine)
Jonathan E. Swinden, MD (Internal Medicine)
Donna M. Wolk, MHA, PhD, D(ABMM) (Molecular and Microbial Diagnostics and Development)

External scientific advisors: 

David Laibson, PhD (Harvard Department of Economics)
Eric J. Johnson, PhD (Columbia Business School)
Joseph Doyle, PhD (MIT Sloan School of Management)

We have a long-term partnership with the National Bureau of Economic Research (NBER) in the NBER Roybal Center for Behavior Change in Health, one of 13 National Institute on Aging (NIA)-funded Roybal Centers.