The Power of Fifty Bits

Even with the very best of intentions, people often fail to make wise choices for themselves—whether for their health, their finances, or their business decisions. Yet it doesn’t have to be that way—thanks to the science behind fifty bits design, a set of principles that helps close the gap between intentions and actual behaviors. Of the ten million bits of information our brains process each second, only fifty bits are devoted to conscious thought. This means that humans are wired for inattention and inertia, so we often choose without thinking and act against our own interests. Understanding this is the key to any behavior change, from increasing charitable donations to reducing unintended pregnancies. As the former chief scientist of Express Scripts, a Fortune 25 health care company, Bob Nease is an expert on applying behavioral sciences to the health care industry. He realized that providing financial incentives and tools—an approach that assumes patients will act rationally—was not having the outcome that he expected. Instead, he had to reengineer patients’ environments in order for their natural inclinations to lead them to the best decisions. In a nod to the brain’s fundamental cognitive limitation, he called this approach “fifty bits design,” and now he applies his knowledge to the wider world, offering important, practical solutions that marketers, human resources professionals, teachers, and even parents can use to improve the behavior of others around them and get the positive results they want. Nease offers a set of powerful and effective strategies for change: • Require Choice: compel people to deliberately choose among options • Lock In Good Intentions: allow people to make decisions today about choices they will face in the future • Let It Ride: set the default to the desired option and let people opt out if they wish • Get in the Flow: home in on where people’s attention is likely to go naturally • Reframe the Choices: set the framework people use to consider options and choices • Piggyback It: connect the desired choice or behavior with something people already like or are engaged in • Simplify…Wisely: make the right choices frictionless and easy; make the wrong choices more difficult The Power of Fifty Bits is the first how-to guide that provides step-by-step instructions for helping customers, employees, co-workers, and clients get the results they truly want. Advance Praise for The Power of Fifty Bits “In many ways, this book is yet another one of Bob’s cleverly engineered systems, expertly designed to hook you with an enigmatic title, hold you with delightful stories and deep ideas, and ultimately leave you better than you were before—wiser about people in general, and about yourself in particular.”—from the foreword by Daniel Gilbert “Want to learn how to design approaches that spur others to achieve their goals—and that do the same for you and your own goals? With clarity, eloquence, and humor, The Power of Fifty Bits shows you how.”—Robert B. Cialdini, author of Influence “If you want to understand how the environment you live in can be reshaped so that your intuitions, fears, hopes, and dreams can best be managed and aligned with your best intentions, I recommend you read this fun, challenging, and useful book.”—Arthur Caplan, professor of bioethics, NYU Langone Medical Center “The Power of Fifty Bits shows you how to produce outcomes that have both high financial effectiveness and high acceptance by employees.”—Bob Ihrie, SVP of Compensation and Benefits, Lowe’s Companies, Inc. “The Power of Fifty Bits is a great resource for creating state-of-the-art programs to promote well-being. Combining evidence for effective behavior change with practical advice, this book will transform your thinking and put you on a path to a much better life.”—Helen Darling, strategic advisor, National Business Group on Health “Bob Nease is a pioneer of implementing social science in business and healthcare, and we are lucky to have him share his expertise.”—Dan Ariely, author of Predictably Irrational “This book proves that scientific insight doesn’t need to be dry and boring. If you want to learn how to make your organization more effective, or just to make your own life better, read it. It’s full of behavioral-science insights in a fun, readable form.”—Peter Orszag, former director, Congressional Budget Office

Bob Nease, PhD, served as the chief scientist of Express Scripts and is the author of more than seventy peer-
reviewed papers. He was also an associate professor of internal medicine at Washington University in St. Louis and an assistant professor at the Geisel School of Medicine at Dartmouth College. He received the Henry Christian Award for Excellence in Research from the American Federation for Medical Research and the URAC’s Health Care Consumer Empowerment and Protection Award. He and his wife divide their time between Phoenix, Austin, and Italy.