Aetna's Attain for Apple Watch benefits health — and privacy

Aetna, a CVS Health business, has just announced Attain, a new health and well-being experience designed in collaboration with Apple. It's an Apple Watch app — for Series 1 and later — designed to help promote a better lifestyle through personalized goals and rewards.

Here are the major features of Attain, or "pillars", as Aetna is calling them:

Achieve Activity Goals: Health ambitions are not one size fits all, and neither are Attain's customized activity goals. Attain provides participants with personalized daily and weekly activity goals, based on their age, sex and weight. Attain's definition of activity is not restricted to steps taken, and includes other activities measured by the Apple Watch, such as swimming and yoga.

Sustain Everyday Health: Attain offers weekly challenges, where participants earn points for taking actions that improve their overall health and well-being. Challenges may include getting more sleep, increasing mindfulness and improving nutrition.

Receive Personalized Health Notifications for Key Health Moments: Attain recommends personalized healthy actions based on an Aetna member's health history as well as their Apple Watch sensor data. Created in collaboration with a team of doctors, the recommendations are based on clinical guidelines. At launch, healthy action notifications will include reminders to meet activity goals, get vaccinations such as the flu shot, notifications to refill medication prescriptions when they're scheduled to run out, suggestions to visit a primary care physician if they have not had a recent office visit, and the availability of a lower-cost option for scheduled lab tests and imaging such as MRI scans.

Earn Rewards: As they complete their activity goals and recommended healthy actions, participants earn reward points, which can be redeemed to defray the cost of the Apple Watch or for gift cards to popular national retailers.

There's so much cool going on here, from the use of machine learning algorithms to hyper-personalize notifications to the use of rewards to incentivize engagement, that's it's hard to know where to begin diving into all this.

But, for me, it's the privacy aspect that's paramount. Because, without privacy, no one could trust Attain, Aetna, or Apple, and then none of the rest would be possible.

Apple's chief operating officer, Jeff Williams:

We believe that people should be able to play a more active role in managing their well-being. Every day, we receive emails and letters from people all over the world who have found great benefit by incorporating Apple Watch into their lives and daily routines. As we learn over time, the goal is to make more customized recommendations that will help members accomplish their goals and live healthier lives."

And here's what Aetna has to say about the privacy-first design:

User privacy and data security are at the heart of Attain. A completely voluntary program, members determine what information they want to share and can discontinue using Attain at any time. All Attain health data is encrypted on the device, in transit, and on Aetna and Apple's servers, where it will be stored in a highly secure environment using industry-leading practices fully in compliance with HIPAA. Information from this program will not be used for underwriting, premium or coverage decisions.

I've covered Apple's approach before but seeing how it can encompass partners is fascinating. Where other companies might skip privacy all together so they could harvest user data to fund their business model, or try to bolt it on at the end as some kind of after-thought, or not even talk about what they're doing — or not doing — at all, Apple and Aetna are clearly living up to not only responsibility but transparency throughout.

The Attain app builds on Apple and Aetna previous collaborations, which began in 2016 with 90% of the participants reporting benefits from their use of Apple Watch.

With it, more than just stand, move, and exercise coaching, participants will receive reminders to get vaccinations like the flu shot, notifications to refill medication prescriptions, and prompts to visit the doctor, all deeply personalized and based on their prior health history.

Completing activities earns reward points that can be put towards the Apple Watch itself or towards gift cards from popular retailers.

But, here's the thing: No participant has to share any of their own private data to be part of the program or to enjoy any of its benefits. Data sharing is a separate option, much like diagnostic analytics in iOS. It's not just opt-in, it's double opt-in.

If participants do opt-in, their data is anonymized, much like Siri data is for everyone. Apple wants to use your data to help train better machine learning models in order to help you get more out of the program. It doesn't want to and doesn't care to know who you are, and doesn't need to in order to facilitate other programs or satisfy other business models.

What's more, Aetna can't use any of the information for underwriting, pricing or instance coverage decisions.

We've all heard of nightmare cases where customers choose to share their data with an insurance company only to have the company turn around and use that data against them to change premiums, refuse care, or deny coverage. That kind of practice has an absolutely chilling effect on usage and participation, which is the exact opposite of what Aetna wants here and what Apple's privacy by design philosophy allows for.

If you do choose to share anonymized data, the system, for example, could learn when and how best to remind, notify, or prompt you. If you don't choose to share, you still get the same benefits, just based on the data of those who have chosen to share. There's zero penalty for opting out.

This isn't just the model for how Aetna and Apple got Attain done — it's a model for how every company and every partnership should look at customer data and consider how they can be of the most service while still being utterly respectful of the people and their privacy.

You can learn more at

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