How one startup improved their first use experience using behavioral principles

Kiwi is a fintech savings platform that enables users to access personalized prepayment health savings plans. Kiwi’s platform integrates with health clinics to provide financially at risk patients access to a planning service that provides financial guidance and a tangible savings method for needed medical procedures.

The problem:

While proper, quality and immediate care for medical procedures is almost always ideal for the patient and their family, it is sometimes not financially feasible. Kiwi understands this and works with the provider and the patient to create customizable health savings plans.

At the clinic and after their doctor appointment, a patient will meet with a Kiwi advisor to plan out the payment terms, frequency and amount. Once terms are developed, Kiwi users are sent home with their payment plan and an activation code. The patient can activate the plan by paying an initial down payment at the local convenience store.

What actually happens after the patient is sent home? Nothing.

During Kiwi’s initial pilot only 1 person out of 40 people actually started the plan post clinic appointment and meeting with Kiwi.

Why is this?

Once a patient leaves the clinic the decision making process becomes complex. Behavioral research suggests that the more complex the decision, the less well equipped people are to deal with it.[1] Unfortunately the decisions which matter the most in life, such as selecting medical treatments or investment strategies, are often those which people are least equipped to make.[2]

How can Kiwi increase the likelihood that patients will start their plan?

For a complex decision like this, the patient will have a tendency to avoid making any decision.[3] They will go with the default option, which in this case is deferring the choice all together.[4]

What can Kiwi do? At StartupOnomics summit with Irrational Labs, Kiwi was able to break through this problem and design a plan that changed the default.

Kiwi made a down payment necessary to the platform by requiring that users to put at least 100 pesos (roughly $8) immediately into their savings account in order to receive a membership card. Now the default behavior is to activate the plan vs. the default to avoid the decision and ‘do nothing’.

Kiwi Case Study

This solution is also elegant because it takes advantage of the foot-in-the-door selling technique.[5] The foot-in-the-door technique suggests it is better (about 13% better[6]) to ask for small things first – like a tiny down payment – before going in for the BIG ask. People are more likely to say yes to big commitments if they have been previously asked and have said yes to small commitments.

This is exactly what happened.

By changing the default with a small commitment that got people activate their plan IN the clinic, Kiwi improved their uptake rate to 15% from a near 0% uptake rate.


With a grant from The MetLife Foundation, Irrationals Labs hosted 12 financial inclusion startups at their third StartupOnomics conference. At the three day event Irrational Labs co-founders, Dan Ariely and Kristen Berman, as well as phDs and professors from the nation’s leading behavioral and economics programs helped companies consider how behavioral economics can improve their users’ health, wealth and happiness