Use case · Health management

Health & Productivity Management × behavior change — paper design
Redesigning an SME exercise program for Bright 500, with behavioral economics

Last updated: May 15, 2026

"PoC" on this page means a paper-design phase where we draft the program's blueprint together, not a tool you receive and trial-run. The output is a design summary you can act on internally — "this is how we'd actually run it." Because the engagement does not assume app deployment or program-running on our side, you can cleanly separate what your team can build, what you'd hand off to an external partner, and what doesn't have enough information yet to decide.

1. Who this page is for

The primary reader is an executive or HR lead at a 30–300 employee SME, with the SME-track Health & Productivity Management Outstanding Organization (健康経営優良法人中小規模法人部門) recognition and Bright 500 in view. We assume there isn't a dedicated Health & Productivity Management lead — the CEO or the head of general affairs is doing it on the side — and we organize the design to reconcile the recognition criteria with what employees actually experience, on a minimal setup.

The same frame applies to large-corporation HR / health-insurance leads (500–5,000 employees, the "next move after step-event fatigue") and to municipalities and health-insurance federations (improving participation among residents or members). Both the lever weighting and the KPI treatment shift with scale. For a specific conversation, please reach out via contact.

The explanation of the exercise area itself within Health & Productivity Management — how it ties into the recognition criteria, the structural reasons exercise programs don't stick, and the behavioral-economics principles — lives on the sister page exercise programs in Health & Productivity Management. This page goes one step further: it shows, in the form of a paper-design phase, what would actually be required to start at your company.

2. Scenario (a 150-person SME)

The setup is illustrative, but it's the configuration we see most. In the actual paper-design phase the prerequisites and pain points below are replaced with yours, based on what the discovery surfaces.

Prerequisites

Industry: service (IT / consulting / professional services — a high share of remote work)
Headcount: 150, average age 38, 6:4 male/female
Health & Productivity Management setup: 1 HR person doing it on the side; an outside occupational physician once a month; Kyokai Kenpo as the health insurer
Prior exercise programs: pedometer handout (2 years ago), internal step-ranking (last year) — participation dropped below 10% within 3–6 months in both cases
Goal: this fiscal year's Bright 500 application. For the "increasing opportunities for exercise" item, get to a state where you can report not just participation but continuation

Example paper-design output

Pick one combination out of the three intervention levers (loss aversion, altruism, peer effect) that fits the company's culture
A two-week-cycle short-form challenge design (self-declared goals) and the evaluation flow that supports it
An operational rule that individual step counts are not visible to managers, plus an anonymized distribution shared with HR / the occupational physician
The fields to capture and the aggregation format so the application can list "participation rate" and "continuation rate" separately
A proposal to align with the occupational physician and the health insurer for consistency with the non-exercise areas (mental health, women's health, lifestyle in general)

With that output in hand, you're in a position to decide whether to run internally, use an external tool (including the ESPL app) alongside, or align with the occupational physician and the health insurer before starting. The paper-design phase is the work of lining up those decision inputs.

3. What we decide together in the paper-design phase

(1) Discovery

We inventory the existing exercise programs — participation rate, continuation rate, budget, operating setup — from both the numbers and the operational reality side. "Data wasn't kept" and "it fizzled out partway" are treated as starting points, not faults. If you have prior Outstanding Organization application history, we also look at the evaluation gap by prior year.

(2) Goal and KPI setting

We separate the recognition criteria from the KPIs you actually want to chase (participation rate, continuation rate, median steps, presenteeism indicators, etc.) and find the landing spot that satisfies both. For an SME, not adding too many trackable KPIs is what keeps the program running.

(3) Intervention design (mapping the three levers)

We pick the lever among the behavioral-economics set — loss aversion and commitment / altruism (return to family, team, society) / social proof and peer effect — that matches the company's culture and existing programs. At SME scale, going deep on one or two levers works better than touching all three. The fuller principles are on the mechanism page (three levers).

(4) Evaluation and review design

We design the review cadence (two-weekly / monthly / quarterly), which meeting body owns it, and how the design survives the annual revision of the recognition criteria. Because the Health & Productivity Management criteria move every year, leaving a "design foundation" that doesn't have to be rebuilt with the criteria lowers long-term operating cost.

(5) Surface the next-phase options

Based on the paper-design output, we list which of (a) internal operation, (b) operation with an external tool such as the ESPL app, (c) align with the occupational physician / health insurer before starting is the most realistic. By default we leave the paper design in a shape where any of the three can move forward naturally.

4. What's included / not included

Included

Discovery and inventory of existing programs
Mapping recognition-criteria requirements to your KPIs
Picking the intervention lever and translating it into operational steps
Operational rules for handling individual step counts and health information
How the application paperwork would look (the participation rate / continuation rate split)
Review design and readiness for the annual revision of the criteria

Not included

App implementation / custom development
Running the step events internally on your behalf
Executing Specific Health Guidance (特定保健指導) or substituting for the occupational physician
Drafting application paperwork to the health insurer or METI
Hosting / custody of employee data

The "not included" items are expected to be carried forward in-house based on the paper-design results, or via a separate engagement with the occupational physician, a labor / social-security attorney, or a Health & Productivity Management operating partner. We'll also share our read on who would be a fitting partner during the design phase.

5. Suggested timeline

Below is a rough guide for an SME of about 150 employees. It can run shorter or longer depending on your situation.

First call (30–60 min): an online conversation about the current state and the goal. This gives you the inputs needed to decide whether to proceed into the paper-design phase.
Design phase (2–4 weeks): one or two discoveries, draft, alignment, final delivery. The duration shifts with what discovery surfaces.
After delivery: you move into internal decision-making — running it internally, pairing with an external tool, aligning with the occupational physician / health insurer. Ongoing support is a separate conversation.

Fees vary with scale, scope, and the number of stakeholders involved, so we give a specific quote in the first call. We can quote the paper design and any follow-on accompaniment as a single package, or split the decisions across two stages.

6. FAQ

Q. Can we request paper design at 30 employees?

Yes. The illustrative example here is 150 people; at 30–50 people the design axes shift — "narrow the KPIs", "raise the review cadence", and so on. A smaller organization is actually a good fit for a design that concentrates on one of the three levers.

Q. Do we have to deploy the ESPL app?

No. The paper-design phase does not assume app deployment. The deliverable lists multiple options — internal operation, an external tool, combining with another vendor. If the ESPL app's features align with your design, we surface it as one option.

Q. Will we have to hand over individual step counts and health information?

Not in the paper-design phase. What we handle there is at the level of program, operation, and aggregation structure; the actual individual data stays inside your organization. The data treatment for the case where you do deploy the app is explained separately.

Q. We haven't fully aligned with the occupational physician / health insurer yet. Can we still talk?

Yes — that's actually a common starting point. Rather than trying to close the alignment gap up front, the paper-design separates "what we can decide on our own" from "what needs an approach to the occupational physician / health insurer". Sequencing it that way makes the subsequent alignment easier to move forward concretely.

Q. We hear the Health & Productivity Management criteria change every year. Won't the design go stale fast?

The paper design on this page aims to build "a design foundation rooted in the principles of behavior change" — not "a program that answers the criteria of the moment". When the details of the criteria change, the foundation almost never needs to be rebuilt. Annual fine-tuning is done by adjusting the wording and aggregation format on top of the foundation.

Start with a first call (free, online, 30–60 min)

"Whether a paper-design phase even makes sense for our situation" — that's something the first call can decide. Reach out any time.

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