Entries in Marketing (17)


HHS-CMS Share Marketplace Projections and Nine Open Enrollment Strategies

By Clive Riddle, October 21, 2016

Earlier this Week, HHS Secretary Sylvia M. Burwell “announced that she expects 13.8 million individuals to sign up for coverage through the Marketplaces during the upcoming Open Enrollment.” In conjunction with her announcement, the HHS Office of the Assistant Secretary for Planning and Evaluation released a report detailing these 2017 enrollment projections for 2017, telling us:

  • The projected enrollment of 13.8 million would represent an increase of 1.1 million from 12.7 million plan selections at the end of 2016’s Open Enrollment.
  • They estimate this will net down to monthly effectuated enrollment averaging 11.4 million people during 2017.
  • 10.7 million uninsured Americans are eligible for Marketplace coverage. Among them, 85% are potentially income eligible for financial assistance,  and 60% have incomes that would also qualify them for cost-sharing reductions in addition to tax credits
  • 40% of the eligible uninsured are 18-34 years old
  • 5.1 million eligible for the Marketplace currently purchase off-Marketplace coverage. Of this group, they estimates 2.5 million people could be eligible for financial assistance via Open Enrollment signups for Marketplace coverage

So how are they going to increase the open enrollment signups to 13.8 million? Last week, CMS shared their open enrollment marketing strategies, noting that “nearly half of uninsured adults are unaware of the financial assistance available to help pay for health insurance, even though about 85 percent of Marketplace-eligible uninsured Americans could qualify for financial help.” Their marketing plan includes:

  1. Increasing direct mail pieces from 800,000 last year to 10 million this year, targeted to “people who were recently uninsured, recently lost coverage, or sought coverage in the past through or a state Medicaid program,” including “people who started to sign up at last year, but didn’t complete the process”; “consumers who lost eligibility for Medicaid or CHIP coverage last year, or who applied for Medicaid or CHIP but had incomes too high to qualify.”
  2. The IRS “will conduct new outreach to uninsured people who paid the penalty or claimed an exemption, letting them know that tax credits are available for Marketplace coverage and providing information about their health coverage options.”
  3. E-Mail marketing will be expanded, as “’s email list has grown by over 30 percent” to 20 million+ people
  4. notes they “learned that simply reminding a consumer about their eligibility for financial assistance in an email increased enrollment rates by 17 percent compared to emails that did not include that information,” and that “emails informing returning consumers of increased costs in their current plan and encouraging them to review their options by shopping increased active renewal rates by 279 percent.”
  5. also learned merely mentioning a deadline in an email increased enrollment by 14 percent compared to emails that did not mention deadlines.
  6. will remind consumers about the a penalty for not having coverage, and cite a study in which “consumers who received an email with additional language referencing the penalty were 13 percent more likely to enroll,” and a test that “found that more prominently displaying penalty information with the deadline (for example, in the email subject line) produced a larger lift in enrollment, 97 percent,” and a “message that gave higher-income people information about the higher penalty levels likely to apply to them increased enrollment by 18 percent.”
  7. Outreach is being expanded to mobile and streaming platforms, and gaming platforms in order to reach younger audiences. cites a partnership with gaming platform Twitch, and notes that they will run ads and sponsor content on YouTube, Instagram and Facebook
  8. will emphasis optimized search efforts and cite that “CMS increased overall search conversion rates by 24 percent compared to the previous year.”
  9.  will “double the number of impressions a consumer sees (“Gross Rating Points”) on TV in the week leading up to December 15th compared to the same week last year.”

Under the Influence

By Kim Bellard, March 18, 2016

new analysis by ProPublica found that doctors who receive money from drug companies do, in fact, tend to prescribe more brand name drugs, and that the more money they got, the more brand name prescribing they did.

ProPublica looked at prescribing patterns from five specialties -- cardiovascular, family medicine, internal medicine, ophthalmology, and psychiatry -- with the restriction that individual physicians had to have had at least 1,000 Part D prescriptions in the study period (2014).  Overall, about three-fourths of physicians took some money from a drug company, although there was wide variation by specialty and geography -- e.g., nearly 9 of 10 cardiologists took payments, just as around 90% of physicians took such payments in Nevada, Kentucky, Alabama, and South Carolina. 

Conversely, in Minnesota and Vermont the percentage was closer to 25%.

The amount of the payments appeared to have an impact.  Internists who received no payments had brand-name prescribing rates of about 20%, while those getting more than $5,000 had rates of around 30%.

The defenses from physician organizations and the drug industry make for fun reading.  Dr. Richard Baron, the president and chief executive of the America Board of Internal Medicine, protested that doctors almost have to go out of their way to avoid taking these kinds of payments.

The president of the American College of Cardiology suggested the patterns were re-enforcing; the more they learn about a drug, the more they tend to use it, and the more they use it, the more drug companies pay them to be speakers and consultants.

Seriously, these are their defenses?

We've been learning a lot more about how pervasive industry payments -- not just pharmaceutical companies but also medical device and other health care suppliers -- are since the advent of the Open Payments initiative.  We're talking about over $6.5b in payments in 2014, made to over 600,000 physicians and 1100 hospitals.  I wrote about this last summer, and the new ProPublica analysis certainly should rattle any remaining doubts anyone might have had about the potential impact of such payments. 

True to form, last fall the AMA called for a ban on DTC advertising.   That's right, they don't seem disturbed about the $6.5b physicians are getting, but they think that the ads that we see are bad.  There's a certain logic to that; it has long been suspected that these ads help drive consumer demand.

Austin Frakt, of The New York Timesrecently challenged this conventional wisdom.  For one thing, he notes that while drug ads do cause an increase in sales for the advertised drug, they also increase sales of other drugs in the same class, using Prozac as an example.  Seeing drug ads may help "normalize" the condition being treated, making getting treatment for it more acceptable, and may also help encourage patients to continue with existing prescriptions.  

Mr. Frakt points out that it is not only the drug companies who benefit from drug advertising, but also physicians.  Every $28 in drug advertising results in an additional doctor visit; someone has to do the prescribing, after all.  And, of course, the DTC spending is dwarfed by the direct-to-physician "promotions" -- Mr. Frakt estimates drug companies spend seven times more on these than on DTC advertising. 

So we're back to the ProPublica analysis. 

It simply is not plausible to maintain that these efforts are not influencing physicians' decisions, and that they may not always be in the best interests of patients.  As Bloomberg put it last summer: the payments "seek to convince doctors that second choice is OK."
Well, I don't know about you, but that is not OK with me. 

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting


What’s In a Name?

By Clive Riddle, December 3, 2014

Wellpoint is now Anthem. The re-titling of the national health benefits company was publicly announced months ago, the new corporate website has been designated as, and the change from the New York Stock Exchange ticker from WLP to ANTM became effective today.  

WellPoint Health Networks and Anthem merged in 2004, with WellPoint assuming the corporate name of the merged company. Why the name change back to Anthem ten years later? It’s mostly about branding. Joseph Swedish, Anthem’s President and CEO tells us “the change to Anthem will help us better communicate our values and simplify the way we connect with our associates, consumers, investors, and the communities we call home.” Simply put, the company has lots of products around the nation branded as Anthem. They have none branded as WellPoint.

So why did they take the WellPoint name in the first place? Branding may have been less the issue at the time than negotiations between two large BBCBS for-profit corporations. The corporate headquarters went to Anthem’s Indianapolis, but with the WellPoint name. WellPoint’s Leonard Schaeffer got the title Chairman of the Board; Anthem’s Larry Glasscock took the title President and CEO. A telling sign of the shifts in competing corporate cultures and recognition of the branding issue would have been in 2009 when the flagship from the WellPoint camp, Blue Cross of California, assumed the trade name Anthem Blue Cross.

The era of corporate names that are independent of the subsidiary divisions and products seems to have faded as branding is deemed more essential.

As we dig around through the graveyard of bygone healthcare names, the branding issue is forever complicated by mergers, acquisitions, spinoffs and scandals. 

Humana once was a hospital company that developed a health plan division, back when corporate integration of healthcare was in vogue in the 1980’s, before falling out of favor in the 1990’s and re-discovered this decade. Humana’s hospital division was spun off as Galen Healthcare, which was acquired by Columbia, which merged with HCA to become Columbia/HCA, and finally just HCA (Hospital Corporation of America), partially to simplify branding, and perhaps more to re-brand away from the Columbia identity after a Medicare fraud scandal in 1997.

Tenet was once National Medical Enterprises, becoming Tenet in 1995 partly to re-brand after large acquisitions, but motivated to distance from the NME name after scandals with NME’s Psychiatric hospitals division.

In New York, Group Health Inc. and Health Insurance Plan of New York merged in 2006, under the corporate name EmblemHealth. Eventually, the corporate name became branded as a product name. Such strategies - to deploy the corporate name in branding - have become much more prevalent during this decade.

But then there is Regence, the Pacific Northwest BCBS company who in 2011 announced their new corporate name would be Cambia Health Solutions, while the health plan products are still branded Regence.  So what’s in a name – and in 2024 will Cambia pull a WellPoint and re-title themselves as Regence?


Get Ready…ACA Superbowl

By Lindsay Resnick, January 23, 2013

Bring your A-game to both sides of the ball, it’s time to play game winning offense and defense. As ACA’s October 2013 open enrollment gets closer, winning health plans are focused on honing their direct-to-consumer marketing skills around retaining and acquiring membership.  It means getting into the Affordable Care Act game by protecting your base with tough defense, and preparing to put points on the board (aka new members) with aggressive offense.

DEFENSE: Retain the members you already have. Prioritize those that are the most valuable and create customized engagement strategies to keep them. Take a data-driven approach to understanding your most vulnerable “at risk” population within your Individual and Small Group businesses that can soon make individual choices.

Core objectives for health plan retention:

  1. Maximize retention of existing membership in both on and off Exchange products by minimizing the potential to lose Individual and Small Group customers to competitors.
  2. Leverage membership data and third-party intelligence to improve understanding of current Individual and Small Group customers.
  3. Communicate a timely and relevant message to existing membership, employers, and distributors to support retention by improving member engagement and building brand loyalty.
  4. Emerge as a trusted source for information regarding what health care reform is and what is means to those most impacted…Who’s eligible for what? What’s in it for ME?

OFFENSE: Get your share of the open enrollment “land grab”. Understand needs and attributes of various segments of new market entrants to optimize acquisition campaigns. Create on/off Exchange strategies to generate new leads and sales from individuals most likely to enter the market as a result of ACA’s disruptive events. Switching will be at an all-time high... make sure they switch to you!

Core objectives health plan acquisition:

  1. Increase sales opportunities to enroll a larger percentage of the individuals across all segments likely to purchase through public/private Exchanges and, small businesses SHOP Exchanges (e.g., uninsured, disenfranchised small group employees, subsidy eligibles, new Individual shoppers).
  2. Optimize and increase the use of database management and segmentation tools to improve targeting capabilities and gain a better understanding of the marketplace than your competitors.
  3. Work in tandem with your product development team to identify various product acquisition paths, mapping current portfolio to a post reform products. These product acquisition paths will be the basis for determining messaging and sales strategies.
  4. Deploy a new business direct response marketing tactics that blends push-based education with pull-based entry into your selling cycle. 

The future of health insurance belongs to the prepared.To achieve and sustain profitable growth, marketing strategies need to look very different going forward. They need to move from product-centric…see who buys it; to consumer-centric…understand how they engage.

Tomorrow’s health insurance consumer needs to be at the center of everything marketers do throughout the customer lifecycle.  An engaged consumer means connecting early and often, nurturing them into the sales cycle, keeping them involved through purchase, and delivering a superior customer experience. A balanced approach to customer retention and acquisition, supported by data-based intelligence and strong consumer engagement, will determine ACA winners.


Healthcare Customer Service and Retention Concepts and Relevant Data Don’t Have to be Specific to Healthcare

By Clive Riddle, December 6, 2012

There can be a mindset within the healthcare industry that management of most core business functions need to be very healthcare specific in order to be relevant. Of course there is truth to that, but sometimes, those within the industry can use healthcare specificity as an excuse for performance levels that might not otherwise be acceptable in other service industries, or as blinders to ignore relevant knowledge and benchmarks that would undoubtedly prove beneficial to the healthcare organization. 

With this in mind, we call your attention to a study just conducted by Accenture, addressing customer service and marketing across ten service industries (including wireless phone, internet service, life insurance and retailers, but not including healthcare). The annual Accenture Global Consumer Survey  pulled together results from 12,000 consumers from 32 countries including the U.S. 

Here are some findings that should have applicability to healthcare, even if the data wasn’t healthcare specific:

  • One in five consumers switched companies they buy from; 85% of consumers say the companies could have done something differently to prevent them from switching
  • 67% pointed to having their customer service issue resolved during their first contact as a factor in switching
  • 54% might have remained loyal if they had been rewarded for doing more business with their provider
  • Broken promises are a top area of frustration for consumers, according to the survey: 63% indicate it’s extremely frustrating when a company delivers a different customer service experience from what it promised upfront
  • 78% of consumers say they are likely to switch providers when they encounter such broken promises
  • 65% are likely to switch when having to contact customer service multiple times for the same reason
  • 65% are likely to switch when dealing with unfriendly customer service agents
  • 61% are likely to switch when on hold for a long time when contacting customer service
  • 48% say that, compared to 12 months ago, they have higher expectations of getting specialized treatment for being a “good” customer
  • 50% say it is extremely important for customer service people to know their history so they don’t have to repeat themselves each time they call
  • 31%  prefer companies that use information about them to make their experience more efficient from one step to the next; but only 24% said their service providers deliver tailored experiences 

Accenture found that, on average, consumers use various channels to learn about and select service providers, including:

  1. Word of mouth, relied upon by 79% of consumers
  2. Corporate websites, used by  71%
  3. Online sources such as expert review sites, news sites and product comparison sites, used by 63% 

Robert Wollan, global managing director of Accenture Sales & Customer Services tells us “the sobering reality is that ‘tried and true’ strategies for customer acquisition, loyalty and retention are struggling to keep pace with consumers who are perpetually in motion, more technologically savvy than ever, and increasingly unpredictable. The news this year is that customers want to be loyal but customer service often fails to meet their expectations. In the digital marketplace, companies must improve social listening capabilities and apply predictive analytics designed to quickly identify and respond to potential customer issues before problems arise.”