Health Datapalooza IV: June 3rd-4th, 2013 Transforming Benefits Design and Delivery Through the Analysis and Exchange of Personal Health Data Moderator: Myrl Weinberg, Chief Executive Officer, National Health Council Speakers: Martha Wofford, Vice President / Head of Consumer Platform, Aetna Sherri Zink, Vice President, Medical Informatics, BlueCross BlueShield of Tennessee New products and services are making it easier for people to gather information about their health, as well as share this information with providers and other health care stakeholders. Learn how health plans are looking at the future of consumer engagement and how new emerging sources and types of health data are being used to prevent and manage disease more effectively. This session is eligible for continuing education credit.

1. BlueCross BlueShield of TN
Consumer Platform
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2. THE STRATEGY: EMPOWERING CONSUMER ENGAGEMENT
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3. CONSUMER CENTRIC VIEW OF “THE DATA”
Integrated Data Anchored around the Consumer
 Clinical
 Financial
 Lifestyle
 Behavioral
Showcasing Consumer Behavior and
Linking Consumer Engagement to Economic
Performance
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Group members into unique
micro-segments based on
lifestyle characteristics such
as age, income, life stage, etc.
Group members into unique
micro-segments based on how
they interact with the health
plan, utilization and cost,
medical risk levels, etc.
Combine a member’s lifestyle
and clinical micro-segment to
form the overall member
persona
Clinical Lifestyle
Lifestyle Clinical Member
360
o
UNDERSTANDING THE CONSUMER BETTER

5. LEVERAGING NEW SOURCES OF DATA
L I F E S T Y L E + C L I N I C A L = ME MB E R 3 6 0 D E G R E E V I E W
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CLINICAL
Clusters
LIFESTYLE
Clusters
Frequent Emergency Room user
Non-compliant with medications
Body Mass Index greater than 35
No established Primary Care
Physician
Frequent Emergency Room user
Non-compliant with medications
Body Mass Index greater than 35
No established Primary Care
Physician
Jackie
Age 55, Diabetes
Liz
Age 55, Diabetes
Struggling society segment
Economically challenged
Not computer literate
Struggling to meet work
responsibilities due to health
Suburban style segment
Permanent residence
Family-centric living
Internet savvy
Productive Employee

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Effectively Meet Consumers Where They Are
 To address current needs and preferences
Appropriately Tailor Consumer Outreach
 To focus on what is important to them
Consistently Flex the Delivery Model
 To better support existing health and financial needs
Proactively Identify Potential Risks
 To alleviate future health issues and unforeseen costs
Continuously Monitor Outcomes
 To improve quality of care
LEVERAGING CONSUMER INFORMATION TO:

7. Call Impact: high
Mail Impact: low
Action: start with call contact,
may follow up with mail
Call Impact: high
Mail Impact: high
Action: choose the cheaper
way to contact
Call Impact: low
Mail Impact: low
Action: alternative outreach
method like email
Call Impact: low
Mail Impact: high
Action: start with mail
contact
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Money to Burn
Stable Spenders
American Melting
Pot
Middle-of-the-Road
Mixers
Single Savers
Generally, mail has greater impact than
phone calls.
Comparing the five clusters:
Stable Spenders responded the best,
followed by the Single Savers
 Money to Burn members respond
considerably better to mail compared to IVR
TRACKING RESULTS: WOMEN’S HEALTH CAMPAIGN

8. Reach: good
Convert: bad
Action: alternative reach method
Reach: good
Convert: good
Action: no change
Reach: bad
Convert: bad
Action: update contact info or
alternative reach method
Reach: bad
Convert: good
Action: update contact info
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Money to Burn
Tend to be more affluent. Like to know how a
product can elevate their status and are more
willing to take risks with their purchases.
Stable Spenders
Young to middle-aged individuals that tend to
be driven by how to get the most “bang for
their buck.” However, they are very aware of
how specific brands can reflect their lifestyle
and tend to gravitate towards popular logos.
American Melting Pot
Contains members from a wide array of
income levels and ethnicities. They take pride
in local and American made products and like
to see a reflection of family when making
purchases.
Middle-of-the-Road Mixers
Middle-class, diverse households and have
spending habits that are just as varied. These
individuals highly regard how products affect
their family when making purchasing
decisions.
Single Savers
Mostly singles living in urban areas that tend
to gravitate towards discounts when spending
their hard-earned money. They aren’t as
concerned with the newest products, but tend
to focus on those that are tried and true.
TRACKING RESULTS TO IMPROVE THE MODEL: ASTHMA CAMPAIGN

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ENGAGING THE PROVIDER: PATIENT CENTERED MEDICAL HOME
 PCMH Web Based Dynamic Tool provides key patient data directly
to clinicians
 Gaps in Care
 Utilization Patterns and Risk Scores
 Interactive Patient Workflow by Disease State
 Understanding Barriers to Care and Socioeconomic Factors
 Real-time Updating of Measure Sets
 Comparison to Peer Group
Results
 Quality in Care Gaps improve 8% over control population with use
of appropriate tools*
 Reduction in ER and Admit Rates
Better Tools - Better Data - Better Outcomes!!!
Gaining Valuable Insights with Enhanced Consumer Profiles

10. Thank You
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