Creative Models for Finding, Reaching and Marketing to the Un- and Under-insured: Lessons Learned from One State Health Insurance Exchange.

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Creative Models for Finding,
Reaching and Marketing to the
Un- and Under-insured:
Lessons Learned from One State
Health Insurance Exchange”
Sponsored by KPS3 Marketing
“

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Presenters
STEPHANIE KRUSE
CEO of KPS3 Marketing
Reno, NV
stephanie@kps3.com
M. DONALD KOWITZ
Retired CEO of Saint Mary’s Health Plans
Reno, NV
mdkowitz@aol.com
S H E R R I R I C E
CEO of Access to Healthcare Network
Reno, NV
sherri@accesstohealthcare.org

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Our topic today:
Two creative models
for identifying, reaching
and enrolling un- and
under-insured persons.

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Model 1:
A creative union between Saint Mary’s
Health Plans and Access to Healthcare
Network to reach uninsured Nevadans and
market the Saint Mary’s health insurance
products on the state exchange

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Model 2:
A successful research-based marketing
AND outreach program developed by
KPS3 Marketing to market Nevada’s health
insurance exchange

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The players in Model 1:
Access to Healthcare Network
»» Mission: increase access to primary and specialty healthcare service for the under and
uninsured, working poor, Nevada residents, through shared responsibility and community
wide partnership
»» The first nonprofit Medical Discount plan in the United States. Licensed with the Nevada
Division of Insurance
»» Served over 35,000 low income Nevadans since 2007
Saint Mary’s Health Plans
»» A regional healthcare company with a full range of commercial health insurance products
and administration services
»» Serves over 65,000 members in Nevada

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Model 1
How the model worked:
• Role of Saint Mary’s Health Plans
»» Competitive product and rates
»» Product design that mirrored member financial responsibility in AHN’s existing medical
discount plans
• Role of AHN
»» Marketing
»» Enrollment
»» Care coordination

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Model 1
Why we thought we could do this and benefit Nevadans, and our organizations.
»» SMHP wanted to participate in the Nevada exchange but minimize the potential risk of a
previously uninsured population
»» AHN served several thousand people with its medical discount plan that placed a heavy
emphasis on member financial responsibility and care coordination
»» Many of AHN’s members were eligible for subsidies to purchase insurance and AHN would
lose them as medical discount plan members
»» Since AHN’s members were already accessing health care, they posed less risk than a
population with no previous health care coverage

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Model 1
Why Health Plans decided to partner with a non-profit.
»» AHN had deep relationships with its medical discount plan members and could influence their
selection of a health plan on the exchange
»» AHN had a care coordination model that was effective in assisting its members to receive care
in the appropriate setting
»» AHN was creative and entrepreneurial; they were willing to become a licensed brokerage in
order to sell exchange products to their members

10. 2 $1,311 $1,744 $1,809 $1,822 $1,967 $1,980 $2,622 $3,278 $3,291 $3,933 $4,261 $4,589 $4,916 $5,244
3 $1,649 $2,193 $2,276 $2,292 $2,474 $2,490 $3,298 $4,123 $4,139 $4,947 $5,359 $5,772 $6,184 $6,596
4 $1,988 $2,644 $2,743 $2,763 $2,982 $3,002 $3,976 $4,970 $4,990 $5,964 $6,461 $6,958 $7,455 $7,952
5 $2,326 $3,094 $3,210 $3,233 $3,489 $3,512 $4,652 $5,815 $5,838 $6,978 $7,560 $8,141 $8,723 $9,304
6 $2,664 $3,543 $3,676 $3,703 $3,996 $4,023 $5,328 $6,660 $6,687 $7,992 $8,658 $9,324 $9,990 $10,656
7 $3,003 $3,994 $4,144 $4,174 $4,505 $4,535 $6,006 $7,508 $7,538 $9,009 $9,760 $10,511 $11,261 $12,012
8 $3,341 $4,444 $4,611 $4,644 $5,012 $5,045 $6,682 $8,353 $8,386 $10,023 $10,858 $11,694 $12,529 $13,364
10
1 $973 $1,294 $1,343 $1,352 $1,460 $1,469 $1,946 $2,433 $2,442 $2,919 $3,162 $3,406 $3,649 $3,892
Model 1
What populations we pursued, and why.
2014 Annual AHN Income Guidelines
Family
Size 100% 133% 138% 139% 150% 151% 200% 250% 251% 300% 325% 350% 375% 400%
1 $11,670 $15,521 $16,105 $16,221 $17,505 $17,622 $23,340 $29,175 $29,292 $35,010 $37,928 $40,845 $43,763 $46,680
2 $15,730 $20,921 $21,707 $21,865 $23,595 $23,752 $31,460 $39,325 $39,482 $47,190 $51,123 $55,055 $58,988 $62,920
3 $19,790 $26,321 $27,310 $27,508 $29,685 $29,883 $39,580 $49,475 $49,673 $59,370 $64,318 $69,265 $74,213 $79,160
4 $23,850 $31,721 $32,913 $33,152 $35,775 $36,014 $47,700 $59,625 $59,864 $71,550 $77,513 $83,475 $89,438 $95,400
5 $27,910 $37,120 $38,516 $38,795 $41,865 $42,144 $55,820 $69,775 $70,054 $83,730 $90,708 $97,685 $104,663 $111,640
6 $31,970 $42,520 $44,119 $44,438 $47,955 $48,275 $63,940 $79,925 $80,245 $95,910 $103,903 $111,895 $119,888 $127,880
7 $36,030 $47,920 $49,721 $50,082 $54,045 $54,405 $72,060 $90,075 $90,435 $108,090 $117,098 $126,105 $135,113 $144,120
8 $40,090 $53,320 $55,324 $55,725 $60,135 $60,536 $80,180 $100,225 $100,626 $120,270 $130,293 $140,315 $150,338 $160,360

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Model 1
Lessons learned during enrollment. What we achieved.
»» SMHP enrolled almost 5,000 exchange members in Northern Nevada
»» A significant portion of those resulted from AHN’s efforts
»» Given the problems with the exchange web site, a partner like AHN, directing members
to SMHP and assisting them in the enrollment process, was critical to achieving targeted
membership results.

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Model 1
Claims experience with AHN members who enrolled. Difference between
care coordinated members and non-care coordinated members.
»» Claims experience still being evaluated

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Model 1
What if you don’t have an ideal non-profit to partner with?
»» Build your own strong care coordination component
»» Partner with social services entity
»» Find an organization with knowledge of what each FPL level qualifies for

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Model 2
KPS3 Marketing: Nevada Health Link’s marketing and outreach firm.
»» Full-service marketing, advertising, PR, digital firm
»» 23 years of healthcare marketing: providers, carriers, public health, associations
»» Founder: 11 years’ prior experience in healthcare marketing
»» Based in Reno and Las Vegas, national client base

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Model 2
The research foundation to discover how our targets think and act.
Especially about an unknown concept and sensitive topic.
»» Secondary research
»» Focus groups on brand, imagery, concepts to reach them
»» Pre-campaign survey
»» Self awareness: “We are not our target audience”

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Model 2
Messaging
»» Explain the concept of an exchange
»» Simple terms, comparisons, graphics
»» Explain value of insurance to uninsured:
avoiding big debt or bills, staying healthy
to work and enjoy life, protecting your
family, the “mom factor,” peace of mind
»» Income based, based on your budget (not
affordable)
»» Our targets wanted to know there would
penalties on taxes
»» $50/month threshold
»» This is no laughing matter

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Model 2
Outreach
»» Trust, personal relationships critical
»» Non profit, religious,
government partners
»» Events and presentations
»» Door to door campaign
»» School program
»» Tupperware parties
»» Enrollment events (updating this year
to storefronts)
»» Measured in “quality of touches”
and cost per touch

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Model 2
Channels to reach prospects
»» Outreach
»» TV
»» Radio
»» Transit
»» Outdoor
»» Digital/mobile (great for measurement)
»» Print for Spanish and rural Nevada
»» PR
»» Some social
»» B2B delayed because SHOP module didn’t function

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Model 2
Challenges
»» Non functioning website for much of
enrollment period
»» Call center not staffed adequately
for first two months
»» Controversy of ACA and HealthCare.gov
»» Pricing of plans above prospects’
stated price point
»» Variations in brokers and
assisters’ approaches
»» Large influx of new Medicaid members
»» “Young Invincibles”

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Model 2
Results
»» 20 million plus visitors to website,
2 million plus unique
»» Hundreds of thousands of calls to call center
»» Post campaign survey: from 11% to 68%
awareness in target audience, remarkable
unaided recall of brand, 87% of prospects
state propensity to buy but BIG price
sensitivity
»» Strong results in digital/mobile -
high click through, views of pre-roll video
»» Less than 90 cents in cost per touch
of 1.6 million touches in outreach
»» 37,937 people enrolled and paid
(payment module didn’t work well)
»» 474,453 people completed applications
and 45,729 selected a health plan

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Lessons learned for
next enrollment
»» Value of people who know the target populations
»» Personal assistance in enrolling
»» Enrollment events - ease of access
»» Have a website that works

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THANK YOU. Q U E STIONS?