Download - Make It Stick: Engaging Today’s Consumer in a Post-Reform ...info.webmdhealthservices.com/rs/webmd/images/Make... · Make It Stick: Engaging Today’s Consumer in a Post-Reform

Make It Stick: Engaging Today’s Consumer in a Post-Reform WorldJohn Mills - Senior Director, Commercial Products, UPMC Health PlanLisa Fry - Partner, Subsidium HealthcareChristine Muldoon - Senior Director of Market Strategy, WebMD

June 3, 2014

© WebMD Health Services Group, Inc.All rights reserved. 2

Our Conversation Today

Introductions and Overview1

2An Outside Perspective: Market TrendsLisa Fry, Subsidium Healthcare

4 Discussion and Q & AJohn Mills

Senior Director, Commercial Products UPMC Health Plan

3 UPMC Health PlanJohn Mills, UPMC

Lisa FryPartner

Subsidium Healthcare


TOTAL MONTHLY UNIQUE USERS

64 MILLION39 MILLIONMONTHLY MOBILE UNIQUE

USERS1

ACTIVE US PHYSICIANS

625,000

440,000REGISTERED US PHYSICIAN

MOBILE USERS

REGISTERED USERS

7.1 MILLION

4.7 MILLIONACTIVATED PERSONAL

HEALTH RECORDS


The Six Key Elements You Need to Knowfor Creating Member Engagement

New eBook!

Stay Tuned For Your Copy!All webinar attendees will receive a copy of the eBook.


Motivate workers to take charge

Encourage workers to become better advocates for their health

Encourage healthy behaviors with financial

incentives

Inspire

Building a healthy workforce is a team

effort

Adopt healthy

behaviors

Engagement is THE Requirement


IT’S ALLENGAGEMENT

An Outside PerspectiveLisa Fry - PartnerSubsidium Healthcare


The stakes are huge….

The Battle for the Hearts and Minds of Healthcare Consumers

Nearly $1 of every $5 spent on health care

$1

….and it attracts a lot of attention from competitors

The Battle for the Hearts and Minds of Healthcare Consumers


Planning Your Consumer Engagement Strategy

Identify Objectives and Define Success

Determine Key Capabilities

Required

Conduct Gap Analysis

Outline Key Programs and

Initiatives

Measure and Iterate


Identify Objectives and Define Success

Overall Member Loyalty

Overall Member Loyalty:• Attracting new members• Retaining existing members

longer to improve ROI

Health Promotion and Improvement:• How will you define engagement?• Improved health status• Lower costs

Health plans will define success with a variety of metrics; these are changing with the impact of ACA and exchanges

Health Promotion

and Improvement

Overall Member Loyalty


Fundamental Characteristics of Successful Consumer Engagement Programs

PersonalizationConvenience

TimeTrust

Easy-to-Understand Information

Resources(Money, Time,

Data)

Success Factors For Engaging Consumers


Key Capabilities Required: Examples

BRANDBRAND

CONSUMER EXPERIENCECONSUMER EXPERIENCE

DATA/ANALYTICS

Rules Engine

Segmentation Profiles

Internal Longitudinal Data

External Consumer Data

TOOLS AND PROCESSES

Rewards, Loyalty Programs

Mobile Tools

Consumer Guidance

Multi-Modal Access and Contacts


40%

17%1%

20%

6%

17%

2 in 5 Are Unaware of Their Insurer’s Health Information Site

Health Info Site Usage

Over half of eligible health plan members say they use or woulduse their insurance company’s health information website

Only 1 in 4 say they don’t use or would not use

Source: 2014 Blue Research® End User Insights Panel

Insurance company has site, I’ve used before

Insurance company has site, I have not used

Insurance company has website, don’t know if I have

used

Insurance company does NOT have site, I

would not use

Insurance company does NOT have site, don’t know

if I would use

Insurance company does NOT have site, but I would use

John Mills Senior Director, Commercial ProductsUPMC Health Plan

Impact of the ACA on Individual and Small Group Markets

16

Premium Subsidies

Cost-Sharing Subsidies

Medical Loss Ratio Rate Review

Premium Tax/Other

FeesRating Rules

Essential Health

Benefits

Individual Mandate

• Major upheaval in Individual and Small Group markets• Influx of newly insured individuals• Insurance is moving towards a consumer market

• 55.7% are Male• 85% are between ages of 19 and 65• White residents make up the large majority of uninsured’s• 64% are below 200% of FPL, however 18% are over 300%• 60% of uninsured’s are working, 25% work for companies with less than

4 employees– Service industry (56.3%)– Retail (16.4%)– Construction (12.2%)– Manufacturing (10.4%)

• Lower income and education than overall population• Reduced ability to interpret labels and health messages

Demographic Characteristics of the New Uninsured Consumer

17

• In the past year:– 40% have not seen a doctor – 60% have not seen a doctor for routine care – Less than 10% have stayed overnight in the hospital – 40% have visited the dentist – 10% sought care at an ER because they could not find a doctor

• Overall– Less likely to take prescription medications on a regular basis– Lower likelihood of seeking preventive care– Greater use of emergency care– Worse overall health status and higher mortality rates

• Cost is a barrier to Care– 10% skip doses or took smaller amounts to make Rx last longer– 20% had to pay $500 or more out of pocket for services in the past year– 40% report having trouble paying medical bills

Health Status of the New Uninsured Consumer

18

• Performed extensive persona work and identified key purchasers– In and Out of Medicaid– Blue Collar– Small Business– Affluent

Persona Work

19

Personas

20

FPL 139-250% FPL 251-400% FPL 401%+ FPL Totals

Annual Income for Ind. $15,856-$28,724 $28,725-$45,959 $45,960+

• Subsidy Eligible• Shop on Price Primarily• Network is Secondary• Highly Likely to Change

PCP for 10% Discount in Premium

Personas

21


Annual Income for Ind.$15,856-$28,724 $28,725-$45,959 $45,960+

• Shop on Marketplace• Tax Credit Eligible• Price Driven• Network is Important• Brand and Access• Wants Insurance that

Covers his Bills without a lot of Hassle

Personas

22



• Shop Direct or Via Producer

• Price is Important• Network is Important• Brand and Access• Higher Income, Can

Afford Brand Choice• Less Likely to Switch Year

to Year

Personas

23



• Shop Direct or Via Producer• Benefits are Most Important• Will Pay More Up Front to

Not Have to Worry About Costs During the Year

• Higher Income, Can Afford Brand Choice

• Less Likely to Switch Year to Year

• Take a Healthy Step (TAHS) program is a standalone health and wellness offering that can be adopted with any medical plan Earn points or dollars Complete set of activities to accomplish goal Incentives can be disbursed in a number of ways, at discretion of employer;

Deductible credits, premium reduction, gift cards, etc..

• HealthyU is a CDHP product with an integrated health and wellness component Earn Incentives during the plan year to use during the plan year Standard Incentive Package Earn dollars, not points Earn up to $500/$1000 each plan year Incentives are used to pay plan covered medical expenses

Consumer Engagement

24

• Financial incentives can be successful in program participation and behavior change

• 2011 Harvard University study found that financial incentives helped improve participation in– Smoking cessation programs– Weight loss activities

• Affordable Care Act permits health plans to charge more for smokers than non-smokers– Rates can be lowered by enrolling in and completing a smoking cessation

program

• Major corporations have used financing incentives as a way to change behavior for years

Financial Incentives

25

Step 1: Traditional HMO/PPO Low Deductible Plan

Traditional EPO or PPO

product

DentalVisionCobra

Workers Compensation

Member

• Little to no member engagement

• Health care is ‘free’ and my behaviors do not impact cost

• Complex administration• Disparate messaging on

Health and Productivity

Plan DesignDeductible $0PCP Copay $15Spec. Copay $30Pharmacy $4-$15-$50

Step 2: Cost Sharing + Integrated Wellness (Option 2)

DentalVision

CobraWorkers

Compensation

Member

• Member is engaged• Health care has a cost• My behaviors impact this cost• Wellness programs lead to

better health

• Complex administration• Disparate messaging for Health and

Productivity

Plan Design-HealthyUDeductible $750

Health Incentive $500PCP Copay 10%Spec. Copay 10%Pharmacy $4-$30%-50%

Step 3: Integrated Population Health Management

Integrated Product with Member Engagement

• Engaged Member• Incentivized Health and Wellness

• With Carrots and Sticks

• “It’s my health and my money and I am going to take better care of both”

• Unified messaging and communications• Ease of administration

Plan DesignDeductible $1,500Health Incentives $500PCP Copay 10%Spec. Copay 10%Pharmacy $4-30%-50%

Tools for Engagement

29

Health Risk Assessment

30

Personalized Health Activities

31

Quality and Cost Information

32

• Compare Procedure Costs

• Compare Pharmacy Costs

• Find UPMC Health Plan Member-only Discounts

Compare Hospitals

33

View Information Regarding:

• Number of Patients• Mortality• Complications• Length of Stay• Safety• Patient Experience

• Identification of members with chronic conditions– Diabetes and Pre-Diabetes– Hypertension– Obesity– Smokers

• Improved program compliance– Success weight loss– Completion of smoking cessation program– A1Cs levels– Blood pressure

• Lower overall medical expenses

Success Metrics

34

• Many individuals enrolling through Exchanges have chronic conditions but are unfamiliar with the healthcare system– Lack a regular doctor– Receive irregular treatment for chronic conditions

• Engagement tactics that have worked in an employer setting may not work with the Exchange population

• Experimentation will be necessary to determine to identify successful programs and interventions

Conclusions

35


Making it Stick….The End Goal


Making it Stick….The End Goal

• Members use your site as an integral part of their daily life, the way they use Facebook.

• They would panic at the thought of you going out of business because you have become indispensable to their health.

• You have engaged them on the level that drives results: Loyalty, retention, and healthy behaviors.


• Map out your plan

• Get members involved

• Make your site awesome –intuitive navigation

• Communicate that awesomeness

Helping You Grow Your Engagement Potential


Q&Awww.webmdhealthservices.comEmail us at: [email protected]

Subscribe to our blog: www.webmdhealthservices.com/blog


Wellness works better with

Download - Make It Stick: Engaging Today’s Consumer in a Post-Reform ...info.webmdhealthservices.com/rs/webmd/images/Make... · Make It Stick: Engaging Today’s Consumer in a Post-Reform

Top Related