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Sponsored by KPS3 Marketing

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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Presenters

S T E P H A N I E K R U S E

CEO of KPS3 Marketing

Reno, NV

stephanie@kps3.com

M . D O N A L D KO W I T Z

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

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Model 1

What populations we pursued, and why.

2014 Monthly AHN Income Guidelines

Family Size 100% 133% 138% 139% 150% 151% 200% 250% 251% 300% 325% 350% 375% 400% 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 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

2014 Monthly AHN Income Guidelines

Family Size 100% 133% 138% 139% 150% 151% 200% 250% 251% 300% 325% 350% 375% 400% 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 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

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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» Value of people who know the target populations

» Personal assistance in enrolling

» Enrollment events - ease of access

» Have a website that works

Lessons learned for next enrollment

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T H A N K YO U . Q U E S T I O N S ?