ACA Retaining Newly Enrolled v7-17-14-Final verCS

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Technical DifficultiesCall Webinar Support at

+1 (855) 352-9023Webinar ID 138-899-491Go to JoinWebinar.com

AudioParticipants can use their computer’s

speakers or telephone- Call (646) 307-1707- Access Code: 793-096-937

Only the presenter can be heard and participants will remain on mute

Comments & QuestionsPlease summit your questions and comments via chat under ‘Question’ section

Welcome to:Winning ACA’s 2nd Growth Race

?

Housekeeping

Dedicated Sessions AvailableDedicated sessions are available over the next 4 weeks. Contact us through our website if you are interested

!

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Welcome to:ACA 2nd Growth Race Webinar!

Carlos Santiago has been guiding strategic growth rooted on predictive analytics for leading marketers in health & wellness for 13 years at SSG.

Mindy Figueroa leads an award-winning team that operationalizes roadmaps helping Hospitals, Providers and Organizations to go-to-market with coaching and proven tools that deliver results.

Juan Ovalle is an expert in predictive analytics, effectively generating insights from data fusion across syndicated, customer databases, custom qualitative, quantitative and Social research in CPG, Telecom, and Health.

About the Presenters

SSG is a growth consulting leader driven by management P&L experience, Big Data and predictive analytics.

We develop fact-based business models, insights, customer experiences and roadmaps that profitably segment distinct customer groups and drive revenue.

We help clients focus their resources where the highest ROI opportunities exist and customize strategies advancing efffective Total Market growth.

About Santiago Solutions Group

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Winning ACA's 2nd Growth RaceAgenda

1. Cultural operations readiness 2. Acquisition

• tools for fine-tuning messaging

• balancing in-person vs. digital touch-points

3. Loyalty• bonding through loyalty

& word of mouth • stewarding brand

advocates in customer experience

4. Profitability• managing costs of care

HOWReadiness, Acquisition, Loyalty & Profitability

in 4 Steps

1. Key Similarities and Nuances by segment vs. Insured counterpart

2. Which key nuances

impact Acquisition and Retention

WHO

New Exchange Consumers

Similarities & Nuances

1. Segments, language, key states, competitors

2. Big Winners &

Losers

WHATDefine

Progress and Opportunity

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1. Progress Attained

& Opportunity Ahead

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CO

MI

WA

PA

NC

GA

TX

NY

FL

CA

2%

3%

3%

3%

4%

4%

5%

8%

8%

25%

States Converting Most Eligibles

States Enrolling Most US Eligibles

Top 10 US best performance states account for 66% of US Actual Enrollment

66%

Source: DHSS Summary Enrollment Report May 2014 & Kaiser Family Foundation, Marketplace Enrollment as a Share of the Potential Marketplace Population

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WNH Hisp AANH AONH Millennials

CA Enrolled One Third of the ACA Eligibles;

Includes Eligible Uninsured + IFP (FPL 139-400)

WNH & Asian/Other performed strongly

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Over One third of Eligibles Enrolled in CA

Source: SSG Analyses of Covered California Press Release on April 17, Kaiser Family Foundation, and Scarborough USA+ 2013 R2; Enrolled a/o Mar 31 vs Uninsured + IFP Opportunity; Total estimated eligibles: Insurable Uninsured + IFP (FPL 139-400%): 3.8M; Age: 18-64

1,396 36%

2,447 64%

RemainingOpportunity

Enrolled

Enrolled

Total Eligible Opp’y 3.8MIn 000’s

Total Enrolled 495 391 39 471 403

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CA Enrolled One Third of the ACA Eligibles; Twice as Much Opportunity Remains Includes Eligible Uninsured + IFP (FPL 139-400)

Overall Hispanic performed very strongly

AA & Millennials trail behind

7

Twice as Many Eligibles Remain in the Sidelines

Source: SSG Analyses of Covered California Press Release on April 17, Kaiser Family Foundation, and Scarborough USA+ 2013 R2; Enrolled a/o Mar 31 vs Uninsured + IFP Opportunity; Total estimated eligibles: Insurable Uninsured + IFP (FPL 139-400%): 3.8M; Age: 18-64

29% 15% 111% 23%

1,396 36%

2,447 64%


Enrolled

Enrolled

OpportunityRemaining

Total Eligible Opp’y 3.8M

27%

In 000’s

-21%v. WNH

-7%v. WNH50%

42%

9%

AA

Hisp

WNH

Total Enrolled 495 391 39 471 403

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NY Enrolled One Fifth of the ACA Eligibles


Hispanic & Millennials performed second after White NH

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One Fifth of the Eligibles Enrolled in NY

Total Enrolled: 213 58 39 62 115

371 22%

1,310

78%


Enrolled


In 000’s

Source: SSG Analyses of NY State of Health Open Enrollment Report June 2014, Kaiser Family Foundation, and Scarborough USA+ 2013 R2; Enrolled a/o April 15vs Uninsured + IFP Opportunity; Total estimated eligibles: Insurable Uninsured + IFP (FPL 139-400%): 1.7 M; Age: 18-64

Enrolled

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NY Enrolled One Fifth of the ACA Eligibles; Four Times is the Opportunity RemainingIncludes Eligible Uninsured + IFP (FPL 139-400)

Hispanic & Millennials performed second after White NH

9

One Fifth of the Eligibles Enrolled in NY

22% 12% 107% 16%

Total Enrolled: 213 58 39 62 115

371 22%

1,310

78%


Enrolled



17%In 000’s

-27%v. WNH

-23%v. WNH

56%

22%

22%AA

Hisp

WNH

Source: SSG Analyses of NY State of Health Open Enrollment Report June 2014, Kaiser Family Foundation, and Scarborough USA+ 2013 R2; Enrolled a/o April 15vs Uninsured + IFP Opportunity; Total estimated eligibles: Insurable Uninsured + IFP (FPL 139-400%): 1.7 M; Age: 18-64

Enrolled

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Inc.WNH Hisp AANH AONH Millennials

Fed Facilitated States* Have Enrolled One Fifth of ACA Eligibles; 4x as Much Opportunity Remains


Four Times as Many Eligibles Remain in the

Sidelines

Hispanic & Millennials are behind

* Idaho & New Mexico are Federally supported SBMs for 2014Source: SSG Analyses of DHHS Summary Enrollment Report-DHHS on May 2014, Kaiser Family Foundation, and Scarborough USA+ 2013 R2; Enrolled a/o Mar 31 vs Uninsured + IFP Opportunity; Total estimated eligibles: Insurable Uninsured + IFP (FPL 139-400%): 27M; Age: 18-64

Enrolled5,44620%

Total Enrolled: 3,424 585 908 529 1,538

Enrolled

Total Eligible Opp’y 27M

In 000’s

10

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Inc.WNH Hisp AANH AONH Millennials

Fed Facilitated States* Have Enrolled One Fifth of ACA Eligibles; 4x as Much Opportunity Remains


20% 14% 20% 44%13%

RemainingOpportunity21,66580%

Four Times as Many Eligibles Remain in the

Sidelines

Hispanic & Millennials are behind

* Idaho & New Mexico are Federally supported SBMs for 2014Source: SSG Analyses of DHHS Summary Enrollment Report-DHHS on May 2014, Kaiser Family Foundation, and Scarborough USA+ 2013 R2; Enrolled a/o Mar 31 vs Uninsured + IFP Opportunity; Total estimated eligibles: Insurable Uninsured + IFP (FPL 139-400%): 27M; Age: 18-64

Enrolled5,44620%

Total Enrolled: 3,424 585 908 529 1,538

Enrolled


Total Eligible Opp’y 27M

In 000’s

-35%v. WNH

-30%v. WNH

63%

17%

17%3%

A/O

AA

Hisp

WNH

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Spa Dom Eng Dom

Sources: Covered California Press Release on April 17, NY State of Health, 2014 Open Enrollment Report June 2014& Scarborough USA+ 2013 R2

Spanish Speaking Hispanics Have Underperformed During Enrollment

Enrollment Rate by Language of Preference Among Hispanics

EligiblesEnrolled

42%

66% 34%

58%

Index 64 171Spa Dom Eng Dom

EligiblesEnrolled

39%

68% 32%

61%

Index 57 191

(Hispanic enrolled) / (Hispanic Eligible)

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31%

30%10%

8%1%, A/O

10%

8%

1%

WNH

Hisp

AA

A/O

14M Uninsured Opportunity Remaining ~34M Opportunity Including IFP Eligibles 10-24M or 69% is Multicultural & Millennial

Opportunity By Segment

1. WNH61%2.Millennials

49%3.Multicultural

39%4.Hispanic

20%5.AA

16%

Multicultural

39%

Millennial 49%

Source: Based on Share of Eligible Opportunity in 38 states (FFM states, CA & NY) projected to US Total

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Winners Rebalanced the Playing Field: Blues & HN in CA & CO-OPs in NY

Sources: Covered CA Enrollment Press Released on April 2014, NY State of Health 2014 Open Enrollment Report June 2014, & Scarborough CA & NY DMAs 2011, 2012 R2

Index3257

161

317

Exchange Enrollment 2014

Commercial Insurance 2012

Index

267

50

180

19%

30%

6%

36%

8%

19%

58%2%

Exchange Enrollment 2014

Commercial Insurance 2012

13%

40%

5%

3%12%6% 6%

17

6%17%

17%

20%9%

8%19%

17%15%11%

62%

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2. Understanding the Newly

Insured Segments

- Similarities & Key Nuances

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Uninsured Wellness Mindset Not Significantly Different From Insured

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Wellness Mindset Opportunity

16%

32%

52%

20%

33%

47%

Insured

Source: Scarborough & GfK-MRI data fusion USA+ 2013 R2 Survey of the American ConsumerUninsured Eligibles: Uninsured, Ages 25-64, FPL 139-400Insured: Insured, FPL400+

Uninsured Eligibles

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-31 -33-44

0

20 176

64

4742

5650

Wellness- Minded Individuals are More Prone to Engage in Prevention

Wellness-MindedWellness-Ambivalent

Wellness-Averse

Regularly Go to Dr. for Check-upsUninsured 18+

SSG Wellness SpectrumTM Powered by GfK-MRI

100 Index US Total

Avg. Tot WnH H AA Tot WnH H AATot WnH H AA

Source: GfK-MRI 2013 double base Survey of the American ConsumerBase: Total Uninsured 18+, National

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Unins. & Ins. Millennials Transact Online; 1/3 Uninsured Still Prefer Store-Front

Insured Uninsured

61% 59%

20% 34%

19%7%

Banking Methods

Insured Uninsured

92% 83%

Internet & Mobile WebMill

Omni-Channel Transactions are not shown, however very key.

Source: Scarborough USA+ 2013 and GfK MRI Fusion R2 Survey of the American Consumer; Enrolled a/o Apr 19 FPL 400%+ vs Uninsured + FPL 139-400%; Age 18-34Significance tests run at 95% confidence level

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6 in 10 Uninsured Eligibles Mobile Savvy; Prefer “Sealing the Deal” in Retail/In-Person

Insured Uninsured

83%

57%

1%

3%

6%

3%

10%

38%

Internet & Mobile WebHISP 25-64

.7x

Insured Uninsured

58%39%

26%53%

14% 8%

Banking MethodsWNH 25-64

WHITE NH

HISP

2x

Source: Scarborough USA+ 2013 and GfK MRI Fusion R2 Survey of the American Consumer; Enrolled a/o Apr 19 FPL 400%+ vs Uninsured + FPL 139-400%; Age 25-64Significance tests run at 95% confidence level

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66%

34%

Span Dom Eng Dom

Insured

Vast Majority of Uninsured Eligibles Lack Communication Essentials

Uninsured Eligibles

HS Dimploma or lessSome CollegeCollege Degree or above

Insured

Uninsured Eligibles

70%

30%

57%

25%

29%

14%

29%

47%

Source: SSG Analyses of Scarborough USA+ 2013R2Uninsured Eligibles: Uninsured, Ages 25-64, FPL 139-400Insured: Insured, FPL400+

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Exchange Population is Very Different From Insured; Millennials Not Too Different

Exchange

Eligible

Insured

Nuances

Importance in Medical Consultation

Uninsured Insured

52% 63%

48% 37%

Doctor Knows Best

I'm My Own DoctorThe uninsured (ages 25-64)

are 29% more likely to act as if they are their own doctors in comparison to those already insured

Source: SSG Analyses of Scarborough USA+ 2013R2Uninsured Eligibles: Uninsured, Ages 25-64, FPL 139-400Insured: Insured, FPL400+

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3. RALP - Readiness, Acquisition,

Loyalty, & Profitability

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OPERATIONS CULTURAL READINESS23

1

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Socio-Economic & Cultural Needs

Too often Latino patients delay medical care until their conditions worsen and necessitate immediate attention

Two main drivers • Socioeconomic factors

– Lack of health care insurance / limited health care literacy– Limited transportation options– Work concerns (i.e., no PTO)

• Cultural factors– Expectation that one should tolerate pain without complaint– Belief that certain conditions (such as pregnancy) are

natural and do not require medical attention

HOW DO WE INCORPORATE CULTURE IN THE CUSTOMER JOURNEY OF NEWLY EXCHANGE INSURED?

Managing Latinos Use Of Acute Care Needs

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Latin Ready Assessment®An Innovation and Growth Tool

• How ready is your organization to provide a seamless customer experience to Latino and other multicultural segments today?

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No opportunities are being explored.

No opportunities are being explored.

Business is considering:

-Operations-Human Resources-Public Relations

Some opportunities are being explored in:

-Operations-Human Resources-Public Relations-Advertising-Community Relations


-Marketing Programs-Social Media

Exploring opportunities in:

-Operations-Human Resources-Public Relations-Advertising-Community Relations-Marketing Programs-Social Media-Financial ROI


-Development of Taskforce-Multicultural Champion

Exploring opportunities in:

-Operations-Human Resources-Public Relations-Advertising-Community Relations-Marketing Programs-Social Media-Financial ROI-Multicultural Champion-Budget

These opportunities are integrated into the business strategy; they are proactive efforts, not an afterthought.

*L2L’s Proprietary Latin Ready Spectrum ™ Tool

Latin Ready Assessment®An Innovation and Growth Tool

• A revolutionary proprietary tool that evaluates how financially, operationally, and emotionally prepared organizations are to address the rapidly growing Latino market.

• The LRA benchmarks an organization’s Latino DNA, objective observations and provides a road map on how your organization can become Latin Ready™, in alignment with CLAS – 15 National Standards by Minority Office.

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Latin Ready™ Spectrum - Benchmarks Surveyed Sectors are Almost Latin Ready™ with an average score of 27.09

*L2L’s Proprietary Latin Ready Spectrum™ ToolAnalysis based on a sample of 11 LRA studies from 2012-2014: 5 healthcare, 5 education, 1 retail/direct sales, 1 non for profit

Healthcare (25.63)

Education(18.75)

(27.09)All Sectors

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Retail (36.8)

Non-for Profit

(27.2)

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Latin Ready™ Spectrum – BenchmarksChallenges and Business Impact

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Operational

Financial

Emotional

ChallengesOperationally Ad Hoc/ One off initiatives Lack of ownership/champion Lack of diversity at C- levelFinancially Insufficient data e.g. revenue,

market size, cultural nuances Lack of metrics of success Lack of financial commitmentEmotionally Disconnect between C-level suite

and middle management on unified strategy

Not consistent external and internal communication

Blame glame on “marketing/advertising”

Business OpportunityOperationally Internal basic readiness/in

language/in culture systems and protocols

Compliance with national standards (healthcare)

Diversity & Inclusion strategyFinancially Established metrics and tracking

mechanisms / results driven on revenue, market share, sales, volume, etc.

Assigned budget 20-60% Latin Readiness increase in

12 monthsEmotionally Internal champion / company wide

commitment External communication and

outreach (segment goodwill)

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Fine-Tuning Messaging2

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How Can A Marketer Reliably Listen To Fine-tune Messaging For Branding & Acquisition?

Best-in-Class Leaders Mine Data to Find Un-Met Needs of Key Segments

ChallengeVoice of Consumers,

with emotions, frustrations, and unmet

needs

ApproachScientific-approach to

sorting through a multitude of insights

using Statistical, Text & Contextual Mining

techniques

BenefitQuickly identify sore

spots from recent ACA enrollees. Insights help optimize messaging for

second round

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Segmented Approach Can Overcome Regional Difficulties

Planet Superheroes

Fit & Trendy

Wellness Strivers

Busy Convenients

Savvy & Carefree

Tech munchers

Source: GfK-MRI 2012 double base Survey of the American ConsumerBase: Total Uninsured 25-64 National

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Selecting Optimal Promotional & Engagement Methods

@

3

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Managed Care Industry Leaders Understand Nuances of Segments

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Best-in-Class Leaders Mine Data to Find Nuanced Segment Personas

ChallengeMarket Leaders interact

with segmentations proactively with

actionable nuanced consumer personas

ApproachScalable Data Analysis that informs marketer

how to improve Awareness,

Consideration, and Preference

BenefitMarketer can interact

with growth segments, and efficiently guide the

consumer through purchase funnel

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Online Radio and TV Key Engagement Channel for Newly Enrolled Hispanics

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White NH Hispanic African Am Asian/O

California Eligible Uninsured

Source: Eligible Population: Uninsured/IFP, age 18-64 in FPL 139-400% (000’s)SSG Analysis of Scarborough USA+ 2013 R2

Managed Care CMO’s can influence new and confused enrollees by connecting with

them in the proper channels…Relevantly!

1.TV viewers

2.Online Radio listeners

1,075 1,595 185 339

441 674 59 162

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Bonding with newly insured for loyalty by tackling segment health disparities

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Bonding with Newly Insured

4

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Reduce Disparities

• Education Partners

• Outcomes• Cost &

Subsidies

• Spectrum• Data Fusion• Individual or

Geo level

• Wait til too sick• Non-compliance• Fear of system

• Cultural Relevancy

• Cultural Readiness

• H/C LiteracyCultural

Readiness

Excess Cost/ Readmission

Drivers

Prevention & Disease Mgt

Wellness Propensity

Cultural Nuances

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SSG Wellness Segmentation Identifies Low Risk Acquisition Pool

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Have/ Had Preventable Chronic Disease (PCD)SSG Wellness SpectrumTM Powered by GfK-MRI

Generations: GenX

Indices vs. US Total Avg.;Likelihood to Have PCD Above or Below US Avg.Source: GfK-MRI 2013 double base Survey of the American Consumer Base: Total Generation X 1968-1982

9

-5

-14Over Index

100 Index US Total

Avg.

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Brand Advocates5

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SSG Brand Heart & Mind Engagement Model™

Advoca

te

Rela

tion

ship

Bra

nd

Com

mun

ity

Activ

e

LoyaltyS

alien

cy D

eep

En

gag

em

en

t

Re-Trial

Purchase &

Experience

Disillusionment

Bitterness

© 2014 Santiago Solutions Group, Inc.

Rational R

esonance

Emotional

Resonance

Fam

iliari

tyP

erfo

rman

ce-I

mag

ery

Favora

bili

tyLo

ve-L

ike

Inte

nt

Cu

ltura

l R

ele

van

ce

39

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-20 -22

-35

71

-4

-26

59 55

71

3643

Top Segment Is Most Likely To Be Brand Advocate

Healthcare: Knowledge & WOMSSG Wellness SpectrumTM Powered by GfK-MRI

Uninsured 18+

Wellness-MindedWellness-Ambivalent

Wellness-Averse

100 Index US Total

Avg.

Source: GfK-MRI 2013 double base Survey of the American Consumer Indices vs. Uninsured 18+ US Total Avg.Category Influentialism Segments*- Categories Recommended To People: Healthcare Family/Friends or Neighbors/Colleagues or People you Don't Necessarily Know (in stores, online, etc.) AND Healthcare: I have a great deal of knowledge in this area

Tot WnH H AA

WnH HTot AA Tot WnH H AA

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Managing Cost$

41

6

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Effective Leaders Solve Strategic Issues Around Cost Management

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How to win enrollment

of loyal members?

How to manage and keep new exchange

members?

How to contain risk and ensure marketing

dollars deliver against goals?

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Manage Costs by Boosting Healthier Segments In Base

43

Through Focused Acquisition, Retention, & Prevention Efforts

Wellness-Minded

Wellness-Ambivalent

Wellness-Averse

100 Index US Total

Avg.

9 9

-5

18

-5-9

5

14

-14

-9

-23

0

Have/ Had Preventable Chronic Disease (PCD)SSG Wellness SpectrumTM Powered by GfK-MRI

Generations: GenX

Indices vs. US Total GenX Avg. Likelihood to Have PCD Above or Below US Avg.Source: GfK-MRI 2013 double base Survey of the American Consumer

Tot WnH H AATot WnH H AA

HTot WnH AA

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Executive Summary

Spotty Progress Vast Opportunity• Progress was spotty for Hispanics, African Am & Millennials• Spanish Dominant eligibles are lagging the most• 3-5 times more FPL 139-400 eligibles remain uninsured or with IFP• 14-34M eligibles remain out of Exchanges; 70% are Millennial or Multicultural

Exchange Brings a New Connsumer• Educational level is vastly < HS• Among Hispanics, the preferred language is predominantly Spanish• Exchange eligible is mobile savvy but also likes to transact in-person• Wellness Minded are most likely to go to Dr regularly

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Executive Summary:Effectiveness Best Practices & Tools

Cultural Readiness through operations gauges gaps in a systematic/standard tool

Fine-tune messaging reflecting voice of consumer to enhance conversion and brand relevance

Focus efforts on individuals with highest wellness propensity

Select promotional mix and engagement methods that reach eligibles directly

Bond with new customers by engaging culturally in treatment of health disparities

Identify and excel delivering to the expectations of Brand Advocates to spread positive word of mouth

Manage costs by focusing prevention efforts on those who are most wellness responsive

Readiness

Acquisition

Loyalty

Cost Management

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Marketing to a Diverse America ConferenceOctober 15-17 – Atlanta3rd Multicultural Health Marketing Conference featuring SSG and leading multicultural marketers.

DTC Perspectives is proud to announce the third annual edition of this exciting and important new marketing conference – The Multicultural Health National: Marketing to a Diverse America (MCH National) – October 15-17 at the Melia Hotel in Atlanta, GA.

Attendance Recommended For: Pharmaceutical (Rx and OTC) Marketers Advertising Agency Executives and

Creatives Representatives from Health Plans and

Managed Care Companies Healthcare Providers Mass and Ethnic Media Companies Government Officials and Policy Makers

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TIME FOR

YOURQUESTIONS

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SSG Monthly Insights Newsletter

Santiago Solutions Group

@Carlos_SSG

818.736.5661

SantiagoSolutionsGroup.com

@Santiago_Group

santiagosolutionsgroup.com/subscribe/

[email protected]

Thank YouWe appreciate the support of

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