Published on February 5, 2014
ACA 2.0: New Eligibles, New Opportunity, New Demands Critical Steps to seize & retain the untapped Hispanic & Millennial ACA Exchange Potential 1. 2014 Opportunity, progress & gaps 2. Main barriers to adoption critical to address 3. An efficient targeting technique to advance conventional age/language engagement approaches 4. New customer experience demands for insurers and hospitals 5. Immediate & Long-Term Tips to maximize growth and retain share
About Santiago Solutions Group 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 efficient Total Market growth. © 2012 Santiago Solutions Group Inc. 2014 Santiago Solutions Group Inc. • 2
About the Presenters Carlos Santiago has been guiding strategic growth rooted on predictive analytics for leading marketers in health & wellness for 13 years. Prior to SSG, Carlos headed segment marketing business units in telecom. Derene Allen specializes in insights & analytics Bessie Ramírez brings healthcare brand management and product development best practices for the development of strategic plans and implementation roadmaps. 2014 Santiago Solutions Group Inc. identifying actionable levers with the highest potential impact for customer experience and brand advocacy. 3
Realistic Opportunity Assessment 2014 Santiago Solutions Group Inc. The opportunity gap for 2014. 4
Currently, 1 in 4 Uninsured Hispanics & Millennials have price expectations aligned with actual Exchange plans options; it’s a good start! Readiest Potential Uninsured eligibles Millennials and Hispanics are willing to pay above $100* monthly premium to avoid 1% penalty vs. 42% of NH *Univision Study on ACA participation, Spring 2013. Q22: If you had to pay a monthly penalty of $[1% of income/12] for not buying health insurance, how much would you be willing to pay each month to have the health insurance coverage for you and your family to avoid paying the penalty? Margin of Error of +/- 4% 2014 Santiago Solutions Group Inc. 1 in 4 5
Of CA’s 1.6M potential (among willing to pay >$100), Hispanics represent 33% & Millennials 43% Huge Potential willing to pay still to be realized: 44-50% of the ready opportunity comes from Hisp & Mill Hispanic & Millennials pace of enrollment is 1/2 of NH pace Uninsured >$100* + IFP (000) NH IFP 650K 42% Hisp IFP 278K 18% HUnIns>$ 100 240K NHUnIns 15% >$100 395K 25% CA Enrollment Progress & Upside Potential** Opp’y Ahead = 696K = 434K = 563K 67% a/o 12/31 84% 33% Attained 83% 17% 16% = 349K = 84K NH = 106K Hispanic Millennial Proj Oppty = 1,563K *“Individuals Enrolled in October, November and December, with Subsidy Status, Across Ethnicity” www.coveredca.com, calibrated to current proportions 19.7% Hispanic and 80.3% NH. *Univision Study on ACA participation, Spring 2013, n=520 Eligible uninsured + IFP 18-64 FPL 139-400 (IFP=Individual & Family Plans) SSG Opportunity Sizing: Scarborough 2013 Double Base USA + n=281,221 2014 Santiago Solutions Group Inc. CA Exch Subsidy Eligibles FPL 139-400 Documented: 6
Of Texas ~1M in potential, 36% are Hispanic and 42% are Millennial; of C/So FL’s ~800K ‘ready’ potential, 20% are Hispanic & 35% are Millennial Eligible FPL Documented 139-400 UnIns>$100K + IFP*1 (000) Central-So2 Share of Exchange Eligibles In 3 Sample States TX FL H NH UnIns>$ 100 356K 36% NH UnIns>$1 00 278K 28% Projected Oppty=985K Hisp IFP 99K 13% H UnIns>$ 100 121K 12% NH IFP 355K 46% NH UnIns>$100 266K 34% UnIns>$100 57K 7% 41% Mill 31% Hisp Projected Oppty=777K SSG Analyses of Scarborough 2013 Double Base USA+ *Univision Study on ACA participation, Spring 2013, n=520 1UnIns>$100 refers to people that are willing to pay more than $100/month; IFP = Individual & Family Plans 2Central-So = Central and South Florida only (excludes Tallahassee DMA) 2014 Santiago Solutions Group Inc. Hisp IFP 230K 24% 7
Opportunity for savvy Hospitals that master Patient Experience and apply to grab competitors’ share H-CAHPS standardizes customers perspectives of care experience1 culminating in Advocacy Patients Who Would Definitely Recommend the Hospital to Friends & Family 92% SFSH SD Avg. 79% 71% National Avg. 1Includes: • • • • Trust In System New Currency Increased Freedom of Choice Cultural Competence To Forefront As Potential Differentiator 78% Rewards Hospitals with Local Local Alternative1 Alternative2 • Loyalty • Higher ROI 2014 Santiago Solutions Group Inc. 78% Brings Consumers Communication - Responsiveness – Cleanliness - Customer Advocacy 8
Mindset, Cultural Barriers Standing Between Eligibles and Adoption 2014 Santiago Solutions Group Inc. The main barriers to adoption and which ones to address 9
Complex System New Concepts & Subsidies Subsidies Metal Program Plan Names Multiple Brands Multiple stakeholders Complex Enrollment Fragmented process 2014 Santiago Solutions Group Inc. Federal, state, County government. 10
Cultural/ Generational Nuances Customer Experience Relevant Comm. Perceived Value 2014 Santiago Solutions Group Inc. Hispanics & Millennials face Additional, Interdependent Barriers to Adoption 11
Hispanic’s Distinct Cultural Nuances I feel healthier than ever I have a degree but work 2 part-time service jobs I watch Drop Dead Diva after my “novela” Not many doctors understand me! I love the web, but prefer transactions in person I’m slow to trust… I’m on my smartphone 24hrs/day I didn’t have health insurance growing up Cash is king! 2014 Santiago Solutions Group Inc. I’m a 27 year old proud Latina Mom… 12
Millennials: Digital & On-the-go Among the uninsured eligible for subsidies, Millennials are more likely than Total to: Often under-employed, living with parents Afraid costs will increase1 Be hyper-connected, hyperinformed, hyper-influenced by SM/video clips Engage in physical activities, often for socializing2 Sources: 1. Harvard Public Opinion Poll, Dec 2013 2. 2. SSG analyses of 2013 Doublebase GfK-MRI 2013 , N= 50,764 2014 Santiago Solutions Group Inc. Believe “I am my own doctor” and only go to doctor when ill2 13
Relevant Communications are Key in the Exchange The ACA has overlooked main cultural communication challenges and in-lingual needs of Hispanics. Lackluster in-culture & in-language offering, devoid of consumer insights Suboptimal use of marketing tools Sources: 1 MRI 2013. 2 The US Department of Health & Human Services. 3 2014 Santiago Solutions Group Inc. Limited in-cultural communication channels 14
Millennials & Hispanics are Facing Value Choices San Antonio, fa. of two,~$36K/yr Basic plans from $1–4K/yr with fa. deductibles from $4.5–13K/yr Healthcare expenses last year ~$1,200 Penalty of $360 is better for us! Los Perez… an Upscale, FPL 250-400 and fully Bicultural/Bilingual Los Angeles, fa. of 5, ~$65K/yr Basic plans from $4–6K/yr with fa. deductibles from $3–10K/yr Healthcare expenses last year ~$4,000 We’ll deal with the Penalty of $650 2014 Santiago Solutions Group Inc. The Moya-Baum’s, a typical eligible Millennial couple in their early 30’s 15
Value & Effective Prospecting 2014 Santiago Solutions Group Inc. An efficient targeting technique to advance conventional age/language engagement approaches 16
The stated 2014 stated potential will expand 3x Opportunity as insurers effectively recalibrate messages, reinforce offering for the untapped potential, grab competitive share, and create loyalty with base It’s a marathon, not a sprint! 3 Key Factors Will Play A Role In Expanding The Initial Pool Of Enrollees • Value Perception will improve with prospects • Tax Penalties will decrease consumers value threshold • Competitive Pressures • Cost-savvy competitors will drive down prices • Effective offering, messaging, targeting, and delivery will lead to share shifts 2014 Santiago Solutions Group Inc. Time 17
The Challenge: How to acquire & retain new entrants in a smarter way? 2014 Santiago Solutions Group Inc. Is there a better mousetrap that leads to increased ROI? 18
Targeting Healthy Lifestyle individuals can yield base that increases competitive edge Directly resonating and connecting with Healthy Lifestyle individuals enhances marketing effectiveness over Generational approaches yielding a pool that is 8-20% less likely* to have PCDs relative to age Index of Preventable Chronic Diseases (PCD) Among Healthy & Unhealthy Lifestyles by Generational Segment Healthy Lifestyle 108 100 = Millennial Avg Individual Healthy Scores 104 103 95 8% 100 = GenX Avg 19% 100 = Boomer Avg 94 10% 87 Millennial Gen X* Boomer* 2014 Santiago Solutions Group Inc. Health Unaware * Statistical 2 SSG significant at 95% confident level Wellness Segmentation™ (powered by GfK MRI) GfK MRI 2013 Double Base , N= 49,970 19
Building Customer Intimacy with the Newly Insured 2014 Santiago Solutions Group Inc. 2013 Santiago Solutions Group Inc. New customer experience demands for insurers and hospitals 20
At each Touch-point of Adoption & Engagement, any “stumbling block” can be disruptive & “scary” Opinion Consideration Validation ACA/ Covered CA Complexity Preference Validation Search for Information Distrust Communication Tools Purchase (Advocates) Validation Application & Eligibility Determination Perceived Value Enrollment Cultural Nuances Brand Promises 2014 Santiago Solutions Group Inc. Awareness/ Interest 21
WHAT do I need to do to ensure a more positive customer experience? Increased Customer Intimacy ensures healthier business growth 2014 Santiago Solutions Group Inc. KNOW THY CUSTOMER 22
Focus on 2 key fundamentals to ease journey of Hispanic & Millennial eligibles and new enrollees • Reduce customer effort & channel switching by ensuring all links work and explanations are short & to the point • Understand key drivers of ongoing satisfaction/monitor always SIMPLE CLEAR COMMUNICATIONS SMOOTH JOURNEY 2014 Santiago Solutions Group Inc. • Simple & clear communications in the language of preference • Relate terms, look & content to something more familiar (ie. car insurance) • Create empathy 23
Strategic Implications 2014 Santiago Solutions Group Inc. 2014 Santiago Solutions Group Inc. Tips to focus on right now to maximize growth and retain share 24
Overarching sustainable growth strategies to win the ‘Exchange marathon’ as opportunities intensify Experience & Advocacy Accelerate Customer Centric Transformation Ease ACA + your own gaps, by delighting and creating Hispanic & Millennial brand advocates Shift From Thinking Of Patient Pools to Customers while applying Best Practices 2014 Santiago Solutions Group Inc. Integrate Strategies Fully understand Total Market similarities & nuances and address them from the outset across functional areas 25
5 Tips/2 Foundations to improve efficacy of Hispanic & Millennial efforts ‘Here & Now’ Simplicity Revisit network design to ensure culturally competent access Secure in-culture and in-language medical and support staff Enable face-to-face, where Hisp & Mill are Relevance Create identity reflecting community Bolster pertinent disease maintenance & prevention programs Bring mobile solutions Leverage personal circles of influence-SM In-person and mobile Go way beyond H-CAHPS 2014 Santiago Solutions Group Inc. Create relevant & relatable identity 26
2014 Santiago Solutions Group Inc. TIME FOR YOUR QUESTIONS 27
Subscribe to the SSG monthly Newsletter Thank You www.SantiagoSolutionsGroup.com/subscribe @Santiago_Group @Carlos_SSG Follow Santiago Solutions Group +1 818.736.5661 We’d like to extend special thanks to Univision for sharing their study on ACA participation, conducted during Spring 2013. 2014 Santiago Solutions Group Inc. www.SantiagoSolutionsGroup.com 28
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