HCSC's 'social marketing marathon' educates consumers about exchanges

Health Care Services Corporation (HCSC) is taking matters into its own hands. Deciding not to rely on federal or state governments to inform and educate the public about the health insurance exchanges, it launched its own advertising campaign particularly aimed at the uninsured population in the four states where it operates Blue Cross Blue Shield plans--Illinois, New Mexico, Oklahoma and Texas.

At the core of the "Be Covered" campaign, which began in March, is almost 200 partner organizations enabling HCSC to have its finger on the pulse of the uninsured community.

To learn more about how HCSC is successfully reaching out to the uninsured public, educating them about the reform law and online marketplaces, FierceHealthPayer spoke with David Sandor (pictured right), HCSC's vice president of public affairs and corporate communications.

FierceHealthPayer: What drove HCSC to take its own action to educate the public and create the "Be Covered" campaign?

David Sandor: The reason we did it was pretty simple. We conducted a significant amount of research that showed there are around 9 million uninsured people in the four states where we operate. And our research shows that the vast majority of the uninsured in our markets are confused about the new law, had very little experience with our industry and need help understanding the basics of connecting with the healthcare system in general. So this was a pretty big revelation for us.

Before we engaged in any product marketing, we decided that basic education was needed to address some of these knowledge and experience gaps that our research uncovered. In order to gain traction with so many people in such diverse communities, we had to start early and establish relationships with credible community organizations that were in a better position than we are to actually reach and motivate people. We couldn't communicate unilaterally. We had to create an infrastructure of community organizations that had existing and ongoing relationships with the uninsured and empower them to help us communicate some very basic information about what was happening and what they needed to be aware of prior to Oct. 1.

There's an opportunity to say something's new here, something changed that's significant and here's why you should care and here's what you need to do in order to benefit from these products. That's simply stated, but it's a very complex communication process, particularly when you're dealing with folks who have no preconceived notion of what regular healthcare or insurance is. Many see insurance as out of their reach, so they don't have a natural disposition to want this product.

So we thought we would create a campaign that we call "Be Covered." Each [one of HCSC plans' Be Covered campaigns] has its own website and own approach to identifying those community organizations that are in the best position not only to communicate but to have these ongoing conversations with uninsured people. We look at organizations like churches, food pantries, social service organizations and civic or ethnic heritage-based organizations. In each state, it's a little bit different. In Texas, we now have 112 community partners, ranging from the NAACP to the Asian American Health Coalition to St. Luke's Methodist Church. It's a real cross-section of organizations.

FHP: How does HCSC partner with community organizations?

Sandor: We approach them, present them with things we think would be helpful from a content standpoint. And we offer to work with them at events and in any other way that they feel is helpful to carry these messages forward. We use a lot of web content, text messaging and a bilingual newspaper supplement with the largest Spanish language newspaper chain. There hasn't been one organization that we've approached in any community in any state that hasn't been receptive to our offer to help empower them with this communication.

We have organizations that have come to us and simply prepared an email link for thousands of their members. Food pantries put our brochures in every box and bag of food that they distribute. Churches have invited us to share information. We go to soccer games and festivals and set up shop, give information, collect names to get people enrolled in our email and text campaigns. We want it to be an ongoing dialogue because even once people have signed up and selected a process, we feel this education needs to continue.

FHP: What type of topics do you include within the Be Covered marketing materials?

Sandor: We did a lot of focus groups to make sure that the information we were creating was accurate and meaningful. So, for example, if you go on a Be Covered website, we have a list of the top questions that people might have about the Affordable Care Act, like, How does the new law help me? Why is October important? Do I have to purchase health insurance if my state doesn't have an exchange? and, What if I can't afford health insurance? And we have an online social media campaign where every day we send information that continues to feed your curiosity, including local events in your community where you can go and learn more. And our partners can take any of the information that we've created, put their own logo on it and send it out to their constituents. We also conduct webinars with our partners. And we're creating a checklist for people as it gets closer to the enrollment period of things they need to have to apply successfully. That will help prevent people from being frustrated when they discover that they can't complete the process because they're missing a piece of information.

Then once you have people enrolled, there will also be a need to help them understand how to benefit from what they just purchased because many of the uninsured have no idea of the terminologies, acronyms. So to get benefit will require continued education explaining how to use the healthcare system.

FHP: Does the "Be Covered" campaign include information about HCSC specifically? Why or why not?

Sandor: This is unbranded. There's no product information. We decided we weren't going to approach this as a mass advertising sprint through an open enrollment period. We think about it as a real social marketing effort versus a traditional product marketing effort. By that I mean we saw there was a social good that could be achieved here that traditional marketing wasn't set up to do. We felt that to succeed, it would require more of a social marketing marathon that was fueled by a good understanding of the diversity and cultures that we're dealing with and the demographic differences and the different value propositions that would be most meaningful to those different cultures and people.

If you think about some of the most pressing health issues of our time--smoking, wearing seat belts, AIDS crisis--they were all enormous public health communication issues that required significant time and energy in order to change behavior and attitudes. That's how we're looking at Be Covered, as really a collaborative community-based social marketing effort. Not only to get people aware of the exchanges, and that's certainly the clear opportunity beginning in October, but we also recognize that whether on or off the exchange, the uninsured represent not only a significant health risk but an economic risk as well because the uninsured typically use the most expensive form of healthcare, emergency rooms, or they will leave illness untreated which ends up costing all taxpayers, businesses and state and local governments. So we feel there's a social and economic good that can come from a campaign like this.

FHP: Do you have any plans, perhaps closer to when the exchanges actually launch in October, to do any product advertising?

Sandor: Not through Be Covered. We see two very important tracks here. Obviously when products are approved, exchanges are launched and there's an action that people can take, we will market the choices available to people both on and off the exchange. But I think the difference here is that before people could even get to that stage, there's a whole lot of information and education that has to take place. We didn't look at it as open enrollment is coming so let's start this mass advertising effort and try to get bodies in the door. We feel like the education piece is an absolutely necessary precursor to success later on.

We're talking about millions of people, most of whom have never had health insurance before, don't regularly visit physicians and don't speak English. We're also dealing with people of different ages and different health needs who may become very big customers of the system and others who might be healthier and not see a value in having insurance. Each individual and family will have a different set of needs and expectations. Simply selling them a product from a cold start may not be the best thing to do here. So that's why we're trying to get deep into these communities, understand where these individuals are and understand what their existing knowledge is of what's happening in the healthcare industry. So you can't just jump in and start advertising and think people are just going to start lining up at the door when it's clear that there's a general lack of awareness of the law.

FHP: Have you learned anything from your community partners?

Sandor: We're always learning. And that's why we did Be Covered the way we did it. These populations are so diverse that there's no one-size-fits-all message or communication tactic. So while we develop some base communications, where we really see the most value is when we go to these organizations and tell them what we're thinking and they have specialties and requests to customize the message for their specific population. We're relying on these community groups for the best way to reach these populations. For example, we formed a partnership this year with H+R Block, which worked out very well, because as people go to file their taxes they will be asked whether they have insurance. This has been a tremendous way to reach people and make them aware that something is happening and give them an economic self-interest to go forward. But what we discovered in the Latino communities is that they don't necessarily go to H+R Block. Instead, they use a network of trusted sources who advise them on taxes, including travel agents. That's something we never would have known. The deeper we go into the communities, the more people we talk to, the more we learn and the better able we are in customizing information and reaching people in the most meaningful way.

Editor's Note: This interview has been edited and condensed for clarity.

Suggested Articles

A judge has dismissed the ongoing case between Oscar Health and Blue Cross Blue Shield of Florida over broker arrangements.

Expanding options for dental care in Medicare is a popular idea, but policymakers could take several avenues toward this goal, a new analysis shows.

Tennessee's proposal for a block grant brings a host of questions