As a marketer, you know that the most vital part of any campaign is understanding who your target audience is and what they value. That’s no different in healthcare marketing. Of all these potential audiences, however, marketing to health plans (aka payors or payers) is perhaps the most difficult. That’s because these companies integrate two very complex concepts—finance and healthcare delivery—into their business operations.
A playbook for marketing to health plans
Understanding how these companies actually operate is foundational to any entity looking to improve its marketing to health plans. Unfortunately, there is no “one size fits all” insurer—some are non-profit Blues that sell a wide range of policies, others are large national insurers focused primarily on commercial group business. (Many of these entities are also undergoing sizable mergers and acquisitions that are changing the very fabric of the healthcare ecosystem.) However, there are many commonalities in the way these payers do business. The following insights are especially important to note as you look to target your marketing and ensure it resonates across the right stakeholders.
Predicting and managing risk
First and foremost, a health insurer’s profitability is heavily dependent on their ability to successfully predict and manage risk. These insurers develop the pricing and benefit structure for their products using underwriting, a process where actuaries use data analysis to determine the possible risk for an individual or group. Once this process is complete, they market their product through a variety of channels based on whether they are targeting large employer groups, Medicare-age individuals or other individuals—often using brokers or group benefit advisors (GBAs) to educate these people and groups about the value of their products.
Contracting with providers
But developing the right pricing and benefit mix is just the first step in effectively marketing health insurance. Health plans must also build their provider network by contracting with entities like hospitals, labs, imaging centers and physician practices. Some insurers are using unique cost-control strategies for these networks today, pursuing clinically integrated networks or narrow (highly restricted) provider networks to keep costs at bay. During this contracting phase, the plan agrees on a particular level of reimbursement for services (fee for service) unless they are working within one of today’s accountable care models (fee for value). Fee for value approaches may include a mixture of upside risk like bonus payments and financial rewards. Or they may incorporate downside risk which requires that providers take on greater accountability for rising claims costs.
The many facets of medical management
We’ve all heard the industry statistic that just one percent of plan members drive 98% of costs. No organization knows this better than a health plan. That’s why these entities try to proactively manage costs through the process of medical management. Medical management includes a wide range of care management, population health, utilization management and disease management efforts. These programs are often designed to support the sickest and highest-cost members, especially those with chronic conditions like diabetes, heart disease and COPD. Other efforts aim to reduce avoidable utilization like certain ER visits and hospital admissions. This medical management area is a critical area of focus for organizations marketing to health plans, especially those selling technology or data analytics. Other firms may be looking to convince insurers to outsource some of these programs and services altogether—for example, care management firms may market to health plans by offering a full suite of complementary services.
What to sell and how
Successfully marketing to health plans requires an in-depth understanding of each entity’s hot buttons in light of these critical business processes. Given their focus on risk management, insurers spend plenty of money purchasing data analytics, proprietary software, disease management services and mobile health solutions. If your suite of solutions requires either a sizable financial investment or a significant change to the plan’s infrastructure, you can expect that a committee comprised of C-suite players will likely all have a seat at the table. These buyers and influencers can include a Chief Medical Officer (CMO), Chief Technology Officer (CTO) and even the CEO. As a result, knowing these organizations from the inside out—including the ways that they predict and manage risk, will ensure that your marketing efforts resonate with these highly influential stakeholders.
Tap into industry trends when marketing to health plans
Many other industry trends are driving interest in new products from organizations marketing to health plans. These include the opioid crisis, which is driving the development of many new medical management models as insurers look to promote safer pain management approaches. In addition, a focus on social determinants of health is also driving a new emphasis on factors not traditionally dealt with by health plans. These factors include all of the areas that drive overall health and wellness, including an individual’s social support, housing, access to healthy food and job stability. Finally, federal- and state-based efforts to counter the effects of rising drug prices are also a trend worth considering when marketing to health plans. Healthcare costs continue to rise, due in large part to powerful but incredibly costly new drugs like specialty medications for Hepatitis C. Insurers and pharmacy benefit managers are looking for new approaches that can help address the financial impact of these costly new therapies.
Find the right marketing partner
An advanced knowledge of the healthcare landscape, combined with an understanding of these trends and hot buttons, will help position your organization for success. However, finding the right partner to assist you in branding your organization and marketing to health plans is also an important next step. That’s where firms like Activate Health can come in. To learn more about how we can assist you in better penetrating this market, contact us today.