aca retaining newly enrolled v7-17-14-final vercs
DESCRIPTION
SSG’s deep analysis of the first ACA Exchange enrollment period reveals that Multicultural & Millennials will constitute the vast majority, 7 in 10, of the 2014-15 ACA Open Enrollment opportunity. As penalties double, the next ACA open enrollment will likely see nearly 6 million new Multicultural and Millennial entrants despite the fact that their enrollment rates were 20-35% below Non-Hispanic Whites during the first open enrollment. Additionally, this new wave of entrants will be strongly influenced by the experiences of the 5.7 million new exchange-insured Multicultural & Millennial consumers.TRANSCRIPT
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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
6
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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WNH Hisp AANH AONH Millennials
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
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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%
RemainingOpportunity
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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WNH Hisp AANH AONH Millennials
NY Enrolled One Fifth of the ACA Eligibles
Includes Eligible Uninsured + IFP (FPL 139-400)
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%
RemainingOpportunity
Enrolled
Total Eligible Opp’y 1.7M
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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WNH Hisp AANH AONH Millennials
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%
RemainingOpportunity
Enrolled
OpportunityRemaining
Total Eligible Opp’y 1.7M
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
Includes Eligible Uninsured + IFP (FPL 139-400)
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
Includes Eligible Uninsured + IFP (FPL 139-400)
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
OpportunityRemaining
Total Eligible Opp’y 27M
In 000’s
-35%v. WNH
-30%v. WNH
63%
17%
17%3%
A/O
AA
Hisp
WNH
11
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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
Business is considering:
-Marketing Programs-Social Media
Exploring opportunities in:
-Operations-Human Resources-Public Relations-Advertising-Community Relations-Marketing Programs-Social Media-Financial ROI
Business is considering:
-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
27
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
34
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
35
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
47
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