bs-ca proposal_public

Marketing Consulting ProposalFor Blue Shield of California

Trina V. Burton, Consultant November 24, 2015

Introduction

Copyright 2015 Trina Burton2

Blue Shield of California is seeking to develop a direct-to-consumer

mechanism to drive high organic growth of consumer membership in its individual, family, and

Medicare health plans. Several discussions with Senior VP of Consumer & Medicare Markets, Ken

Wood, and Internet research yielded significant information included in this document. Upon sorting

and categorizing the content, three very notable points—in the opinion of this consultant—will drive

program development.

The marketplace is a transitional and dynamic environment where product differentiation is

virtually gray among all competitors for many reasons which are explored in this document.

Share of voice is low in comparison to major competitors. The plan is not driving its own

“noise” in the marketplace.

The ratio of members to the state’s population presents rich opportunity for growth.

This document sifts that information and pushes it through marketing structures at a high-level.

Immediately following this introduction is a brief Situation Analysis and Market Overview proposing a

strategic framework as a foundation to build a new and effective consumer strategy. The Planning

Overview presents architecture for further analysis including a Logical Framework, a Competitive

Analysis, and a SWOT Matrix. This consultant believes these marketing pillars are essential in leading

Blue Shield of California to greater clarity about its place and products in a shifting environment

lending itself to a firmer direction for consumer acquisition.

Situation Analysis

“…one of our executives drove

from the airport to the office

and saw 13 competitive

billboards and nothing from us.

Our share of voice is quiet.” (Paraphrased)

Sr. VP of Consumer & Medicare Markets

Blue Shield of California

Copyright 2015 Trina Burton 3

is not news to any of us that competition in the US health care industry grew

even more variables into an already complex equation of member acquisition. The

Affordable Care Act, put in place by the Obama Administration, to enable health care

access for all Americans, rearranged the marketplace model for businesses, health

providers, and consumers alike. The tidal wave of change challenges those of us who

manage health care to rethink funding and costs, benefits, and the overwhelming

choices consumers must now wade through on their own. It’s a new marketplace with

new rules, new and emerging players, altered offerings and benefits with very active

Federal and state governance. Amidst the stormy marketplace, all entities whether

employers, health plans, or other providers, are working to find their brands’ sweet-

spot with consumers, gain dominant and “loud” share-of-voice, and exceed

subscriber/financial growth projections.

The Affordable Care Act pushed the health care industry into a new era of reform and rearranged the marketplace


It

Product similarity/parity is significant creating a “graying” of differentiation. This

also means that every like-product message is virtually the same. Blue Shield of California

is no different as it operates in a marketplace the size of the 7th largest country in the

world with a population of 38.9 million* citizens, that is growing at rate of 4.2% every 3-4

years.* The dominant consumer products cover individuals, families, and the segment of

each that is Medicare eligible. Blue Shield of California’s membership is 4 million, a 10.2%

population penetration rate. Achieving organic growth of one-half million additional

members within the next few years will require more aggressive approaches toward

eligible consumers, and partnerships with the new entities (The Exchanges and brokers)

influencing their choices. This proposal targets the 2017 open enrollment season to

rollout a new direct-to-consumer strategy that becomes scalable with increased

projections.

* Source: US Census Bureau 2010

Health care plans are scrambling to find their brands’ sweet-spot with consumers

Copyright 2015 Trina Burton

5

Market Overview

Exchanges funded by gov’t at 1B

Medicaid expanded 4M

50% drop in uninsured

4.5M selected coverage

Cigna, Aetna left mkt;

returning to CA for 2017

open enrollment*

1M pay penalty uninsured

State agencies manage

patient rights

Medicare is nearly free,

richer benefits, more gov’t

funding

Brokers expanded role

advising consumers

Employer market growth

limited

Consumers drive their own

plan selection

Low product differentiation

Digital individual plans

enter market, volume over

revenue

Estimated 600K/day turn 65


* Re-entry of such big hitters will drive greater market dynamics.

Goals, Opportunities, and Credibility

Grow organically 500K members by

direct-to-consumer mechanism

Position price from level offered by

Kaiser Permanente to low end of

market

Plan data management moving to

CRM level to steer members to

other plan products

Create investment stream for

emerging markets

Create message stream featuring

3rd party endorsements promoting

brand as top in state (i.e. ethics,

quality, best of blue); target brokers


Target growing Medicare

Advantage market as 600K per day

celebrate age 65

Target large individual market

estimated at 2.7M

Target remaining 1M paying the

penalty as uninsured by choice

Reduced product differentiation,

opportunity to personally target

(CRM)

Strengthen Exchange

relationships, partner

Strengthen agency relationships -

DMHC, OPA-mitigating negative

consumer impacts

Deepen broker strategy, favorable

endorsement, “advise” consumers

California Plans

6 million members

8 million members

4 million members

Re-entering CA market 2017 open enrollment season

Re-entering CA market 2017 open enrollment season


California Health

Exchange offering 12*

plans to state citizens

* Number of competing plans will change as Aetna and Cigna re-enter market in 2017 enrollment season

Planning Overview


9

ProjectLogical FrameworkApproach


LogFrame Approach brings clarity to diverse projects,

such as improving internal procedures, developing new systems,

streamlining operations, leveraging quality improvement, implementing

change initiatives, and other important topics that require a systematic

approach. It is built on answering four interrogative questions, that greatly

aid communication, collaboration, and consensus.

What are we trying to accomplish and why?

How will we measure success?

What other conditions must exist?

How do we get there?

The concepts scale and flex to accommodate one-person projects, team

efforts, or larger programs or functions. Originally created to help the

United States Agency for International Development (USAID) effectively

plan, implement, and evaluate the thousands of development projects in its

global multibillion-dollar foreign aid program.


DRAFT EXAMPLE

Logical Framework Approach*

Objectives Success Measures Verification AssumptionsLogical Hierarchy of If-Then Objectives Conditions When Objectives are Achieved Source of Evidence to Verify Measures Additional Factors Necessary for Success

Goal

What are we trying to accomplish and why?

Increase consumer plans' membership organically by 500K

accelerating new market growth across consumer products

How will we know we are successful?

Membership growth/numbers

Per product growth

Retention

How will we measure?

Month-end financial reports

3rd party reporting

Per product growth

What other conditions must exist?

Assumptions to reach goal

Greater share-of-voice

Deployed integrated marketing

See Situation Analysis in this deck

Improved relationships brokers, agencies

Activated investment stream

Purpose

Change or benefit expected from project.

Create direct-to-consumer strategy that is scalable by

product and market dynamics

Increased growth per product, by geography by

___% by ___date.

Per product month-end financials

Assumptions to achieve purpose

IT CRM focused technology in place supporting new

metrics reporting

Outcomes

Project deliverables. What happens?

New strategy becomes tactical plan

Execution occurs with in integrated consumer reach

vehicles

Best practices identified and shared

Challenges clearly identified with risk mitigation steps in

place

Outcomes date-completion included

Tactics deployed and presenting within targeted

mediums

Share-of-voice is higher or on par with largest

competitor

Evidence of deployment (cross-functional

presentations, kick-off showing final product, risk

plan approved, etc.)

Media reporting per vehicle used

Completed project framework approved

Assumptions to achieve Outcomes

Management supports

Marketing team supports

Plan execute community activity to heighten

outcome impact

Campaign is constant throughout the season to

12/15/16

Inputs How? Who? When?

IFP GM perspective/discussion Jeff Smith

Project Schedule by Week, MonthMedicare VP-GM perspective/discussion Cathy Campbell

Sr VP Consumer Markets/further discussion Ken Wood

EVP Markets/discussion David Fields

Other Stakeholders Name

Other Stakeholders Name

*This LogFrame Approach brings clarity to diverse projects, such as improving internal procedures, developing new systems, streamlining operations, leveraging quality improvement, implementing change

initiatives, and other important topics that require a systematic approach. The concepts scale and flex to accommodate one-person projects, team efforts, or larger programs or functions. Originally created in the

1960's to help the United States Agency for International Development (USAID) effectively plan, implement, and evaluate the thousands of development projects in its global multibillion-dollar foreign aid

program.


Returning to CA 2017 OE

Metric BS-CA Kaiser HealthNet United HC Stride Health Cigna Aetna

Size 4 million 8 million

Market Share 10.2%

3-yr growth rate

Segmentation Individuals, Families,

65+

Targeting Consumer

Positioning

Value propositions

Products Individual, Family,

Medicare, Medicaid

Product dev

Pricing

Promotion

Channels Exchange, Brokers

Technologies Digital plan

Resources

Service Delivery Group providers

Competitive Analysis


13

SWOT Activity Notes Information Source Owner Completion

Strengths: Define the company's current mission statement. As a not-for-profit health plan, Blue Shield is guided by our mission and values, which encourage innovation

and enable us to be a catalyst for constructive change. Our mission and values are embodied in our proposal

to guarantee health coverage for all Californians, the first time a major health plan has called for universal

coverage.

Strengths: Identify market segments in which the company will

participate by conducting primary and secondary market research.

1-Individuals, 2-Families, 3-Medicare, 4-1M not choosing HP, 5-competitive plan members

Strengths: Identify the company's value proposition and how it will

differentiate itself within the marketplace.

General-we put the care of our members before profits

ID VP per product: 1-Individual, 2-Family, 3-Medicare

Marketing materials

Agency creative briefs

Weaknesses: Identify any barriers to market entry (for example,

capital requirements, technical barriers, patents, and process

barriers) that the company needs to overcome.

1-ACA changed Product, Price, Promotion, Place, Positioning

(i.e. Medicare is nearly FREE funded by the government, richer

product offering)

2-Broker-focused mkt; brokers advising consumers (was just

ERs)

Competitive creation of digital platforms reduces overhead,

makes nimble operations where volume is primary, not

monetization

3-CRM ready customer data to support Promotion, Place,

Positioning

4-Pricing-plans to be at Kaiser level or lower

5-Processes?

6-Needed capital for____________

7-Technical?

Weaknesses: Identify any risks inherent to the organization that

need to be mitigated so that the company can realize the business

plan.

1-Inability to segment customers for target mktg using CRM data

(maintaining sustained relationships with customers)

2-Not gaining greater broker endorsement toward consumers

3-No investment stream for emerging markets

4-Not having a robust direct-to-consumer model for acquisition

5-Maintaining silos of product org and marketing org

Opportunities: Identify areas where the current market is

underserved that provide an opportunity for the company.

1-Medicare: 1,000/month turning 65 in CA=30k consumers (5-600/day)

2-1 million folks paying penalty not choosing a HP, (why)

3-Medicare supplemental offerings, more available

4-Individual mkt?

6-Family plans group and non-group??

Opportunities: Identify any key processes, intellectual capital, or

other resources that the company can use to its advantage in the

marketplace.

1-ACA>consumer driven marketplace

Threats: Identify primary competitors, and then analyze competitor

performance by using all available data and additional data that can

be verified.

1-Kaiser, 8M members

2-Anthem Blue Cross (goal is margins)

3-The Exchange ACA, disables competitive differentiation

4-HealthNet

5-Covered CA

Threats: Identify secondary and potential future competitors that

might affect the business plan.

1- The Exchange, ACA, disables competitive differentiation

2-DMHC magnifies consumer issues with plan (i.e. directory issue); creates public platform of HC delivery +

and - (may not have been so PUBLIC before ACA)

Threats: Develop strategies for mitigating primary and secondary

competitive threats.

1-Create investment stream for emerging markets

2-CRM data, ability to target members for transition through plan products

3-Defined model, implemented for direct-to-consumer per IFP and Medicare products

4-Demolish product & mktg silos, merging strategies & tactics

Schedule


Year Month Timeframe

Week 1 Week 2 Week 3 Week 4

2015 December

2016 January

February

March

April

May

June

July

August

September

October

November

December Ends Mid-Month

2017 Open Enrollment Season

Proposal Approval

Deploy Campaign

Create Project Plan

Building 2017 Open Enrollment Roadmap

Creative Development, Finalized, Media Purchased


Tackling business challenges with her impeccable planning, nurtured

partnerships, and transparent communications, Trina is a results-driven career marketer. She brings

her vast business skillset drawn from combined global industry experiences in healthcare, technology,

wireless telecom, pet food, veterinary, credit cards, and the Internet.

Early in her career she quickly learned how to apply strategic concepts and tactical plans across

different types of business problems and issues regardless of industry. Though she’s worked in many

industries, health care is her favorite, as she has nearly 15 years experience (of her 30 years in

marketing) applying all marketing and communications components to managed care growth

(consumer, business, Medicare, Federal Employees, brokers, benefits managers). Her tenure includes

Humana and Blue Cross Blue Shield of Georgia where at the latter she was director of sales and

marketing administration. Her strategies smoothed Humana’s rocky entry into the Kansas City market

with the news media and brokers. An open enrollment advertising campaign developed just weeks

before the plan had permission to market to the target audience, doubled the subscriber base in 90

days to 200K. Her Medicare direct-to-consumer campaigns met a corporate mandate to the

executive director to quickly move monthly closed sales from 250K to 750K.

She was recruited to build a new communications department for an HMO and started by assessing

existing materials and messages and how they impacted the consumer brand experience. The market

was experiencing managed care growth and she determined the messages would not support the

necessary member education. A calculating risk taker, she discarded the information and started

from scratch using member focus groups, on-site visits to the plan’s 15 medical centers, and

meetings with department heads, learning the member experience first-hand.

Trina Burton,Consultant

Continued


Researching, writing, designing, and producing new member handbooks, provider directories,

monthly member magazine, and a showcase business/broker piece, she redefined the plans’

consumer messaging and tactical sales approaches. This work was recognized by Crain’s Modern

Healthcare and the Public Relations Society of America.

Her biggest successes are her integrated marketing programs for a new wireless carrier with no name

recognition, that derailed Sprint’s digital phone market introduction in its own home town.

Managing a national team of 80 project managers she installed the prepaid business unit into the T-

Mobile corporation amidst 3 dysfunctional mergers, separate operating platforms, 3 mixed brands

and multiple product denominations.

Trina has made big marketing impacts in 5 Fortune 500 companies generating combined gross

revenues upward of 1 billion. She has an MBA in business administration from Regis University in

Denver, and a BA degree in communications-journalism, public relations, and English from Drake

University in Des Moines, Iowa. She’s five classes away from her second MBA in health care

administration. Living in Redmond, WA near Microsoft world headquarters (also a client) she

supports and cares for her 86-year-old mother, enjoys the company and activities with her many

friends (she never meets a stranger) and is the favorite dog sitter to VIP clients Thumper, Jet and

Ziggy.

Linked In Profile

http://www.linkedin.com/in/tvb19


Health Care and Community Honors and Appointments

Washington State Alzheimer’s Community Board

Strategic planner supporting National Institutes of Health (NIH) ethnic trials at University of

Washington, event speaker sharing family story (4 years)

Missouri Board of Healing Arts

Appointed by late Missouri Governor as Public Member of the Commission for Physician Assistants;

also served as secretary (3 years)

Truman Medical Center

Missouri teaching hospital; Governors Board (2 years)

Visiting Nurses Association

Board of Directors, Marketing chair (2 years)

The Women’s Foundation for a Greater Memphis

Advisor to executive director: board strategy, creative fundraising, events, performance, assistance to

Hurricane Katrina (2000-present)

The Women’s Foundation of Kansas City

Board Director; committee chair: grants allocations, feasibility review, fund-raising, strategic planning;

philanthropist; as a consultant she developed the first strategy building donors relationships

attaching them to the organization in multiple ways (4 years)

Kansas City Business Journal/Junior Achievement

Up and Comer recognized for career long contributions to Kansas City business growth

Girl Scouts of USA

Lifetime commitment; Board Director (6 years); committee chair: fundraising, board nominations,

public relations, program development, scholarships; Wider Opportunities & United Way motivational

speaker throughout council, TV, radio talk shows; First Class recipient (Gold Award), philanthropist

(35 years)


“Trina’s greatest gift is her ability to strategically build and execute marketing campaigns that drive high brand awareness/consideration and top line growth. She has a unique ability to courageously perceive the most compelling story, identify the best target market for the solutions and design plans that showcase her strong expertise of marketing channels. Tactically, collaboratively and cross-functionally she knows how to make things happen and constantly adds to her base of knowledge.”Rene Parson, GM Cricket Wireless (now owned by AT&T)

“Applying her excellent consumer marketing and general business skills, Trina lead a cross-functional business team that evaluated and recommended a redesign of our unprofitable consumer prepay program. The integrated relaunch of service became a significant contributor to Aerial’s growth and profitability. Trina is very intelligent, a hard worker, anda self-starter. I have known her for over 20 years and watched her build brands, grow revenues and make permanent positive changes in consumer business.”Andy Fountaine, former VP Marketing, Aerial Communications (now T-Mobile)

“This was our largest and most complex event since taking control of building 25. Your contributions are numerous and I want to thank you for all the hard work and dedication.” (reference to her project lead role in executing the world conference for Microsoft Innovation Centers in Redmond, WA bringing 90 managers from 30 countries)Andy Gammuto, Microsoft DirectorDeveloper Experience team managing 4,000 events worldwide

Endorsements

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