Big Data vs. Big Regulation in the Quest for Consumer Loyalty - Experiences with Digital and Social Media in the Health Insurance Industry
•
2 likes•5,656 views
Andrew Hetzel, VP of Corporate Communications for Blue Cross Blue Shield of Michigan, speaking at S.I. Newhouse School of Public Communications Global Leaders In Digital & Social Media Speaker Series #NewhouseGLDSM at Syracuse University. Speaking on "Big Data vs. Big Regulation in the Quest for Consumer Loyalty - How digital and social media can achieve health and marketing outcomes in a highly regulated environment." - How the Affordable Care Act is forcing health insurers to get more personal, despite the regulatory limits of HIPAA. - Why the largest health insurer in Michigan for 74 years sees social and digital media as vital to its future. - Experiences with digital health tools and e-prescribing in Michigan.
Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (14)
Similar to Big Data vs. Big Regulation in the Quest for Consumer Loyalty - Experiences with Digital and Social Media in the Health Insurance Industry
Similar to Big Data vs. Big Regulation in the Quest for Consumer Loyalty - Experiences with Digital and Social Media in the Health Insurance Industry (20)
More from Dr. William J. Ward
More from Dr. William J. Ward (20)
Recently uploaded
Recently uploaded (20)
Big Data vs. Big Regulation in the Quest for Consumer Loyalty - Experiences with Digital and Social Media in the Health Insurance Industry
- 1. Big Data vs. Big Regulation In the Quest for Consumer Loyalty Experiences with Digital and Social Media in the Health Insurance Industry Andrew Hetzel VP Corporate Communications Blue Cross Blue Shield of Michigan #NewhouseGLDSM
- 3. Today’s Discussion • My Company and Me • Regulation in Healthcare • The Changing Marketplace • Deploying Big Data Successfully #NewhouseGLDSM
- 4. • Blue Cross Blue Shield of Michigan (BCBSM) • Guarantee-issue insurer (only one in Michigan) • Licensee, Blue Cross and Blue Shield Association • Nonprofit healthcare corporation #NewhouseGLDSM
- 5. BCBSM Revenue $20.4 billion in revenue (GAAP 2011) would place BCBSM at 138 on Fortune 500 21 20.8 20.6 20.4 20.2 20 19.8 19.6 19.4 19.2 #NewhouseGLDSM
- 6. Claims Paid by BCBSM $50 million PER DAY $18.2 billion PER YEAR #NewhouseGLDSM
- 7. Michigan’s Health Insurance Market BCBSM Competitors Government Uninsured #NewhouseGLDSM
- 8. About Me • Syracuse University, BA 1990 – Newspaper / International Relations • BCBSM, VP Corporate Communications since 2005 • 67 full-time employees • 4 agencies of record (advertising, PR, social, research) • Portfolio: – Brand and reputational management – Communication strategy – Advertising – Marketing communications & publications – Media relations – Social media and email marketing – Employee communications #NewhouseGLDSM
- 9. There is no industry that is more personal than healthcare Your life (quite literally) could be in our hands And your most private information surely is #NewhouseGLDSM
- 10. #NewhouseGLDSM
- 11. The Importance of Regulation • Ensures the availability, confidentiality and integrity of your most personal data • Ensures that companies and individuals entrusted with your data are held accountable for its secure storage and use #NewhouseGLDSM
- 12. Protections in Federal Law • HIPAA – Health Insurance Portability & Accountability Act (1996) • HITECH – Health Information Technology for Economic and Clinical Health Act (2009) #NewhouseGLDSM
- 13. Required HIPAA Safeguards • Administrative – All healthcare entities must have policies regarding access to PHI • Physical – All must have secure access to facilities and buildings where PHI is kept • Technical – All must deploy safeguards, such as unique user IDs and data encryption to protect PHI #NewhouseGLDSM
- 14. HIPAA Privacy Breaches - 2011 #NewhouseGLDSM
- 15. Source: Healthcareitnews.com #NewhouseGLDSM
- 16. Impact of HITECH on HIPAA • Establishes random audits by “We’re federal regulators to enforce privacy and ensure compliance watching safeguards are in place you!” • Requires health plans to publicize breaches of more than 500 “Shame on individual records to local news you!” media and on the web • Sets out increasing levels of costly “Pay up!” financial penalties #NewhouseGLDSM
- 17. HITECH Penalties Maximum HITECH Violation Category Tier Penalty Range - Each Violation Penalty Entity did not know (and, by exercising reasonable 1 $100 to $50,000 diligence, would not have known) that it violated the applicable provision. $1,500,000 Violation is due to reasonable cause and not to 2 $1,000 to $50,000 willful neglect. $1,500,000 Violation is due to willful neglect and was corrected 3 $10,000 to $50,000 during the 30-day period beginning on the first date the entity knew, or, by exercising reasonable $1,500,000 diligence, would have known that the violation occurred. Violation is due to willful neglect and was not 4 At least $50,000 corrected during the 30-day period beginning on the first date the entity knew, or, by exercising $1,500,000 reasonable diligence, would have known that the violation occurred.
- 18. Regulatory Challenges for Social • Health plans must ensure that the method and means of communication are consistent with our legal obligations under HIPAA – Insurers must have a means to verify the identity of the individual submitting the request for information (is Andy really Andy, or some other person fishing?) – Insurers must maintain an appropriate audit trail to log system activity related to incoming requests #NewhouseGLDSM
- 19. Social Media vs. Big Regulation HIPAA is from Mars Social Media is from Venus #NewhouseGLDSM
- 20. Healthcare reform is changing the game for health insurers #NewhouseGLDSM
- 21. #NewhouseGLDSM
- 22. Market Impact of the ACA • The Affordable Care Act is changing where and how health insurance is purchased: – Enables people up to age 26 to remain on their parents’ insurance plan – Creates online marketplaces (exchanges) where consumers will shop for health insurance plans – Creates tax incentives and disincentives for businesses to offer health insurance as a benefit – Provides financial support (subsidies) for many consumers to buy insurance on the exchanges • These changes are shifting the marketplace quickly toward a “B-to-C” orientation #NewhouseGLDSM
- 23. A Changing Marketplace 2013 2017 (estimated) Employer Employer Individual Individual Charts represent BCBSM segment share data only #NewhouseGLDSM
- 24. Big Data = Competitive Advantage • Health • Loyalty & Affinity Management Call Centers Bio Data CRM Nurse Lines Social Media Personas Claims Data Research VOC • Revenue • Marketing Management #NewhouseGLDSM
- 25. Social media is a communications imperative in a B-to-C marketplace #NewhouseGLDSM
- 26. My Views on Social • Social media is not about brands – It’s not about marketing – It’s not about selling – It’s not about PR – It’s not about content – It’s not about telling anyone anything It’s not about anything other than… #NewhouseGLDSM
- 27. “Peoples” http://www.youtube.com/watch?v=Dfru4pDrC4o #NewhouseGLDSM
- 28. Social media is about people #NewhouseGLDSM
- 29. Social carries the human experience Chat Share Connect Document Support a Cause Stalk Fl i Involve Contribute AssertOpine rt Be Heard Become Famous Learn #NewhouseGLDSM D sput e i
- 30. SCREAM!! #NewhouseGLDSM
- 31. People expect brands that deploy social channels to listen and respond #NewhouseGLDSM
- 32. Servicing on Social Channels • Customer service issues on social channels are typically a customer’s last resort. • BCBSM team replies on the social channel, letting person know they’ve been heard. • Team takes details offline, either over phone or email to ensure HIPAA compliance. #NewhouseGLDSM
- 33. Social and digital media can connect people to brands (This is different than connecting brands to people) #NewhouseGLDSM
- 34. BCBSM’s Approach to Social • Listen • Identify Our Content Bubbles • Publish Excellent Content • Build Our Communities • Engage Our Employees • Measure and Refine #NewhouseGLDSM
- 35. Content Must Connect People’s Our Passions Passions Great Content Lives Here #NewhouseGLDSM
- 36. BCBSM’s Social Media Network ahealthiermichigan.org mibluesperspectives.com Facebook Twitter LinkedIn Google+ YouTube bcbsm.com/news #NewhouseGLDSM
- 37. mibluesperspectives.com #NewhouseGLDSM
- 38. facebook.com/BCBSM #NewhouseGLDSM
- 39. Twitter - @BCBSM #NewhouseGLDSM
- 41. ahealthiermichigan.org #NewhouseGLDSM
- 42. How We Measure Social • Community Growth • Content Generation • Community Participation • Site Traffic • Social Mentions • Search Volume • Referral Traffic to Blogs • Referral Traffic to BCBSM Website • Share of Voice • Share of Search #NewhouseGLDSM
- 43. Visits to ahealthiermichigan.org Visits 40,000 37,660 35,000 30,000 28,048 21,868 25,000 21,980 20,556 20,302 20,125 19,149 20,000 18,035 16,812 19,976 14,614 14,181 15,081 14,214 13,879 15,000 13,444 9,962 12,871 10,000 12,000 6,851 5,222 4,008 5,000 0 #NewhouseGLDSM
- 44. Social media opens the windows of the Ivory Tower – allowing us to see our customers and allowing them to see us as people #NewhouseGLDSM
- 45. #NewhouseGLDSM
- 46. “I’ve always known your building was there… …I just never knew any humans worked in it.” A customer, in 2010, after I started tweeting for BCBSM #NewhouseGLDSM
- 47. Beyond social, digital media are connecting consumers to their health #NewhouseGLDSM
- 48. Health is a Social Phenomenon #NewhouseGLDSM
- 49. Leveraging Technology for Health • Employers are looking for health plans to offer solutions to get employees actively engaged in corporate wellness programs. • Health plans now design insurance products that reward customers with lower out-of-pocket costs for maintaining a wellness plan. • BCBSM is working with major customers to equip employees with social technology to encourage their participation. #NewhouseGLDSM
- 50. A Wellness Community #NewhouseGLDSM
- 51. Building a Health Network • Adds a social networking dimension to BCBSM’s online health management portal • Leverages the members’ social networks • Incorporates games and challenges to motivate • Open platform - eligible members can invite non-members (age 18+) to participate • Track activity - exercise minutes, steps, weight, and nutrition #NewhouseGLDSM
- 52. Personalized Sign-In #NewhouseGLDSM
- 53. Smart Phone Tracking • Daily SMS Activity Tracking for: – Weight – Minutes exercised – Fruits/vegetables servings – Steps – Challenges • Menu and Help prompts • Confirmation SMS sent • Days missed calculated and sent via SMS #NewhouseGLDSM
- 54. Reminders and Challenges Appear on the Member’s Site #NewhouseGLDSM
- 55. Physical Activity Core Challenges Three 8-week team physical activity and weight loss challenges spread throughout the year to drive high engagement and long- term behavior change Ready, Set, Go Step It Up Face-Off • Activation challenge • Intermediate challenge • Advanced challenge • Program intro • Step up your game • Highly competitive • Team formation • Harder goals each • Sites/regions compete week #NewhouseGLDSM
- 56. Smart Phone Reporting #NewhouseGLDSM
- 57. Promoted to Customers #NewhouseGLDSM
- 58. Can Incorporate Any Fitness Device #NewhouseGLDSM
- 59. Follow Recommendations • @andrewhetzel • @BCBSM • @HealthierMI • @davemurr • @shannonpaul • #hcsm #NewhouseGLDSM
- 60. Closing Thoughts for Students No person has ever been considered a success… … living in the basement … of their parents’ house. #NewhouseGLDSM
- 61. The information and opinions expressed as part of this presentation, both written and verbal, are those of the presenter, offered for academic purposes. They are not the opinions or positions of Blue Cross Blue Shield of Michigan. #NewhouseGLDSM
Editor's Notes
- The Pew Internet & American Life Project's “Health Online 2013” survey found roughly 70-75% of Internet users aged 18-64 search online for health information, as do 58% of Internet users aged 65 and over. Data, the web and the social web are certainly important to health care.But there are obstacles – some institutional and others that have been put into place by government – that must be considered before health care and big data can really come together to improve patient outcomes and the patient experience.
- As we start, I think this infographic really illustrates the challenge that health organizations face today with data.Lots of information flowing through this old factory originally designed mostly to process data and turn it into money – not to understand data and turn it into better patient health.Like an antiquated factory would – it produces a big pile of waste. In the lower left is the 80% of patient data that can’t be used today for anything meaningful.As healthcare moves forward, one of the biggest challenges is building a modern and efficient system of IT infrastructure to process this data well and use it for meaningful improvement in the quality of care and patient outcomes.
- Michigan has a little more than 10 million people.BCBSM covers 4.4 million.Our competitors cover 2.5 million.The government covers a little more than 2 million through Medicare and Medicaid.There are 1.1 million people uninsured.
- We have so many fascinating and uplifting stories to tell in healthcare – but we can only do it with your permission.We take your privacy very seriously. Other than improving your health, giving you the best care and patient outcome and ensuring your bills are paid, there is no higher priority.
- We have access to every piece of data about every person’s healthcare. There are literally thousands of codes that are used to record treatments and procedures, and enable doctors, hospitals and other professionals to be paid for them.We know if a person has a chronic heart condition that a prospective employer may be interested in knowing about. We know about the termination of a pregnancy that others in the family may never know about.Big Data is available. But it’s a Big Responsibility to keep it secure and private.
- PHI is Protected Health Information. We consider PHI to be almost any data that – if disclosed to a third party – could put your privacy at risk. This includes basic information such as name, address and the subscriber number on your Blue Cross card.When a person calls BCSBM, we have tight controls in place (the Identity Verification Guide) to confirm, using a combination of public and private information, the identity of the individual. Where we cannot do so we limit the information we'll disclose to the caller.
- Breaches of electronic records are clearly a concern for all organizations – but particularly health organizations given the regulatory pressures we face.
- HITECH passed during first Obama termFirst step in the development of a national health IT infrastructureOne of the big problems in healthcare is the number of information systems in use across systems of care. You may have a hospital that works with a number of physician organizations – groups of doctors organized into a practice group – with as many as three or four different IT systems in use.This leads to redundant care – the same test performed at the doctor’s office and the hospital. It leads to misdiagnosis, if physicians can’t compare records in real time. It may lead to mistakes in care and readmissions to hospitals.All of this redundant and wasteful care adds to the cost of healthcare – currently at about $2.7 trillion, or about 17 percent of US GDP.The cost of care for each American is more than $8,600 per year.
- In most instances, the regulatory standards imposed by HIPAA are not available on social channels because the health plan does not own the social media platform.These sorts of legal barriers, and difficulty of ensuring HIPAA compliance through systems health plans cannot control, generally have pushed insurers away from using social channels for direct member servicing.
- HIPAA is old (in tech years) and has not kept up with change.The government’s concern is your privacy, not your ease of communication.Social media channels are inferior to 20th century channels from a privacy and security standpoint.
- The Affordable Care Act – Obamacare, some call it. It is literally reshaping our entire industry.
- After decades of debate, we have finally arrived.Just like arriving in any new town, we need to figure out where we go from here.The Affordable Care Act is the most dramatic change in healthcare since Medicare and Medicaid were created in the 1960s.It is the federal government’s biggest foray into reshaping an industry since the deregulation of “Ma Bell” and the creation of regional telephone systems.It affects everyone in healthcare – insurers, hospitals, doctors, the pharmaceutical industry, insurance agents, lawyers, tax professionals, businesses and consumers
- Importantly, the ACA also prohibits commercial insurers from rejecting people for pre-existing conditions.In Michigan, BCBSM is the only carrier that does not reject. As a result, we cover about 95 percent of people with pre-existing conditions in the individual market. This drives up insurance costs for people who need coverage most. And it results in BCBSM losing about $100 million a year that must be accounted for elsewhere.The ACA also requires all insurers to charge older people no more than 3 times as much as a younger person for the same coverage. Unfortunately, this provision will drive up insurance costs for younger people. Many in our industry are concerned that this sticker shock – coupled with a lack of a strong enforcement mechanism for the requirement that all people carry health insurance – will allow younger people to go without coverage, driving up costs for everyone.
- A huge shift from employer-sponsored coverage to individual coverage.No help from your HR department if you’re on your own.New marketplace to buy from – people are unfamiliar with what policies cover and how much they really cost.Communication has become more important than ever.
- The insurers that can win the data game will win the marketplace.I am going to discuss two areas – first, social media. Then, I’ll talk briefly about how health plans are using data to help their customers manage their health and engage within their social networks about health issues.
- In a recent study, JD Power and Associates found that 87 percent of people who like a brand’s social media content are more likely to buy that brand’s products. This is a landmark quantitative study that points to a definitive social media ROI for brands.In an industry that is rushing to a business-to-consumer posture, getting social media right is a business imperative.
- If you have launched a Twitter handle for your brand, the worst thing you can do – other than use profanity in your tweets – is not respond when someone “at tweets” you.Brands get into Twitter and Facebook to “talk at” consumers and push content at them. This is a mistake for any brand.Listening comes first, second and third. Responding comes fourth through tenth. Then you as a brand earn the right to talk at your customers.
- It’s different in other industries with other brands. Discuss Delta Airlines example.
- Listening is the activity by which we will gather social intelligence and information. By monitoring the social web regularly, we will collect valuable information about what’s important to our members, industry news and trends, and what the current perception of our brand is… all of this is critical to effective content generation.Our Content Bubbles define the subjects around which we interact online. They are where our passions and our audiences’ passions intersect. Effective Content Bubbles ensure that our social communications are relevant, meaningful and valuable to the people and organizations we want to connect with. When we publish, we generate and post specific and unique content through each of our social media channels. We operate like a news organization. Our team meets regularly to discuss our publishing efforts. This keeps our content fresh and relevant.We can’t build brand affinity without strong communities. Brand loyalists, industry enthusiasts, health experts, and current and potential customers make up our communities, and our goal is to get these groups to actively refer our brand and services to their immediate and extended networks. This delivers ROI for the business.Our employees are our brand’s biggest champions. The social team has constructed a social media champions roundtable with people who work in divisions across the company. This provides a fresh view. Our company blog gets its strongest regular readership from employees – meaning that our workforce is turning to social content as a source of company information and insight. This engagement is a sign of a maturing and successful social media function.The social web is constantly changing. Accurate and meaningful measurement will allow us to change with it, and to organically evolve our strategy along with our audience’s needs.
- By listening, you will understand the passions and concerns of your customers.You also should work to identify what drives the soul of your brand – and find areas of common ground where the content that you develop as a brand reaches a crescendo of relevance with your primary social audience. That’s when conversations happen and engagement takes place. That two-way passionate conversation is the secret sauce of social media. Those who do it well are the top chefs of social branding.
- Discuss how the online community’s Blue branding isn’t as prominent and why.
- 1. Total subscribers across all our active social networks2. Total individual pieces of content posted across all our active social networks3. Total ‘engagements’ around our posted content4. Track how many visits to bcbsm.com are coming from our social networks5. The number of times our brand and services are mentioned across the entirety of the social web, tracking positive and negative mentions6. The number of times our brand name is being searched7. The number of blog views compared to social referrals8. Thenumber of website views compared to social referrals9. The total positive and neutral social mentions, calculated againstpositive and neutral social mentions of our competitors. Share of voice = each company’s percentage of all mentions.10. Measure our search volume, calculated against the search volume of our competitors. Share of search = each company’s percentage of all searches.11.
- Two good signs of long-term success for this blog:Unique visitors have grown from 4,000 at the left of the chart – in February 2011 – to what will be more than 40,000 for January of this year.This growth has come from increased traffic through search, and from recommendations of content. We are not paying to promote ahealthiermichigan.org – it is growing organically and through search.
- Health insurance isn’t a sexy industry – like cars, or running shoes or technology.For us, social media has served to humanize our company and our brand. It has given our company a face, a personality and a pulse that didn’t exist before with many consumers.
- Start the Matt Dibble story
- Tell the story of meeting Matt Dibble.
- In a study published in 2007, two researchers,Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.Dused data from a 32-year study into the prevalence of heart disease within large social networks to conclude that obesity also traveled in networks. That is, your contacts can increase your risk of obesity. They concluded that a person’s health is influenced significantly by the health of people they interact with socially.
- 70% have registered already for the program and 62% already registered for the first core challenge – very high for the first year and only in February so far– partly for the money but still….
- In addition, there are Nutrition and Seasonal Core Challenges- 3 six-week team challengesBalancing ActExercise and nutrition challengeHelps find a balance between healthy and unhealthy habits6 weeks in durationFit & Festive Seasonal challenge Teams balance healthy and unhealthy behaviors during the holidays 6 weeks in duration Flex Your FoodNutrition challenge with a weekly focus on one aspect of healthy eatingEncourages participants to try new, healthy foods6 weeks in duration
- Core Challenges are multi-week, team-based challenges, which can include fitness, pedometer steps, and weight loss competitions.Participants build a culture of wellness by recruiting and encouraging each other on the path to better health.
- Syracuse University has provided you with a solid foundation of knowledge.You must build a career on top of that foundation.Never think you know it all.Listen more than you talk.Seek mentors.Never stop learning on your way up the ladder.Do right by those who stood behind you.