To be sure, for anyone who is so fortunate, a birthday card from Grandma lined with a crisp $20 bill is always a welcome treat in the mail.
But aside from Grandma’s annual acts of munificence, mail generally disappoints. Between postcards from local real estate agents, offers for pre-approved credit cards and envelopes full of coupons for curtain cleanings, there is the ominous mailer from your health insurance company.
Generally enclosed in a foreboding off-white no-nonsense envelope, and stuffed with pages upon pages of fine print, mail from your health plan is generally relegated by its recipients to a sort of home office purgatory; too important to throw away, yet too intimidating to tackle, these letters are often left opened, but unread, their important messages waiting for another day.
Overall, the amount of mail in the United States is trending downward, but the volumes are still mind-boggling—in 2018, the United State Postal Service (USPS) sent an estimated 146 billion pieces of mail. But unlike those post cards advertising 25% off dog shampoo, a piece of mail from your health insurance company cannot be casually cast aside to the pile of papers headed for the recycling bin. There might actually be something important in there.
Yes, for those of us who have private insurance or who are covered by Medicare or Medicaid (altogether nearly 300 million Americans have some sort of health coverage), getting two—sometimes three—envelopes a week is not uncommon. Stuffed with an assortment of grimly worded explanations of benefits (“This Is Not a Bill”) and other seemingly important communications, health care correspondence is part and parcel of that last and greatest of American pastimes known as “going through the mail.”
Remarkably, many of these mailings are regarded as “customer engagement materials” by health plans; somewhere inside those densely packed envelopes are messages encouraging you to “get your annual flu shot,” among other beneficial actions you might want to consider.
Unsurprisingly, “health care engagement,” as oxymoronic as the term might sound (who wants to engage with health care if you can possibly avoid it?), is a big deal for private and government-backed health insurers. If a health plan can get you to the local clinic for an annual check-up, it might stave off more serious—and costly—illnesses down the road.
To be fair, mail is not the only medium health plans turn to for reaching their members; most attempt to employ the full repertoire of modern vectors of communications: email, text, live agent phone calls, even social media. But effectively engaging with their members has proved particularly elusive for health plans, so much that many who are in the business of health care engagement have begun moving the goal posts, redefining the term “engagement” as getting someone to answer the phone or click on a link in an email.
“In health care, engagement has a very different meaning than it does in e-commerce, retail or even politics,” said Bradley Honan a former political pollster for Hillary Clinton, Michael Bloomberg and Tony Blair whose firm, Honan Strategy Group, conducts marketing research across the health care ecosystem. “True customer engagement in the way that Amazon, Visa or Delta Airlines might define it, is in its nascent stages in the health insurance industry.”
“The imperative key word in health care is ‘health action’—the ability to get members to take proactive steps to improve their health, protect their loved ones and live better, longer lives,” added Honan, whose firm has conducted wide-ranging marketing studies for companies across the health care spectrum, such as GSK, Johnson & Johnson, Brigham and Women’s Hospitals and Boston-based Partners HealthCare.
One would think that in the era in which the Targets and Citibanks of the world have mastered the art of highly personalized customer communications—so well, in fact, that some of us find it eerily Orwellian the degree to which many of these massive retail and tech juggernauts are able to not only capture our attention but also suggest products and actions that seem to perfectly align with our preferences—that health plans would have figured out better ways to connect with their members as well.
“There are lots of reasons I can think of not to like big health insurance companies,” said Ethan Bearman, an analyst for Fox Business News. “But one thing that really irks me is how bad they are at trying to engage their members to do much of anything. Whether it’s the ridiculously complex verbiage or the way in which they blast you with messages that are so off the mark and have nothing to do with you or your family—it seems that many of Big Health’s marketing and engagement tactics haven’t really evolved like they have in basically every other consumer-facing sector in the economy over the past 15 years.”
Put another way, if Amazon is able to alert you when the silver earrings you fawned over six months ago are finally on sale, one would think an insurance provider would be able to do a better job of convincing their members of the benefits of getting a breast cancer screening or a colorectal exam.
But the days of low-fidelity health care communications seem to be coming to an end.
A Quiet Revolution in Health Care Communications Is Underfoot
Despite their reputation for being C- communicators, how health plans reach you, what they say to you and, more importantly, what they get you to do, is changing very quickly. Soon, the days of mindless mailings, “spray and pray” emails, robocalls and other forms of highly ineffectual communications from insurers will be supplanted by a new generation of tactics and messaging techniques that will be a lot more Jeff Bezos and a lot less Dale Carnegie.
Quietly, without much fanfare, Minneapolis-based Revel Health is rewriting the health insurance sector’s playbook on how to connect with members.
Although its corporate vibe seems to be more Silicon Valley than Upper Midwest, its location, not far from the headquarters of health sector titans like UnitedHealth Group, Mayo Clinic and Medtronic, has given Revel Health a bird’s-eye view of the challenges that health care is facing as it bobs and weaves, trying to keep up with an increasingly consumer-first marketplace.
Revel Health is the health care industry’s first modern engagement communications company; it looks at health plan members as consumers, and markets to them accordingly. But instead of pitching Toyotathon or Cyber Monday, Revel is helping health insurers motivate their members to do stuff that springs them into health action. And the results are oftentimes jaw-dropping, which is why many in the sector believe Revel is stirring up a quiet revolution in health care with far-reaching repercussions.
Revel Is Designing the Next 50 Years of Health Care UX in the United States
Revel’s approach to health communications is remarkably different from typical health care messaging and can be best illustrated with an example. Consider Bonnie, a 57-year-old project manager at a large accounting firm in Boston whose health plan is offered as a benefit through her employer. For years, Bonnie’s health plan sent her, as they did for literally millions of other members across the country, post cards, letters and emails encouraging her to get an annual flu shot. But as far as their records indicated, Bonnie never took them up on their offer. Not once.
A few years ago, Bonnie’s health plan contracted Revel, with the express goal of increasing the percentage of plan members who get an annual flu shot. As Revel’s team of data scientists began parsing and scrubbing the data, they realized that Bonnie fit the profile of someone who didn’t have a high number of health incidents of any kind: low frequency of visits to her primary physician, very few trips to the ER, no hospitalizations or major surgeries. In all likelihood, Bonnie was a generally healthy, middle-aged woman who rarely got sick and therefore saw no need to disrupt her schedule to get a flu shot.
But, as Revel’s quant jockeys began overlaying more data sets—such as publicly available census information, local, state and county records, and other consumer marketing lists—and cross-referencing them with the health plan’s provided data sets, the Revel team made an important discovery: everything seemed to indicate that Bonnie lived in a multigenerational household with at least one adult child and several school-aged grandchildren.
Furthermore, Revel’s team discovered that the sequencing the health plan was using to engage Bonnie was the same every year. In late September, the health plan would send a nondescript benefits mailer, and buried inside the envelope was a flyer with some general words of encouragement about getting a flu shot. This was followed up with an email blast in mid-October and finally a live agent phone call in early November. Yet none of these methods managed to motivate Bonnie into getting a flu shot.
To change the equation, the Revel team created a profile for Bonnie that would focus on her role as the head of a multigenerational household by delivering targeted messaging through mail, email and text messages about the importance of adults in a family getting flu shots, principally to protect young children living in the household from getting sick. They also tested changes in the sequencing, discovering that Bonnie was most receptive to an initial phone call, followed up with text and mail reminders.
The imagery selected in the mail and email pieces specifically featured older adults who appeared to be grandparents, surrounded by young children. The copy was also crafted in a way to strike a chord with Bonnie’s lifestyle. Knowing that she had a full-time job, the messaging focused on the busy life she led, but pointed out that no one can ever be too busy to take care of those who need them most.
And it worked. Revel figured out how to push Bonnie’s buttons, and for the first time in many years, Bonnie got her flu shot.
But what makes Revel special isn’t that the company convinced Bonnie to get her flu shot; it’s that Revel was able to do what they did for Bonnie simultaneously for tens of millions of other people, each with a unique data set with hundreds, if not thousands, of parameters and each person getting a highly personalized, in fact, bespoke messaging package.
“Revel takes, literally, tens of billions of data points, connects them, interprets them and then transforms them into actionable health communications plans—all at scale,” said Sara Ratner, a veteran health care consultant who has worked with some of the largest private sector and government health plans in the country, helping them find better ways to impact the lives of the insured. “For health plans, these health actions lower costs, allowing these programs to better employ their capital by either lowering rates for members or offering a greater array of services to them.”
“A lot of things in health care are nuanced and hard for the average consumer to understand, but Revel’s value proposition is quite simple,” Ratner continued. “They take big data sets, create precision profiles and connect with consumers just like Amazon would. But instead of trying to sell you a blender, Revel is empowering health plans to get their members to be proactive about their own health.”
Already, Revel is working with five of the 10 largest health plans in America, and its impact is beginning to get noticed at scale. Plans that have hired Revel to encourage their members to get an annual wellness visit have seen their numbers skyrocket—up 63% over the national average.
It’s Always About the Money
Revel’s DNA is equal parts Madison Avenue, big data and health care. The company’s nearly 100 employees form an admixture of data analysts, artificial intelligence and machine learning experts, behavioral scientists, human-centered communications designers and marketers.
At the core of Revel’s mission is helping health insurance companies do the things that they are not very good at—namely, using the diverse array of modern communications tools available, creating high precision profiles that enable highly personalized and relevant messaging, and delivering it at scale across millions of members.
For health plans that administer government-backed Medicare and Medicaid programs, the value that Revel brings to the table can be worth hundreds of millions of dollars. Several years ago, the Centers for Medicare & Medicaid Services (commonly known as CMS), perhaps inspired by Zagat, Amazon and iTunes, created a “star system” for rating the relative performance of different health plans. In the CMS star rating system, explicit performance metrics can position plans to earn (or lose) hundreds of millions of dollars in incremental government bonuses.
Many of these star metrics are ultimately driven by the degree to which the health plan can enable its members to take specific health actions, which is why many of them are turning to Revel for help. Oftentimes, the government bonus payouts translate into increased benefits for members and a greater array of available services for Medicare and Medicaid members, such as reimbursing Uber and Lyft rides to the doctor, among other bells and whistles.
A Focus on Action, Not ‘Engagement’
Many of the traditional players in the “health care engagement” space like to point to metrics, such as “click-throughs” and “page views,” as a sign that their specific email or social media campaign engaged with health plan members. But if there is no trail of data crumbs that can connect a click-through to an actual doctor visit or flu shot, claims about the impact of the campaign and its ROI are spurious at best.
Although the industry is only slowly beginning to move away from traditional, one-size-fits-all engagement tactics, Revel represents such a quantum leap in terms of what it’s offering versus what has been on the market over the past few decades that one of the company’s biggest challenges has been informing and educating health plan administrators about what big data and artificial intelligence can really deliver at scale for these health plans.
“If the only tool you have in your tool kit is a shovel, it still may have to serve as a hammer from time to time—but it’s still a shovel,” remarked Coral May, president of eTrueNorth, a Texas-based health care company that is enabling over 7,500 retail pharmacies across the country to play an increasingly larger role in the delivery of primary care services, such as administering flu shots and identifying undiagnosed conditions. “The difference with Revel is that it’s not just not a shovel, but it’s all these other tools in the tool kit coupled with the science behind the profiles, and matching different types of personas with the right communications tools, sequencing and methodology.”
As one might suspect for any industry that is being disrupted, Revel is not without its share of competitors. For traditional communications and marketers in the health care engagement space, such as RedBrick Health (which recently merged with Virgin Pulse, part of Richard Branson’s Virgin Group, but continues to operate as a separate brand), Welltok, Rally Health and others, Revel has become something of a bête noire—particularly because of how Revel charges its customers.
“We work 100% at risk,” Revel Health CEO Jeff Fritz told Observer. “We don’t expect our customers to pay for effort, we only ask them to pay for results. We have such a high degree of confidence that we can move the needle in terms of measurable health plan member action that we prefer to design how we charge based on incremental gains.”
“We know Revel works, and we’re willing to put our money where our mouth is,” added Fritz.
It would seem that Revel is ushering in a new era of personalization in health care, mirroring a trend that has been affecting a host of other industries. The era of the family doctor visit to the home is something that has long been gone, and in the ensuing years, health care became highly centralized and awkwardly depersonalized. Revel seems to be on the path towards creating personalization once again in health care, but at a scale where the economics make sense.
It’s clear that market forces will be forcing health plans to become increasingly more consumer focused and effective at capturing their members’ attention, driving them to be proactive about their health. And as this transformation unfolds, Revel will likely be playing an important role behind the scenes, knowing how and when to push your buttons to get you to take proactive health actions.
But until then, make sure you get that flu shot. Winter is coming.