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Direct Response Marketing

Cover Story: Marketing With High Marks

1 Jun, 2017 By: Thomas Haire Response

Chris Zdanowski says combining performance-based metrics with brand engagement helps drive healthcare leader Highmark’s success across demos.


“I’ve been doing it so long now that it’s hard to remember there being a divide” says Chris Zdanowski, director, strategic marketing, senior markets, commercial markets, and retail, for Pittsburgh-based Highmark Inc., about the combination of performance-based marketing and branding.

“Consumers are demanding such tactics, so the question really is ‘How can we push the marketing envelope and get more out of our efforts?’” she asks. “Consumers want real, authentic conversations with a brand, so it’s our job to get someone to naturally engage in our brand. If our outreach is a little too direct, they might take offense. So if we can connect them with a positive brand experience — something useful to drive response — then we have an interaction.”

Highmark is a national, diversified healthcare partner that serves members across the United States through its businesses in health insurance, dental insurance, vision care, and reinsurance. Highmark and its affiliates operate health insurance plans in Pennsylvania, Delaware, and West Virginia that serve 5.2 million members and employ approximately 18,000 people.

With such a wide customer base, the Blue Cross and Blue Shield-affiliated company uses the full array of online and offline marketing to reach its customers — and potential customers. One of Highmark’s most recent campaigns — “Ask the Doctor,” targeting both its own Medicare Advantage members, as well as other Medicare enrollees — focused on promoting its “Doc Talk Checklist” (doctalkchecklist.com), which helps remind patients the questions they should ask their doctors.

The campaign included three TV spots, digital banner and mobile ads, and direct mail, among other media. “TV helps tell the story with humor to disrupt the market,” Zdanowski says. “Our market consumes television. Then the digital and direct mail pieces hit our customers where they are, and drive home the message to engage with their doctors.”

Highmark’s efforts as an insurer to aid patients’ relationships with healthcare providers are part of a larger trend in the space. With consumers facing massive uncertainties about coverage, providers, and more, the leaders in the space agree: helping healthcare consumers along every step of their journey is more important than ever.

Backgrounds of Innovation

Understanding the changing nature of marketing’s interactivity with consumers is a strength that Zdanowski has built during a career that’s spanned many industries.

“I spent some time in the telecom business during the big M&A (mergers and acquisitions) days,” she says. “There, I learned to embrace change and how to use direct marketing. It was a constant stream of new purchases of telcos, new CEOs with new plans, and new products being driven to market in a matter of weeks. I was working on so many different things — driving revenue for both mature and new products.”

Zdanowski also spent some time on the healthcare delivery side. “I worked with providers and finance, systems and insurers. It provided me a good foundation in the healthcare business. When I saw the opening at Highmark a couple years ago, I was intrigued because I liked where the company was headed and how I could integrate my expertise in both the delivery and financial sides.”

Now two years into her time at Highmark, Zdanowski is responsible for the company’s Medicare business, its retail stores inside its footprint, and the company’s commercial business-to-business segment. “I’m responsible for customer acquisition, retention, and engagement,” she adds. “This latest campaign, like most of our others, was borne out of the notion of engagement — to demonstrate Highmark’s everyday value and prompt our customers to behavior that will result in them living their optimal lives.”

It’s a big job, considering that Highmark is the fourth-largest Blue Cross and Blue Shield-affiliated company in the United States as an independent licensee of the Blue Cross and Blue Shield Association. Highmark is part of the larger Highmark Health enterprise, a diversified health and wellness system — and its affiliates operate health insurance plans in Pennsylvania, Delaware, and West Virginia: Highmark Blue Cross Blue Shield serves 42 counties in western, north central, and northeastern Pennsylvania; Highmark Blue Shield serves 21 counties in central Pennsylvania and the Lehigh Valley; Highmark Blue Cross Blue Shield West Virginia serves the entire state plus Washington County, Ohio; and Highmark Blue Cross Blue Shield Delaware serves that entire state.

It also operates other businesses in the dental, vision, and health-related insurance industries that are not Blue Cross/Blue Shield affiliated, while also partnering with the Allegheny Health Network, the parent company of a unified healthcare system.

With a history dating to the 1930s genesis of the Blue Cross/Blue Shield movement, Highmark was formed in 1996, when Blue Cross of Western Pennsylvania consolidated with Pennsylvania Blue Shield. The West Virginia business was added in 1999, and Delaware in 2010.

Intriguingly, the independent organizations that eventually formed Highmark in 1996 were responsible for creating precursors to two of the nation’s most powerful healthcare programs: a children’s health insurance program that became the model for the national CHIP program that was created in 1997; and a dedicated program for seniors that predated Medicare.

Asking the Right Questions

That history of innovation continues today at Highmark. Just listen to Zdanowski talk about the genesis of the “Ask the Doctor” campaign.

“It came from two things: we know our members value their relationships with their doctors, but we also know they don’t always ask the right questions when they’re in his or her office,” she says. “We knew we could leverage those insights and give them that reminder. If they didn’t realize they should ask about something in particular, the Doc Talk Checklist can make that conversation easier.”

The campaign’s execution also stems from how brands now engage with consumers — and how different performance metrics can be used to measure the success of that engagement.

“Our customers are engaging where they want to. It’s our job to find them,” Zdanowski says. “The other day, I was looking at a consumer journey map for our Medicare Advantage product — it’s about both marketing engagement and the consumer’s own engagement with their health. As marketers, yes, we want to get consumers enrolled in a plan, but it’s also important to help them leverage that plan once they’re customers.”

The “Ask Your Doctor” campaign touches all these bases. Not only do the three TV spots, the direct mail outreach, and the digital components hit customers — both current and prospective — where they are, but they also drive them to take control of their own health.

“If you’re a Highmark Medicare Advantage member already, not only do you see the nine general questions offered on the Doc Talk Checklist, but you also see questions that are specific to your needs and history,” Zdanowski says. “It’s about getting our members engaged in reaching optimal health.”

In a release announcing the campaign, Cindy Donohoe, chief marketing officer at Highmark, says of the TV spots, “The ads are powerful because they let patients know it’s ok — even encouraged — to talk with your doctor. At the same time, they are funny and memorable in showing how playing 20 questions with your doctor won’t get either of you to the right answers.”

The campaign, created by Rochester, N.Y.-based integrated ad agency Partners + Napier, expands on those TV spots — which have aired across Pennsylvania and will roll out to other markets later in 2017 — with those aforementioned direct mail and digital aspects.

“In terms of key performance indicators (KPIs), we have a couple of things we’re looking for: a total number of folks to have the conversation with their doctors and return the business reply card (BRC) with a doctor signature, and star-metric ratings of the patient’s Medicare plan,” Zdanowski says.

That Medicare ranking is done on a one- to five-star scale. “A lot of it has to do with how the customer engages in their plan and care and how satisfied they are,” Zdanowski says. “Highmark’s goal is to help create that best experience and influence that star measure. A surefire way to get the best out of your Medicare plan is working closely with your doctor to reach optimal health.”

She adds that the digital portion of the rollout was crucial — which might sound odd considering the demo of the Medicare market. “It’s interesting, though,” Zdanowski says. “Facebook is one of the best mediums for this campaign — and we have many other campaigns out there that show this. Facebook is generating the lowest cost-per-lead (CPL) and is one of our fastest growth markets for consumer engagement. We leveraged that with this campaign.”

And how about the results for this three-month-old campaign? “Subjectively, it’s great: our patients are armed with the right questions, and doctors are pleased with the tool — it’s making everyone more productive,” Zdanowski says. “Objectively, we sent out more than a quarter-million BRCs, and we’ve had more than 20,000 returned — that means 20,000 people have gone to the doctor, asked the questions on the checklist, and had their doctor sign the BRC before returning it. It’s far above the pace we hoped for when we kicked off the campaign — we have the eventual expectation that 60,000 customers will engage with their doctors and return their cards.”

Zdanowski says the outreach has also prompted more than 2,500 leads for Highmark.

Always Test, Always Engage

While the Highmark team is excited about the campaign’s results so far, there’s no question that Zdanowski and her crew will continue to seek out key lessons from its execution.

“Over time, I’ve learned that a campaign doesn’t necessarily have to be highly produced or fancy to be good — but to be great, it always has to be focused on gleaning that one key insight you’re looking for,” she says.

Zdanowski points to a couple of key campaigns during her career that have given her the greatest insight that she carries into each new campaign today.

“One was a campaign we worked on recently here that targeted customers who were new to Medicare — they’re 64 and making that decision for the first time,” she says. “They’re looking at federal programs, considering their Social Security — there’s a lot involved and a lot of decisions for them to make. It can be overwhelming.”

The problem with Highmark’s — and many other companies in the space — marketing materials? “All the materials look the same — and they’re treating people in their early-to-mid 60s as senior citizens,” says Zdanowski. “That’s not who these people are — they were rocking in the 1970s and generally don’t feel their age. We had to change the whole campaign and make it authentic and real to this market.”

The solution? “Instead of talking down to them because they’re turning 65, let’s flip the idea on its head,” Zdanowski says. “Don’t create some false sense of urgency, but be real with them about where they are and why Medicare is a good option for them — now and in the future. The campaign became much more real and relevant — and very successful.”

Another campaign that Zdanowski carries with her comes from her days in the telecom business. She recalls, “This is when I learned — once and forever — always test!”

Zdanowski adds, “We used to test different direct mail packs, and this one offered students an opportunity to access an 800 number to call home from college for free. We came up with this fancy direct mail envelope that had a complex reveal of the special offer. I thought, let’s test this version against something more benign — a simple letter with the offer, two-color in a basic envelope. What happened? The simplest design earned triple the response rate. That’s right: always test!”

That also goes to how Zdanowski looks at partner agencies and vendors. While she says that Highmark works with “multiple partners” and has a “great internal agency,” the relationship with Partners + Napier stretches back “a couple years.”

“The relationship came through a request for proposal (RFP) and was sealed by testing their creative,” she says. “What we love about them is that they will always bring a concept to the table that’s right within the strategy and brand, another that’s more generally down the middle, and a third that’s out there on the edge — they’re always trying to find out how much we want to push the envelope.”

Zdanowski says that creativity helped on the “Ask Your Doctor” campaign, which she calls “challenging.”

“Bringing a business objective together with a consumer website is a fun and disruptive way to get people talking,” she contends. “We did a test with GutCheck (a market research company) and consumers said, ‘I can see the importance of this. I forget to ask questions.’ Partners + Napier really got this campaign, what we needed it to do, and what they needed to do to execute it.”

Flexibility, testing, creativity — these aren’t revolutionary ideas on today’s marketing landscape. But they remain the most powerful traits behind most every successful campaign, even as marketing media and consumer control over the messages they receive continue to expand. How has — and how will — Highmark evolve in this environment?

“By continuing where we’ve been heading,” Zdanowski says. “In the past 18 months, we’ve really picked up where our customers are online, and we’re using offline marketing to engage with them there. We’ve had immediate engagement prompts in almost every campaign during that timeframe. Multiscreen, multichannel marketing gives us the perfect opportunity to lift brand and engagement at the same time.”

She also says that in Highmark’s vertical — healthcare — it is even more crucial to create “a positive experience with the brand … quickly.”

Zdanowski adds, “It’s a challenge to do that. It’s not tangible, like a food product. We’re trying to create ways to broaden and improve all of our customers’ experiences. The Doc Talk Checklist does that. It connects delivery of care with the coverage we provide — and our campaign brings it directly to them in a way that simplifies their lives.” ■


About the Author: Thomas Haire

Thomas Haire

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