Connecting with consumers

Companies find inspiration in other industries

Health plans spend $9 billion each year communicating with members, but most of it doesn’t reach the right consumers and engage them.

Stan Nowak, CEO and cofounder of Silverlink, a healthcare communications company with 50 clients representing 150 million lives, based in Burlington, MA, is not sure healthcare is spending its communications money as effectively as it could.

In the not-too-distant past, healthcare companies did not view member engagement with as much focus as they do today.

“The time is now to treat member communications more strategically. Now members are making more choices and have increased financial responsibilities,” says Nowak.


Nowak says one of the biggest drivers of the change within healthcare from a business-to-business to a consumer focus came with the Medicare Modernization Act in 2003. Consumers increasingly have more say as to which services to choose, and health plans and DM companies need to offer services that engage consumers, he says.

But health plans have not been using communications as much as they could to promote their services and improve the member experience. According to a recent Forrester’s North American Technographics Customer Experience Online Survey, consumers ranked medical insurance providers below many other industries—such as retailers, investment firms, insurance companies, and Internet service providers—in terms of customer experience.

Rather than continuing that dissatisfied customer trend, Silverlink—which offers communication solutions in numerous areas, such as Medicare, Medicaid, population health and DM, managed care, pharmacy benefit management, and medical supplies—is looking beyond healthcare for inspiration. Silverlink officials have tapped into the experience of consumer-based industry leaders, such as American Express, Capital One, and Harrah’s Las Vegas.

Those industries have invested hundreds of millions in analytics and engage potential customers by segmenting and personalizing the outreach. By leveraging that consumer data and behavior, those companies are leading their industries, according to Silverlink.

Silverlink believes it has created a way to more effectively reach and engage members. Building upon the company’s automated phone system, Silverlink announced improvements in March that merge decision science methodologies and analytics with personalization technology. The three-tier approach is:

Adaptive HealthComm Science, which includes decision science methodologies, an iterative process, and continual integration and optimization

SAVS 5.0 Technology Platform, which offers flexible architecture and extreme personalization; rapid program development; and visibility, measurement, and control

Expertise and service delivery, including communication, healthcare, and consumer-marketing expertise

The idea behind Adaptive HealthComm Science is to drive consumers’ actions in a personalized way that adapts and improves with each iteration. This is done through the SAVS 5.0 Technology Platform, which provides memory, on-call calculations, and dynamic path-ing to enable the delivery of highly personalized, HIPAA-compliant, and interactive communications programs, according to Silverlink.

The new technology allows Silverlink to offer programs to clients through a multichannel approach, rather than merely automated calls. “That core capability is able to build things very quickly without programming; that allows us to microsegment populations and to move a population of a million people in any direction. That is what the consumer industry has learned in the past two decades,” says Nowak.

The platform applies real intelligence and allows Silverlink to personalize communication. For example, the technology tracks call times to figure out when a customer is usually home. It also follows a person’s health status, including collecting clinical data, over a set amount of time and escalates the call to a nurse if there is a continuing problem.

The platform allows Silverlink to change the message according to by age, sex, location, or other subgroup.

The Adaptive HealthComm Science program also allows Silverlink to take a health plan’s customers and find the proper communication program.

That communication change could be as simple as changing the caller’s accent. “We found a thing like using a Southern accent in certain ZIP codes improves the yield on programs by 40%. It really blew us away,” says Nowak.

By looking at the microsegments’ demographics, Silverlink can assign the right voice based on the age and gender mix and even modify the script for a lower language level. “Our latest technology allows us through a single call program to create the best experience based on the segment you belong to,” says Margot Walthall, director of product marketing at Silverlink.

Nowak says Silverlink is now able to conduct constant experiments to find best communication practices for each microsegmented population. “As we were building this capability, we talked to people who run these functions at large companies, like American Express, who have been doing things like this for 15–20 years now. They will tell you the same thing ... You look at what your population shows you, you measure it, and that’s how you define what the interventions are.”

Some may possess a negative view toward automated calls, but Nowak says they actually should be a “key component of communication strategy.”

“The data now shows that the response rate for automated interactive calls is dramatically higher than any other form of communication,” says Nowak.

Nowak says Silverlink’s new offerings merge healthcare with the best consumer engagement sciences. “We’re taking disciplines from 20 years of customer marketing science and combining that with some of the predictive modeling capabilities that have been built in healthcare,” he says, “and then combining that on a highly flexible platform designed for adaptive control that allows us to get much smarter and drive much higher instances of behavioral change.”


Many employers with wellness programs barrage employees with health-promoting posters and incentives, but HealthMedia doesn’t think that’s the best way to reach and engage consumers. To engage a population in company wellness programs, businesses need executive sponsorship, appropriate resources, a strategic plan, proper incentives, consumer-friendly access, and intervention strategies that fit the readiness of the population.

“We know that when behavior change happens, it reduces risk, which reduces costs,” says Alicia Rinaldi, MPH, manager of participation strategy at HealthMedia in Northborough, MA, which combines technology and behavioral science to help clients—including Kaiser Permanente, Cleveland Clinic, and eight Blue Cross Blue Shield organizations—and partners with APS Healthcare, Health Dialog, and Wellsource. Rinaldi presented a free HealthMedia-sponsored Webinar January 31 on maximizing participation and outcomes in health management initiatives.

Many companies don’t get the wellness program participation they expect because they don’t learn about their employee population, says Rinaldi. She suggests that companies need to avoid the Field of Dreams mistake—“If you build it, they will come”—which is believing that everyone will get involved merely because a program is available.

Before implementing programs, companies need to reflect and ask:

What are we trying to achieve?

What are our goals and objectives?

How will they be measured?

What is our focus? Some examples might include reducing healthcare costs, improving productivity, increasing member satisfaction, changing behavior, and improving health.

“The process is about taking a step back to know not only where you are, but where you want to go,” says Rinaldi.

Once a game plan is chosen and goals and objectives are created, HealthMedia suggests companies implement a 12-month action plan that allows them to review progress throughout the year.

Once the game plan is set, the company will need to use intelligent recruitment by creating an individualized wellness program. This is done in large part through a health risk assessment (HRA), which collects health information from an individual and gauges that person’s desire to change his or her lifestyle.

Rinaldi says an important part of communication is not bombarding people with too much information. The wellness program should tackle each problem separately and provide personalized information on each area of concern.

This kind of initiative has been successful for HealthMedia clients. Rinaldi highlights an example of recommended changes that worked with a healthcare system, including moving from a gift card to a benefit-based incentive, promotional integration with a communitywide health and wellness Web site, and tailoring communications to individuals who completed health risk assessments (HRA). (For examples, see “Best practices for effective incentives” to the right.)

What the healthcare system found was that program participation increased from 1,307 in the year prior to HealthMedia’s work to 9,374 in the next year, a participation increase of 7.2 times.

Even a minor change can engage employees, such as improving online access. HealthMedia recommended Kaiser Permanente do just that by changing its Web site to include behavior change programs on the home page. This allowed for easy access and reduced barriers. Kaiser Permanente reported a twofold participation increase from just that improvement.

When creating an incentive plan, HealthMedia suggests a plan that moves from extrinsic to intrinsic motivation, such as encouraging employees to complete HRAs that will be used to tailor communications.

“This is a really exciting strategy to look at how we are mining data wisely to send individual-salient messages,” says Rinaldi.




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