Mass. Appeal:How One State Spread the

Word on Health Care ReformCenter for State Health Policy

Rutgers University, June 21, 2011

Paul WingleDirector of Creative Media

Phase 1: The Initial PushFall 2006 – 2007

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Goals for Phase 1

Launch an aggressive public education campaign to:

• Provide information about the new law and raise awareness

• Promote the availability of new plans, all certified by the state for quality and value

• Promote the Health Connector’s ability to offer unprecedented choice

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Who Are the Uninsured?

• 56% between ages 19 to 39

• 57% male

• 70% are employed– Of these two-thirds worked for small firms with

fewer than 50 employees– About one-third reported that their employers

offer health insurance

Source: Massachusetts Division of Health Care Finance and Policy 2006 household survey of Mass. residents

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What Market Research Showed

Two basic messages resonated:

– Health Security: Protection from financial ruin in the event of an unexpected accident or diagnosis

– Access to Preventive Care

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Public Education and Outreach Campaign

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Elements of the Campaign

• Partnerships w/corporate and civic organizations including the health care community, faith communities, unions, business groups, sports teams, etc.

• Media Outreach • Direct Mail• Seminars & forums (over 150 presentations) • Grassroots Outreach • Paid Advertising• Public Information Unit• Grants to Community Organizations

The Ultimate EndorsementHealth Connector teams up with

Boston Red Sox to build enrollment in new health insurance plans.

Other corporate/civic partnerships announced as part of public

education campaign

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Boston Red Sox

• Information booth at Fenway Park for all home games (focal point for media outreach)

• Live NESN interviews with Health Care Reform proponents – Senator Kennedy, Governor Patrick, State Sec. HHS Judy Ann Bigby, Connector Executive Director Jon Kingsdale

• Public Service Announcements

• Connect to Health Day at Fenway

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Boston Red Sox

• Tim Wakefield PSA

• NESN Interview with Senator Kennedy

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Health Care Reform Coalition

• Group of 18 organizations, including Boston teaching hospitals, Blue Cross, Greater Boston Chamber, Mass Taxpayers, Health Care for All

• Raised funding for complimentary ad campaign

• Enabled the Health Connector to focus on target market, while the Coalition focused on broad-based awareness

• Provided the glue to hold key supporters together

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Health Care Reform Coalition

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Our Partners

• Other State Agencies• Greater Boston Interfaith Organization

– Developed train the trainer materials – Educational workshops following weekend

services– Went door to door– Helped at grassroots outreach events

• CVS– Window Signage, info at pharmacy counters,

overhead radio announcements• Shaw’s and Star Market Supermarkets

– Messaging in circulars, messages on store receipts

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Our Partners Continued

• Associated Industries of Massachusetts, (AIM) – Partnered with key business associations to

co-sponsor 16, three-hour sessions across the state.

• Retailers Association, NFIB, Bank of America– helped with business outreach

• IBEW– Messaging on lighted billboard on Expressway

• Comcast– pro bono advertising

• Zip Car– website link

• Massachusetts Health Plans– MMCOs and commercial plans advertised

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Other State Agencies

• Department of Revenue– Postcards to tax filers (3.1 million), letters to

employers (193,000) and uninsured • MassHealth (Office of Medicaid)

– EOHHS Outreach and Enrollment Grants• Division of Insurance & Division of Health Care Finance

and Policy– Presentations

• Registry of Motor Vehicles– Notices to new Mass. residents via new license

process • Division of Unemployment Assistance

– Inserts in resident mailings• MBTA

– Advertising on subway cars and buses

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Grassroots Outreach

• 20 community-based enrollment events during Fall & Winter 2007

• Partnered with:– Legislators – Mayors/City Councilors– Local Hospitals – Community Health Centers– Community Groups– Health Plans– MMCOs– School systems

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Advertising

• Television, including New England Sports Network

• Radio • Print, including community, ethnic and

college newspapers• Internet• Transit• Targeted to all geographies, from

western Massachusetts to Cape Cod

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Our Message

• There's a new law - you need health insurance

• Unprecedented choice of plans

• Easy comparison of plans and prices through our website

• State Seal of Approval for quality and value

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Health Connector Advertising

TV ads began mid-May 2007:

“I’ve Got It”

Broken Arm

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Health Connector Advertising

Message updated as deadline for tax penalties approached, as this fall 2007 radio ad indicates.

Sign Up by Nov 15

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J uly 1st: Mandate goes into effect.

Nov. 15th: Final push to sign-up to avoid 2007 tax penalties

Spike in visits to web site prior to tax penalty going into effect (May ’07 to Jan ’08 shown below)

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Public Information Unit

• Created to focus on calls regarding Health Care Reform law and business questions

• Alleviated pressure on two enrollment call centers

• Handled up to 2,500 calls/e-mails a week.

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Results of Outreach efforts

• By end of 2007, Massachusetts had over 300,000 newly insured residents

• Law and penalties were fully implemented

Phase 2: 2008 - 2009

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Goals for Phase 2

• With over 300,000 newly insured, the focus turned to those hardest to reach

• Get their attention

• Motivate them to enroll

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Who said it would be easy?

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What Market Research Showed2008

Those who remain uninsured resist health insurance because they:

• Would rather play the odds

• Feel they can’t afford it

• Believe they don’t need it

• Object from a civil liberties, anti-government perspective

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What Are the Best Motivators?

• Knowing the Tax Penalties

• Understanding how costly medical treatment can be

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Our Challenge

• Come up with an edgy as well as educational campaign

• Develop creative that is visually compelling

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Health Connector Advertising

Radio Ad: Not Gonna Happen to me

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Social Media

• Facebook

• Digital display and SEM/PPC advertising

• Search Engine Optimization

• Twitter

JaclynCommonwealth Care Member

Cancer free for two years. “If I didn’t have health insurance, I would never have made an appointment with my doctor because of the cost. The cancer would have spread and I would not be alive today to tell my story.”

New to Massachusetts, Abbie was not optimistic about obtaining health insurance because of a pre-existing condition. “I figured I would go through the same process and be turned down again. But I wasn’t. I did the whole thing online and got a very good plan. I was just thrilled!”

AbbieCommonwealth Choice Member

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Rate of Uninsured

• By November of 2008 only 2.6 % of Massachusetts residents were uninsured

• Best in Nation

Source: Division of Health Care Finance and Policy

Phase 3: 2009 - present

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Signs in 2009 that Health Care Reform Is Working

• More than 400,000 newly insured• One third in commercial

(non-subsidized) plans• 34% reduction in free care pool spending• Non-group premiums down• Opinion poll shows public continues to

support the law (59 – 75%)

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Goals for Phase 3

Promote Health Connector Brand attributes– You owe it to yourself to compare– The Health Connector can help – Choice and Comparison of Price and

Plans– Peace of Mind through the Seal of

Approval

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Health Connector Advertising

• TV Commercial: Comparing Apples

• Radio Ad: Expert Guide

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Lessons Learned

• It takes a community effort (ask for help) • A variety of approaches are critical• Build partnerships and work to sustain

them• Opportunities for outreach are

everywhere from ballparks to churches, pharmacies to grocery stores