Healthcare Firm Uses Data to Get Personal

Customer Experience
Customer Experience

Healthcare organizations are known to be reactive to patient situations - when symptoms appear, when someone gets injured, etc. But one HMO decided that a proactive approach would create healthy patient relationships while saving the company money over the long term.

Group Health Cooperative of Eau Claire, an HMO based in Wisconsin, had long tried to remain on a first-name basis with its members. Employees personally answer every phone call, and its business model is set up as a cooperative nonprofit organization. However, with membership topping 57,000, in 2005 Group Health embarked on an extensive customer relationship push.

The organization partnered with CPM Marketing Group, a CRM firm specializing in the health field. The first step was to get to know plan members, on their terms. Group Health created a central data warehouse of members, and worked to gather information from new members whose medical situations were yet unknown. In March 2006 Group Health sent out a direct mail package containing information about the group's services, as well as health management resources and a patient survey.

Members were asked questions about diseases and conditions, as well as their communication preferences. Households that didn't respond to the initial communication received another one a month later, with a customized letter and the survey.

For plan members, the advantages to sharing their personal health information outweighed the drawbacks, says Carol
Ebel, Group Health's manager, health management. Roughly one out of every seven members who received the survey responded to it. The higher-than-expected response rate gave Group Health and CPM the information they needed to put into place predictive modeling capabilities.

Personalized news and information

For example, opt-in members were enrolled in relevant disease-management programs and other preventative programs. As a result, plan members receive relevant and timely information. Women who regularly get breast and cervical cancer screenings receive a reminder mailing 11 months after their last visit. Those who don't get the screenings, however, get reminders sent around their birthdays.

Group Health also created a customized print newsletter, Segment of One. Articles in the newsletter are customized to each subscriber's needs, says James Hallick, CPM's director, research and development. Certain articles in each issue go to all subscribers, such as one explaining about a generic version of a popular drug. But most also include highly specific information based on the lifecycles and interests of certain customer groups divided into categories like age, gender, and medical condition.

"Why execute a newsletter if it doesn't yield results?" Hallick asks. "If you're a 30-year-old male, you don't have
any interest in the heart/cancer/stroke material in most one-size-fits-all newsletters." The quarterly newsletter is
custom published, resulting in thousands of versions per issue.

Eliminate the emergency

The program that has Ebel most excited is one targeting members who consistently use the emergency room as their primary-care option. "It's a huge challenge across the country," she notes. "Lots of the time, they use the ER because they don't know how to move around the health system. We're here to help."

Group Health claims data was added to the larger data warehouse, and then started to generate a monthly report highlighting members who use the ER inappropriately (seeking help for a simple sprain, for example) three times in three months. From there, a Group Health nurse contacts those individuals and offers guidance. "We speak with them and tell them the options that are available," Ebel says. "We let them know we can help them get into a pain clinic if needed."

Ebel says the new programs are works in progress, and doesn't share hard results. Nonetheless, she already has grand designs for another project. "We recently had a discussion about the overuse of antibiotics," she explains. "You don't think of that as a marketing problem, but you don't think of what we're doing with the ER as a marketing problem, either."