How Horizon Healthcare Services Inc. marketed their portal to “Chief Medical Decision Makers” of the household

In 2020, Horizon increased the number of members on their portal and app who could actually change care decisions based on plan information. This report outlines the three steps that Horizon took, from creating a single app, to identifying the ideal utilizers (care decision makers in a household), to changing their marketing to resonate with this specific persona.

The three steps
Horizon streamlined their portal marketing using the following three steps:

It is difficult to send a clear message to members about the plan app if the plan has multiple apps and tools on the market. Horizon, like many other plans, uses multiple vendors for different aspects of their digital platform (virtual visits, HSA/FSA, nurse chat, and service live chat) because each vendor excels in a different area.

As plans are familiar with, it’s hard enough to get members to download a single app, let alone to ask them to download multiple apps and create multiple accounts. If members had to log onto a separate app for each of these tools, they would quickly become frustrated and give up on using any of them. Not to mention the challenges that having multiple apps presents for keeping a consistent brand reputation.

Therefore, before marketing to members, Horizon first focused on combining all their tools into a single app. Horizon asked each technology vendor that they partner with to create a Software Development Kit (SDK) that would allow Horizon to integrate and white-label the tool into their app.

Their idea for a single app came from the travel industry, which used to be quite fragmented. Travelers booked flights, car rentals, and hotels all through different sites, before one-stop-shop travel sites gained prominence. Horizon wanted their app to be like the “Expedia” of health care: a digital front door.

The challenge though is getting vendors to create a SDK. Horizon purposefully decided to partner with startup vendors because startups were more likely to personalize their services to Horizon’s needs, rather than offer standardized solutions.

Horizon coached the startups, telling them that they could differentiate themselves from their competitors once they had the SDK. Horizon volunteered to be a guinea pig for these startup vendors and allows the vendors to sell the base SDK to other plans in the future. This provided a mutually beneficial relationship for both Horizon and digital vendors because now Horizon could implement all their tools into a single app, while vendors now have the base formula to integrate their tool into other health plan apps. Other alternatives to SDKs include Horizon's ability to consume vendor API’s for the build out of native app experiences.

Now, Horizon has built this requirement into their vendor assessment process. Horizon tells vendors that they don’t want to confuse members with multiple apps and that they expect vendors to build a SDK for them. This will increase member utilization as well, which would increase revenues for the vendor if they are paid on an outcomes-based model.

Because of Horizon’s success with these vendors, 1) vendors want to use SDKs with more plans, and 2) plans are reaching out to Horizon asking how they can get vendors to use SDKs.

Once Horizon created their single app, they brainstormed how to best market it to their membership. When they promoted it to their entire membership, uptake was not as high as expected given the effort it took to mass mail, email, or text everyone.

Even once they segmented their membership, Horizon had focused most marketing to the “Chief Financial Officer (CFO)” of the household and to the very sick population.

• The “CFO” was an obvious first choice because he/she is the one who originally signed up for health insurance coverage and is continually paying premiums. But if this person isn’t making care decisions for the household, then he/she won’t use the portal tools that help them choose lower cost procedures or sites of care.
• Although plans always want to engage sick members, the very sick population should be engaging with the health plan through care management or through their doctor rather than solely through an app, so this was not the ideal group of utilizers.
• While the obvious choice for portal marketing may be the younger, healthier population (or “Young Invincibles”), Horizon realized this group presents a challenge. Since theses members are often healthy, their care utilization is limited. While this younger generation may be more tech-savvy and inclined to use digital self-service options, often times there is little for them to do on the plan portal if they aren’t trying to get care or have not had a claim experience.

After analyzing their portal utilization data, Horizon learned that the ideal portal user was the “Chief Medical Decision Maker (CMDM)” of the household: the person making care decisions for the family. While in some cases the “CMDM” and “CFO” were the same person, the “CMDM” was most likely to be 40-55 years old, female, and have one or more children.

The “CMDM” is the one who would find more value in the portal’s information on various care options. Also, the “CMDM” has influence on the family’s care decisions, which ultimately results in more ROI per user for the health plan because the “CMDM”, for example, can dictate whether someone goes to a virtual visit over an Emergency Department (ED) visit.

Learnings from Horizon’s portal utilization data

Horizon also found that this group of “CMDMs”: 1) was likely to be early adopters of telemedicine and 2) prefers the app over the web portal. Consequently, Horizon continues to market telehealth offerings on their app to these demographics.

Horizon changed all their marketing and advertising (on the website, emails, texts, app store, etc.) to attract this persona by showcasing what these members find valuable. The marketing materials highlight how simple it is to use their app from anywhere at anytime and prominently features virtual visits.

When choosing images, Horizon was constantly asking “could the CMDM see this visual and see themselves in it”? Horizon chose images involving a man and a baby, or young parents, or a mother with a sick child in order to target these household CMDMs.

“This isn’t a new concept. Consumer goods companies have been marketing to mothers for decades now because they are often the shoppers in the household. While times are changing, Horizon looked at their data and saw that this discrepancy in family roles still exists and could help with member segmentation.”

Horizon launched their app in September of 2018 and has over 380,000 app downloads as of October 2020.

In the short term, Horizon measures ROI and justifies the app investment using a decrease in call center volumes. The main reasons members call Horizon are to check on claims and to find a doctor—both of which can be done on the Horizon portal and app. Members who use the app or portal are less likely to call into Horizon’s call center, which saves Horizon $7 to $10 in administrative per call.

In the near- to long-term, Horizon measures ROI by tracking the decrease in medical spend when members are diverted to lower cost sites of care through the portal. On the portal, Horizon has seen a 60% increase in telehealth visits in 2020 as well as a 56% increase in nurse chats.