The Growth Channel

Five groups of exchange enrollees to target


Anna Yakovenko, Marketing and Planning Leadership Council

Who will the new exchange enrollees be? A recent report, conducted by Enroll America, has identified five consumer profiles.

  • Unnecessary and uninterested: The youngest and consisting of mostly men (67%), the majority of this group does not see health insurance as necessary and is motivated by financial security that plans can provide.

  • Reluctant but reachable: This cluster is the most diverse and least educated but sees health insurance as necessary (71%) and is most interested in finding out minimal requirements all plans must cover.

  • Desperate and believing: The poorest and sickest among the profiles, this cluster expresses the strongest interest and least skepticism to new exchange options.

  • Connected low-income women: Among the sickest, this group is most likely to have medical bills and live in rural areas. While about one-third express strong interest in the new options, they need convincing about affordability and coverage.

  • Insured but at risk: While the majority of this group is insured, the risk for losing coverage is high. Like the “unnecessary and uninterested”, this cluster expresses weak interest and are very skeptical.

Each group, the study found, is motivated by unique factors and has different preferences for communication channels and messaging when considering new options for coverage.

  • Get a pulse check on Obamacare

    On Nov. 15, join Dan Diamond and Ben Umansky as they examine the state of Affordable Care Act implementation—with a close look at the new health insurance exchanges and a broader review of delivery system reforms. Register now.

Leveraging CRM to build awareness of the exchanges

Tailoring what we say and how we say it, based on a patient’s profile, is nothing new. But now, in addition to educating patients on services they may need, providers are also helping them enroll in health insurance exchanges.

A number of our members are already using their Customer Relationship Management (CRM) systems-- which leverage billing, claims, and clinical data, as well as demographic and consumer behavior information--to target uninsured patients and prospects.

Here are two steps providers can take:

  1. Segment the uninsured patient population by household income level and location to align each potential enrollee to Medicaid expansion or one of the state exchange plans, thus, more effectively tailoring the information delivered to each potential enrollee.

  2. Use direct mail to guide recipients to a website that screens potential enrollees to establish their qualification for Medicaid or state exchanges, provides in-depth information about the exchanges, and even connects them with navigators or brokers.

More segmentation in the future?

As a next step, providers could further segment the uninsured and at-risk populations into the five clusters, identified by Enroll America, to tailor messaging and provide the appropriate type and level of information that is likely to resonate with each group.

Ultimately, strategy will depend on the demographics of your community, the number of states your organization spans, state regulations governing enrollment procedures, and outreach efforts by other organizations. 

However, given their ability to reach individuals most likely to need the coverage and support customized messaging, CRM systems are likely to be a key component of outreach efforts for many organizations.

Your Next Step

Want more information on the exchanges? Take a look at these resources:

To do by Oct. 1: Educate staff, hire a celebrity?

Navigating Health Insurance Exchanges

Don't count on your 24 million new customers just yet


More on Insurance Exchanges

What is a health insurance exchange?

It's official, health insurance exchanges are live. Dan Diamond explains the Affordable Care Act's 'one-stop-shop' marketplaces in three minutes.


The difference between 'picked a plan' and 'enrolled'

At least 150,000 Americans have picked a plan through the Affordable Care Act's new insurance exchanges, but that doesn't mean that they've enrolled in coverage yet.




Recent Posts from The Growth Channel

To innovate, think inside the box

Five must-dos to boost physician outreach

Five 'rules of social media'

Is a clinical ‘franchise’ in your future?