BlueCross BlueShield Heads Toward Personalized Health Care Communication

BCBSTThese days, BlueCross BlueShield of Tennessee is focused on multichannel personalized communications. About three years ago, it had yet to implement email.

“We really wanted to optimize our outreach, to optimize the customer experience and help customers understand exactly what we’re offering,” said Sherri Zink, VP of medical informatics at BlueCross BlueShield of Tennessee (BCBST), which serves roughly 3 million subscribers across the state.

But there’s nothing more personal than health data, and that can make data-driven personalization and targeting a little tricky.

It’s a balancing act between legislation like the privacy clause in HIPAA (Health Insurance Portability and Accountability Act), which protects consumer health information, and communicating with consumers in a way that enables them to take full advantage of their benefits and maximize their health coverage.

For that reason, BCBST began working with data and analytics company Teradata in 2012 to create an internal system called the Member Centric Decision Management (MDCM) program.

Zink referred to its launch as the beginning of BCBST’s “multichannel journey.”

At its core, MCDM is a data-management platform/marketing automation solution that combines data from all of BCBST’s various business units – group policies, individual policies, Medicaid and Medicare – in one place.

The system serves as a hub through which BCBST handles consumer preference, content management, timing and frequency.

Zink and her team also created a series of patient personas based on lifestyle attributes and clinical considerations in order to power its personalization machine.

The personas serve as a layer of privacy protection by focusing on groupings, rather than individual identity. Having all the data in a central repository also helps make it more easily governable.

“Tennessee centralized how data was being handled across clinical outreach, health marketing and customer service,” said Rose Cintron-Allen, senior industry consultant for health care at Teradata. “Beyond that, only the higher-level information or personas – the groupings of people – is available for segmentation purposes; the selection criteria are not. That data is not accessible to anyone unless there’s a clinician that needs it.”

The lifestyle personas take into account socioeconomic status, family size, demographic groups and buying patterns, which can often be a signal for whether a user is more likely to purchase brand-name drugs or generic.

On the clinical side, the aim is to analyze a consumer’s overall approach to health care by looking at how often that person uses benefits, whether he or she has a primary doctor, what sort of health care choice that individual made in the past and more.

For the last couple of years, BCBST applied the personas generally across its various business units. Now, it’s in the process of creating new personas for each. The needs of a Medicare user, for example, are not necessarily those of someone on Medicaid.

“With each, we’re dealing with a very different population set,” Zink said. “We’re redefining each of those personas by category and line of business so that we’ll have corresponding content to feed into each.”

BCBST is also in the process of developing psychographic and attitudinal factors.

SherriZinkFor example, if consumers are given the opportunity to participate in a wellness or lifestyle program, will they? How likely are they to engage with a health care professional if given the chance? Do they take advantage of BCBST’s members-only BluePerks discount program? These are the sorts of insights BCBST is looking to gain access to.

All of that data goes right into the MCDM platform. But BCBST places a limit on the number of personas it creates on purpose, Zink said. There are only about five of each type – and that’s because content doesn’t grow on trees.

There’s no point in creating personas if there isn’t complementary content to go along with them. Zink made a point of including the marketing department at BCBST in discussions early on to determine how much customized content it could feasibly create.

“It takes a lot of work to operationalize something like this – personalized content takes a lot of content management,” Zink said. “Say you build 20 or 30 personas, which we could do. Then you also need to develop corresponding content to go with each one.”

Beyond communicating with its members directly, BCBST feeds insights from its downstream system to its clinical management team. If it becomes apparent that a consumer needs help with disease management, for example, that information is automatically transmitted to a clinical professional.

The point is to leverage the data, not sit on it. If you can’t operationalize your insights, “then all you have are insights,” Zink said.

Consolidation is one example of an insight in action. Rather than creating monthly campaigns based on general themes as it used to, such as those around women’s health or flu vaccine reminders, BCBST began to bundle its communications to help close gaps in care. Members will commonly neglect to take advantage of recommended services – prescriptions, lab tests, regular checkups and the like ­– which are necessary for their particular condition or demographic, resulting in a gap.

If a member is overdue for a mammogram and also happens to need a flu vaccine, a single, more personalized message is now sent out rather than two separate messages.

According to BlueCross BlueShield Tennessee, implementing the MCDM system has closed more than 422,000 gaps in care and saved the company more than $3 million.

“Members need to understand their benefits and they use them in a way that’s both beneficial to them and cost-effective so that premiums don’t continue to go up,” said Teradata’s Cintron-Allen. “That’s what this is about – education and influencing behavior.”

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