By KATHLEEN NELSON
For many millennials, ignorance is bliss, at least about health insurance. Defined by the U.S. Census Bureau as those born between 1982 and 2000, millennials comprise more than 80 million people, about a quarter of the U.S. population. Most are healthy, and the younger ones still rely on parents to foot the bill for health care.
The image above is from an Avera Health Plans postcard marketing campaign to millennials. "What's your plan?" was dropped from the copy in subsequent advertising after marketers learned college students are tired of that question.
Millennials are an attractive, relatively untapped market for health insurance. According to estimates in September from the Department of Health and Human Services, half of the 10.5 million uninsured who were eligible to sign up for coverage under the Affordable Care Act were millennials.
Delivering an effective message about health insurance and health care to millennials and starting to build brand loyalty among members of that generation provided a challenge that turned into an opportunity for Avera Health Plans, which researched millennials then tailored messages and services to attract them.
To figure out how to speak to a generation young enough to consider itself invincible, Avera collaborated with Augustana University, both in Sioux Falls, S.D., on a 2014 study called MillenniCare. Avera helped marketing students set up questionnaires that were filled out by 150 adults and assisted with interview questions for dozens of participants in focus groups. The survey respondents and focus group participants were ages 26 to 35, the older half of the millennial generation as defined by the Census Bureau.
Avera went into the research not knowing what motivated a millennial to purchase health insurance, said Jackie Jockheck, marketing director for Avera Health Plans. At the time, Avera was using what Jockheck called "a soft approach in our messaging — avoiding the conversation all together about tax penalties" established in the Affordable Care Act for people who fail to have insurance coverage.
The MillenniCare re-port included results from surveys and focus groups. Among the findings:
- "Scarlett O'Hara syndrome," said Jaciel Keltgen, assistant professor of marketing at Augustana, whose students conducted the study. "Millennials would rather worry about it tomorrow — reporting they would prefer taking the hit on their taxes through noncompliance than take the time to go on the exchange and locate an insurer by a certain deadline."
- "Millennials needed a wake-up call," Jockheck said. When shown an ad that focused on the amount an uninsured person would have to pay if something went wrong, a majority of the respondents said the premium payment was no longer a drawback to purchasing individual health insurance coverage.
- The cost of the premium was more important than the cost of the co-pay or deductible in a millennial's decision on whether to buy insurance and which plan to buy.
- Low marriage rates create a large number of single millennials who could be seeking out individual insurance plans.
- More than 70 percent of the respondents to the questionnaire expected dental and vision coverage to be included in health insurance.
The report also included recommendations that insurers targeting millennials offer free informational sessions and resources about the health care market, market to nontraditional families and use multiple digital platforms with a consistent message and branding.
Avera first responded by changing its message in 2014. "We needed to be blunt and maybe more dramatic to help the millennial understand the consequences and the expenses to health care," Jockheck said. "Our ads were changed to reflect health care costs without health insurance."
Before and during open enrollment that ended in January 2015, Avera scheduled 20-minute webinars in the evening. Avera continues to offer webinars to its health plan members. Jockheck said each webinars has attracted between 65 and 150 viewers.
A KentuckyOne employee talks to millennials about health care during an event at the University of Louisville student center. The system says it is working to be millennials' first choice for health services.
Avera also set up, and continues to maintain, a simple email address, Ask@AveraHealthPlans.com, where "many will share their frustrations and questions about health insurance in an email before picking up the phone," Jockheck said.
Other ministry members are reaching out to millennials before they age off of their parents' health plan by meeting young people on their own turf. Louisville, Ky,-based KentuckyOne Health, for example, partners with the University of Louisville, which draws students primarily from the state. It has worked with the school's student health office to hold free monthly programs on such topics as stress release during finals and skin cancer prevention and has offered health screenings before spring break.
"As they come off their parents' insurance, KentuckyOne Health is positioning to be their first choice," said Stephanie Sarrantonio, KentuckyOne's marketing director for central and eastern Kentucky. "It's definitely more about community outreach than a hard sale. It's cultivating a relationship over time."
Millennial Kylee Brown, 27, gets her sore throat checked by Dr. Kim Hanssen, a family practitioner with Avera Medical Group McGreevy.
Sarrantonio said KentuckyOne's millennial clients are fans of Anywhere Care, online and phone consultations that cost $35 per virtual visit, less than a typical urgent care visit and a fraction of the cost of a typical emergency room visit.
Jockheck said millennials who sign up for an Avera health plan rely on the mobile app more than any other age group. The most popular feature for them on the app is the ability to pay monthly premiums. She predicted that ease of access to information from multiple sources — online and in person — will be the key to attracting millennials for the next decade, as they continue to come off their parents' insurance.
"More education is still needed," she said. "There is still a need to walk them through basic steps to enroll, see a doctor and pay a bill. We need to provide millennials access when they are ready to look and/or enroll."
Copyright © 2016 by the Catholic Health Association
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