Mass. Appeal: How One State Spread the Word on Health Care Reform Center for State Health Policy Rutgers University, Jun

1. Mass. Appeal: How One State Spread the Word on Health Care Reform Center for State Health Policy Rutgers University, June 21, 2011 Paul Wingle Director of Creative Media

2. Phase 1: The Initial PushFall 2006 – 2007

3. Goals for Phase 1 Launch an aggressive public education campaign to: • Provide information about the new law and raise awareness • Promote the availability of new plans, all certified by the state for quality and value • Promote the Health Connector’s ability to offer unprecedented choice

4. Who Are the Uninsured? • 56% between ages 19 to 39 • 57% male • 70% are employed • Of these two-thirds worked for small firms with fewer than 50 employees • About one-third reported that their employers offer health insurance Source: Massachusetts Division of Health Care Finance and Policy 2006 household survey of Mass. residents

5. What Market Research Showed Two basic messages resonated: • Health Security: Protection from financial ruin in the event of an unexpected accident or diagnosis • Access to Preventive Care

6. Public Education and Outreach Campaign

7. Elements of the Campaign • Partnerships w/corporate and civic organizations including the health care community, faith communities, unions, business groups, sports teams, etc. • Media Outreach • Direct Mail • Seminars & forums (over 150 presentations) • Grassroots Outreach • Paid Advertising • Public Information Unit • Grants to Community Organizations

8. The Ultimate Endorsement Health Connector teams up with Boston Red Sox to build enrollment in new health insurance plans. Other corporate/civic partnerships announced as part of public education campaign

9. Boston Red Sox • Information booth at Fenway Park for all home games (focal point for media outreach) • Live NESN interviews with Health Care Reform proponents – Senator Kennedy, Governor Patrick, State Sec. HHS Judy Ann Bigby, Connector Executive Director Jon Kingsdale • Public Service Announcements • Connect to Health Day at Fenway

10. Boston Red Sox • Tim Wakefield PSA • NESN Interview with Senator Kennedy

11. Health Care Reform Coalition • Group of 18 organizations, including Boston teaching hospitals, Blue Cross, Greater Boston Chamber, Mass Taxpayers, Health Care for All • Raised funding for complimentary ad campaign • Enabled the Health Connector to focus on target market, while the Coalition focused on broad-based awareness • Provided the glue to hold key supporters together

12. Health Care Reform Coalition

13. Our Partners • Other State Agencies • Greater Boston Interfaith Organization • Developed train the trainer materials • Educational workshops following weekend services • Went door to door • Helped at grassroots outreach events • CVS • Window Signage, info at pharmacy counters, overhead radio announcements • Shaw’s and Star Market Supermarkets • Messaging in circulars, messages on store receipts

14. Our Partners Continued • Associated Industries of Massachusetts, (AIM) • Partnered with key business associations to co-sponsor 16, three-hour sessions across the state. • Retailers Association, NFIB, Bank of America • helped with business outreach • IBEW • Messaging on lighted billboard on Expressway • Comcast • pro bono advertising • Zip Car • website link • Massachusetts Health Plans • MMCOs and commercial plans advertised

16. Other State Agencies • Department of Revenue • Postcards to tax filers (3.1 million), letters to employers (193,000) and uninsured • MassHealth (Office of Medicaid) • EOHHS Outreach and Enrollment Grants • Division of Insurance & Division of Health Care Finance and Policy • Presentations • Registry of Motor Vehicles • Notices to new Mass. residents via new license process • Division of Unemployment Assistance • Inserts in resident mailings • MBTA • Advertising on subway cars and buses

18. Grassroots Outreach • 20 community-based enrollment events during Fall & Winter 2007 • Partnered with: • Legislators • Mayors/City Councilors • Local Hospitals • Community Health Centers • Community Groups • Health Plans • MMCOs • School systems

19. Advertising • Television, including New England Sports Network • Radio • Print, including community, ethnic and college newspapers • Internet • Transit • Targeted to all geographies, from western Massachusetts to Cape Cod

20. Our Message • There's a new law - you need health insurance • Unprecedented choice of plans • Easy comparison of plans and prices through our website • State Seal of Approval for quality and value

21. Health Connector Advertising TV ads began mid-May 2007: “I’ve Got It” Broken Arm

23. Health Connector Advertising Message updated as deadline for tax penalties approached, as this fall 2007 radio ad indicates. Sign Up by Nov 15

24. Spike in visits to web site prior to tax penalty going into effect (May ’07 to Jan ’08 shown below)

25. Public Information Unit • Created to focus on calls regarding Health Care Reform law and business questions • Alleviated pressure on two enrollment call centers • Handled up to 2,500 calls/e-mails a week.

26. Results of Outreach efforts • By end of 2007, Massachusetts had over 300,000 newly insured residents • Law and penalties were fully implemented

27. Phase 2: 2008 - 2009

28. Goals for Phase 2 • With over 300,000 newly insured, the focus turned to those hardest to reach • Get their attention • Motivate them to enroll

29. Who said it would be easy?

30. What Market Research Showed2008 Those who remain uninsured resist health insurance because they: • Would rather play the odds • Feel they can’t afford it • Believe they don’t need it • Object from a civil liberties, anti-government perspective

31. What Are the Best Motivators? • Knowing the Tax Penalties • Understanding how costly medical treatment can be

32. Our Challenge • Come up with an edgy as well as educational campaign • Develop creative that is visually compelling

35. Health Connector Advertising Radio Ad: Not Gonna Happen to me

36. Social Media • Facebook • Digital display and SEM/PPC advertising • Search Engine Optimization • Twitter

37. Jaclyn Commonwealth Care Member Cancer free for two years. “If I didn’t have health insurance, I would never have made an appointment with my doctor because of the cost. The cancer would have spread and I would not be alive today to tell my story.”

38. Abbie Commonwealth Choice Member New to Massachusetts, Abbie was not optimistic about obtaining health insurance because of a pre-existing condition. “I figured I would go through the same process and be turned down again. But I wasn’t. I did the whole thing online and got a very good plan. I was just thrilled!”

39. Rate of Uninsured • By November of 2008 only 2.6 % of Massachusetts residents were uninsured • Best in Nation Source: Division of Health Care Finance and Policy

40. Phase 3: 2009 - present

41. Signs in 2009 that Health Care Reform Is Working • More than 400,000 newly insured • One third in commercial (non-subsidized) plans • 34% reduction in free care pool spending • Non-group premiums down • Opinion poll shows public continues to support the law (59 – 75%)

42. Goals for Phase 3 Promote Health Connector Brand attributes • You owe it to yourself to compare • The Health Connector can help • Choice and Comparison of Price and Plans • Peace of Mind through the Seal of Approval

43. Health Connector Advertising • TV Commercial: Comparing Apples • Radio Ad: Expert Guide

44. Lessons Learned • It takes a community effort (ask for help) • A variety of approaches are critical • Build partnerships and work to sustain them • Opportunities for outreach are everywhere from ballparks to churches, pharmacies to grocery stores