The Digital Health Guy Gets the Expert Opinion: David C. Edelman, Chief Marketing Officer, Aetna

In the minds of patients and consumers, insurance companies once seemed to occupy a secondary position in healthcare. Consumers visited physicians, hospitals, testing centers and other care-providers and thought of them as the enablers of their care.

If you asked those customers what they thought of their insurance companies, most would have said, “They are there to process my medical claims.” The notion that an insurance company cared about their wellbeing or wanted to keep them healthy was simply not on anyone’s radar.

But while customers were looking the other way, a seismic change has taken place in the role that insurers are playing in their wellness journey. And even bigger changes are coming.

When Aetna hired David C. Edelman as Chief Marketing Officer in October 2016, the company was looking for someone to refocus Aetna’s marketing on the individual customer.

“I was hired to transform Aetna’s marketing organization, creating meaningful consumer experiences and new initiatives to unlock growth,” Dave told Kevin Pereau recently.“ We are only at the beginning.”

But what a beginning. Dave and his team are succeeding by applying both proven ways of marketing insurance and thinking that is new to the insurance industry. Perhaps that is not surprising, given his background. Before joining Aetna, Dave co-led the Global Digital Marketing and Sales Practice at McKinsey, where his cross-functional team focused on digital marketing, analytics, and process redesign. Prior to McKinsey, Dave was executive vice president for the Strategy and Analytics practice at Digitas. Earlier still, he helped to build the Boston Consulting Group’s “Segment-of-One Marketing” and “E-commerce” practices.

I am delighted that Dave agreed to discuss with me some insights on what is going on at Aetna, and to share some of his keen insights on the changing world of healthcare too. Let’s hear what he has to say.

How Edelman Has Aetna Refocusing its Marketing

• Marketers, and digital marketers in particular, have developed and perfected tools to optimize and measure the effectiveness of their marketing. The strategies are to develop marketing programs, test their effectiveness, and then optimize them to improve results.
• In Dave’s words, those skills are “fundamental to our day-to-day work. We continue to work closely with our business partners to raise the bar on the traditional marketing to support our sales force.

• Yet things are changing. At Aetna, Dave Edelman and his associates are shifting the focus toward finding the right creative ways of connecting with individual consumers – not to just sell to them, but to support the goal of helping them take better care of themselves.

• Dave explains that there are two sides to how Aetna is reshaping its marketing. One is engagement, which Dave defines as “Using marketing techniques to get people involved.” The other side is experience, which Dave summarizes as, “Making people’s experience with us something that’s distinctive, branded, and worthy of sustaining over time.”
• The success of that process will mean getting people to become more engaged in managing their care, in becoming more aware of the decisions that they can make and the tools that they can use to take greater control over their own healthcare.
• “We need to bring marketing discipline into the actual care management process,” Dave summarizes. On the surface of things, that might sound straightforward. But when I take a moment to think about it, I realize that Dave is talking about a change that is profound.

Reinventing the Aetna Brand

Dave and his colleagues have launched a new brand positioning that is simpler, more direct, more active, and livelier.

“We’re not just about sick care; we want to be about healthcare and helping people realize the joy of achieving their health ambitions, whether that’s running a marathon or attending a family wedding” Dave explains. “So we dedicate every ounce of our energy to helping people reach their health goals, big and small, at every stage of life.”

That new emphasis is reflected in the new tagline that is central in the marketing programs that Dave has begun at Aetna . . .

“You don’t join us. We join you.”

To make that brand promise come authentically alive, it is critical to understand and support individual consumers’ individual health ambitions. It is a process that will require rethinking the entire member experience.

“In some ways, you might say we are not the marketing department, but `the office of the consumer,’” Dave explains, “even though that is not our title.”

Turning the Insurance Industry on Its Ear

In years past, helping insured customers become healthier was something that just kind of happened because they had insurance coverage. Now that is changing to a new paradigm in which the individual customer’s health journey will move to the very center of what insurers do.

“There is a growing realization that for health insurers to survive, they cannot just pay claims,” Dave states. “The old model was insurers would get a bucket of money from an employee or an employer or from the government, and they would spend some of that to play claims, and whatever they could keep was profit.”

Predictably, the insurer’s ability to be profitable depended on spending as little as possible to cover claims. And other unfriendly practices took hold, such as making customers expend lots of effort to find in-network care providers, to avoid certain costly procedures – and worse.

“But there should be more to our business than just being parsimonious about paying claims, which often didn’t help the consumer very much” Dave states, noting that today’s consumers are increasingly interested in assuming more responsibility to manage their conditions, to manage costs, and to make very informed decisions about their care.

Can this increased customer involvement create a more efficient, more profitable way of providing insurance? Dave believes that it will. “There were, in fact, enormous costs involved in doing business in the old way,” he states, “because people were just bouncing around like bumper cars or balls in a pinball machine, finding different care providers in the healthcare system. There has been no one place to coordinate that care within the clinical complex, and beyond the clinical complex.”

When an insurer can understand informed consumers’ concerns and partner with them to make the best decisions regarding the care of chronic and other conditions, both better care and reduced costs can result. Both those goals can be reached by shifting the emphasis to helping customers stay healthy instead of paying claims to help fix them when they become ill.

The Role of Data

In the past, Dave points out, insurers collected data about customers’ care not only to increase profits, but to be responsive to employers who were providing coverage, or to the government, which might have been paying Medicare expenses.

“Insurance companies’ systems were not originally crafted to gather and use individual data to the benefit of the consumer,” Dave explains. “They were mostly gathering information on instances of ER use, on this, on that . . . and just basically reporting back, and using data to make some decisions on where to focus more on utilization reviews, things like that.”

Was useful data being gathered? Yes, but the purpose of the gathering was not to help individual consumers proactively deal with their health concerns. Now that is changing. Aetna is developing systems that are acting as smart, cognitive databases that alert customers to ways to improve the quality of their care.

Dave summarizes, “We are re-architecting our systems in ways that provide customers with constant, optimized messaging that leads them to engage in smarter ways to help themselves. And we have actually gotten quite far in that process.”

Data from Day One

As soon as a new Aetna customer comes on board, Aetna asks “just a few questions” to make sure that the company understands their conditions, concerns, the health options they are utilizing – and can suggest appropriate care options they might not be utilizing.

“And then from that,” Dave says, “we can decide about what level of support they will need, and what kind of support. And then within that support, we’re going to track certain things to see if somebody is on track. If somebody who is a diabetic has not had their A1C checked in a while, we want to immediately get on that and trigger them to go into a clinic someplace and get their A1C checked. We want to translate this data into active triggers that we can use to help people.”

There are wider ways to use that data too. If Aetna suddenly sees a surge of flu claims in a region, for example, “we are going to work across the company to encourage members in that area to get flu shots,” Dave says.

The objective, which Aetna is already meeting, is to use data as something active that can be used to help keep members healthy.

Do members sometimes worry about sharing their data? “There are privacy concerns.” Dave says, “and they are valid. But our intent is to focus on achieving positive health outcomes for the member. That’s the standard that we are using. They choose it because of care, because of health.”

Branding to Build Loyalty

Aetna foresees that those points of contact will provide opportunities to build durable loyalty and affinity for its brand.

For example, Dave believes that as they move forward in their lives and their careers, younger consumers will have more opportunities to choose their insurers. “More employers are offering not just one, but many healthcare options, “he states, “and so people have choices. We want to be the brand that is preferred, and for reasons that go beyond the basics about cost and network coverage. We want it to be about the experience and what we do to help people’s care.”

In part, opportunities will arise from what insurers in the past have seen as concerns. In the increasingly complex world of insurance, individuals will have more responsibility to decide how they will pay for care. “There will be more interaction because consumers are getting more bills,” Dave explains. “They need more help, so they can make smarter decisions for themselves. On one level, they need help to stay in network, to manage costs, and to find their way to the right care. The result is that they are expecting much more from their insurance companies because they, as individuals, have more responsibility and need more help.”

But underlying those complications and concerns, Dave sees an opportunity to make consumers feel more intimately connected with Aetna, and more loyal. That connection is the key to Aetna’s evolving future.

Breaking Down the Clinical/Industrial Complex

“I think that one important trend is the breakdown of what I call the clinical/industrial complex,” Dave comments, “It is very easy for people to get lured into big, high-tech medical complexes when what they really might need is just a really good massage therapist, or other forms of alternative support. Maybe they need a nutritionist at a Safeway store who can guide them toward the right foods when they are in the store. I think we’re going to see, and are already building at a community level, extended networks that go beyond the clinical complex to include other forms of support that help people in their care – and in their health. We’ll also see more of those networks formally becoming parts of networks in a more rigorous way. It’s just starting. I see us doing it. I think others will too.

“It will go beyond just saying, `You’ll get a few dollars off a gym membership as an Aetna member.’ It’s going to be more explicit interconnection to new, more extensive, alternative forms of health support.”

Important Trends

Exercise clubs, pharmacies, exercise clubs, nutritionists and more will all be brought into that matrix. And in their marketing, insurance companies will move beyond talking about coverage and fees paid and tell more of the stories about how they helped individual people in their health journeys.

But perhaps the biggest trend will be that the emphasis in insurance will move from paying bills to partnering fully and actively with consumers to build wellness . . . to build health.

“Everything in the past was about transactions and driving down the cost of those transactions,” Dave said as our talk came to a close.

“I think you’re going to see a re-centering of the entire business around driving outcomes which can be summed up simply as, ‘health.’”

David C. Edelman is Chief Marketing Officer, Aetna. His current responsibilities include refocusing Aetna’s marketing on the individual customer through the addition of new retail pharmacy facilities and services. Follow David on Twitter: @davidedelman

David C. Edelman is one of the thought leaders who made Kevin Perau’s book,  “The Digital Health Revolution”,  possible – sign up here for updates and get your copy today.