In the rapidly evolving landscape of digital marketing, the healthcare industry has witnessed a surge in the demand for affiliate marketing, with aggregators playing a central role. Over the past decade, insurers, brokers, and senior care companies have increasingly turned to aggregators, paying a percentage of the product sold or a flat rate for a lead or referral. The rise of digital marketing has propelled these aggregators, who leverage sophisticated online comparison platforms, digital marketing expertise, and superior online customer experiences.
The insurance aggregator market in North America stands at an impressive $7 billion, according to data from Allied Market Research, showcasing the substantial influence of aggregators in the healthcare industry.
Lead Generation Aggregators vs. Product Comparison Aggregators
Understanding the nuances between lead generation and product comparison aggregators is essential for companies navigating the affiliate marketing landscape.
Lead Generation Aggregators
Lead generation aggregators employ their own no-brand-name marketing strategies to create demand, capture consumer interest, and subsequently sell leads to end-users such as insurers, brokers, or senior care companies. This can take various forms, including customer lists, leads, and introductions.
Exclusivity: In addition to determining the depth of lead generation, executives must weigh the importance of exclusivity in their partnerships with aggregators. Many aggregators sell the same leads to multiple partners unless the end user pays a premium for exclusive leads or referrals.
Figure 1: Higher and lower cost and exclusivity in partnerships with aggregators
Product Comparison Aggregators
Product comparison aggregators sell directly to consumers by collecting branded digital marketing from competing companies on a proprietary online platform. This enables consumers to comparison shop in an unbiased manner. These aggregators often partner with trusted retail, pharmacy, and wellness brands to create co-branded marketing, offering consumers a convenient one-stop-shopping experience.
Aligning Marketing Goals to the Right Affiliate Marketing Options
Leveraging affiliates for acquisition can be a lucrative endeavor if approached thoughtfully and executed with care. A clear understanding of the quality of memberaffiliate marketing can be crucial.Oftentimes, there are tradeoffs between lower acquisition costs and potentially lower customer lifetime value.
Leveraging Aggregators for Acquisition
Acquiring members via affiliates is more than a “fire and forget” exercise. To maximize effectiveness, carriers can take concrete steps:
Capture Comparison Shoppers: Identify and capture consumers who are likely to comparison shop, ensuring a strong online presence on well-known comparison-shopping websites.
Increase Awareness for a Halo Effect: Elevate product and brand awareness to create a halo effect. Even when shopping around, consumers want to feel confident in their choices.
Broaden Reach: Aggregators, with their marketing efforts, have additional reach. Target audience segments that companies may not have otherwise captured, particularly in areas or demographics with lower penetration.
Optimizing Member Retention
Retaining members acquired via aggregators presents unique challenges. To enhance retention, marketing executives should focus on four key factors: good data, early engagement, strong aggregator partnerships, and holistic analyses of aggregator-captured members.
Good Data: Tracking member cohorts based on sales channels and applying predictive indices for likelihood to switch is essential for identifying high-risk members.
Early Engagement: Members captured indirectly need early engagement strategies to foster a connection. Promote downloading the app, selecting a primary care provider, and completing the member profile.
Strong Aggregator Partnerships: Collaborative communication plans between aggregators and insurers can improve retention among converted consumers, avoiding confusion and reinforcing the plan selection.
Holistic Analyses: Regular analyses of aggregator-captured members are necessary to assess goal achievement and optimize aggregator utilization for future strategies.
Navigating the Future of Healthcare Marketing
In conclusion, aggregators are an integral part of the health insurance landscape, offering companies the choice to actively capitalize on their strengths or passively receive sales. A scientific view of indirect channel tradeoffs, leveraging data to determine the future role of aggregators in a marketing and sales channel strategy, is key. To delve deeper into the intricacies of sales disruptions and recalibrated selling motions prompted by the pandemic, we invite you to download our whitepaper for invaluable insights.
Download our whitepaper, “Navigating 5 Fundamental Shifts in Healthcare Marketing and Sales Channels”
For a more in-depth exploration of the the role of aggregators, and four other disruptions, download our whitepaper.
Today, 39% of health insurance consumers purchase online, and this percentage is on the rise. However, it’s important to note that 61% of consumers still rely on face-to-face or telephonic agents for their insurance needs.1 Therefore, insurers must navigate the right balance between self-service-led experiences and agent-led experiences effectively.
3 Key Steps to Balancing Self-Service and Agent-Led Models
Fortunately, finding the right balance between self-service and agent-led can be undertaken systematically:
Embrace the notion that channels don’t choose customers; customers choose channels. It’s a foundational principle for any go-to-market strategy. Regular buyer research is crucial for understanding why buyers prefer one channel over another.
A Self-Service Digital-Led Channel is defined as customers independently navigating digital platforms for transactions. When customers engage with agents—either virtually or in person—for assistance, guidance, or to finalize complex transactions, that is considered an Agent-Led Channel. As you can see in Figure 1 below, both Channels include owned (direct channels owned by an insurer) and rented channels (such as brokers, aggregators, etc.).
Keeping an ongoing 360-degree view of how customers buy is critical to deeply understanding why buyers within each line of insurance are choosing one channel over another. These varying customer intentions and motivations by channel will provide insight into current and potential future buyer segments, and ultimately, the path to designing a more relevant CX.
Figure 1: Health insurance channel landscape
Step Two: Adjust for Channel Economics
Channel economics are the efficiencies (or lack thereof) to acquire new customers. Focus on three key performance indicators (KPIs) to adjust appropriately:
Selling expense-to-revenue ratio (E/R) – Measuring E/R by channel ensures that cost-of-sale economics are affordable in the context of overall business profitability targets.
Customer Acquisition Cost (CAC) – Understanding the cost to acquire a member provides insight into the upfront channel cost, which is essential to forecasting and projections.
Member Lifetime Value (LTV) – While some channels may be more expensive in the short-term, they may yield high lifetime value customers for greater long-term results.
Step Three: Design Routes-to-Market Resources
Conduct thorough resource planning for each channel, covering infrastructure, training, and marketing. Ensure clear documentation of resources allocated to each channel, including expenses, and review this at least quarterly to align with channel performance and buyer feedback.
Update Infrastructure: For Self-Service Digital-Led channels, prioritize a best-in-class online experience. For Agent-Led channels, secure or renew partnerships with brokers and aggregators.
Ongoing Training: Train technologists to troubleshoot issues via Self-Service Digital-Led channels and train agents how to use sales platforms and understand the nuances of plan benefits in local areas.
Marketing Support: Deploy demand capture campaigns for Self-Service Digital-Led channels to drive awareness and traffic. For Agent-led channels, deploy awareness marketing to drive consumer awareness and consideration, as well as provide agents with audience-specific materials to aid in the sales experience.
Planning for Tomorrow’s NextGen Distribution Model
Health insurers are facing a dynamic landscape where the balance between self-service and agent-led channels is pivotal. Adapting to evolving customer expectations and optimizing business outcomes requires a strategic approach. The three steps detailed in this blog should be addressed in the context of long-term strategy. Utilizing a “clean sheet” technique, it’s important to envision a distribution model five years ahead to foster innovative test-and-learn opportunities.
Adapting to digital and omnichannel experiences is essential for success. Doing so while adjusting for channel economics, and investing in effective routes-to-markets, insurers can not only thrive in the present but actively prepare for the uncertainties of tomorrow.
Download our whitepaper, “Navigating 5 Fundamental Shifts in Healthcare Marketing and Sales Channels”
For a more in-depth exploration of the changing balance between self-service and agent-led channels, and four other disruptions, download our whitepaper.
When it comes to Medicare insurance marketing, leading payers must navigate the implementation of National versus Local media. Over the last few years, the top incumbent Medicare Advantage payers have spent 70%-80% of their media budgets on national media buys versus 20%-30% on locally based media.1 So, what’s the big deal? Make no mistake, the path to developing, implementing, and measuring a National versus Local marketing strategy is fraught with unique challenges.
From our experience working with top Medicare Advantage payers, we’ve identified three core issues causing friction. By addressing these issues, payers can improve strategic planning, implement more omnichannel marketing, and ultimately, drive membership growth:
Poor cross-functional team collaboration is often rooted in conflict between different business objectives. While working with Medicare Advantage payers, we find that the National teams tend to be more marketing-centric and Local teams tend to be more product and sales-centric. That means, despite the value that can be tapped from collaborating, these teams tend to be more siloed than not. And when that’s the case, bringing teams together for planning and alignment can be a point of friction.
For example, when it comes to specific objectives, the National team is focused on cost-effective marketing. Since they have access to national media buys, they benefit from economies of scale; meaning they gain significant media cost advantages by reaching consumers across the national footprint. However, a key consideration in marketing across a national footprint is that messaging cannot include specific plan benefits that may vary from ZIP code to ZIP code due to CMS guidelines. This isn’t a disadvantage, as often National objectives like brand building or motivating a consumer to call to shop for a plan, can be successful without benefit-specific details.
However, when you’re a member of the Local product team that worked for months to invest in competitive benefits, it can feel frustrating not to see those benefits front and center in marketing messaging – especially if they present a competitive advantage. Local marketing can help showcase those benefits and bring awareness to market-specific circumstances, such as entrance into a new market.
Alignment to Goals and Omnichannel Messaging
Successful cross-functional collaboration is dependent on gaining alignment. The alignment of common goals and key objectives is a necessary starting point before media plans are designed. This cannot be accomplished without regular ongoing collaboration. Each enrollment or planning season, it’s imperative to reassess the short-term and long-term goals and objectives as they often shift in scope or priority. This process requires cross-functional updates that share consumer, product, marketing, and sales channel insights.
As you’ll see in the chart below both the National and the Local teams tend to be steeped in deep data and insights. And when this information is shared, it can unlock integrated media and channel strategies that can holistically advance a payer’s go-to-market strategy including landing on the right mix of National versus Local Marketing.
2. Changing Industry and Market Dynamics
Another issue that complicates optimizing the right mix of National versus Local marketing is changing industry and market dynamics. While the Medicare Advantage (MA) industry is experiencing growth, the “where” and “how” of MA growth are becoming increasingly nuanced (Chartis).
Medicare Advantage has seen record 2023 enrollment, with program participation adding 2.7 million beneficiaries, or YOY growth of 9.5%. Today, 48% of Medicare eligibles are enrolled in a Medicare Advantage plan (Chartis). And with 10,000 seniors “aging in” to Medicare every day, MA total enrollment is expected to grow from 64 million to 80 million by 2030 (Managed Care).
However, “how” to capture this growth has become more complex due to shifting consumer behavior, evolving CMS regulations, and a crowded competitive environment. Here are just some of the staggering facts:
Shifting Consumer Behavior:
MA Switching: Consumers are switching MA plans at an increased rate. Deft Research reported that MA switching saw an increase during AEP2023 (the first time since 2019) to 15%.
OM Contraction: Original Medicare is losing enrollees at a rapid pace. From 2022 to 2023 OM enrollment contracted by 1.3 million.
Sales Channels: More than half of switchers enrolled through an Agent, and about a quarter of those via in-person meetings (Deft Research).
Crowded Competitive Environment:
Marketing Spend: 10% to 30% of the annual $2B AEP marketing spend comes from third-party aggregators/partner call centers, with the balance of the spend from payers.2
Competitor Growth: While incumbents United and Humana accounted for 44% and 23% of enrollment, newer entrants delivered nearly 22% growth (100K lives) Devoted Health accounting for nearly two-thirds of this growth.
Quality scores: 73% of MA beneficiaries are enrolled in health plans with 4+ stars.
Evolving CMS Regulations:
Marketing/Advertising: From specific advertising language to tighter messaging based on plan availability, to new TV ad approval processes and timelines, etc.
Third-Party Marketing Organizations: Stronger TPMO oversight, including beneficiary data collection and restricted distribution.
Permission to Contact: Extended expiration dates
Nuanced Market-Level Dynamics:
Disruptions: Competitive entrants, exits
Target Audiences: Dual-eligibles, multi-cultural, etc.
Plan Competitiveness: 5-star plans, MACVAT scores
If you didn’t think cross-functional team collaboration was important before, reviewing this list should emphasize the critical nature of coordinated planning amidst these complex and ever-changing dynamics.
Analyze the Four C’s
The reality of these conditions means regularly adapting your go-to-market plans and the role of National and Local marketing within them. Begin by reviewing the four C’s: Consumers, Competitors, CMS, and the Community. It’s a critical process for auditing the current and future state dynamics that payers need to factor into strategic planning, or else fall behind.
3. Complex Media Budget Allocation and Optimization
Allocating and optimizing marketing budgets across media and geographies is a common challenge. Most payers are using Marketing Mix Modeling (MMM) and Multi-Touch Attribution (MTA) analytic approaches to answer questions such as, “How did marketing impact the number of enrollments?” and “What is the true return on brand investments?”
Brand/Awareness Marketing
When it comes to upper funnel Brand/Awareness marketing, National and Local marketing face a similar measurement challenge. The objective of this upper funnel marketing is the attitudinal measures of awareness and consideration. This requires consumer survey data versus a KPI metric such as enrollments.
Where things differ is Local Marketing suffers from a lack of scale. More times than not, Local Awareness campaigns run for too short of a period to measure changes in behavior, or the marketing investment levels are too small to drive significant impact because thinner Local budgets were spread across too many Local markets at a time.
Lead Generation Marketing
When it comes to lower-funnel lead generation marketing, National and Local campaigns typically have the objective of driving a consumer response; a phone call, or filling out a web form. Measuring these types of campaigns can be straightforward, using last-touch attribution, though MMM and MTA models would provide a more accurate, holistic view of channel impact.
Measurement of any kind (last touch, MMM, and MTA) requires clean and consistent data. That means all marketing data should be exhaustive (including all channels), keyed (a reliable way to identify individual-to-channel interaction), and labeled (clear metadata to enable analysis).
This is where measuring Local marketing performance can encounter friction. First and foremost, if the teams setting up Local marketing campaigns are different than the teams setting up National campaigns, the processes for tagging, tracking, and capturing campaign data are often not universal. Unfortunately, this is typically the root cause of lost Local marketing data and insights.
Another issue that Local marketing must navigate is the end sales channel. Many times, Local lead generation campaigns route to local agents in the field, which adds a level of tracking complexity that can lead to lost attribution.
Inputs for Measurement Success
Best-in-class MMM and MTA models help payers understand the recommended marketing mix (across the funnel media) and geographies. But, simply having these models in place is not enough. It’s very important to audit these models to be sure both National and Local marketing data are regularly and accurately included as inputs. Media vendors change and feeds break, so don’t forgo this step. Ensuring accurate marketing data feeds will allow for a read on National and Local media tactics and the role they play in the consumer purchase journey.
Finally, because Local marketing budgets are smaller, it’s imperative to have them work harder for you by honing in on location, location, location. There is no simple one-size-fits-all solution. This requires aligning business goals with market goals and assessing the market dynamics and marketing gaps to make the best choice. Sometimes, you’ll have invested in specific Local markets near-term for a quick win that season, other times you’ll invest in key markets to continue building a long-term path to enrollment growth.
Summary
Ultimately, it’s important to remember that both National and Local media reach consumers locally, and both have pros and cons depending on what you need to accomplish. Despite the challenges from the three common issues discussed, 1. Poor cross-functional team collaboration, 2. Changing industry and market dynamics, and 3. Complex media budget allocation and optimization—payers that do the work to address these issues can reduce friction points, improve strategic planning and ultimately, drive membership growth with a custom mix of National and Local marketing.
Download our whitepaper, “Navigating 5 Fundamental Shifts in Healthcare Marketing and Sales Channels”
For a more in-depth exploration of how to leverage local marketing strategies effectively, along with and four other disruptions impacting go-to-market strategy, download our whitepaper.
Today the health insurance industry is as crowded as it’s ever been, making the race to the top a steep climb. Incumbents are expanding plans, new entrants are bringing innovative new business models, and let’s not forget the lead aggregators angling for the attention of the same consumer group as every individual health insurer.
What magnifies this dynamic is the local nature of health insurance markets. Plans are designed and distributed within ZIP Code ranges. As a result, most insurers have a focus on market-level budgets, market-level membership goals, and even market-level advertising. However, conditions often vary from market to market which can make market-level planning and preparedness in this crowded environment a bit of a quagmire without a clear assessment.
Market Assessment for Health Insurance Leaders
After working with some of the nation’s largest health insurance companies, we’ve found there are nine imperatives that when jointly implemented are the building blocks for market success. We’ve organized these nine imperatives into three tiers:
Addressing the Foundational tier first is essential, as without doing so, the remaining tiers will be significantly less effective.
For anyone in the insurance industry, these imperatives will be familiar. The organization of the imperatives in this assessment was developed by our Marketbridge team when asked to diagnose the root cause of why specific markets for a particular insurer were underperforming. After countless discovery interviews and performance analysis across marketing and sales, we learned these nine imperatives—when activated collectively and effectively—were the key to achieving membership goals at the market level.
Not surprisingly, during our initial analysis for the insurer, it was common to find gaps across the nine imperatives. It was also common to see a disjointed focus on where to invest the most time, resources, and budget given the context of those gaps. This assessment served as a tool to quickly convey how to view all nine imperatives, where to start to address gaps, and in what priority order.
1) Foundational Tier—Why will consumers consider your brand and plans?
As you’ll see foundational imperatives are the highest priority as they are what’s needed to compete in the market. These imperatives answer the question, “Why will consumers consider your brand and plans?”
Benefits Package: Offer plans with competitive benefits and competitive prices.
Provider Network: Include notable local hospitals and a wide network of healthcare providers.
Member Experience: Take a member-centric approach to caring for members.
Benefits Package/Provider Network
Research has shown the cost of benefits and lack of access to providers are reasons why consumers consider buying or switching plans, so it’s no surprise to see those among the first two imperatives Benefits Package and Provider Network.
Member Experience
The third imperative, Member Experience, is linked to keeping existing customers, as any marketer knows the cost of acquiring a new customer is higher than retaining one. Of course, avoiding an exodus of members also helps bolster membership goals. This is something a handful of Medicare aggregators and carriers struggled with this past AEP as they lost members, resulting in significant drops in their company stock prices.
One other note on this imperative is the emphasis on being member-centric. Customer experience in a commoditized industry like insurance can be a powerful differentiator. Unfortunately, 60% of insurance executives agree that their organization is lacking in CX strategy (Forrester). So, a word of caution; beware the urge to ignore Member Experience as a foundational imperative. Its placement as a priority in this assessment is significant.
2) Table Stakes Tier—How will consumers hear about your brand and plans?
Table Stakes imperatives are what’s needed to win in the market. These imperatives answer the question, “How will consumers hear about your brand and plans?” and consist of the core Marketing, Sales, and Provider channels.
Marketing Channel: Deploy a multi-channel marketing plan to drive awareness and generate inbound leads.
Provider Channel: Engage with providers to build spheres of influence to drive awareness and consideration.
Marketing Channel
When it comes to Marketing, consumer shopping behaviors are shifting. We’re seeing more consumers shopping and purchasing online; either across the full purchase journey or navigating across online and offline channels throughout the journey. While that’s not news to health insurance marketers, it can be a challenge when it comes to giving consumers an omnichannel, frictionless experience. Too many carriers are still working with siloed media teams focused on a limited section of the experience. They are also working with disparate technology systems—some old, some new—but none seamlessly integrated.
Another challenge within the Marketing Channel is determining the media mix. As the marketplace has become increasingly crowded, marketing cost-pers have increased. And with budget allocations often tight, marketing teams must spend each dollar as efficiently as possible. In fact, Gartner has predicted that this is the year profitability will overtake customer experience (CX) as a top strategic priority. Unfortunately, the answer to “what’s really working and what’s not” is not simple or easy, but there are solutions that can help. See our whitepaper, “Measuring Marketing’s Effectiveness.”
Sales Channel
Now, once a consumer is ready to purchase a health plan there’s a natural segue to the Sales Channel imperative. Over the years, the health insurance industry has seen significant investment in building direct-to-consumer online purchase paths. While some consumers are taking advantage, most are using digital channels to compare plans and better educate themselves, but often still choosing to speak with a licensed agent when it comes time to purchase. Therefore, equipping and enabling agents to conduct a best-in-class buying experience is crucial; from the plan information, they share with consumers to the platforms they use for enrollment.
Of course, there are many types of agents, from telesales to field with carrier-exclusive contracts to multi-carrier contracts which introduce unique dynamics such as compliance and incentives that may impact how you implement across the Sales Channel.
Provider Channel
The last Table Stakes imperative is the Provider Channel. The critical role of providers in the healthcare value chain positions them as key influencers and partners in local communities. Admittedly, the relationship between provider and insurer can be a complex one. Providers want to remain carrier-neutral but desire to help build their patient population and appreciate the advertising and on-site event support carriers can offer. Bottom line: Insurers who have support from key providers are often winners within their market.
3) Advantage Tier—What will consumers remember about your brand/plans vs. competitors?
Advantage imperatives are what’s needed to stand out in the market. These imperatives answer the question, “What will consumers remember about your brand and plans vs. competitors?” Standing out when you are offering a commoditized product like health insurance isn’t easy, especially during demand capture seasons like Open Enrollment (OE). Here are the three imperatives in the Advantage Tier:
Specific Benefits: Provide consumers with high-demand benefits, perks, and key differentiators.
Personal Service: Ensure and deliver personal and timely service via all distribution and service channels.
Relatability: Show consumers you deeply understand who they are and what they value.
Can you win without these three imperatives? Yes, it’s possible. That’s why these are not included in the Table Stakes section.
However, given the shifting market dynamics such as aggregators outspending insurers in advertising and insurers partnering with retailers to foster familiarity and brand preference, those companies that don’t focus on these imperatives will continue to fade into the background.
Keep in mind that this isn’t just an acquisition challenge, it is also one for retention. Customers who have a poor experience, or don’t feel connected with their insurer, will be more readily coaxed over to a hungry competitor.
Specific Benefits
Specific Benefits are a way to spotlight a particular benefit consumers want. An example may be a Healthy Foods Card, something Anthem leaned into when it announced co-branded Medicare plans with supermarket chain Kroger.
Personal Service
Personal Service is how to put the human back into the experience of shopping and utilizing health insurance. Your health is personal. Companies helping you care for your health should show they understand that. Arguing on the phone over a claim, after having been hospitalized, is an experience that will sour a consumer’s attitude. A recent LinkedIn post I saw showed a Humana Medicare Advantage member who had been recently hospitalized coming home to a “Mom’s Meals” package from the insurer. This made sure she didn’t have to worry about shopping or cooking food for the week. That’s Personal Service done well.
Relatability
Finally, the last imperative is Relatability, which means showing your consumers you deeply understand who they are and what they value. United Healthcare embraced this concept with its Dual Complete television ad that shows those eligible for Medicare and Medicaid. However, often there are Relatability gaps in markets. For example, multicultural populations may not feel represented or heard by insurers. Insurers that embrace the Relatability imperative will have the advantage of better connecting with consumers in the market—a true advantage in today’s crowded health insurance marketplace.
Achieve Your Market-Level Goals
When activated collectively and effectively, we’ve found these imperatives are the key to achieving membership goals at the market level.
Download our whitepaper, “Navigating 5 Fundamental Shifts in Healthcare Marketing and Sales Channels”
For a more in-depth exploration of how to leverage local marketing strategies effectively, along with and four other disruptions impacting go-to-market strategy, download our whitepaper.
