@HealthPlan: How insurers use social media

After staying on the sidelines in the early years of the social media explosion, health plans are now trying to add their own voices to the chatter.

Most popular for health insurance companies is using social media as a customer service portal or a marketing outlet. Some are doing both. But generally, big health plans are not using Facebook, Twitter or YouTube to talk to physicians.

Health plans' involvement in social media sites varies widely, so unlike traditional media relations or marketing, there is no standard social media presence or benchmark. Without a blueprint for success, health plans have been left to figure out what online identity they want to have, and how to build it.

If there is a common use for social media among the big health plans, it is making sure that no gripe goes unanswered. With so many people chattering about them on social media sites, most health plans have concluded that they can't afford to let their brand names be bounced around without watching and trying to get in on the conversation.

Social media experts say health plans face special problems when trying to play on social media sites. First, their product is not an obvious social topic -- it's not Paris Hilton, or President Obama, or the latest viral video.

"Health insurance is boring. It's important and critical, but there's not a whole lot that's sexy about it," said Jason Falls, a digital marketing expert in Louisville, Ky. Among his recent projects was helping Humana pilot its customer service Twitter feed, @HumanaHelp.

Then there are regulations that bar health plans from sharing personal health data, so they are subject to the same restrictions that a physician would responding to customer complaints or questions.

For some plans, social media is not a part of their corporate life. Among the seven largest publicly traded health plans, Coventry Health Care is alone in having no social media presence. The company did not say why it has not established itself in social media.

Talking to the social universe

Other large health plans say they can't afford to stay silent on social media. At the same time, they can't just spout news releases on a Facebook page.

"You have to be real and authentic and talking about things that matter," said Meg McCabe, vice president for consumer marketing and product for Aetna. "Just a general presence is simply not acceptable."

There are common approaches health plans have taken in social media:

Health tips: When health plans decide to put out content rather than or in addition to monitoring what is said about their company, they frequently post health advice, or tips meant to promote wellness. Around the first of the year, for example, many BlueCross BlueShield-affiliated plans tweeted advice about how to stick to New Year's resolutions to lose weight or eat better.

It's also common for health plans to tweet about symptoms of diseases such as diabetes, or to post tips on how to avoid sunburn in summer or frostbite in winter. Sometimes the message reads like physician's advice, but health plans typically are careful to hedge what they say online.

"Our health and wellness information is reviewed to be sure that it is accurate and it is consistent," said Health Net spokesman Brad Kieffer.

Political messages/advocacy: Though insurers offering health advice via Facebook may not sit well with physicians, many health plans have used social media for even more controversial communications: They talk to their members or to the public about health system reform, rising premiums and other hot-button issues.

Some of those efforts appeared during the debate about a health reform bill and later went dormant, such as @nchealthreform, a Twitter feed accompanying a website hosted by BlueCross BlueShield of North Carolina. The feed offered links to video of the company's executives discussing reform and to reports that suggested reform would lead to higher insurance premiums. The last post was Dec. 30, 2009.

Microsites for sponsored projects: Rather than try to give voice to a corporate point of view, some health plans have taken the route of focusing social media resources on specific, targeted sites highlighting individual efforts.

Aetna, for example, sponsored a Twitter feed, Facebook page and YouTube channel for the Food Fight Healthy Food challenge, a project promoting better nutrition and good cooking. The recipe contest and cook-off ended in November 2010.

Humanizing the brand: WellPoint's Facebook page, like Aetna's, promotes healthy lifestyles. The Anthem page features a "Healthy Footprint" calculator that demonstrates how one person's behavior affects their friends and family and video health tips from celebrity trainer Bob Harper. But the page also features documentary-style videos profiling WellPoint employees and network physicians. The videos, profiling nurse case managers, a network pediatrician and customer service representatives, help members and prospective members assign faces to the company.

Digital marketing expert Falls said humanization is a key benefit to using social media.

"In the consumers' mindset, the health insurance company is generally the faceless, nameless, monolithic corporation screwing everything up," he said. "They see their doctor; they never see anyone from their health insurance company."

Listening to the social universe

Besides trying to put out their own messages and improving the brand's image, health plans are busy monitoring what's being said about them online, and in some cases responding to members who either directly ask for or just appear to need customer service.

"I think if you use [social media] to push your messages like you do with TV, you're kind of kidding yourself," said Kelly Colbert, marketing strategy director for WellPoint, the Indianapolis-based company that operates for-profit Blues plans in 14 states. "You have to listen. Those are the table stakes of this media. You have to listen and understand what people are saying about you."

Cigna communications and customer service staff monitor what is said about the firm on Twitter and respond to complaints. "Social media is a channel for us to listen through, not talk through," said Ingrid Lindberg, customer experience officer for the Philadelphia-based insurer.

When a Cigna member or a physician complains about Cigna on Twitter, someone at the company sees it and responds. Even if the person ignores the response from Cigna, at least there's a public record that the company tried to respond, and everyone who saw the complaint can see the response.

That helps counter the image of the big evil health plan, Lindberg said. "One of my favorite lines ever is, 'Ten years ago if you were ticked off at a company you would tell seven people you dislike a company. ... Now if you're [angry] at a company you tell Google.' "

Tweets, Facebook updates and YouTube videos carry weight with prospective customers, so it's important that Cigna respond, she said. "At the end of the day, people do trust what friends or family tell them," Lindberg said. "In the advent of social media, everybody out there is one of my friends and family. ... People like to find people like them they can take information from."

Still, health insurers are somewhat limited in what they can do online. Because of regulations of the Health Insurance Portability and Accountability Act, Cigna and other companies always move those conversations offline and on to the phone as soon as they go beyond, "Hey, @HealthPlan, why have I been on hold for so long?"

Few direct messages to doctors

Although companies are beginning to look into the best way to reach out to physicians, there's a notable absence of consistent back-and-forth between health plans and physicians on the big social networking sites.

Falls said more communication can only help the relationship between health plans and physicians. "I'm a communications professional, so I'm always going to say you should try to bridge those gaps," he said. "Give physicians an opportunity to have a voice within your company."

But reaching physicians is easier said than done, Lindberg said, because market research shows that those communications must be integrated easily into what physicians already are doing. So far, social media is not the preferred "channel," she said.

WellPoint's Colbert said the company is researching the best approach to reach physicians through social media, as well as through mobile devices.

"What we don't want to do is build something that physicians should use. We want something they will use, and need, and have identified as a need for their practice that creates kind of an indispensable asset."