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HMOs sponsor dances, other events to market themselves to seniors
Tuesday, May 04, 1999 By Christopher Snowbeck, Post-Gazette Staff Writer
Larry Johnson asked his wife to marry him by leaving a note in her desk.
They were sixth-graders.
"He used to walk up behind me and pull my hair -- my curls," said June Johnson, 79, of Sheraden. "I went to open up my desk one day and here was this note from the little devil."
They started dating when they were 17, got married at age 20 and now, in their 59th year together, they're still dancing -- literally.
As healthy, active seniors, the Johnsons were among the many attractive health plan candidates who attended a swing dance last week sponsored by HealthAmerica. Larry Johnson said he has no interest in switching from his standard Medicare insurance into HealthAmerica's Medicare HMO, but the couple still enjoyed dancing and sharing tales of their courtship with new friends.
The swing dance at the elegant Victoria Hall in Bloomfield is one of the more innovative attempts by a local HMO to market a health plan to seniors. Organizers say the event was meant simply to boost awareness of the Advantra health plan, but it has raised a few eyebrows among consumer advocates around the country.
The marketing techniques of HMOs around the country have been controversial, with consumer advocates charging that some health plans seek out the "well elderly" rather than to sicker patients who accumulate hefty medical bills. In that regard, the swing dance resembled -- but some say stopped short of -- the questionable marketing practices that federal regulators and senior advocates say they are increasingly concerned about.
"That's very subtle -- you're going to nicely weed out people," said Judith Stein, director of the Center for Medicare Advocacy, a Connecticut-based consumer group. "You're not going to get sick, homebound people to a dance."
Cindy Hatcher, the vice president in charge of Medicare programs for HealthAmerica, said the company was not trying to screen out sick people.
For starters, there were no marketing presentations at the dance -- although those in attendance could pick up an Advantra brochure as well as a flier explaining the time and location of education sessions to learn more about the HMO. The dance was simply an opportunity for health plan members and non-members to mix -- both to dance and talk about health insurance.
"There was no selling going on," Hatcher said. "It's an opportunity for people who are Medicare-eligible to mix with people who are Medicare-eligible who are members."
More than 460,000 people in the Pittsburgh area are eligible to participate in Medicare HMOs and, as of September, about 30 percent of them had chosen to do so. The plans have existed in the local market for five years.
In general, HMOs provide insurance at a lower cost to seniors, but place more restrictions on how members receive their health care. Medicare recipients in Pittsburgh can choose to leave the traditional Medicare program and receive their health care through one of 11 HMO plans, offered by four companies.
The dance is one of many efforts HealthAmerica makes to be involved in the community so that if seniors consider moving to an HMO in the future, they'll know to ask about HealthAmerica, Hatcher said.
Federal officials have been concerned about the quality and character of the marketing appeals health plans make to seniors. Most recently, a report in April from the General Accounting Office found that some health plans regularly give seniors inaccurate information on HMO benefits and costs.
But Hatcher said HealthAmerica officials were very careful in planning last week's event to make sure they followed the government's rules. For example, the Health Care Financing Administration -- the federal agency that manages Medicare and is called HCFA, for short -- prohibits health plans from distributing gifts to potential and enrolled members that have a value of more than $10.
During the dance, HealthAmerica distributed door prizes worth between $15 and $30 -- but those prizes were donated by local businesses and therefore didn't involve any insurance company money, Hatcher said.
HealthAmerica sent out invitations to 7,000 members and non-members and nearly 400 said they would attend the three-hour event. The dance was also publicized in local senior centers. About 200 people showed up, organizers said.
A live band, Marty Shor and the Swinging Seniors, played songs from the 1930s and 1940s as couples danced everything from a simple two-step to the Charleston. A dance instructor stopped the music at times to review old dances and teach new ones like the Macarena. Some HealthAmerica workers danced alongside the seniors. Others occasionally served as waiters, carrying trays of cookies and cheeses through the hall's plush sitting rooms and offering snacks to non-dancers.
Some consumer advocates said they didn't like the idea of a swing dance.
Vicki Gottlich, a lawyer with the National Senior Citizens Law Center, a Washington D.C. advocacy group, said she was glad HealthAmerica didn't resort to any "hard sell" tactics during the dance. But she wasn't completely comfortable with the event.
"As soon as you're holding a dance, that excludes a bunch of people," Gottlich said.
She said the event resembled the actions of some HMOs around the country, which have held enrollment meetings on the second-floor of buildings that lack elevators. Other senior advocates don't know of specific cases where discriminatory tactics were actually used, but they share the concern about HMOs not offering their services to the frail elderly as well as to young disabled people, who are also eligible for Medicare.
"One of the concerns has been that companies have targeted the well elderly -- and that's a way to cherry pick," said Alfred Chiplin, an attorney with the Center for Medicare Advocacy. "If you do most of your signups in areas where you're dealing with healthy, active seniors, you're getting a safer pool to insure."
Local competitors had a mixed reaction to the event.
Michael Weinstein, spokesman for Highmark Blue Cross Blue Shield, said Highmark has shied away from events like swing dances in its recruitment of members for Medicare HMOs.
"We'd be a little hesitant to do that," Weinstein said. "That has a subtle way of attracting only the healthiest people into the program."
Highmark has relied on its large share of the health insurance market to raise awareness of its Medicare health plans, with direct mailings to consumers and invitations to educational meetings.
But William Jesserer, director of marketing with Aetna US Healthcare in Pittsburgh, said he didn't think HealthAmerica was stepping too close to any ethical boundaries with its swing dance. US Healthcare hosts educational meetings for prospective enrollees. The company also gets its name out to seniors by sponsoring a concert series with the Pittsburgh Symphony Orchestra.
Those in attendance didn't seem to have any problems with the marketing effort, either -- in fact, some seniors came expecting to receive more marketing information than they got. Harriet Cohen, 73, of Oakland, for example, is already a member of Advantra and was more interested in getting an update on her health plan than dancing the cha-cha-cha.
Others, such as Horace Bonner, 63, of Penn Hills, told HealthAmerica officials before attending that they weren't interested in joining Advantra. The seniors were told to come to the dance anyway. Bonner, who was crowned the "King of Swing" at the end of the afternoon affair, said he likes dancing and enjoys watching new steps like the Electric Slide.
"It's nice of the company to do that," Bonner said of the dance. "It's good to see people out exercising and dancing."
And swing dancing might not be a big draw for people with illnesses -- but Ralph Didonna, 73, of Bloomfield came to the dance accompanied by his oxygen tank.
"I came for the music," he said.
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