Enrolling patients within a covered population

Many digital care companies utilize a B2B2C grow model. Their paying customer is a health plan, health provider or employer, but they also market directly to people to drive patient acquisition. I call this patient acquisition within a “covered population”. 

This strategy is so common (see Livongo, Omada, One Medical, Virta, Hinge, Sword, Propeller, Lyra, Landmark to name a few), but public information on how to acquire patients in this structure doesn’t exist. Over the last few years, I’ve talked with many of the people who actually send the emails, run the ads, and make the phone calls at these companies to acquire patients, and I’ll share what is working and why.

The problem of targeting

Especially as a digital care company is starting out, their covered populations are needles in the general population haystack. This means mass marketing is not an option. If I signed a deal with Blue Shield of California in order to cover my service in California, and I run a TV ad, given the 5-10% market share for BSCA I’ll have 18 or 19 unhappy prospects for every one I can enroll. This means targeted marketing is the only marketing for covered populations. Note: Once a company is huge (like Teladoc) and they have secured most healthplans’ coverage, then mass market advertising makes sense.

What targeted marketing options do you have? The list is finite: email, phone calls, texts, Facebook ads, mailers, in-person events, and care navigators. I’ll share details on the most important ones.


Best for marketing to employee populations.

For marketing to covered employee populations, email wins. It's free, and employers are often willing to share email lists with health vendors. 

The best performing emails come from the company’s HR team, so also get those if you can. When sending emails from your own domain, make sure to get your domain whitelisted within the corporate email system, since it could easily go to everyone’s spam folder.

Get permission to send as many emails as possible on a weekly cadence. Like any advertising medium, more exposure will lead to more incremental patient acquisition.

In the different companies I’ve talked with, email will usually get 5%-30% of the target population to enroll. The enrollment rate depends on how universal and appealing your service is.

Facebook Ads

Good add-on to email or alternative if you don’t get email permission.

There are two ways to make targeted Facebook ads work for covered populations. First, if you can get an employee roster from the employer, you can upload this to Facebook and create a Custom Audience. This gives you a high quality targeting list to run ad campaigns targeting employees. Many of the digital care companies I have talked with have gotten this permission and do this.

The second method is to use Facebook’s employer targeting function. This works for larger employers (+5k employees) and it does work well. It doesn't include all employees, but is useful if you can’t get an employee roster.

Facebook Employer Targeting

Companies I’ve talked with can acquire new patients for their digital service on Facebook between $50-200 customer acquisition cost, so it usually makes sense financially.

Cold Phone Calls

Good for endorsed and highly targeted outreach.

Most digital care companies I’ve talked with have not had success with cold phone outreach, but a few have. Cold phone outreach seems to work if your message can appear to be highly relevant and ‘not just an ad’. An example of this is a digital care provider that has partnered with a local healthcare system and they can start a phone call saying “Hello this is Sarah from Blah Health calling on behalf of Dr. [PCP of the recipient]”. Most people who receive a phone call from their doctor will either listen or call back. In order to get permission to share this endorsement, your service needs to be clearly relevant to this person that the PCP will agree to endorse. One company I talked with was enrolling 60% of people on their phone call list with this strategy. Crazy.

A few other channels

I have seen companies try: 

  • Mailers: They work a little but are expensive, so try email and Facebook first.
  • Webinars: Good tactic as the call-to-action on any other channel.
  • In person events: Most companies I’ve talked with started with these but decided they were too expensive as they scaled.
  • Cold texting: I haven’t heard of a successful example of a digital care company using cold texting.
  • Care navigators: Theoretically a good idea, but I’ve seen them usually to get in the way. 


In marketing to covered populations, you need to get permission for most marketing tactics, which can really hold back your ability to reach people who could really use your service. When asking for marketing access from an employer or health plan customer, this is what I would ask for (in order of priority).

  • List of covered population emails, permission to send a series of emails from your own domain, and domain whitelisting.
  • Email from HR publicizing your service.
  • Employee roster with some identifiers (Name, DOB OR email OR phone) and permission to upload to Facebook.
  • Mailing addresses and permission to send mailers

This is based on my own experiences acquiring patients within covered populations and conversations with others doing the same. I'd like to know what's working for you. Please share.

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