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Since 2013, BlueCross has been combatting the opioid epidemic in the state, which ranks third in the nation for prescribing and fourth for overdose deaths related to prescription opioids. In 2016, the BlueCross BlueShield of Tennessee Health Foundation partnered with the little-known but extremely effective Count It! Lock It! Drop It! initiative based in Coffee County. That partnership began with a $1.3 million multiyear grant to expand CLD to 44 counties in the state identified as “hot spots” for opioid abuse.

Here, Mary Danielson, director of corporate communications, shares how BlueCross got involved and helped achieve success.

How did BlueCross become aware of this grassroots initiative out of Manchester, Tenn.?

Mary: BlueCross had already been working on the opioid epidemic in Tennessee. One way was on the clinical side of the equation. We made changes to our pharmacy policies so that for the safety of our members we could better manage the quantity of opioid prescriptions. This involved implementing best practices and continuing education with our physicians as they engaged with their patients and our members to ensure opioid prescriptions were the right course of treatment.

We also recognized the need for a social aspect to accompany the clinical effort. Clinical changes necessitate conversations between doctors and patients, so that social aspect would focus on the preventive side of the equation.

As the largest health insurer in the state and a trusted health care company, we could have effectively served as the sole source of opioids information in a public education campaign. But we wanted to partner with an organization at the grassroots level, with a cultivated network and that was seen as a trusted source  in its community. Through our research and work with our PR firm, MP&F Strategic Communications, we became aware of Count It! Lock It! Drop It!

What made the program stand out?  

Mary: From the get-go, their message resonated with us. It was so simple.

You count your pills, you lock them up, you drop them off when they’re no longer needed. That was an immediate call to action as opposed to just being aware of the issue.

It was something that an individual could actually do to protect themselves or their loved ones.

During our initial meeting with Kristina Clark and Christina Merino, who started the program through the Coffee County Anti-Drug Coalition, it was evident they had those community connections. They had already done a lot with their limited resources. We knew they had the knowledge and the passion necessary to help take CLD statewide.

I remember that passion really coming across through a story they told. When they started noticing the opioid problem in their community, there were more pain clinics than McDonald’s in Coffee County.

How did the CLD mission align with efforts made by BlueCross to combat opioid misuse and abuse?

Mary: They’d been on the ground in their communities, collaborating with school systems, the businesses, providers, pharmacists, etc. Everybody was working toward a goal of keeping their community safe from the opioid epidemic.

We were absolutely aligned in our goals in what we wanted to achieve, and that’s to keep Tennessee from being anywhere near the top of the list in terms of states that overprescribe opioids, and to help our fellow citizens not fall victim to the epidemic.

What did BlueCross bring to the table?

Mary: With a small team, there’s only so much you can do. With our expertise in marketing and communications, we were able to help them elevate their message and take it statewide, if you will, as opposed to regionally in the dozen or so counties that they were operating out of.

CLD is now in 81 counties across the state. The goal is to, by the end of October, when BlueCross Foundation funding expires, to be truly statewide and represented in all 95 counties.

Through our connections with anti-drug coalitions, we were made aware of numerous stories, unfortunately, of people who had been impacted by the epidemic. Things get tricky when trying to persuade someone to go public and share their story.

During that time, we were also looking for BlueCross employees who would be willing to give their testimony to what happened to their family members. I saw a very heartfelt, gut-wrenching Facebook post from an employee named Beth Anderson about how she had recently lost her 24-year-old daughter, Olivia. That post didn’t mention opioids specifically, but the way she shared that story led me to believe they were involved. We spoke on the phone, and she confirmed she lost Olivia to an overdose. She was gracious and brave enough to share that story with the rest of her BlueCross family.

We also shared Beth’s story in an op-ed for The Tennessean written by Dr. Andrea Willis, BlueCross chief medical officer, to announce our partnership with the campaign. What was very eye-opening – and maybe it shouldn’t have been, if you read the stats about opioid abuse at the national and statewide levels – was that once Beth shared her story, dozens of our employees shared their stories, too. Whether it was one of their children, a brother or sister, they all were able to empathize.

That was just further validation that what we were doing was meaningful and hopefully would have a positive impact.

We also tested potential taglines. Ultimately we came up with “Don’t be an accidental drug dealer.” That was quite provocative and intentional – there was a lot of internal debate about using it. But we wanted something a bit jarring to really gain people’s attention.

The tagline worked because of the term “accidental.”

An opioid addiction is the result of many factors. It can happen to anyone, and there should be no shame for an individual to admit that he or she has a problem and needs help.

Blame should not be placed on a single entity; you can’t blame it on the doctor; you can’t blame it on the pharmacist; you can’t blame it on the insurance company. We all play a role, whether it’s negative or positive.

What made our partnership a success?

Mary: You can get all the anecdotal information in the world about whether something is a “success,” but until you see numbers that support that feeling, you don’t know if you’ve moved the proverbial needle.

During three U.S. Drug Enforcement Administration National Prescription Drug Take-Back Day events and at permanent prescription drop boxes, we collected more than 105,000 pounds of pills. We saw nearly 62,000 website visits, including more than 19,000 to the drop box finder – that’s a conversion rate that exceeds similar call-to-action campaigns related to nonprofits and public education. Plus, 41 percent of BlueCross members surveyed in 2017 had an awareness of CLD, up from 32 percent in 2016.

Our recent Silver Anvil award recognition from the Public Relations Society of America shows the campaign was obviously well-received. What elements made CLD “Best of Silver Anvil”?

Mary: Our numbers were the key. Within the PR industry, metrics aren’t always the focal point for many campaigns. So we were very diligent in all of our pre-launch research, everything from investigating news coverage and  messaging to identifying organizations in the state that have been tackling the opioid epidemic. We then conducted a survey so that we could get a baseline understanding of:

• What is the level of awareness?
• Is there a concern on the part of individuals?
• Have they heard of Count It! Lock It! Drop It!?
• Do they think that it’s the duty or responsibility of an insurance company to tackle such an issue?

The Silver Anvil judges were impressed with the research and the post-campaign evaluation, which proved our impact. They also saw through the content and creative we produced that we could humanize the problem for our fellow Tennesseans.

We were tackling a social issue. We weren’t trying to elevate our brand reputation.  Obviously, people have a better perception of you as a company when you do good. So, do what’s right and the rest will follow. But it was an absolute honor to help lead the effort and a point of pride that so many of our fellow employees rallied around it, and that we were honored in that way.

What’s next for CLD and BlueCross?

Mary: Through our foundation, BlueCross has long supplied grant monies to worthy organizations, but this was the first opportunity where we really identified a social issue and an organization and then led a public awareness campaign. We are continuing to engage with and support CLD, but our foundation grants are set up so that at some point in time, the recipient can become self-sustaining. So following our efforts of the past two years, we’ve set up CLD for continued success, where they can further expand their program and footprint not only statewide, but nationally. They’re now in 10 states.

As for our efforts, BlueCross has made and will continue to consider clinical changes – from quantity limits and morphine equivalency doses to prior authorizations on long-acting and short-acting opioids. And anytime you make a change, for a member or doctor, there are going to be questions. Those questions lead to important conversations between our members and their health care providers. Our job is to help facilitate those conversations through our own communications efforts, whether that’s direct mail, social media, provider outreach, etc.

There are still so many who need to hear the evergreen message of Count It! Lock It! Drop It! and help contribute to this lasting impact we’re committed to making.