Healthcare.gov has, by all accounts, been an absolute train wreck of a website roll-out. Weeks after the site for the Affordable Care Act went online, users still couldn’t sign up for insurance or, in many cases, even get page site to load.
But one thing the site hasn’t lacked is traffic: It saw 4.7 million unique visitors in its first 24 hours online. And according to the web analytics firm SimilarWeb, which monitors network traffic, it has a government contractor called GovDelivery to thank -- at least in part.
GovDelivery, an IT company best-known for its emergency alerts and email newsletters, was the number-one source of referral traffic to Healthcare.gov in September and October. That means when a user came to Healthcare.gov from a link on another site, that site was frequently Govdelivery.com -- more often, even, than the websites of Medicaid, the White House, and the Department of Health and Human Services.
That’s not entirely surprising, since GovDelivery is a marketing and communications firm that works, per CEO Scott Burns, with every federal agency and hundreds of local and state governments. But it’s an interesting commentary on how the government gets the word out, particularly about big public health issues with life-or-death consequences.
Health insurance is, after all, painfully complicated, and educating people about the new marketplaces has been an expensive and politically-fraught proposition from the start. Various federal agencies inked contracts worth more than $60 million with two big-name public relations firms, Porter-Novelli and Weber-Shandwick. (That’s not unusual -- the government also pays PR firms to get the word out about things like the food pyramid and "No Child Left Behind.") These campaigns, however, came with a strident digital focus: “The campaign will use a range of communications tactics, with an emphasis on paid media and digital outreach,” is how the award from the Centers for Medicare & Medicaid Services put it.
GovDelivery definitely falls in that “digital outreach” sphere -- the 14-year-old start-up, based in St. Paul, Minn., is the contractor that powers just about any email alert you get from a federal (and in many areas, local) government agency. Think weather alerts, emergency notices, small business newsletters -- those are all run through GovDelivery, which reported revenues of more than $15 million in 2012.
The agency also dabbles in social media marketing, but its main focus is definitely emails. So all that traffic to Healthcare.gov from GovDelivery? It came through old-fashioned email blasts. Not Facebook, which accounted for roughly 2.6 percent of traffic. Definitely not Twitter, which drove only 1 percent of Healthcare.gov’s visitors to the site.
There’s a big problem here, however, and it’s one hundreds of distinctly non-governmental organizations (think Gap and Newegg) have complained about already. Some email services are increasingly moving toward a system that de-prioritizes mass emails and hides them from readers. Gmail recently introduced a “tabbed inbox” system that pushes marketing emails into a separate folder, outside the main inbox where users get their most important mail. Mass emails already had a lousy open rate -- well under 50 percent, according to email marketing firm MailChimp -- and this kind of change only makes it worse.
That clearly isn’t impacting GovDelivery, at least not yet: In addition to being the number-one referrer to Healthcare.gov, the service has also managed to sign up more than 1 million subscribers for the Department of Health and Human Services’ ACA email list, a company spokeswoman said. (The department's goal is 7 million.)
Still, the issue promises some big implications for health literacy. And it's a salient reminder that people don't always get information the way we expect them to -- after all, 20 percent of American adults aren't even online.