Can hospitals go it alone in an era of reform with average marketing?

There is an article in the March, 2013 issue of Hospitals and Health Networks, "Is going it ALONE still an option for your hospital? YES!". It covers briefly the mission critical decisions and viewpoints, but sadly, it left untouched any discussion of marketing's role in all of this. So not being able to leave well enough alone, I started thinking about what role and competencies of marketing that would be needed to be in play to remain an independent, stand-alone hospital in an era of reform.

First challenge, the current state of hospital marketing overall is not good enough and needs leadership, vision and new competencies. The second and even harder challenge is that hospital leadership is clueless about healthcare consumerism, how you market to the healthcare consumer and the marketing investment required, but they think they do. The third major challenge is admitting to the "I don't know healthcare consumer marketing" challenge in number two.

If you're lacking the following, then it's going to be even more of a challenge.

Marketing Leadership

Marketing is strategy first, tactics second. The voice of marketing should reflect the voice of your customers and not be a second thought. Your future programs and services will be determined by the needs of the market, not your gut feeling. You cannot become a healthcare consumer-driven or market-driven organization if the skills and experiences of marketing is not at the leadership table.

Managing the Patient Experience

If anyone is prepared to understand and manage the patient experience across the organization it's marketing. Hospitals in particular are making the mistake of putting clinical or operations in charge of patient experience. Patient experience means just that- understanding what that patient experiences is at all touch points. And then changing or managing that experience to its fullest potential for the benefit of the patient and the organization. Patient experience is an integrating process across the entire organization internally and externally. One organization to the patient, one patient to the organization. It is not simply another quality program or flavor of the day.

Understanding and Executing Demand Management

The hospital is no longer the center of the healthcare universe. In an era of reform the last place anyone will go for treatment is the hospital. Marketing needs to understand what the demand for healthcare services will be, where they will be needed and manage that demand making sure that the hospital or health system has the right resources, in the right place, at the right time to meet demand. Gone are the days where marketing departments will be driving demand to fill hospital beds. They will drive demand to the appropriate place and location of service and it may not be a hospital or hospital based ambulatory service.

Communicating With the Networked Patient

The networked patient is someone who has an intense curiosity about their health condition, expects to have an active role in making healthcare decisions and this is most important, they want control of their health information.

They actively use the internet, social media , blogs, web site, apps and seek out others. They read and study about their health condition. They ask questions and will seek out alternatives. They look at providers from a quality standpoint and make judgments based on outcomes information. They want an answer to their own needs. The patient is asking what is their ROI by using you?

Healthcare Consumer Value Marketing

With healthcare changing so rapidly, is it time to move healthcare marketing beyond " it's all about us" to "it's all about you" through focused brand architecture containing a clear and compelling brand promise that proves every day the value of your healthcare brand to the healthcare consumer? Unless you are a new provider in the market, you have been beating the healthcare consumer for years now all about your features and benefits. They get it.

In today's brave new world, it's about brand value to the healthcare consumer, perceived and real along several dimensions that most healthcare organizations haven't paid too much attention too, but the healthcare consumer is. Your brand will be viewed and will be challenged by multiple audiences along these dimensions: price; outcomes; experience; access; convenience; and choice.

Meeting the Healthcare Consumer Cost Choices

Member co-pays and deductibles are rising. Employers moving to defined contributions. Millions of individuals potentially coming online with health insurance in 2014. Healthcare consumers are facing the economic reality that they now have some "skin-in-the-game". In a article recently published in the Wall Street Journal, "Another Big Step in Reshaping Healthcare" in pilots for Health Insurance Exchanges, individuals will choose a narrowly defined and limited choice healthcare network if their premium savings is at least 10 percent less than the premium for the larger more expansive networks. When people are paying they exhibit more consumerist behaviors.

There are more, but this post is too long already.

As you determine your ability to remain a stand alone, it won't only be determined by clinical, financial and operational issues. It will also be affected by how you market and your responsiveness to the healthcare consumer. Succeed in reaching the newly developing healthcare consumer and you have got a real chance.

Michael J. Krivich, MHA, FACHE, PCM, is an internationally followed healthcare marketing blogger with over 5,000 monthly pages views read in over 52 countries worldwide on Healthcare Marketing Matters. He is founder of the michael J group, a Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association. Like us on facebook at the michael J group, and connect with me on LinkedIn, Twitter and Pheed.

How do you market to the cost sensitive healthcare consumer?

There is a subtle but important market shift developing healthcare. And it's really a result of the growing healthcare consumerism movement I wrote about last week. That is the "patient" who is evolving into the healthcare consumer is making healthcare choices based on cost.

Look, I get that we don't sell widgets. And as much as we decry and bemoan anybody that dares to bring up the subject of price, consumerism and patient dominated decision-making and choice in healthcare spawns from the devil himself, the fact remains that the "patient" is becoming a healthcare consumer and making choices based on cost. You can't ignore it, or hide your head in the sand anymore because it's not going away.

Here's some of the evidence:
(I receive no payment, nor have any contractual of relationships with the following aforementioned companies.)

Aetna's easy-to-use, out-of-pocket payment estimator. Simple really, know the cost of a test, visit or procedure; know what it will cost you out-of-pocket. But it doesn't stop there, it allows the healthcare consumer to compare the cost across multiple in-network providers. You can compare costs across 10 different hospitals and doctors. Choose the one that is the lowest cost and has the lowest out-of-pocket expense.

WellPoint through its AIM subsidiary has shown where it was possible to incentivize physicians and plan members to shop for radiology services and choose the lowest cost provider. It's reducing healthcare costs; while maintaining quality.

United HealthCare, though its Innovation Center, is empowering its clients and 70 million members across a broad array of data driven products and services, for the healthcare consumer to better understand their healthcare utilization, and make cost effective choices.

In the Wall Street Journal article on Friday, March 1, 2013, "Another Big Step in Reshaping Healthcare", research is showing the consumer buying insurance will accept a narrower network of hospital and physicians, if the cost differential is at least 10 percent lower than the cost of the broader and larger healthcare network with more choices. Models are showing that price and cost will be a big driver in consumers choices of plans.

Forget the quality argument.

Just because you charge more doesn't mean you have higher quality. Saying you have high quality with high cost when you are unable to differentiate yourself in the market because you won't use outcomes data, is a claim that falls on deaf ears. Quality is now a given. It's a prerequisite of the business.

So now cost rears its head in the healthcare consumer's decision-making process. And when all other things are equal in the mind of the consumers, cost is king. Quality is assumed. Caring is assumed. It's what you do.

Most healthcare organizations aka hospitals, have never really had to deal with the cost equation on a competitive basis. For insurance, medical device, pharma and other suppliers to healthcare, price and cost competition has been a requirement in their markets since the beginning of time. Now, doctors, hospitals, and others will need to change their marketing operations and begin to deal on cost. Your brand and quality take on new meaning when cost is influencing choice and is a critical component in the healthcare consumer decision-making process. High cost, undifferentiated quality won't sell.

What to do?

Value marketing and measurable quality outcomes marketing together not separately, can influence the cost-conscience healthcare consumers choices.

Value marketing really, is making the case to your healthcare consumer how you are solving a problem, offering a solution, giving results and even making them happy. Value marketing is a creative exchange between people and organizations in the marketplace. It is a dynamic transaction that constantly changes based on the needs of the individual vies a vie what the healthcare organization has to offer. You are answering the consumers value equation by answer their question, what is my ROI for using you. Answer that successfully and cost becomes a lesser issue.

In quality outcomes marketing, you become the transparent healthcare organization. You differentiate from other high-cost providers along this important dimension of choice. It doesn't hurt either if you can show how higher quality actually reduces the cost of healthcare. This of course assumes that your outcomes justify the cost of your services. And oh by the way, it's not just throwing out a third party logo on an advertisements and saying we have high quality.

Healthcare consumer cost will be coming to the forefront in 2014 and will greatly influence a healthcare consumers choices of where to purchase care. Your answer is value and outcomes marketing. But for you, value and outcomes marketing starts today not in 2014. By then the horse is already out of the barn and it's too late for getting them back in.

Michael Krivich is  an internationally followed healthcare marketing blogger with over 5,000 monthly pages views in over 52 countries worldwide on Healthcare Marketing Matters. He is founder of  the michael J group, a Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association.  Like me on  facebook at the michael J group, and connect with me on LinkedIn, Twitter and Pheed.

How can you successfully market your ACO?

Now that PPACA is the law of the land, private and public ACOs will be springing up like weeds in a field. It may really be the last best chance to bend the cost and quality curve of the American healthcare system which is unsustainable. After all, its now about the right care; at the right time; for the right cost; in the right care setting.

In the end though, the basic premise remains the same, to engage the patient, aka the healthcare consumer, in the care and treatment decision making process. The marketing challenge before you is to attract members to your ACO, engage and retain them with outcome and price transparency delivered with an exemplary customer/patient experience.

In entering the brave new world of ACOs, here are some things that you need to consider for marketing:

1.) Transparency and Quality dashboards. This is about improving care, using best practices, learning and improving as a system to the individual level, by engaging the patient. If you do not plan to report back on at least a quarterly basis to your audiences, you will not be successful. You must be prepared to provide individual level utilization and quality patient reports, to engage the person in a meaningful way, to create change health behaviors, foster appropriate utilization of services and reduce costs.

2.) Voice of the Customer (VoC) program. You gave to be in constant contact and monitoring member attitudes, beliefs and reactions to you. VoC. It's all part of the patient experience program and process. These are open networks, if you are not fully and completely customer focused, trouble will ensue and it won't be pretty,

3.) Ongoing customer experience management program and process. This isn't just about delivering a exceptional customer service at the point of care. You must identify all customer touch-points, from beginning contact to end point, and mange that experience across all of those touch-points.

4.) Highly integrated marketing plans. You will need to integrate your messaging like never before across the traditional, online, mobile and social media platforms. You can't afford not too. You also need a presence in all platforms. One that is sustainable over time through dedicated marketing resource allocation. One shot ads won't work ; develop sustainable integrated campaigns.

5.) Comprehensive member communications. Ongoing communications beyond health and wellness tips. Communications that are individualized, engage the patient and are meaningful. They must also be delivered the way that the member wants them, be it on an Ipad, member web portal, email, hard copy etc. One size does not fit all.

6.) White pares and case studies. This is about transparency and quality that is data driven. It's about accountability to your members, payers, employers and physicians. Medical device, pharma and specialty pharmacies have been engaged in white papers and case studies driven by data for years. And it works. But, it will make you uncomfortable if you have never engaged in this type of activity and communication vehicle .

7.) Marketing leadership. Marketing especially in most, not all hospitals and health systems, needs to move from the basement and take its seat at the senior management table, reporting directly to the CEO. . Marketing now needs to be seen in hospitals and health systems as a defined, accountable strategy , that is fully integrated into the business plan. That doesn't happen if marketing is not present and engaged in the discussions at the highest possible level.

8.)Return on Marketing Investment (ROMI). In an ACO, there is just no doing things because someone wants them. Every action must be measureable against a defined goal and objective. Every action must have a call to action. Every action must evaluated against a predetermined ROMI. If you are not held accountable and your activities are not measured, then how will you know you were effective and produced results. What gets measured get done.

9.) Marketing automation systems. Need I say more. Marketing needs these systems to understand markets, track activities and campaigns, as well as produce various marketing reports and dashboards. This really in concept is no different than financial reporting, clinical reporting, quality reporting systems etc. Capital budgets will have to be allocated to marketing in order to automate marketing functions and planning.

10.) Marketing staff evaluation. This is probably the hardest activity, but few have the level of staff with the expertise and capability, to operate in an ACO environment. You don't know, what you don't know. Clayton Christensen understands and says, " ACOs are a disruptive business model and they must compete for consumers. Providers that are not accountable and transparent will lose, and those that meet patient needs and improve care will win." Your marketing staffing, organizational structures and resources will be to be changed and adjusted in order to meet new market conditions.

Michael Krivich is an internationally followed healthcare marketing blogger with over 4,000 monthly pages views in over 52 countries worldwide. He is founder of the michael J group, a healthcare marketing consultancy dedicated to creating value through strategic marketing for hospitals and health system regardless of payment mechanism, either fee-for-service or value-based to increase market-share, revenue , brand and demonstrate actual return on marketing investment. Michael is a Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association.

How Will You Market Your ACO Solution?

Now that the final rules for ACOs have been released by CMS, it seems that there is more positive interest in the ACO model first proposed under PPACA. The basic premise remains the same, to engage the patient, aka the healthcare consumer, in the care and treatment decision making process. Medicare ACOs remain open networks, meaning that members can go outside the ACO for service.

The marketing challenge before you is to attract members to your ACO, engage and retain them.

You must be prepared to deliver an individualized experience that meets the needs of that patient. A mass customization, of your patient experience process, down to the individual level. One size does not fit all.

In entering the brave new world of ACOs, here are some things that you need to consider for marketing:

1.) Clear and easily stated Value Proposition. Not a mission statement, this is crucial for communications and focusing the message to members, employers, payers, government and community. Not flowery or full of jargon. It's your elevator speech that can be delivered in 30 seconds about your ACO, what you do and the value it brings. Twenty-five words max.

2.) Transparency and Quality dashboards. This is about improving care, using best practices, learning and improving as a system to the individual level, and by engaging the patient. If you do not plan to report back on at least a quarterly basis to your audiences, you will not be successful. You must be prepared to provide individual level utilization and quality patient reports, to engage the person in a meaningful way, to create change health behaviors, foster appropriate utilization of services and reduce costs.

3.) Voice of the Customer (VoC) program. You gave to be in constant contact and monitoring member attitudes, beliefs and reactions to you. VoC. It's all part of the patient experience program and process. These are open networks, if you are not fully and completely customer focused, trouble will ensue and it won't be pretty,

4) Ongoing customer experience management program and process. This isn't just about delivering a exceptional customer service at the point of care. You must identify all customer touch-points, from beginning contact to end point, and mange that experience across all of those touch-points. Here is what a customer experience program looks like:

5.) Highly integrated marketing plans. You will need to integrate your messaging like never before across the traditional, online, mobile and social media platforms. You can't afford not too. You also need a presence in all platforms. One that is sustainable over time through dedicated marketing resource allocation. One shot ads won't work; develop sustainable, integrated campaigns.

6) Comprehensive member communications. Ongoing communications beyond health and wellness tips. Communications that are individualized, engage the patient and are meaningful. They must also be delivered the way that the member wants them, be it on an Ipad, member web portal, email, hard copy etc. One size does not fit all.

7.) White pares and case studies. This is about transparency and quality that is data driven. It's about accountability to your members, payers, employers and physicians. Medical device, pharma and specialty pharmacies have been engaged in white papers and case studies driven by data for years. And it works. But, it will make you uncomfortable if you have never engaged in this type of activity and communication vehicle .

8) Marketing leadership. Marketing especially in most, not all hospitals and health systems, needs to move from the basement and take its seat at the senior management table, reporting directly to the CEO.  Marketing now needs to be seen in hospitals and health systems as a defined, accountable strategy , that is fully integrated into the business plan. That doesn't happen if marketing is not present and engaged in the discussions at the highest possible level.

9.)Return on Marketing Investment (ROMI). In an ACO, there is just no doing things because someone wants them. Every action must be measureable against a defined goal and objective. Every action must have a call to action. Every action must evaluated against a predetermined ROMI. If you are not held accountable and your activities are not measured, then how will you know you were effective and produced result?. What gets measured get done.

10.) Marketing automation systems. Need I say more. Marketing needs these systems to understand markets, track activities and campaigns, as well as produce various marketing reports and dashboards. This really in concept, is no different than financial reporting, clinical reporting, quality reporting systems etc. Capital budgets will have to be allocated to marketing in order to automate marketing functions and planning.

11.) Marketing staff evaluation. This is probably the hardest activity, but few have the level of staff with the expertise and capability, to operate in an ACO environment. You don't know, what you don't know. Clayton Christensen understands and says, " ACOs are a disruptive business model and they must compete for consumers. Providers that are not accountable and transparent will lose, and those that meet patient needs and improve care will win." Your marketing staffing, organizational structures and resources will be to be changed and adjusted in order to meet new market conditions.

Is there more? Yes. But you have to start somewhere. Marketing can't be just an after-thought. Too much is at stake.