Is it time for hospital advertising to change?

With the healthcare consumer having a higher cost stake in healthcare choices with larger deductibles and co-pays, combined with the availability of price and outcomes data; it would seem that the time for change has come.

If one was to look at healthcare consumer in terms of interaction with the brand, only one-third of the time is spent as a patient during diagnosis and treatment. Two-thirds of the time they are healthcare consumers making choices and decision about where to receive care.

What should hospitals be advertising to create an unassailable market position, a strong brand, as well as an enlightened and informed consumer?  

Is it the "we are unique and world-class", have best doctors and locations that are accessible and convenient?

Then there is the ever popular, the technology is state-of-the-art, photo of the shiny new building or the doctor looking skyward like they are in great deep thought.

Another winner; we have the most shiny trophies and quality awards for several services. Oh, and even though we don't have a quality award for all services, if everybody else was as good as us message to go with it, “100,000 lives would be saved annually".

I think, that pretty much for the most part, sums up the current state of hospital advertising.  And when several hospitals are staying all of these things at the same time in a market, does anyone really believe that the consumer is paying any attention at all, when there is so little differentiation?  It all looks like "me too" and just shouting for attention.

It makes the Board, senior management and physicians feel good, all the while your audience receives absolutely no information that will help them make some of the most critical choices and decisions in their life.

The time has come healthcare providers to provide meaningful information in the marketplace that will allow the healthcare consumer to become informed, educated and participatory in the care decision-making process. 

The hospital or health system should be transparent and talking about outcomes and prices.  The healthcare consumer is hungry for information and searching the internet as well as other sources about you and how you perform. They are paying more of the cost and demanding more say in the process. And they don't like being treated like they are some small child who can't make a decision.

To use an often quoted metaphor, the wave of change is upon the hospital industry as we move from provider-dominated and controlled decision-making model, to a healthcare consumer and patient-directed controlled model, that is evolving into a semi-retail environment. 

Changing markets unless responded too can be a harsh mistress. 

Have you made your healthcare marketing resolutions for 2014?

New Year's Resolutions, for the most part, play an important role in most everyone's life.  To lose weight. Live life more fully. Be a better husband, wife, or significant other etc.  Value more what we have in our family and friends.  And many more that I have missed. But have you ever considered New Year' Resolutions as a part of your business and managerial life? 

So my last Healthcare Marketing Matters blog for 2013 is about New Year Marketing Resolutions.  My own Top 10 list to get things started.  What are yours?

10.  Focus on meeting the needs of the healthcare consumer aka the newly insured.

9.  Learn from the healthcare retail giants like Walgreens, CVS Caremark and others. Healthcare continues to evolve into a semi-retail market and what has worked in the past won’t work anymore.

8.  Marry price to outcomes and be transparent to the healthcare consumer. Prove value.

7.  Integrate traditional, online and social marketing strategies. All are complementary to one another and drive multiple successes.

6.  Innovate- again and again and again;

5.  Foster a spirit of and demand marketing excellence in the marketing department.  Good enough is not good enough.

4.  Focus on the data and show ROI. If it doesn’t work then stop doing it.

3. Stop using the words "unique", "state-of-the-art", and anything that is considered “buzz word" terminology in my marketing communications.  Unique can be duplicated easily. State-of-the-art refers to yesterday's systems as things change so fast. Buzz words quickly fall out of favor.

2.  Bridge the divide between sales and marketing.

1.  Serve and be humble, for working in healthcare is a privilege, not a right.

It’s been a most interesting year, HMM went over 5,000 page views a month and is now read in 52 countries around the world.  There was a lot of spirited discussion in LinkedIn groups about several of the posts. I fielded calls on various topics from Bloomberg Weekly, Reuters, Associated Press, Crain’s and Strategic Health Care Marketing (published December 2013).  It was all appreciated and fun.  But most of all thank you for reading, for that is what really makes doing this worthwhile. I am taking a couple of weeks off. See you in 2104.

Merry Christmas, Happy Holidays and Happy New Year! Have a healthy, safe and prosperous year.

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

The great healthcare experiment; will consumers buy on value or price?

It’s the great healthcare experiment really when you stop and think about it.  Today, thousands of individuals are going to public and in some cases private exchanges to purchase health insurance for themselves and families. Different levels of plans, varied coverage’s, deductibles and copays with open or limited networks, drug benefits etc.

So the healthcare consumer is now making the grand choice. Will they choose value by what they perceive based on experience, relationship and no real outcomes data to make a rational decision to keep the doctors and hospitals in their network? Or, will the healthcare consumer now shopper for care, decide to choose by price and consider value as a given among all providers.

There probably at this point no definitive answer to the question. The signs are all around that healthcare is evolving to a semi-retail market.  And the decision now facing healthcare consumers of choosing healthcare via insurance by value or price will only accelerate change.

When an individual is facing a decision with multiple price options, they will exhibit consumeristic behaviors and shop on price when all else is perceived as equal.  And healthcare for all intent purposes, is the ultimate (and pardon my use of a sports analogy, just can’t help myself) example of league parity in the minds of consumers.   Seen one doctor, seen one hospital, and seen them all.  For years healthcare providers have offered up platitudes of world class care, best doctors, high tech, Centers of Excellence and so on, that value is totally undifferentiated. In the absence of information, markets like nature abhor a vacuum. Price fills the void.

Now that the barn door is open and no getting the horse back in, what can a healthcare provider do? No simple answer this time around. Healthcare consumerism is a new phenomenon in healthcare. To adjust to that seismic shift, the healthcare provider regardless of type will now need to get serious about brand, outcomes, value, experience and price.  Total transparency really.

Oh and one other thing, the conversation with the healthcare consumer and newly insured is going to have to change from just stating that we are the best, to here’s why we are the best and what you are the best at.  Can’t be great at everything and the healthcare consumer already knows.

This is going to be a struggle for most healthcare providers.  It will be as much about changing internally as externally.  Going from being in control of the process, to being subjected to the needs and wants of consumers on a value, quality and price basis is not an easy transition.  Some will make and others will fail.  That’s life. That’s the nature of markets.

Take a look at the marketing strategy and organizational readiness as well as the consultants that you hire. Are they telling you here is your best customer go forth and fill the beds, or are they preparing you to be a responsive healthcare consumer-centric organization in how you approach the market and win the confidence and dollars of the new healthcare consumer?

It’s the great experiment; healthcare choice purchased on value or price. Something tells me that price will win the day. The horses are out of the barn.

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. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

How will you explain pricing to healthcare consumers?

The eight hundred pound gorilla is in the room and it’s not going away any time soon if ever. With the newly insured, current and former patients and the healthcare consumer all facing increasingly larger out-of-pocket expenses for healthcare, how will you explain pricing?

Case in point. A couple of weeks ago I was exhibiting the signs of a heart attack. So after being sent to the ER by my primary physician, an EKG and blood work was done and after several hours I was admitted to the 23 hour observation unit. The other day I received the bill for $23,000 which works out to around $1,000 an hour.  And yes it was sent to my insurance carrier and I have my portion to pay. But there was no explanation of how those charges were determined.  Here is the bill; you owe; so pay it.

But it got me to thinking. I had no idea how the $23K was arrived at and whether or not that was representative of the most accurate value for the care received, especially when the total bill would buy a nice car for that type of money. I mean, a less than friendly radiologist, an arrogant hospitalist who was an internal medicine physician, and a cardiologist who seemed like he did not want to be there added to the wonder if it all. I especially liked being awakened at 12:30 PM for a saline IV that had to be started because a doctor ordered it.  My biggest chuckle was that I could not get a Tylenol for a headache, but there was a physicians order for morphine. Go figure. It’s probably a standard order set and no one is paying attention.

 

I wonder how many meals I was charged for since I only ate once because no one explained to me that I had to order each meal off a menu and never did have breakfast because of that little omission?

As healthcare evolves to a semi-retail model with the healthcare consumer aka the patient at the center of it all, explanation of pricing, what care and test were provided is no longer something that hospitals, health systems and other providers can afford to ignore.  Can you really imagine going to buy a large ticket item and not knowing all charges? And healthcare is a large ticket item.

This is a reasonable expectation for the healthcare consumer, to be able to know all that was done and how much it cost in detail.  The healthcare consumer is paying more out of my pocket. You can bet they want to look at billing by line item. And they really don’t have the time to chase down with your billing department the detail.

It’s called accountability and it’s a two way street.  Accountability on my part to understand the who, what and where of treatment, and accountability on your part to be price transparent. This will lead to some uncomfortable discussions with the healthcare consumer as they seek to understand it all, but that is why you have a marketing department. They need to be involved by understanding the informational needs of the healthcare consumer, design of the bills and training of staff to handle inquiries.

Healthcare is changing and the old ways of doing business no longer work.  Because if you don’t change billing practices and become more price and treatment transparent, someone legislatively, or through the courts will force you too.

Its your choice on price transparency. Inform the healthcare consumer now, or inform them later when you are forced too. Either way it’s going to happen.

Now where is the address for the FTC and my Senator and Representatives?

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. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer,American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

Why isn’t hospital advertising changing with the times?

I have to admit, this is a pet peeve of mine, disingenuous hospital advertising. In a day and age where healthcare is evolving to a consumer centric, semi-retail model, some hospital marketers and C-suite leadership continue to treat the healthcare consumer like they are incapable of making informed choices.

With the healthcare consumer having a higher cost stake in the process with larger deductibles and co-pays, your price, and outcomes data readily available, it would seem that the time for change has come.

Remember, when you are marketing to individuals, they don't become a patient until they receive a service from you.  So in one-third of the time in their interactions with you, the healthcare consumer is only a "patient" during diagnosis and treatment. Two-thirds of the time they are not patients, and most likely are arguing with your billing department about the charges.

Arguments aside, what should hospitals be advertising to create an unassailable market position, a strong brand, as well as an enlightened and informed consumer?  

Is it the "we are unique and world-class", best doctors, hundreds of locations, even though The Joint Commission was just there for a sentential event?

Our technology is state-of-the-art.  Never mind that a new technology was just introduced and you don't have it.

Another winner; we have the most shiny trophies and quality awards for several services. Oh, and even though we don't have a quality award for all services, if everybody else was as good as us message to go with it, “a 100,000 lives would be saved annually"! Really.

How about the ever present focus on the physicians with messaging about having the best primary care or specialists in the region that drones on about everything other than healthcare.  Prove it.  Maybe the healthcare consumer will take you seriously when you finally report Dr. Hodad and remove him from your medical staff.

I think, that pretty much for the most part, sums up the current state of hospital advertising.  And when several hospitals are staying all of these things at the same time in a market, do you really believe that the consumer is paying any attention at all, when there is so little differentiation,  it all looks like "me too" and just shouting for attention?

It makes the Board, senior management and physicians feel good, while your audience receives absolutely no information that will help them make some of the most critical choices and decisions in their life.

The time has come healthcare providers to provide meaningful information in the marketplace that will allow the healthcare consumer to become informed, educated and participatory in the care decision-making process. 

You should be transparent and talking about your outcomes and prices.  The healthcare consumer is hungry for information and searching the internet as well as other sources about you and how you perform. They are paying more of the cost. Demanding more say in what goes on. And don't like being treated like they are some small child who can't make a decision.

To use an often quoted metaphor, the wave of change is upon the hospital industry as we move from provider-dominated and controlled decision-making model, to a healthcare consumer and patient-directed, controlled model. 

Your choice so chose wisely, the future of your organizations depends on it.

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. These views are my own. He is founder of the michael J group, a Fellow, American College of Healthcare Executivesand a Professional Certified Marketer, American Marketing Association.  Like us on facebook at the michael J group, and connect with me on LinkedIn and Twitter.

How are you improving market share and revenue in healthcare?

As healthcare evolves into a consumer-centric, semi-retail market with you existing in a multitude of reimbursement schemes each nuanced for a different market segment, have you  identified from a marketing perspective immediate actions to  improve your market position and revenue generation?  This isn't about massive advertising campaigns, gimmicks, wellness programs, etc. It’s more about getting the basics right, understanding who pays for what and how, the needs of your healthcare consumers, as well as driving demand, managing demand and moving demand to the right locations. In some circumstances it may even mean de-marketing certain services.

This is a difficult question to answer given the focus and preoccupation with hospitals and health systems, with EMR, readmissions, cost reduction, quality improvement, etc., but at the very least, it does not mean that marketing leadership cannot make a difference in their organizations, lead change and make a meaningful, measureable difference.

So very quickly, here are seven ways to improve your market position and generate revenue.

1.  Brand and competitive position.

Consumers and patients are ready for convenient technology-enabled access to care. Healthcare providers that are capable of identifying their needs and how they want their healthcare needs meet though technology focused on them, will gain new patients and the next-generation of physicians.  It's not a crime to use text messaging to send people information or confirmations about appointments, health reminders, or use QR codes to link to specific education or health offers.

 2. Engage existing customers and patients.

An individual is only a patient 1/3rd of the time they come in contact with you.  That is during the diagnosis, treatment and recovery phase.  Pre and post this, they are a consumer not a patient.  So why then is it the only time you meaningfully engage them is during the period when they are a patient?  Doesn't make a lot of sense really. Consumer and patient engagement is about all of the time, not just some of the time.  Engaging the individual on a continuous basis builds loyalty and return use or repurchase behavior.

3. Engage the physicians.

No matter the payment model you will still need a physicians or physician extenders order to get anything done in a healthcare setting. That means engaging physicians in meaningful ways, using the methods, technology and systems that will make their life easier, improve their productivity and protect or increase their income. An effective and efficient physician has more to do with the impact of cost and quality in your organization then you control.

4. Focus on the physician experience.

How hard is it for a physician or physician extender to practice medicine in your organization?  Have you looked at the hassle factor that physicians encounter when they try to get things done in your care setting?  Understand how the physician experiences your organization at every touch-point they encounter you. Understand their experiences overall from beginning to end, not just in an isolated segment. Fix what is broken, keep what is working. The more satisfying the experience, the better you will do financially.

5. Focus on the consumer/patient experience.

A healthcare provider's ability to deliver an experience that sets it apart in the eyes of its patients and potential patients from its competitors - traditional and non-traditional - serves to increase their spending and loyalty to the brand. You need to actively manage the customer experience in total by understanding the customer's point of view.  That is, all touch points internally and externally that a customer/patient comes in contact with which in turn creates the experience. Exceptional experience means gains in market share, brand awareness, and revenue.

6. Embrace retail healthcare.

Traditional ways of delivering healthcare will go by the wayside in many cases.  Price convenience, access and outcomes are the drivers in retail healthcare.  Find the need, understand the consumer’s behavior drivers, design offering around the consumer not you in a convenient location and price it appropriately. If you can't compete in this way, your market position, share and revenue will erode.

 7. Turn to social media and networks to engage, manage the experience and drive adherence.

 

As healthcare continues the evolution to a healthcare consumer dominated semi-retail environment, social networking is a healthcare marketing channel that is underutilized and underperforms today, but holds great potential to improve engagement, experience and adherence. And that takes healthcare marketing leadership, executive vision and meaningful action.

 
Seven step to market and revenue growth in an evolving healthcare market place. Not an impossible task, but one that does require focus. In the ends it's all about:

 

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. These views are my own. 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

Is your automated voice answering attendant harming the patient experience?

How often do you call in from an outside landline or cell phone, to your organization to experience what a patient, a family member or a healthcare consumer does when calling?  This isn't such a strange question.  We all go through the evaluation process, seek the system we believe will reduce our cost, improve response and service and enhance the experience.

But you know, sometimes we make the system so complicated, that we forget why someone calls us.

For this I have coined Mike's Law:  "The smaller the organization, easier to use is the automated answering solution. The larger the organization, the more complex and harder the automated answering solution is to navigate." Use is very different than navigate. One implies simplicity, the other complexity.

Let me give you an example. In calling a local hospital when a family member was hospitalized, it was really very straight forward. Dial in, hear the message, dial the extension or room number if you know it, or wait for an attendant to come on the line and assist.

I have found that most of the time you can short circuit the whole thing and just dial 0.Get to the live person and to where you need to be.

Then there is the most complicated system, integrating your existing customer data into the call, because you are a current customer. Then it plays what seems the game of 20 questions, tries to push you entirely to an automated solution to solve your problem that could be resolved in less than 60 seconds if you could get to a live person.  

Oh yea,  and when you keep trying to get to a live person,  that systems automated response keeps attempting to push you to an automated solution.  Even when, I indicated every way that I could, three times (yes three separate calls),  that I wanted to talk to a service representative before hanging up.  The best part of the encounters was the "voice" telling me, "I can't help you, goodbye".

It was like being in a Monty Python episode.

From a marketing standpoint, your automated answering attendant is an integral touch-point in the healthcare consumer/patient experience chain.  It may even be the first experience that someone has with your organization. But, how many times has marketing been included in selecting the automated answering attendant, beyond, writing the copy for the greeting, options menu and submenus?

Marketing should be involved in nearly every decision you make that effects your healthcare consumers and patients from an experience standpoint. 

It's seemingly the rare organization that considers the experience and needs of its audience in selecting the system. It’s more based on what the needs of the organization and solutions to cost and headcount issues, than what will make the healthcare consumer experience exceptional.

The moral of the story. Consider the healthcare consumer/patient experience and the impact both positive and negative, that your automated answering system will have on a caller. You have a clear choice. You can make a customer evangelist with a great experience, or create a customer  with a negative experience and  view of your company, no matter what good you have done, simply because, you couldn't answer the phone.

After all, that old land-line technology which even cell phone users will access is get to you usually is the start of a positive or negative consumer/patient experience. 

Which one do you want?

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. These views are my own. 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 can you create a high performance healthcare marketing operation in 2013?

With healthcare changing so rapidly, 2013 promises to be even more challenging as the implementation of ACA moves forward. The healthcare industry whether they like it or not is becoming more consumer oriented. Those individuals enrolled in Consumer Directed Health Plans are shopping for healthcare services based on price and are price sensitive for example. Many more changes are coming that will put the healthcare consumer in charge and they will be demanding answers.

Here are 10 more steps that healthcare marketing departments need to take right now to be relevant and lead their organizations to a more healthcare consumer focused environment.

10. Educate your organization about the value of your department and work. Lead and prove your departments ROI. Marketing just doesn't make things "look pretty".

9. Scan the B2C companies for their marketing successes. Learn about them, adapt them to healthcare, and implement successfully. Healthcare will take giant steps in 2013 to become consumer driven, so you had better learn how to market effectively to the healthcare consumer. And that means meeting their needs not yours.

8. Invest in market research. It's the only way you can obtain an unbiased view of your healthcare consumers and their needs. I think I know, the physicians know or senior management knows without the quantitative data won't work anymore.

7. Integrate traditional, online and social marketing strategies. All are complementary to one another and drive multiple successes. Figure out how the healthcare consumer wants information and give it them their way

6. Focus the company on the Voice of the Customer and the entire Patient Experience and work tirelessly to improve both. From your VoC efforts will come innovation.

5. Use data to drive change. There is so much healthcare data available, now is the time to learn how to manipulate the data sets and use outcomes to your advantage. No more guessing.

4. Define the brand, brand promise and show what the value of that brand is to your internal and external stakeholders.

3. Stop using the words "unique", "state-of-the-art", and anything that is considered "buzz word" terminology in marketing communications. Unique can be duplicated easily. State-of-the-art refers to yesterday's systems as things change so fast. Buzz words quickly fall out of favor.

2. Bridge the divide between sales and marketing. Without effective working relationships neither will be successful.

1. Be agile in your plans, execute crisply, measures and evaluate often and change immediately. Fail fast.

Get ready for the healthcare world to be turned in its head in 2014.

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 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. Like us on facebook at the michael J group.

Can you leverage the hospital readmissions issue in your market?

Okay, before I start getting bombarded with the "how can you even think that you can use the readmission penalties being leveled against hospitals in marketing" statements, hear me out. Readmissions is a complicated issue that involves a lot more than the hospital stay. In some cases, it is the hospital and I have experienced it personally.

So, what does it mean to leverage the readmissions issue with your hospital good or bad in your market area? Two trains of thought here.

The first one is if you're getting the charged with a penalty and identified in the CMS list, then I suggest to you, instead of diving for under the desk and ignoring the issue hoping that the public won't pay attention, is a dreadfully wrong strategy. Ignoring it because people can't understand it, and its way to complicated to explain anyway.

You need to design a PR and marketing campaign that explains the readmissions issue in terms the healthcare consumer can understand.

People are paying attention and will assume that if you aren't talking about it then you're hiding something. So, leverage it and turn the tables. Show how you are becoming the market leader by attacking the complexities of the issue. Turn it from a hospital-focused issue to a healthcare delivery issue. Don't blame, lead.

Remember, if you have been touting those quality awards, and when this happens, the healthcare consumer will have some cognizance dissonance going on in their head. The two aren't mutually exclusive in the minds of consumers and are linked. Which really only reinforces their belief that those awards are meaningless, if you are being penalized because patients are being readmitted to your hospital in less than 30 days for what they were treated for in the first place. If you let that happen, shame on you.

The second thought is leveraging the issue by moving into the realm of outcomes transparency in your marketing and PR efforts.

I am not advocating in the least to link outcomes to readmissions. What I am saying that is if you have a very low readmissions rates, there are a lot of reasons for that and you need to be clear about why what you are doing is so different than everyone else. The healthcare consumer what's to know. Start talking about your outcomes, linkages in the community and support provided. It's called leading with a better way and informing the healthcare consumer.

It takes finesse to handle, but you have one very large opportunity to redefine the market and perceptions based on transparency.

Hospital senior leadership and Boards, can no longer take the road of silence. Healthcare has already changed too much and the healthcare consumer is demanding more. Old ways don't work, so you might as well get with the program and start leveraging opportunities as they present.

Readmissions PR and marketing is one of those opportunities and it's not going to be the last.

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.

Who do you market, primary care physicians or specialists?

Another way to ask that question is who matters more going forward; the high-cost specialist or the primary care physician who is the gatekeeper for admissions, referrals and treatment? The answer is really self explanatory.

So why then do hospitals and health systems continue to market their specialists?

I think there are a number of reason for that, but mainly healthcare marketing and in some cases senior leadership is slow to change their marketing paradigm. It's easier internally to promote specialists. Its feeds internal hospital beast that marketing is doing something. It makes the Board and senior management happy not to mention the specialists.

Let's face it, I never heard hospital senior management jump up and down with glee when I talked about physician referral advertising and promoting primary care. And that was in the 1990s. Still pretty much true today in 2012.

But primary care is where it is at and healthcare marketing departments with their senor leadership teams need to get on the train. This goes well beyond just employing primary care physicians. It mean making substantial changes in your healthcare marketing and not focusing on the gee-whiz technology or specialty physician.

With millions of people potentially gaining health insurance, their first stop is going to be the primary care physician not the specialist. It may even be a physician extender in a retail clinic setting. But, it won't be the hospital or the specialist.

Okay, maybe the hospital ED where you can get the chance to involve a primary care physician in the follow-up care. But in the near future that's the last place you want to see someone for routine care. And people will continue to go there if they don't have a primary care physician.

So when you think about 2013 marketing, I highly recommend that all you healthcare marketers out there start focusing on marketing your primary care physicians. Including those primary care physicians that are employed as well as those that are independent practitioners admitting to your inpatient beds and referring to your outpatient services.

Building a differentiate-able market position, defendable experience/service strategy to get ahead of your competition, as well as the ability to participate in risk sharing and value based purchasing agreements is going to depend heavily on your ability to market your primary care physicians.

If you wait until 2014 to change your healthcare marketing strategy from specialist to primary care, it will already be too late.

That sound you hear is the train leaving the station.

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.

Why can't you get the customer/ patient experience right?

Patients and healthcare consumers alike are seeking information on great outcomes and experience. That's right. Great outcomes and experiences. Not ordinary outcomes or experiences. Telling the healthcare consumer that you provide compassionate care and high-quality medical care, is falling on deaf ears. Especially, when the experience doesn't even come close to the claim.

And as we get deeper into the Affordable Care Act with risk and value -based payment models, experience will play a deciding role in success or failure. Healthcare consumers will bypass those hospitals and healthcare providers that have less than great outcomes or experiences. Same for insurance plans, doctors and others. When the individual has some skin in the game, i.e., high out-of pocket expenses and deductibles, their experience matters.

I am not saying that is fair, or right. It is a reality of a changing marketplace.

When healthcare executives are surveyed, the majority say that customer/patient experience management is a critical business success factor along with patient safety and cost reduction. But at the same time, the majority of healthcare CEOs, admit that they really don't know where to start on successfully managing the experience.

And it is just not hospitals. Insurance companies, specialty pharmacies, PBMs, home health and others, that are experiencing the same challenges in managing patient, consumer or member experience.

I know leadership is considering the ever increasing role of satisfaction scores in the CMS value purchasing programs and they effect of HCAHPS on revenue. It has a direct financial outcome. Do well and receive additional revenue, fail and it will cost you. Insurance companies will follow the government and move to more value purchasing arrangements as well.

A financial whammy approaches that requires new ways of doing business for the healthcare provider. News ways of marketing and communicating to patients and healthcare consumers. Change and you can prosper. Refuse and find financial difficulties caused by market share losses.

Experience management is about changing the way you interact with the individual or family from start to finish. Not just at isolated points along the care continuum, Managing the experience requires a complete understanding of what the patients expectations are, not yours. Experience Management is culturally and organizationally uncomfortable. And that is because it's not about you anymore.

If you are not in direct conversation with your patients or healthcare consumers you will never get it right.

The speed of change in healthcare has accelerated beyond the point of no return. Healthcare providers no longer have the time to engage in endless internal dialogue, and paralysis by analysis planning loops, before moving forward. Individuals expect you to care. Individuals expect you to have high-quality outcomes.

The only way you can differentiate is through creating and maintaining that exceptional experience. And that only comes through active management of the experience process.

If you want to succeed you have to learn to manage the whole experience process, not just one piece of it. Until you do that, you can't get it right.

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 can you quickly improve healthcare market position and generate revenue?

Have you ever taken a step back and from a strategic standpoint looking at what you can do to nearly immediately improves your market position and revenue generation? This isn't about massive advertising campaigns, gimmicks, wellness programs, etc. Its more about getting the basics right. The blocking and tackling that you need to do now, to prepare for risk and value-based payment models. If you can't get it right in fee-for-service model, then how do you expect to get it right in a risk model?

So very quickly here are six ways to improve your market position and generate revenue.

1. Brand and competitive position.

Consumers and patients are ready for convenient technology-enabled access to care. Healthcare providers that are capable of identifying their needs and how they want their healthcare needs meet though technology focused on them, will gain new patients and the next-generation of physicians. It's not a crime to use text messaging to send people information or confirmations about appointments, health reminders, or use QR codes to link to specific education or health offers.

2. Engage existing customers and patients.

An individual is only a patient 1/3rd of the time they come in contact with you. That is during the diagnosis, treatment and recovery phase. Pre and post this, they are a consumer not a patient. So why then is it the only time you meaningfully engage them is during the period when they are a patient? Doesn't make a lot of sense really. Consumer and patient engagement is about all of the time, not just some of the time. Engaging the individual on a continuous basis builds loyalty and return use or repurchase behavior.

3. Engage the physicians.

No matter the payment model you will still need a physicians or physician extenders order to get anything done in a healthcare setting. That means engaging physicians in meaningful ways, using the methods, technology and systems that will make their life easier, improve their productivity and protect or increase their income. An effective and efficient physician has more to do with the impact of cost and quality in your organization then you may have considered in the past.

4. Focus on the physician experience.

How hard is it for a physician or physician extender to practice medicine in your organization. Have you looked at the hassle factor that physicians encounter when they try to get things done in your care setting? Understand how the physician experiences your organization at every touch-point they encounter you. Understand their experiences overall from beginning to end, not just in an isolated segment. Fix what is broken, keep what is working. The more satisfying the experience, the better you will do financially.

5. Focus on the consumer/patient experience.

A healthcare provider's ability to deliver an experience that sets it apart in the eyes of its patients and potential patients from its competitors - traditional and non-traditional - serves to increase their spending and loyalty to the brand. You need to actively manage the customer experience in total by understanding the customer's point of view. That is, all touch points internally and externally that a customer/patient comes in contact with which in turn creates the experience. Exceptional experience means gains in market share, brand awareness, and revenue.

6. Embrace retail healthcare.

It's not going away as some may still think. There is a reason why Walgreens just purchased a health plan with millions of potential customers coming online for insurance and medical care in 2014. Traditional ways of delivering healthcare will go by the wayside in many cases. Price convenience, access are the drivers in retail healthcare. Find the need, understand the consumers behavior drivers, design offering around the consumer not you in a convenient location and price it appropriately. End of story. If you can't compete in this way, your market position, share and revenue will erode.

Six steps. Not so easy, or not so hard. Just takes courage and leadership.

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.

Will price competition change healthcare marketing?

The game is changing. Rapidly.

Game changer. That's what I call Aetna's introduction to its members, of its 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. But it doesn't stop there, it allows the healthcare consumer to compare the cost across multiple network providers. You can compare costs across 10 different hospitals and doctors.

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.

And these are just a couple of the price and cost decision-making information tools that the healthcare consumer is starting to receive. Nothing like having higher out-of-pocket expenses, coupled with the ability to obtain pricing information, combined with the ability to estimate your own costs to get healthcare consumers to pay attention. Shopping for care and it's not mystery shopping..

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". Can you really think of any better way to control healthcare costs by introducing a level of price competition and providing information which really up until now, was essentiality unattainable?

Forget the quality argument.

Just because you charge more doesn't mean you have higher quality. The healthcare consumer already assumes quality. And they assume that it is equal across multiple providers. Saying you have high quality 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. It's a given. It's the business you are in.

So now , pricing begins to rear its head in the healthcare consumer's decision-making process. And when all other things are equal, in the mind of the consumers, price wins. Quality is assumed. Caring is assumed. It's what you do.

Your marketing needs to change.

Most healthcare organizations aka hospitals, have never really had to deal with the pricing equation on a competitive basis. For insurance, medical device, pharma and other suppliers to healthcare, price 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 price. Your brand takes on new meaning when price and choice become a critical component in the healthcare consumer decision-making process. High price, undifferentiated quality, won't sell.

Competing on price vs. claims of quality requires a different set of marketing skills than what you have traditionally found in most healthcare marketing operations. It requires more than a communications skill set, or senior leadership thinking that they know how to market.

Change is never easy, especially old attitudes towards the value of, and need for, healthcare marketing.

Repeat after me: Brand, Value, Price.

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.

Have you seen any goofy hospital advertising lately?

I have to admit, this is a pet peeve of mine, stupid hospital advertising. In a day and age where healthcare is experiencing great change, some hospital "marketers" and C-suite leadership continue to treat the healthcare consumer like they are some kind of idiot, incapable of making informed choices.

Do you believe that by offering a massage with a digital mammography, that women will choose to have their mammography at your facility? I would like to see the market research on that one. But then, odds are on that there wasn't any market research.

Remember, when you are marketing to individuals, they don't become a patient until they receive a service from you. So in one-third of the time in their interactions with you, the "person" is only a "patient" during diagnosis and treatment. Two-thirds of the time they are not patients, and most likely are arguing with your billing department about the charges.

And healthcare marketers wonder why no one takes them seriously.

Arguments aside, what should hospitals be advertising to create an unassailable market position, a strong brand, as well as an enlightened and informed consumer?

Is it the, "we are unique and world-class"? Even though The Joint Commission was just there for a sentential event.

Our technology is state-of-the-art. Never mind that a new technology was just introduced and you don't have it.

Another winner; we have the most shiny trophies and quality awards for several services. Oh, and even though we don't have a quality award for all services, if everybody else was as good as us message to go with it, "a 100,000 lives would be saved annually"! Really.

Or, how about the ever present focus on the physicians with messaging about having the best specialists in the region. And just so happens that these same physician practice medicine at the hospital down the street or across town. Hmm, does that make less qualified at the other place?

Then there is the here are the insurance plans we accept, you're the center of our world, followed by the we have big screen TVs and private rooms!

Let us not forget for a new hospital that just opened, "the air in your room is like the clean air in surgery."

I think, that pretty much for the most part, sums up the current state of hospital advertising.

And when several hospitals are staying all of these things at the same time in a market, do you really believe that the consumer is paying any attention at all, when there is so little differentiation, it all looks like "me too" and just shouting for attention?

I am sure it makes the Board, senior management and physicians feel good. All the while your audience receives absolutely no information that will help them make some of the most critical choices and decisions in their life.

And that can't go on any longer.

Time really to stop treating the healthcare consumer like they are some kind of idiot. People are coming to the realization that healthcare is not such the "black box that the consumer can't possibly "understand the complexity of medical care".

Time for meaningful information in the marketplace that will allow the healthcare consumer to become informed, educated and participatory in the care decision-making process. Time for marketing to begin to lead in hospitals instead of being order takers, and talking nonsense in their markets.

You should be transparent and talking about your outcomes. You need to engage in a meaningful dialogue that gives individuals the information that they want and need. The healthcare consumer is hungry for information and are searching the internet and other sources about you and how you perform. They are paying more of the cost. Demanding more say in what goes on. And don't like being treated like they are some small child who can't make a decision.

To use an often quoted metaphor, the wave of change is upon the hospital industry as we move from provider-dominated and controlled decision-making, to consumer and patient-directed, controlled healthcare. Your choice, change, be responsive and surf the wave to success, or be washed over and deposited on the ash heap of history.

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 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.

Can you see the 10 signs of an ineffective healthcare marketing operation?

The arguments are in. SCOTUS has already voted on healthcare reform. The majority and minority opinion writers are chosen. Regardless, healthcare will continue to change in very fundamental ways. And that means marketing has to change as well.

Marketing strategy and effective marketing operations is everything today in healthcare marketing. And if you have a bad strategy or no strategy, combined with marketing operational deficiencies, then no amount of tactical execution will overcome ineptitude. Some of the verticals in the healthcare industry are notorious for no strategy and just plain bad marketing operations, following the herd and just keeping the internal audience happy with what they want.

Here are the 10 signs spelling marketing doom in your hospital or other healthcare organization:

1. The marketing plan is not integrated with the organizations business and financial plan.

2. Your brand messages are not clear, and are not integrated across internal and external audiences.

3. The CEO sets the marketing priorities based on what others are doing , the loudest voice in the room or just because he or she likes it.

4. Departments are creating their own logos and communications. Only coming to marketing to "make it look pretty".

5. Marketing has little or no resources allocated for market research.

6. Marketing does not have an organizational voice or champion.

7. Your marketing department can't demonstrate an ROI.

8. The triangle of Public and media relations, social media and internet and traditional marketing is nonexistent or if it exists, lacks integration.

9. Little internal communication throughout the organization regarding marketing efforts.

10. Marketing is not at the senior management table.

Healthcare is transforming from a provider-dominated and directed model, where these types of behaviors and operational deficiencies really didn't make much of a difference. In the evolving consumer or patient-directed and dominated healthcare model, continuation of these marketing operational structures and behaviors need to be weeded out.

The healthcare consumer will become a harsh mistress, and will not tolerate an unresponsive healthcare organizations. Old ways of marketing must be replaced with a new understanding of marketing in healthcare and its power in the marketplace.

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. Fellow, American College of Healthcare Executives and a Professional Certified Marketer, American Marketing Association.

Have You Made Your Healthcare Marketing Resolutions for 2012?

New Year's Resolutions, for the most part, play an important role in most everyone's life. To lose weight. Live life more fully. Be a better husband, wife, or significant other etc. Value more what we have in our family and friends. And many more that I have missed. But have you ever considered New Year' Resolutions as a part of your business and managerial life?

So my last Healthcare Marketing Matters blog for 2012, is about New Year Marketing Resolutions. My own Top 10 list to get things started. What are yours?

10. Educate my organization about the value of my department and work. I will lead and prove my departments ROI.

9. Continue to scan other industries for their marketing successes. I will learn about them, adapt them to my industry, and implement successfully.

8. Expand my marketing education through webinars, seminars and conferences. There is always something new on the horizon to learn.

7. Integrate traditional, online and social marketing strategies. All are complementary to one another and drive multiple successes.

6. Innovate, discover the needs of my customers and drive consistent brand messaging.

5. Foster a spirit of and demand marketing excellence in my department. Good enough is not good enough. I owe nothing less to my organization and my customers.

4. Create brand zealots, and show what the brand promise, brand reputation and brand equity mean to my organization in revenue terms.

3. Stop using the words "unique", "state-of-the-art", and anything that is considered "buzz word" terminology in my marketing communications. Unique can be duplicated easily. State-of-the-art refers to yesterday's systems as things change so fast. Buzz words quickly fall out of favor.

2. Bridge the divide between sales and marketing and in doing so, together we will drive value, customer satisfaction and create customer evangelists all the while reaching new revenue heights.

1. Serve and be humble, for working in healthcare is a privilege, not a right.

Finally. I would like to thank everyone that read these posts over the past year. Your comments, suggestion and readership is very much appreciated. Healthcare Marketing Matters is now read monthly in 52 countries around the world. Maybe we aren't as different as we may all like to think when it comes to healthcare.

Happy New Year Everyone. Have a healthy, safe and prosperous year.