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.

Does your patient experience fail the test?

True story.  "Well, you can always bring her back to the hospital if she still has trouble breathing", said the home health care nurse sent from the hospital less than 2 hours after a patient had been discharged.  Oh, and did I tell you that her eye was infected, almost fell going to the bathroom in the hospital and informed the nurse, had slurred speech and could barley ambulate?  That patient had been cleared by all to be discharged from the hospital.

And then the family hears or sees an ad about all the wonderful quality care awards from third parties that they receive, and how many lives would be saved if everyone was as good as them.

What do you think the now healthcare consumer, formally the patient thought?

Countless times every day, the patient experience goes fails the test.  Big things and small things alike that take place in the healthcare encounter all add up to one patient experience, good or bad. 

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.

Experience management is about changing the way you interact with the individual or family from start to finish.  Not just managing the experience at isolated points along the care continuum. It's not about just focusing on service recovery like something was wrong with a hotel stay.  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.

So when the patient experience fails, your reputation, your brand and your future in a risk or value-based payment environment fails as well. And then there are those readmissions penalties you face when a patient like this comes back in less than 30 days.

You should see what's being said on facebook and in social media circles from others that chime about how bad their experience was at that particular hospital. Do you still think social media is nothing more than a billboard?

Yep, the chuckle factor is really high when those quality award ads are heard and seen.  Pay attention to the patient experience, and pay attention to the marketing. They are not separated, but closely related.

The newly insured healthcare consumer is paying close attention now. It costing them money, they have too.

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.

Are you using social media marketing for an exceptional healthcare experience?

In the new world of healthcare where price, quality and a newly insured healthcare consumer is paying more out-of-pocket costs for healthcare, social media marketing represents an opportunity that can be used advantageously to meet healthcare consumers demands for a better experience.

Social media represents a great opportunity for establishing a one-on-one relationship with the patient, aka the healthcare consumer, directed by the healthcare organization that breaks from the pack, by creating a social media healthcare experience that is memorable, exceeding an individual or families experience and expectations.

Most healthcare organizations are still stumbling with using social media and the online experience to drive differentiation, meaningful information and experience. Think of this in terms of a channel of communications and engagement that meets the healthcare consumer on their terms but with your messaging.

In any case, when you look at your social media strategy and presence, does your social media experience:

Ø  Delight your customer?

Ø  Create sustainable differentiation?

Ø  Is adaptable to new opportunities?

Ø  Leverages your investment?

Ø  Deliver in every situation?

Ø  Connect with the newly insured?

Ø  Does it engage the healthcare consumer?

Ø  Provide answers or guidance looking for solutions to medical challenges?

Ø  Define experience, outcomes, price and value?

Or, is it just pushing out information that is that you have deemed valuable to you, but carries no relevant meaning for the healthcare consumer?  

This is the lens of criticality needed to objectively evaluate efforts.  If it's not doing these things, then chances are nil in delivering an exceptional social media experience. But for that matter, neither are your competitors. 

Make your social media presence not just "good enough" but exceptional.

On another note, my apologies for missing a post last week. I was out of town with my wife and daughter last weekend. Alex is a left-handed pitcher on a 16U a fastpitch softball college exposure team and we were in Des Moines, Iowa for the ASA 16U A Heartland Showcase Series College Exposure Tournament.   Saturday was playing for college coaches and scouts. Sunday was a single elimination tournament.  There were  27,16U A teams playing. We made it to the final four and a three way tie for 1^st place because the final games were canceled due to rain. It was a good time.

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 do you market to the newly insured?

Here comes the newly insured. They are not in ACOs.  Some will have chosen high deductible plans.  Some have even chosen narrow networks to limit their premium cost.  Some of the newly insured will be in the expanded Medicaid program.  What we do know is that it will be a potpourri of ages, sex, income, health status, relationship status and education.  We know that there will be a lot of people who never had access to health insurance.

So how do you market to the newly insured, knowing that the probably haven’t seen a doctor in a few years? They most likely don’t have a primary care physician. And when they needed care as the uninsured, they most likely used Emergency Rooms as their primary source for medical care considering themselves to be ER frequent flyers.  They will be less healthy and in need of navigation though your healthcare system.   They can be a financial godsend to your hospital or a drain depending on their medical condition and source of payment.   

Because you waited until now to start marketing, the chance to establish a relationship with the newly insured prior to the opening of the HIX and that insurance purchase has been lost.  Now you have to compete. And telling the newly insured you have the best doctors and most caring staff is right out of the nineties and meaningless.

The healthcare market is changing and these people are paying out of pocket and they will be paying attention to price, quality and experience. So it is really along these three dimensions that you need to focus your integrated strategic marketing efforts.

Push the newly insured to the primary care doctor.  Pull the primary care doctor to the hospital.

Push the newly insured from the emergency room to free standing clinics and other less costly settings.

Engage the newly insured in meaningful ways along price, experience and quality.

Look out for Walgreens and CVS Caremark, Rite Aid and others whose retail clinic strategy is perfect for the newly insured, and will limit their out of pocket expenses better than you can.  Look out for the hospital or health system that will be the first in your market to engage the newly insured in meaningful ways along price, experience and quality.

The age of semi-retail healthcare is now beginning.  That means the healthcare consumer, aka the newly insured, have some leverage and bargaining power.  Meet their needs and establish a meaningful relationship on their terms, or keep doing what you have always done in marketing and watch them walk away.

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.

Can patient experience and satisfaction drive healthcare marketing?

Patient experience and satisfaction is no longer a nice too have, but a got to have in the evolving consumer-centric healthcare market place.  Consumers are paying more out of pocket and when consumers pay more they expect more.  A better healthcare consumer and patient experience in the end means a more compliant patient pre and post treatment.  Higher level of service and medical process satisfaction brings the healthcare consumer back in a sea of providers who all offer the sameness. 

It is one of the primary drivers for a reason to return. And when all things are equal and undifferentiated, experience and satisfaction become a major determination of return and for their recommendations of you.

Difficult to achieve and tough to competitively beat once you have it, experience and satisfaction with your medical products, clinical services and processes regardless of the vertical, be it specialty pharmacy, medical device,  pharma, hospitals, doctors etc., will drive revenue.  Revenue from the standpoint of Pay-for-Performance (P4P) programs and volume from healthcare consumers aka patients, selecting you in a very commoditized and provider undifferentiated healthcare market place is at stake.

Not everyone will be in an ACO or risk-sharing agreements.  Some will choose narrow networks to save a buck on premium. Fee-for-service will still be around for awhile.  The opening of public insurance exchanges in October, 2013, Medicaid expansion in some states and the now becoming ever more popular the private insurance exchange where companies are moving to defined contribution (see Walgreens, Sears and others in recent times), means that you have a direct to consumer opportunity along very different dimensions then in the past.

The healthcare consumer of today will view your services as: value= f(cost, quality, satisfaction) as compared to the near past where value= f(cost, quality). Value as described by the healthcare consumer here is the result of the function of cost, quality and satisfaction with you.

Why is it important:

• High levels of experience and satisfaction are a powerful differentiator in your market.
• Done correctly, your experience improvement and satisfaction program becomes the ongoing Voice of the Customer (VoC) program to drive real organizational change.
•  It is a strategic and tactical edge for your brand and your marketing communication efforts. 
• Think customer evangelization.
• Think of the power of a high-quality experience and exemplary satisfaction and what that can do for your organization. Think of what it can do in your effort to differentiate.

The choice is yours.  Make it before others make it for you.

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.

The media is calling; how do you respond to PR crisis?

Sometimes, another organizations PR missteps are an opportunity to learn how not to handle a PR crisis.  Just ask the any of the hospitals and health systems that have been in the media the past few weeks with HIPAA violations for data beaches. And what I have seen from the healthcare consumer side in the coverage and their responses have been arrogance, apathy and really stupid responses by senior management.

I mean really, “We had a panic button and security camera.”  Does it matter in your response that the theft happened after hours?  Or the, “We had 60 days under the law before we had to report it.”  How do you think the public reads that answer of hiding behind regulations when their personal data is at stake?

In an age of healthcare model evolution from provider-dominated models of decision making to consumer-directed models, those bygone days of being able to mismanage a PR crisis and response and get away with it are gone.

Is your response to dive for under the desk? Do you send out poorly prepared underlings, to face reporters and the public? Does leadership, make proud pronouncements at the outset, that could come back to haunt you because at this point, you just don't know?   Do you react as an arrogant organization with the, "How dare you question us response"?   Do you think that it can never happen to you? Do you have a crisis communications plan in place?

Every healthcare organization will face a PR crisis. How you handle the communications, will determine the amount of brand damage and length of time people remember, the good and the bad.  In this age of social media and the Internet, there are no, "We just need to wait 3 days to weather the storm", anymore.

Many times organizations respond with:

·         Lack of organizational understanding of the need to handle a situation as crisis communications;

·         Different, conflicting senior management messages;

·         Testy responses to questions;

·         Lack of preparation by speakers in understanding the seriousness of the communication;

·         Poor speaker body language;

·         No overriding organizational message;

·         Organizational arrogance;

·         Lost messaging opportunity;

·         Appearance of blaming others;

·         The organization appearing not accountable;

·         The organization furthering to anger the media;

·         No response at all with the "it's just a three day story and will go away";

·         Sending out unprepared underlings to face the media;

Is it not true that any press is good press!  Every day, someone somewhere faces a crisis communications issue which is poorly handled.

By following these planning guides, you can weather any storm, limit reputation, revenue and ultimately brand image damage:

·         Understand the nature of the situation;

·         Be transparent;

·         Be proactive in how you intend to address the situation;.

·         Limit the amount of time senior leaders i.e. the CEO or president speak;

·         Make sure everyone has the same message and is on board;

·         Develop strong organizational messaging of care and concern;

·         Don’t scapegoat, blame others or give the appearance of blaming others;

·         Don’t tell people things will change when things are not changing;

·         Practice, practice, practice;

·         Bring in an outside PR firm for another viewpoint;

·         Understand that your reputation is built up over a long time and can be destroyed in a few short minutes;

·         Remember that it is not just a three day story;

·         Watch your body language;

·         Know your facts about past performance, reporters will be prepared;

·         Learn from others;

·         Each year engage in a day of media training for executives. Dealing with the media is a learned skill that the majority of executives do not have.  It is not as easy as it looks.

Most importantly, engage the media all the time all year round not just when you have a problem.  By establishing positive media relations with the good you do, you won't necessarily be cut any slack in a bad situation, but you will get the opportunity to tell your side.  You won't if you don't have good media relations already in place.

Plan now for that crisis communications event, and you will better off as a prepared healthcare organization.

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.