Sunday, July 26, 2015

Defiant to the end, hospital closes. Nobody cares?

Dateline Anywhere USA. Hospital anywhere closed today after serving the community for 80 years. Beset by changes in reimbursement, competition from retail medicine, telehealth, innovation and an empowered healthcare consumer, hospital leadership and Board of Directors could not adapt to the new healthcare market.  Several hundred employees lost their jobs.  No one in the community seemed to care… as reported in the local paper.

Is that the headline of a story being written across the country fueled by provider leadership? It’s a scary thought and unfortunately it is being written all too often. From a marketing perspective it’s not entirely avoidable but could be. 

In the end, the inability to adapt quickly enough and meet the needs of the healthcare consumer and patient utilizing less costly treatment alternatives and innovative services that meet their needs along the dimensions of price, outcomes, engagement and experience will write that story.

Blaming declining reimbursements as the sole contributor to the closure of a hospital would be a mistake. An important contributor as the leadership could not adapt or guide the healthcare enterprise through the transition to a quality based reimbursement system, yes.  But not the sole reason as some may have you believe.

Will anybody care if the hospital closes?

Unless the healthcare enterprise is the sole community provider probably not, there are always alternatives. If leadership is being honest, this is a new reality for many.

What to do.

This isn’t about P4P, capitation, risk-sharing, ACOs, Bundled Payments or any other of the myriad of reimbursement models being proposed, tested or put into operational practice.  This is about what providers can do from a marketing standpoint to mitigate the risk of that headline becoming a reality.

Marketing is an asset and not just there to make things look pretty.

Survival in today’s environment requires focus beyond readmissions, patient safety improvements, elimination of preventable deaths, cost reductions, quality improvements etc.  All very important business critical mandates as well as the cost of doing business in today’s healthcare world. While doing all of that you still have to find ways to grow.

Here’s how to grow along the four dimensions of price, outcomes, engagement and experience:

Become the customer focused organization in reality not thought.
It’s about focus on the healthcare consumer and patient, not the hospitals. It’s an external market focus compared to an internal focus. It’s about becoming the healthcare consumer/patient focused hospital. And saying that the healthcare enterprise is doesn’t make it so.  Measure the healthcare enterprise against the 20 MAKKOR scale attributes of a customer focused organization.  Then and only then will one know what it takes to be the customer focused organization and the improvement steps needed for that journey.

Evaluate the healthcare enterprise brand and competitive position.
Consumers and patients are ready for transparency and convenient technology-enabled access to care. Healthcare providers that are capable of identifying meeting these needs and how they want their healthcare needs meet though technology focused on them, will gain new patients and the next-generation of physicians. 

Engage healthcare customers and patients all of the time.
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 experience, they are a healthcare consumer not a patient.  So why then is it the only time one chooses to meaningfully engage them is during the period when they are a patient?   Engaging the healthcare consumer on a continuous basis builds loyalty and importantly keeps them in network, which has some pretty significant financial ramifications in a risk-based reimbursement model. 

Engage the physicians.
No matter the payment model the hospital or health system still needs a physician or physician extender’s 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 the hospital than any other factor.

Improve 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 physician’s encounter when they try to get things done in the hospital setting?  Understand how the physician experiences your organization at every touch-point they encounter the hospital. 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. 

Make the healthcare consumer/patient experience memorable.
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 loyalty to the brand. One needs to actively manage the customer experience in totality 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. 

Embrace and join the retail healthcare movement.
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 the hospital in a convenient location and price it appropriately. If you can't compete in this way market position, share and revenue will erode.

Social media is the currency for reaching audiences.
urn 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.

All of this takes organizational change, leadership, vision and meaningful action.  Unless things change its over and done. The headline will be a reality.

For more topics and thought leading discussions like this, join Healthcare Marketing Leaders For Change, a LinkedIn Professional Group.

Sunday, July 19, 2015

Divided confused markets? Healthcare provider marketing in a quandary?

I used quandary as the word choice in the title because providers are caught between two worlds, it’s still a fee-for-service environment shifting to fee-for-value and risk.  Two very different reimbursement models but both are having significant impact on utilization and revenue. 

Another quandary is the clamor in the market from government, employers, healthcare consumer and patient with the desire for price and outcome information to make informed decisions.  Then there is the whole experience and engagement that healthcare consumers are demanding in many ways mirroring the level of experience and engagement that they have with Amazon and others for example.

Faced with several seemingly contradictory market requirements and needs internally and externally, what is the healthcare marketer’s answer?

I propose to the healthcare provider marketer that in reality, these markets for one’s strategic marketing purposes to drive growth, revenue and appropriate utilization are not that dissimilar.  Especially in a market that is bifurcating where the need to drive fee-for-service utilization still makes the hospital a revenue center.  And this does not mean that two strategic marketing approaches need to be taken.

The healthcare consumer, is the healthcare consumer, is the healthcare consumer….

That is the focus, not the reimbursement model.

They don’t change because they are in a fee-for-service model/plan or a quality/risk model. That really impacts the provider’s revenue. The healthcare consumer/ patient still have to pay premiums.  Still has to pay deductibles and co-pays.  Still has to make choices such as selecting a narrow network or obtaining care in or out of network for example. In that regard the healthcare consumer will shell out of pocket over $300 billion in 2015 for premiums, deductibles and co-pays. They are paying attention.

In either model, provider marketing comes down to meeting the healthcare consumer and patient needs along four dimensions:  price; outcome; experience and engagement.  


As one designs the marketing strategy and key messages for the brand by fully understanding the retail healthcare consumer driven market, one can have the best of both words.  That is if there is a willingness to lead and stop the nonsense brand messaging of we are the best, look at our awards, have all the technological bells and whistles and we care more messaging that still goes on today.

If provider marketing began to focus the brand and marketing messages in these four dimensions now, while still in a fee-for-service environment they will accomplish several things.  Be the first in their market to do so and take the high ground with competitive positioning.  Secondly, everyone else becomes an also ran and me too, it’s called a Blue Ocean strategy. Third,   the needs expressed by the healthcare consumer and others are meet. Fourth, you have the momentum in a competitive retail medical, healthcare consumer driven market place. And lastly by doing this now, no need to spend great sums of money coming up with strategic campaigns along these four dimensions because you now have too.

This model of four dimensions for provider marketing can be effective in any kind of market, for any kind of reimbursement mechanism.  Especially as early indicators are that Bundles Payments may actually work better than ACOs.  Bundled Payments bring price certainty to the healthcare consumer.

Focus on the needs of the healthcare consumer and patient along the dimensions of price, outcome, experience and engagement to build the brand, drive revenue and growth in a healthcare world full of quandary.

To take a saying from Jake Poore, Founder and President of Integrated Loyalty Systems on patient experience, which I borrowed for provider healthcare marketing, “It’s really simple, but really hard”.

For more topics and thought leading discussions like this, join Healthcare Marketing Leaders For Change, a LinkedIn Professional Group.

Sunday, July 12, 2015

Is hospital control of healthcare an illusion from a marketing view?

Think for a moment using the lens of marketing, and ask what does a hospital or health system for that matter control? Do they control the insurers? No. They negotiate but do not control them. Do they control Medicare or Medicaid? No.  Do they control the independent physician whom they need to utilize the hospital inpatient, outpatient and emergency room facilities and services? No. Do they control the healthcare consumer in any manner? No.  Do they control patients at any other time when they are not in the system of care receiving some type of medical care?  I think that is a no as well. Do they even control the ability to stop deaths due to preventable medical errors?

Now for sake of the discussion, control could be viewed a too harsh a word. So maybe the better choice would be influence, but in many ways the answer would still be a resounding no from a marketing viewpoint. Especially in a buyer’s market beginning to exist today.

The emperor has no clothes and here is why.

In the four areas that ultimately impact the hospital or health system  ability to survive,  insurers- private and governmental, physicians, healthcare consumers and patients, with the velocity of the transformation  of healthcare to a retail medical environment replete with consumer choice,  demonstrates  that the hospital or health system has little, if any control or influence.   If there was control and influence, then providers would be proactive instead of reactive or even “circling the wagons” for that matter.

Now that being said, what if anything can be done?

It is clear that providers need to influence the choices and decisions of the healthcare consumer, patient, and physician.  And it doesn’t matter where the audiences are found be it in Exchanges, the community or in social media.  When faced with factors beyond one’s own control, it can be easy to take the viewpoint and action based on past solutions. Convincing oneself that the past actions to stay at the top of the food chain will continue to work going forward is a prescription for failure.  Familiarly breeds contempt in this case.

So how is influence in a turbulent market accomplished?

Reluctant to change but mandatory for survival and growth, the healthcare provider now needs to focus on these areas:



To achieve market influence, the sweet spot for the provider brand now sits at the intersection of the four areas. Notice too, that all four areas intersect with one another, posing additional challenges and opportunities. Everything is interrelated now and not isolated.

I fully realize that what I write about many times and the perspective I bring to critical issues of today is widely unpopular and not reflective of what the “thought leaders” are stating. So be it. I have never been about telling an organization what they want to hear.  I am about changing through strategic vision and leadership, where the healthcare organization needs to be to take advantage of the growth opportunities that are available. But that requires difficult and challenging change.

It starts with understanding the healthcare provider controls nothing in the market but has the opportunity to influence everything with a strong brand, brand promise and healthcare consumer/patient focus.

Successful market influence in a buyer’s market falls along four dimensions.  If one believes that they have or can maintain control, have it for control in a buyer’s market is an illusion.

Join me in Healthcare Marketers For Change, a LinkedIn Professional Group. 

Sunday, July 5, 2015

The healthcare consumer has a buyer’s market now; how will providers respond?

“Insurer consolidation will continue as the regulators think buyers should have more power than sellers. The balance of power has permanently shifted to the buy side.” Anonymous Health System CEO.

In a very short but interesting  piece, 5 Health system CEOs get candid about mega-mergers between health insurers, Becker’s Hospital Review,  Molly Gamble, June 25, 2015, some very candid views were expressed.  Though this comment applies to the insurers, this can easily be extended to the healthcare consumer and patient who are buying or already have insurance.

Healthcare consumerism is no longer an “it will happen someday”, but is a consequence of the SOCTUS ruling on ACA subsidies that brings this reality to the market place now. Through consolidation Insurers will drive prices down.  Providers respond with mergers and consolidation in an attempt to create market power for negotiations. This in turn creates the probability of a vicious cycle that because of size and economic power; the insurer will probably always win.

It remains to be seen if the pricing concessions will be passed along to the healthcare consumer, who is the ultimate beneficiary. Rest assured that the Justice Department will be watching this closely and actively challenging the mergers and consolidations.  But it’s foolish to hope that is the best line of defense for hospitals and health systems.  They are not immune either.   I think it’s interesting to note that the Federal Trade Commission is challenging hospital mergers and acquisitions, recently winning some cases and forcing the unwinding of the transactions.

Which brings us back to how you market to the insurer, healthcare consumer and patient is markedly different in a buyer’s market then what takes place now.

In this kind of environment the buyer is king and queen. It now comes down to price, quality, engagement and experience.  In essence, what value does healthcare provider bring to all its segments be it insurer, healthcare consumer or patient. It’s really in many ways about accountability to the consumer’s of your offerings regardless of the segment they may live.

Moving forward with seven ways to respond in a buyer’s market with value

1.  Brand and competitive position.
Consumers and patients are ready for transparency and convenient technology-enabled access to care. Healthcare providers that are capable of identifying meeting these needs and how they want their healthcare needs meet though technology focused on them, will gain new patients and the next-generation of physicians. 

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 experience, they are a healthcare consumer not a patient.  So why then is it the only time one chooses to meaningfully engage them is during the period when they are a patient?   Engaging the healthcare consumer on a continuous basis builds loyalty and importantly keeps them in network, which has some pretty significant financial ramifications in a risk-based reimbursement model.

3. Engage the physicians.
No matter the payment model the hospital or health system still needs a physician or physician extender’s 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 the hospital than any other factor.

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 physician’s encounter when they try to get things done in the hospital setting?  Understand how the physician experiences your organization at every touch-point they encounter the hospital. 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 loyalty to the brand. One needs to actively manage the customer experience in totality 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 the hospital in a convenient location and price it appropriately. If you can't compete in this way 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 under performs today, but holds great potential to improve engagement, experience and adherence. And that takes healthcare marketing leadership, executive vision and meaningful action.

Seven steps for providers  to achieve market and revenue growth in an buyers  market place. Not an impossible task, but one that does require focus and a willingness to break from the past.