Saturday, March 28, 2015

Are hospitals on the hot seat now, replacing pharma and insurers?

Whoa there now. Hospitals starting to be cast as the villains in the healthcare debate, after flying under the public radar  for so long as the bastions of fairness, and taking care of the communities and all who come to their doors? 

Maybe so.

In a Becker’s Hospital Review article on March 25, 2105 by Molly Gamble,  Hospitals: The new villains in the story of American healthcare? (What Slate has to say), posed some interesting thoughts based on a Slate article.


Predatory monopolies?


Bleeding us dry?

Just because its Slate doesn't means it’s not a growing public sentiment. Pharma has had its time in the penalty box.  So have the insurers. And in a society and culture that thrives on the sensational and taking pot shots at celebrates and companies, it’s not a surprise really. 

There is after all a growing public scrutiny of hospitals prices and profits by nationally respected publications like Time magazine. Then there is the ever growing list of preventable deaths in a hospital killing 160,000 people a year.

Name one place in the nation after a merger or hospital acquisition that decreased competition in a market, where the price and cost of healthcare actually went down, or duplicative clinical services and technology were eliminated?  I can’t either.

And with an election coming up in 2016, at the first sniff of a major public issue, the politicians will be falling over themselves to be cast as the reformer protecting “the little guy” from the big bad greedy hospitals.

It’s early in the game, but the signs of a growing and potentially lethal public relations nightmare are in the offing. And the AHA won’t be able to save the hospital in the local market or major urban areas from inquisitive reporters, consumers with a story to tell, big headlines or negative TV news coverage.

What to do? Dust off that PR campaign!

Sometimes it’s back to the future and some good old public relations work that should be in the marking.  Dust off those old PR and communications plans by investing and building relationships with reporters.  Become the price and outcomes transparent hospital. Do the market research to completely understand what the brand image and reputation of the hospital is in the market.  The time is now for the development and crisp tactical execution of a long term and sustainable public relations campaign.  

There are no guarantees that it will work, but if the hospital starts now and gets ahead of the potential PR nightmare, then the hospital may just have a chance.

Or, one can ignore the growing hospital as a villain noise, and then wonder why everyone is so angry.

Saturday, March 21, 2015

Are hospital marketing campaigns aligned with the culture?

Here’s one for you.  Has the healthcare enterprise ever done a reality check of marketing campaign messaging with the real culture of the hospital before launching?  For example, I saw one campaign courtesy of Jake Poore founder of Integrated Loyalty Systems, in his seminar on Aligning Inpatient and Outpatient Experience Across the Continuum of Care at #ACHE2015.  (My thanks to Jake for the blog topic from one photo he had in the presentation.)

It seemed harmless enough with the usual hospital marketing campaign and meaningless fluff around “we specialize in smiles”.  I won’t start on a tangent about this kind of hospital marketing because it drives me crazy, and the industry isn't really interested in providing useful information for consumer decision making at this point anyway. But I digress.

As I was saying, it seemed harmless enough until you encountered the culture and found a wide experiential disconnect for the healthcare consumer and patient, because it wasn't true.  When one creates a campaign it affects three things: the brand; the creation of the expectation of something to happen; and the actual experience. So when the reality of the culture in which smiling to the healthcare consumer or patient doesn't take place all of the time, it’s a disconnect.  It is a failure of the brand promise.  It is a failure in the experience.  It is a failure by not fulfilling the already established expectation.

That is why it is so dangerous to run these types of brand campaigns.

No doubt about the creativity of the campaign. I am sure everyone loved it from the marketing team to physicians, senior management, the Board of Directors and beyond.  But in the end because no one did a culture check to see if smiles where happening, it’s a busted brand promise, experience and expectation.

Today in our social media driven world, culture impacts marketing because it is always on.  The culture of the hospital or health system is 24/7. It’s always, I mean always on. Culture impacts the brand, the brand promise, the expectations of the healthcare consumer or patient and the experience. And when going out to market with these types of fluff campaigns a new reality check is needed.
It’s not hard and is asking only one question, is the brand promise being made in the campaign supported by the reality of the culture of the hospital or health system? If the hospital marketing campaign is not aligned with the reality of the hospital culture, it is a prescription for disaster in the making. Pun intended. Walgreens and other medical retail giants figured this out a long time ago.
Now the challenge is for hospitals and health systems to learn the same lessons.

Healthcare is becoming a consumer driven retail operation. So while everyone’s focus is on reducing cost, improving quality and figuring out how to survive in a world shifting from volume to value, marketing becomes far more important than cute catchy phrases and seemingly harmless brand promises.

The easy way around this is to go to market with campaigns that differentiate the hospital or health system. A campaign that is based on providing meaningful and understandable information along the dimensions of price, outcomes, and experience that defines the brand, and establishes reasonable consumer experience expectations.  It focuses on a brand promise can be delivered on always by everyone, no exceptions to that statement, in the healthcare enterprise  24/7.

Like Jake states in aligning the inpatient and outpatient experience, “It’s really simple, but really hard”. 

Saturday, March 14, 2015

Is hospital marketing unintentionally driving inappropriate utilization and cost?

The other day, an individual who I follow and respect very much, Paul Levy author of the blog,  NOT RUNNING A HOSPITAL- THIS IS A BLOG BY A FORMER CEO OF A LARGE BOSTON HOSPITAL TO SHARE THOUGHTS  ABOUT HOSPITALS,  MEDICINE, AND HEALTHCARE ISSUES, wrote an interesting post  S(uch) S(trange) M(edicine). Very eloquently, Paul raised some every significant questions based on the blog, SSM and Health Fair: what happens when you don’t use Google, and the experience of Vik Khanna in his blog post Over Diagnosis . These were not low cost screenings either. I highly recommend that everyone read these posts.

The discussions addressed the ethics based on the stated mission and value statements of SSM, by packaging and selling of cardiovascular screenings that except for one of the six screenings, were RECOMMENED NOT to be done by USPSTF and the medical community.

Oh.. oh…

It did provide a pause for me in considering healthcare marketing and its place and role in today’s evolving medical retail market.  And yes when I was the hospital side, I did promote screenings.

But it doesn't mean it was right then, or the right marketing strategy today without pause.

There is a fine line between promotions of disease screenings that are needed in a population that may be exhibiting for example cardiovascular disease, and promoting screenings to the general public that has been determined as medically unnecessary and may produce false positives. This is especially true in an environment where we all hear so much about customer focus, patient centered care, cost reduction and meeting the Triple AIM messaging from hospitals and health systems.

It’s not easy….

It’s not easy when the business model is changing from being paid for the production of care to being paid for the risk and quality of care. There is still the need to put “heads in the beds” to generate revenue while the transition from revenue center to cost center plays out for the hospital.

The market is shifting to a consumer focused medical retail model based on cost and quality as well, which requires a different marketing skill set. It can make healthcare marketers and hospital leadership schizophrenic in many ways.  

The moral of the story is……

I do not think it’s to promote medically unnecessary tests and screenings, even as the market shifts to a consumer driven model.  This isn't like selling cars or shoes.  Shoes are needed.  Unnecessary medical tests are not.

The role of healthcare marketing in hospitals is to understand the healthcare consumer and dynamics of the market so completely, that they develop those marketing strategies and tactics that are based on the needs of the healthcare consumer, are priced correctly and move the healthcare consumer to obtain the right care, in the right place, for the right cost.

It is also to be the leadership voice in the healthcare enterprise, and to fact check and verify that the screening program is not promoting tests, that that have been determined not to be medically necessary by the medical community and evidence based literature. Marketing leadership in the healthcare enterprise has the responsibility and accountability to lead a fact based discussion about the program.  

Retail medical marketing is more than just slapping some screening tests together with a pricing discount.  That’s not marketing. That is just throwing stuff up against the wall and seeing what sticks.

And that is a major cultural shift and understanding of the nature and function of healthcare marketing in a medical retail environment in the hospital and health system.

Saturday, March 7, 2015

What is the healthcare consumer to do?

“It’s the time… of the season”…. as the lyrics from the 1968 hit by The Zombies, Time of the Season say in the Odyssey and Oracle album. Yep, that time when hospitals and health systems across the country walk down the red carpet of healthcare awards (with apologies to the Academy Awards). Claiming their place of the “highest quality imaginable” because they are in some top hospital list as a “best” place for care.  Never mind that a different list has them in the worst category.

With so much conflicting information available what is a healthcare consumer to do? Better yet, does it really make any difference to the healthcare consumer? The answer is they probably don’t care and don’t pay attention. See What Are the Best Hospitals? Rankings Disagree, by Melinda Beck, Wall Street Journal, March 2, 2015.

That statement does not mean that I am against hospital quality ratings for the consumer. I think that those ratings can be useful in the decision making process in choosing providers. They also have the potential to give hospitals a much needed boost in the constant battle to differentiate from competitors.

But they don’t. And it’s because the healthcare consumer has no context or appropriate content to educate and inform them as to why they should even care. Let alone what makes that “quality” award meaningful.

Just slapping the awarding organizations logo on an ad that doesn’t say anything other than screaming “We Won!”   with some vague language about world-class and highest quality, can be seen as a disservice to the healthcare consumer.

The times, they are a changing.

Hospitals and health systems cannot stop or slow down the transformation of the healthcare industry from a provider dominated business model, to a retail consumer oriented model.  As a reminder by 2020, it’s predicated the 30 percent of the hospitals will be gone either liquidated or acquired. Only 25 percent will grow and thrive. See Stagnation with a chance of decline: Healthcare’s 5 year forecast, Becker’s Hospital Review, February 20, 2015 by Emily Rappleye.

Carpe Diem

Seize the day for the hospital that is a third party quality award winner.  Turn it into the competitive advantage that can differentiate one in the market.  Besides, in a retail medical environment competitive advantage is everything, even for a not-for-profit. And markets do not behave under the Queensberry rules. The sooner hospital leadership learns that there no such thing as “friendly” engagement with competitors, the sooner one has the chance for survival.

Some do’s and don’ts

Just don’t put an ad out there with the award logo saying we won.
Do explain what the award is and how it was determined.

Don’t make grandiose claims that if everyone else was as good as us, 160,000 lives would be saved annually.  Really and the healthcare enterprise doesn’t make medical mistakes that kill people?
Do put the award in context and how that shows you are better than average.

Don’t put a smiling executives or physicians in the advertisement.
Do combine the award in an ad with a real-life patient and their testimonial.

Don’t use the award to make claims that the hospital is excellent at everything.
Do use the award for the specific clinical services that were mentioned.

Don’t hide the data underlying the hospital performance to achieve the award.
Do be data transparent in terms the healthcare consumer can understand.

Don’t expect the healthcare consumer to care about the award.
Do engage and educate the healthcare consumer on why the ward is important to them.

Don’t just put the award ad out as a brand image piece.
Do create a strong and measurable call to action for the brand based on the award.

“The time has come, the walrus said, to talk of many things……” from The Walrus and The Carpenter by Lewis Carroll.  The time has come for hospitals to do the same.

Sunday, March 1, 2015

Wait…What? Its healthcare consumer’s 1 & hospitals and health systems nil?

In another market development benefiting the healthcare consumer that can be seen as a small but important victory in cost transparency, an easy to use web site Guroo  was launchedGuroo, latest tool for healthcare price transparency, launches, Healthcare Finance News, February 26, 2015, is an easy to use web site for consumers that look at 78 common procedures, based on data from the Health Care Cost Institute database.

This was probably meet with ears covered and the sound of la, la, la, coming from hospital executives all over the country.  That is if they were paying attention. As the battle for cost transparency progresses, it’s now healthcare consumer 1, hospitals and health systems nil. 

There are pricing calculators from some of the payers, but you had to be a member and in their contracted networks. And few healthcare analytics companies have them for employer clients for their employees to use, but not released for the general public.  

I tried the web site and you know what?  It is easy to use; really easy to use. Now Guroo  won’t show one the cost for a particular hospital or doctor, but that is on the way.  There is no current indicator of the quality of the hospital procedure or doctor, but I would expect that will be a future enhancement as well.

There one has it, coming soon to a smartphone or desk top near you, usable cost and quality data.

Healthcare consumer 1 - hospitals and health systems nil.

There is no running away and hiding one’s head in the sand, hoping that those pesky healthcare consumers wanting price transparency and innovative entrepreneurs meeting those needs will go away anytime soon. 

Healthcare consumerism is here to stay, so one might as well get with the program and save some heartburn for other things the hospital or health system does not want to do.

So, what to do?

This requires a thoughtful marketing response on the part of the hospital or health system. And it’s not with the “well, we cost more because our patent are sicker and high quality cost money” traditional response which happen to be some of the great lies in healthcare.  The healthcare consumer and media don’t buy it any more anyway. That response does not back the patient- focused or consumer-focused claims one makes in advertising the healthcare enterprise either.

And for those that doubt the power of social media and why it’s important to the hospital and impacts the healthcare enterprise, let me illustrate.  In a few clicks of the mouse with a personal recommendation message, I shared the web site with Facebook friends, Twitter followers, LinkedIn connections and followers, as well as Google + people. In a matter of a couple of minutes and a few mouse clicks, this information was shared with around 8,000 individuals. 

Now this blog post will be sent to the same number of people plus picking up additional readers who I am not connected with on social media.  Now all told, this message will have gone to over 21,000 people. I think one could see how the law of large numbers begins to apply as people share the information across their social media platforms.

In turn, it does require a careful and measured response from the hospital or health system.  If one starts developing an integrated and effective marketing and public relations campaign now, the scramble to respond to the market  later on will be avoided.

Knowledge is power for the healthcare consumer

It’s just a matter of time before someone comes in for a procedure, asks what the cost is and tries to barter for a lower cost. It will impact their deductible costs, especially if they are in a plan that is very high deductible.

This isn’t by any means the be all, or end all for healthcare consumer cost information. It’s early in its infancy but easy to use and clearly understandable.

The health care market is moving at breakneck speed in becoming a consumer centric business environment and model.  That means innovation, customer centricity, price, outcomes, convenience accessibility, waste elimination and responsiveness to the needs of the healthcare consumer is ruling the day.   Guroo takes change this one giant step further.

This development requires change and  it’s a choice to change or not.  But, in the next five years for hospitals by 2020, it is predicted that 25 percent will grow, 30 percent will be liquated or acquired and 45 percent will live on a razors edge just squeaking by until the next market disruption.  See Stagnation with a chance of decline: Healthcare’s 5 year forecast, Becker’s Hospital Review, February 20, 2015 by Emily Rappleye.

Always remember some wise words in this time of change:

"Keep in mind that you cannot control your own future. Your destiny is not in your hands; it is in the hands of the irrational consumer and society. The changes in their needs, desires, and demands will tell you where you must go. All this means that managers must themselves feel the pulse of change on a daily, continuous basis.... They should have intense curiosity, observe events, analyze trends, seek the clues of change, and translate those clues into opportunities."
— Michael J. Kami

Carpe Diem.