There is likely no other form of marketing communications more compelling than word-of-mouth, the recommendation from a person you like and trust. It's no wonder that virtually every business-to-business marketer prizes it. But some businesses, especially on the B2B side, rely far too heavily on organic word-of-mouth strategies and, specifically, on acquiring new customers primarily through referrals, according to this article in Marketing Profs.
Blogger Keith Jennings notes that the Olympics has the torch relay, medal ceremonies backed by national anthems, and opening and closing ceremonies. Hamilton Medical Center, in Dalton GA, has the annual Love Light Tree during the winter holidays. The American Cancer Society has the "Relay for Life," he adds. Jennings then asks marketers what do you (or can you) offer that brings people together year after year that garners tremendous publicity and good will?
A growing number of Americans are so disgusted by the state of healthcare that they are willing to tear down the system and start anew. Studies show that Americans want a new healthcare system in which a provider coordinates a patient's care and in which physicians, pharmacists, therapists, and other healthcare providers communicate on a secure computer platform.
Americans may not know the phrase "medical home," but that is what they are describing. They want a medical home because they have seen how a lack of coordinated care affects them. They don't understand why they have to fill out medical and family history forms at each doctor's offices, why their doctors don't communicate with one another, or why their physicians request duplicate tests because one doctor doesn't know what another is doing.
The concept is being tested in pilots throughout the U.S., and the Centers for Medicare and Medicaid Services is planning a demonstration project in 2010. For those struggling with the healthcare system, these far-off dates are not comforting. They want better care coordination now. Rather than wait to follow CMS' lead, there are health insurers who are funding medical home-inspired programs. Progress has been slow and more players are needed to make the medical home more than a movement.
Here are four ways healthcare leaders can jumpstart greater care coordination:
What's needed first is a groundswell. For this reason, providers must demand better care coordination. There are groups working on promoting the medical home, including The Patient-Centered Primary Care Collaborative. Physicians need to join forces and reach out to other healthcare stakeholders so a legion of leaders can advocate these kinds of care improvements. Once that collaboration is accomplished, they need to reach out to the payers. Healthcare is so stuck in its silos that physicians might not realize that payers agree that care coordination is needed. Care coordination is not just a patient care issue, but could ultimately improve physician payments as a number of payers have implemented pay for performance programs through care coordination.
The next step is for payers to test the medical home by offering grants to create technology platforms that allow for greater communication across networks. This is happening in small pockets of the country, such as Massachusetts' eHealth Collaborative (funded through a $50 million commitment from Blue Cross Blue Shield of Massachusetts) and Rocky Mountain Health Plan's medical home program. Better technology isn't just a communication or convenience issue, but affects quality of care and costs.
Payers must develop programs that adequately pay providers for spearheading this kind of care coordination. To truly create a medical home, physicians will need to implement technology, hire staff, and coordinate the patient's care. They are not going to welcome a new venture as large as the medical home without payers stepping to the plate.
Once those pilots are completed, researchers must conduct objective studies to see which programs lower costs, improve outcomes, and provide for care coordination, and which ones do not.
Most agree the current healthcare system is not working properly. It doesn't make sense to continue to pump money into a flawed system and get the same results. A better alternative for health insurers is to improve processes, through concepts like the medical home.
As The Commonwealth Fund study shows, the healthcare-paying public is not happy with the services provided. Are you going to answer your customers' requests or wait until the government legislates wide-ranging changes to the healthcare system?
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So I'm thinking of taking a part-time job as a healthcare secret shopper or mystery patient. In the past year, I have been to five different hospitals as a family member or, most recently, as a patient. And since, in the past, I've railed about poor customer service and dirty bathrooms, I figured this time I ought to give credit where credit is due.
On Friday afternoon I went straight from my doctor's office to a nearby community hospital, which squeezed me in for an emergency CT-scan because there was, my doctor told me, a 10% chance I had appendicitis.
(A side note: I'm not writing this column from my hospital bed, and I didn't need an appendectomy. The moral: Never go to your primary care physician with a mysterious stomach pain on a Friday afternoon, because she will go to the ends of the earth to get a diagnosis before you ruin her weekend.)
It's been pouring rain for about two months straight here, and this afternoon was no exception. And, of course, I'd forgotten my umbrella. Which is why I was so relieved to see a clear sign at the entrance to the hospital parking lot directing me to the free valet parking. My very first experience at this hospital on this day was a positive one. And so was the second: The woman behind the window at the front desk greeted me immediately and pleasantly directed me to radiology.
Of course, by the time I got off the elevators, I couldn't remember if she said to take a right and then a left or a left and then a right. I stood there for a while. I was overwhelmed because this had all happened so quickly, worried that my appendix was about to burst, and now confused about which way to go.
And that's when a hospital employee came over to me and said "You look a little lost." And then, rather than just giving me directions to radiology, he actually walked me to my destination.
"Hey," I said. "You must read my columns." (OK, I didn't really say that, but I'd like to think he does.)
And this wasn't a fluke—it wasn't just one guy who took pity on a pathetic-looking patient. Later, I saw a physician in a white coat walking an elderly woman to her destination. After they parted ways with a smile, I heard the older woman say to herself, "Well, wasn't that nice of her?"
Guess what? You can spend $50,000 on a slick TV and radio campaign. You can spend a million dollars on the latest piece of equipment. You can spend half a billion building a new wing or tower.
But being nice is free.
There should not be a hospital in the world that cannot manage to pull this off. What could possibly be stopping you? Is it too hard, too expensive, to train your employees to say hello? To make eye contact? To smile? To be friendly?
In fact, it is neither difficult nor expensive. In staff meetings, talk about the power of being kind. Put the occasional reminder in the employee newsletter that the little things make a difference. Reward employees when you catch them doing something nice. Shout it from the rooftops when a patient or family member writes a letter of thanks. Celebrate when patient satisfaction scores improve. Hire people who know how to smile. (Or, as a last desperate measure, hire me to be a mystery patient at your hospital.)
And the return on that miniscule investment? Better patient satisfaction, which leads to better HCAHPS scores, which leads to better quality rankings, which leads to a better reputation, which can make folks, when they have a choice of where to go for care, choose you.
Being nice isn't just free—it's a good investment.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
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The idea of consumers managing their own healthcare has been around for decades. Walter McClure's championing of a "buy right" model for healthcare included both employers and consumers engaged in value-based purchasing, and dates back to the 1970s. It re-emerged with the promotion of consumer-directed health plans (CDHPs) in more recent years, adding personal health spending accounts (HSAs) as a way to make consumers more accountable for their health and healthcare management.
Making consumers more accountable has been suggested as part of the recent "patient safety" movement, with consumers advised to ask the right questions of their healthcare providers, and monitor the care they are offered for potential mistakes. Shifting more responsibility and costs to consumers is widely lauded as the way to overcome the "tragedy of the commons" where consumers' lack of "skin in the game" makes them lean toward unnecessary or overly expensive healthcare, along with slovenly management of their own health.
Shifting more roles and responsibilities to consumers is an ideal "market solution" to the healthcare cost crisis because it reduces the government role and business costs simultaneously. But is it realistic to expect consumers to adopt and execute their role effectively?
One way to examine this question is to consider three key elements with respect to consumers' behavior in general:
Their motivation to carry out their role
Their capacity for doing so
Their likelihood of being conscious of the proper thing to do at the right times. (referred to as the "MC2" model of consumer healthcare demand in S. MacStravic & G. Montrose, Managing Health Care Demand, Aspen, 1999.)
Motivation
It can easily be argued that consumers ought to be sufficiently motivated to manage their health as well as healthcare demand for their own intrinsic reasons. Their health and life quality greatly depend on how well they manage their health behavior, as well as healthcare use.
Consumer behavior has been credited with affecting, if not determining, as much as 50-75% of all health problems and healthcare use. Recent epidemics of HIV/AIDS, obesity, and diabetes have clearly shown that consumers' self-interest in their health is by no means sufficient motivation for them to behave "correctly," however. Employers and insurers have recognized that intrinsic motivation is not enough. The majority of employers who offer their employees (along with dependents or retirees in many cases) health management programs also offer incentives to entice them to participate.
These range from as little as a few dollars worth of T-shirts or coffee mugs to as much as thousands of dollars in health insurance premium reductions, cash or other rewards. And the effectiveness of incentives has been clearly demonstrated by making the difference between participation rates in the 10-30% range and those as high as 90-95%.
Capabilities
There is no strong case available indicating that consumers are inherently capable of health self-management. All the suggestions for consumer-directed health management that I have read address the necessity for employers, insurers, government, and cooperating providers to supply additional education, training, or information to consumers in order to empower them to carry out such a role effectively. In fact, the combination of managing both their health and their healthcare effectively calls for an immense information infrastructure investment.
Given the wide variations in consumer capabilities in general, with respect to factors, such as innate intelligence, literacy, language skills, reading and learning speed, etc., it is clear that we do not really know how much of an investment in capability will be necessary to enable truly effective consumer management of their health. We lack the scientific foundation to even identify and promote what are the best approaches to health management in general, much less what are the best ways to enable consumers to use them
Consciousness
While this factor is ".honored more often in the breach than in the observance?" (Shakespeare's Hamlet), it is increasingly recognized as an essential third leg in supporting consumer behavior management—whether by themselves or by others. Reminding consumers of the right thing to do at the right time and place, using the right media and messages, is recognized as an essential element in marketing, for example, as well as management.
Fortunately, recent technology developments in computer analysis and communications make the delivery of reminders far more cost-effective than would have been true in the past. Computer-automated analysis of individual consumer characteristics, preferences, attitudes, and personality traits, along with "brain science" learning of how emotions affect behavior, along with rational thought, have vastly increased the potential for effective messages to be created.
Along with the analytic potential, developments in wireless and Internet communication have made it dramatically less expensive to deliver messages to consumers at the right time and place, rather than relying on less effective disconnected remote communications or less efficient face-to-face alternatives. As health management programs have moved from a narrow chronic disease focus to holistic health and entire populations, these communications technologies have become far more widespread, if not dominant in such uses.
The challenge for all stakeholders who champion the idea of consumer self-management of their health and health care is to ensure that all three elements are in place to motivate, enable, and remind consumers how they can and should behave. Given the millennia-old challenges of governing consumers' public and private behaviors in general, along with managing their employment behaviors and marketing their purchasing behaviors, this is not a challenge to be taken lightly.
Scott MacStravic, Ph.D., is semi-retired after a 35-year career as a hospital and health system executive, a professor and consultant on hospital planning, healthcare marketing and customer relationship management. He is the author of 10 books and 500 articles on these subjects. He may be reached at scottmacstra@earthlink.net.For information on how you can contribute to HealthLeaders Media online, please read our Editorial Guidelines.
Nearly a quarter of Americans have reduced the number of times they see their doctor because they want to save money in these tough economic times, according to a survey released by the National Association of Insurance Commissioners. Eleven percent of those surveyed also said they had cut back the number of prescription drugs they take or the dosage of those medications to make the prescription last longer and save money. In response to the survey, some physicians noted an increase in such behaviors by their patients and were concerned about potential health consequences.