Dr. H. Lee Adkins, a primary care physician who runs Ft. Myers Family Medicine in Florida, recently changed his Web site, posting what he charges for everything from office visits to lab work. His move is part of a national push toward greater transparency in healthcare, as more Americans go without health insurance and there's expected to be an increase in people moving to high-deductible health plans that force them to consider the cost of services. Thirty-three states, including Florida and Michigan, have laws that require price transparency, according to the Deloitte Center for Health Solutions. Some medical and policy experts believe greater transparency will lower care costs.
BJC Healthcare, the area's largest healthcare system, will provide a 25% discount to all hospital patients without insurance under a new class-action settlement agreement. Some uninsured patients treated in the past also may be eligible for refunds or discounts. Under the settlement, uninsured patients who were treated at a BJC hospital since Jan. 1, 1999, and paid some or all of the cost, may be eligible for a partial refund or reduction in their bill. Class members will be notified of their right to submit a claim for the refund. The discounts will also apply to uninsured patients receiving treatment until at least 2012.
The media are filled with reports of consumers seeking more control over their own healthcare. But we've found that with a few exceptions, healthcare executives and physicians are slow to adapt to this trend. Are the executives and physicians correct to move so slowly? Is the media correct in its assessment? Or has the emergence of consumerism in healthcare been over-hyped?
Rhea + Kaiser Marketing Communication's Healthcare Group set out to quantify whether a genuine disconnect exists between consumers and healthcare executives and physicians.
We engaged Synovate, a global research firm in Chicago, IL, to manage the study implementation and data tabulation using a random sample of their 72,000 household national consumer panel. In our recent online survey, 659 consumers representing the U.S. adult population responded..
The study clearly showed that most hospitals aren't adapting their organizations to embrace the sea change of consumers taking a much more active role in making healthcare decisions. The same disconnect extends to the vast majority of physicians, too.
The underlying reasons include the following:
Serious affordability concerns by consumers
A lack of pricing and performance transparency on the part of hospitals and physicians
Not providing consumers with the convenience and responsiveness they've come to expect from other retail service organizations
In the absence of objective measures, the majority of consumers rate their primary care physician and specialists as the same as other physicians or they don't know. Quality is assumed. There's nothing new here.
The study clearly shows that in this new era of consumerism, physician and hospital selection will be based on other differentiators.
Four themes emerged from our study. Consumers want:
Transparency to aid decision making
Convenience
Responsiveness
The same level of online connectivity they've come to experience from other retail service organizations
We suggest that forward-thinking hospital CEOs and physicians should shift their view from "inside-out" to "outside-in" by getting closer to their customers. By changing their viewpoint, hospitals and physicians will focus on the priorities consumers find important and appealing.
The most successful ones will reorder their priorities. Then they will communicate their shift in priorities to consumers in a differentiating and engaging fashion as any retailer would do.
What's important and appealing to consumers
There is generally a high degree of correlation between what's important and what's appealing to consumers.
Consumers expect their hospital and physicians to keep them well and to have access to the best. It's a given.
Our study then confirmed what we hypothesized: That consumers' idea of what is important and appealing in their hospital and physicians aren't what most hospital CEOs and physicians are focused on. Five of the top ten attributes ranked "most important" by consumers, and seven of the top 12 attributes ranked "most appealing" by consumers related to transparency in pricing and outcomes, convenience and responsiveness.
The following are the most important attributes, listed in order of importance, followed by the percent of respondents responding:
Keeping me well (73%)
Immediate access to specialist at forefront of medicine (68%)
Letting me know prices in advance (59%)
PCP at forefront of medicine (56%)
Receiving test results in 24 hours (51%)
MD ranking vs. peers (47%)
Hospital ranking on outcomes (44%)
MD and hospital treats most difficult cases (37%)
MD has EMR (30%)
hospital retains non-profit status (30%)
The following are the most appealing attributes, listed in order of importance, followed by the percent of respondents responding:
Keeping you well (80%)
Scheduling appointments online (72%)
Immediate access to specialists at forefront (66%)
Test results in 24 hours (67%)
Letting me know your prices in advance (66%)
Able to order prescriptions via the internet (64%)
Ranked in U.S. News & World Report (63%)
PCP at forefront of medicine (61%)
MD ranking vs. peers (60%)
Physician or hospital has EMR (60%)
Hospital ranking on outcomes (57%)
Regardless of age, consumers want online access for a variety of reasons related to convenience and responsiveness. It was surprising that the second most appealing attribute was being able to schedule appointments online over the Internet.
These results clearly shatter the old myth that all consumers think their physician has an electronic medical record. Prior research conducted in 2004 indicated at that time most consumers felt if their physician used a computer they had an electronic medical record. Today, most recognize their physicians don't have them. The consumer has become better educated.
Summary Conclusions and Recommendations
Physician quality and performance is viewed as a commodity by 60% of consumers. Quality is the price of entry. As a result it will be the other attributes related to transparency, convenience and responsiveness that will drive initial choice and loyalty.
We believe decisions about hospital and physician choice are now made with the same expectations as other retail transactions.
With few exceptions hospitals and physicians have a long way to go. But seismic shifts now occurring in healthcare have happened in other American industries. Examples include:
The automotive industry
The airline industry
The banking and financial services industry
Curt Ippensen is with Rhea + Kaiser Marketing Communications in Naperville, IL. For more information on this topic, contact Sue LaBarbera, management supervisor at R+K, via e-mail at slabarbera@rkconnect.comor by phone at 630-955-2533.
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No industry wants to be called inflexible, incompetent, arrogant, greedy, unresponsive, pushy, unethical, or careless, but that's how hospitals and physician groups described managed care companies in a recent survey.
Davies Public Affairs, a communication firm based in California, recently released its 2008 National Payor Survey, which asked 113 top healthcare provider organizations that represent 500 hospitals about payer negotiating behavior, business practices, and personal interaction. Hospitals leaders from 44 states and Washington, DC, who are responsible for negotiating contracts with major health plans, completed the survey during April and May 2007.
The results released this month are not pretty. Of the six large health plans featured in the survey, the managed care company hit hardest was UnitedHealthcare. A whopping 91 percent of those surveyed have an "unfavorable" view of UnitedHealthcare. When respondents were asked to choose which word or two best describe the Minneapolis-based payer in its dealings with hospitals and physician groups, 14 percent used the word "negative." The rest of the top five words were "difficult," "rigid/inflexible," "incompetent," and "arrogant."
The top issues hospitals and physician groups have with UnitedHealthcare are contract negotiations, fixing claims, processing/paying claims, and honesty and candor. Sixty-four percent of respondents remarked that UnitedHealthcare was the most difficult to negotiate with, pays the worst reimbursement rates, and has the worst reputation for dealing with critical hospital issues.
Though the highest percentage of respondents took aim at UnitedHealthcare, the company was not the only one bashed by hospitals and physician groups. Forty-eight percent of respondents rate WellPoint/Anthem unfavorably and 47 percent view CIGNA unfavorably.
The Davies survey was largely negative, but one managed care company that received mostly positive results was on the receiving end of negative publicity and dissatisfied providers not long ago. Aetna (57% favorable/37% unfavorable) has turned around providers by changing leadership and addressing provider concerns.
Altering a company's culture and dealings with clients are not easy, but, as Aetna showed, it is possible.
Brandon Edwards, the head of Davies' healthcare division, says providers would prefer better relationships with payers. Providers "want legitimate, honest P4P programs, data exchange, streamlined business processes, and clarity. Those things are achievable if all parties really want the same thing--access to quality healthcare at reasonable rates, delivered as cost-effectively and efficiently as possible," says Edwards.
So, how can health plans improve provider relations? I spoke to one of the leading advocates for payer-provider collaboration, Emad Rizk, MD, president of McKesson Health Solutions, which was not reviewed by respondents in the Davies survey. Rizk says McKesson has created a collegial relationship by reaching out to providers. In the state of Illinois, for instance, McKesson approached 10-15 top hospitals to forge better working relationships. "We're not going to do it without you and you're not going to be able to do it without us," Rizk says McKesson told the hospitals.
Rizk gives seven tactical steps for payers to improve provider relationships:
Pick a geographic area of density where the payer can have a significant impact on physicians and providers, such as if a managed care company covers more than 15% of the patient population in a region.
Identify a specific disease or specific population that you want to manage.
Identify the physicians and hospitals that you want to target.
Outline the clinical processes that both the payer and provider can agree upon.
Outline the outcomes that you want to achieve in a specific timeframe.
Outline the financial incentives that you are going to give providers.
Agree on how often you will share data with them.
Many in the industry view the Davies survey as a negative, but rather than bash the findings, managed care companies should use the results to improve relationships with providers.
It doesn't serve anyone (most especially the patient) to continue this bad blood.
One of the biggest issues facing healthcare is the mistrust between payers and providers. Emad Rizk, MD, president of McKesson Health Solutions, gives his ideas as to how payers can create a more peaceful coexistence with providers.
Riley Hospital for Children, part of Clarian Health in Indianapolis, has developed an ongoing awareness campaign to promote child safety. During the colder months of the year Riley Hospital for Children was seeing scald injuries that, with some safety precautions, could be prevented. With that motivation, the health system decided to start the second wave of their safety awareness campaign complete with an original, informative, approach.
To get things started, Clarian looked to their injury protection experts to establish how to convey the messages of safety properly. According to Holly Vonderheit, Marketing Manager for Riley Hospital for Children, nurses in the burn units were seeing a lot of injuries resulting from children in the kitchen. "A lot of food companies have developed products that children can easily cook themselves, like macaroni and cheese, however most microwaves are usually above stoves or in a place where children would have to reach up and pull the food down." Though there are other ways scalding injuries can occur, it was from this concept that Riley Hospital got the inspiration.
Using the public advocacy message "Kids scald fast. Cool it first," designed with help from Clarian's agency The Heavyweights, also located in Indianapolis, Riley Hospital developed a full-scale campaign to help get the message across complete with an interesting piece of collateral: microwave clings.
"Educational materials can only go so far," says Vonderheit, "we needed a visual reminder for families." The clings, which were distributed at schools, through civic groups, and also at local appliance retailers, are safe for the microwave or refrigerator door, removable, and clearly get the message across in an eye-catching way for both parents and children.
With an effective concept, Clarian Health and Riley Hospital for Children created a campaign that also helped to form an important and valuable relationship with the Indiana Department of Child Services, which helped to expand the reach and exposure of the campaign by dedicating portions of their radio buys to the message.
"This campaign was a great way for two groups, whose missions focus on safety, to work together," says Vonderheit.
For additional information on the safety awareness campaigns visit www.acalltochange.org.
Kandace McLaughlin is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kmclaughlin@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
For the past week bloggers and reporters for marketing and advertising pubs have been typing furiously about Nationwide Children's Hospital in Columbus, OH, which plans to name its trauma center after local clothing manufacturer Abercrombie & Fitch, which donated $10 million to the hospital.
The retailer's marketing, aimed at teens, is racy and provocative, damages the self-esteem of young girls, promotes unrealistic body images and exacerbates eating disorders, says the Boston-based Campaign for a Commercial-Free Childhood.
The group has launched a letter-writing campaign urging the hospital to drop its naming plans. The call-to-action page comes complete with pictures from Abercrombie & Fitch ad campaigns, some of which have black bars across the racy bits.
When I wrote last fall about accepting donations from charitable organizations (see A Money Mission and What's in a Name?), opinions were varied about the concept of naming hospitals or parts of hospitals after corporate donors. Some said that hospitals should proceed with caution; others said it was downright irresponsible.
Children's, I should point out, was confident in its decision, in part because it had buy-in from community leaders and in part because charitable giving to Children's is so ingrained in the fabric of the community that it is seen in a positive light, according to Jon Fitzgerald, president of the hospital's foundation.
So who was right--the experts who warned of dire consequences for the hospital or those who were confident that the hospital's brand wouldn't be harmed?
It's still early to tell, but it does seem as though Abercrombie is taking the brunt of the beating on this one.
A psychiatrist quoted in the advocacy group's press release calls Abercrombie & Fitch a "corporate predator." The form letter that group wants supporters to sign reads, in part: "When it comes to sexualizing children, Abercrombie & Fitch is among the worst corporate offenders. These naming rights will entwine an institution of healing with a company whose advertising is notorious for undermining children's wellbeing and will promote the exploitive Abercrombie brand to children in a hospital setting."
So Abercrombie is predatory and exploitive, but the hospital is an institution of healing. And, after all, no one is asking Children's to give back the $10 million.
So what's the problem?
The problem is that the hospital never had control over Abercrombie's brand. And now it's lost control of its own image and message. The popular press and online chatters are not making the distinction that Abercrombie did not buy naming rights for $10 million, but rather the hospital named the trauma center after the company as a way to honor its generosity, as it does for all of its major donors.
It's a subtle but important distinction that's lost in the din of sensationalism, sex, and protests.
Take note: The deadline to throw your organization's hat into the ring for the HealthLeaders Media Top Leadership Teams, which honors the best in senior leadership teamwork at hospitals, health plans and medical group practices, is March 27. This year's conference will be held October 16-17 at The Drake Hotel in Chicago--our 2008 marketing awards will also be held in Chicago, on October 15. The deadline to submit entries for that program is May 30.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
Marketers still have not figured out that the interaction between people on social networks is unscripted. Like the people interacting within these networks, marketers have to learn to just react to what's going on.
Hospital marketers often stroll the halls of their facility, confident and nonplussed in their roles as healthcare marketing professionals. They meet the eyes of patients and empathize with their plight as they continue to talk about the newest expansion, brand campaign, or survey results. But when it's the marketers turn to be the patient, boy do things feel different.
For some organizations, it's just smart business to raise prices when the country is facing a recession. It may also be necessary. Cost of goods may be on the rise, or labor might be costing more for most businesses. But there is a right way and a wrong way to raise your prices.
