Retail health clinics are adding treatments for chronic diseases to their repertoire, hoping to find steadier revenue but putting the clinics into greater competition with doctors' groups and hospitals. The new strategy comes as an initial thrust by clinics providing basic services fizzled. As part of their efforts to halt losses at the clinics, the chains are lobbying for more insurance coverage, and angling for a place in pending healthcare reform legislation.
The British healthcare system has two major strengths that the U.S. can learn from, according to a study: strong primary care and NICE, the agency that assesses and approves reimbursement for cost-effective treatments. Primary care docs in the U.K. are well-trained and are thus able to reduce hospitalizations, unwarranted investigations, and unneeded prescriptions, according to authors of the study published in the New England Journal of Medicine.
As the Obama administration and Congress struggle with broad health policy legislation, the technology industry is pursuing the opportunity in digital health records. Although most of the government money will not start flowing until next year, the companies hoping to get their share include technology giants like General Electric, IBM, and Verizon. Also in the hunt are smaller health technology specialists like Athenahealth, eClinicalWorks, and Practice Fusion.
More than half (55%) of individuals age 50 or older who were questioned in a new survey conducted a few days ago by AARP, the American Medical Association (AMA), and the American Nurses Association (ANA) do not think enough physicians or nurses will be available to support their healthcare needs in the future.
In addition, the same percentage said they were very concerned health insurers would not pay for medical treatment or prescription drugs for them—or someone they know. Overall, those answering the survey reinforced the idea that despite scare tactics deployed this summer on health reform, many think that "the current health system is not sustainable and has to be fixed," said Nancy LeaMond, AARP's executive vice president, at press conference announcing the results on Wednesday.
Using considerably stronger language from earlier this summer, Nancy Nielsen, MD, AMA's immediate past president, said, "This summer, the rhetoric on health reform boiled over at times and it was often more heat that light."
She said AMA was joining with AARP and ANA "to urge Congress and the president to build on the national conversation" and "work fearlessly in the face of fear-mongering" to achieve "meaningful" health reforms this year.
The poll is a reminder that "the status quo isn't acceptable," Nielsen said. "We shouldn't lose sight of that as this debate heats up and the reset button gets pushed. What we want is to build on what works and fix what doesn't work."
Rebecca Patton, ANA's president, said the survey showed the country's "unease with our current healthcare system"--including the current level of nursing. More than two-thirds of those questioned said they did not think there were enough nurses to support the healthcare system today.
Among the other findings:
97% of respondents thought that being able to choose one's physician was "very important" or "somewhat important."
69% of respondents reported hearing "a lot" about healthcare reform in the media.
42% reported that they—or someone they knew—spent time trying to get an insurer to pay a medical bill.
87% said it was "very important" or "somewhat important" for physicians to get reimbursed adequately so they could continue to get reimbursed by Medicare.
As Congress reassembles and the health reform debate heats up anew, a lot of what is under discussion has to do with correcting a system of unfairness.
The reports, audits and analyses we've written about so much in recent months speak to the wide variations in availability and quality of care, as well as in the differences in costs of services and health insurance.
The poor have a harder time getting quality care than the rich.
The insured have an easier time financing care than the uninsured.
Those in small rural areas have more trouble finding quality care than people in many large urban areas.
Doctors in some high-cost parts of the country get paid a lot for treating patients, while doctors in other high cost parts of the country get paid much less.
The people in McAllen, Texas, may get too much care, while the people in some communities in Alaska get too little.
In one region of the country, for example, a Medicare beneficiary is eligible for a certain procedure, such as surgery with Cyberknife technology, while in another region, the same beneficiary's Cyberknife procedure would not be reimbursed.
And a lot of this is just unfair, unequal, perhaps even unethical.
But if getting our country to a system of fairness is the argument, then is the next step making sure that healthcare for all is a right? Many in this country don't agree that it is. They perceive it as a fundamental necessity, perhaps, but not as a fundamental right.
But I may be off target.
Ernie Moy, MD, steered me in a slightly different direction. He's the medical officer for the Agency for Health Research and Quality, the federal group that has been churning out volumes of documents showing disparities and inequalities in healthcare services for people across the country.
For his agency, the question is not one of fairness, or rightness or wrongness of access. "Our charge is not ethical in nature, so from our perspective, we don't talk about the ethics of providing care," he says.
Rather, what the AHRQ tries to do is show what is scientifically proven to work.
"We think of it this way: Either a person would benefit from getting a particular service, or they wouldn't benefit. And having different rules, or allowing different rules, suggests that somebody (under one set of rules or another) is getting suboptimal care."
Quality, not fairness, gives the argument a different perspective.
With millions of dollars allocated in stimulus funds, his agency is trying to make sure the right analyses are done so that policymakers and providers will agree on what sorts of fundamental, basic minimum care—care that works pretty much all of the time—can be provided for everyone.
So people in Alaska get the same kind of care as people in Texas, and that in both places the quality of it is just as good—in a proven, scientific sort of way.
"When there is federal financing of healthcare, and there's a public good component to it, you would expect that beneficiaries would receive healthcare under a comparable set of rules," Moy says. But that kind of a system doesn't yet exist.
"If you're a diabetic, there are certain things that you need to have to manage the disease. And yet we see highly variable rates in people getting that care—often related to their insurance coverage, or their race, ethnicity, or the part of the country they're living in."
Moy says, "We don't like disparities because they indicate inefficiencies, departures from high-quality care."
He pointed to a study published in the New England Journal of Medicine by Rand researcher Elizabeth McGlynn several years ago that found that less than 55% of Americans received recommended, preventive, acute, or chronic care.
"The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public," the study concluded. ‘Strategies to reduce these deficits in care are warranted."
So maybe thinking about the health reform debate under a light of quality, rather than fairness, does put it in a different perspective.
The long-term cost to the federal government of a healthcare reform bill that includes a public option health plan would add $1 trillion to the deficit between 2020 and 2030 because healthcare costs would outpace revenues, according to new estimates by The Lewin Group.
The report, Long-Term Cost of the American Affordable Health Choices Act of 2009: As Amended by the Energy and Commerce Committee in August 2009, found that America's Affordable Health Choices Act of 2009 (HR3200) would constrain the growth in the federal government's healthcare costs to about $39 billion between 2019 and 2019, but would fail to keep costs from growing faster than funding sources in the long-term, beyond the normal 10-year budget projection period.
The Lewin Group, which is owned by United Healthcare Group, one of the country's health insurers, also estimates that:
30 million people would gain insurance coverage in 2011 under the act, which would reduce the uninsured population by 60%.
41 million people would obtain health insurance through newly-created health insurance exchanges, including 21 million in the public plan. Medicaid enrollment would grow by 10 million.
Families in which all members now have insurance would save an average of about $176 under the reforms, while families with one or more uninsured members would, on average, see an increase in family health spending of $1,410 per family.
Overall, employer health spending would increase by an average of $305 per worker. Employers that now offer insurance would see an increase in health spending of $123 per worker, while employers that do not now provide coverage would see an increase averaging about $813 per worker. The study notes that most economists believe that employers would offset the cost increases with slower wage growth. As a result, families and individuals would ultimately bear the burden of higher healthcare costs. Small businesses that now provide insurance would save up to an average of $811 per worker due to a tax credit.
The number of people covered in employer-sponsored plans—outside of the health insurance exchanges—would fall by 11 million, and overall enrollment in private plans would decline by about 900,000.
The Act would result in a net savings to state and local governments of about $62.6 billion from 2010 through 2019, due to savings in safety-net programs. States would save about $125.7 billion over the 2020 through 2029 period.
A teenage boy and his mother were sitting at the breakfast table in their Minnesota home when the boy noticed a hospital-sponsored article in the newspaper about people who suffer from eating disorders. "I'm one of them," he told his mother. The young man soon checked himself in to Park Nicollet Health Services—one of the organizations that sponsored the article—for treatment.
The Minneapolis health system partnered with a local television station and newspaper to sponsor the Stay Healthy Minnesota campaign, which features educational print ads, TV spots, and Web content about several health issues. The campaign began in 2007 when the Milwaukee-based Zizzo Group Advertising + PR agency suggested the health system create an educational campaign similar to ones Zizzo had done for hospitals in other markets.
"We really wanted to increase our brand presence, our branding, our logos, and our colors," says Carol Greenland, vice president of marketing and communications. "We've progressed and learned and we really wanted to be out there more often."
The ads and articles feature a different health issue each month, ranging from the treatment of cancer and Parkinson's Disease to bariatric surgery.
Each print ad features a large photo of a patient who was treated at Park Nicollet alongside an article written by a Zizzo associate and featuring specific Park Nicollet physicians.
In addition to increasing brand awareness, Park Nicollet hoped the campaign would increase its patient volume.
The recent eating disorder campaign has done particularly well and information sessions are always filled, Greeland says. In fact, they've seen such an increase in patient volume that the eating disorder institute has had to increase its staff.
Editor's note: The following article originally appeared jn the August, 2009 edition of Healthcare Marketing Advisor, a monthly healthcare marketing newsletter published by HealthLeaders Media.
It's time to take your hospital into the world of social media marketing, but first there are a few items to consider. Too many organizations are pursuing social media without first developing the strategic rationale that supports and guides the program. The appropriate first step is the development of a social media marketing plan.
When developing such a marketing plan, there are many tools for you to consider employing, and the options grow more varied every day.
For example:
Blogs (e.g., Wordpress, Blogger, and Typepad)
Social networks (e.g., Facebook, MySpace, LinkedIn, and Ning)
Microblogging (e.g., Twitter, Pownce, Tumblr, and Jaiku)
Social bookmarking/content sharing
(e.g., Delicious, Digg, Diigo, Fark, and Squidoo)
Discussion boards and forums
Online video (e.g., YouTube and ICYou video)
Patient communities (e.g., Patients Like Me, MedHelp, Daily Strength, and Revolution Health)
Podcasting
Photosharing (e.g., Flickr)
Presentation Sharing (e.g., Slide-Share, myplick, and SlideBoom)
Virtual worlds (e.g., Second Life)
Wikis
Widgets
But looking at social media tools is really putting the cart before the horse. You should get familiar with these tools, but before taking action, you need a strategy for how you'll engage your stakeholders and target audiences using social media.
How do you get started? Generally, your social media marketing plan should emulate the following typical marketing communication plan:
Identify goals and objectives
Conduct market analysis (e.g., look at trends, needs, competition, and best practices)
Implement social media program
components, including integration
with a traditional campaign
Assess and allocate resources
Monitor and measure
That's the big picture. The following steps specify what you should consider when creating a social media marketing plan for your hospital. Although there are several steps to the process, this need not be an overwhelming endeavor. Given what you already know about your market and your target audiences, you should be able to draft a preliminary social media marketing plan in just a few days. Don't try to write a book.
Keep it simple and direct. For example, focus on:
Participation. If you're not involved in social media, get involved. Consider this remedial training. At a minimum, join Facebook, LinkedIn, and start following some industry blogs. You will find it difficult to sell or even construct a social media marketing plan if you aren't familiar with the functionality, strengths, and weaknesses of the various platforms.
Culture and preparedness. Start by assessing your organization's appetite for social media. How risk averse is it? Fear in the C-suite is one of the major obstacles you'll face when implementing a social media marketing program. Determine the steps you need to take to bring members of your leadership along and prepare them for this venture into the world of social media. Start feeding them a steady diet of articles, white papers, and books on the subject.
Ideally, presenting them with a well-reasoned, strategic social media marketing plan will help make your leadership more comfortable with the idea.
Target audience. Define your target audience and key stakeholders and research how they use social media. This will provide insights that you can apply to your plan.
Objectives and goals. Take each group (e.g., grateful patients, referring physicians, employees, reporters, influentials in the community, and your board) and outline its associated marketing objectives.
Compare these objectives to what you've learned about how each group currently uses social media. Also look at industry best practices and review the activities of your top competitors. As you move forward, you should be prepared to adjust your goals based on new learning about the potential that social media represents. You may well learn that possibilities exist that you had not anticipated, and this may affect the goals you set.
Desired outcomes. Clearly define your organization's goals. They may include increases in brand awareness/ stature, enhanced search rankings and Web traffic, improved preference, engaged brand ambassadors, and growing patient volumes.
Be as specific as possible. The desired outcomes should affect the ways in which you measure results.
Toolbox and channels. Identify social media channels that will help you accomplish your marketing objectives for each audience. This will become your toolbox.
The vehicles you select must consider several factors, including resources, desired outcomes, and their ability to effectively deliver your message and content. This assumes that you know the strengths of various social media platforms. (Hopefully, you've done the earlier analysis of each group's use of social media.)
Identifying the appropriate social media tools may require the most research. For example, you may not know which LinkedIn groups reach a specific target audience, so you'll need to get online and start digging around. Join those groups and start following the conversation. Find out what these people care about. Identify the top bloggers and thought leaders that you want to influence. Start following those blogs and monitoring those conversations.
Integration. Define the process you'll use to integrate the program with the traditional marketing and branding efforts of your organization. And don't forget about PR and media relations. There are many great social media tools that can make your PR program more effective, such as pitch engine, LinkedIn, filtrbox, and Meltwater News. Be sure to incorporate those into the plan. Consider, too, the role of social media in internal communication.
Resource allocation. If you allow it to happen, your social media program may end up dominating your life. That fear keeps many people from taking the plunge. It is vital that you make your program sustainable, avoid overtaxing your internal resources, and fend off social media fatigue.
You'll need to get tactical by identifying how you'll use each platform in your plan given the internal or external resources you have available. Much information can be repurposed and shared within various social media platforms.
A simple press release can be distributed through LinkedIn groups, become a blog post, a tweet on Twitter, and fodder for the wall of your Facebook group. You must also define work flow and who will do the work. Who will develop content for these various outreach mechanisms? How will information travel within your organization to the content generators?
It's important to recognize that you don't have to do everything at once. You will be more likely to experience success if you avoid biting off more than you can chew. Start small and you can always grow the program over time.
Measurement. Determine how you will measure results, knowing that not everything can be measured. Build these measurement tools into your plan. Whether it's Google Analytics for your blogger site, Wordpress' built-in analytics (e.g., page views, referrers, and comments), Technorati's blog rankings, friend counts, or member volume on your Facebook group, it is not difficult to find meaningful ways to measure the appeal and relevance of your social media efforts.
It is also important to measure productivity on your part, not just the activity of your target audience. This means you should measure your posting frequency and your level of engagement.
Conversation tracker. Develop a plan for actively monitoring social media conversations. It is essential that you know what's being said about your brand online. The most obvious tools are Google Alerts and Yahoo! Alerts. If you don't have these set up for your hospital, you should do so immediately. Each service will send you e-mail alerts when your keywords come up in blogs or traditional news reports.
This article originally appeared jn the August, 2009 edition of Healthcare Marketing Advisor, a monthly healthcare marketing newsletter published by HealthLeaders Media.
Although marketers have made major inroads in reaching online audiences, their efforts have gained little traction with female consumers, according to new research by ad:tech Chicago and Q Interactive. A study that analyzed how women engage online with brands finds that 75% of women reported that social networking sites have little bearing on their purchasing decisions.
A growing amount of customers are flocking to social networks to comment about their brand experiences and companies are logging-on to manage customer relationships. Twitter has emerged as a primary destination for consumer feedback, having grown 1,928% between June 2008 and June 2009, according to Nielsen.
