It's pretty rare that I have a hard time forming an opinion on any given topic, but I'm conflicted about the latest healthcare marketing controversy. At issue: Should newspapers and hospitals team up to provide healthcare content? A number of arrangements have drawn fire of late—including a newspaper that "sold" its health section to a local hospital, which then provided content for the section, and a TV station that had an exclusive arrangement to run stories that one of its local hospitals suggested.
Now two journalism trade groups have condemned the practice. The Association of Health Care Journalists and the Society of Professional Journalists are urging media outlets to avoid arrangements with hospitals that improperly influence healthcare coverage, calling such partnerships unethical and saying they interfere with independent news coverage of healthcare.
I've been on the fence about this one for a while because I can see both sides so clearly. As a reporter, I cringe at the thought of allowing any organization to influence editorial content, especially if there's money involved. As a reporter who covers healthcare marketing, I think sponsoring a special section on health in the local newspaper is a smart idea.
And it's not like this is anything new: Local newspapers run "advertorial" content all the time. Those wedding, parenting, real estate, and vacation inserts are a vehicle for businesses to promote their services. The articles in those sections aren't hard-hitting news; they're thrown together to make money for both the newspaper and its advertisers.
Apparently, it's OK for florists, baby furniture salesmen, Realtors, and travel agents to make money. But hospitals and health systems are supposed to be above all that. Newspapers, too.
In fact, newspapers and healthcare organizations have a lot in common. They're each a business that has to pretend it's not a business and both industries are struggling financially.
Newspapers and hospitals are both viewed by the public as altruistic organizations that exist first and foremost to serve the public. They shouldn't be in it for the money—hospitals should be saving lives and newspapers should be exposing corruption. They should not be wasting their money on such vulgarities as marketing, advertising, and public relations.
It's as if the public has no notion that it costs money to run a hospital (or a newspaper, for that matter). If no one signs the checks and pays the bills, lives go unsaved and corruption goes unexposed.
So where is the line between right and wrong, here? Unfortunately, there are no easy answers.
You'll probably never convince the public that a hospital is, in fact, a business. But you can't stop marketing and just hope the patients will wander in on their own, either. You can't stop paying the bills and hope the lights stay on.
While I'm figuring it out, I suggest you start being a little more careful with your ad buys. And transparent in your relationships. And go on pretending that your hospital doesn't need money to operate.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
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NASCAR Nationwide Series driver Brad Coleman, of the No. 27 Ford Fusion Kimberly-Clark car, received 27 helping hands during the Kroger 200 at O'Reily Raceway Park.
The event marked the 10th year of a partnership between Kroger Central Division, sponsor of the race and owner of food stores, pharmacies, and fuel centers in the Mid-Atlantic States, and Riley Hospital for Children (located in Indianapolis). To celebrate, Kimberly-Clark worked with Riley Children's to orchestrate painting handprints representing 27 Riley patients and their families onto Coleman's race car.
"We've been the beneficiary of Kroger activities in the past," says Jason Mueller, communications manager for Riley Children's Foundation. "This awareness event supported an annual fundraising event that Kroger hosts for us—the 'Race for Riley' go-cart event. So, this partnership with Kimberly-Clark was just one way to branch off and further our relationship."
The handprints were a change from the typical sponsor-driven paint scheme and were done with multiple colors and with the children's names in them. Across the car's hood read the slogan, "Making a difference, hand in hand."
"The kids represented on the car were current and past patients that we knew would appreciate the opportunity of having their names on the race car," says Mueller. "It was one way to get their minds off treatment while enjoying one of their interests."
Riley Hospital hosted a 'NASCAR party' the day before the race so that Coleman could visit with the children who would be featured on the car. "It is very inspiring to have these children featured on our race car . . . I'm thrilled to be a part of such a one-of-a-kind program," Coleman said in a statement.
For Riley Hospital and the patients and families involved the event was especially meaningful. "We are very excited that these children will be a part of such a memorable event," Mueller said. "I know these families have been through a lot and are grateful for the opportunity."
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.
One thing that community hospitals have in common—at least if they want to be successful in the years ahead—is a strong tie to the community. Most of these facilities exist because the community built them. That connection is what helps keep many of these small-town hospitals open amid declining reimbursement rates and the rising ranks of the uninsured. What the community thinks matters. And many communities place a high value on local autonomy because they are invested—either through taxes or donations—in the local hospital. They want to ensure that their hospital has their best interests at heart.
But maintaining independence is becoming increasingly difficult for smaller community hospitals. One of the biggest threats in today's market is increased competition from larger health systems that are expanding their reach into suburban and rural markets. This competition is forcing some community hospitals like Northern Hospital in Mount Airy, NC, and Hugh Chatham Hospital in Elkin, NC, to compete with larger hospital systems. Northern Hospital, which is spending $22 million to more than double its space for operating rooms and outpatient care, and Hugh Chatham, which is spending $41 million to increase capacity in its emergency room, are expanding their facilities so that they can treat more patients locally (complex cases will still be transferred to nearby tertiary systems).
Not all community hospitals have the resources to expand or modernize their facilities. Still, viewing a merger or affiliation with a large system as strictly a last resort may not be the best strategy. I've spoken to many hospital executives who say that independence is a state of mind. They maintain that it really doesn't matter if you are independent, partnered with a management company, affiliated with another hospital, or part of a hospital system, as long as you are meeting the needs of your community. What matters is that you have the resources required to update your facility, invest in new technologies, improve quality, or expand services.
If you can maintain independence and still meet the needs of your community, great. But if you are struggling financially and watching patient volumes slowly decline, you may want to think about joining or partnering with a health system sooner than later.
Not all partnerships are created equal. Some affiliations allow the community hospital to maintain a local board with reserve powers and independent decision making, while others do not. Waiting until you need a system to save your hospital from closing is not a good position to be in. It limits your choices and makes it more difficult to find a system that is a good fit for your facility and community.
Regardless of what option you choose to strengthen your hospital financially, experts contend, community support is a must. You need to maintain that connection to the community. Craft an elaborate communication strategy so that members of the community understand what is going on and why. And above all, try to build a consensus in the community that the path your hospital is taking is the best one.
Editor's note: This is my last column for HealthLeaders Media Community and Rural Hospital weekly. I'd like to thank all of the readers for the great feedback. I'll be taking over our leadership newsletter, HealthLeaders Media Corner Office, starting Friday. John Commins will be writing the Community and Rural Hospital eNewsletter.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.
Seven months after the Centers for Medicare and Medicaid Services spiked the disease management-inspired Medicare Health Support (MHS) program, CMS announced last Thursday that a physician-run demonstration improved quality of care and saved money in the areas of congestive heart failure, coronary artery disease, and diabetes mellitus.
The 10 physician groups taking part in the Physician Group Practice (PGP) demonstration project earned $16.7 million in incentive payments and four of the groups earned an additional $13.8 million in performance payments.
Five of the physician groups also achieved benchmark quality performance on all 27 quality measures, and 10 of the groups achieved benchmark or target performance on at least 25 out of 27 quality markers.
"This CMS PGP demo project is a great example of large integrated delivery systems producing high quality of care while lowering costs," said James Lee, MD, who is spearheading the PGP project at Everett (WA) Clinic, during an American Medical Group Association teleconference last Thursday. "It is a great model for future American healthcare." If PGP is the future, does that mean DM and the Medicare Health Support (MHS) project are the past? By its actions this year, it seems CMS thinks so. "We are paying for better outcomes and we are getting higher quality and more value for the Medicare dollars," said Kerry Weems, acting administrator of CMS, in a prepared statement. "And these results show that by working in collaboration with the physician groups on new and innovative ways to reimburse for high quality care, we are on the right track to find a better way to pay physicians."
CMS' announcement about PGP is in stark contrast to the organization's thoughts about the DM-inspired MHS project. Some of the biggest names in the DM world joined MHS to test the model in a sickly Medicare population.
CMS is ending MHS this year, citing disappointing results. DM advocates are displeased with the project's demise, how the end was announced—a FAQ file on CMS' Web site and no press release—and lack of specifics as to the program's failings and lessons learned.
I recently spoke to a CMS official about the MHS project and the person said the demonstration is just the latest DM project to fail in the Medicare population. The official said CMS is ending MHS because it did not see "significant impact on utilization of services and therefore on costs."
The fact that physician-led projects in the PGP are showing savings and higher quality while the DM project is being shelved shouldn't come as a surprise. Patients feel a greater connection and have more respect for their doctors than a faceless nurse on a phone.
But don't write DM's obituary just yet. There is still a place for DM and health management in healthcare. It's probably not in the remote nurse call center though. The PGP project, which is the first pay-for-performance initiative for physicians under the Medicare program, shows the importance of involving physicians in care. Many DM companies have avoided physician interaction and dealt strictly with the patient. This has created confused patients and miffed doctors.
There has been movement in the past year to change that model. More DM companies see the importance of having the face-to-face advocacy of a physician in the care process. There has been an added focus away from the call center program that reaches out to the chronically ill to health management and wellness programs that connect with everyone. In fact, DM's major industry organization, the Disease Management Association of America, even changed its name last September to DMAA: The Care Continuum Alliance because of the industry's changed focus.
The demise of the MHS project was bad news for DM, but innovative leaders have already moved beyond the nurse call center model of DM to one that includes physician offices.
Care coordination is the present and future, and the DM companies that lead the way will be the ones that flourish.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com .
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The Nevada-based Dayton and Fernley Rural Mental Health offices are both scheduled for permanent closure by September. Both mental health offices have provided healthcare services for mental health treatment in the Dayton and Fernley areas, and their closure will leave a substantial void in the healthcare net of Lyon County. With rising gasoline costs and no available public transportation system, the closures will be even more difficult for clients, experts say.
One July weekend in Wise, VA, a huge annual medical and dental expedition was set up by Remote Area Medical, a nonprofit organization that provides basic medical and dental care to people in the world’s most inaccessible regions. This year, more than 1,800 volunteer doctors, dentists, nurses, and assistants descended on Wise, setting up enormous field-hospital-style tents in which they saw roughly 2,500 patients over the course of two and a half days. The Knoxville, TN-based Remote Area Medical runs about 15 similar clinics around the world every year, from Guyana to East Africa and rural parts of Appalachia, and the clinics underscore the healthcare dilemmas of the poorest Americans.
'Critical Access' Hospitals are given a federal designation that allows it to bill Medicare for 101% of its outpatient, inpatient, laboratory, physical therapy, and post-acute care costs. The critical access hospital program was designed to ensure access to emergency, primary, and acute care in rural areas across the country. In Kansas alone, almost all of the state's rural hospitals are now critical access hospitals, and many are prospering.
Deborah Chiaravalloti, vice president of public relations and marketing for Anna Jaques Hospital in Newburyport, MA, discusses how she increased top-of-mind awareness at her hospital from 17% to 68% in just two years.
Fred Karutz, senior vice president of business development of Norvax, an online health insurance technology company, talks about the individual market and how the shift to individual policies is affecting healthcare.
Although the hospital needs to establish itself as a center of excellence, the individual doctors are the most important element in hospital marketing, according to this posting from Anas' Weblog. When a doctor first starts working for a hospital, they will draw new patients largely from the pool of patients they have previously treated. But doctors need to work with hospital marketers to increase the size of that patient pool from the beginning, the author says.
