A couple retiring in 2008 will need about $225,000 in savings to cover medical costs in retirement, according to a study released by Boston-based Fidelity Investments. The figure, calculated for a couple age 65, is up 4.7 percent from the $215,000 estimate for 2007. It is similar to other projections for healthcare costs in retirement, figures that show longer life spans also are requiring workers to increase retirement nest eggs dramatically.
Located just an hour west of Boston, Worcester, MA, is New England's second-largest city, and for hundreds of years has existed independently from its big sister to the east. But that's all beginning to change. As Boston residents move west in search of more affordable housing and a slower pace, their expectations for healthcare have stayed the same.
That's why two of Worcester County's hospitals-Milford Regional Medical Center and Saint Vincent Hospital, located in Worcester Medical Center-have recently announced affiliations with big-name Boston hospitals. They recognize what names such as Beth Israel Deaconess and Dana-Farber Cancer Institute have accomplished in Boston and hope that now the big names will keep Worcester County patients at home for healthcare.
Milford Regional, in cooperation with Dana-Farber Cancer Institute and Brigham and Women's Hospital, both in Boston, opened a newly constructed cancer center in January. Saint Vincent began an academic affiliation with Beth Israel Deaconess Medical Center in July 2007, bringing surgical residents to Worcester. The hospital also contracts with the associate physicians of Harvard Medical Faculty-Beth Israel Deaconess to work in the hospital's radiation/oncology, emergency, and cardiac surgery departments.
"We're proud and pleased to be affiliated with associate physicians of Harvard Medical Faculty Physicians-Beth Israel Deaconess Medical Center," says Dennis Irish, spokesperson for Saint Vincent, a 348-bed hospital. "It may be an understatement, but it doesn't hurt us to be affiliated with Harvard faculty."
Since its affiliation began, Irish says that Saint Vincent has seen an increase in the number of cardiac procedures performed at the hospital, as well as a bump in volume in the emergency department.
"[The ER volume increase] is a result of a number of factors that I would speculate includes the performance of associate physicians of Harvard Medical Faculty-Beth Israel Deaconess Medical Center," Irish says.
Although its too early to tell how having Dana-Farber Cancer Institute physicians running its radiation and oncology program will affect patient volume, Terri McDonald, director of PR and marketing for the 121-bed Milford Regional Medical Center, says that the cancer center has created buzz in the community unlike anything she has seen before.
"There's never been a service offered when I've had as many people call my office to find out when the facility is going to open," she says.
A growing community Between 2006 and 2007, Worcester County's population of 784,992 grew 1.4%, with the city of Worcester itself increasing 4.1%, says Mark Cherry, a market analyst at HealthLeaders-Interstudy, a Nashville-based healthcare research company. The population growth that the Worcester area has seen in recent years has helped to fuel hospital competition, he says, as has the growth and success of the county's largest hospital, UMass Memorial, an academic medical center.
"UMass Memorial has put out the message 'Stay here in Worcester and we'll take care of you,' " says Cherry. It has earned a reputation of offering excellent healthcare, allowing it to overcome a $24 million deficit in 2002 and become a "financially sound powerhouse," Cherry says in his November 2007 report about the Worcester healthcare market.
This powerhouse status has other hospitals in the county scared, he adds, resulting in the affiliations with Boston hospitals. With these partnerships, Saint Vincent and Milford Regional are David fighting back against Goliath, says Cherry.
"They can use the [Boston] name, and it's great publicity for them. It's leverage against UMass Memorial, which has been trying to say that it's one of the top 10 medical training centers in the country . . . With these affiliations, Milford Regional and Saint Vincent can now say, 'We offer that, too.' "
But representatives from both Milford Regional and Saint Vincent hospitals say the HealthLeaders-Interstudy analysis overstates the competitive aspect of the relationships.
"In the report, it references antagonism between UMass Memorial and Saint Vincent, but I think that's a strong word," Irish says. "We have a healthy respect for UMass Memorial and healthy competition, but we believe that competition benefits the community. While we compete clinically and intend to outperform them in terms of outcomes and patient satisfaction, where we do not do so already, there is also a significant amount of collaboration between the two institutions."
Francis M. Saba, CEO of Milford Regional, agrees. "We've had a very strong relationship with UMass Memorial," he says. "We are a teaching site for [its] medical students and residents. We feel that our relationship with [it] is not competitive but complementary."
Satisfying patients close to home Before its new cancer center opened earlier this year, Milford Regional Medical Center had its own cancer care program but was unable to offer radiation services to its patients, meaning that those in need of such treatment would have to drive to UMass Memorial in Worcester or one of the Boston hospitals several days per week for treatment. Now, having treatment available close to home will certainly bring new patients to Milford Regional, Saba says.
"Boston is certainly a Mecca of healthcare, but it is also crowded, congested, landlocked, and difficult to get to at times," he says. "When you're dealing with such a serious illness, it's nice not to have the hassles and still get the same level of care that you would in Boston."
Milford Regional, located 25 miles from Worcester and about 40 miles from Boston, raised the money to build the new cancer center and located it right next to the hospital's main building. Milford Regional will act as a landlord for Dana-Farber Cancer Institute and Brigham and Women's physician organization, which will occupy the space. Diagnostic imaging, a laboratory, and radiation services will be offered at one location.
McDonald emphasizes that the affiliation with Dana-Farber was made not to take patients away from UMass Memorial but instead to do what a community hospital does best-offer care close to home. "The reality is we are a community hospital. We depend on UMass Memorial. We have long-term affiliations with [it] because we recognize that we are a community hospital. We focus on doing the basics well, but we recognize our limitations, and we value our affiliations."
Marketing the relationship At a time when quality is a hot topic in healthcare, Irish says being able to market health services with a big-name Boston hospital connection is an advantage for Saint Vincent.
"Partnership, and I mean that figuratively, with a Harvard Medical School-affiliated Boston teaching hospital implies a certain degree of quality," he says. "From both a regulatory perspective and a marketing perspective, it's important that Saint Vincent has an emphasis on quality. "
That quality reputation is important everywhere, McDonald says, but especially in Worcester County, where people are invested in their healthcare and very interested in the happenings at their local hospital. During an open house at the cancer center in December 2007, more than 1,800 came to preview the new facility. Even the state's governor, Deval Patrick, has come to visit, she says.
"We had a great oncology program, and there are a lot of people who are dedicated to that program but would have to travel elsewhere for radiation," she says. "I think that's why people are so excited. We're bringing in the piece that is missing."
To communicate the arrival of the missing piece, Brigham and Women's and Dana-Farber have been running billboards in Milford and surrounding towns, and print advertisements were scheduled to run as the opening of the new center approached. "There's been a lot done to make individuals aware that we'll be opening in January," McDonald says.
Irish adds that Saint. Vincent has also worked hard to publicize the arrival of Harvard Medical Faculty/Beth Israel Deaconess physicians at its facility, specifically its emergency department.
"We've done some promotions around the emergency [department] relationship, because it is a gateway to all of our other services. We've made several mentions of the fact that our department is staffed by associate physicians of Harvard Medical Faculty-Beth Israel Deaconess Medical Center," he says.
Editor's note: HealthLeaders-Interstudy is owned by Decision Resources, LLC, and not affiliated with HealthLeaders Media, a division of HCPro, Inc.
For the first time in three years, Graceville-Campbellton (FL) Hospital is operating in the black. After being overrun with debt, the hospital made a complete turnaround and has managed to pay off all its vendor debt. To complete the turnaround, hospital officials brought in new equipment to add to the services they provide. As a result, it decreased the number of patients transferred to other healthcare providers.
In 2007 the Radiology and Mammography Department at Fort Campbell, KY-based Blanchfield Army Community Hospital was ranked among the top 10 percent of hospitals in the United States--civilian and military--in screening measures. Some of the credit for the ranking can be attributed to a women's initiative campaign on the importance of mammograms and self-examination. In 2007, the Radiology and Mammography Department performed about 5,300 mammograms.
On the advice of its political consultants, the board of directors at Oceanside, CA-based Tri-City Medical Center took no action at its regular meeting to place a third hospital bond on the June primary ballot. The board informally directed its political consultants to keep doing their homework to better understand what it would take to get voters to support a bond. Tri-City faces a state-mandated deadline of 2013 to repair or replace two of its oldest buildings because the buildings do not meet updated earthquake safety standards.
Because consumers have the desire and ability to control what information they receive and how they receive it, marketers have a more difficult job than ever trying to reach them. For Rush-Copley Medical Center in Aurora, IL, an established positive brand image allowed their marketing team to focus their recent campaign efforts on what really matters to patients: themselves.
"Marketing and advertising is increasingly getting more difficult for all businesses today," says Mary Zokan, director of marketing for Rush-Copley Medical Center. "Consumers are controlling their information, music, movies, and media in ways we've never seen before; they want to interact with it. That level of sophistication has given rise to a 'You' movement that hospitals, we believe, must embrace."
Being patient-focused was important for Rush-Copley, but that hadn't been reflected in their marketing. To change that, the organization thought about healthcare from the patient perspective and devised a campaign strategy and message that asked, 'What Kind of Patient Would You Be?'
The various campaign elements, which focused on three different service lines using a multi-integrated approach, asked that question of consumers while pinpointing various emotions. One campaign piece starts with the question, "If you had a heart problem, what kind of patient would you be?" Copy accompanying an image of an older woman reads: "Surprised? Some people are surprised to learn of a heart problem." The ad goes on to describe what Rush-Copley can provide to educate patients and help them through their conditions.
What's distinctive about this strategy is that Rush-Copley is not only providing the consumer with a thought-provoking question to draw them in, they're also giving them a persona (with the imagery) and an emotional state within the campaign message that they can easily identify with.
"We worked to get into people's heads, because after all, choosing healthcare can be a very emotional decision," says Emily Calvo, a co-creative director on the campaign. "We used emotional states to acknowledge real feelings that the audience can relate to. Then we [showed] how Rush-Copley's services benefit each type of consumer."
Though the campaign is still running, current results show that the campaign has been well received leading to increased call volume, referrals, and Web traffic. The campaign message, as Zokan says, "embraces the very essence of consumerism in a simple, relatable, and effective way."
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.
Healthcare marketers have a wide variety of responsibilities on their plate, from conducting market research to launching multimedia campaigns to proving return on investment. Marketing to physicians, which is a new focus for many hospitals, is one more large and complicated task to add to the mix. But sometimes a small change can make a big difference. Here are seven ways hospitals can improve physician relations, shared by speakers at a physician strategies conference held this week in Los Angeles. Most of them don't require a lot of time or money to implement, but one of them might have a big impact at your organization.
1. Add interactive services. New technology can keep physicians loyal to your healthcare organization, said Kathy Divis and John Eudes, president and executive vice president of Greystone.Net. One suggestion: Put interactive physician profiles on your Web site that include short video clips of the physicians introducing themselves and describing their philosophy of treatment. When a patient can see the doctor speak and watch his or her gestures and facial expressions, the physician seems much more human and approachable, making it easier for patients to make a decision.
Another idea: shoot short videos of specialists discussing hot medical topics. Set up an interview with an anesthesiologist to talk about the rarity of the phenomenon of patients who are aware of what's going on during their surgery, as depicted in the movie "Awake," for example. Embed the videos in online or e-mail press releases, helping to get more media attention for your physicians.
2. Give physicians what they want. "Don't assume that everyone knows how to use a computer," said Douglas Backous, medical director of the regional clinicians program at Virginia Mason Medical Center in Seattle, WA, at a session on physician referral and outreach. His department was thinking of discontinuing a physician newsletter, but the docs asked them not to give up on it--they loved the publication. "We really have built our program around what our physicians need," he said. And so the newsletter was saved.
3. Organize by location. Marketers should reach out to physicians by region, not service line, Backous said. That way, physicians don't get hit with visits from several different people from your organization in one week. "That's a good way to look like a drug rep," he said.
4. Customize your services. Backous also noted his organization is looking to do more online for the physicians in his vast region, which spans different time zones. One possibility under consideration is offering continuing medical education online and on demand. Physicians don't live and practice in Alaska so they can get up at 6 a.m. to earn their CME credits, he said.
5. Make docs the stars. It's not exactly a state secret that physicians, especially surgeons and other specialists, can have a bit of an ego. One way that you can play to that and engender loyalty is to include physicians in your advertising campaigns. That's what Florida Hospital in Maitland is doing, says C. Josef Goshen, vice president for strategic planning there.
The physicians were engaged and involved in creating the campaign, Goshen reports. And they were thrilled with the resulting ads. "I don't have to tell you what happened to their volumes," Goshen said. "No one had to work on them anymore after that."
So how does Goshen choose which physicians to feature without snubbing anyone or causing hard feelings? He doesn't. He leaves that up to a panel of physicians. They recruit volunteers and pick the participants. "I don't get involved," Goshen said. "It has to be a very collegial environment.
6. Simplify the numbers. When you're reporting trends and results to senior leaders, they don't want to look at big, complicated spreadsheets crammed with data, said Sean Duffy, physician liaison at Geisinger Health System in Danville, PA. A simple chart or bar graph is much more effective. "And as long as it's going up, everything is great," he added.
7. Show up uninvited. When physician relations reps at McLeod Health System in Florence, SC, first began eating lunch in the doctor's lounge, the regulars there wondered why their space had been infiltrated. But Catherine Lee, McLeod's corporate chief of staff, announced that someone from her department would henceforth be joining the docs for lunch to make sure someone was always present to answer questions and address concerns. Plus, she told them, the food was better than in the cafeteria.
It took about two months, but eventually the doctors would notice if someone didn't show up--and sometimes even call to ask someone to come down. "It sounds like the simplest thing, but what we did was create a consistent presence," Lee said.
So it turns out you don't have to spend a ton of money to forge inroads with physicians. From playing to their egos to simply listening to what they want, you can improve relations, increase referrals, and engender loyalty. Have any physician relation tips you want to share with other readers of HealthLeaders Media Marketing Weekly? Send me an e-mail or leave a comment about it, below.
Faced with escalating healthcare costs, most health plans and employers increase copays and deductibles to bridge gaps, but growing research is showing that the reverse is actually the better alternative.
A recent study published in Health Affairs of a large employer's value-based insurance design (VBID) program showed how cutting copays for life-saving medications increases adherence. VBID supporters say the theory works: Affordable medicine increases adherence, improves outcomes, and may even save money in the long run through averted ER visits, hospitalizations, and decreased costs associated with chronic disease.
In the study, the employer reduced copays for five chronic medication classes within a disease management program: angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), beta-blockers, diabetes medications, HMG-CoA reductase inhibitors (statins), and inhaled cortiocosteroids (steroids). And these cuts were significant. The copayment rates for generic medications went from $5 to zero. Copays for brand-name drugs were lowered by 50 percent.
The results showed increased medication adherence in four of the five medication classes and reduced non-adherence by 7-14 percent.
VBIDs have grown in popularity since Pitney Bowes blazed the trail in 2002 by reducing copayments for several classes of prescription drugs. The Stamford, CT, company reported favorable clinical results, medication compliance, and cost savings. Since those first days of VBIDs, a growing number of employers, organizations, health plans, and academics have promoted VBIDs as a solution to medication compliance problems.
I am hosting an audio conference on the topic of VBIDs on March 13 with two of the leaders in the movement, A. Mark Fendrick, co-director of the University of Michigan's Center for Value-Based Insurance Design, and Gregory B. Steinberg, MD, chief medical officer at ActiveHealth Management in New York. Fendrick and Steinberg will provide information on VBIDs, and will highlight the study in Health Affairs.
They will also talk about how a more advanced VBID program could mean greater long-range savings. A tighter VBID option that offers different copays depending on health status goes beyond the more basic programs described earlier in this column. The more sophisticated design:
Uses decision-support algorithms to identify people who, based on medical literature, would benefit from specific medications
Identifies those who are already appropriately on therapy as well as individuals who are not (but should be)
Notifies both the member and the doctor that the member is entitled to a reduced copay
Evaluates each consumer's health situation to decide copay costs, which could mean two people who purchase the same drug could pay different copays depending on health status
The tighter option needs a decision-support system to identify the right people and create an infrastructure that ties the pharmacy benefits manager to adjudicate and administer the program once the individuals are identified.
With an increasing number of studies showing the benefits of VBIDs, why have health plans been slow to join the party?
Here are three reasons:
The program's newness combined with a lack of detailed research
The potential confusion and anger that could come from creating a system with differing copays--and the education program needed to inform people and quell complaints
For the tighter program, the initial costs to implement the program's infrastructure scares away some insurers and pharmacy benefit managers--though long-term savings are possible
There is the possibility of great advancement in VBIDs, particularly as health plans and pharmacy benefit managers find ways to better utilize technology.
There are lingering questions about actual savings, but the literature is pointing to its potential. What's needed now is for health plans and the greater healthcare system to fund further VBID research and programs to see if the theory's potential matches reality.
California nurses at Alta Bates Summit Medical Center campuses in Berkeley and Oakland and at San Leandro Hospital have voted to give their union the authority to call a 10-day strike. The union says that the key issue in the strike is "Sutter's refusal to schedule RNs to care for patients when nurses are on legally mandated meal, rest, or bathroom breaks." Nurses at 11 Sutter hospitals held two-day walkouts in October and December 2007.
A proposed agreement between Helen Ellis Memorial Hospital, Tarpon Springs, FL, and a developer could bring doctors, jobs and affordable housing to the the city, officials say. Three referendum questions will ask Tarpon Spring voters to amend the city's lease with the hospital. If approved, two parcels of land just north of the hospital would be made available to developers who propose a mixed-use project at the site.
