There's a shift under way in how healthcare leaders view marketing in tough financial times. Rather than cut marketing when money is tight, as has been standard in the past, the 2007 HealthLeaders Media Annual Marketing Professionals survey suggests hospitals are starting to view marketing as a way to expand market share or at least hold on to what they've already got.
UnitedHealth Group estimates that 46 percent of employees are not taking full advantage of their health benefits. In response, UnitedHealth has created United with Me, a program that analyzes whether employees are taking advantage of available resources and choosing the optimal health approach. In this podcast, Dr. Deneen Vojta, medical director for new product development at UHG, talks about how to drive behavior change, effectively reach consumers, and customize messages to improve the way people access and use the healthcare system.
In my last column, I wrote that 2007 was the year of the consumer, as hospital and health system marketers increasingly referred to patients as customers and focused much of their attention on improving service, engendering patient loyalty, and creating a positive brand experience. So, what will 2008 bring for healthcare marketing? I have a few ideas (and some of them might even come true). Also, make sure to keep reading for a link to the 2007 HealthLeaders Media Annual Marketing Professionals Survey--I think you'll find the results quite helpful in formulating your own predictions.
1. A growing emphasis on internal communications: As the trend toward consumerism grows, healthcare organizations will expand their definition of "customer" to include internal stakeholders--from employees and staff physicians and board members to referring physicians. Why? Because patient satisfaction cannot improve without strong employee satisfaction. Is there any industry where every single employee--volunteers, admissions staff, cafeteria workers, nurses, hospitalists, anesthesiologists, physicians, surgeons, and anyone else you can think of--has such a profound impact on the patient experience?
2. The death of customer-written review Websites: Sites where patients rank physicians, nurses, or hospitals in general? They just don't work. They hold absolutely no value other than for the person who wants to let off a little steam about a bad experience. The reviewer is extraordinarily biased and the reader knows that. Sure, word of mouth referrals are key to hospitals' survival. But potential patients want that word to come from a mouth they know and trust.
3. The rise of hospital-specific bash fests: On the other hand, blogs and other sites that are created to target a specific hospital are on the rise. And because they tend to be created by a small community of people with first-hand knowledge of the organization, they carry much more weight than one of those large, impersonal rankings sites. Current and past hospital employees often contribute to these sites (see prediction #1), lending them even more credence. You should regularly use search engines to find out what folks are saying about your organization and crafting an appropriate response to any sites that are dedicated to bashing it. In particular, look for sites with your hospital's name and the word "sucks" in the URL. You'd be surprised how many exist.
4. More innovative use of new media: OK, I'm still not willing to say that in the future all marketing will be done via cell phone. But considering how quickly technology advances, it is entirely possible that in 12 months I'll be writing about a new media that isn't even on the radar yet. It's more likely I'll be writing that hospital marketers are using "old" new media in new ways, however. Either that or there will be a backlash against all forms of new media, everyone will abandon their cell phones and trash their PDAs, and marketers will go back to putting ads in the yellow pages again.
5. Nuevo-niche marketing: Hospitals do know how to reach out to audiences with targeted messages. They send direct mail pieces to new movers introducing their docs and their services. They don't send OB/GYN marketing to single men and they don't remind women to get a prostate cancer screening when they turn 50. But when it comes time to really drill down, they don't do as well. If you have a large Spanish-speaking population in your community, is it enough to publish your patient newsletter in two languages or add subtitles to an existing TV ad for a run on the local Spanish cable station? Or do you need to go further with a campaign that's designed to speak exclusively to a specific community and its unique culture? To stay competitive, it's the latter that makes the difference.
You'll note that I left out a lot of looming trends, but these are my fave five and I'm sticking to them.
Of course, I'd also like to hear your predictions. Is this the year that transparency truly rears its ugly head? Will retail clinics and medical tourism force a change in your market strategy? Will every hospital hire a chief experience officer in the next 12 months? Will marketing managers completely re-jigger their budgets so that 98 percent of their ad buys are online? Let me know what you think. You can e-mail me or click the link below to leave a comment right on this page.
The results of the 2007 HealthLeaders Media Marketing Professionals Survey are in and available to view or download in PDF format on our Web site. The marketing survey offers a snapshot of where hospital and health system marketers stand when it comes to trends, from the increase in consumerism to the rise of new media.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
Traditionally, hospital quality and patient safety have been left in the hands of the clinical staff--board members and senior executives focused more on the strategic and financial goals of the organization. However, that dynamic is no longer the case. Hospital executives and community board members are taking an increasingly larger role in defining and monitoring the hospital's quality goals. So how can senior leaders and trustees ensure that physicians are on board with their quality agenda?
Ask physicians how the hospital can improve quality, says Melissa Coleman, a board member at Delnor-Community Health System in Geneva, IL. The 128-staffed-bed hospital has several physicians on the hospital board as well as the quality committee. The physicians help the quality committee set agendas based on their daily interactions and observations, she says. "They are out there on the frontlines. They know what will improve quality. . .If you are initiating or implementing a quality initiative, get doctors involved and let them drive it."
Have a sincere and intensive discussion with the medical staff at least once a year on what they are doing to improve quality, advises James A. Rice, PhD, vice chairman of The Governance Institute. For instance, physician leaders should inform the board what processes they are establishing to guard against medical errors, enforce hand washing, and handle credentialing and privileging issues.
Align the quality goals of the physicians and the hospital. Rather than asking, "Why can't we get doctors engaged in our quality agenda?" senior leaders and board members should ask themselves, "How can we get engaged in the physicians' quality agenda?" says James L. Reinertsen, MD, president of the Reinertsen Group and a senior fellow at the Institute for Healthcare Improvement. Physicians' focus on quality usually relates to their patients' outcomes and wasted time. So if the hospital's quality goal is to look good on the Centers for Medicare & Medicaid Services' core measures for evidence-based medicine, that probably won't engage docs. But framing the organization's goals around improving patient outcomes for specific disease states and basing the clinical indicators to monitor the organization's progress on evidence-based medicine and CMS guidelines will more than likely get physicians on board, says Reinertsen. "Now you have a plan that is exactly the same plan, but it has been framed in a way that engages physicians."
Establishing medical conference committees can also help align the quality agenda of the medical staff, board members and senior leadership. These committees are usually composed of three or four key physician leaders and three or four board members who come together two or three times a year to look at the quality agenda, monitor performance, and brainstorm on strategic initiatives, says Rice.
Include the medical staff in strategic discussions on technology trends that have the potential to improve clinical outcomes and patient safety. Board members, senior executives and medical staff leaders should look at the efficacy of the technology--both clinical and IT--as well as the capital consequences for the hospital, says Rice, adding that the discussion can take place two to three years in advance of those capital decisions. "That is another partnership or culture of respect that is important to build between the board, management and physician leaders," he says.
To read more about board members' role in hospital quality, see HealthLeaders December cover story, "Board on the Floor". Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com
An ambitious plan to offer universal access to affordable healthcare services for every resident in San Francisco is now in jeopardy due to a ruling in a federal lawsuit. That lawsuit is challenging the legality of a fee the city plans to impose on employers who do not offer healthcare coverage to their workers.
During its first six months of limited operation, the program enrolled over 6,500 residents and city officials planned to begin rolling out the program for all 73,000 uninsured residents beginning in 2008. That plan, however, has been preempted by the successful challenge launched by the Golden Gate Restaurant Association.
Championed by Mayor Gavin Newsom and supported by the Board of Supervisors, the Healthy San Francisco program was the first of its kind in the nation. The novel program is not insurance because its coverage exists only within the confines of the city, but it does offer beneficiaries access to a full range of in-patient and outpatient care through a network of contracted providers and city-run clinics, as well as prescription drug coverage and mental health services.
Enrollees pay for access based on a sliding scale. Residents earning up to 100 percent of the federal poverty level would be eligible for free coverage, while those earning between 200 and 300 percent of the FPL would pay $150 per quarter for coverage. The program would top out at $2,700 a year for those earning at least 500 percent of the FPL.
The troublesome part is that the act also requires medium- and large-sized employers to spend between $1.17 and $1.76 per hour, per employee on comprehensive health benefits, or contribute an equivalent amount to the city to pay for employee access to the Healthy San Francisco program. The employer assessments, along with member premiums, are the linchpins to funding the full expansion of the program, and now that funding is in doubt.
Federal Judge Jeffrey White ruled December 26 that the employer assessment is an improper intrusion into the federal domain. While he found that the assessment is preempted by the federal Employee Retirement Income Security Act, White maintained that there may be other alternatives to fund the expansion such as a general fee to support a public healthcare system or an increased tax on employers that is offset to some extent in the form of tax credits for healthcare expenditures.
While the ruling is preventing a full expansion, city officials say they are committed to the program and as of yesterday have expanded access to all residents earning up to 300 percent of the federal poverty level. "Despite today's ruling, we are undeterred," Mayor Newsom said after the judge's order came down. "We will move forward with this innovative program. We are working with the City Attorney to appeal the ruling, and we will win."
In spite of Newsom's confidence, the issue of ERISA preemption is a daunting challenge to would-be reformers. ERISA preemption is what doomed a 2006 Maryland law aimed at forcing large employers like Wal-Mart to spend more on employee health benefits. And ERISA preemption is expected to raise its head again in the Golden State if a plan to cover nearly every Californian is ultimately passed.
There is one wild card in the mix, however. San Francisco's appeal is pending before the Ninth Circuit Court of Appeal, which is generally considered to be the most liberal in the federal system. A ruling in favor of San Francisco could prompt a broader examination of the respective roles of federal, state and local governments in healthcare policy . . . but I wouldn't bet on this leading to a change in federal policy any time soon.
Brad Cain is editor of California Healthfax and executive editor for managed care with HealthLeaders Media. He may be reached at bcain@healthleadersmedia.com.
There's a battle going on for the hearts of Middle Tennessee residents. In the latest volley, Vanderbilt University Medical Center is spending $1 million on advertising to brand itself as the hospital "where heart is headed."
The Matagorda General Hospital Foundation hosted an event to kick off a hospital employee fund-raiser designed to get the employees to commit to making at $100 donation to the foundation's general fund.
The forecast for future needs of knee and hip replacement surgery suggests robust demand. This growing market is largely driven by changing consumerism, sociocultural factors and population demographics in the United States. However, while there is optimism about the future need of joint care, there are many concerns about how to meet this growing demand given the current health care and orthopedic landscape.
In 2008, it will be about the economy and politics. Growth is slowing, fuel prices are high and credit is tight. That's a difficult mix for marketers to face as consumers will continue to pull in the reins as disposable income tightens dramatically.
If your resolution is to be fully staffed in the New Year, look to Saint Francis Medical Center's newly-launched recruitment campaign for inspiration. Facing a growing regional healthcare employee shortage, Saint Francis, in Cape Girardeau, MO, needed to fill 26 nursing positions immediately and hoped to hire as many as 100 new nurses each year going forward.
Working with The Roberts Group in Waukesha, WI, Saint Francis developed a multimedia recruitment campaign. An internal employee referral program combined with a mix of print, TV, outdoor, online, and a DVD were used to drive the audience to a new micro site (YourNursingFuture.com) where users can watch streaming video featuring real St. Francis nurses, request more information, apply online, and forward the link to friends. The hospital also plans to add a blog.
The results of the campaign should alleviate doubts about the effectiveness of online campaigns. After the first week, the hospital received more than 250 employee referrals. After four weeks, the number jumped to 750. After three months, Saint Francis filled 16 of 26 nursing vacancies. The average visitor was spending almost four minutes on their site--five times longer than the national average for other Web site users.