It's a twist on the old chicken-and-egg question. Which is more important, marketing to physicians or direct-to-consumer marketing? Although there are some who still insist that plenty of patients self-refer, the fact is that—at least for now—patients usually go where their doctors tell them to go, especially for major procedures.
The just-released 2009 HealthLeaders Media Industry Survey of 1,148 healthcare leaders from across seven departments—including finance, quality, and marketing—offers some insight. But will it answer the question once and for all?
Who's your best customer?
Let's face it, the real money is in referrals, argue those who say the physician is king. That's why hospitals are increasingly deploying fleets of salespeople to call on physicians to ask for their business. It's why they're scrutinizing referral patterns and calling docs whose stats have dropped off to ask them what's up. And why they're engaging in two-way conversations with physicians, stepping up those face-to-face visits, and getting the whole hospital involved in the effort to increase referral market share.
Then again, maybe they aren't.
What's your style?
In our survey, we asked marketing leaders about the initiatives that their organizations regularly undertake to increase or maintain physician referrals.
The largest percent, almost 76%, said they engage in information sharing (communicating to physicians about the hospital). A smaller number, 65.5%, say they engage in information-seeking to learn about physicians' concerns. A respectable number conduct in the field, face to face sales calls, but only half said they have in-house programs.
Another discouraging number, only 20.69% say they have a full staff commitment to physician relations. And almost 13% said they have no regular initiatives at all.
Hospitals that aren't taking advantage of all of these methods must live in that elusive, magical place called the competition-free market. It's like hand writing a letter with a quill and ink pen and delivering it by horse-drawn carriage.
At least marketing leaders recognize this.
How aggressive are you?
In our survey, we asked respondents: "How aggressive is your hospital in marketing to physicians?" Aside from the nearly 15% who said they are not aggressive at all, the answers were evenly spread along the spectrum. About 29% said they are highly aggressive, 30% said they were moderately aggressive, and 27% said they are slightly aggressive. Not exactly a bell curve.
So what's going on here?
Have you hugged your CEO today?
One question hints at the answer, suggesting marketers just don't have enough influence over physician relations efforts. Or, more specifically, they don't have enough much influence over the leader who is ultimately responsible for volume: The CEO.
We asked marketing leaders to describe their place in the CEO's inner circle. About 30% said they are a key, valued advisor. A larger number said they can get the ear of the CEO when needed.
Interestingly, about 10% said they have little or no interaction with the CEO. I'm guessing that many who chose that response are the same folks who said they aren't aggressive and have no programs to boost physician referrals.
More bad news on this front: About 27% of marketing leaders rate their organization's marketing as "very strong." The number of CEOs who agreed? Eight percent.
What are you doing?
The fight for market share has become increasingly brutal. And, along with it, so has the fight for referral share. Any hospital or health system or clinic or program that is not doing everything they can to convert those splitters into loyals, any organization that has passive efforts or are making no effort at all should take another look at their strategy.
I spoke to a CEO recently who said that, in his market, which has a mostly affluent and mostly older population, there's enough business and market share to go around. It's a crowded market, but his hospital has a good chunk of the market share.
"Still," I said. "Wouldn't you like to have more?"
The University of Southern California has agreed to pay Tenet Healthcare Corp. $275 million to acquire USC University Hospital and USC Kenneth Norris Jr. Cancer Hospital. Tenet said USC had agreed to retain the 1,600 current employees. The two hospitals, located on USC's health sciences campus in Los Angeles, include 471 inpatient beds. The deal puts an end to a bitter dispute between Tenet and USC over control of the hospitals.
Maryland would set a minimum statewide standard for hospitals on providing free or reduced-price care to patients and prohibit hospitals from filing liens on patients' primary residences under a bill introduced in the General Assembly. The bill would require hospitals to provide free care to patients whose incomes are at or below 150% of federal poverty guidelines. The legislation would also bar hospitals from placing liens on patients' homes, ensure that hospitals provide details to state regulators about their oversight of contracts with collection agencies and attorneys, and require hospitals to provide details about the availability of financial assistance.
Officials at Dallas-based Parkland Memorial Hospital have announced changes in emergency room procedures to improve care and reduce long waits. Included is a new process for evaluating patients entering the ER, allowing them to confer immediately with a nurse or paramedic. Those interactions will permit better observation of patients as they await care, the hospital said. Some of the changes were the result of an Oct. 21 evaluation of Parkland's emergency operations by the Joint Commission.
Anthem Blue Cross, California's largest for-profit health insurer, has agreed to pay a $1-million fine and offer new coverage to 2,330 people it dropped after they submitted bills for expensive medical care. As part of a deal with the California Department of Insurance, Anthem also will offer to reimburse those people for medical expenses that they paid out of pocket after they were dropped. The company estimated that those reimbursements could reach $14 million. In exchange, California agreed to drop its prosecution of its accusation that the company broke state laws in the way it rescinded members in preferred provider organization policies between 2004 and 2008.
CMS has revised its RAC expansion schedule, according to the new "RAC Phase In Map" posted February 10 to the CMS Web site. The first phase is set to begin March 1, 2009. The second stage will begin August 1, according to the map.
The prior expansion schedule was set to occur in three stages, however, the now-resolved protests by the unsuccessful contract bidders Viant, Inc., and PRG Schultz, USA, Inc. delayed the initial onset of the permanent RAC program.
"For those hospitals who have a couple of weeks to prepare, I believe one of the biggest challenges is to have well established coordination of denials and appeals and an effective tracking tool," says Yvonne Focke, RN, BSN, MBA, revenue cycle director at St. Elizabeth and St. Luke Hospitals in Covington, KY. "For those of us who have until August, we?ll have to continue on course with our RAC preparedness, including assessing our gaps, quantifying our risk and establishing a tracking mechanism."
Editor's note: To view the updated expansion schedule, visit the CMS Web site. For more general information on the Medicare RAC program, visit www.cms.hhs.gov/rac.
This story first appeared as a breaking news item from the editors of The Revenue Cycle Institute, a division of HCPro, Inc. The Revenue Cycle Institute is a multidimensional resource for healthcare professionals offering consulting and on-site education for a range of revenue cycle issues.
Rose Lee Diggs, an 89-year-old woman whose body was found on the roof of University of Pittsburgh-Montefiore, was the victim of a vast, impersonal hospital system that favored profit over patient care, claims a lawsuit. The suit, brought by Diggs' son, accuses the University of Pittsburgh Medical Center of being "recklessly indifferent" in its handling of her treatment. The lawsuit also charges that UPMC created a dangerous healthcare environment with inadequate staffing levels, poor security, a dismal records system, and a patient population bursting at the seams.
Although some physicians who do not accept health insurance could be considered insurance providers, many "boutique" or "concierge" practices can avoid being regulated by state insurance administrators by following market-value guidelines for services they provide and by going over their contracts with the Maryland Insurance Administration, according to findings issued by the agency. The report was prompted by the insurance administration's concerns about some doctors' switching their business models to charge patients an annual, flat fee for services, rather than continue to accept health insurance.
The St. Bernard Parish Council will conduct a special meeting to consider disbanding the five-member hospital board it created more than a year ago and appointing replacements. The measure is the third time since October that the council has proposed a shakeup involving the parish's Hospital Service District Board, tasked by the previous council with building St. Bernard's first post-Hurricane Katrina hospital. Councilman Wayne Landry said the council's proposal comes after a series of problems with the board during the past year, including potential conflicts of interest and issues with properly advertising contracts.
Blue Cross and Blue Shield of Massachusetts said it will eliminate executive bonuses, cut bonuses for other employees, and freeze pay and hiring this year in an effort to save between $10 million and $25 million. The moves come in anticipation of a difficult year because of the economic recession.
