So
here's a question - will health care marketing be relevant after reform?
Or maybe the question is - will we call it marketing any longer?
Here is my
two cents. I still in 20 years have not seen much change in how
health care is so called marketed in this country. I still see billboards,
newspaper and television advertising that is irrelevant to most and that
is selling specific services. And they are selling 'sick' services as
reform is trying to move us to 'wellness.'
When we all
of a sudden have a huge access issue (read 50 million more people with
insurance), we will also have a huge patient experience issue and a public
relations issue at the end of the day. Things will get worse before they
get better.
The
following recently caught my eye.
Middlesex
Hospital in Connecticut has started putting ED waiting times online to
direct patients to the facility with the shortest door-to-doctor wait,
based on current patient volume. The idea behind the program is to ease
overcrowding and to alleviate problems associated with a shortage of
specialists. The Connecticut program is modeled after one in New Orleans.
Studies there have found that a good number of patients would seek out the
emergency department with the shortest reported wait.
OK, that
doesn't address a systemic issue, the misuse of the ED, but at least it
attempts to address access. And this remember is in a state that mandated
coverage for everyone. So even after all people in theory were covered,
they did not access the system any more intelligently.
Marketers Must Be Educators
When I came
into this profession in the Stone Age, healthcare marketing was just
'invented.' What we actually did was perform good old solid community
relations and education. And that is the role I see marketing moving back
into in the future. We are going to have to educate people on how to
access the system. As Middlesex did it may involve the use of online tools
but could just as well mean the use of community liaisons that are active
in your primary service area, just as we utilized way back in the 80's in
inner city Philadelphia.
While I applaud any attempt at education around wellness and the
marketer's role-be it through online assessments, preventive screenings,
etc.-frankly until the reimbursement systems starts paying for wellness,
this is more lip service than anything. Bundled payments, not reimbursing
for never events, even looking at readmission rates and reimbursement-all of these are carved around episodes of sickness. Keeping people well
and out of the hospital is not how hospitals are paid. That does not look
like it will change after reform. Diverting inappropriate traffic from the
ED, partly because of the PR and experience ramifications, might be the
short-term goal of any wellness slant.
Marketers Can Influence Brand Extensions
Part of the access issue will be the ability to direct care to the most
appropriate settings. Hospitals missed the boat somewhat in getting in on
the ground floor of the retail clinic movement. Yet there are probably
still opportunities. True strategic marketers will help influence
operational behaviors. That may include opening retail clinics,
partnering with others to do so or operating the clinics of major
retailers. Or it might mean looking at other delivery mechanisms. Jay
Parkinson, M.D., a Brooklyn physician, conceived what I call a blue-collar
concierge approach to primary care medicine and it was initially aimed at
the artist community in his neighborhood who could not afford health
insurance. For a set fee he would visit patients in their home, then
provide them with virtual access - emails, video chat - and cell phone
access to assure ongoing care. That model has evolved into
Hello
Health.
Marketers Must Understand Medical Home and Medical Tourism
There has
been a lot of talk about this concept of medical home. The idea is not
that different from the managed care concept of gatekeepers except that
the tone is different. Whereas managed care tried to control and mandate
access, the medical home concept is about getting to know each person and
their needs and assure that their care is coordinated. Through
coordination come costs savings and fewer hospitalizations. Well hospitals
would seem to not benefit on the surface. However as insurers see their
claims drop the thinking goes that they will save a huge amount of money
and actually be willing to relinquish some of that back to hospitals
through more favorable rates.
For marketers fewer admissions should mean more intense scrutiny in
holding the organization accountable. In short if something is not a
center of excellence, by whatever internally and externally defined
parameters you define, don't offer and market it. Even more, make the
center of excellence a destination center that people will travel to
because of the quality and the experience. It has been shown that
healthcare is not necessarily local any longer. It doesn't mean having to
go overseas or just going around the U.S. to the name healthcare brands.
It could mean jumping across counties or states to go to a destination
joint camp that is known for its outcomes and its patient experience.
Some may argue that the sheer number of elderly and boomers will keep
hospitals packed no matter what the scenario. That might be true to an
extent. But a more educated consumer, a shopping consumer, a demanding
consumer could mean that you have to think beyond primary, secondary and
tertiary service areas to a brand new unlimited service area. And as you
empower consumers add transparency of quality and price to your list of
responsibilities. With that you can easily see online strategies and
social media becoming more a part of the marketing mix. In terms of price,
I hosted a roundtable on price at a national marketing conference earlier
this year. No hospital marketers felt compelled to sit at the table (at
least until there were no seats left at other topics and they wanted
lunch!). So that should indicate we have some work ahead of us to embrace
the issues that the public is already embracing.
So What About ROI and Budgets?
In healthcare, ROI will remain fuzzy as long as there is no direct selling
process so I don't look for any real answer in showing ultimate value
through numbers.
In terms of budgets, in the short term I see them increasing at least
until the advertising wars stop. That is a hard sell but they really need
to. The public is picking up on how all of the advertising (the most
costly part of the marketing budget) is just adding to the healthcare
costs. The Internet will continue to evolve into the great leveler of the
playing field. Only until marketers understand how to better leverage word
of mouth and feel safe letting go of their safety net (advertising) will
budgets adjust accordingly.
The profession will remain strong from a head and body count, though
budgets for non-salary expenses, such as ads and publications, will
decrease.
So given all that, will we call what we do marketing in the future? What
do you think? And are you ready for the new world order?
