Sunday, March 26, 2017

Can Health Care in The U.S. Be Reformed?

No.

Not with the health care delivery system and financing model that exists.

Tinkering around the edges and playing the little Dutch boy putting his fingers in holes in the dike to stop the water accomplishes nothing and doesn’t work. We find time and time again; this is the direction elected officials at all levels and policy wonks take while listening to the lobbyists for the different provider and insurer groups, who are more concerned about increasing their share of the trillion dollar health care industry than they are about patients.

I have worked in healthcare with the introduction of DRGs in 1983.

I have worked in healthcare during the 1990s and HMOs, capitation payment systems, the employment of physicians, the formation of health systems, provider driven insurance plans, etc.

I have worked in healthcare during the 2000s when the cost of medical care skyrocketed; the ACA was passed because nothing from the tinkering and experience of the previous 20 years worked.

I work and watch in healthcare during the 2010s, as we revisit the failed models of the 1990s and 2000s.

And here we are nearly 40 years later, with the same problems only bigger and more expensive.

We continue to “reform” a health care delivery system and financing model that is unsustainable.

This is just craziness.

The following is not a political statement but an observation.

For seven years we have heard the loud carrion cry of Conservatives doing the repeal and replace ACA dance. Now given a chance after all that wailing and whining the Republicans were: 1) never ready with any replacement; 2) incapable of articulating a coherent health care policy, delivery and financing model; and 3) are incapable of governing given a chance. Some old song. Same old story. Same old Washington.

The question is and always been, for which there has never been the national dialogue, is health care a privilege or a right? Then comes the consideration that also requires a national debate, how do we pay for care?

It’s not a matter of reform of the reimbursement models. It’s a matter of needing to change the health care delivery and financing model entirely.

Both parties only tinker around the edges bringing about unintended consequences that only make matters worse and solve nothing.

Understand that people have always gotten care, of which the cost of care was off-loaded onto the backs of healthcare providers, meaning doctors and hospitals. It is the medicalization of a societal issue. People do get care; it may be in an inappropriate care setting (ER) and at the wrong time, but care nonetheless.

Until the healthcare delivery and finance model is addressed at its root failure cause, and an honest national discussion is held, nothing more will happen except for the wild back and forth political swings of both parties.

Michael is a healthcare business, marketing, and communications executive, strategist and thought leader.  As an internationally followed healthcare marketing strategy blogger, his blog, Healthcare Marketing Matters receives over 20,000 page views a month and read in 52 countries.  He is a Fellow, American College of Healthcare Executives, Professional Certified Marketer, American Marketing Association and HubSpot Academy- Email Marketing, Inbound Marketing & Inbound Sales Certified. Post opinions are my own.

For more topics and thought leading discussions like this, join his group, Healthcare Marketing Leaders For Change, a LinkedIn Professional Group.

Sunday, March 12, 2017

Provider’s, calculating RMOI on your marketing efforts? No, well here’s how.

With so many changes in the healthcare market and resource constraints in hospitals, it’s a wonder they attempt any marketing at all. As much has healthcare has changed, provider marketing just hasn’t kept up. In hospitals saying your brand awareness is up is essentially a waste of marketing resources.

Big deal.

Your outcomes, patient satisfaction, price, experience and preventable death rate tell another story which negates the undifferentiated all about you feel good marketing. The healthcare consumer and patient isn’t dumb you know. They see the numbers and can figure it out.

What must I do?

To do Return on Marketing Investment analysis, you must market something that is measurable. Surprise!  Brand ads just won’t do it. It won’t tell you what to sell and how, as that is not the focus of the blog post. If you can’t figure it out then maybe it’s time for a different profession.

Moving forward.

Below is an example of an actual ROMI computation for a multi-hospital organization. I am assuming that you can identify and pull down the information that you need across many platforms of the organization to produce such a result.  If you can’t measure, then broaden your technological capability and move towards a higher level of computerization and system integration that you already experience.

The role finance plays.

Work with your finance department. They are a great source of information. With a high degree of collaboration and understanding their viewpoints and perspectives regarding marketing, you can lead and make a difference. By answering questions, concerns and opinions with solid data, you can move the discussion from marketing does “stuff’ to marketing is a financial contributor to the organization.

The formula and method.

The way forward below can be adapted to any campaign and provides you with the data fields, and logical analysis one needs.  This is an actual RMOI calculation on a physician referral campaign and call center.

PRCC ROI

An analysis was undertaken to look at the ROI of the Physician Referral Call Center. The study matched a database of call center name records for the period to financial records which had already been downloaded.  The data produced the following results:

*      9,102 call records were matched with utilization and financial data.
*      9,102 calls led to a total of 9,121 encounters in the ER, Inpatient and Outpatient categories of service.
*      751 contacts were ER
o   177 returning encounters
o   573 first time encounters
*      1,105 contacts were Inpatient
o    530 returning encounters
o    699 first time encounters
*      7,267 were Outpatient
o   2,014 returning encounters
o   5,253 first time encounters
*      Total charges for all encounters equaled $22,522,649
*      Charges for new encounters all services totaled $16,085,198 or 71 percent of the total charges
*      Average charge per ER Encounter  $1,304
*      Average charge per  Inpatient Encounter $13,581
*      Average charge per Outpatient Encounter  $903
*      Gallup measures loyalty at 68 percent (would return for service) which means that for every 100 patients 32 would not return for care- therefore:
o   ED- 57 returning encounters captured that would not have returned
o   Inpatient – 170 returning patients that would not have returned
o   Outpatient- 645 returning visits that would not have returned
*      Incremental charges counted returning consumers not loyal
o   ER - $74,337
o   Inpatient- $2,308,851
o   Outpatient-  $582,505
o   Subtotal charges counted:  $2,965,693
*      Overall market share in primary and secondary service area is 14.53 percent. The number of first-time encounters has utilized us above market presence is, therefore:
o   ER 573 first time visits,  83 not countered, 490 counted –
o   Inpatient – 699 first time admissions, 101 not used,  598 admissions used
o   Outpatient – 5,253 first time encounters, 763 encounters not counted, 4,490 counted
*      Based on an overall market share of  14.5  percent the  incremental charges counted for new  encounters, not because of market presence:
o   ER - $638,960
o   Inpatient – $8,121,438
o   Outpatient –  $4,054,470
*      Total Charges counted: $12,814,868
*      Discount from gross charges for Medicare, Medicaid, Managed Care, Bad Debt and Charity Care @ 65% is $8,326,644
*      Net Revenue:  $4,488,224
*      PRCC program costs:  $233,410
*      Net contribution:  $4,254,814
*      ROI 18.22:1

Much is written and made of the importance of calculating a Return on Marketing Investment (ROMI) for healthcare organizations.  Most often regulated to producing brochures and other items, healthcare marketing departments need to exercise a leadership position and talk the financial language of senior management.

Otherwise, marketing is just a cost center and not an organizational asset.

Michael is a healthcare marketing business, marketing, and communications strategist and thought leader.  As an internationally followed healthcare marketing strategy blogger, his blog, Healthcare Marketing Matters receives over 20,000 page views a month and read in 52 countries.  He is a Fellow, American College of Healthcare Executives, Professional Certified Marketer, American Marketing Association and HubSpot Academy- Email Marketing, Inbound Marketing & Inbound Sales Certified. Post opinions are my own.


For more topics and thought leading discussions like this, join his group, Healthcare Marketing Leaders For Change, a LinkedIn Professional Group.

Saturday, March 4, 2017

Dark Social, It's Far More Important for Success than Bright Social.

Bright social, where you can see your handiwork, and revel in the brilliance of your content driving the unsuspecting company or individual to your site,  where you immediately being to inundate them with AdRoll programs, emails and other forms of intrusive marketing, may be on the way to the trash bin.

Oh, I bet that got your attention!

Not entirely mind you, but with the changes in Facebook, LinkedIn, Tumblr and other social media platforms becoming content publishing houses without the links, and they don’t want your links. The social platforms crave and are demanding inspiring, relevant, game-changing content for their members. But you know, that is only 25 percent of your audience reach.

Where in the world is this going?

Two-thirds of internet social media activity occur in what has been termed dark social. I am not speaking of the nefarious activities of drug dealers, gun runner’s, blackmailers, etc. using TOR or another program that allows one to search the web anonymously. I am referring to all the social media activity that can’t be traced such as email link sharing, some applications and one-on-one messaging.

Don’t believe me? Then I suggest you read this article, “ The best free privacy software in 2017,”  on techradar.com

Now what?

For example, a healthcare provider is looking for a solution to a problem.  They do the research on the IoT, speak with colleagues and others, possibly read some thought leadership and examine social media.  But in this process, friends and others may send an email or direct message with a link to a source of information or solution that would be of interest. It is the method of sharing information that makes it dark and at this time untraceable.

And what is of interest to me at least, is not the quantity of dark social traffic, but the quality of that sharing traffic that goes on unseen.

Think about this for a moment. How important is the recommendation from someone you know about a service or solution when you receive a link to a website or shares some meaningful information? It’s one-on-one messaging as compared to the mass messaging which has some traits of personalization, but still a mass market message.

That’s what I thought too.

Therein lays the opportunity. Remember all the talk and activity about word-of-mouth marketing that was always the perceived key to success over the years? Well, word-of-mouth marketing hasn’t gone away, it’s just gone dark. 

Pun intended.

So how do you reach the two-thirds of the internet that are currently not visible to you? Most marketers use some form of marketing automation providing us at least the very basic information of  “shared.” Seeing the word “SHARED” can be the equivalent of shouting the word  “squirrel” and having the dog reaction of quickly turning around as in the Disney movie Up.  Does your neck hurt yet?

But by whom and where was it shared?

Was it shared externally or internally in the recipient’s organization?  Was it shared with a  supportive recommendation message,  or, reaching high in the chuckle factor? Important to know as dark sharing impacts and influences the buyer’s journey and sales process.

Changing how we track what’s going on.

We are early in the process of discovering the hidden treasure trove of data in dark social, but there are ways to begin to understand how your information is being shared and used.

One way is to add trackable code to URLs someone may copy and paste in messages. Another way is to add trackable code to your website content for when it is copied and pasted.  When publishers participate with you, a short trackable code added to any text for when it is copied and pasted into a message.

It’s early, and more ways are being developed to track the activity on dark social. But all marketers need to begin to understand and respond to the influence of dark social on their marketing and find ways to leverage what is unseen.

Michael is a healthcare marketing business, marketing, and communications strategist and thought leader.  As an internationally followed healthcare marketing strategy blogger, his blog, Healthcare Marketing Matters receives over 20,000 page views a month and read in 52 countries.  He is a Fellow, American College of Healthcare Executives, Professional Certified Marketer, American Marketing Association and HubSpot Academy- Email Marketing, Inbound Marketing & Inbound Sales Certified. Post opinions are my own.


For more topics and thought leading discussions like this, join his group, Healthcare Marketing Leaders For Change, a LinkedIn Professional Group.