Why are some people healthy and others are not? How does a
person's ZIP code really affect their health? According to a new report, as the healthcare industry
accelerates its transition from a fee-for-service model to a
value-based one, population health initiatives will be larger than
ever in 2015.
Hospitals are in the business of caring for the sick and the ACO
shift to focusing on health and wellness is a cultural adjustment
that we just aren't used to. After all, if the health of the
population improves, won't that keep people out of the hospital?
There are a variety of reasons why it is necessary for critical
access hospitals (CAH) to implement population health strategies.
Not only is it the right thing to do, but it also builds patient
trust and loyalty and increases market share. In our post about turning
competition into opportunities, we explored the M&A wave,
explaining how mergers and acquisitions can be beneficial for CAHs
to strengthen their value proposition.
But, a partnership, merger or acquisition isn't always
better. CAHs are heavily linked to the communities they serve and
many are well positioned to thrive in the changing marketplace by
developing effective population health strategies.
Here are 8 smart marketing activities
CAHs can do today to get started:
- Start paying closer attention to recruitment/retention and
- Have marketing staff get involved in community workgroups,
committees and task forces that address population health
- Work with HR to develop and/or implement employee wellness
programs to encourage healthy behaviors.
- Engage staff in conversations.
- Include population health on the agenda at meetings.
- Focus marketing efforts to the uninsured.
- Reach out to the community and engage in conversations with a
wide variety of community partners and leaders.
- Keep boosting and increasing your community presence/engagement
through your marketing efforts. Get the CFO involved and discuss
charity care, bad debts and community benefit reporting.
Stay tuned to the next few posts where I'll explore other
challenges facing critical access leaders such as physician
engagement/recruitment and pay-per-performance models.
No. Not even close. Many opinion bloggers and industry writers
may think so. To us here at Legato, we see opportunity for you.
In case you missed it, Facebook dropped big news in January,
announcing to its users that they will see fewer promotional posts
in their news feeds. To brand pages (or hospital and health
system pages), this means your posts should expect organic reach to fall significantly
Specifically, Facebook is making it harder for posts that push
products, services, application installs and promotions.
Essentially, what Facebook is trying to say is that you need to
reach your audience by buying an ad. That message shouldn't come as
a surprise; in fact, it was bound to happen sooner or later.
If you think your Facebook pages are now worthless-think again.
Facebook is only trying to surface content that people care about.
So while the number of people you reach may have dropped, the
quality of those people has probably increased.
Here are 3 reasons to keep your Facebook brand pages:
1. Amazing content is king.
First, and foremost, you have to create content
that keeps fans coming back. Think about your audience and what
they will find value in. Create content that entertains, informs or
otherwise engages your audience. This is a critical piece in
boosting engagement and visibility on Facebook.
2. Facebook ad boosts aren't expensive.
In fact, for as little as $1 per day, you will get in
front of thousands of people who wouldn't have seen you otherwise.
If you are doing that and your competitors aren't, you're winning.
With more than 1.19 billion monthly active users and an advanced
set of targeting options, you can place your best posts in front of
a very targeted audience. When done correctly, advertising can
greatly improve visibility and engagement.
Advertising on Facebook will be necessary to boost
visibility on posts, attract more fans and increase engagement. We
can no longer think of Facebook as a free advertising platform.
Those days are over.
3. Fan engagement is increasing.
Despite the drop in organic reach, many
pages are seeing an increase in engagement on their pages and page
posts. This is because Facebook's algorithm is getting smarter. The
small percentage of fans who do see a page's posts are the fans who
are most likely to engage with the post. Although Facebook pages
are reaching a smaller audience, they are reaching a more engaged
audience and building a core group of engaged users.
Perception of quality. Awareness of services. Likelihood to
Imagine if you knew this important information about your
healthcare facility's target audiences. It could help shape
marketing objectives and strategies, determine what services need
to be marketed more - or less - and give you a baseline
understanding of your audiences' behaviors.
That's the power of market
Now I know it's a common concern amongst healthcare marketers -
especially if you work at a critical access hospital or rural
facility - that research is too expensive or that it won't reveal
any new information. But if done correctly, market research can
truly create a solid foundation for strong, strategic
There are two basic ways market research can benefit your
- It enables you to make marketing decisions based on objective
- It sets baseline measures that you can use to evaluate the
effectiveness of marketing efforts
And in addition to perception, awareness and likelihood to
use, there are many other insights you can gather from market
- Demographics of users and non-users of your services
- Reasons why non-users choose competitors
- The best media channels to use to reach your audiences
Still not convinced of the power of market research? Use
the link below to register for our upcoming National Rural Health
Association webinar to learn more about different research methods
and see a case study of how one critical access hospital has
successfully used market research to set and meet its marketing
Register today for "Research in Rural Health:
Building a Foundation for Strategic Marketing."
March 26 | Noon (CDT)
If you're a leader in a critical access hospital, chances are
you've had your fair share of sleepless nights. One of those murky
issues keeping you up is probably strategizing how you'll lead your
hospital through a period of major change.
Although there are many issues facing critical access hospitals,
competition seems to always rear its ugly head. Hospitals often see
their biggest competition as each other - for obvious reasons, I
understand. But I believe there are also a number of promising
opportunities for rural hospitals to utilize "the competition" for
future success, especially when it comes to shared services and the
potential for regionalization and/or partnerships with larger area
The M&A wave
Mergers and affiliations among hospitals, health systems and
physician practices can overturn traditional market dynamics,
leaving existing systems with new and bigger competitors. For
example, take the merger between Advocate Health Care and
NorthShore University Health System. Overnight, two of the largest
competitors in Chicago's metropolitan area became one of the
largest systems in the country. This deal created a 16-hospital
system called Advocate NorthShore Health Partners, which will be
the largest in Illinois and the 11th largest nonprofit system in
the country. Deals like this dramatically and quickly alter the
landscape for other hospitals in a similar market.
Keep in mind that critical access hospitals bring tremendous
value to healthcare systems because of their ability to provide the
right care at the right place, locally. That's going to make them
attractive to larger systems, especially when these systems are
looking at the potential expansions of Accountable Care
So at some point, it will become beneficial for CAHs to consider
a range of partnership and affiliation opportunities to strengthen
their value proposition. Even hospitals that are independent in a
corporate sense typically participate in various partnerships or
affiliations, such as clinical affiliations and cooperation
agreements for sharing expertise and best practices.
As we mentioned in a
previous post, in order for rural hospitals to survive in this
climate, the development of innovative solutions that promote the
delivery of integrated, quality healthcare within budgetary
constraints is a must. Resource sharing, affiliations and joint
venture arrangements with regional partners can yield benefits
without surrendering independence.
In the next few posts, I'll explore other challenges
facing critical access leaders such as ACO, population health,
physician engagement/recruitment and pay-per-performance models.
The rural healthcare system has changed dramatically over the
past decade due to the implementation of the Affordable Care Act.
However, overall resources still remain relatively inadequate. Many
rural hospitals continue to experience shortages of physicians,
reimbursements, financial strains and new information technology
requirements. In fact, nearly 50 rural hospitals have closed their
doors since 2010. But is it all doom and gloom? Not if we stay
ahead of these three trends:
TREND 1: Telemedicine, EMR and digital
We have to embrace technology. We can no longer deny it,
especially since telemedicine - the use of telecommunications
technologies to support long distance healthcare - has become more
common and isn't going away. It helps tackle the problem of
physician shortages by connecting patients and providers over long
distances, as well as increasing your patients' access to specialty
Telemedicine is also a great use for extended therapy; patients
can do sessions from their home, using video game consoles and
telecommunications with therapists, hopefully saving more money
than they would if they went into clinics.
Electronic medical records were mandated by a 2009 federal law,
but many rural hospitals have still not gotten on board. Electronic
medical and health records are not only easier to organize and
understand, but they also allow different doctors' offices and
clinics to collaborate on patients' care and better understand
their patients' medical histories, especially those with chronic
illness. Not to mention, this kind of technology helps rural
hospitals attract more physicians.
A third digital trend is the digital health clinic, which
increases access to care while reducing costs. This allows patients
in rural areas who don't have access to specialists, or those who
can't leave their home, to get the treatment or advice they
TREND 2: Prevention, education and outcomes
Generally speaking, rural hospitals care for an older, sicker,
less educated, less-affluent and more overweight population. That
can pose many challenges when it comes to the shift of
reimbursements from fee-for-service toward pay-per-performance.
As healthcare becomes increasingly outcome-based, evidence and
definitions for high-quality outcomes will be in high demand. We'll
also see pressure to deliver better outcomes at lower cost. Rural
healthcare providers must acknowledge and confront this challenge
by emphasizing prevention.
TREND 3: Mergers, acquisitions and
We're seeing this across the board in Wisconsin. And the
strategy for many of the mergers and partnerships is to negotiate
now, from a position of strength, rather than waiting for market
pressures to force a move. In order for rural hospitals to survive
in the changing climate, we must focus on the development of
innovative delivery models that promote integrated, quality
healthcare within budgetary constraints. Resource sharing,
integration, and joint venture arrangements with regional partners
can yield benefits without surrendering independence.
What can you do today to stay on top of the
1. Keep track of market share to determine how many patients are
leaving town for care.
2. Use surveys and/or focus groups to understand your weaknesses
so you can improve your community perception.
3. Develop messaging strategies based on your strengths.
Want to discuss
any of these trends in more detail? Send me an email or give
me a call at 920-544-8102.
Under the Affordable Care Act (ACA), primary care has taken
center stage - and for good reason. Reorienting hospitals and
clinics toward primary care is a fundamental step in making
healthcare more accessible and affordable. It can decrease ER
visits, reduce hospitalizations and even lower mortality rates.
But as the number of PCPs continues to shrink, the demand for
primary care continues to rise. That begs the multi-million dollar
question: How can rural hospitals keep pace?
The answer is far from simple. In fact, there is no "one"
answer. All hospitals, especially rural hospitals fighting to
compete with bigger healthcare systems, will need to take multiple
steps to help offset the increased demand for primary care
services. That brings us back to the question of, "How?"
I'll sum it up in one brief but critical statement: By turning
their focus on prevention, patient education, diagnosing and
managing chronic diseases, as well as alternative approaches to
delivering care. Here are some examples:
- Offer virtual learning opportunities and build out your website
to include risk evaluation surveys and general health information
- Implement web-based screening and treatment reminders.
- Create and promote programs that teach self-screening.
- Develop a medical home program that coordinates patient care
across all settings. Primary care physicians could manage a team of
non-physician practitioners; an advanced-practice nurse could
conduct follow-up visits with patients with chronic diseases, like
- Create a health action team that includes leaders from all
sectors of the community to discuss local health issues.
ThedaCare's Community Health Action Team (CHAT) is a good
- Consider the role of transitional care nurses (TCNs). A TCN is
generally an advanced practice nurse with a master's degree in
nursing. After a patient is released from the hospital, the TCN:
- Conducts weekly home visits for a certain period of time and is
available to the patient seven days a week via phone.
- Accompanies the patient to the first post-discharge physician
- Helps patients and caregivers successfully manage the patient's
care at home.
- One evidence summary shows a 30-50% reduction in
rehospitalizations, and net savings in healthcare expenditures of
approximately $4,000 per patient, within 5-12 months after patient
It's not a matter of "if" these and other steps need to be taken
by CAHs. It's a matter of "when." And that answer can
be summed up in one word: "Now."
The Affordable Care Act (ACA) has opened the floodgates to
changes in the insurance industry. You already know about the
Health Insurance Marketplace and other insurance exchanges. But
have you heard about fast-growing startups like Zenefits?
Long story short, companies like Zenefits are tapping into the
post-ACA insurance market. They're giving small to mid-size
businesses and their employees new options to buy insurance online.
No news there - but …
Now that consumers can easily compare coverage and costs, many
are choosing plans with higher deductibles and out-of-pocket
expenses. That means "value" is a hot button. But you know as well
as I do that "apples to apples" comparisons rarely exist in the
complex world of specialty services and surgeries.
Changes in the insurance industry also pose another challenge
for hospitals. Many newly insured will have limited knowledge about
their coverage or how the healthcare system works.
So what's a CAH to do? Change the way you communicate.
- As more and more consumers begin to shop for "value," it's
critical to provide them with information about quality of care as
well as price.
- Different patients need different types of pricing information
based on their insurance coverage. For example, consumers with
covered hospital services may be concerned about out-of-pocket
expenses and may want to compare your hospital with another. Make
it easy for them to get the information they need. If you don't,
they'll simply move on to the next choice.
- Consider creating videos to address frequently asked questions
that consumers and patients can view from home or even on a tablet
in your waiting room. You may have featured physicians in previous
videos. This time, focus on FAQs that are answered by your billing
expert and front-office staff on a daily basis. For example,
feature a brief tutorial on basic insurance terminology.
- Partner for prevention. You may already attend local health
fairs to talk about nutrition or to give free blood pressure
screenings. Consider inviting professionals from different health
plans to join you and answer questions. Another option is to bring
health plan representatives to your hospital for Q&A
- Take another look at how you're advertising. As more
patients gain coverage, hospitals can benefit from advertising to
the newly insured with targeted messages.
Healthgrades. Facebook. Angie's List. Twitter. These are only a
handful of online sites where prospective patients can learn about
your healthcare organization and current patients can share their
experiences. The power these sites have on consumer decisions can
be intimidating, but also incredibly beneficial to your
So needless to say, it's important to not only be aware of these
places, but to also take an active part in the conversations -
which can be done through strategic digital marketing efforts.
When approaching marketing in the digital world, there are two
areas to think about:
"Building" covers the development of online elements you can
control, like your website and online advertising. These tools
ensure your audiences have access to accurate information about
your facility and providers. They also help audiences form their
first impression of your organization.
"Protecting" is managing online features you are not in complete
control of, such as review sites or comments on social media. We
call this online reputation management, and it involves:
- Monitoring review sites and social media
- Engaging with your online audiences to address negative and
- Being honest and transparent in communications
But you shouldn't think of "building" and "protecting" as two
separate efforts. They go hand-in-hand when it comes to ensuring
your organization is well represented online.
If you are interested
in learning more about healthcare marketing in a digital world,
attend our webinar this Thursday, January 15 at noon
(CST). We will take a deeper look at several strategies to
build your organization online, including modern web design and
SEM, as well as effective ways to protect your online
Click here to register
Health exchanges are here - and so are millions of newly insured
patients. That means your CAH has a decision to make. Do you "duck
and cover" or come out fighting to gain some much-needed ground
from your competition? If you choose to leverage this opportunity,
be prepared. These aren't your "typical" patients.
The truth is, many newly insured patients will have plans that
pay lower rates to your hospital. But there's a flip side to this
downside. These patients' plans are required to cover a broader
range of services. Services your CAH can provide to grow revenue
from consumers who have never walked through your hospital's doors
Here are some ways to optimize this opportunity:
- Promote prevention, wellness and diagnostics
as volumes will shift in this direction. This goes beyond the
"norm," like colonoscopies and mammograms, to include diet
counseling and other wellness services. Another thought: Could your
CAH benefit from extending your marketing strategy to include
- Define your hospital's role in
outreach and develop and promote programs that will
educate the newly insured. With limited knowledge of the healthcare
system, these new patients are more likely to use ER services. Work
with your marketing department to develop programs and materials to
educate new patients on the best way to manage their health - and
- Address patient access issues. With more
complex billing, eligibility and collections processes, it's
critical to confirm eligibility and review obligations with the
patient upfront. This may include incorporating new tools to verify
coverage and screen for Medicaid eligibility and exchange
- Train "financial counselors," "care navigators" or
"insurance assisters." Whatever title you choose, you'll
need knowledgeable staff to help individuals fill out paperwork and
determine eligibility for coverage and subsidies.
- Don't lose sight of patients with employer-sponsored
plans. As you address the needs of the newly insured,
don't overlook the fact that employer-sponsored plans are shifting
more responsibility to the patient. You'll need to adjust your
marketing strategy to address the needs and demands of these
consumers as well.
How to Talk to Physicians to Build Relationships
You say, "provider;" I say, "physician."
While it may seem like a matter of semantics, healthcare
marketers need to choose their words wisely - especially when
talking to physicians. One internist summed it up this way: "Today,
doctors are called providers. I didn't go to provider school."
But choosing a complementary common noun is just the beginning.
Today, many hospitals - caught up in service model mayhem -
overlook one critical fact: Doctors are faced with similar
challenges and they're concerned about the future. In fact, six in 10 say that the practice of medicine is
While it may sound disheartening, rural hospitals can turn this
concern into an opportunity to strengthen physician relationships
and increase referrals. But just as the healthcare landscape is
changing, so too, are the mindsets of physicians. That means the
way healthcare marketers talk to them also needs to change. For
- Show empathy (but be careful not to patronize). Assure
physicians that your hospital understands the additional pressures
they face today, and maintain direct dialogue as new payment models
and integrated care methods are developed.
- Profile physicians so you can personalize and specifically
target your message to them.
- Free online tools like SurveyMonkey can help identify
physicians' interests, challenges and concerns.
- Consider investing in research and/or a medical staff
satisfaction survey to help clarify physicians' opinions about a
variety of issues relating to their practice and their relationship
with your hospital.
- Develop key messages around physicians' wants and needs as well
as how your hospital is addressing those issues to benefit them and
their patients. You may find your messaging may relate to some of
these areas that physicians feel strongly about:
- Developing patient relationships.
- Protecting and promoting the health of individuals.
- Interacting with colleagues.
- Match your values to physicians' values. What's important to
your CAH is most likely important to doctors as well.
- Speak in a language physicians understand. Most physicians are
logical thinkers, so getting them to act often comes down to
evidence-based conclusions. Stick with the facts; they'll help draw
physicians to the conclusion you want them to reach.
- Establish each doctor's preferred communication method and use
The 2013 Deloitte Survey of U.S. Physicians found
that nearly two-thirds of physicians believe doctors and hospitals
will become more integrated in the next one to three years. That
can be a golden opportunity for your rural hospital - if you know
how to talk to physicians to build trust and relationships.
Watch for my upcoming blog on how to talk to patients in a new
era of healthcare.