8 Ways CAHs Can Start Addressing Population Health Today

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:

  1. Start paying closer attention to recruitment/retention and employee satisfaction.
  2. Have marketing staff get involved in community workgroups, committees and task forces that address population health needs.
  3. Work with HR to develop and/or implement employee wellness programs to encourage healthy behaviors.
  4. Engage staff in conversations.
  5. Include population health on the agenda at meetings.
  6. Focus marketing efforts to the uninsured.
  7. Reach out to the community and engage in conversations with a wide variety of community partners and leaders.
  8. 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.

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Organic reach: Is it dead?

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 over time.

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.

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Market Research: The Missing Link in Your Marketing

Perception of quality. Awareness of services. Likelihood to use.

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 research.

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 marketing.

There are two basic ways market research can benefit your marketing efforts:

  1. It enables you to make marketing decisions based on objective information
  2. 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 research, including:

  • 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 objectives.

Register today for "Research in Rural Health: Building a Foundation for Strategic Marketing."
March 26 | Noon (CDT)

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Take Competition from a Threat to an Opportunity

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 facilities.

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 Organizations (ACO).

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. Stay tuned.

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Trending in Rural Healthcare: Three Ways to Stay Competitive

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 clinics

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 care.

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 need.

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 collaborations

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 trends?

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.

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How to Meet the Demand for Primary Care

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 sources.
  • 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 diabetes.
  • 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 example.
  • 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 visit.
    • 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 discharge.

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."

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Insurance Industry Changes are Changing the Way Hospitals Communicate

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 sessions.
  • 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.

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Harnessing the Marketing Power of the Digital World

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 organization.

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:

  1. Building
  2. Protecting

"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 positive discussions
  • 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 reputation.

Click here to register today!



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Newly Insured Patients...Ready or Not, Here They Come

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 before.

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 referring physicians?
  • 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 receive care.
  • 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 subsidies.
  • 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.

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What's Up with Doc?

How to Talk to Physicians to Build Relationships

You say, "provider;" I say, "physician."  Potato/Po-tah-toe, right?

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 in jeopardy.

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 example:

  • 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 it consistently.

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.

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