The Upstream Healthcare Audience Puzzle

In healthcare marketing, it’s often assumed high-visibility, consumer-facing communications are the primary areas of focus. But the healthcare ecosystem is complex, and there are multiple upstream influencers who determine the total number of consumers eligible to come to your hospital or physician network for treatment.

In healthcare marketing, it’s often assumed high-visibility, consumer-facing communications are the primary areas of focus. After all, the response rates to these campaigns drive the Return on Investment (ROI) metrics shown in quarterly reports. But the healthcare ecosystem is complex and there are multiple upstream healthcare influencers who determine the total number of consumers eligible to come to your hospital or physician network for treatment.

Changes in influencer priorities or relationships can dramatically decrease or increase your pool of commercially insured prospects. So, a strategic approach to marketing requires being mindful of these upstream stakeholders, crafting aligned audience-based messages and conducting focused outreach that keeps your brand as a ‘must have’ in their decision-making.

Where Upstream Healthcare Influencers Come Into Play

For example, let’s say there’s a long-established manufacturer in your market with 500 employees. It’s considered one of the best places to work because of advancement opportunities and good pay, so people stay a long time. Because of that, the workforce’s average age has drifted up into the 40s. Some still use maternity services, but the claims history now includes more high blood pressure related encounters, hip/knee replacements and oncology care.

The cost of claims to the insurer rises to over 85 percent of total premiums paid by employer and employee. Months ahead of open enrollment, the insurer proposes a significant rate increase to the broker the company has relied upon for years. The company’s CFO strenuously objects because the increase would squeeze its margins, forcing it to raise its own prices or cuts costs elsewhere.

The haggling between employer, broker and health plan begins in earnest and trade-offs are explored. These usually involve changing benefit structures, but in some situations, the manufacturer will change insurers completely or move to a narrow network product.

If your doctors and hospitals are ‘high performing’ and remain in-network, this can be a growth opportunity. For everyone else, that workforce and all those dependents just became unpersuadable through consumer advertising — they simply won’t pay out-of-network rates to come to you.

I’ve seen these volume shifts undo the progress made through consumer-directed outreach.

How do your physicians, hospitals — and your marketing — influence this chain of events?

Yes, much of it is based on hard data about per-encounter costs, clinical quality, chronic illness management and readmission rates, but negotiations also have a perceptual side. What’s the awareness and perception of your organization among these influencers?

Here’s where a marketer’s expertise can help:

Existing Patients/Members

Help your organization achieve quality and patient engagement goals by using your knowledge of persuasive techniques to improve shared-decision making efforts. According to Health Affairs, patients who are not engaged in their care incur costs up to 21 percent higher than patients who are very engaged.

Additionally, even small improvements in medication adherence, appropriate use of the Emergency Department, handwashing and post discharge follow-up appointments with Primary Care Physicians can pay off noticeably in quality and cost metrics.

A marketer’s understanding of patient experience mapping, consumer psychology and communications tone can support patient and staff engagement efforts. Touch base with clinical and case management leaders and offer your help.

Employers

In the U.S, half of health insurance coverage comes through employer-sponsored plans. The yearly determination about benefits is a serious discussion that involves human resources/benefits, as well as finance/administration.

How to Map Your True Hospital Marketing Area

Do you know your hospital’s true marketing area? This answer is a foundational element for any strategic healthcare marketing plan. The scope and shape of your marketing area determines what marketing strategies and tactics make sense when trying to increase hospital’s patient volume.

Do you know your hospital marketing area?

This answer is a foundational element for any strategic healthcare marketing plan. The scope and shape of your marketing area determines what marketing strategies and tactics make sense when trying to increase hospital’s patient volume.

You need to build hospital marketing area maps.

One of the ‘rules’ about marketing is that it’s usually more cost effective to increase frequency among existing customers than it is to attract entirely new ones. Although pure consumer selection does drive volume for some services, physician recommendations drive a greater share of volume for non-emergency inpatient admissions and outpatient procedures. (For today’s purpose, we will focus on ‘decision simplicity,’ physicians as customers and referral patterns, and tackle how to leverage pure consumer preference in another article).

The purpose of creating maps is to create a common, objective understanding of your primary and secondary marketing area. The size and shape will be determined by the distribution of your physician network, economic circumstances in different areas, competitor locations and expertise, traffic flow barriers and travel time.

After all, most healthcare is local. By understanding the size and shape of your marketing area, you can evaluate marketing and business development tactics with an eye toward impacting physicians and consumers.

Additionally, hospital marketing area maps are a great visual tool to use when explaining your marketing strategy and tactics to administration and medical leadership.

The first step is to work with your finance, strategic planning or business development departments to pull the information needed to generate your maps. Include 12 months of admissions/procedures to allow for seasonality and service lines that have a long lead time. Keep in mind these data pulls can take a while to fulfill, so submit your requests early in the strategic marketing process while developing messaging and proof points on a parallel path.

Slices to Consider in Your Hospital Marketing Area Map

1. All Patient Home Addresses/All Services

When working with patient information, HIPAA compliance is essential. The goal of patient origin mapping is to visualize patterns while preserving the anonymity of each ‘dot.’ (See tips at end.) The areas with the highest density of dots represent your primary hospital marketing area. Your marketing investment would extend beyond this core area when:

  • You are opening new satellite facilities near the edges or outside of your primary area.
  • Your competition has experienced substantial negative change in reputation, medical leadership or scope of services.
  • Your media options are scalable and are more cost-efficient than geographically targeted tactics.
  • You need to make a high-impact statement to raise top-line awareness, improve your hospital’s reputation, re-launch a brand, or attract and retain highly covered clinical leaders.
  • You are marketing a specialized service line where there’s greater willingness to travel.

2. Patient Home Addresses by Key Service Line

The more significant a diagnosis or procedure, the more likely it is the specialist will express a preference about where it would it should be performed, and the more likely a consumer will travel further for it. This is usually the secondary service area captured on your map. The dot density will be less, but the commercial or Medicare reimbursement may be very attractive.

To visualize your secondary service area by service line, you will need to define the CPT (Current Procedural Terminology) codes to include in the request you provide to finance or strategic planning. CPT codes are standardized and used in billing/claims processing to indicate the services rendered. The key is determining which CPT codes to include or exclude to get an accurate picture of just that service line’s market area for higher margin procedures. For example, in the case of an orthopedic service line, you may wish to exclude related services like physical therapy or lab tests and focus more narrowly on knee replacement surgical patients. You can get a 14-day free trail of a tool to identify CPT codes from the AAPC to help.