Get FIT to Build G.I. Patient Volumes

April 2, 2010

You can quickly and profitably build gastrointestinal patient volumes by targeting those who need a Fecal Immunochemical Test (F.I.T.)

By mailing out the easily self-administered fecal occult blood test – better known as a F.I.T. kit – to a targeted list you will drive a predictable volume of patients.

BTW- Who needs a F.I.T. kit? Just about everyone over 50 years old, but the target can get even sharper than that if you want.

A Real Life Case Study

A mid-market hospital sent out 10,000 kits to a targeted list:

6% were returned… or 600 kits were sent back to the lab for testing

60% of those 600: 360 returned were positive for cancer

90% of those 360: 324 chose to take the next step with the hospital (colonoscopy, other lab work, other images)

20% of the 324: 65 patients needed ongoing medical care like surgeries, imaging, medical oncology, radiation oncology, inpatient care, etc.

Here Is The Business Case You Must Understand: The whole program cashflowed from Day One

The return envelope included a pre-signed doctor’s order for lab work – which makes everything reimbursable from the very beginning of the program.

The total bottom line Contribution Margin for mail sent to 10,000 households was in the tens of millions by the end of year two. Not at bad investment for 10,000 pieces of mail.



Coordinate All Service Line Marketing To Increase Patient Volume

March 16, 2010

A common and destructive hospital marketing problem – which is very easily solved – is when every service line has autonomous marketing and budgeting.

At best, this means needless expense from uncoordinated media purchases. At worst, it means that the health system has a fragmented brand reputation that inhibits driving patient volumes.

A real life example:

I recently met with a $2 billion+ dozen-hospital system. They were very proud of their creative and beautiful marketing campaigns all running at the same time:

  1. their OB/maternity program had a pink-and-blue-cute-fat-baby campaign
  2. the heart program had a valentine red heart campaign featuring doctors and great outcomes
  3. a sports medicine program used colorful inspirational scenes of athletes in action
  4. their cancer center featured a documentary style doctors-doing-research-to-cure-cancer motif

All these campaigns are good individually, but together their marketing is a hot mess. They don’t realize they are just confusing people.

How could they fix this quickly?

1st: The system brand promise, visual identity and tone should be the same for each campaign.

This increases consumer message retention, and most importantly, every service line communication also builds every other service line. For example, during a CV campaign it is common that patient volume also increases in cancer and ortho simultaneously – and vice versa.

2nd: A marketing calendar and coordinated media plan should be instituted.

This eliminates competing messages in the market place from within your own organization and clarifies the brand messages in physicians’ and consumers’ minds. It also minimizes media expenses.

These changes are relatively easy to make compared to some of your bigger challenges in hospital marketing, but these changes will have an immediate and profitable effect.


The Fastest Way To Increase Patient Volumes- Capitalize On The Co-Risks

March 11, 2010

Marketing to your existing patients is not only the fastest to increase patient volumes, but also the cheapest way. And Bonus: It is the kindest thing you can do to serve your patients.

We all have enough statistics to know that our patients are very likely to have one or more co-morbidity.

Recently we got a peek at a proprietary normative database. “Normative” means it is set up as a benchmark of what is “normal” statistically speaking.

There were some surprising learnings in there. Here are a small amount of practical examples:

  • Did you know that anyone that fails a simple CV risk assessment, whether or not they have an actual CV problem, have a 30% chance of needing an orthopedic procedure? Or a 10% chance of having cancer?
  • If they fail a cancer exam, the numbers are flipped: and 30% chance of a CV problem and 10% chance of a ortho problem
  • If they are a bariatric patient, they will fail a PVD screening 99% of the time and have over 30% chance of needing a joint replacement
  • If your hospital is like everyone else’s, then over 60% of your inpatients have a primary or secondary diagnose of diabetes. The list of likely co-morbidity issues is huge with diabetes- but those patients are rarely cross screened while being treated.

It is worth the hassle to ask your medical staff to allow patient cross-screenings for a co-morbidity. It is the right thing to do for the health of the patient and the right thing to do for the financial health of the hospital.


The Hidden Benefit to Building Patient Volume: Downstream Revenue

March 10, 2010

Your successful efforts to build patient volume have a big hidden upside: Downstream Revenue. This later revenue will likely far exceed the amount of money you drove in by the initial marketing campaign.

For Example #1:

A program in a medium-sized market Academic Medical Center to increase mammograms drove in a marginal 1000+ mammograms per month for nine straight months. This was considered a fantastic success. The bottom line (minus all costs and marketing expenses) Contribution Margin from imaging, lab work, and biopsy surgeries was $2.7 million.

There was measurable Return on Investment (ROI). Everyone was thrilled.

But over the next year came more money from inpatient surgery, outpatient medical oncology, radiation oncology, and more imaging. The additional bottom line money a year after that nine month campaign was over $12 million. That is in addition to the initial $2.7 bottom line Contribution Margin in Year One.

For Example #2:

Another unexpected driver of business we have seen is Cardiovascular campaigns. We can’t fully explain it (although we have some answers and some theories), like cause and effect when a hospital runs a successful CV campaign, other procedures go up during the campaign period.

Some of this gain in business is obvious from the cross screening for other risks when a patient comes to a screening event. But like I said above, some I can’t completely explain. But as sure as summer follows spring it happens every time.

We recently saw a CV campaign that drove over $12 million additional Contribution Margin into the system. But the “unexplained” increase in business was over $40 million in net bottom line Contribution Margin.

The real interesting thing about CV campaigns is that when you find a high-risk patient, they eventually turn into a surgery patient. CV campaigns keep paying off for years to come.

You are doing great work as a health system marketer. You can drive business with measurable ROI. But what you may not have noticed is the additional downstream revenue you have been driving into the system.


Understand Access Points Into the Hospital to Build Patient Volume

February 22, 2010

90% of patients came from physician referral in 1999. Today, it's far less.

Hospital marketers seem to think that if they do a great job with branding… Or if they have great advertising… or if they are a well-known and respected community partner patients will somehow get into the system. Frankly, that is crazy.

One of the key questions you must ask before you do any hospital marketing is how will this drive a patient to one of the access points into the system?

So what are the access points into the hospital?

  • Most patients come from physician referral. But it is dropping- maybe 90% came from referral in 1999, but by some calculations, that number is now 50% or less in 2010. Those with strong physician liaison programs and comprehensive employer and on-site programs are winning this game compared to their competition.
  • Emergency Department/Trauma: here is where the General Surgery and Orthopedic volume benefit most… but all kinds of profitable procedures come through the ED. The key is to not let it become a Primary Care facility.

Our tendency is to lump the rest into “self-referral,” but that is way too general. What are the self-referral sub-categories?

  • Second Opinion Patients: When a person gets a catastrophic diagnosis, they and/or their family immediately go to the internet to find the latest protocols and leading doctors to treat the problem. Those that are experiencing pain or repetitive use injuries, diagnose and educate themselves online. Hospitals that have a comprehensive digital strategy to highlight capabilities win this patient.
  • The Pre-episode/Asymptomatic Patients: Maybe 5% of the adult population has a serious undiagnosed cardiovascular issue.  Maybe as much as 7% has an undiagnosed  cancer. Maybe 5% of adults over 55 could benefit from an an orthopedic procedure.  Hospitals that have a program to engage these patients win: Online Screenings, Early Detection events, Wellness information, and Informational Seminars. They key here is to provide easy opportunities to make appointments after each contact, and to provide a structure to evaluate co-risks. Did you know, for instance, that 30% of all CV patients need an orthopedic procedure? Or almost 100% of Bariatric patients will fail a Peripheral Vascular Disease screening?  Or that 10% of all cancer patients have cardiovascular disease- mostly undiagnosed? You have to look for co-risks.



The Three Keys To Building Breast Cancer Patient Volume

January 18, 2010

An Academic Medical Center drove an additional 9700+ mammograms in just nine months, generating $2.7 million dollars in net Contribution Margin from imaging, lab work and biopsy surgeries.

Later much more Contribution Margin was realized from additional surgeries, medical oncology, and radiation.

They did this without advertising price discounts on mammograms, adding new facilities or recruiting new doctors. They also did this in spite of the national trend that fewer women are getting mammograms.

How did they do it? Of course they targeted the right demographic audience with a well executed and creative campaign- but every health system does that. What made their results so extraordinarily successful?

  1. Be willing to do mammograms at convenient times (They understood that women are busy. Mammograms have to happen after work and on weekends.)
  2. Make scheduling convenient with online and mobile sign up (If she can easily sign up on her computer at work or 24/7 when she has a minute, she is hundreds of times more likely to sign up.
  3. Make it a girls group thing (They ran programs like “Good Morning Mammogram” that had group coffee on weekends or “Girls Night Out” that started with a mammogram. She was likely to go if recruited by her friends.)

Your mammogram marketing is probably 99% of the way there. But by adding the three keys above into your marketing, the last 1% can bring explosive growth.


To Drive Patient Volumes Stay Focused on What Matters to Your Target

January 12, 2010

Drive Volume: Beware of the Not So Low Hanging Fruit

Screenings are one way of driving volume. They are also an easy way for pre-episode patients to find your health system.  However, not all screening campaigns will produce the same results.

Let’s take colorectal cancer for example.  According to The Centers for Disease Control and Prevention (CDC) cancer statistics:

  • Colorectal cancer (14.6): Third among women of all races and Hispanic origin populations.
  • Colorectal cancer (21.0): Third among men of all races and Hispanic origin populations.

When colorectal cancer is found early and treated, the 5-year relative survival rate is 90%. Because screening rates are low, less than 40% of colorectal cancers are found early.

This should be a slam dunk volume driver. However, screening campaigns targeted at men generally don’t produce half the results of a screening campaign targeting women. The statistics point to this low rate of screening.

The Centers for Disease Control and Prevention (CDC) use their resources to promote screenings such as these public service announcements (PSA) on YouTube.

These spots are good because the focus on the personal call to action or plea. However, the celebrity endorsement creates a barrier to the personal approach and is unlikely to motive a man to take action.  Check out this spot and see what you think: “Your Wakeup Call”

Idea:   Use a sports star or more relatable messenger to Middle America.