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.



Want To Build Sleep Center Volume- Look Under Your Own Roof

March 3, 2010

Quit wasting money on Sleep Center advertising- all the patients you need are in your hospital now.

A study just concluded that 60% of all inpatients have sleep apnea  or other sleep disorders that should be treated by CPAP or other therapies.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.

How do you find them?

Set up a program of screening likely candidates: like every bariatric patient, any CV patient, many cases of memory loss (some misdiagnosed as age related dementia), 80% of any patient that has a primary diagnosis of diabetes, or any man over 50 with a BMI of 30 or greater just to name some.

Doing risk assessments of inpatients isn’t just good business, it is the right thing to do and can improve lives dramatically sometimes even save lives.


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.



Can You Really Use Pro Sports Sponsorships to Drive Patient Volume?

February 19, 2010

It sure isn’t easy, but it is possible to experience some level of measurable ROI from pro (and other) sports sponsorships.

Most health systems get sucked into pro sports sponsorships at some level because they feel either obligated to participate in their community by sponsoring local teams or they think the investment is justified to keep in front of referring physicians and consumers that likely have great payers.

(This discussion is different from school sports sponsorships sometimes coupled with a school nurse program that can especially lift sports medicine and other orthopedic business. That is a discussion we cover in a different post.)

The Key is how you activate those sponsorships.

Here are some quick tips:

  • FIRST AND MOST IMPORTANT: Make it look like they are sponsoring you. That arena or stadium is full of corporate ad signage for beer companies, soft drink companies, fast food franchisers and other products. You do not want to look like a greedy over-priced corporate advertiser. You want to look like a healthcare mission that the team is sponsoring.
  • As part of your deal, include live kiosks for online screening set up around the arena. The headers on the kiosks may say something like “7 Minutes to See if You Will Have a Heart Attack Soon” or something else like that to provoke usage.  You will get a shocking number of people do it, and about 40% of those will ask to be contacted by you for more information- and most of those will end up in an appointment.
  • Include player and other team celebrity appearances at events all year-round. If a former player, coach, or even a benchwarmer shows up to screening event, a couple hundred more people will too.
  • Get on-site staff involved to interact with the public– like your health promotions team or even RN’s will work at pre-games as ambassadors for tickets. This drastically increases consumer participation and the perception of your organization.
  • Set clear metrics for success and ROI measurement. You are probably doing this for other spending, but it must be done for sponsorship too. Anything measured and reported grows.


A Quick Tip to Build Your Reputation & Drive Your Patient Volumes

February 15, 2010

An example of the kind of articles YOUR doctors should be writing about but don’t.

Nearly 2,400 Americans die of CVD (Cardiovascular Disease) each day, an average of one death every 36 seconds.

This stat was included in an article written for a magazine targeted to entrepreneur and business owners who have high stress and based on the article and the stats – some of these people are at risk for heart disease.

The author of the article, “Go Red! The Stress-Healthy Heart Connection,” Carol Scott M.D.,  increases her reputation by being where her potential target is already seeking other information.

A couple of quick tips regarding blogging and articles written by YOUR doctors:

  • Make sure you know the audience – is it patients with some knowledge, other doctors or medical professionals, or a at risk community that may not be aware.
  • Make sure the audience has a call to action or some kind of take away.
  • Get the hospital system name in it.    Dr X currently practices at X hospital system.


Hospital Administrators are Bad at Marketing Strategy that Drives Patient Volume

January 22, 2010

A lot of hospital marketing strategy is awful.  Especially marketing that is heavily influenced by hospital administrators and physicians. They are usually terrible at understanding the kind of marketing strategy that drives patient volumes.

The Big problem is, they don’t know how clueless they are.

Hospital administrators want data-based decisions but marketing strategy is not data-based and not a linear problem. The “data” they should analyze is admissions data, increases in contribution margin and equivalent procedures after a campaign.

However, when you explain strategy formulation to your executive team, strategy can be explained by two important questions that must work together:

  1. Where will we play?
  2. How will we win?

Let’s quickly look at both questions

#1 In what areas will we compete as an organization: meaning what demographic are we chasing with what service lines?

Look at this Venn diagram: the sweet spot of where you compete is the intersection of your genuine expertise (and capacity), your most profitable procedures, and where you see an under served geographic or demographic group.

For instance, the example we will use here is for a cath lab: we have seen hospitals pour tons of money into Business Development of programs like CV cath labs when they are fighting tooth and nail for every procedure with other local hospitals. So they have expertise and capacity, and they make money doing it, now you have to address question number 2:

#2 How will we gain significant advantage- or avoid competition completely?

In the cath lab example, we recently saw a CV program stop competing for physician referrals because they identified an under served group: the asymptomatic pre-episode patient.

They realized that 1 in 20 adults would find out they had a CV problem from a heart attack. They set up online screenings, events early detection, prevention and wellness seminars that drove over 400 heart procedures in less than six months outside of traditional physician referral.

When forming a strategy, these two strategy questions always go together. It isn’t linear and logical but it works and can help you explain your strategy to the organization. Remember: he isn’t bad CEO, he’s just bad at strategy.

Nine Steps To Drive Measurable Patient Volume

January 8, 2010

With 9 simple steps, hospital marketing can go from an expense to a revenue producer.

My basic philosophy is that is if hospital marketing departments do not drive patient volume in a measurable way, they will always be an overhead expense.

But if hospital marketers deliver measurable Return on Investment (ROI), they will be valued as a key component of long-term sustainability.

Here are my nine proven things you can start doing right away to begin driving measurable patient volume.

  1. Target a very specific patient (No General Targets like “women 35 – 64”. Every service line has a specific segment of the market they are targeting- many have several. Ortho, for instance, has different segmentation for joint replacement, shoulder surgery and sports medicine)
  2. Collaborate with Finance to set measurable goals (Maybe admissions data. Maybe filter out previous patients. Whatever it is, set it upfront.)
  3. Choose your DRG’s wisely the most profitable DRG’s where the organization has excess capacity (Where do you have capacity AND Contribution Margin? Where those intersect is your sweet spot.)
  4. Target “pre-episode patients” (For immediate results, risk assessments and seminars will bring in patients faster than you can effect a change in referral patterns. We recently saw a CV program drive over 400 new procedures this way.)
  5. Master the 3M’s: 1) Media Mix, 2) Message, and 3) Movement ( 1) reach your target in surprising places where they can listen; 2) use a message that will stir them to action; 3) and then clearly give a call to action so they know exactly what to do next.)
  6. Opt-In Marketing is not optional (Don’t talk at them, give them an opportunity to ask you questions. Start a dialog.)
  7. Become the Patient Distribution Czar (We believe the Marketing Department is best suited to set up a system to sort patients that ask for risk assessments.)
  8. Capitalize on Co-risks (See #7 above. Did you know 30% of Ortho patients have a CV problem that needs surgery? Or 45% of CV patients have either an ortho or cancer problem? Once you find these profitable patients, sort and distribute them.)
  9. Follow the downstream revenue (You set up the metrics with finance in step #2, now track these patients through the system. Marketing job security depends on it!)

For more information on the 9 steps, download the Free “9 Things all Healthcare marketers should do to drive the right patient with the right payer to the right service line” eBook.