The Key To CV Patient Volume Increases- PV Screenings

April 12, 2010

I know how you can add millions of dollars to your bottom line fast– by screening for peripheral vascular disease.

You may be running a very good CV program, but equivalent procedures are off anyway. Why? Statin drugs actually work. Drug eluting stents work. Boomers are a whole lot healthier that we thought they’d be.

So why is PV the growth area?

  1. PV is way under diagnosed
  2. It is a high-incidence disease
  3. It is easy to treat (cath lab, surgery, imaging)
  4. It has rich reimbursement – even from medicare
  5. Interventional Cardiologist made an estimated 9 – 11% less money last year- here is a way to help them re-coop their losses
  6. You already have the staff
  7. No new capital investment is required

Your Next Steps-

Start screening appropriate inpatient and outpatients (especially for any bariatric or diabetic patient); provide ultrasound screenings for the carotid artery, abdominal aortic screening, ankle-brachial index (ABI) and peripheral arterial screenings.

Targeting Peripheral Vascular Disease is great marketing: targeting a high-contribution, high-incidence procedure all by leveraging existing assets. This is the kind of marketing that contributes to the financial sustainability of the health system- and that is why health system marketing exists.




Do CT Heart Scans Build Clincal Volume? Yes!

April 9, 2010

A self-paid $99 CT heart scan should break even on imaging, but can drive millions of dollars of CV business into the system.

As a marketer, I love CT heart scans. They are a fabulous call-to-action for your advertising. I have seen many health systems do a fantastic job promoting these in primary care offices and to consumers.

Why isn’t everyone doing it?

I had a head of cardiology at an academic medical center kill the idea because the American College of Cardiology is ambivalent in their endorsement of CT scans- or non-endorsement of scans is more like it. CT scans have radiation, of course. And they will miss many types of heart disease while possibly showing a clean score on calcium.

But nobody is saying not to get one, they are simply warning that the test is an incomplete heart evaluation on its own.

After the above academic doc killed the idea, a local hospital system picked up the idea and ran with it. The competitor’s increase in equivalent procedures went through the roof- as did their marketshare. I wish my client had put their hesitations aside and at least played defense by promoting the heart scan.

If the calcium score reads anything but zero, insurance pays from then on. It is the green light to great paying patient. And most people in their 50’s or older fail to score a zero.

I am an enthusiastic supporter of using a CT heart scan as your advertising call-to-action. Not only for all the reasons above, but also as a defense to keep a competitor from taking the business from you.


Become the “Patient Distribution Czar” to Increase Patient Volumes

March 15, 2010

Sort the patients that come into the health system through advertising and communications to quickly increase your clinical volumes and build great relationships with physicians. We humbly call this being “The Patient Distribution Czar“.

Let me give you a real-life example from a cardiovascular marketing program:

A campaign drove thousands of patients into risk assessments- both at events and online. Of a typical 1000 patients, because they targeted correctly, about 400 failed a CV screening. Of those 400, about 200 opted-in and asked to see a cardiologist.

Wow! Successful campaign, right? Then why were the CV doctors so angry? Because their office staff became overwhelmed with appointment requests- and most of those patients did not need to see a cardiologist.

Oooops. What did we learn?

First we learned that cardiologists are upset when you clog up their appointments with someone who should have seen a Primary Care doc. They are even more upset when the leg pain that caused the failure in a CV screening turns out to be an orthopedic problem.

There is a way to make everyone in the whole system happy and raise the perceived value of the marketing department. You must distribute the patients.

Step One:

When a patient fails an online screening, a nurse should call them back immediately (stats show the lead is cold in 72 hours). The nurse should walk through their screening answers with them- make sure they understood and put in the correct numbers.

If indeed this is still a high-risk patient then…

Step Two:

Set up a face-to-face meeting with a Nurse Practitioner or an RN for a cursory exam. That nurse should determine if a cardiology consult is needed- or if very severe symptoms exist, an immediate ER visit. Also maybe that leg pain is a ortho problem and a consult with an orthopedic surgeon is the right next appointment.

Everybody in the health system is now happy. You are building PC practices, CV practices, and other specialties as needed. Now the money spent to find patients is paying off by plugging patients into the system efficiently for your physicians while truly improving patient health.


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.


Quit Competing with Other Hospitals to Increase Patient Volume

October 29, 2009

Focus on Expanding the Market for Profitable DRGs by developing an early detection program.

We just witnessed a Midwestern health system (in a medium-sized market) bring in over 400 additional CV procedures, a significant change in year-over-year equivalent procedures, without directly competing with other local hospitals. They just found an additional 400 procedures. This brought in a conservative estimate of over $3 million dollars in bottom line contribution margin.

So, how did they do it without aggressively “competing” for the business? Is this a trick question? Did they buy physician practices; or buy new facilities; or hire new specialists; or open surgery centers; or any other expensive gambit?

No. Not a trick question. They did it by actually creating a new market—and you can too.

Most health systems/hospitals compete in expensive ways such as acquisition and advertising. But this hospital did it by constructing an early detection program that at the screenings (both online and in person) asked at-risk persons if they wanted to opt-in to a program to see a physician. More than 80% took them up on the offer.

Similar success has been seen with hospitals that have used organized online and in-person screening for cancers, stroke, joint, spine, and bariatric procedures just to name some of the major high-incidence, high-contribution DRGs (Diagnosis-related groups).

This sounds simple, but efficiently executing this program takes some planning and know-how to maximize your success and ROI. Done correctly, you can go from looking like a money-grubbing hospital to a valuable community asset and partner working to save lives in the community you serve.

Your bottom line and your reputation improve simultaneously, and there is no need for expensive marketing “competition.” Just the thought of that makes my heart feel better.