I need the following question answered and addressed:
Question
: Do you think it is ethical for physicians to publish their quality performance standards as compared to other physicians based upon publicly available data? Why or why not?
Marketing the Health Care Organization Marketing the Health Care Organization References: Marketing for Health Care Organizations Philip Kotler Roberta N. Clarke Prentice Hall, Englewood Cliffs, New Jersey 1987 The Role of Marketing in the Health Care Organization What is marketing? Not just public relations Not just fundraising Not just selling, advertising or branding Not just planning Kotler ‘s definition The analysis, planning and implementation and control of carefully formulated programs designed to bring about voluntary exchanges of values with target markets for the purpose of achieving desired organizational objectives This makes marketing a managerial process Note that marketing is designed to align the services delivered by an organization with desires, wants or needs of customers Forcing a product on a target market will most likely end in failure Distinctive Characteristics of Health Care Organizations It is becoming increasingly difficult to distinguish between for-profit and not-for-profit healthcare organizations Revenue and expense pressures have caused this blending of characteristics For profit oriented healthcare organizations the need for marketing was historically less complex Determining current customer needs and implementing mechanisms to meet those needs Anticipating needs or new markets and designing services around those needs Not-for-profit healthcare organizations have historically had two major markets Patients or clients Donors or sources of funds Given that not-for-profit organizations will often pursue many objectives simultaneously they will often end up with complicated mission statements and marketing plans States of Demand States of Demand Negative Demand – customer avoidance No demand Latent demand – need without a developed service line Falling demand Irregular demand – varying need Full demand – service needs perfectly matched with providers of service Criticisms of Marketing Marketing wastes money Marketing is manipulative Marketing will lower the quality of care Marketing is intrusive Marketing will cause healthcare institutions to compete Marketing will create unnecessary demand for healthcare Organizations Types and Marketing Responsive Organization – meeting customer needs Determining the business we are really in Exchange systems – how do we receive revenue and expend resources Determining publics Who are we marketing to and for what desired result Determining customer satisfaction and measurement Adaptive Organization – changing organization Monitor environmental changes Rapid or gradual Readiness to alter mission and objectives to evolving opportunities Entrepreneurial Organization – focus on identifying and exploit new opportunties Idea generation Idea screening Concept development and testing Marketing Commercialization Marketing Infrastructure Marketing assigned to no one Appointing a marketing executive to the Board Invite help from marketing faculty and students Hiring outside expertise – consultants Sending an internal staff member to marketing seminars Appoint a marketing committee Hiring a professional marketer to run an internal marketing operation Determine level of position within the organization and reporting line Organizational structure sends a signal about how important the function is Marketing Information and Research Marketing information system System for gathering, analyzing and disseminating relevant marketing information for decision making Marketing intelligence system Monitoring changes in the external environment Market research Systematic design, collection, analysis and reporting of data and findings relevant to a specific marketing situation Types of marketing research Advertising research Product research Sales and market research Marketing Research Process Research problem identification Exploratory research Observational research Qualitative interviewing Questionnaire design and sampling Fieldwork for collection Data analysis and report presentation Market Measurement & Forecasting Defining the market Who is the market? (market definition) How large is the market? (current market measurement) What is the future size of the market? (market forecasting Market segmentation Geographic Demographic Multivariable Psychographic Four P’s of Marketing Product What services are we delivering? Place Where are we delivering those services? Price How much are we charging for the services? Promotion How are we telling our potential customers about the services? Case One for Discussion You have been hired to assist an existing ten physician practice in expanding their practice in the metropolitan area. You have been asked to develop a plan for marketing the practice in the hopes of attracting new patients. What are the key information points you need to begin work? What mechanisms should you recommend to the physicians? How would you structure your initial report? Case Two for Discussion You have been hired by a non-profit hospital to market the hospital and its service lines to both physicians and patients in the hospital service area in hopes of increasing the shrinking daily census of the hospitals. You have been asked to present a report to hospital management for the development of a marketing plan. What are the key information points you need to begin work? What mechanisms should you recommend to the hospital management? How would you structure your initial report? Defense Self-Reporting Honest and cooperative with the OIG Willingness to engage in self-critical analysis Corporate compliance Community Need Financial Hardship HCAHPS & Loyalty_8.5x11.indd The HCAHPS Survey is a valuable tool for hospitals seeking to promote service consistency and ensure that basic elements of the service experience are being performed throughout the hospital. However, patients’ perceptions of “how consistently” a service was provided are not the same as understanding their perceptions of “how well” that service was provided. HCAHPS focuses on behaviors that are expected of every hospital during every inpatient stay. If your hospital does well on HCAHPS, you demonstrate that, like most other hospitals in the country, you are a capable provider of care. Focusing on consistent behaviors is only one piece of a successful strategy to differentiate your hospital and win the loyalty of your patients. As the industry leader in loyalty research, PRC has developed highly regarded toolsets and analytical approaches that have helped many hospitals and health systems achieve distinction for service excellence in their markets. Our PRC Patient Loyalty Surveys are purposefully designed to provide hospitals with actionable information on their patients’ perspectives of how well care was In order to optimally position your hospital, PRC recommends a two-pronged strategy that centers on the PRC Loyalty Survey augmented with either a separate HCAHPS survey or in combination with HCAHPS survey questions. H C A H P S & P R C L o y a l t y Su r v e y s Why Measure Both? July 2009 provided, and they highlight those specifi c areas that are key to building loyalty. CMS Has Changed the Landscape Hospitals and health systems today are being called to accountability for the quality of patient care from an increasing number of directions. As healthcare becomes a more dominant topic in the public forum, a greater number of external forces begin to cast a critical eye toward hospital practices. The largest, and most obvious, of these forces is the Centers for Medicare and Medicaid Services (CMS), with their Reporting Hospital Quality Initiative. The measures, both clinical and perceptual, that the CMS is asking hospitals to record and report represent a demand for proven methods of treatment and consistent methods of patient care: • Did someone give every heart attack patient an aspirin upon arrival? • Did someone give every pneumonia patient advice about smoking cessation before discharge? • Did someone give every surgery patient a preventive antibiotic one hour before incision? • Did the nurses always listen carefully to patients? • Did the hospital staff always tell patients what a new medicine was for? • Did the hospital staff always do everything they could to help patients with their pain? It is safe to assume that where the CMS leads, private payers will follow, and most industry leaders assume that the era of pay-for- performance is in the very near future if not already here. Adherence to these methods will be tied to a very specifi c dollar amount (and in most estimations, a very large dollar amount). For the clinical measures, hospitals have already invested countless hours and dedicated staff members to make sure that treatment methods are being followed, patient records are being documented thoroughly, and data collection for the CMS is being handled accurately and timely. It can be tempting to play it safe at this point and assume the extreme: that the dollars attached to HCAHPS reporting (and ultimately performance) will be substantial, and that providing consistent patient care will be enough to carry your organization fi nancially. We strongly encourage hospitals to take a longer view, to translate those dollars back to what they represent about the care you provide to patients. The CMS’s goal is for every hospital to perform all of the behaviors addressed in the HCAHPS survey always, and this is what hospitals will be paid to accomplish. When you are doing all of these things always and focusing your staff’s efforts on these behaviors, will your patients: • Receive care that is more consistent? Yes. • Realize better outcomes? Presumably. • Evaluate their care as the best it could be? Not necessarily. • Feel loyal to your hospital? Not necessarily. The CMS’s goal is for every hospital to perform all of the behaviors addressed in the HCAHPS survey always, and this is what hospitals will be paid to accomplish. Operational HCAHPS Survey Identifi es areas for increasing consistency of behaviors Service PRC Loyalty Survey Identifi es areas for increasing patient loyalty Excellence in Data 2 common source cited for information on local doctors, hospitals and healthcare providers was family and friends. This reliance upon personal recommendations has grown by 25% over the past 25 years. Additionally, consumers have decreased reliance on their family doctor as their primary source for local healthcare information. In 2009, 33.6% of consumers relied on family and friends, 21.1% relied on their family doctor, 8.6% relied on the internet, 6.7% relied on the insurance, 6.4% relied on experience, and the remaining 23.6% relied on various other sources. Once you determine that patient loyalty is your objective, you must understand what makes patients loyal. You give patients an experience, not just a service encounter. You give them a story to tell based on memorable events during their stay. You exceed their expectations and strive to make them feel that they received EXCELLENT care. You WOW them. PRC research conducted with over 200,000 inpatients discharged during 2008 shows that patients who rated their overall quality of care as “Excellent” were nearly four times more likely to recommend the hospital than patients who felt the overall quality of care was “Very Good.” The aspects of care addressed in the survey are those that we have identifi ed over the past 30 years as exhibiting the most infl uence toward patients’ perceptions of Overall Quality of Care. Although the ultimate fi nancial impact of HCAHPS is still unknown, everyone seems to acknowledge that we will be able to put a dollar amount on it soon. The fi nancial value of patient loyalty is more diffi cult to identify precisely, but the intangible benefi ts are clear. Loyal patients will return to your organization if they need further treatment or care for another condition. Loyal patients will be advocates for you in the community and will be more likely to respond to your requests for resources (including time spent volunteering and donations). Most importantly, loyal patients will talk; they will recommend your hospital to friends and relatives who may need healthcare services. Of the 1,000 consumers surveyed in the 2009 PRC National Consumer Study, the most Patient Loyalty Vital to a Hospital’s Success 3 Loyal patients are the key to increasing market share and earning your hospital the opportunity to continue providing excellent patient care. Different Surveys Fullfill Different Objectives 4 Many of the aspects of care included in the PRC Patient Loyalty Survey are also addressed in the HCAHPS survey, but the perceptions being measured by the two different scales are separate and distinct. In reliability testing conducted by PRC, the PRC instrument is shown to have a Cronbach’s alpha value of 0.960 (on a scale from 0 to 1, where 0.700 is considered a valid threshold for reliable), and the HCAHPS instrument has a Cronbach’s alpha value of 0.865, indicating that both tools are reliable for what they measure. When combined together and examined as one instrument, however, the Cronbach’s alpha value drops to 0.684, indicating that the two sets of questions are measuring different facets of the hospital experience and cannot be exchanged, one for the other, with an expectation of using the results to achieve the same goals. Certainly, maintaining two separate and distinct measurement systems can be challenging for administrators and staff, as they try to decide where to focus their attention. When making a decision about what to measure and how to measure, you must account for the end-users you seek to serve, keeping in mind that different end-users may have different objectives, and one instrument may not fi t all. According to the CAHPS Hospital Survey Fact Sheet (CMS, updated 10/2007), the HCAHPS survey “was designed to produce data on patients’ perspectives of care that allow objective and meaningful comparison of hospitals on topics that are important to consumers.” When consumers are reviewing HCAHPS data to make comparisons between hospitals, we assume that their intention is to