Navvis and Company

Accountable Clinical Management - Driving Sucess through Shared Leadership

2010-06-29T05:23:00.000-07:00

Integration, alignment and, more importantly, engagement of physicians is a strategy critical imperative for health systems seeking to create high-performing, future-ready, accountable care organizations. Over the past decade or so, many models have been tried – some successfully, others not so much. In the search for the holy grail of physician integration, most hospitals have concluded that a pluralistic approach, pursued in the context of an over-arching framework for clinical care and performance transformation, will be required to address the rapidly evolving world under healthcare reform.

Clinical co-management is an integration structure that has seen renewed interest from both hospitals and physician organizations. Under the co-management arrangement, hospitals contract with an organized group of physicians to provide day to-day management services for the inpatient and outpatient components of a specialty service line such as cardiac, oncology or orthopedics. The first generation of co-management was an outgrowth of gainsharing where physicians benefitted from cost savings arrangements. Most of these early models, however, faded quickly once savings reached a point of diminishing returns. And many failed when financial rewards didn’t materialize because cost improvements weren’t achieved.

The new generation of clinical co-management, however, provides a foundation for creation of "accountable" clinical care models at the service line level. It offers substantially more value in that the agreement between the hospital and physician organization provides for and rewards physician engagement and leadership in a broad spectrum of activities that improve patient care and outcomes, generate cost efficiencies and make the clinical service more competitive in the market. The model also differs from conventional hospital-physician joint ventures in that the hospital maintains ownership of the clinical service line and resulting revenue stream, while physicians gain much greater participation in and compensation for strategic planning, budgeting, clinical program development, quality oversight and improved patient experience.

With this approach, physicians have more clinical and operational influence than they have had traditionally. The hospital gains from quality, safety, cost efficiency and patient satisfaction improvements, especially where pay for performance and physician quality reporting initiatives are prevalent, since these directly tie financial reimbursement to outcomes. And the strategy-critical structures, processes and relationships are forged to create and build success in the new 'value-based' healthcare economy.

The real winners, however, will be the patients that benefit from aligned hospital-physician incentives that have a positive impact on patient care.

The importance of marketing alignment with brand strategy development and leadership

2010-05-18T15:06:00.000-07:00

As more health care organizations begin to adopt BRAND as a business strategy, it is imperative that marketing leadership is aligned with strategy at the leadership level of the organization. For those charged with managing the brand, having a voice and seat at the executive table is critical where brand strategy discussions and decisions are taking place.

Strategic brand management is an increasingly important competency requirement for health systems today. A strong brand is an important asset that drives growth, profitability and long-term competitive advantage.

We have recently seen movements toward executive leadership aligned in a triad with the CEO—the chief strategy officer, the chief operating officer and the chief physician executive. This group is charged not with optimizing performance of a collection of strategic business units as has traditionally been the case in the past, but with delivering on a value proposition for the organization—which is the BRAND promise.

Brand leadership is key to a successful growth strategy. It requires a specific strategy and action plan to position the health system, differentiate services, increase brand equity and evolve the brand with the organization’s overall strategic plan and business initiatives.

The brand provides a strategic advantage in forging new business ventures, negotiating reimbursement contracts, and attracting the best talent. And the brand drives increased customer loyalty, utilization and powerful word-of-mouth endorsements for aligned clinical services and physicians. At a time when profitable growth seems elusive and where competition has never been fiercer, brand leadership has become the new imperative for health care organizations seeking to create and sustain a competitive business advantage.

Don’t relegate your marketing leaders to tactical responsibilities and assignments. Engage them in the conversation about building the business and the brand, and challenge them to focus their energies on driving growth. You might be pleasantly surprised.

Check out our white paper on the topic.

Aligning competitive strategy in the face of major industry change

2010-04-29T09:23:00.000-07:00

Health care organizations are rapidly assessing their future in light of recent health care reform legislation. On the table: How will the new laws impact their ability to deliver quality care and in particular, how it will change the basis of competition for the future? What adjustments will need to be made to business strategy to maintain a competitive advantage in the marketplace?

In times of major industry structural change, new positions often arise and new, more nimble competitors emerge. Strategy can be threatened externally by competitive behavior, or internally, by a misguided view of competition, organizational failures or just by the desire to grow. These threats often increase imitation, rather than differentiation.

The requirements of hospitals and health systems to measure and deliver on a host of quality measures and become more operationally efficient, while important, elevate the bar for everyone and provide relative improvement for no one. In essence, all hospitals will look more alike than they currently even do.

This raises the question: How will hospitals compete? Strategy is about being different, about developing a set of activities to deliver a unique mix of value that is distinctive.

When determining changes in strategy, hospitals must now ask themselves:
• Which of our products or services are most distinctive?
• Which are most profitable?
• Which customers are most satisfied?
• Which customers and channels most profitable?
• Which activities are most different and effective?

It’s often more about deciding what not to do. Hospitals will need to focus on their unique core of business and realign activities, ensuring fit and sustainability of activities, as well as effective integration, making it more difficult for competitors to imitate or replicate their service offerings.

By choosing to perform a tailored set of activities differently from competitors, hospitals can begin to effectively differentiate themselves in the market. Hospitals should also consider deepening their strategic position rather than broadening – looking for extensions that leverage existing activities – offering features or services that competitors would find impossible or costly to match on a stand-alone basis. An organization can often grow faster and more profitably by better penetrating needs and offerings where it is distinctive rather than duking it out in potentially higher growth arenas in which the company lacks uniqueness.

The hospital systems that will perform best will be those whose strategy allows them to align activities for consistency, reinforcement and optimization of effort. Competitive advantage is sustained out of the coordination of the entire set of activities and how well they perform together to reduce cost or increase differentiation.

President Signs Health Care Reform Act; Now What?

2010-03-24T04:56:00.000-07:00

This week, President Obama signed into law the most significant social legislation since the 1960s. The Patient Protection and Affordable Care Act (H.R. 3590) extends health insurance coverage to 32 million uninsured Americans ― at a cost of $940 billion over the next decade.

The legislation ensures that by 2014, nearly all Americans will be required to be insured, and by 2016, the majority of the uninsured (30 million people) will be covered. To do this, the legislation expands Medicaid to cover families making as much as $88K a year. It also creates state-supervised exchanges to expand coverage access to individuals and small businesses. Other goals of the legislation are to improve affordability and accountability, crack down on waste, fraud and abuse, and ensure fiscal sustainability.

What Didn’t Get Passed? There is no government-run insurance plan. People can buy coverage through the state exchanges, but these will be private, nonprofit plans.

How does this impact the major health care players? Some of the key tenets are described below:

Extending Coverage for all Americans – On one hand, it is believed that the bill will benefit hospitals because more people will have insurance and hospitals will have to provide less charity care, which should result in fewer ‘write offs’ and a reduction in bad debt. However, expanded Medicaid enrollments could be a mixed blessing because Medicaid often pays hospitals less than the actual cost of care.
Improving the Quality and Efficiency of Care – It provides incentives for doctors, and hospitals that improve quality while providing for better coordination that helps to reduce harmful medical errors and healthcare-acquired infections. The bill will also provide payment reforms so providers are rewarded for the quality of care they provide, rather than just additional tests or treatments. And it rewards innovative practices where doctors and nurse practitioners provide more primary care that is coordinated with every doctor or specialist involved with a patient’s care.
Focusing on Prevention – This legislation will promote prevention, wellness, and the public health and provides an unprecedented funding commitment to these areas. It directs the creation of a national prevention and health promotion strategy that incorporates the most effective and achievable methods to improve the health status of Americans and reduce the incidence of preventable illness and disability in the United States. It increases prevention and wellness services for Medicare beneficiaries by waiving co-payments for most preventive services and by fully covering an annual wellness visit and personalized prevention plans for American seniors on Medicare.
Expanding the Healthcare Workforce – The act will fund scholarships and loan repayment programs to increase the number of primary care physicians, nurses, physician assistants, mental health providers, and dentists in underserved areas of the country. With a comprehensive approach focusing on retention and enhanced educational opportunities, the Act combats the critical nursing shortage. And through new incentives and recruitment, the Act increases the supply of public health professionals so that the United States is prepared for health emergencies.
Transparency and Program Integrity – Doctors with financial interests in imaging services, like MRI services, must inform the patients in writing that they can obtain the recommended imaging service from a person other than the referring physician, and provide a contact list. The Act also requires all drug companies, device, and medical supply manufacturers to fully disclose and report any gifts they make or financial arrangements they have with doctors, a physician practice or group. Providers enrolled in Medicare, Medicaid and CHIP programs will undergo increased scrutiny for new compliance requirements. The bill calls for increased governmental auditing and revenue oversight requiring providers to become more efficient and accountable for utilization, quality and cost of care.
Funding the Program - Funding for the landmark legislation will come from a variety of initiatives, including increased Medicare taxes for high-income individuals and an excise tax on insurers offering high-premium plans. In addition, hospitals agreed to help pay for the costs of the legislation and will contribute $155 billion over 10 years, primarily through lower Medicare payments. Health systems will also see reduced disproportionate share funding payments and cost-saving provisions resulting from program cuts for high-cost, less efficient hospitals in high cost markets. Moody’s Investors Service speculates that not-for-profit hospitals will struggle with reimbursement and efficiency pressures under health care reform legislation, triggering spending cuts, mergers and changes to revenue streams.

Most of the initiatives won’t take effect until 2014; however, the time for health systems to address both short and long term implications of the legislation is now.

Coming next: What to Expect from Industry-Leading Health Systems

Karen Corrigan

St. John's Mercy Physician Clinical Council

2010-01-06T05:02:00.000-08:00

A Shared Governance Model for Physician Engagement

Denny DeNarvez, president and CEO of St. John’s Mercy Health Care in St. Louis, Missouri, is a fan of the Physician Clinical Council (PCC). Which is no surprise when you learn that she first developed a similar shared governance model in 1999 while serving as CEO of the Minneapolis Heart Institute; and again, a few years later, as CEO of Abbott Northwestern Hospital. Now she’s imported the Physician Clinical Council to St. John’s Mercy with significant and positive results.

The PCC concept is based on a simple set of truths, says DeNarvez. “The business decisions of the hospital affect physicians, just as their business decisions impact the hospital. The reality is that patient care is largely directed by physicians who are practicing independently. Doctors and hospitals must work together to ensure quality and efficiency in patient care.”

At St. John’s Mercy, the Physician Clinical Council is a shared leadership model that engages physician leaders in the business side of running a hospital. Ten physicians sit on the council – chosen for their leadership abilities vs. longevity or representational position – and meet every two weeks to discuss and weigh in on issues such as new clinical services, technology acquisitions, business strategies, market dynamics, physician recruitment. Physicians are paired with an executive counterpart and receive coaching on aspects of leadership, conflict management and finance, among other topics.

“Establishing the Clinical Council has been a positive development for the medical staff,” said Dr. Charles Rehm, president of the St. John’s Mercy medical staff. “It created another level of much-needed dialogue and signaled that the CEO really wanted to engage physicians in two-way communications.”

Download our white paper to learn more about how the Physician Clinical Council works, as well as steps to take when considering a shared governance structure.

Karen Corrigan

5 Key Areas of Focus when Assessing Physician Need and Alignment

2010-01-05T07:57:00.000-08:00

What health system doesn’t have physician recruitment, integration and alignment at the top of their strategic priorities? Market competition, pipeline shortages, failing practice economics and a growing recognition that they can’t achieve quality and financial goals without physicians at the table, have organizations jockeying to win the race for physician integration and commitment.

A well-planned approach requires superb strategic thinking about possible, probable and preferred futures, and a well-crafted plan to bring vision into reality. The process will be better informed through an analysis about the current state of physicians in the marketplace and how that is likely to change in the future.

However, data is just data unless you use it strategically. Navvis & Company's 5Rs™ provides a framework and methodology in which to discover and calculate opportunities:

Recruitment — Recruitment strategies address physician shortages when both strategic and community assessments indicate a need for physicians in a particular specialty.
Retention — Top producing physicians are candidates for retention strategies based upon historic commitment of activity to the hospital for inpatient and outpatient service volumes.
Redirection — Physician candidates for redirection strategies are typically those aligned with competitor hospitals.
Redeployment — The goal is to increase practice volumes through better geographic location of the practice or through the presence of multiple practice sites.
Retirement — Transition planning should be considered for top producing physicians over the age of 55.

Insights from this analysis will launch health systems out of the starting gate and into the field by producing a focused set of tactics to support the overall physician engagement strategy.

Don't Wait for Congress!

2009-12-02T08:40:00.000-08:00

While Congress is wrestling with health care reform, many hospitals and their marketing executives are wondering how to prepare for something that may -- or may not -- happen. Rather than remain paralyzed by congressional uncertainty, there are many ways the marketing team can position its health system to be ready for changing times ahead.

But wait! Why do anything now if we don’t know what form “reform” will take? Because regardless of the legislative outcome of national health reform, public payers reimburse about half of all health care today, and federal and state governments are operating at huge deficits. Cost cutting measures in the form of reimbursement reductions and policy changes are a necessity. In fact, Blue Cross Blue Shield of Massachusetts just announced that it is changing the way it pays hospitals and physicians through a capitation system (BCBS is paying for the care of 60,000 enrollees within the Caritas hospital system regardless of whether they get sick).

The good news is that many hospitals and health systems are working toward many of the elements that must be in place to deliver the best health care at the best cost. Physician alignment, system integration, and outcomes measurement are important as reimbursement policy shifts from procedure-based to bundled payments. A physician alignment strategy means that both the hospital and the doctor are working together for the patient. System integration, which translates into operating efficiencies, means streamlined care delivered synergistically. And measureable health outcomes mean providers delivering care that works (not just “gets paid”). All of this translates into better value for the consumers’ health care dollar.

In other words, the right time is now to market system changes that restructure the delivery of care around value for patients, and by telling them what hospitals do to keep people healthy and how they treat those who are sick. No need to wait for Congress after all!

Brand Management Requires a Comprehensive, Robust Framework

2009-11-16T07:21:00.001-08:00

Brand management is an essential core competency for healthcare organizations seeking growth, market differentiation and competitive sustainability. And the creation, building and management of brands requires a comprehensive, robust framework to guide brand strategy, brand alignment and brand performance. At this past week’s Chief Marketing Officers’ Innovator’s Studio work session, Mike Eaton, vice president for Navvis & Company, and Rob Klein, President of Klein & Partners, presented a 6-stage structure for brand management, and led the group on a discussion regarding the complexities and opportunities for building a powerful brand portfolio. Here’s a glimpse into their workshop session.

CMO Innovator's Studio Brand Mastery Framework

View more presentations from Karen Corrigan.

Chief Marketing Officers' Innovator's Studio Explores Brand Mastery

2009-11-08T03:36:00.000-08:00

The Chief Marketing Officers’ Innovator’s Studio convenes this week (November 9 & 10) in Chicago. This session’s deep dive topic – The New Brand Mastery – is significant and timely given the changing nature of the health industry. Increasing consolidation among providers, physician alignment and integration activities, emerging retail models, growing consumer expectations, new media channels, the new economics of health care reform – all play part in the complex dynamics shaping competition. And all have implications for health system brand strategies. On the agenda:

A brand excursion to Whole Foods Market in Lincoln Park, led by Maggie Bahler, Regional Marketing Director and Executive Marketing Coordinator for Whole Foods. There we’ll learn how the retailer achieves company-wide alignment to its brand strategy while emphasizing local market connections (sound like a familiar challenge?).
Jen Wagner-Mauk, Executive Director of Brand and Marketing for Affinity Health (Menasha, WI) and Megan Manahan, Vice President for Marketing and Communications with Mercy Health Partners (Toledo, OH) will share their journeys in repositioning their health system brands, including methods for creating brand alignment and commitment across their organizations.
Mike Eaton, vice president of the brand and marketing consultancy for Navvis & Company (St. Louis, MO), and Rob Klein, president of Klein & Partners (Hinsdale, IL), will facilitate a Brand Mastery Workshop, where they will frame out an approach to creating a comprehensive, robust brand leadership method – and put everyone to work brainstorming, prioritizing and designing innovative approaches to meet the brand challenges of the changing competitive landscape in healthcare.
Rob Klein will also share research results from a recent Omnibus survey. This consumer ‘kitchen sink’ study focused primarily on healthcare reform with selected other topics of interest.

You can follow session highlights on Twitter at #iscmo.

Health System Performance Varies Significantly State to State

2009-10-16T11:34:00.000-07:00

The cost and quality of health care, as well as access to care and health outcomes, continue to vary widely among states, according to the 2009 state scorecard report of Commonwealth Fund Commission on High Performance Health Systems.

The report, Aiming Higher: Results from the 2009 State Scorecard on Health System Performance, is a follow-up to the Commission's 2007 State Scorecard report; it ranks states on 38 indicators in the areas of access, prevention/treatment quality, avoidable hospital use and costs, healthy lives, and equity.

In 2009, Vermont, Hawaii, Iowa, Minnesota, Maine, and New Hampshire lead the nation as top performers on a majority of scorecard indicators. Leading states set new, higher benchmarks on a majority of indicators. Conversely, states in the lowest quartile often lag the leaders on multiple areas and the gaps have grown wider in multiple areas.

"Leading states have raised the bar for better access, quality of care, and reducing disparities," said Commonwealth Fund Senior Vice President and study co-author Cathy Schoen. "Where you live in the U.S. matters in terms of your health care, and it shouldn't.”

The sharp variation across states spans access, quality of care, costs, and lives. For example, rates of hospital readmissions (within 30 days of a previous hospital stay) among Medicare beneficiaries ranged from a high of 23 percent of hospital admissions in Nevada to a low of 13 percent in Oregon. The percent of adult diabetics getting recommended preventive care ranged from a low of 33 percent in Mississippi to a high of 67 percent in Minnesota as of 2006–07, a new high. On these and other measures, the lowest ranked states would have to improve 40 percent to 100 percent on average to achieve the performance of top ranking states.

The scorecard points to substantial opportunities to improve. If all states could reach the level achieved by the top performing states:

Twenty-nine million more people would have health insurance—cutting the number of uninsured by more than half;
Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care;
Nine million more adults age 50 and older would receive recommended preventive care, and almost 800,000 more children would receive key vaccinations;
Five billion dollars could be saved annually by avoiding preventable hospital admissions and readmissions for vulnerable elderly and disabled residents.

You can download the report Aiming Higher by clicking here. An interactive map that allows users to look at and download individual state information and compare states on various measures is available at www.commonwealthfund.org/Charts-and-Maps/State-Scorecard-2009.aspx.

Karen Corrigan

Re-Energizing

2009-10-07T09:15:00.000-07:00

I recently returned from a marvelous vacation that included a cruise in Europe. The time away from the intensity of a new environment and responsibilities allowed for a “cleansing of the mind” in regard to day-to-day engagement with clients and colleagues after an intensive orientation process. I was cognizant of my advice over the years to colleagues, associates, and coaching clients about the need to become mentally rejuvenated; advice easily given, but not so easily followed.

Spending time with my wife doing things we might not routinely do also contributed to an ability to look at future opportunities with new perspective and hope. Being a leader in an organization brings a responsibility to constantly renew the energy and efforts toward our corporate goals and initiatives. In order to do that, we need to be both mentally and physically at our best, and that won’t happen unless we do as my mother used to tell me, “Remember to take care of Andy first.”

Without occasional respites, it becomes difficult to continually engender the passion and energy that our organizations need and expect. The passion expressed by the senior leadership of any organization should generate the ongoing enthusiasm for each employee’s personal fulfillment about what they are doing and how they contribute to the organization. We all know individuals whose energy pervades the room and encourages us as individuals to achieve more than we ever thought we could alone: the essence of team motivation.

Is it always possible to experience something as explicit as a cruise to cause this reflection? Absolutely not. Those major opportunities come along rarely. But an occasional golf game, a weekend with family (or in my case grandchildren), or participation in an organization that allows one to give back to others not as fortunate -- all can give one the opportunity to pause and reflect on what is important in life. It also can rejuvenate what it is that caused us to be in the profession we’re in and reinforce our personal priorities in life. The result is a happier and more fulfilled individual that others want to be around.

That alone creates energy for leadership!

Andy Allen

How do You Know When You Have a Brand?

2009-10-05T17:24:00.000-07:00

At an Innovator’s Studio work session for Chief Marketing Officers, someone asked guest catalyst Kent Seltman (recently retired Mayo Clinic CMO) about the difference between a brand and a well-known name.“You know you have a brand,” said Seltman, “when you can leverage it to gain something.”

It’s a great insight, and poses a question that healthcare CMOs should stop to ponder: is your brand an asset that can be leveraged for competitive gain?

Many health systems have invested in brand building. Some have succeeded in creating stronger brand identity. A few have improved market position. Only a handful have fully realized the substantial, measurable advantage of a fully activated brand strategy:

Strong brands influence consumer choice
Strong brands attract and retain the best talent
Strong brands create contracting, partnering leverage
Strong brands shape referral patterns
Strong brands build customer loyalty
Strong brands better weather economic cycles

On his blog, author Seth Godin described a marketing asset as a “tool or platform, something you can use over and over without using it up. In fact, it’s something that gets better the more you invest. Running an ad is an expense. Building a brand people trust is an asset.”

Godin goes on to explain that Amazon’s marketing assets are two: “a brand people trust, and a one-click shopping relationship with 50 million people.” Can you boil down the essential elements of your brand’s competitive strengths in such a distinct fashion?

The charge to CMOs is an unwavering focus on driving growth – a great brand provides powerful leverage to do so.

Karen Corrigan

Building the Case for Brand Alignment

2009-09-22T05:38:00.000-07:00

“The New Brand Mastery: Integrated Business, Brand and Marketing Strategies to Drive Growth” is the topic title for a session that Joel English of BVK, Rob Klein of Klein & Partners, and I will be presenting at this year’s annual SHSMD conference (Orlando, Florida; September 30 - October 3, 2009). Our premise is three-fold:

First, the central and foundational asset in competitive strategy is an organization’s brand and the leverage it provides to drive growth, profitability and customer loyalty

Second, organizational misalignment – across operational, clinical, business development and marketing functions – is the primary cause of brand under-performance and wastes marketing dollars

Conversely, brand alignment results in a powerful, relevant and differentiated brand-driven culture by transforming an organization from one that simply ‘promotes a brand’ to one that ‘delivers the brand.’

During the session, we’ll provide a multi-dimensional exploration of brand as an essential business strategy for healthcare organizations, present a framework for developing, activating, growing and protecting the brand as a strategy-critical asset, and illustrate return on investment in terms of volume, revenue and market performance.

The session is scheduled for Friday, October 2, 2009 from 10:15 to 11:30 am. To learn more about this year’s SHSMD Conference and download a schedule of events, click here: SHSMD 2009 Conference.

I hope to see you there – stop by to say ‘hello’ at The Strategy Group/Navvis & Company booth in the exhibition hall.

Karen Corrigan

Hardwire Your Organization with a “Can Do” Attitude

2009-09-20T16:00:00.000-07:00

A funny thing happened to me last week while traveling with one of my colleagues for an onsite client visit. The hotel we were staying in “lost” our rental car as well as the keys. While certainly inconvenient and at the same time humorous, the hotel staff did an exemplary job of service recovery. We never really had an opportunity to have a bad experience. Every need was anticipated in advance and from the moment we were confronted with the problem the staff worked tirelessly to resolve the issue.

There was never an “if we solve the problem” attitude; it was “when we solve the problem.” To make a long story short, our car was located as were the keys. We were treated to a lovely dinner in a terrific restaurant that evening. When I arrived in my room that evening I found fresh flowers waiting for me along with a note signed personally by each of the valet staff apologizing for the incident. Not only that, during the time we were without a car, the valet staff shuttled us to and from meetings with physicians for the entire day; always with a smile and never a complaint. It was obvious that our needs were their primary concern.

On the other hand, we had a mediocre customer experience with the car rental agency we were consulting during the course of the “rental car” adventure. There was little if any concern and very little compassion. The contrast in service delivery was as clear as the nose on my face. The result? Even though a mistake was made, I guarantee you I’m now a loyal customer, not only of that particular location but the hotel chain as a whole. It is obvious to me that they want me as a customer. On the other hand, I’m having second thoughts about renting from that particular rental car agency in the future. I’m not sure I matter to them.

The point of my story? In any service business, mistakes are going to happen. That’s a given. How you handle those mistakes and interact with the customer is paramount to service recovery and retaining the customer.

It’s all about attitude. When I did volunteer work in New Orleans, LA shortly after Katrina our motto was “whatever it takes.” This taught me that “no” wasn’t an excuse and never the answer. And it was empowering to experience this attitude of no limitations. The hotel staff demonstrated this 100%.

In the healthcare arena, how you manage the customer experience speaks volumes about the sincerity of your brand – a direct reflection of your attitude. It’s about taking the time to care about the customer and deliver service in a sincerely compassionate manner. Throughout the organization, look for ways from top to bottom to nurture and create opportunity for the “can do” attitude to express -- in every patient room, outpatient site, waiting room, treatment room, physician’s office, surgery suite, recovery room, ED, lab, with every call answered, meal that’s served, medication dispensed, heart that is mended, room that is vacuumed and floor that is cleaned.

Hardwire the collective consciousness of your organization with that “can do” attitude. When you do this you own the customer – you own the market.

Michele Bordelon

California Hospitals Reducing Costs

2009-09-19T14:08:00.000-07:00

California hospitals are using Medicare reimbursement to set cost base. What are you doing?

In healthcare, like in many other industries, what happens in California tends to happen in the rest of the country shortly after that. It seems that a number of leading hospitals in California have decided that their cost base should be the same as Medicare reimbursement. In other words, they want to have a low-cost operation that “breaks even” on Medicare and that they would make their margin on commercial and employer-based reimbursement. Given that Medicare reimbursement is significantly (25 to 30%) below commercial rates, this requires California hospitals to run lean operations.

While this philosophy is an admirable one, Medicare reimbursement will likely be reduced as a result of the coming healthcare reform – as it is one of the very few levers, if not the only one, that the Federal government can pull to reduce healthcare costs.

Hence, the prudent thing for hospitals to do is to use the current Medicare reimbursement rates as a starting point but set the goal at some lower percentage reflecting best estimates of how much further reduction is the Federal government likely to impose on Medicare.

I would be very interested in other’s thoughts about this philosophy, likely further reduction in Medicare reimbursement and what strategies are being put in place as organizations contemplate the implications of reform?

Saad Allawi

Follow the Innovator's Studio Social Media Intensive on Twitter

2009-09-17T07:33:00.000-07:00

Twitter was abuzz (or should I say atweet) yesterday with real time conversations, insights and ideas generated by the participants and catalysts at the Innovator's Studio Social Media Intensive in Chicago. The deep-dive is being held at the Catalyst Ranch and continues through today. Can't be there? You can follow the conversation on Twitter at http://search.twitter.com/search?q=issmi. I picked up lots of good leads and links from yesterday's tweets. Enough to feed my research habit for a while!

HealthLeaders Service Line Strategies 09 Virtual Workshop

2009-09-16T04:40:00.000-07:00

On September 24, 2009, HealthLeaders Media will bring together more than 20 service line experts for a unique, virtual seminar featuring cardiovascular, orthopedics, neurosciences and oncology tracks. The event offers healthcare marketing executives and service line leaders a great learning and networking opportunity without the cost and time commitments of travel. Health systems can register for individual or all four clinical program tracks.Each track is designed to deliver content on the following topics:

service line delivery
medical staff development and physician relations
service line organization and structure
subspecialty program development
market share and marketing

Speakers include service line executives from Beth Israel Deaconess, Washington Hospital Center, Barrow Neurological Institute, Yale New Haven Hospital, Vanderbilt Heart and Vascular, among others.

For more details about the sessions, view the conference brochure at the HealthLeaders Media website.

The Chief Marketing Officer's New Agenda

2009-09-15T04:57:00.000-07:00

Marketing executives have never had a more opportune time to better establish the discipline of marketing as a strategy-critical business competency for healthcare organizations.

The underlying basis for competition in the industry is shifting -- driven by the converging forces of healthcare reform, physician services restructuring, provider consolidations, consumer expectations, and networked information technologies. Changing economics are front and center, and make a compelling case for the role that marketers must play in an increasingly competitive industry.

What is the new agenda for Chief Marketing Officers? To adopt a market-making P & L mindset. To transform the discipline from promotions-oriented tactics to growth-oriented strategic leadership. To drive value-innovation across the health system. To crusade for customer-centered practices. To prepare and position organizations for long term success while simultaneously enhancing and growing the core business.

The imperative is three-fold.

First, to build a marketing organization that is strategic and focused on near-term enterprise growth as well as creation of future customers, products, and channels.
Second, to establish the critical relationships and linkages across the value chain (clinical operations, finance, purchasing, IT, physicians, partnerships, etc.) to orchestrate alignment to customer needs and company growth goals.
And third, to develop a results-oriented marketing operation that delivers on revenue growth and profit goals.

The next decade may well represent a period of signficant change and transformation in our industry. What great opportunity!

Karen

Learnings from Bumrungrad International Hospital

2009-09-10T13:21:00.000-07:00

Thailand’s Bumrungrad International Hospital treats more than a million patients a year – 30,000 from North America. International patients from Europe, the Middle East, Asia and the Americas represent 42% of Bumrungrad’s volume and greater than 50% of revenues.

So how did this Bangkok-based medical center become known as the mecca for medical tourism?

The answer lies in a pretty straightforward value proposition - quality, value and access - and in a management perspective that understands the marketing power of needs-based segmentation, value innovation and brand experience.

Bumrangrad’s CEO, Mark Banner, and director of marketing, Kenneth Mays, were recently interviewed by Ravi Aron, a senior fellow with the William and Phyllis Mack Center for Technological Innovation at Wharton. You can listen to the interview and download a PDF transcript at Wharton's website. Click here: Bumrungrad Hospital: Expanding the Footprint of Offshore Health Care.

Karen Corrigan

Financial, Strategic Outcomes Count When it Comes to Return on Marketing Investments

2009-09-03T03:44:00.000-07:00

If marketing is to be valued as a core business investment, then the chief marketing officer must instill a rigorous, results-oriented discipline to set quantifiable goals and demonstrate ROI. Too often, marketing goals are either missing in action or stated in terms too 'soft' to get the CFO's endorsement. Performance measurements are often activity or process oriented, which while important for managing an efficient marketing operation, don't always link expenditures to business outcomes.

The bottom line is this: in the C-suite, only two sets of metrics count -- results related to financial performance and results related to strategic performance. Revenue. Volume growth. Market share. Profitability. Brand loyalty. Differentiation. Competitive sustainability.

We all know the challenges faced by healthcare CMOs when it comes to ROI -- information systems that aren't oriented to customer transactions or purchasing patterns, extensive variations in pricing and reimbursement, complex channel relationships, long buying cycles, etc. -- but, in my experience, the quest for the holy grail of marketing ROI is derailed at three key junctures.

1. Production of marketing plans that are really tactical 'to do' lists confined to marketing department activities

Many a marketing effort falters because actions are created and dollars expended without the strategic underpinning that aligns the organization's growth goals with market opportunities. This happens when marketing is disconnected from growth discussions, then called in after the fact to put a communications spin on the decision-making.

A strategic marketing plan is a derivative of the company's strategic plan -- addressing how the health system intends to grow, what markets it will serve and with what products and services, how it will create differentiation and sources of competitive advantage, how brands will be positioned, how the portfolio will be configured to optimize profitability, how marketing investments will be prioritized, what the expectations are for returns.

2. Marketing investments that overly-emphasize promotions as the primary customer acquisition strategy

At a recent gathering of healthcare marketing executives, the CMO for a well-known, national electronics retailer shared the business analytics that framed his company's marketing strategy and modeled how he could project (with great accuracy) changes in sales and profitability by manipulating various aspects of the brand strategy and marketing mix.

What he demonstrated was how a strategic balance of marketing investments focused on segmentation and targeting, product development, market expansion, channel relationships, pricing, customer experience and, yes, promotion, were required to drive business outcomes.

This means an investment in research methodologies that go beyond the awareness-preference studies so prevalent in our industry, and integrated business, operational, clinical, brand and marketing strategies that encompass more than promotions.

3. Lack of ownership at the executive team level for marketing performance

The nexus of the problem may well reside here if marketing is simply viewed as a functional department and not as a core business discipline and competitive competency of the organization. A marketing orientation is derived from an organizational culture centered on customer needs as well as the sum of organizational activities designed to create profitable exchange relationships by fulfilling those needs.

Marketing department activities have limited utility when access, capacity, pricing, products, customer service, clinical quality, physician relationships and other operational aspects of the business are out of whack. It's critical for the CMO, with the CEO, to drive co-ownership of the marketing goals, strategy and investments - and co-accountability for delivery and performance outcomes - across the entire executive team.

The end game is results

The end game is customer engagement that results in growth, profitability and sustainability. But without full engagement of the organization's leaders in establishing marketing performance targets, strategies and investments - and without agreement as to the strategic and financial metrics that spell success - the CMO is left to defend marketing department activities and expenditures that appear discretionary, rather than essential, to winning in the marketplace.

Karen Corrigan

What if Your Competitor Delivers on Your Brand Better Than You Do?

2009-09-01T15:24:00.000-07:00

That's the difficult conversation we had with a hospital recently as it explored how to activate its brand. Market research showed that the hospital trailed the competitor on the core attributes of its brand position. A facilitated, candid discussion with staff confirmed that the competitor simply executed better than our client on their own brand position.

Unfortunately, this dynamic plays out for many hospitals and health systems that fail to deliver what their brand promises to their customers. Often it is because operations is not aligned to deliver on the brand attributes. As a result those attributes remain empty promises, the brand then has no credibility, and even less market impact.

So how to respond? The critical first step is having a candid conversation with both marketing and operations leadership in the room. That conversation should be structured around the following points and informed by real data:

Know what matters to your customers. Don't guess. If your team cannot tell you with clear specificity the three most important benefits to customers you do not have enough information.

Define what makes you different. "Being the preferred provider in the market" does not suffice. Do the work to be specific. It may be that "what you do" is unique. It may be that "how you do it" is meaningfully different for consumers. Use data to undestand how your customers think you are different. Often you will be surprised.

Create separation. Incrementally better is a rewarding story to tell in a board meeting. It is meaningless to customers making a purchase decision. Work to make the differentiation so stark that your competitor is not even in the consideration set on your core brand attributes.

At Navvis and Company we have a process to help you create signficiant separation from your competitors on the features and benefits that deliver your brand and matter to your customers. It is a matter of aligning strategy and operations to your brand. We believe it is a critical determinant of your future success.

Leveraging Brand Activation to Address the "Elephants in the Room"

2009-08-31T13:56:00.001-07:00

Which is a stronger position in the market: a women's health program with a $500,000 digital mammography machine but a 10 day turnaround time on results; or, a competitor with an $125,000 conventional film machine but the ability to generate mammography results on a same day basis?

It depends, of course, on who you ask. A clinician may say the stronger program is the one with greater accuracy and ability to manipulate digital images, resulting in fewer call-backs and enhanced ability to diagnose with fewer false positives.

A patient may respond that the uncertainty of waiting 10 days for results is a far worse outcome than the risk of a call-back for a second set of images.

The best answer, of course, might be the market-leading technology and the ability to deliver results on a same-day basis. Even beyond that there is the ideal of being able to channel abnormal mammograms into same-day ultra-sound or even biopsies for those who choose that option for purposes of peace of mind.

Today, a client of ours was wrestling with that question as it tries to activate its brand. As my colleague Carla Bryant helped facilitate that discussion, she fostered a dynamic that forced the team to see the brand through the eyes of the customer and to candidly confront attitudes, behaviors and processes that result in a less than ideal patient experience.

It was an encouraging process! The result was the client work team:

prioritizing for action some "game-changer" strategies;
building an unvarnished assessment of barriers to the desired position;
proposing to focus operational resources on meaningfully different features and performance that deliver the brand benefit to the customer.

With Carla's facilitation the team leveraged its discussion of brand activation to address long-standing "elephants in the room". In an time when our agendas are crowded with legacy issues and unspoken challenges, it is refreshing to have a means to clear the room and feel real progress.

Sustainable Cost Savings are Critical, Elusive without a Strategy

2009-08-29T07:00:00.000-07:00

OMB Report: Health Care Costs at Heart of Budget Deficit is the title of a recent post in the WSJ Health Blog. It makes a important point about the impact of even fractional reductions in the total cost of care. For example, quoting the Office of Management and Budget report on health care spending, the article notes that reducing the rate of growth of health care costs by 0.15% would, by itself, equal the amount needed to close the 75 year Social Security shortfall!

Given that projections in growth in federal spending on Medicare and Medicaid in the OMB report, and the unsustainable overall deficits projected for the next 10 - 15 years unless the health spending trend lines are changed, it is almost a given that - with or without an omnibus health care reform package - providers are going to get paid less to provide more care to more people in the coming years.

That fact underscores the imperative of health systems acting now to address their own cost structure. One particularly fertile opporutnity for many systems is indirect costs. As systems have careened back and forth between centralizing and decentralizing support services they have often left behind pockets of "unseen" indirect costs.

Traditional cost reduction efforts often miss these pockets, because they do not start from an understanding of the optimal balance point between centralization and decentralization. This is a lesson we have learned in through our work in Performance Transformation at Navvis.

I am curious to ask the readers whether their cost reduction efforts are tied simply to a cost savings benchmark, or grounded in a broader understanding of what is the appropriate balance between centralization and decentralization of services? It seems the answer to this question might influence the sustainability of the savings achieved.

Extraordinary Online Brands Start with Great Offline Stories

2009-08-26T20:55:00.000-07:00

The Secret to Standing out in Social Media is a blog entry that raises an interesting point about success in the social media channel. Specifically, the article states that a successful blog presence is not about what you do on-line, but what you do off-line. For your health system or service line to have an extraordinary presence in the social media realm, you need to have one in the real world!

It is an obvious, but often overlooked truism that health care marketers would do well to heed. Bad or bland programs that simply mimic the market will do no better in a social media forum than they will in traditional marketing channels. With that in mind, we suggest that health care marketers respond to internal pressure to create blogs, Twitter identities, Facebook pages, and Youtube channels as follows:

Have a great story;
Have an interesting point of view from which to tell the story;
Learn to tell it in the audience's language to demonstrate that you are listening.

In essence, the focus of social media is your audience's needs - not your strengths. This is how you build credibility in a social media channel.

For example, if you want to offer a blog about a cardiac program, the focus should not be on how great your doctors and facilities are (save that for traditional media) but about how much better people's health can be if they manage their heart health and conditions. The goal is to create online mechanisms to get the audience to make the "ask" about your offline capabilities.

It is a subtle change in point of view, but a vital one to building a strong health care brand on the internet. Just as in real life people are drawn to people who listen to them; so, too, your blog should emphasize that you are paying attention, not simply talking at the digital crowd.

Innovation Won't Thrive where Creativity isn't Valued

2009-08-26T09:07:00.000-07:00

In Sparking Innovation (Harvard Business Press), Stanford University professor Robert Sutton describes how the ‘hippie’ founders of Lotus woke up one day to realize that a multi-billion dollar company built on creativity was stifling the very innovation that made it successful.

This ‘face the mirror’ moment came when they decided to put the resumes of the company’s creators (under assumed names) through its human resource screening system and discovered that they couldn’t even get a call-back for open positions. As the company grew, it brought in ‘suits and ties’ that could operate the business and sell the products but not create innovations to sustain competitiveness.

Health system CEOs lament the lack of innovation in their organizations and are perplexed as to how quickly innovation initiatives fizzle out. All too often, health system structures, operating systems, policies, culture and hiring practices form the antithesis of innovation. Our business practices, reward systems, hiring and promotions policies support left brain thinking and behaviors. We crave the orderliness of it, find safety in its logical processing, relax in its familiarity.

By contrast, while we love the output of a creative, right-brainer – be it a work of art, a brilliant book, or a breakthrough product innovation – we are mystified, even fearful of the creative process. It’s messy, non-linear, riddled with risk. So, we tend to hire to our safety zone – and end up with a company of smart people that can build organizations, systems, flowcharts and spreadsheets to manage the business, but can’t create the value innovations that drive growth, profitability and future success.

Sometimes “the difference between innovative work and routine work are the types of people who do the work.”

As with most things, the key is to strike a balance. If health systems are to spark the innovations needed to thrive in an industry undergoing massive transformation, they’ll need to address not only ‘how’ to acculturate the creative process but also ‘who’ is sitting around the table.

Karen Corrigan

Brand Mastery Topic of Fall CMO Innovators' Studio

2009-08-25T04:46:00.000-07:00

The Chief Marketing Officers’ Innovators’ Studio will hold its next working session on November 9 and 10, 2009 at the Catalyst Ranch in Chicago, Illinois. The focus of the gathering is "The New Brand Mastery," which will address head-on how operational, clinical, business development and marketing alignment can create a powerful, relevant and differentiated brand-driven culture –transforming an organization from one that simply ‘promotes a brand’ to one that ‘delivers the brand.’

Whole Foods marketing executive Maggie Bahler will be a guest catalyst for the Chief Marketing Officers’ Innovators’ Studio brand mastery work session scheduled November 2009. Maggie will engage the group in a discussion about brand as a driver for growth, and share how Whole Foods works to create company-wide alignment to the brand strategy while emphasizing local community connections. She’ll also lead us on a brand excursion to their newest Chicago store where we will experience the brand in action.

Additional catalysts and brand explorations will be announced soon.

Karen Corrigan

Running a Hospital is a Blog Worth Following

2009-08-23T09:18:00.000-07:00

Running a Hospital (www.runningahospital.blogspot.com) by Paul Levy, President and CEO of Boston’s Beth Israel Deaconess Medical Center, is a blog worthy of following. And a great example of how a social media tool can be used to reach out and create relationships with key audiences. Paul’s blog is followed by employees, doctors, patients, peers, media and many others. As of this writing, his profile alone has been viewed 55,000 times.

You can also follow Paul Levy on Twitter (paulflevy).

Karen Corrigan

Aurora's Path to 'Best in Quality' among US Health Systems

2009-08-22T17:52:00.001-07:00

For the second year in a row, Aurora Health Care (Milwaukee, WI) is ranked as the nation's highest performing health system in terms of quality, based on work in a CMS - Premier quality demonstration project involving 250 hospitals.

As a former member of the Aurora leadership team, I know the investments the system board and senior management made to improve quality. Three specific things stand out to me as root drivers to Aurora's success:

Aurora is patient focused. Founding CEO Ed Howe preached the importance of staying focused on the customer, not the competitors. Too often I see hospitals lose sight of the patient in their quality improvement efforts. At Aurora, quality was always understood as a partnership between provider and patient. Obviously, that partnership has paid off.
Aurora is clinician led. Current CEO Nick Turkal is a physician, but clinician-led has meaning well beyond the current occupant of the top post. Aurora channeled clinical leaders into creating care management protocols to attack the root causes of higher costs and poor health outcomes. Nursing leaders like Sue Ela and physician leaders like Mike Jaeger and Bruce Van Cleave pushed hard to standardize best practices, fix clinical operations, and apply technology to improve outcomes.

Equipped to question current practices and make them obsolete through transformational changes, these clincians created a culture that demands (and has delivered) the best. Their leadership was not limited to managing the business; it was more importantly focused on building the value.
Aurora is market driven. Incremental change was never the goal of the Aurora leadership. Market leadership was the goal, and the system was willing to take risks to achieve it.

The top performing hospital in quality in the US, according to the CMS - Premier study, was Aurora BayCare, a joint venture between Aurora and BayCare Medical Group, a 100+ physician multi-specialty medical group. At the time it was conceived and built it was the source of great controversy. But the senior leaders at Aurora and BayCare had a vision for something that transcended current market dynamics and made the investment to do it right.

Additionally, Aurora was an early leader in finding new ways to partner with physicians; to leverage scale for advantage and strategy for long-term competitive gain and performance improvement. Not every risk paid off, but creating an environment that empowered teams to throw out the industry script and do things differently enabled a culture to go for truly different, and now, demonstrably better results.

These lessons-learned would serve many systems well. Too many lose sight of the role of the patient in improving quality; channel clinicians into governance but fail to leverage them to lead value creation; and see market advantage as a by-product, not the purpose, of transformational performance improvement.

Mike Eaton

Whatever Happened to Retail Health Care?

2009-08-22T14:23:00.000-07:00

Just a few years ago, there was a palpable sense we were going to see consumer behaviors change in a way that favors the rise of retail medicine. The core assumptions were people would be more price sensitive because they pay more out of pocket; demand greater convenience; and, channel more of their spending into preventive and routine care so that they could avoid higher cost hospitalizations.

We spoke of health care expanding broader and deeper; deeper in the sense that combining genetic profiling with nano-technology would create mass-customization of medicine, and broader in the sense that consumers would extend their definition of health care to include things like personal trainers and living "green" as well as doctors, hospitals and pharmacies.

The relatively low-profile of retail medicine today begs the question: were we wrong?

I'd argue not. Certainly, those who operate retail sites believe they are a viable competitor to the classic physician office-based, hospital-centric business model. As noted in an August 20 artricle in Modern Medicine, a host of new retail services are being offered, including Walgreen's subsidiary Take Care adding dermatology procedures; and CVS' Minute Clinic offering treatment for motion sickness and corneal abrasions, sports and college physicals, and vaccinations.

I heard affirmation of the vitality of the retail model from the senior leadership team of a large integrated health system in the northeast. The team is exploring how to activate their brand in a retail channel; and shape conventional channels with retail principles. My sense is they are ahead of the game. My believe is that it will pay off in a meaingfully different market position that will drive future growth.

If your team has lost the focus to build a retail presence in the market, re-check your vision. If you need inspiriation or validation, the senior consultants at Navvis & Company can facilitate a discussion to assess and tune-up your retail strategies.

Mike Eaton

Prioritize Marketing Investments in a Downturn

2009-08-22T03:39:00.000-07:00

We all know the drill. Volumes soften and the first order of action is to slash marketing expenditures. Not that managing costs isn’t important – it’s essential – but reactionary and indiscriminate cost cutting is a mistake according to Harvard Business Review authors John Quelch and Katherine Jocz.

Instead, now is the time to reprioritize your marketing investments – focus on brand building, adjust your product mix, deliver exceptional customer service, and reexamine customer needs. In How to Market in a Downturn, Quelch and Jocz suggest that “companies put customer needs under the microscope and take a scapel rather than a cleaver to the budget.” This means developing a solid understanding of how demand patterns are shifting – both short term and long term – and adjusting strategies, tactics and offerings in response.

The question for healthcare marketers to ponder is whether demand is simply being deferred until better times, or whether consumer values and purchasing behaviors will be more permanently altered by this deep and prolonged recession (think ‘depression era’ consumers). Either way requires focused efforts by marketing executives to identify emerging opportunities and put successful customer acquisition strategies in play.

Karen Corrigan

Develop Competencies for Brand Leadership

2009-08-20T03:15:00.000-07:00

For far too long, health systems have been trying to build brands almost exclusively through communications processes, which waste marketing dollars and undermine competitive performance when the image portrayed is not the experience delivered.

Powerful brands do not happen by accident. They are carefully discerned, purposefully positioned and aggressively managed to create connections that stimulate demand, build customer loyalty, drive growth and improve profitability.

The well-developed competencies underlying great brands include:

Brand Intelligence – brand leaders employ advanced research and analytic techniques to inform positioning, segmentation, targeting, product design, channel, pricing and promotions decision-making. Real brand intelligence takes more than awareness and preference research.
Brand Positioning – strategic processes are in place to create a core positioning strategy, articulate the brand value proposition, and formulate integrated operational, clinical, business development and marketing strategies to achieve meaningful competitive differentiation.
Brand Alignment – strategic processes are in place to unify brand building across the value chain in order to focus design; align operations and organizational policies; build and support effective channels; drive service delivery innovations; create advertising that works; and build staff commitment to ‘live the brand.’
Brand Portfolio Management – large, diversified, complex health systems are evolving methods for determining, managing, and building brand portfolios, addressing multiple facilities, strategic business units, markets, physician integration, and partnering ventures.
Brand Evolution – brand leaders measure and track brand performance, and consistently evolve and renew brands to address new opportunities and changing competitive dynamics.

If you want to put rocket-boosters behind your brand, then focus investments to build brand leadership competencies. The payoff is better business performance.

Karen Corrigan

Flirting with Market Irrelevance?

2009-08-18T07:48:00.001-07:00

I visited recently with a senior business development leader for large midwestern health system. As we talked he candidly shared a concern that his system might not survive in the market. He noted that repeated growth strategies to reverse a steady decline in market share had been tried to no avail. The system was on its third iteration in five years of cost-cutting, eliminating positions, programs and shuttering some underperforming sites.

"We can't cut our way to market relevance," he said, "but nothing else seems to have worked."

The irony of his situation is that the system's decline has come during a period of steady growth in overall demand and technological innovaiton that has improved the product. Much like the venerable auto brands Oldsmobile, Plymouth and (soon) Pontiac that have disappeared from the market because they were no longer meaningfully different to customers, the decline of my friend's employer begs the question whether there is a coming shake-out of health system brands.

Whether health system reform passes or not, we know that demand will continue to grow and that reimbursement to providers will likely be cut. To balance this dynamic will require payers to allocate resources to those providers who can deliver better outcomes and radically different service at a lower total cost. Some systems will have the leadership, market and performance transformation strategies to make that leap. Many others will not.

So I pose this question: will incremental peformance improvement position your system to survive in a market that will likely demand transformational change? If not, do you have in place the leadership and strategies to become meaningfully different? Those questions ought to be at the forefront of health system thinking. Failing to ask and answer the questions just might relegate a system to the same fate that has beset much of the domestic auto industry.

Innovators' Studio Virtual Work Session to Feature Scott Davis

2009-08-18T03:33:00.000-07:00

A C h i e f M a r k e t i n g O f f i c e r s 'I n n o v a t o r s ' S t u d i o web session is scheduled for September 2, 2009 from 1:30 pm to 3:00 pm EDT. Scott Davis, author of the recently released book The Shift: The Transformation of Today’s Marketers Into Tomorrow’s Growth Leaders, will be our guest catalyst for this virtual working session. For those CMOs that attended July's Innovators' Studio, this is a great opportunity to have your staff learn about marketing's role in driving growth, and, of course, for those CMOs that couldn't make the summer session, this webcast will afford you the opportunity to better understand how to redefine the role of the chief marketing officer and build a future-ready marketing organization. If you are an Innovators' Studio CMO, register by emailing Jody at jcorrigan@navvisandcompany.com or calling her at 540-545-8260.

Karen Corrigan

Marketing Orthopedic Services

2009-08-17T06:47:00.000-07:00

Tomorrow, August 18, 2009, Bill Munley, vice president for professional services and orthopedics at Bon Secours St. Francis in Greenville, SC, will be joining me on a HealthLeaders Media Webcast -"Advanced Service Line Marketing: New Orthopedics Growth Strategies." During this session, we'll talk about trends influencing demand for orthopedics and explore three key initiatives that Bon Secours has undertaken to drive volume and revenue in this category. The session begins at 1:00 p.m. eastern on Tuesday, 8/18. HealthLeaders Media senior managing editor Gienna Shaw will moderate. To hear a brief interview (The Future of Orthopedics) that Bill and I did with with Gienna,click here.

Karen Corrigan

Industry Transformation Requires a Long View Strategy for Health Systems

2009-08-17T03:53:00.000-07:00

Over the next decade, the US healthcare system will undergo an unprecedented era of reform and transformation, driven by the tenets of government-led reform. A shift of this magnitude changes the underlying basis for competition and will challenge even the most successful of health systems to stay ahead of the curve.

In the short term, the end point and exact design of health care reform are less important than the wheels being set in motion regarding increased industry consolidation, physician integration, care coordination, cost restructuring and competitive positioning. Over a longer horizon, however, the elements of success for health systems will be dramatically different than today, requiring a vision-driven approach to evolving and transforming the enterprise.

Now is the time for health systems to take a fresh look at their strategic plans, and assess whether they are prepared to compete in a value-based marketplace with increased emphasis on cost, quality and access.

Success will require executives, board members and physician leaders to develop a shared understanding of industry changes, adopt a vision for the future of the health system, anticipate the pace of market transformation and maintain focus through the stages of strategy execution.

Here are 7 key questions to get the conversation going at your next leadership meeting:

How does the leadership of the health system believe the future is likely to unfold?
What will be the fundamental requirements of success and how do those differ from today?
What role do you want to play in that future and what will it take to get there?
In what businesses and markets should the health system invest its resources, either through ownership or partnership?
What core competencies will create sources of advantage and market leverage?
How should the parent company influence and relate to the businesses under its control?
What changes will be required in the operating and leadership structure to achieve the vision?

A defining characteristic of leadership is the ability to drive strategy-critical change in the face of uncertainty. This is certainly one of those times.

Karen Corrigan

Closing the Brand Equity Gap of Investment and Realized Return

2009-08-10T03:20:00.000-07:00

Over the past couple of decades, health systems have made substantial investments in brand building. Many have succeeded in creating stronger brand awareness. Some have improved market position. Only a few, however, have fully realized the substantial, measurable advantage of a fully activated brand strategy.

What these brands leaders have discovered is that:

Strong brands influence consumer choice
Strong brands attract and retain the best talent
Strong brands create contracting, partnering leverage
Strong brands shape referral patterns
Strong brands build customer loyalty
Strong brands better weather economic cycles

The gap between investments in a brand and realized return cannot be closed with brand advertising alone; nor, can it be resolved by customer service, clinical quality, lean operations and other initiatives pursued in isolation of a comprehensive, integrated approach to better leverage the outcomes for market advantage. Greater share. Increased volumes. Better profitability. Customer loyalty.

The only way to narrow the brand equity gap is to effect strategic, operational, clinical, physician and marketing alignment to create and deliver a meaningful, differentiating and durable brand value proposition. Brand alignment builds the brand-driven culture that transforms an organization from one that simply ‘promotes a brand’ to one that ‘delivers the brand.’

Karen Corrigan

Chief Marketing Officers Convene at Innovators' Studio

2009-08-06T16:46:00.001-07:00

Last week I had the pleasure of spending time with healthcare marketing executives at the Chief Marketing Officers’ Innovators’ Studio. This group meets three times yearly in ‘deep dive’ working sessions designed to advance the discipline and practice of marketing as a driving force for growth and innovation in health systems. Our July session had a two-fold aim: (1) the evolving role of the marketing executive as chief growth officer and (2) transformation of the marketing operation to that of a strategy-critical business competency.

Over the course of two days, we dissected the current state of marketing in healthcare organizations and created a framework in which to evolve marketing’s role and competencies as the organizational growth engine. We took a hard look at the professional skills requirements for chief marketing executives, the capability requirements of future-ready marketing organizations, and the marketing performance expectations that should be requirements at the C-suite.

How fortunate we were to have Scott Davis, author of The Shift, and Don Friedman, chief marketing officer for CA, as guest catalysts for this work session. Their insights, perspectives and experiences seeded valuable ideas and stimulated much discussion.

Over the coming month, I’ll be blogging on the ‘ah ha’s’, explorations and recommendations from the CMO’s Innovator’s Studio and invite you to join in with your own questions, observations, comments and BIG IDEAS.

Karen Corrigan

Technology Can Drive Personal Connections

2009-08-06T12:27:00.001-07:00

Hospitals have spent many years and millions of dollars competing in a technology ‘arms race’ in an attempt to differentiate themselves in their market. But how many patients really keep track of which hospital has what piece of equipment, and select providers accordingly? Do physicians really base their referrals on which community hospital has a 264-slice CT Scan or is it more likely that referrals are based on where they have personal relationships with other providers and how they’re treated as individuals?

Yesterday I was reminded once again how technology can be used to improve and solidify the emotional relationship between individuals and organizations. I had to call Southwest Airlines to cancel a flight reservation. I initially encountered the dreaded voice automated system, but then I heard something so surprising – not only did Southwest’s system tell me that the wait time for an operator would be 10-13 minutes, but that if I left my phone number they would call me back when an operator was available. I felt so acknowledged! Respected! Appreciated!

The first thing I did upon hanging up the phone was to call 2 other people to tell them how fabulous this service was. When I did speak to the Southwest operator (within 10 minutes, as promised), I was offered a refund or a credit. Despite not needing it, I almost took the credit, just to demonstrate my loyalty and gratitude.

Providers should remember that technology doesn’t just have the potential to produce health quality outcomes, but a tool to produce good will and loyalty that the patients themselves will promote to their network of family and friends. It is just one example of how technology can facilitate patient-centered care transformation

The Critical Conversations

2009-08-04T12:11:00.000-07:00

Throughout my career in health care, I have been well served by those individuals who possess candor and integrity in their communications with superiors and subordinates. This candor helps assure that the type of feedback given and received is the basis for "The Critical Conversations." These are the conversations that we all need to have, but are sometimes reluctant to deliver or to receive. While these conversations are important no matter your role in an organization, they become even more so as you rise to any senior executive position. Why is it, then, that these conversations become less frequent?

When I took over a new chief executive role, the best COO I have ever worked with asked me, "OK, who in the organization tells you to sit down, shut up and listen? " Some of his excellence in organizational effectiveness was due to the fact that whether it was me or one of his subordinates, he was always candid and truthful in his assessment of their judgment and decision making capability. Let's face it, people want to know where they stand in the organization, whether it is positive or negative. Delivering that message isn't always easy, but often needed. This guidance is an important part of helping employees develop and grow their skills and build on their strengths.

When colleagues are prepared to offer candid and constructive criticism, it shows a desire for the success of the entire team and therefore the organization. Positive and constructive communication can help avoid confusion and a lack of clarity with regard to roles, expectations, performance and outcomes. Additionally, forthright communication saves precious time while lending to the culture of the organization a level of transparency that builds teamwork and cooperation.

So, the next time you are engaged in a situation that could be enhanced by a "candid conversation"- do the right thing. You and your organization will be well served.

Andy Allen
Senior Vice President

Rapidly Restructuring Healthcare Markets Require New Approaches to Brand Management

2009-08-03T05:01:00.001-07:00

Ever more complex health system structures, physician relationships, expanding clinical portfolios, new business ventures and expansion into new markets require a proactive, focused and purposeful plan to build and leverage brand equity across the enterprise – across geography – across constituencies.

Today, health systems’ approaches to branding must evolve to address and manage the complexities of:

Hospital and health system mergers & acquisitions
Physician integration, joint ventures and owned medical practices
Ambulatory, post acute and retail diversification
Academic, technology and business partnerships
Multi-market, multi-state expansion initiatives
Enterprise IT/EHR/Website strategies
Co-branding/co-marketing relationships

This activity requires greater and more sophisticated methods for determining, managing, and building brand portfolios in diversified health systems, addressing the core brand value proposition, competitive positioning and brand identity of multiple facilities, strategic business units, markets, physician integration, and partnering ventures.

Because at the end of the day, the objective isn’t what to call something, it’s market leverage.

Karen Corrigan

Keeping Your Brand Healthy After Physician Integration: Part II

2009-08-01T06:28:00.000-07:00

Health systems that ignore the implications of physician integration to the organization’s brand do so at their own peril. Hundreds of doctors in an employed physician structure can produce hundreds of thousands of patient visits in a year – each visit shaping and reinforcing the organization’s brand reputation.

Without an explicit strategy for creating and delivering a brand-defined experience in physician practices, health systems run the risk of developing a brand reputation they don’t want – formed from inconsistency of service, customer indifference, fragmented care, complex processes, poor medical care.

But it doesn’t have to be that way. The key question for health care executives is how to leverage investments in physician integration to increase total brand equity – to build a powerful, differentiated brand presence and to drive growth from a core positioning platform.

To do so, we must first understand brand as a central and foundational underpinning of competitive strategy. Brands are potent business-building assets for driving growth, engaging customers, building profitability. As you develop and evolve the integrated physician structure, key issues regarding brand and business building strategies should be addressed from the beginning.

So how can a health system turn a potential brand liability into an advantage?

Determine your unique brand value proposition. How you plan to create and deliver value to current and prospective customers through the fully integrated physician practice is fundamental to long term success. What significant customer-centered benefits (more timely appointments, better coordinated care, personalized service, best in class physician talent, etc.) will your patients gain as a result of the integration strategy?
Agree on brand identity. Names may be about egos, but brands are about business. The right brand identity should, first and foremost, ease the selection process for your customers. Brand identity for the physician group should be chosen in the context of the health system’s strategic positioning and growth goals, as well as its overall brand building strategy.
Create brand alignment across operating, clinical and marketing systems, and build a discipline to channel investments into those things that matter most.
Hardwire customer service, operating and patient care processes to ‘deliver’ on the brand. Patient experience is born through brand activation, a process whereby the brand value proposition is translated and transformed into actionable principles, features, service standards and behaviors. Remember that brand reputation is built primarily through customer experience.
Enhance brand performance. Establish and monitor key metrics regarding growth, revenue, profitability, brand awareness, brand preference, customer advocacy and staff engagement. Identify growth opportunities in key segments, markets, channels. Address barriers that may limit the power of your brand to move market share.

The mantra for health systems seeking leverage from their physician integration investments is simple. Build the brand. Build the business.

Karen Corrigan

Keeping Your Brand Healthy After Physician Integration: Part II

2009-07-29T13:20:00.001-07:00

The rapid restructuring of the physician services sector and resulting physician alignment, integration and employment models are presenting new brand building challenges for health systems, hospitals and physician organizations. Assuming the average primary care physician sees about 5,000 patients visits a year, back of the napkin math shows us that a health system with 100 employed physicians brings in a half million visits or so annually – with 300 to 400 physicians that number can rise upwards of 2 million. Now assuming that brand impressions are shaped through familiarity and frequency of use, then it’s easy to see how a large employed physician practice can be the catalyst for building – or unraveling – brand reputation.

You see, what we’re still learning in healthcare is that brand is built more powerfully through the customer experience than through promotions. The most creative imagery and well-crafted messages of killer advertising will not survive poor or inconsistent customer service – physician offices that don’t return patient calls, or don’t answer calls over the lunch hour when it’s most convenient for patients to make them, or can’t make timely appointments or see patients on time, or the poorly trained and groomed front desk staff, or the torn upholstery of the waiting room chairs, or the rushed appointment, or the doctor or nurse that enters the exam room, eyes on the chart and not on the patient. Or even worse – the missed diagnosis, the wrong medication, the preventable error.

The significance and potential impact of these everyday irritants and sometimes serious missteps cannot be underestimated once aggregated under the brand umbrella of a large health system. Every physician practice is now a branded access point, perhaps even the most critical of those touch points capable of enhancing or destroying brand reputation.

Brands are about business – growth, customer loyalty, profitability. It just doesn’t make good business sense investing millions to effect a large scale physician integration strategy if only to lose that and more by not purposefully addressing how brand equity will be preserved and enhanced.

So how can brand be unleashed to drive growth and innovation for the health system-physician enterprise? Well, that’s Part II – coming soon.

Karen Corrigan

Is Service Line Success Embedded in Design or Execution: Part 4

2009-07-21T05:38:00.000-07:00

This is the final installment of four posts on healthcare service line strategy and structure.

With Service Lines, Imitation is Not the Answer

The classic flaw of imitation is the assumption that someone else is doing it right.

For the service line management model to be an effective growth engine, providers must move beyond benchmarking and replication to forge a distinctive position in the market. The secret to competitive effectiveness is not to be better than the competition. But to be different in a way that is distinct, relevant and truly meaningful to your customer base -- by seeking different value-producing approaches to the market, by driving innovations in service delivery, by creating unique approaches to integration and service consolidation, by cultivating unique partnerships, by understanding how different degrees of centralization, delegation of authority, and functional specialization work together to achieve differentiation.

The key consideration for health care leaders is how those differences add value to the service line model in achieving the company’s strategic vision and goals.

So, the critical question for service line execs is how differentiated value is defined, created and delivered. This requires more than an aggregation of tactics, but a leadership-driven approach to identifying opportunities, crafting strategies to create a distinct and compelling value proposition, developing a effective business model and operating structure, forging physician partnerships, and prioritizing investments.

What's important to keep in mind is that service line management, in and of itself, is not the goal. When aligned to an organization’s strategy and configured to achieve results, it can, however, be a powerful model for creating and sustaining competitive advantage.

Karen Corrigan

Is Service Line Success Embedded in Design or Execution: Part 3

2009-07-13T11:26:00.000-07:00

This is the third installment of four posts on healthcare service line strategy and structure. Watch for the 4th post in coming days.

Brand vs. Service Line Management

In comparing and contrasting healthcare’s service line model with industry’s product or brand management model, fundamental differences are realized across key factors:

Market orientation -- A key difference between service line and brand managers (and among better performers and poorer performers of service line management) is the vantage point from which decisions are made – poorer performers operate from the inside out (“here’s my program – let’s see if we can find some customers”) versus outside in (we’ve identified segments offering significant opportunity for growth – let’s build a product to attract them.”). In competitive consumer markets, maintaining an external focus while keeping a direct line into the operations team to deliver against changing consumer requirements is paramount to success.

Strategic focus – Historically, the strategic focus for hospital service lines has been development of profitable clinical services to compete with other health institutions; improving quality, lowering costs, aligning physicians, and adding services all are aimed at creating a better offering. Competitive advantage, however, isn’t sustained by being “better” than the competition but from being “different.” Brand managers seek to create markets and new sources of revenue by finding new and different ways to meet customer needs, extending the life cycle of the brand and representative products, forging strategic partnerships to enhance product offerings, and developing proprietary approaches for channel leadership.

Competitive posture – The health industry’s supply-side orientation to strategy tends to favor defensive posturing. Service line initiatives are over-invested in similar activities amongst providers in a market to protect position and share, as opposed to proactive strategies to leverage strengths against emerging market conditions that offer opportunity for substantial growth. A demand-side perspective acknowledges that consumers have shifting needs that can be met in a myriad of ways. It opens up our thinking as to not only “who” but “what” we compete against.

Value innovation – Organizations that consistently perform above industry norms are those that better anticipate changes in competitive dynamics and continually innovate to create greater value for customers and the market. However, the health industry’s penchant for benchmarking and low tolerance for risk-taking sentences service lines to numbing sameness and marginal improvements. Value innovation does more than raise the bar – it resets the rules of competition by de-commoditizing health care services. The ultimate pay-off is substantial gain in growth.

Marketing – The traditional service line marketing toolbox has offered up a limited set of tactical activities to promote service line offerings and cultivate referral relationships. In consumer markets, marketing is a strategy-critical core business competency to create profitable exchange relationships between an organization and its publics. It is the principal process for creating and linking customers to the organization’s products and services. In comparison, the traditional industrial marketing model includes major functions of producing, packaging, pricing and promoting individual products.

Scope of responsibility and authority – One of the fundamental issues with the service line management model is lack of agreement as to whether service line leaders are operations managers, clinical leaders, business developers, marketing managers or some combination of the mix. A matrix reporting structure, which is often poorly defined, limits the manager’s ability and authority to achieve service line objectives. If we contrast this model to that where cross-organizational teams work for a brand manager who reports to senior executives, there are lessons to learn about lines of authority and accountability for performance.

Performance metrics – In poorer performing service line organizations, performance objectives and measures of success are unclear and reward systems are not linked to achievement of specific goals. Even worse are those where authority and accountability are so misaligned that turf wars break out inside the very service line structure intended to “break down silos.” Consider the service line leader who is held accountable for volume growth and profitability, but has no authority to impact capacity, through-put or supply costs. In competitive consumer markets, metrics such as preference share, conversions to trial, percentage of revenue growth from introduction of new products, and repurchasing rates, among others, are leading success indicators.

Coming next: Imitation is Not the Answer

Karen Corrigan

Is Service Line Success Embedded in Design or Execution: Part 2

2009-07-11T15:06:00.000-07:00

The following is a continuation of an earlier posting.

The Disconnect Between Strategy and Service Line Structure

At the risk of boring repetition, structure should follow strategy. There is no universal ‘right’ way -- or ‘wrong’ way, except perhaps blind restructuring of clinical services into service lines without a defined strategy as to how value will be created and what capabilities and resources must be brought to bear effective execution.

Strategy then is not just an aggregation of tactics, but a leadership-driven approach to articulating a futuristic vision for how a service line intends to compete. To get to this point, health systems must develop a point of view as to how the market is likely to unfold, identify specific strategies to create a distinct and compelling market position and then create a business model and structure to effect achievement of its goals.

In its generic form, the product line and brand management models developed by industry leaders such as Proctor and Gamble and GE, are useful frameworks for designing an approach to service line leadership with the fundamental intent of optimizing the organization’s market position for a defined service line.

There may be more to learn today from the product or brand management models that evolved in the consumer goods and services industries as we address increasing consumer influence in the selection, purchase and use of health services and products. However, to be receptive to the advantages offered by brand management models, we must suspend the predominant notion about brands as communication devices and adopt an understanding of brand as the totality of customer experience resulting from organizational decisions regarding positioning, design, development and delivery of products and services.

Fundamental differences are realized across key factors. Part III will compare and contrast healthcare’s service line model with industry’s product or brand management model.

Join the discussion. What do you believe to be the key strengths and pitfalls of service line management models?

Karen Corrigan

What’s worse? Having a policy you don’t follow or not having a policy at all?

2009-06-26T07:02:00.000-07:00

I thought of this conundrum recently while preparing a client for an upcoming Joint Commission survey. We were working through the new 2009 Leadership Chapter – addressing disruptive behavior, creating a culture of safety and managing conflicts. When asked to supply documentation, as is required in a number of standards in this chapter, the Vice-President dutifully complied by sharing various policies with appropriately matching titles. So far so good. But just like the Joint Commission, Navvis & Company utilizes Tracer Methodology when assessing a client’s readiness for a survey. It didn’t take long to realize, policies or not, this hospital had some work to do to meet the intent of the standards located in this chapter.

I know it can be easy to focus on the deliverable or the one item that says, when done, you can now check it off your list. Unfortunately, words like “culture” and “conflict” don’t lend themselves to easy solutions. But, I believe there’s a bright side. I think focusing on the documentation is causing us to miss opportunities. I say, let’s look at the new and improved Leadership Chapter as a gift from the Joint Commission. A gift to anyone who has struggled with getting hospital administration, the Board of Directors and the Medical Staff to sit around a table and work together to provide the best care possible. It’s really the answer for anyone who works in a facility where the same quality report is given three different times, to three distinct groups, on three separate days. What might happen if those three groups were all sitting in the room at the same time, hearing this information and working collaboratively to improve patient care? Now that’s a policy that writes itself!

How Many Primary Care Physicians do We Need?

2009-06-18T16:55:00.000-07:00

Hospital primary care physician integration continues to accelerate. This trend is driven by numerous external market factors: Clinical Integration, Strategic Needs, Bundled Payments, and Physician Preference & Lifestyle to name a few. One of the more compelling questions for health systems is how do we best determine how many primary care physicians we need to drive the volume of inpatient and outpatient services required for us to achieve our optimal market position.

Several hospitals we are working with are taking a different approach to answering the “how many question”. Rather than asking how many physicians they need, they are asking “How many practice office visits do we need?”

In today’s world with part time physicians, nurse practitioners, and physician assistants participating in how care is delivered in the primary care setting, trying to determine need based on a physician count just doesn’t work. How a clinic or primary care office generates 10,000 office visits varies greatly from one site to another even within the same system. But those 10,000 visits result in a measurable amount of downstream activity.

So, instead of trying to count doctors consider counting office visits.

Some interesting statistics from a recent study:

Every 1,000 office visits generates 28 hospital admissions
Every 1,000 office visits generates 480 outpatient procedures
A typical Internal Medicine practice generates 38 admissions for every 1,000 visits
A Family Medicine practice generates 18 admissions per thousand visits

How are you sizing your primary care network?

Is the Nursing Shortage Over?

2009-06-17T07:21:00.000-07:00

A friend’s daughter who lives in Florida graduated from nursing school last month and is having trouble finding a job. Maybe you’ve heard similar stories from around the country. Maybe your own hospital is enjoying the lowest vacancy rate you’ve seen in years. Don’t let the current economic climate lull you into a false sense of complacency. As soon as the economy gets back on track, and it will, nurses will return to part-time status or decide not to go back to school after all. Elective procedures and volume will pick up again. Don’t find yourself saying, “But I thought the nursing shortage was over!”

Why does it take an economic crisis for families to align spending with income? Apply that same reasoning to how you staff your nursing units and you will demonstrate a consistent methodology for patient care delivery regardless of supply and demand. For example, when was the last time you looked at data to determine if your top admitting diagnoses match your bed complement? Have your top service lines changed yet you still have the same number of “medical” beds? Is your length of stay in Intensive Care out of line because physicians aren’t following established criteria?

Don’t wait until the next nursing crunch to manage this. It’s a little like someone with diabetes using insulin to cover eating whatever he or she wants. You may have to do it sometimes, but it’s much better to establish a practice that balances food intake, exercise and medication. Have a plan and stick to it knowing there are going to be times when you have to flex staff up or down. Dust off your Admission, Discharge and Transfer criteria, review your Hours per Patient Day targets, ensure your position control reflects targets and then hire/staff accordingly. But in the meantime, enjoy those lower than usual vacancy rates!

Is Service Line Success Embedded in Design or Execution? Part 1

2009-06-09T11:45:00.000-07:00

The popularity of service line management has waxed and waned over the past two and a half decades. This can be attributed to a number of factors ranging from the changing nature of competition in the health industry to misalignment of internal resources to variations in clinical practice to mixed financial results.

Since its origin in the early 1980s, much has been debated about the structure, strategy and capabilities resident in service line organizations. In general the service line business model has evolved from service line marketing to clinical program operations to a more systematic approach of managing a defined line of business delivering a bundle of services to distinct market segments.

In practice, however, service line models differ widely across health systems and hospitals – and with varying results. Not all service line marketing models failed in the 1990s; not all integrated service line business models work today.

The key question to explore is “what” creates success – the model itself or superior execution of a service line strategy. In coming posts, I'll compare and contrast the various aspects of design and leadership. Please join the discussion.

Karen Corrigan

When "Stretch" Challenges "Strategy"

2009-06-07T14:07:00.001-07:00

I met recently with the CEO of a relatively large integrated health system. We had just finished a meeting with her leadership team reviewing our strategies for growth and performance improvement. There was concurrence around the table that the strategies provided a clear path to future success; the meeting ended with the senior leader of the physician group voicing his enthusiasm for the plan.

Moments later, behind closed doors, though, the CEO said what others in the meeting had left unspoken. “This is a real stretch for us,” she said. “I’m not sure we can do this.”

Give her credit for raising the question. Designing a strategy without developing the competencies to execute it is a common malady facing many health systems today. The competitive demands on systems in terms of performance improvement and market growth are increasing exponentially. Many top leaders are highly skilled at working in the business, but less ready to work on the business. As a result, many organizations underperform and lose faith in their leaders and strategy.

At Navvis, we are purposeful about evaluating leadership competencies as we build a strategic plan – not with an intent of building anything less than a state-of-the-art strategy, but to ensure that we also build a state-of-the-art leadership team to execute it successfully. Along the path of strategy development, we continually test whether leaders:

Can articulate in a few brief sentences not simply “what you are going to do” but “how customers will experience that difference” in the years ahead;
Understand specific things they must do differently in order for the organization to succeed;
Demonstrate the ability to have critical conversations and build collaborative solutions across management disciplines and service lines.

Is your organization underperforming relative to your strategic plan? Is the Board of Directors pressing for accelerated results? Before concluding that you have the wrong plan, you need to determine whether your leadership has the right competencies to execute the plan. Even the best teams need to refresh their skill sets to meet the changing demands of a highly competitive health care market. The mark of failure as a CEO is not acknowledging your team needs help, but in ignoring the reality that keeping pace means staying a step ahead on the learning and leadership curve.

Giving Credit Where It’s Due: Ratings Agencies Now Weighing Physician Alignment

2009-06-02T05:07:00.000-07:00

Given the current state of the U.S. financial markets, hospitals and health systems need to be even more mindful of their credit-worthiness and access to capital in a tightening economic environment. For non-profit and tax-district hospitals, one of their ongoing challenges is the continued attention on the part of financial ratings companies such as Moody’s and Standard & Poor in their assessments on how well a hospital has aligned with its medical staff. Physician recruitment and retention is considered one of the top five factors in terms of gauging a hospital’s credit profile, along with balance sheet management, the use of financial structures to reduce borrowing costs, achievement of key quantitative ratios and qualitative factors that affect debt capacity.

Moody’s assesses physician alignment as part of a hospital’s overall market position. It evaluates the potential feasibility and success of a facility’s physician strategy in relation to the hospital’s particular market and circumstances, using available metrics. For instance, Moody’s may assess a hospital’s “dependency on physicians,” especially for hospitals with small medical staffs. The “dependence” metric used may be the percentage of admissions or revenue brought by the “top 10 referring physicians,” or it can be as simple as whether there have been any significant medical staff changes.

In some cases, aligning with key physicians is even more important than sheer financial performance. For instance, BayCare Health System of Tampa, FL received an upgraded Moody’s bond rating in 2006. Although BayCare loses money on employed physicians and plans to hire more, the system has demonstrated a “declining loss year-over-year,” which Moody’s has deemed as a stable physician integration strategy. South Lake Hospital in Clermont, FL enjoyed an upgraded bond rating based in part on the hospital’s ability to address competitive challenges with local physicians and “explore a wide array of integration strategies,” such as joint ventures and a participating bond transaction.

Clearly, physician integration strategies are just one factor in assessing a hospital’s overall financial profile. While the impact of upward movement in ratings has historically meant significant benefits through lower overall costs when it comes to bond issues and other means of accessing capital, recent turmoil in all areas of the economy is likely to bring changes which we are only now starting to see. I believe one impact of these changes will be increased attention and focus by rating agencies and other on health systems that are successfully integrating key physician stakeholders. For hospitals that successfully align their physicians, these strategies can be like money in the bank.

2009-01-08T03:27:00.000-08:00

In recent years most health systems have invested in building a brand. Many have succeeding in creating a stronger corporate identity. Fewer have truly built brands that stir an emotional response with customers. Only a handful has activated a brand strategy to turn those emotions into measurable advantage when competing for patients, talent and resources.

This gap between investments in a brand and realized market return is a source of frustration for senior executives. It is not a gap that can be closed with advertising; nor, can it be resolved simply by improving customer service and clinical quality scores. The industry is rife with health systems with big advertising budgets and rising satisfaction and quality scores that have delivered only incremental market growth.

Today, the field is crowded with consultants offering to help reorganize structure; re-engineer process, re-train people, and redesign facilities. Clinicians have paid handsomely for counsel on “doing better”, prompted by the promise of pay for performance and scorecards that make service and quality seemingly more transparent

In our view, though, it’s not simply about doing better. It’s about doing better by being different. Closing the brand equity gap requires a strategy to align operational inputs – structure, process, people, and facilities – to create an experience that is meaningfully different for customers.

What makes The Strategy Group different is that we align brand strategy and operations not as competing uses of scarce resources but as the inter-dependent means to a common end – activating a core competitive position for market advantage.

If successful, health system executives should be able to report to their boards that “because of our brand strength… we negotiate better contract terms; recruit better talent at a lower cost; and, have patients and employers willing to pay a premium to access our care.”

Imagine that conversation....imagine health systems delivering real value in the form of new products and processes and services that go beyond the clinical expertise provided by the doctors and nurses....in that kind of world maybe there would be fewer poor performers surviving in the market and more value in the services that we receive for an ever growing out of pocket expense.

Enter Tom Daschle

2009-01-01T08:39:00.000-08:00

Tom Daschle's book, "Critical: What We Can Do About the Health-Care Crisis", forecasts the mindset of the incoming DHHS Secretary. Many of the ideas in the book frame what is likely to be Daschle's approach to President-Elect Obama's goal of reducing the number of uninsureds. There are three main points from the Daschle book that are key:

First, Tom Daschle is an activist. He wants to leverage government's growing role in health care spending (46%) to reshape the market. Especially in this downturn, with public support for the government to "do something", there is a ripe political climate for an activist agenda and Daschle knows it.

Second, Daschle has in mind the "machinery" for leveraging change. He proposes a National Health Board, which he likens to the Federal Reserve Board, with a role he defines as:

"[T]he Fed Health would ensure harmonization across public programs of health-care protocols, benefits, and transparency. Ultimately, the Fed Health would offer a public framework within which a private health-care system could operate more effectively and efficiently."

Lurking behind the "policy-speak" of that statement is a central idea that the Federal Health Board can leverage a 46% share of overall health expenditures to standardize terms and transactions in the market. Of course, even Daschle acknowledges that by itself, administrative savings from standardization is not enough, thus....

Rationing is needed to deliver both lower costs and better (and more fair) access. In his book, Daschle cites the role of the Britain's National Health system in enforcing rationale use of scarce health resources, with a particular focus on what he considers inefficient spending on technology and medications. In case his favorable citation of Britain's National Institute for Clinical Excellence (NICE) leaves any doubt, Daschle spells out specifically that the Federal Health Board would:

...[T]he Fed Health could set standards for quality and coverage, promoting best practices and identifying the trade-offs on services (emphasis added). It would use information on the comparative clinical and cost effectiveness of different treatment options to set standards for Federal programs."

Third, "trade-offs on services" is the key to Daschle's vision. If Daschle is going to deliver on the twin demands of lower cost and more care, either the Federal Health is going to have to say "no", or consumers are going to have to start making smarter choices on their own so that the market can drive out products, services and providers that do not deliver real value added. Daschle seems to have little confidence in consumers at this point; his focus is on having the NHB make the tough decisions.

Smoking Ban Reshapes Heart Market

2008-12-31T13:06:00.000-08:00

I read some dramatic numbers today from Pueblo, Colorado. In the three years since implementing a ban on smoking in public places, hospitals admissions for heart attacks dropped 41 percent!

In the new study, researchers reviewed hospital admissions for heart attacks in Pueblo. Patients were classified by ZIP codes. They then looked at the same data for two nearby areas that did not have bans — the area of Pueblo County outside the city and for El Paso County. In Pueblo, the rate of heart attacks dropped from 257 per 100,000 people before the ban to 152 per 100,000 in the three years afterward. There were no significant changes in the two other areas.

There are multiple implications from this data. First, obviously, it is a good thing. As someone who has a family history of heart disease and has paid a few visits to the cath lab myself, the potential that reduced exposure to second-hand smoking actually does reduce the risk of heart attacks is encouraging news. For those focused on population-based health statistics, or reducing overall costs of health care, the study adds fuel to the fire to push for broader smoking bans.

For hospitals facing a dominant competitor in the heart care market, the study begs an odd question: would the better way to address the competitors' heart care market share be [1] build a heart program of your own; or, [2] invest in a couple of lobbyists to push through a smoking ban to both improve community health AND cut your competitors' top line volume by half?

Buy Low: Growth in a Down Economy

2008-12-30T08:28:00.000-08:00

I spoke this morning with two health system executives about the current economic downturn. Both shared the same message. October and November volumes missed budget by 4 - 6%. Bad debt and charity care will likely be up between 6% and 8% when things settle out. December is obviously not closed, but census at their hospitals is holding steady.

Both were already weighing significant cost reductions in the first quarter so that they can preserve resources for physician acquisition and IT investments. We discussed short-term tactics that can build a firewall around clinical niches where the hospital has market share strength and stronger margins. The objective is to target market those niches, and consumer segments within them, to maintain volume, revenue and margins.

One of the two shared an interesting observation: with her competitors largely shelving strategic marketing efforts in the third and fourth quarters, in response to leaner financials, she feels he can acquire market share in priority segments at a discounted cost. "We're still funding our strategy; we've just focused it more tightly around acquisitions and referral source management, and scaled back on advertising," she said.

This strategy of targeted investment in market segments and clinical niches is one of the most successful at delivering growth in the short-term, and, positioning you for significant market share expansion in the long-run. I'll keep in touch with my colleagues and report back on the outcome of their efforts over the coming months.

The Competitor You Do Not See: KwikMed.com

2008-12-29T15:20:00.000-08:00

KwikMed.com promotes itself as "the ONLY company granted regulatory approval to prescribe FDA-approved and domestically manufactured medications online."

Under an agreement with the Utah State Department of Occupational and Professional Licensing and the Utah State Boards of Pharmacy, Medicine and Osteopathy, KwikMed.com offers patients expert medical advice, full confidentiality and lower costs to deal with sensitive medical issues.

With an exhaustive, physician-approved online diagnostic assessment and interactive follow-up communication whenever necessary, KwikMed.com's licensed physicians establish a physician-patient relationship with all individuals seeking KwikMed.com's medical services. This interview is far more comprehensive than the face-to-face examination conducted by most doctors during a routine office visit. All prescriptions are dispensed only by physicians who are fully licensed by the appropriate authorities in their state of residence. These doctors go beyond regulatory requirements by examining each patient file for a broad range of related medical issues.

I shared the KwikMed.com approach with a few colleagues today. Three physicians expressed concern for the quality of the diagnoses being developed, but agreed that similar business models will likely emerge as pressure continues to build to deliver more convenient care at lower cost. "There's an inevitability to this approach," one primary care physician said, "based on people's growing comfort with web-based medicine and preference for lower-cost care." All three concurred that it is this type of innovative marriage of technology and knowledge that will reshape health care into a more consumer friendly market.

Strategy with Purpose: Positioning for Growth

2008-12-28T21:01:00.000-08:00

A recent conversation with the COO of a large midwestern integated health system produced some interesting perspectives on the impact of the current economic downturn on the industry.

The COO noted that he was under pressure to cut costs and delay capital projects as a result of falling volume and growing numbers of self-pays. Over the short-term, he sees the inevitability of hospitals closing, for-profit ventures going out of business, and physicians merging into larger systems. Within 3 - 5 years he believes market conslidation will leave a limited number of large, multi-state systems with the access to capital to make required investments in technology and the scale to improve quality and drive down costs.

When I asked whether his system would be one of the regional survivors, he candidly admitted he did not know. "We're on the cusp - which means even as we cut costs to survive the current downturn we need to position ourselves for rapid growth when times get better."

Critical to his survival strategy: shedding unproductive services and assets to free up capital that can be reinvested in new products and services that can generate higher margins to fund future growth.

"We've assessed and ranked our service offerings as best we can based on market share, margin, growth potential, and our competitive position in the market", the COO explained. Our intent is to redirect resources from those offerings at the bottom of the list to those at the top. "We'd rather be the clear market leader in key market niches, and generate strong margins to reinvest and protect and grow that position, than to muddle along in the middle of the pack."

Everything Matters

2008-12-02T10:01:00.001-08:00

On my umpteenth commute through an airport this past year, I picked up a book from Tom Peters' Essentials series called "Design." It's a quick and entertaining read perfectly designed for cover to cover perusal over the typical span of time one spends waiting for planes, waiting on planes, riding on planes, deplaning - well, you get the idea.

Peters hooked me on page 16 under a quick passage called 'Hotel Hell.' What any road warrior will tell you is that after getting up at 4 am for a 6 am flight to make an 9 am meeting that finishes at 4 pm in time for you to catch a 7 pm to arrive at the next stop by 9 pm where you get to your hotel by 10 pm and hope to catch up on the day's emails and prep for tomorrow's meeting before falling to sleep at midnight -- what MAKES YOU CRAZY is that most of the time, you are moving furniture or crawling around to find a power outlet close enough to lounge on the most comfortable piece of furniture with your laptop. To quote "only 1 in 10 or 15 hotels get it." It, being that after 16 to 17 hours of hard labor, the last place I want to sit and work is "at a crappy desk, with unbelievably crappy desk chairs. "

The point Peters makes is that design is the principal difference between 'function' and 'experience.' Peters explains, "For me, design encompasses not just manufactured goods . . . but a company's entire value proposition. In other words, every aspect, tangible and otherwise, of the experience on offer by the company."

In other words, everything counts. And it counts from our customer's point of view. Walk into Apple, Starbucks, Whole Foods -- look up, down and sideways -- everything from layout to decor to uniforms to product mix to technology to employee engagement is purposefully designed to create an indelible experience. Customer experiences create brand perceptions, brand perceptions influence consumer behaviors, consumer behaviors drive business outcomes. It's a pretty simple formula.

How many of us as health care executives have spent the day waiting in our own emergency rooms, sat in a hallway half dressed for hours, tried to call and schedule an appointment with a doctor's office on our lunch break, met a registration clerk that doesn't look up while barking 'next,' didn't get the call about biopsy results because no one thought it was necessary to report a happy negative, tried to schedule appointments around working hours, filled out the same information over and over on forms -- should I go on? The point is -- it all matters. No matter how much we fall in love with the 'promise' of our brand, it's the 'action' of the brand that imprints like permanent ink.

Fast forward to chapter 3: "We continue to talk about 'service and quality' as the key attributes of value; instead we must understand that "EXPERIENCE" is not only a very big word . . . with far reaching implications . . . but it is nothing short of the basis for a . . . totally re-imagined organizational life form. (Truly.)"

(Composed after finding a power outlet behind the bed)

From Brand Promises to Brand Action

2008-11-28T06:04:00.001-08:00

Healthcare is one of the most competitive of US industries; and one of the more complex in which marketing and brand strategies are developed and executed. The growing demand and influence of aging, informed consumers, increasingly tighter integration and alignment between health systems and physicians, complicated reimbursement mechanisms and higher deductibles, widespread shortages of physicians, nurses and other staff, and challenging economics are creating an environment in which brand is growing in importance as a strategic asset.

So how do you turn your brand into the secret weapon of the health system’s competitive arsenal? By embracing the concept that brands are built more powerfully through the customer experience than through promotions alone; that great brands are created by integrated business, brand and marketing strategies.

For too long, health systems have driven brand building solely from the marketing department and primarily through a communications perspective where brand promises are created from positioning themes and communicated through a wide variety of promotions vehicles. Not because marketers covet sole control of brand management – I know plenty that worry daily about their company’s ability to live up to advertised promises – but because the broader organization has not realized the importance of the customer experience in creating powerful, relevant and defensible brands. And consequently, have not aligned services, products, processes, systems, employees and communications to deliver the brand experience consistently – every day, every time. Creating expectations you can’t meet is the fastest path to brand irrelevancy.

I propose that we set aside the idea of a ‘brand promise’ and think of brand as the health system’s value proposition towards its patients, customers and constituencies. Thus, the brand value proposition becomes the sum total of benefits – emotional, practical – which gives meaning to the customer experience and builds stronger, more loyal relationships. As Kent Seltman, now retired CMO for the Mayo Clinic, puts it – ‘our brand is built everyday on the fly by every employee that interacts with our patients.’

In the enduring lyrics of Elvis Presley, what brands need now is a ‘little less conversation, a little more action.’

Online reviews

2008-11-26T10:20:00.003-08:00

I have been seeing new studies that address the impact of online reviews - and it appears their importance is second only to word-of-mouth. What has been interesting about this, is that while only a small portion of web users are contributors, the majority of web users are considered "watchers or readers" and many companies discount sites or online reviews because of this. I believe that marketers should not overlook these as they are disproportionately influential in purchasing decisions. See Rubicon's study on this: http://www.marketingcharts.com/interactive/online-reviews-second-only-to-word-of-mouth-in-purchase-influence-6968/?camp=newsletter&src=mc&type=textlink

Online marketing

2008-11-26T10:05:00.003-08:00

I've been seeing lots of information about the growth of online marketing and activities, and marketers are wondering how much to invest in this fairly new medium. While most are not doing banner ads, the range seems to be somewhere between 9-12% of advertising budgets allocated to online, with it projected to grow slightly every year.

SEO seems to be the other area getting alot of focus and resource as well so that hospitals can devise a plan to increase the rankings, or improve the quality and volume of traffic on the web. This is a complicated process and needs to be handled by an expert. You need to understand if the services they offer will actually drive more visitors who are prospective patients or customers.

Mobile Marketing

2008-11-26T06:45:00.003-08:00

Mobile seems to be the hottest new marketing opportunity, and all indications point to marketers shifting some budget dollars to this very targeted, measurable and more cost effective medium in favor of traditional media. The Mobile Marketer newsletter offers some great resources for mobile commerce and mobile advertising. Most important, depending on the population and number of mobile users in your hospital's service area, you will want to have a useful mobile site so consumers can access pertinent information from your website, like phone numbers and directions. Hospital marketers should also consider targeting younger users via mobile for outpatient services and elective procedures. Appointment reminders would also be another great differentiator.

The CMO's New Agenda Part II

2008-11-25T15:05:00.001-08:00

1. Discovering, creating, exploiting growth markets

2. Building strong, differentiated, defensible brands

3. Increasing customer responsiveness and loyalty

4. Redefining and leveraging new channels of distribution

5. Embracing new media

6. Leading the development of strategic pricing capabilities

7. Building the marketing organization of the future

The Chief Marketing Officer's New Agenda

2008-11-24T15:58:00.001-08:00

Marketing executives have never had a more opportune time to better establish the discipline of marketing as a strategy-critical business competency for healthcare organizations – changing, challenging economics are front and center, and make a compelling case for the role that markers must play in an increasingly competitive industry.

What is the new agenda for Chief Marketing Officers? To transform the discipline from promotions-oriented tactics to market-making, customer-oriented strategic leadership. To drive growth and value-innovation across the health system. To prepare and position the organization for long term success while simultaneously enhancing and growing the core business.

The imperative is three-fold. First, to build a marketing organization that is strategic and focused on near-term enterprise growth as well as creation of future customers, products, and channels. Second, to establish the critical relationships and linkages across the value chain (clinical operations, finance, purchasing, IT, physicians, partnerships, etc.) to orchestrate alignment to customer needs and company growth goals. And third, to develop a results oriented marketing operation that delivers on revenue growth and profit goals.

Sustainable competitive advantage is the goal -- in times of prosperity, and especially in times of economic turndown.

In Pursuit of Competitive Advantage

2008-11-24T03:07:00.001-08:00

The most important decisions faced by healthcare executives and governing boards are, more often than not, posed by the marketplace. The expectations and actions of consumers, doctors, government agencies, philanthropists, stockholders, suppliers, the labor market and industry at large continually reset both requirements for success and the rules of competition. The development and implementation of strategy is the principal means to create and sustain competitive advantage over the long term. It requires continuous leadership attention and engagement in ever-higher levels of strategic thinking, discussion and decision-making.

Successful organizations approach strategy as a compilation of processes to discern the boundaries of the business, redefine the basis of competition, and create an organization capable of success in ever-changing and unpredictable markets. Strategy cannot be delegated; it is the core duty of executives and boards to define the future and to lead the company, its people, its customers, and even its competitors, in that direction.

Strategic leaders – those at the forefront of markets and industries – approach strategy formulation and execution in myriad ways. Of more interest are the commonalities that characterize great strategists and great organizations, and form the foundation for great plans – among them an artful mix of analytical processes and intuitive leaps of faith; strategic thinking skills that engage discussion at all levels about the future and its potential opportunities and threats; a willingness to recognize weaknesses and challenge prior successes; a laser focus on what’s important; and a long view that is little obscured by short term and lesser significant issues.

This blog exists to explore matters of strategy -- especially as it is practiced by market-driving companies. I invite you to join the discussion.

Karen

How blogs can impact your business

2008-11-18T12:36:00.003-08:00

It was fascinating to read the articles about how quickly bloggers undermined the latest Motrin Mom ads, http://adage.com/digital/article?article_id=132622. Health care organizations need to quickly recognize the impact consumer-generated content can have on their businesses and develop strategies to both engage with and monitor social networking. As I heard one speaker this past week say, 'social networking is like air". It is not going away, and organizations need to determine how to embrace this new medium. There are a number of great guidelines and policies out on the net in the private sector to review and emulate already, and way that organizatations can start simply without requiring huge amounts of resources. Hospital legal and IT departments need to be made aware than consumers are viewing and writing about their organizations, and hospital employees need access to what their consumers are saying.

Social Media

2008-11-12T05:59:00.003-08:00

At the Greystone Internet conference yesterday, I listened to Shel Holtz, a web communications guru, and he shared many practical examples of how organizations are using social media and really engaging consumer segments by utilizing all the social media to make the human connection. He encourages transparency, authenticity and ethical behavior and believes that not filtering negative information will add credibility.
I really liked the way he simplified social media into the following platforms:
Conversation-enabled publishing
-blogs and podcasts
Social Networks
-LinkedIn, MySpace, Facebook
Democratized content networks
-wikis, Digg, bulletin board, Dell IdeaStorm
Presence networks (micro-blogging)
-Jaiku, Twitter, Pownce
Content-sharing sites
-YouTube, Flikr, del.icio.us
Virtual Networking
-SecondLife, There.com
He had some wonderful examples, like DeLoitte, who created a recruitment video called “The Green Dot.” He also talked about the consumer involvement in product development, and referenced the Dell ideaStorm site, MyStarbucks (which I belong to) and the P&G Connect and Develop site, which now drives a majority of their new product ideas.
There was some dialogue and questions about the legalities and risks of blog information, and he suggested reviewing IBM’s social computing guidelines for recommendations. Great stuff…

Navvis and Company

Accountable Clinical Management - Driving Sucess through Shared Leadership

The importance of marketing alignment with brand strategy development and leadership

Aligning competitive strategy in the face of major industry change

President Signs Health Care Reform Act; Now What?

St. John's Mercy Physician Clinical Council

5 Key Areas of Focus when Assessing Physician Need and Alignment

Don't Wait for Congress!

Brand Management Requires a Comprehensive, Robust Framework

Chief Marketing Officers' Innovator's Studio Explores Brand Mastery

Health System Performance Varies Significantly State to State

Re-Energizing

How do You Know When You Have a Brand?

Building the Case for Brand Alignment

Hardwire Your Organization with a “Can Do” Attitude

California Hospitals Reducing Costs

Follow the Innovator's Studio Social Media Intensive on Twitter

HealthLeaders Service Line Strategies 09 Virtual Workshop

The Chief Marketing Officer's New Agenda

Learnings from Bumrungrad International Hospital

Financial, Strategic Outcomes Count When it Comes to Return on Marketing Investments

What if Your Competitor Delivers on Your Brand Better Than You Do?

Leveraging Brand Activation to Address the "Elephants in the Room"

Sustainable Cost Savings are Critical, Elusive without a Strategy

Extraordinary Online Brands Start with Great Offline Stories

Innovation Won't Thrive where Creativity isn't Valued

Brand Mastery Topic of Fall CMO Innovators' Studio

Running a Hospital is a Blog Worth Following

Aurora's Path to 'Best in Quality' among US Health Systems

Whatever Happened to Retail Health Care?

Prioritize Marketing Investments in a Downturn

Develop Competencies for Brand Leadership

Flirting with Market Irrelevance?

Innovators' Studio Virtual Work Session to Feature Scott Davis

Marketing Orthopedic Services

Industry Transformation Requires a Long View Strategy for Health Systems

Closing the Brand Equity Gap of Investment and Realized Return

Chief Marketing Officers Convene at Innovators' Studio

Technology Can Drive Personal Connections

The Critical Conversations

Rapidly Restructuring Healthcare Markets Require New Approaches to Brand Management

Keeping Your Brand Healthy After Physician Integration: Part II

Keeping Your Brand Healthy After Physician Integration: Part II

Is Service Line Success Embedded in Design or Execution: Part 4

Is Service Line Success Embedded in Design or Execution: Part 3

Is Service Line Success Embedded in Design or Execution: Part 2

What’s worse? Having a policy you don’t follow or not having a policy at all?

How Many Primary Care Physicians do We Need?

Is the Nursing Shortage Over?

Is Service Line Success Embedded in Design or Execution? Part 1

When "Stretch" Challenges "Strategy"

Giving Credit Where It’s Due: Ratings Agencies Now Weighing Physician Alignment

Recommended Reading

Enter Tom Daschle

Smoking Ban Reshapes Heart Market

Buy Low: Growth in a Down Economy

The Competitor You Do Not See: KwikMed.com

Strategy with Purpose: Positioning for Growth

Everything Matters

From Brand Promises to Brand Action

Online reviews

Online marketing

Mobile Marketing

The CMO's New Agenda Part II

The Chief Marketing Officer's New Agenda

In Pursuit of Competitive Advantage

How blogs can impact your business

Social Media