ready for health reform - mckeever cragin aamc presentation

8/14/2019 Ready for Health Reform - McKeever Cragin AAMC Presentation

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Health Reform Are You Ready?

AAMC/GIA Marketing


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Major Hospital ImpactsFinancial

Millions more low income people (patients) withinsurance, both private and Medicaid

Increased price competition among carriers for the newlyinsured; negative price pressure on hospitals

Potential for more carriers and national for-profit ones

that specialize in Medicaid

Downward pressure on government program rates forproviders


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Major Hospital ImpactsService Delivery

More population management

More formal relationships with community outpatient

providers Accountable Care Organizations

Emphasis on wellness and prevention

Publicly reported quality measures and comparativeshopping


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Commonwealth Care Billboard


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Commonwealth Careand

MassHealth Wrapped Bus


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BENCHMARKINGSURVEY RESULTS


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Priorities Misaligned?

0%

20%

40%

60%

80%

100%

Emphasized for 2009

OthersMedical HomePandemic prep

Promoting clinical researchGrowth & FinancesSatellite locations


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But Rightly Focused on End -Results

0%

20%

40%

60%

80%

100%

Emphasized for 2009

OthersMedical HomePandemic prepPromoting clinical researchGrowth & FinancesSatellite locations


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Warning!

0%

10%

20%

30%

40%

50%

Minimized in 2009

Othersemployee satisfaction/involvement


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63%

26%7%

Investment

A Cost

Unsure

Leaders See Marketing as Investment


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Brand Management Focus for Some

We've been attacked in by our local newspaper for our prices so alot of effort has been put into positioning ourselves as pro-reform.Looking to rehabilitate the brand a bit.

Our focus has been on positioning, not on increasing anyexpenditures.


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Marketing is Persuasion

0%

20%

40%

60%

80%

100%


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Value of Marketing has Increased

39%

48%

11%

IncreasedStay same

Declined


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And is Expected to Increase

50%41%

9%

Increase

Stay same

Decline


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But Need to Provide Solutions

33%

33%

17%9%

Developing Strategic Scenarios

Staying Abreast of Changes

Taking Action Now inAnticipation of Change

Nothing


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And Keep on Top of Unfolding Events

0%

10%

20%

30%

40%

50%

5 (Extremely) 4 3 2 1 (Not at All)

ReportedKnowledgeLevels


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But, Collectively, We Are Not Prepared

0%

10%

20%

30%

40%

50%

5 Prepared 4 3 2 1 Not at allPrepared

How does this relateto other

unpredictableevents?


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Not On Our Radar Yet?

None (several responses)

Not at all. We have not used the issue of healthcare reform toadvance our marketing efforts. Our marketing efforts are focused on

volume, CMI, service line and brand building. However, we havemade healthcare reform a central focus of our government andcommunity relations objectives in 2010.

None. The HI reform debate has had no impact. Probably because

there is nothing tangible to respond to.


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Leadership Doesnt Seem to Care

Even trying to get someone to pay attention to the new IRS 990requirements and the impact on community perception of fiscalresponsibility has been met with total indifference. I'm hoping forproactive response for MarCom, but expecting to be stuck in the roleof simply reacting. Very frustrating.

Our department was just cut. We lost 4 staff members due to cutsand were restructured into another department. Our expenses havebeen cut overall.

It hasn't come up. As a state -supported institution, our mainconcern has been declining funding from the state as a result of thesevere recession.


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Uncertainty Causes Pause

We have not initiated a real dialogue about this yet, as the continuinguncertainty in the healthcare bill makes it difficult to do so.

Not at all yet, since it's very unclear how, if at all, reform will change our economic environment.

Increased importance to create consumer demand for our product so theywill advocate with health plans. Important to continue to demonstrate tomanaged care what distinguishes us from community providers.

Don't know. The legislation is a moving target with huge implications everytime any paragraph (out of thousands) is edited. It would be a hugelyunproductive use of time to plan anything at this point. It is all changingdaily/weekly.


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AMCs Play a Key Role

To make sure we capture the market that does not have a primary carephysician.

We have had a town hall with our community partners and have beenpitching media stories about how we already have some of the models (e.g.,medical home) that are encompassed within the healthcare reformdialogue.

Focus has been on payer mix, cost containment, budget reductions,strategic plan roll out and other pressing matters. Health/insurance reform

adds one more element to economic uncertainty of the enterprise.However, we've not used it specifically to make the case for marcom.

Need for better communication for patient safety and related matters.


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Marketing = Demand Generation

In the need to build and maintain market share.

Leadership has recognized the need to maintain/grow market shareand build the brand in prep for h/c reform.

Increasing need to go direct to consumer with key messages toshow value.


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Some Examples

Mayo Clinic Cleveland Clinic Insurance Pharma

AMA AHA AARP AHIP

Lehigh Valley Health Network. Dr. Sussman is the President andCEO and also the Chairman of the AAMC. CHW - our own team is working with Speaker Pelosi and the Obama

Administration

What do they have in

common?


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Best Practices

Active monitoring Constant leadership agenda item Newsfeeds (e.g., AHA)

A clearly articulated stance www.makemedicinebetter.org www.mayoclinic.org/healthpolicycenter

Legislative advocacy Member organizations Congressional presentations

Scenario planning


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WHAT TO EXPECT


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Adverse Financial Impact

Overall reduction in financial viability.

The increased emphasis on wellness/primary care and reduced emphasison specialty care as our strategic priorities have been centered aroundspecialty care - cardiovascular, neurosciences, orthopedics, and cancer.

Cuts to Medicaid and Medicare.

Price difference. If we're more expensive, are we worth it...i.e. quality of care, comparative effectiveness, etc.

Reimbursement

Reduction in reimbursement rates from Medicare, Medicaid and medicaleducation.


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Need for Quality Communication

Need to tell a more complicated story, not just save a life any more.Defining and defending quality more rigorous and good news on this frontalways begs the question of what were you doing before or you haveinfections there?

Need to demonstrate value of academic centers in terms of investment infuture of healthcare-- particularly research and teaching components.

AHCs stand to lose a lot in this deal. Better communication about thevalue of AHCs (which the public doesn't understand).

Value proposition. Why do we exist?

Having to report quality data to payers and employers. What, where, howto we report it to the public. Will a public option mean no need for targetedmarketing strategies?


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Changes to Service Delivery

Access challenges posed by increased coverage -- how do you market tothe 'right' volume?

Efforts to control costs could result in payment policies and individual costshare provisions that ignore the different cost structure of academic medical

centers, especially as it relates to services available generally in thecommunity but because of the nature of teaching need to be part of theAMC clinical enterprise.

Restrictions on high quality costly treatments and procedures that are great

examples for media of exceptional care available only at teaching hospitalsthat might not be covered or available any longer due to cutbacks inreimbursements and unwillingness to cover such costs in the future. Also,any kind of innovative treatment that involves compassionate care topotentially illegal immigrants.


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Challenges in the Professional Pipeline

residency slot reallocation.

Reductions in ability to conduct clinical research and train newphysicians Inability to have enough primary-care physicians and mentalhealth experts for the increased number of people seeking care.

For our community -based school: The need for more primary carephysicians and how to attract more students into primary care fields.


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Marketing Priority Shifts

Depending upon the reimbursement mechanisms that are articulated in afinal reform plan, marketing and communications efforts might shift withrespect to target audiences. Should that happen, however, availableresources to market and communicate will likely be diminished greatly.

A federal program may reduce need for marketing but increase need for communications.

A broadening of consumer choice (more patients with some form of insurance) [but] reduced reimbursements could negatively impact dollarsavailable for marketing.

The legislation could easily force massive cost reduction, and would almostassuredly dry up marketing/communications budgets as those are typicallythe first items to be jettisoned in austere times.


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Implications for AMC Marketing

Direct patient advertising will increase Newly insured Choosers

Segmentation even more important Targeting De-selection

Strengthening referral channels More PCPs (in theory) Patient education to avoid switching


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Communicating Value

Treatment and prevention

Education clinical

Research

Patient education

Medical home

EMR advances

Outcomes measurement (evidenced-based care)


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Addressing AMC Needs

Philanthropy

Alternative funding sources (e.g., state)

Changes

Employee retention/enthusiasm

Patient experience management


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John McKeever

281-759-3600 [email protected]

John Cragin

617-748-6097 [email protected]

For write up and slides, pleasecontact us or leave your cards

ready for health reform - mckeever cragin aamc presentation

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