Engaging Customers to Gain Competitive Edge

HealthServicesAmerican MARKETING ASSOCIATION / Marketingpower.com Spring 2013
big data
Vanguard Health Systems creates
a tech-savvy engagement strategy
cRISIS RESPONSE
Six tips on how to implement
a crisis preparedness drill
insurance exchanges
Expert insights on how to handle
the new insurance marketplace
Baystate Health
finds its competitive
edge by engaging
customers to create
the experience
Collaboration
Commonwealthin the

collaboration in
the commonwealth
Baystate Health finds its competitive edge by
engaging customers to create the experience
By Suzanne Bharati Hendery
and Wilson C. Mertens
contents
28
cover story
departments
04
Marketing
Mix
features
20
A Sea Change
From Exchanges
Health insurance
exchanges could
alter the flow of U.S.
health care promotion
and delivery
By Preston Gee
24
MakingtheConnection
A strategy for lever-
aging Big Data, and
new digital and mobile
tools to effectively reach
health care consumers
By Devin Carty
american marketing association MarketingPower.com/magazines
HEALTHSERVICESAMERICAN MARKETING ASSOCIATION / MARKETINGPOWER.COM SPRING 2013
BIG DATA
Vanguard Health Systems creates
a tech-savvy engagement strategy
CRISIS RESPONSE
Six tips on how to implement
a crisis preparedness drill
INSURANCE EXCHANGES
Expert insights on how to handle
the new insurance marketplace
Baystate Health
edge by engaging
customers to create
the experience
Collaboration
Commonwealthin the
Spring 2013
Volume 33
Number 2
Debra Landers,
CMO of Community
Health Systems,
discusses
enterprise-wide
marketing
Interview by
Rhoda Weiss, Ph.D.
knowledge
base16
Editorial board analysis Online Insurance Exchanges By Rhoda Weiss, Ph.D. 06
social strategy Content Enjoys a Glorious Reign By susan solomon 08
Customer Experience Lessons Learned By Beth Bradfield Wright 10
in the trenches Practice Makes Perfect By diane Gage Lofgren & John Nelson 12
strategic insights A Remedy for Readmissions By Rhoda Weiss, Ph.D. 14
Executive Perspective Everyone Benefits By Howard Lee 32

Rhoda Weiss, Ph.D., editor-in-chief
rhoda@rhodaweiss.com
2 marketing health Services
Spring 2013
Welcome to another issue of Marketing Health Services. One
of the most transformative changes in health care will soon be open for
business. Online marketplaces, better known as exchanges, could sig-
nificantly alter how we do marketing. Trinity Health’s Preston Gee offers
a comprehensive overview and editorial board members describe their
strategies for the new marketplace.
Another transformation is occurring in digital and social media.
St. Joseph Health’s Susan Solomon stresses the importance of content
generation in building a digital reputation. And Devin Carty outlines
Vanguard Health Systems’ efforts in leveraging Big
Data, new digital tools and traditional media to
effectively reach consumers.
Imagine supporting the marketing needs of 135
hospitals. That’s a reality for Community Health
Systems’ Debra Landers, who shares her mega-health
system’s successful strategies to standardize market-
ing in every CHS location.
Gaining the competitive edge is on everyone’s
must-do list. Suzanne Hendery chronicles Baystate
Health’s engagement of customers in their patient
experience that’s helping achieve market share
prominence.
Today’s complex, transparent organizations are
ripe for crisis. Kaiser Permanente’s Diane Gage
Lofgren and John Nelson delineate how crisis drills
can spell communications success. And my column
suggests new ways of reaching stakeholders.
Coverage alone does not guarantee a healthy population. CEO
Howard Lee details how University Health Alliance’s groundbreaking
initiatives are putting health back into health insurance.
Marketing executive Beth Wright has spent her career promoting
the importance of medical screenings. Then she received a diagnosis of
cancer. Beth’s unforgettable journey should impact the way that we all
provide care to our communities.
Phone (800) AMA-1150 • Fax (312) 542-9001
American Marketing Association
David Reibstein Chairperson of the AMA Board 2012-2013
Dennis Dunlap AMA Chief Executive Officer | ddunlap@ama.org
Editorial Staff
Rhoda Weiss, Ph.D. Editor-in-chief | rhoda@rhodaweiss.com
Mary M. Flory Managing Editor | mflory@ama.org
Marguerite McNeal Staff Writer | mmcneal@ama.org
art
Kristina Walton Graphic Designer | kwalton@ama.org
Advertising Staff
Richard Ballschmiede Advertising Sales Director | rballschmiede@ama.org
Catherine Eck Advertising Account Representative | ceck@ama.org
Sally Schmitz Production Manager | sschmitz@ama.org
Brian Thompson Advertising Production Coordinator | bthompson@ama.org
Marketing Health Services (ISSN: 1094-1304) is published quarterly by the
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The opinions expressed herein are those of the authors and not necessarily
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Spring 2013 | Vol. 33 | No. 2
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marketingpower.com
Copyright © 2013
American Marketing Association
Leonard Achan, CCO/VP, Marketing & Communications, The Mount Sinai Medical Center / Judy Akins, SVP, Marketing & Communication, Mercy Health Ministry /
ELLEN BARRON, AVP, Marketing & Communications, University of Iowa Health Care / PETER BRUMLEVE, CMO, University Hospitals / DEVIN CARTY, CMO, Vanguard Health Systems / KATHLEEN DEAN,
System VP, Communications, Marketing & Public Affairs, PeaceHealth / Kathleen DeVries, VP, Marketing & Communications, University of Chicago Medicine & Biological Sciences / ERINNE DYER,
VP, Corporate Communications, Marketing & Outreach, Carolinas HealthCare System / PATRICK DYSON, EVP, Strategy & Corporate Services, Borgess Health / DAVID FEINBERG, SVP/CMO, New York-
Presbyterian / DIANE GAGE LOFGREN, SVP/CCO, Brand Communications, Kaiser Permanente / Preston Gee, SVP, Planning & Marketing, Trinity Health / BILL GLEESON, VP, Communications, Sutter
Health / ROSE GLENN, SVP, Marketing & Public Relations, Henry Ford Health System / DEBORAH GORDON, CMO, Network Health / Matt Gove, CMO/SVP, External Affairs, Piedmont Healthcare /
DALAL HALDEMAN, Ph.D., SVP, Marketing & Communications, Johns Hopkins Medicine / MISTY HATHAWAY, Chair, Marketing Enterprise, Mayo Clinic / SUZANNE HENDERY, VP, Marketing & Commun-
ications, Baystate Health / JEAN HITCHCOCK, Corporate VP, Public Affairs & Marketing, MedStar Health / OREST HOLUBEC, SVP, Marketing & Communication, Providence Health & Services / Deborah
Italiano, Executive Director, Marketing, Stanford Hospital & Clinic / SUE JABLONSKI, SVP, Corporate Marketing & Communications, Ohio Health / LINDA KALAHIKI, SVP/CMO, UHA Health Insurance /
MICHAEL KILLIAN, VP, Marketing & Public Affairs, Beaumont Health System / MARK KLEIN, SVP, Communications, Public Affairs & Marketing, Dignity Health / DEBRA LANDERS, VP/CMO, Community
Health Systems / CAROL LOVIN, President, CHS Management Company, Carolinas HealthCare System / MEGAN MANAHAN, VP, Marketing & Communications, Mercy / PAUL MATSEN, CMO/CCO,
Cleveland Clinic / JUNE MCALLISTER FOWLER, VP, Corporate & Public Communications, BJC HealthCare / Teresa Murphy, VP, Marketing & Communications, Fletcher Allen Health Care / Sarah
Newson, AVP, Communications, University of Texas MD Anderson Cancer Center / MARK PARRINGTON, VP, Strategic Transactions, Catholic Health Initiatives / KEALA PETERS, VP, Marketing &
Communications, Hawaii Pacific Health / KIM REYNOLDS, VP, Marketing, LifePoint Hospitals / JOYCE ROSS, SVP, Communications, Catholic Health Initiatives / MARK ROTHWELL, VP, Marketing
& Communications, Dean Clinic / JULIE SHERMAN, Senior Director, Brand Services, Banner Health / STEVE SHIVINSKY, Corporate VP, Communications, Blue Shield of California / SUSAN SOLOMON,
VP, Marketing & Communications, St. Joseph Health / DON STANZIANO, Corporate VP, Marketing & Communications, Scripps Health / TOM VITELLI, AVP, Communications, Intermountain Healthcare /
Holly Vonderheit, VP, Marketing & Community Relations, Indiana University Health / BETH WRIGHT, VP, Corporate Communications & Strategic Marketing, Capella Healthcare
A note from our editor
Editorial Board

3marketing Health services
Spring 2013
South African families who
participate in a program
sponsored by the country’s
largest private insurance company receive rebates for
buying healthier foods, such as produce and whole
grains. A family is entitled to a maximum refund of
$125 a month.
$125
by the numbers
bn
Two nonprofit health care groups
analyzed states’ efforts to make
medical care pricing information
widely available to consumers. Overall, 36 states
received letter grades of D or F.
36
also find us on
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Tube
find out more at
marketingpower .com
Recent AMA podcast Author Series: Converge:
Digital marketing expert Ray Velez explains how the
merging of technology, media and creativity is revolutionizing
marketing. Listen in: MarketingPower.com/podcasts
Recent AMA webcast KeepYour Stories Straight:
Learn how to align your social media and content marketing
strategies, and how to measure the success of your efforts.
Log on: MarketingPower.com/webcasts
Now on AMA TV
Loyalty program trends,
analytics and the customer
experience, interview tips
and more.Tune in:
MarketingPower.com/AMATV
Get Digital! MHS subscribers, you can read your latest
issue on your computer, smartphone or tablet. Check out our
digital edition at MarketingPower.com/digitalpubs.
HEALTHSERVICESAMERICAN MARKETING
ASSOCIATION
/ MARKETINGPOWE
R.COM
SPRING 2013
BIG DATA
Vanguard Health Systems createsa tech-savvy engagement strategy
CRISIS RESPONSE
Six tips on how to implementa crisis preparedness drill
INSURANCE EXCHANGES
Expert insights on how to handlethe new insurance marketplace
Baystate Health
edge by engaging
customers to create
the experience
Collaboration
Commonwealthin the
The Alzheimer’s Association reported
that health and long-term care
services for people living with the
disease will total $203 billion in 2013.
$203BILLION
The U.S. Department of Health and Human
Services is testing three dozen care delivery
models involving 50,000 health care provid-
ers and more than 1 million beneficiaries.
The Obama administration said that it could take up to one
year to see results.
03Dozen
According to market research company
Lab42, 57% of consumers do not fully
understand what their insurance covers.
The U.S. spends 20% of GDP—an
estimated $2.8 trillion for 2013—on
health care.
Industry Vitals Edited by Marguerite McNeal

Spring 2013
marketing Mix
mM
Recruiting participants
for HIV prevention studies
and treatment can be a
challenge, so Dr. Raphael
Landovitz of the UCLA
Center for Clinical AIDS
Research & Education
used Grindr, an app
popular with young,
gay men for sexual
partnering, to find 375
participants for a survey,
according to a study
published in the Journal
of Urban Health.
Sourcing
gets techy
Real-time surveys
Harnessing personal technologies
to prevent, manage heart diseaseThe home health care
aide is the fastest-growing
profession in the U.S.,
according to the U.S. Labor
Department. As baby
boomers age, the number
of in-home care workers is
expected to increase 70%
between 2010 and 2020.
However, despite the rising
number of job opportu-
nities, the average hourly
wage is $9.70.
Booming job,
small paycheck
Smartphones, apps, sensors and other
devices will help researchers study cardiovascular health in
real time. A new project called the Health eHeart Study aims to
gather data from up to 1 million participants on a wide variety
of measures associated with cardiovascular health, including
blood pressure, physical activity, diet and sleep habits. The
researchers, from the University of California, San Francisco,
hope to find more precise strategies to predict the development
and slow the progression of heart disease. Their strategy high-
lights the growing potential of smartphones and other devices
in medical research, Jeffrey Olgin, chief of cardiology at the
University of California, told The Wall Street Journal.
$
9.70
Some employers
are using private
exchanges to allow
workers to shop for
health plans in an
online marketplace.
Last fall, Sears
Holdings Corp.,
Darden Restaurants
Inc. and Aon Hewitt
offered employees a
set contribution to
use toward health
benefits. Workers
could pay a larger
monthly fee for
richer plans or
choose cheaper
options that require
higher out-of-pocket
fees. Of the 100,000
employees who used
the exchange, many
more opted for
lower-priced plans
with bigger fees, ac-
cording to consult-
ing firm Aon Hewitt,
which operates the
online marketplace.
Health
Exchange Inc.
Timely topics in the health care space Edited by Marguerite McNeal

Spring 2013
marketing Mix
Although California
voters struck down Proposition
37, a controversial ballot mea-
sure that
would
have re-
quired
the la-
beling
of certain
genetically
modified
products,
Whole
Foods
is not
letting the issue rest. The
health-conscious grocery chain
announced that by 2018, all
items sold in its American
and Canadian stores will note
the presence of genetically
modified organisms, or GMOs.
Industry experts predict that
other retailers will join the
movement.
Leading labels
Social power
Diabetic Connect, a social network
site for people living with the dis-
ease, drew more than 1.4 million
monthly unique visitors in January,
more than the American Diabetes
Association’s website, according to
comScore. One of more than 50
condition-specific socially powered
sites owned by Alliance Health
Networks, Diabetic Connect offers
personalized content, tracking
tools and discussion platforms
for its members.
Last year, a New York doctor launched
Sherpaa, a virtual doctor’s office with
physicians and specialists who examine
patients by e-mail and text. A real-time
command center for health needs, Sherpaa
works exclusively with companies and counts
500 customers from 30 businesses.
From Nike’s FuelBand to Weight Watchers’ points system, health-tracking
tools abound in today’s marketplace, but they’re not for everyone. A survey from the
Pew Research Center found that 69% of U.S. adults track some sort of health indica-
tor for themselves or a loved one, such as their exercise routines, weight, diet, blood
pressure, blood sugar, headaches or sleep patterns. Of the survey respondents, only
29% said that they use a gadget, app or website to monitor or record this information.
The majority of participants just keep the data in their heads or jot it down on paper.
Old-school tracking
The doctor’s IMing
Dr. Susan Gonnella,
chief physician
Courtesy of NikeInc.com
CourtesyofSherpaa.com

Spring 2013
Matt Gove
CMO and SVP
of External Affairs
Piedmont
Healthcare
Deborah Gordon
VP and CMO
Network Health
(Massachusetts
health plan)
“With six years of experience in
reform, we learned the criticality of,
(1.) public awareness, as exchanges
significantly change how consum-
ers purchase health insurance, and
marketers should promote their
offerings, and educate and help
people through the transition;
(2.) delivering value, as consumers
‘vote with their wallets,’ and it’s
critical that health plans design
options based on market demands,
representing the customer’s voice
in that process; and, (3.) collabo-
ration, because although we’re ac-
customed to competing, we must
now focus on common interests to
ensure that the market succeeds
for the benefit of end users.”
“Last year, we decided that the
best strategy for population health
is partnering with WellStar, another
Atlanta system, to form a health
plan. This adds scale, a physician
network, expertise and ability to
participate in the exchange, if we
wish. Marketing a new insurance
product is an enormous undertak-
ing, but by leveraging the branding
of our organizations, Piedmont
WellStar Healthplans should hit the
ground running when we introduce
the brand to consumers. For open
enrollment this fall, we’ll add direct
mail, community events and digital
campaigns to the mix.”
editorial
board analysis
Interviews by Rhoda Weiss /  rhoda@rhodaweiss.com
How is your organization
getting ready for the
exchange? What
marketing strategies
are you pursuing?
I
t’s the centerpiece of U.S. health reform. Online
insurance exchanges, or marketplaces, start
offering insurance plans this fall to individuals
and small employers, and will go into full swing in
January 2014 when coverage begins. Consumers
will be able to compare health plans, purchase
insurance and learn if they’re eligible for Medicaid
or subsidies to help pay premiums. Exchanges
are expected to enroll about 7 million people in
2013 and 24 million by 2016, according to the U.S.
Congressional Budget Office, creating countless
marketing opportunities. Eight editorial board
members—representing health systems, hospitals,
physician groups and insurers, and including one
who is experienced in exchanges—share how
they are getting ready for this new marketplace.
•
MHS•

Patrick Dyson
EVP of Strategy
& Corporate
Services
Borgess Health
“As Michigan continues to devel-
op its exchange, Borgess is focus-
ing on financial planning related
to provider rates for health plans
obtained through the exchange;
the impact of an exchange on
small, medium and large em-
ployers’ potential migration to
the exchange; and the impact of
Medicaid expansion. Further, it
appears that while some health
plans may offer products on the
exchange by Jan. 1, 2014, most
plans are targeting Jan. 1, 2015.”
Spring 2013
Mark Rothwell
VP of Marketing &
Communications
Dean Clinic
Tom Vitelli
AVP of
Communications
Intermountain
Healthcare
“We continue to promote and
strengthen our brand as we have
always done, since a strong brand
will be more important than ever as
more individual consumers make
health plan purchasing decisions
through the exchange. We are also
planning to reach out to consum-
ers and small businesses to help
them understand the Affordable
Care Act provisions that take effect
in 2014, including the availability of
premium subsidies.”
Erinne Dyer
VP of Corporate
Communications,
Marketing & Outreach
Carolinas
HealthCare System
“Our teams are aligning mas-
ter brand communications and
messages to create and build a
stronger relationship with
Carolinas HealthCare System.
We are evaluating ads to ensure
that they reach the right audi-
ences with the right messages.
We are staying abreast of fed-
eral and state policy changes to
ensure that we fully understand
the implications on our business,
specifically how we market and
communicate to patients, and to
ensure that we have a seat at the
table as decisions that impact our
world are made.”
Teresa Murphy
VP of Marketing &
Communications
Fletcher Allen
Health Care
“Fletcher Allen leads an account-
able care organization, OneCare
Vermont, under the CMS shared
savings program for Medicare
beneficiaries. Participants include
Dartmouth Hitchcock Health,
nearly all of the state’s communi-
ty hospitals and many health pro-
viders. OneCare Vermont could
potentially include a multi-payer
shared savings program for
patients enrolled in the exchange
next year. Through our subsidiary,
Vermont Managed Care, we pro-
vide care management services
to populations covered by
Vermont Health CO-OP,
Vermont’s first cooperative
insurance company, available
on the exchange in 2014.”
Dalal Haldeman
SVP of Marketing &
Communications
Johns Hopkins
Medicine
“We have been working closely
with local government officials,
insurance companies and con-
sumer groups to prepare for the
impact of exchanges and other
reform provisions. We initiated
additional education, training and
outreach, including a symposium
on primary care—all with the aim
of increasing the understanding
of impending changes on admin-
istrative staff, physicians, local
communities, and our network of
physicians and other providers,
and making stakeholders more
aware of our managed care offer-
ings and products.”
“Our integrated system (hospital,
clinic, health plan) is strategizing
on what the future looks like. We
are continuing current marketing
strategies, but given our market’s
capitated nature and the pending
launch of the exchange, we’re in-
vesting more resources in segmen-
tation beyond current audiences.
We will focus on targeted vehicles
(digital, CRM, community relations
partnerships and public relations)
that deliver the right message to
the right audiences to ensure the
right result, selecting Dean as their
health care partner.” mhs

Spring 2013
C
ontent has forever been king
for marketing professionals,
yet recently, discussions have
intensified about the importance of
content generation in building a digital
reputation. “Content marketing” and
“brand journalism” are widely
talked about.
First, some definitions: Content
marketing is the process of creating
and distributing relevant and valuable
content to attract, acquire and engage a
target audience. It can leverage a variety
of channels (print, mobile, social, etc.),
but unlike pure advertising, it relies on
storytelling rather than bravado. Or, to put
it simply, if you want to tell the world that
you’re a rock star, advertise. If you want to
show why you’re one, have great content.
Brand journalism follows the same
philosophy but contains a dash of
controversy, especially for journalists.
It employs digital publishing and social
media to spread content and speak
directly to consumers. Marketing
professionals disintermediate news
professionals by writing and distributing
their own stories.
Journalists’ concerns aside, why have
content marketing and brand journalism
become such hot topics?
One reason is that the platforms for
content dissemination have exploded in
recent years. Whereas there were formerly
just Facebook and Twitter, there now are
so many new options. It’s enough to make
marketing professionals’ heads spin. (For
example, are you familiar with Vine?)
Also, with Google’s Penguin product,
the rules of search have changed and
great content is key to winning the game.
Traditional chest thumping and flaccid
text that fails to engage readers are not
going to get anyone anywhere because a
bad user experience is synonymous with
low Google rankings. And low rankings
are death to marketing professionals.
The Cleveland Clinic’s Health Hub
is one of the leaders of the content
marketing pack. The site is filled with
content generated by experts within the
organization. Users are encouraged to
share as much of the stories on as many
platforms as they choose. Mayo Clinic
offers a similar site.
So how does one get started with
content marketing? First, eschew any
preconceptions that content is purely the
social strategy
Content Enjoys a
Glorious Reign
Why stocking your website with
exclusive content is worth the effort
Susan Solomon
 susan.solomon@stjoe.org
content marketing

Spring 2013
written word. Social media platforms are
driving a visual revolution. Think about
the unique and, admittedly, addictive
visual platform of Pinterest, and if seeking
an example of how it’s done right, go
to The Wall Street Journal’s Pinterest
site, where the editors have created a
fascinating blend of words and images.
Also, don’t forget Instagram, the fun
photo-sharing network. Not only can
users post photos, but also they can edit
them with sophisticated tools to make
their visual postings truly intriguing.
Even the traditionally text-focused
platforms have gone visual. Google+
offers lots of white space and larger photo
options, and it’s no secret that Facebook
content with attractive visuals gets noticed
more in a news feed.
It’s not all about pretty pictures, though.
There has to be a great story to tell, which
usually doesn’t worry most marketing
professionals. But if you’re one of those
rare marketing professionals who isn’t
writing the next great American novel in
your after-hours, here are some ideas for
search-engine-loving content:
• Interviews: With interviews, there’s an
added bonus because the experts likely
will link back to you. Also, your readers
trust information from experts.
• Lists: Think “top 10.” There’s no need
to be as clever as David Letterman,
but keep the lists short and
information-rich.
• Polls and surveys: Display results
visually and publish them on your
site. Then reach out to media outlets
to discuss your findings.
• React to news: Journalists do it all
the time: Find a local angle to a story
that everyone is talking about. This
technique helps the content provider to
be viewed as relevant and as an expert.
• User-generated content: Ask readers
to comment on or review a recent
health seminar. Yes, there’s a risk,
but positive comments from
unbiased readers are well worth it.
Of course, have a social media policy
clearly visible that protects you from
any potential HIPAA issues.
Once the stories are lined up,
establish a reliable editorial calendar.
Track your material’s placement and
production, and plot its repurposing
and promotion. For example, content
placed on Facebook one day can easily
become Web copy, an Instagram
upload and a Pinterest post the next.
Content is the new king? Not exactly.
For marketing professionals leveraging
the new platforms, it’s more like a
diamond jubilee celebration. Now go
join the party. mhs
✒ Susan Solomon is vice president of mar-
keting and communications for St. Joseph Health,
a 14-hospital health system in California, Texas and
New Mexico.
.com learn more! Read about the Cleveland Clinic’s content marketing efforts in
the Winter 2013 issue of Marketing Health Services at MarketingPower.com/mhs.
If you want to tell the world that
you’re a rock star, advertise.
If you want to show why you’re
one, have great content.

Spring 2013
H
aving worked in health care
since 1980, I have been
promoting mammography for
more than three decades as the single
best way to find cancer in its earliest,
most curable stages. As a marketing
professional, I know that one in every
eight women is going to need additional
diagnostic testing, most of which will
rule out cancer.
It’s my job to know that these
additional tests and procedures—then
treatment for the small percentage who
actually do have cancer—allow my
hospital to generate enough income to
cover the costs for our services plus make
a profit, thus showing an ROI on our
marketing efforts.
I was always that one woman in eight
who needed more testing. The first time
it happened, following my baseline
mammogram in 1997, I was alarmed, but
as the follow-up testing was requested
year after year, it became routine.
Imagine my shock, then, at being
diagnosed with Stage II breast cancer
in 2012, which I discovered myself just
a month after my routine screening
mammogram. According to most
research, my three-centimeter tumor had
to have been growing for more than five
years. After my surgery, three additional
cancer sites were found in the same
breast, none of which had been detected
by the mammogram, ultrasound, breast
MRI or physician exam.
At first I felt betrayed. Then I knew
that I’d been blessed. Sixteen doctors,
three hospitals and four outpatient
centers later, here’s what I’ve learned
thus far in a journey that’s making me a
stronger person and a better health care
marketing professional.
The Benefits
The silver lining, from a professional
standpoint, of facing breast cancer is
that I’ve seen the customer experience
firsthand and I’ve learned so much more
about what can improve patients’ inter-
actions with health care providers.
For starters, first impressions count. At
my first meeting with my breast surgeon,
he concluded our appointment by hand-
ing me his cell phone number because he
“didn’t want me to experience additional
anxiety when a simple phone call to him,
day or night, might provide an answer
or reassurance.” I was so impressed that
I told a lot of people about it, but I never
actually used his cell phone. For a min-
imal investment in time, this physician
likely is generating a huge ROI with this
approach, which makes every patient feel
very special.
I also felt special when I called his
office, even though I got an answering
machine, because it told me that I should
press “one,” just like the doctors were
instructed to do. I felt like a priority.
Second impressions count just as
much. As special as I felt at first, I just
felt like a number later. At my next visit,
there weren’t enough chairs in the wait-
ing room for all of the patients awaiting
follow-up visits. And in future meetings
with my surgeon, he always seemed to be
in a hurry.
My medical oncologist, with whom
I spent the most time, always spent as
much time as needed answering ques-
tions from my husband and me. And
while I’m sure that she answered the
same questions day after day from nu-
merous patients, she made me feel good
about asking, commending me for re-
searching and inquiring.
My plastic surgeon’s office always had
treats waiting, from coffee and pastries
in the morning to an ice cream cart one
afternoon. I didn’t mind waiting as much
there. My interventional radiologist al-
ways called me personally from his cell
phone at the end of the day following a
procedure and he was the only physician
who made it a point to ask for my feed-
back on one of those numerous physi-
cian rating sites.
Health care marketer’s takeaway:
Find ways to make a great first
impression, but don’t limit that to the
patient’s first visit. Encourage satisfied
patients to take that extra step and
evaluate your practice or organization
on a specific rating site. (The negative
feedback will find you all by itself.)
Lessons Learned
A patient’s perspective on the
health care experience
Customer Experience
Beth Bradfield Wright
 beth.wright@capellahealthcare.com
user insights

Spring 2013
An Engaged Consumer
While not a clinician, I was likely a
more educated and engaged consumer
than most. Because of that, and my lack
of intimidation in asking questions, I
prevented at least a couple of medical
errors. Additionally, I liked being able to
provide input into my care.
And while I was quite engaged and
inquisitive throughout the process, it
does concern me now that I signed
many papers that I never read. Several
waivers had to do with taking photos
of my breasts—before and after—with
full license to post on the Internet and
showcase in binders for others to see.
When I signed, I just wanted to facilitate
treatment. Now I’m looking for those
papers to read the fine print.
Health care marketer’s takeaway:
Work harder to encourage patients
to be involved in their care and ask
questions if they don’t know what’s
going on or what’s expected of them.
Moving Ahead
How blessed we are to live during this
time, when there are improved tests to
detect cancer, better options for treat-
ment and new medicines to minimize
side effects.
All three of the chemotherapy
medications that I was given listed
nausea as a potential side effect, so I
can’t say enough about the powerful,
new medicines that I was given to
prevent nausea. My nurse told me about
a man she treated a decade prior who
so dreaded the nausea that he would
get sick in the parking lot, even prior to
entering the building for his chemo. She
had just run into him again, 10 years
later, in a grocery store. He was doing
very well, but upon seeing her face—a
full decade later and possibly before he
even consciously recognized her—the
man immediately
threw up, right there
in Kroger. The mind,
along with our
sensory memory, is
more powerful than
we know.
Health care marketer’s takeaway: We
would do well to remember the power
of the mind and engagement of all
five senses. What can we do to make
patients’ treatments go as smoothly as
possible and to make their lives better
afterward?
I finished my chemotherapy in
December, have started medication to
minimize the risk of a recurrence and
am now re-growing hair. Reconstructive
surgery will be completed shortly.
My diagnosis, treatment and recovery
have been a strategic opportunity to
experience the health care system as a
consumer. My cancer has given me a
new perspective—on life, on health care
and on the patient experience. mhs
✒ Beth Bradfield Wright is vice
president of corporate communications and
strategic marketing for Capella Healthcare, which
owns and/or operates 14 acute care and specialty
hospitals in six states.
Beth Bradfield
Wright poses with
figure skater and
fellow cancer survivor
Scott Hamilton.

B
y its very definition, a crisis is no
time to get on-the-job training.
It’s a time of intense pressure
when systems are strained, weaknesses
are amplified and crucial decisions
must be made on the spot. A blown first
impression can leave a lasting mark—and
be difficult to correct. The best way to
handle a crisis is to be prepared for one,
and the best way to do that is to practice.
In other words, drill.
Crisis drills are a critical part of health
care communications success, especially
in the age of social media. Crises are
more frequent now because of the com-
plexity and increasing transparency of
today’s environment, and the ramifica-
tions are instantly known in one contin-
uous news cycle. The Internet and social
media have created more moving parts
and accelerated the making or breaking
of reputations during a crisis.
During crisis drills, organizations con-
duct training to practice ways to protect
the brand while informing the public in
the event of a crisis. Drills allow orga-
nizations to practice making decisions
and engaging stakeholders in response
to the unexpected. They help to critique
individuals and responses before there’s
real reputational skin in the game so that
when the time comes, teams are prepared
to respond in real time. Hosting crisis
trainings is critically important, even for
the most veteran issues manager.
A Drill That Produces
Results
To run a good simulation, leaders must
create a crisis scenario that includes
meaningful, challenging and realistic ele-
ments for the team to practice. In a recent
crisis drill, Kaiser Permanente designed
a scenario that was fictional but ground-
ed fully in reality, and it evolved and
escalated over time. Participants initially
were faced with what appeared to be a
medical error, but the crisis quickly grew
to include elements of medication abuse,
compliance failures, union concerns and
political sensitivity. This scenario was
played out over the course of 90 minutes
and was very carefully planned to
engage crisis communicators who share
accountability but work in nine
different states.
When the drill was over, a thorough
debrief was conducted. All participants
shared their learnings, which ranged
from social media eye-openers to re-
newed awareness around the speed that
information and misinformation travel.
Here are some proven processes to help
you and your organization plan an effec-
tive crisis drill:
1. Know your focus. The planning phase
is one of the most important parts of
a simulation. Before coming up with
a scenario, teams should decide on
the set of skills, structures or other
elements that they want to test. It’s not
necessary to practice on all aspects of
a crisis. Setting up a scenario that is
overly broad, especially if the drill is
only an hour or two, is guaranteed to
make it too superficial. Conversely, a
training that is too narrowly focused,
requiring too deep a dive into one
issue or process, could fail to engage
all participants and could appear too
artificial. Most drills planned at Kaiser
Permanente last between 90 minutes
and a full day, and typically last less
than half a day.
2. Determine how to measure success.
Once a focus is decided, the next step
in designing a scenario is to decide
how the results will be measured.
What should participants walk away
with? Is it experience, education,
awareness or knowledge? While
training for the sake of gaining
experience is not a bad goal, consider
maximizing the investment of time
and effort by ensuring that specific
activities are tested and measured. Is
there a desire to practice and uncover
gaps in a team’s timing or nimbleness,
or to offer an experience that tests the
quality of the organization’s messaging
response? Should both timing and
Spring 2013
in the trenches crisis response
Practice Makes
Perfect
To best prepare for a crisis, drill!
Diane Gage Lofgren & John Nelson
 diane.gage-lofgren@kp.org
 john.e.nelson@kp.org

Spring 2013
quality be measured? This helps
determine if the drill has met the goals
that you set out to achieve.
3. Teams should accept that not all
aspects of the drill will be realistic.
Make it as realistic as possible, but
remember that it’s just a drill, so it
will not be perfect. Don’t get bogged
down with logistics, but use the drill
as a learning experience. If there are
participants who are known to have
difficulty “suspending disbelief,” coach
them beforehand or involve them on
the team doing the role-playing, rather
than with those being trained.
4. The best drills are fun. Crises are
stressful—especially when it comes
to health care—so keep simulations
positive. Find ways to break the
tension by using humor. Comic relief
may be added where appropriate. For
example, those who are role-playing
(pretending to be bloggers, reporters
or politicians, say) may want to use
humor to emphasize a point. Take
opportunities to laugh while in the
middle of the drill. Also, allow people
to step back if they are getting too
stressed or upset.
5. Create a learning space where
participants know that it’s OK not
to be perfect. No one should feel as if
his or her career is on the line during
an exercise. Participants need to know
that it’s OK to fail. In fact, a little
failure helps people remember not to
make those same mistakes when the
real thing happens. The goal should be
visibly focused on, and supportive of,
learning.
6. Determine how to use what is
learned to improve. Evaluate the drill
after it’s complete. Things tend to pop
up that may not have occurred to the
team previously. Make sure to take
note of these items to discuss after the
drill is over and then come up with
what will be done differently next
time. mhs
✒ Diane Gage Lofgren is chief communica-
tion officer and senior vice president of brand com-
munication, and John Nelson is vice president of
brand communication at Kaiser Permanente.

Spring 2013
I
t never made much sense, especially
to those paying the bills. The more
patients were readmitted to an
inpatient facility, the more the hospital
gained additional revenues.
Many return admissions are beyond
a hospital’s control and are due to
factors such as chronic conditions,
unexpected complications, unhealthy
lifestyles or non-adherence to prescribed
medications. But hospitals share
responsibility, including a historic lack
of coordination and communication
among those involved in patient care.
The Accountable Care Act attempts to
stem the problem. Last fall, Medicare—
which annually spends $15 to $20 billion
for unnecessary readmissions—began
penalizing hospitals for readmissions
within 30 days of discharge deemed
excessive for specific diseases. To
remedy this, marketing executives are
facilitating conversations and crafting
plans to reach stakeholders, build
relationships and promote partnerships
to ensure a seamless, uninterrupted
continuum of care.
Activities include forming
e-communities that encourage digital
conversations among stakeholders,
offer information and address similar
challenges; distributing e-newsletters with
tips on caring for chronically ill patients;
and sharing resources and data that help
community providers and patients thrive.
Efforts also target incentive-based
initiatives: pay-for-performance, financial
incentives ties to patient experience scores
and bundled payment programs. To
stem chronic disease costs, Accountable
Care Organizations—where groups of
providers receive payment for the entire
health of a consumer—promote wellness,
prevention and evidence-based medicine
while avoiding duplicated services, medical
errors and unneeded referrals. And in
medical homes, physicians lead a team of
providers who embrace evidence-based
and preventive techniques to contain costs
in every aspect of a patient’s care with
payment based on data that identify trends
and uniform care.
Here are some stakeholder strategies to
consider in reducing readmission rates,
better coordinating care and impacting
community health.
Hospitals are improving discharge
planning, with education and
counseling beginning even before
planned hospitalizations, and
continuing throughout and following
the inpatient stay. Nutrition, resource
and socioeconomic assessments are
increasingly performed to ensure that
proper medications are taken, healthy diets
are followed and additional resources—like
home health services and transportation—
are tapped.
To help ensure that post-hospital
instructions are understood and
followed, interactions may be recorded
and shared online with patients and
their families. Within a day or two of
leaving the hospital, a nurse may call to
assess the patient’s condition, identify
issues requiring attention, continue
the education process and ensure that
physician follow-up visits occur.
For those at higher risk of readmission,
follow-up calls are intensified and
home visits added as part of a disease
management program. Hospitals are
facilitating stronger seamless relationships
with community physicians, post-acute
care, pharmacists and others who impact
care in the community.
Physicians and their office staff
are receiving more timely and
comprehensive communication about
their hospitalized patients who may
be admitted without their knowledge
through the ER or whose hospital
care often is assigned to a hospitalist.
Hospitals are ensuring that information
is relayed to physicians in real time when
their patient is admitted with updates
and discharge summaries; follow-up
physician appointments are made and
kept; and medications are coordinated
with physicians and pharmacies.
A Remedy for
Readmissions
The Accountable Care Act will
increase health care collaboration
on the patient’s behalf
strategic insights Coordinated care
rhoda weiss, Ph.D.
 rhoda@rhodaweiss.com

Spring 2013
Family members are becoming more
engaged in patient decision-making and
patient care. Someone close to the patient
often serves as a “coach” to assist in the
transition.
Home health care is beginning prior
to discharge, often on the first day of
hospitalization or even before the inpatient
visit occurs, rather than seconds before
the patient is ready to go home. It is not
unusual for a home health nurse, aide,
social worker or physical therapist to visit
the home prior to hospitalization to assess
nutritional habits and medications, and
potential risks or hazards, thus readying
the home environment for a safe and
healthy recovery. Telehealth monitoring
devices are used more frequently to
transmit vital signs to medical personnel.
Nursing homes are often a source for
readmissions, yet there has been little
collaboration or communication between
hospitals and post-acute facilities. That is
changing as hospital physicians, nurses,
rehabilitation staff, case managers and
discharge planners go into post-acute
facilities to offer education on keeping
residents healthy and out of the hospital,
identifying serious issues early on,
successfully reducing falls, and improving
the facility staff’s clinical and patient
management skills.
Senior living facilities, senior centers
and Meals on Wheels offer opportunities
for improving seniors’ health and
independence. Senior centers represent
essential partners in improving community
care. Meals on Wheels volunteers—armed
with information and skills on identifying
clients with unmet needs—also are crucial
partners in the continuum of care.
Public health, pre-hospital teams
and pharmacists are vital to community
health. With the emphasis on incentives
for improving population health, hospitals
are looking to public health departments
and neighborhood clinics to collaborate
and act upon the findings of community
needs assessments, identify high-risk
patients, and partner more fully in
immunizations and the identification of
community resources to assist patients.
Pre-hospital teams—paramedics, EMTs,
ambulance drivers and police officers on
the front line of patient care—as well as
pharmacists, present opportunities for
further collaboration, communications
and education.
Health plans are important to patient
follow-through and sources of access
to community resources, whether it’s
transportation, home care or direct support.
While in the past, there was a schism and
an “us versus them” environment between
health plans and providers, insurers now are
seen as a source of collaboration, education
and pilot projects to improve community
health.
Businesses represent sites where
clinicians can offer education, screenings,
immunizations and programs on
prevention, healthy living and caring
for an older adult.
Less likely stakeholders, like schools,
places of worship, community centers
and more, are additional groups that can
influence the well-being of communities.
By bringing together stakeholders
in virtual integrated delivery systems,
health care providers are taking a giant
step toward another hallmark of health
reform: population health management
that better manages the health of entire
communities. mhs
✒ Rhoda Weiss, Ph.D., speaker, consultant and
columnist, is past president of AHA Society for Healthcare
Strategy and Market Development, receiving its inaugural
award for Individual Professional Excellence, and chair
and CEO of the 32,000-member Public Relations Society of
America, receiving the Health Academy’s Lifetime Achieve-
ment Award. A Kellogg Foundation Fellow, she was named
UCLA Extension Distinguished Instructor and she is the
author of Managing Health Care Reform: Ideas for Leaders.
learn more! For more on marketing's response
to the Accountable Care Act, turn to page 20.

Spring 2013
While health systems
continue to address
the challenges of
standardization, centralized man-
agement and choosing the right
marketing model that meets both
corporate and local needs, at
Community Health Systems (CHS),
these are part of the culture. CHS
has earned a national reputation
for supporting networks of thriving
hospitals, some in competitive
As vice president and chief mar-
keting officer of Community Health
Systems, DEBRA LANDERS
leads hospital strategic planning
development, culture and leader-
ship development, patient experi-
ence, affinity relationship programs
and traditional marketing, including
digital, CRM and advertising. She
has more than 25 years of expe-
rience in nonprofit and for-profit
health care organizations.
Headquartered in Franklin, Tenn.,
COMMUNITY HEALTH
SYSTEMS INC. is one of the
nation’s largest publicly traded
hospital companies, and a leading
operator of general acute care
hospitals in non-urban and mid-
size markets. Through its subsidiar-
ies, the company currently owns,
leases or operates 135 hospitals
with about 20,000 licensed beds in
29 states. Its Community Health
Systems Professional Services
Corp. subsidiary provides man-
agement services to affiliated
hospitals.
markets and others that are sole health providers in their
communities. By applying sustainable processes, the
organization helps affiliated hospitals improve operations
and marketing.
An executive at CHS since 2003 and now its vice president
and chief marketing officer, Debra Landers leads a marketing
team that serves 135 hospitals across the country. Marketing
Health Services recently spoke with Landers to learn about
how CHS standardizes its marketing efforts, engages team
members, addresses the customer experience, curtails
outmigration, on-boards new facilities and communicates
across the enterprise.
knowledge base
10 minutes with
Debra Landers
Interview by Rhoda Weiss /  rhoda@rhodaweiss.com

Q
A
knowledge
base
Spring 2013
Q: How have you been able
to standardize marketing
throughout a very large health
organization like CHS?
A: Community Health Systems
Professional Service Corp. is a manage-
ment subsidiary known for standardized
and centralized processes that support
hospital operations. Business functions
like IT, materials management, finance,
operations, home health and others pro-
vide the tools and support necessary for
our affiliated hospitals to focus on quality
care delivery, not developing processes
and selecting vendors to help offer pro-
grams and services.
Marketing is no exception. Our
marketing department is responsible
for establishing marketing partners
and resources. Since standardizing the
marketing department 10 years ago, our
affiliated hospitals have worked with
just one advertising agency. That enables
efficiencies through shared costs and
materials across the organization. It also
helps ensure that materials are reviewed
for accuracy and quality. Economies of
scale for this one marketing tactic have
saved millions of dollars.
We also provide Web support for all
of our affiliated hospitals and clinics
in-house. By utilizing templates, we’re
able to act fast and turn around quality
materials. This standardized system
allows us to test products and, when
we know they are a best practice, share
them with facilities that have a need for
a certain product. That allows hospital
teams to select and implement quickly
the products that work best for their
markets. With research for new products
done here, hospitals can spend their time
on implementation, plus developing and
maintaining important relationships with
their local stakeholders.
While many systems may struggle
with standardization, it is part of our
organization’s culture, evolving over the
last couple of decades. It is more afford-
able to create tools and resources that
work for multiple business units than for
each to create their own. This enables our
affiliated hospitals to move quickly and
be confident in their strategy and direc-
tion. It also is important in our recruiting
that leaders value this culture. CEOs un-
derstand the critical role that marketing
plays and the resources available to them.
Q: In what ways are you
engaging the marketing team?
Can you give examples of joint
programs that have worked
across the system?
A: The marketing team meets every
Monday to discuss strategy and best
practices from across the organization.
Every other month, we host a webinar to
share best practices, new resources and
tools with marketing teams across the
country. Additionally, when a new idea
needs to be vetted, affiliated hospitals
are always willing to be pilot facilities.
Our emergency room discharge callback
program (DCA) we created in 2009 is a
great example. DCA creates a call queue
of ED discharges from the last 24 hours.
In 2012, hospitals across the system com-
pleted 1.5 million calls. That extra touch
point with patients is important to each
hospital’s culture and the quality of care
that it strives to provide.
Based on DCA’s success, this year an
inpatient callback program (ICA) was
implemented whereby each facility calls
discharged patients within 48 hours.
Both systems were created internally,
saving more than $5 million in product
costs. From product development like
DCA and ICA, to CRM, and traditional
marketing tools like advertising and
interactive, we focus on creating great
products. Most tools would not be af-
fordable for smaller, community-based
hospitals. This model gives every
hospital access to the same resources
at their fingertips.
Q: Many health systems brand
their hospitals with the system
name, while others maintain the
hospital name only. Why did you
decide on the latter?
A: Health care is delivered locally and
we recognize that each hospital, practice
or clinic is unique. Each creates its own
brand based on the services it provides,
the people it employs and the role it plays
in the community. In 55% of the markets
where we have an affiliated hospital, it’s
the only hospital in town. Employees and
physicians of that local hospital create
the brand for their facility. The brand is
created by the quality of care that patients
receive, and the customer service and
comfort provided for patients and families.
A key branding strategy for our affil-
iated hospitals is to ensure that internal
relationships with physicians and em-
ployees are strong so they become the
sales team in each community. With
each new acquisition, we work hard to
demonstrate the value of a standardized
model and what we call our ‘Community
Cares’ culture. Within the first week of a
new hospital acquisition, there is a
Community Cares kick-off meeting to
explain the ‘why’ behind the strategy.
Whether it is the only hospital in town or
it’s in a very competitive market, leaders
have the tools to differentiate themselves
in their market and create a culture of
quality that every member of that team is
proud to represent.
Employee engagement is really im-
portant. Across our organization, 85% of
employees surveyed in 2012 were satis-
fied with the hospital where they work.
Since there are 96,000 employees across
the organization, we think that’s a great
accomplishment.

Q: Patient satisfaction is gaining
importance as health care moves
from a volume-based to a value-
based business. How are you
ensuring great experiences for
customers?
A: Customer experience is important for
all of our affiliated hospitals. This is not a
new strategy because of value-based pur-
chasing. Leadership development efforts
over the past few years added processes
and tools that have changed culture. This
culture change started with customer
service training and quickly morphed
into a way of life for team members on
how they introduce themselves, clinical
hourly rounding standards, alignment
and accountability for goals, and a totally
transparent leadership style.
As I look back on the last few years, the
Community Cares culture has helped us
move confidently into the next level of a
standardized business model. With align-
ment of goals across the organization,
there’s opportunity for more transparency.
With standardized goals, performance
across the organization is ranked in an
objective manner and leaders can bench-
mark their accomplishments against top
performers. These results are then tied to
evaluations and incentive compensation.
This also helps ensure that quality efforts
are aligned in each hospital.
Each quarter for the past four years, I
have shared through a webinar for over
7,000 leaders the ‘Top 10’ and ‘Bottom
10’ HCAHPS results. [Editor’s note:
HCAHPS, or Hospital Consumer
Assessment of Healthcare Providers, is a
nationally standardized, publicly reported
survey of patients’ perspectives of hospi-
tals.] This transparency lists the hospital
name and their score for each HCAHPS
category. The effort is twofold: recognition
for superstars and motivation for lower
performers. Hospital leaders can be very
competitive; it’s a race to the top. It’s com-
mon for calls and e-mails to start flying
a few days before a leadership webinar
from people trying to learn who made
the ‘Top 10.’ This healthy competitiveness
helps create great places for employees to
work, physicians to practice and patients
to receive care.
Q: A big challenge for rural hos-
pitals is stemming outmigration
to urban and suburban areas.
What strategies have you exe-
cuted to keep patients in your
communities?
A: Research for years has shown that
people prefer to get their health care close
to home. We know that patients go where
their family, friends, physicians and in-
surance coverage direct them to. Culture
efforts—coupled with physician recruit-
ment, technology investments and facility
enhancements—are all factors to reduce
outmigration. Our affiliated hospitals
have access to capital and invest greatly
in their facilities, medical technology and
other resources so they can be competitive
in the marketplace, whether across the
street or 60 miles away. It all boils down
to consumer preference, physician confi-
dence and making sure you’re part of the
providers’ plans.
In Northeastern Pennsylvania,
for example, a network called
Commonwealth Health includes eight
affiliated hospitals with more than 1,200
hospital beds, 1,600 physicians and 6,500
employees. Even though each hospital
is independently operated, they work
together as a system to share resources,
skills and experience on a geographic
basis to better serve patients. Due to the
Affordable Care Act, this type of regional
integrated delivery system is more
important than ever.
Not all markets have the infrastructure
or number of hospitals and other
providers necessary to become integrated
delivery systems. Those hospitals have
to work especially hard to offer the
best-quality services possible to keep the
care local. Through affiliation with our
organization, they are able to invest in
technology, equipment and physician
recruitment as a core strategy to
encourage residents to seek care in their
communities. This effort, coupled with
skilled staff and specialty accreditations,
hopefully helps demonstrate that there
is no reason to leave town to access the
care they need for themselves and their
families.
For example, many of our affiliated
hospitals have certified chest pain and
stroke centers. When they can offer
high-quality care and exceptional
service, the hospital sells itself. Some
affiliated hospitals offer a pledge to see
Spring 2013
knowledge base
Through its subsidiaries, Community Health Systems Inc. owns, operates or
leases 135 hospitals with about 20,000 licensed beds in 29 states.

Spring 2013
ER patients within 30 minutes. Each
ER demonstrates and maintains quality
and service metrics to offer this pledge.
The results have been an increase in
ER visits. Our affiliated hospitals—
focused on improving quality care
versus outspending the competition on
advertising—are challenged in every
market with competitive systems trying
to market themselves.
Health care is a top industry for
advertising expenditures, but instead
of spending more on advertising, our
affiliated hospitals focus on quality
care and service to make sure that their
patients, employees and physicians are
the advertising tools. That’s not to say
that they don’t advertise. They do. But
they won’t throw dollars at messages
that don’t have a direct consumer call
to action. It’s about being selective on
what the message is and what the return
should be. Each year, marketing ROI
tracking gets more sophisticated. Across
our organization, we use customer
relationship management to track just
about every marketing dollar. Then we
know what works and can quickly share
that information across the system.
Q: On-boarding of new hospi-
tals into health systems is a hot
topic in marketing. How does
CHS help new hospitals adjust to
your culture and processes?
A: Our management subsidiary has a
comprehensive on-boarding process for
the entire hospital. From the marketing
perspective, we have a comprehensive
plan that outlines all resources and tools
available. We start this process during
due diligence and transition most acqui-
sitions to standardization within three
to six months. The
Community Cares
culture kick-off
happens within the
first week and align-
ment with goals
starts then. I think
it’s fair to say that
newly acquired hos-
pitals are apprecia-
tive of the support
and resources. This
is one of many dif-
ferentiators for our organization. We focus
on support and respect for local teams
and communities, and are dedicated to
supporting each local hospital’s effort to
play a critical role in its community.
Q: How do you keep track of all
of those facilities? How do they
communicate with you and each
other?
A: The marketing team in our man-
agement subsidiary is very lean, with
29 people. We work closely with each
hospital to help it develop both the stra-
tegic plan and marketing plan, and then
offer support as each is executed. We hold
national calls and tons of individual calls to
support their needs. Most tracking is done
throughout standardized systems, which
saves a great deal of time for the hospital
team. The pace is always fast and e-mails
total hundreds on most days. What’s criti-
cal is that our culture is one of service. The
marketing team is always available to help,
regardless of the need.
While our marketing resources cover
traditional elements like strategy, adver-
tising, digital and customer engagement,
they also help drive the culture and how
hospitals differentiate in the marketplace.
Those of us who are part of marketing
teams during times of great national tran-
sitions must be focused on the strategy and
how to align all of the moving parts that
make up health care systems today. mhs
“Instead of spending more on
advertising, our affiliated hospitals
focus on quality care and
service to make sure that their
patients, employees and physicians
are the advertising tools.”

spring 2013
otentially one of the most transformative market changes for the
U.S. health care industry is months away, in the form of health
insurance exchanges (HIX), or what the federal government now
is trying to re-label as health insurance marketplaces (HIM). Whatever name
or acronym by which they are known, the upshot is the same: This initiative—
the implementation cornerstone of the Affordable Care Act—has vast
potential to alter the way that health care is promoted, selected and delivered
in the United States.
Despite their potential to shift the way that the health care sector conducts
business, the response to exchanges by a surprising number of organizations
has been mild at best, if not outright dormant, this spring. This quiet response
comes despite the reality that exchanges offer an avenue for millions of
individuals to access the system with insurance, which many of the likely
enrollees have not had on a consistent level.
A Sea Change
From Exchanges
Health insurance exchanges could significantly
alter the flow of U.S. health care promotion and
delivery, and marketing professionals can help
direct their organizations' next moves
By Preston Gee
geepr@trinity-health.org
A f fo rd ab l e Ca re A c t
P

spring 2013

spring 2013
f greatest surprise in
this non-responsive-
ness by the provider
sector is the lack of advo-
cacy and preparation exhibited from
the marketing function. Exchanges
provide a rich and robust opportunity
for marketing professionals, and for
those in the market-facing functions,
to gain cachet and to exhibit the acu-
men that they have gleaned over the
years.
If anyone should be leading the
charge in each organization to gal-
vanize the leadership team and the
entire organization to rally around
this new reality, it should be those in
the strategy and marketing areas, who
not only stand to gain cachet, but also
can provide expertise and insights
into how to tap this large wave of HIX
enrollees and potential new patients.
It could be argued that the imple-
mentation of exchanges represents the
climactic realization of the Affordable
Care Act, enabling a wide swath of
previously uninsured individuals to
have access to the delivery system via
established infrastructure, economic
support and, in some cases, govern-
ment subsidies. Individuals can par-
ticipate in one of four tiered levels or
programs, from bronze to platinum,
that are differentiated by character-
istics such as price (per-month fees),
level of service, breadth of provider
networks and economic responsibility
for services received. The exchanges
are state-based and have one of three
constructs: state-run, federally run or
a partnership between the state and
the federal government. The determi-
nation has been made for most states
as to which program they will offer.
The mechanics may not be as im-
portant as the underlying dynamic
that exchanges prompt—namely, a
decades-old shift from group-based
purchasing to individual selection
and purchase of health care in this
country. This is seismic on several
levels, but from a marketing stand-
point, it underscores the need for an
organization to be well-positioned
in the consumer’s mind, as well as
transparent in its cost-versus-quality
equation. In essence, it represents
the long-awaited moment when
health care moves from basically
a wholesale industry to more of a
retail model, with consumer-driven
characteristics and implications. It
represents a turning point at which
marketing and strategy professionals
may finally have found their forum,
and a time when market-facing
functions may finally have arrived.
American Idle
This is, of course, a sea change for
the health sector in this country. In
the past, the American health care
consumer/patient has not been as
engaged—economically or selectively—
as he or she is in virtually every other
industry. Consequently, the notion
that health care is consumer-driven
is both fundamentally false and ide-
alistically fanciful. However, much of
that may be about to change.
Nothing engages the consumer
more than financial accountability
and responsibility, and insurance
exchanges provide that basic market
O

spring 2013
dynamic. Enrollees in exchanges not only
will be responsible for monthly premiums—
which, as learned from the Massachusetts
experience, will have a high level of price
elasticity—but also will feel a much larger
economic impact when services are deliv-
ered. For example, those who enroll at the
bronze level will be responsible for 40%
of the cost of the services delivered, silver
enrollees will cover 30%, gold will cover
20% and platinum will cover 10%. This
heightened level of fiscal responsibility
likely will drive enhanced engagement,
heightened awareness and dramatically
increased interest in the transparency of
costs and overall quality.
In addition, health care marketing and
strategy professionals should see in this
actualization of insurance exchanges a
broader dynamic at play, one that moves the
nation from defined benefit (as currently
available through employer-sponsored
insurance) to defined contribution. To
gauge the real-time effect of this change and
its impact, just observe what has happened
on the financial-support side in American
industry, as employers have migrated from
yesterday’s model of post-retired pensions
to the defined contribution approach, such
as with 401Ks and 403Bs. This approach
arguably has been an economic boon to
employers and likely is the precedent for
employer-sponsored health benefits.
Consequently, many industry pundits
believe that employers eventually will shift
their employees away from the current
model to one in which the employer makes
a contribution and allows the employees to
select and manage their health benefit op-
tions. This will begin with small businesses
and likely will migrate to larger organiza-
tions over the next few years. Supporting
that premise is the rapid rise of private
exchanges that are emerging to allow large-
and small-scale employers that very option.
It basically comes down to this: The world
as we know it—and have known it for
decades—is changing. mhs
✒ Preston Gee is senior vice president of strategic
planning and marketing at Trinity Health in Livonia, Mich.,
which recently merged with Catholic Health East. The new
organization has more than 87,000 employees, 82 hospitals
and 89 continuing care facilities, with facilities in 21 states.
Reform Schooling
If the actualization of HIX/HIM does usher in a
brave, new world and a brand-new day in the
health industry—particularly for providers—what
can marketing and strategy professionals do to
prepare their functions and organizations for
the imminent changes from exchanges?
Understand the timing, key elements and
milestones related to the implementation of
the HIX/HIM, and keep the initiative front and
center with senior leadership and, perhaps, the
board.
Assess the impact on each market in terms
of increased volume, capacity constraints and
stresses (e.g., emergency room), and financial
implications.
Research, highlight and underscore the
organization’s current market position related
to perceptual positioning.
Provide the game plan and glide path for the
meaningful preparation and successful execu-
tion of market-based strategies to implement
HIX, and to realize the benefits of this critical
element of reform.
Develop marketing tactics, educational and
promotional materials, and consumer outreach
programs to inform, educate and engage the
HIX enrollee population.
Provide the ongoing tracking of marketing
strategies to senior leaders to assess the
achievement of desired goals, increased vol-
ume and enhanced market position, as related
to HIX.
1
3
5
2
4
6

spring 2013

spring 2013
Connection
Making the
By Devin Carty
dcarty@vanguardhealth.com
A strategy for leveraging
Big Data, and new digital and
mobile tools to effectively
reach health care consumers
t happens every second of every day.
A consumer needs a quick answer to a
nagging health care issue. An aching
knee. A sharp pain in the side. A sudden
tightness in the chest. So where do today’s
consumers turn to find answers to their
health care troubles? More than likely, the
impatient patient starts on the Internet,
often using a mobile device, letting the
Web provide a quick diagnosis.
In this same universe sit a thousand
eager health care marketing professionals
in a thousand different offices, all searching
for new ways to connect with patients and
consumers along every point of the health
and wellness continuum. But how? Today’s
communication options are complex, with a
multitude of marketing channels. What’s the
best way to connect with patients? On the
Web? Through traditional media? A mix of
both? Where and how does consumer
data fit in?
For Vanguard Health Systems, a solution
was found in building hyper-personalized
connectivity among patients, physicians
and health care organizations.
Based in Nashville with 28 hospitals in
five states, Vanguard saw that the days of
basing health care marketing on pretty
billboards had long passed. It recognized the
need to profoundly evolve the way that health
organizations communicate with patients—to
leverage health, diagnosis and behavior data for
the good of the patient, grow and acquire new
customers, and expand communication with
consumers in a hyper-personalized way that
meets their needs and advances the experience.
The strategy was simple: Make use of tech-
nology and tools readily available—including
vast amounts of patient data (Big Data) and
rich analytics—to reach the right consumer at
the right time, using a blend of both traditional
evidence-based marketing and new digital and
mobile marketing methods and tools.
I

spring 2013
The Importance of ‘Brand’ and the Digital Universe
In today’s health care landscape, brands and experiences are
critical to building patient loyalty, and it is becoming increasingly
evident that patients care deeply about what their health organiza-
tions and providers say and how they say it.
Patients also increasingly are turning to the Web to do research
and help make health care decisions. In fact, health care is the
single most searched topic on the Web:
• 83 million consumers conducted online searches for “find a
doctor” in a single month, according to recent Google
AdWords search data.
• 77% of patients searched the Web before making a doctor’s
appointment, according to the 2012 Google/Compete
Hospital Study.
• According to the same study, 44% of consumers who
conducted Web research for hospitals via mobile devices
scheduled an appointment, as did 34% of those who
searched via computers.
Patients are taking the reins when it comes to finding the health
information that they need, on their terms. Health organizations,
therefore, need a way to provide easy access to information on the
products and services that the community needs and wants, while
encouraging repeat visits to keep them healthy, attracting new
patients and growing the health organization itself.
Given the importance of digital tools and information in con-
sumers’ health care experiences, Vanguard sought to create a
solution that would accomplish several goals: Leverage analytics
to provide precisely targeted, customized information to individu-
als who might be at risk for certain conditions, as well as to house-
hold decision-makers; communicate with them in the ways that
they prefer, whether via text, e-mail, postal mail or social media;
and think through an empathic lens to make it easy for those in-
dividuals to engage with health products and services by offering
same-day visits, online check-in services and the like.
The last requirement was intuitive—almost a Customer Service
101 element—since as with any service, consumers expect and
demand hassle-free accessibility. Targeting the information would
inspire consumers to engage, while providing a better consumer
experience would encourage them to stay engaged long term and
ultimately help improve patient care. The pathway to achieving
these goals became clear: Connect patients with health care or-
ganizations and providers by using a mix of data and marketing
tools.
Blending Emerging and Traditional
Evidence-Based Methods
Today’s database-driven digital marketing tools make it possi-
ble for consumers to connect with their health care providers
in ways that were nearly impossible not that many years ago.
By combining data, tools and technologies widely used across
other industries, Vanguard created what it calls Health IDology
to leverage data and transform communication between health
organizations and consumers. Specific goals for Health IDology
were to increase patient engagement via continuous and targeted
communications between patients and their aligned physicians;
pinpoint and connect the right consumer with the right provider
at the right time with the right methodology by mining rich pa-
tient and consumer data; stay connected throughout the continu-
um of care via automated communication methods; improve the
experience by making it easier for consumers to make appoint-
ments, exchange information with their providers and conduct
customized online searches; and make the process of engaging in
wellness efforts easier for both the patient and the provider.
Through research, it became clear that Health IDology need-
ed to include a blend of digital marketing and more traditional
methods, since no single method would be effective for every
consumer.
One component merges both a comprehensive patient data-
base and a consumer buying behavior database, which enables
targeted communications based on demographic profiles for
everything from gender and age to elevated disease risk and
grocery and magazine preferences. By mining and analyzing this
rich data, health organizations and providers now are able to
create more custom communications to foster long-term
patient-physician interactions—another factor to improve
patient care.
An advanced CRM platform enables patient tracking by touch
points from initial marketing outreach to doctor appointments,
screenings and the like so that patients don’t fall out of the loop
of health and wellness. Staying in touch with patients throughout
the care continuum also helps offer reassurance that their provid-
ers are continuously working behind the scenes to manage their
comprehensive health care needs. From a patient’s perspective,
peace of mind is priceless. From a provider’s perspective, it is
essential to building patient loyalty and keeping patients healthy.
Health IDology also incorporates Web tools including search
functionality powered by Google, mobile-friendly websites,
content-rich landing pages for patient education and engage-
ment, and physician-finder engines that quickly connect patients
with physicians with one-click online scheduling. This last fea-
ture does more than deliver an important convenience to facili-
tate patient loyalty; it frees staff to focus on actual patient care.
For those populations not inclined to access health informa-
tion via the Web, direct communications via text, e-mail, mail or
social media remain effective and important engagement tools.
Health IDology generates simple postcards, texts or e-mails from
the CRM database to remind patients about health care mile-
stones including screenings and regular checkups. For example,
a 40-year-old woman could be reminded to schedule a mammo-
gram, or a mother managing the health of her household could
be contacted when her children need vaccines before going to
summer camp.
With so many consumers moving to mobile and e-mail,
these are key components of the solution. E-mail is a preferred
method for many patients, and physicians increasingly employ
its use. A recent study by Manhattan Research shows that nearly
40% of physicians use e-mail or some other form of electronic

spring 2013
communication with patients. Sixty-nine percent of physicians in
that segment are using e-mail to answer questions after patient visits.
Enhancing Patient-Physician
Connectivity and Building Loyalty
By harnessing the power of the Web, marketers across the country
are opening new avenues of health care communication, making
it easier for patients to find health information, physicians or
both. The advantage is that most consumers already use the Web
as a search tool. To maximize the effectiveness and value to con-
sumers, Health IDology employs the latest search engine optimi-
zation methods to glean the most current data on top searches for
health care information. Based on those searches, Health IDology
generates information-rich landing pages about symptoms,
treatments, tests and more. Embedding physician finders, online
scheduling functionality or both in landing pages helps patients
find nearby physicians who can treat their conditions with step-
by-step directions from their homes—and it helps patients sched-
ule appointments with a single click.
Like most consumers, patients are fickle. Brand loyalty has
given way to convenience and price. This is why Health IDology
also incorporates affinity cards: to inspire patient loyalty first by
simplifying the process of visiting a provider and later by offering
attractive consumer incentives based on individual buying behav-
iors (mined from the robust CRM database). Incentives include
discounts with local partners such as gyms, health food shops and
local restaurants.
The affinity cards, managed by a third-party partner, securely
hold a range of patient data from basic demographic information
to dates of visits. The cards are offered on the patient’s first visit
to a participating physician partner and are swiped at check-in
at each subsequent visit. This helps speed access to vital patient
data, which can support improved outcomes. Use of the cards
also eliminates the need to complete forms at each visit, increas-
ing convenience by condensing wait times and greatly reducing
administrative demands on staff. The results: ease of use, ease of
access, and potentially a richer, longer-term relationship between
patient and provider.
Transforming Communication,
Improving Patient Care
To reach consumers who span a vast range of demographics and
needs, health organizations are increasingly focused on aligning
the efforts among marketing, organic growth, operations, prod-
ucts and services. Health IDology is just one example of how
leveraging data and digital, mobile and traditional marketing
tools can better connect patients with health organizations and
providers—and ultimately change the way that health and health
care are delivered.
Solutions that leverage the latest marketing technology and
analytics can help health organizations target specific popula-
tions and connect them with the appropriate providers,
products or services. These solutions also place an increased
emphasis on wellness and keeping people healthy as organiza-
tions move toward a new care delivery model. As new
marketing technology methods emerge, Health IDology will
continue to evolve as part of Vanguard’s goal to transform the
way that health care providers communicate with consumers
to build life-long relationships. mhs
✒ Devin Carty is vice president of culture, chief marketing officer and chief
experience officer at Vanguard Health Systems.
Data
Patient database includes geographic and behavioral data plus
medical data.
CRM
Enables ongoing patient communications through direct mail,
e-mail, text and social media.
Search
Robust search engine optimization powered by Google helps
consumers find physicians online.
Web
Content-rich landing pages for patient education and
engagement.
Find You Physician Finder engines connect patients with physicians.
Schedule
Schedule Now one-click scheduling allows patients
to make appointments online.
Records
VIP cards provide patient information and keep patients
engaged.
Makes it easier
for patients to
find physicians
and schedule
appointments
Improves
the patient
experience
Keeps
patients
engaged
The Health IDology Road map

spring 2013
Baystate Health finds its competitive edge
by engaging customers to create the experience
Suzanne Bharati Hendery suzanne.hendery@baystatehealth.org
and Wilson C. Mertens wilson.mertens@baystate.health.org
Collaboration
Commonwealthin the

spring 2013
W
hen the audience of clinicians sat silent and unengaged
after receiving approval to build a new $37.5 million
cancer center in 2001, senior leaders at Baystate Health
decided to change the conversation. They invited patients to design
the center that they wanted to see.
Twelve years later, after experiencing sustainable results and
exceeding every metric for success, senior leaders realize that it
was the right decision. With a new vision to transform the delivery
and financing of health care to provide a high-quality, affordable,
integrated and patient-centered system of care, Baystate is replicating
the customer engagement process across the organization.
Treating Cancer Patients but No Cancer Program
Baystate Health, headquartered in Springfield, Mass., is one of New England’s largest not-
for-profit health care systems. Like many hospitals, however, its cancer patient offerings
were fragmented. Patients, many of whom already were compromised, had to walk long
hospital corridors to receive the care that they needed. Communication between physi-
cians was inconsistent. Patients were expected to coordinate their own care and appoint-
ments among a myriad of physicians and specialists, laboratory and radiology services.
Baystate’s CEO at the time noted that the institution “had many practices for cancer
patients but did not have a cancer program.”
Facilities were tired, unattractive and unfriendly. Patients saw clutter. Business and
technical functions were in full view. The result was a cold, unprofessional environment,
uninviting to patients and their families, and unpleasant and inefficient for staff.
The volume of radiation oncology patients was stagnant. Surgical oncology patients
elected private community surgeons over Baystate-affiliated surgical practices. Of the eight
centers of excellence at Baystate Medical Center, the cancer program had the lowest recog-
nition and awareness among health care consumers in the area, under 50%. Even Baystate
Health’s primary care physicians preferred to use community oncologists over their own
hematology/oncology faculty by a ratio of three to one.
The medical director for cancer services and the marketing and communications team
banded together to define a patient-driven culture, create an integrated program and build
a strong brand anchored by the new facility. The goal for the renovated strategy was to gain
a competitive advantage by developing a relationship-based approach that would exceed
customer expectations for service.

spring 2013
Initial Steps: istening and Engaging Customers
Efforts began by identifying opportunities to improve efficiencies
in patient care and costs. Interviews with the community’s refer-
ring physicians focused on how they chose an oncologist for their
patients, what they looked for in a cancer program and how they
perceived Baystate’s program compared with others. Suggestions
for improvement—changing the management of patients in the
inpatient oncology unit, clarifying the oncologic specialties and
interests of oncology physicians, improving supportive care and
end-of-life management—were shared with Baystate’s medical
staff and administration. Changes communicated back to referring
physicians quickly resulted in more referrals to Baystate, and built
visibility and credibility for the cancer program and its leadership.
Initial steps in listening and engaging customers included:
• Conducting patient focus groups in key areas (radiation, adult
and pediatric hematology/oncology and breast services) to
determine high-value services, share positive and negative ex-
periences, and learn wishes for the future program and facility.
• Hosting a series of cancer program-customer experience
retreats with physicians, nurses, administrative and clerical
employees, current and former cancer patients, cancer patient
advocates, community members, architects, interior designers
and construction managers. The group explored the changing
economy, how developing an engaging customer experience
is fundamental to an effective growth strategy, the current
state of the cancer program from both clinical and patient
perspectives, the development of a cancer center theme, the
clarification of staff roles, and the reorganization of the cancer
program based on functions rather than physician-defined
divisional and departmental lines.
• Identifying strategies to design the space through the eyes
of patients and families rather than physician specialty silos.
When the work of several subcommittees was complete, a pa-
tient or patient advocate would review the plans with a senior
cancer program physician or administrative leader, all signed
off with approvals, and the subcommittee would “sunset.”
• Establishing a “core group” consisting of senior hospital
administrators, cancer program medical leaders and admin-
istrators, hospital construction managers, clinical engineers,
internal communicators and information technologists to
manage the program and facility design from both timing and
budgetary perspectives. This group would make all strategic
decisions, review subcommittee results to ensure consistency
with the theme and program goals, and communicate mile-
stones to internal and external (referring physician) audiences.
Partners on YourJourney of Well-Being
Several groups began writing a theme for the cancer program that
would describe how it should be perceived. There was similarity
between the results of all of the groups and unanimity regarding
the final articulated theme, “Partners on Your Journey of Well-
Being.” The theme demonstrated that cancer is a life-long and
life-altering challenge with an uncertain destination. While a cure
is not always the outcome, at Baystate Regional Cancer Program,
the goal is to ensure that every patient receives the optimal
achievable outcome.
The theme became the most critical step in both the program
transformation and the facility design process. It served as an
internal touchstone, not an advertising tagline. Every request
was tested against the theme to ensure the consistency of mes-
sage and strategy. It allowed the team to achieve consensus on
program and facility needs, and to use resources more effec-
tively. This resulted in a facility and patient conveniences that
resonated with the theme.
The theme was embraced by community partners, including
the American Cancer Society, which sponsored a patient resource
center in the facility. Community-based advocacy and support
groups spread the word about the center, serving as design a
dvisors, a source for referrals, and a destination for patients
desiring support, complementary therapy and fellowship.
Philanthropy was rejuvenated. The D’Amour family, inspired by
the theme and the promise of improved care for the community,
donated a major gift that was honored in the new name, The
D’Amour (French for “of love”) Center for Cancer Care. Regular
updates on the construction progress to all donors helped to
generate naming opportunities for loved ones whose lives and
legacies were celebrated by their gifts.
Personalizing the Experience
The message from patients was clear: “I want you to listen to me,
know me, partner with me and create an experience just for me.”
As a result, personalization in the Baystate Regional Cancer
Program takes many forms. Each patient receives a multidisci-
plinary consult with the entire care team together to discuss op-
tions on the most successful treatment plan. When patients with
tumors that require concurrent chemo-radiotherapy are referred,
consultations are booked with an oncologist (radiation, medical
or surgical) who takes the lead on the patient’s care, with other
relevant specialists seeing the patient at the same time, either as a
formal booked consultation, or as a short, introductory meeting
with a more formal consultation at a later date.
Patients completing their chemotherapy and radiation treat-
ments engage in a personalized educational session to discuss
potential side effects, and receive an individualized “side effect
management manual” with information about their specific
treatment regimen.
In focus groups, radiation therapy patients asked to replace the
communal gowning and waiting areas with private spaces. These
were provided, increasing patient privacy, satisfaction and
efficiency, and reducing the possibility of error resulting from
patient misidentification.
Based on customer feedback, unique architectural, design
and process-of-care elements were incorporated into the facility
to create a feeling of comfort and a connection to nature. Physical
barriers like glass reception windows and desks were eliminated.
Charts, paperwork, phones, office procedures and the noise asso-
ciated with all of these elements were relegated to a non-patient
L

spring 2013
floor to promote quiet and healing. Patients suggested appealing
color schemes and ecologically friendly materials. All oncology
services were consolidated into one location. Complimentary
valet parking is available so that patients do not have to struggle
to walk from the parking lot to the front door.
Marketing the Experience,
and Building on the Success
The marketing campaign and advertising creative that included
television, radio and print was meant to speak directly to the
issues that patients expressed in the focus groups.
Wanting to elevate the brand to national prominence, the group
sought out Ed Begley Jr., an actor of stage, screen and television
with ties to the area. Perhaps best-known for his role as Dr. Victor
Ehrlich in the 1980s hit television drama St. Elsewhere, Begley
narrated radio and TV messages that spotlight the Baystate
Regional Cancer Program’s unique approach to cancer care for
patients and families through the D’Amour Center for Cancer
Care. Begley, who donated his time to do the messages, applaud-
ed Baystate’s patient-centered approach to care and for “actively
involving patients in the redesign of its care.”
The internal theme, “Partners on Your Journey of Well-Being,”
evolved into the external message: “The Baystate Regional Cancer
Program. Experts in Cancer, Every Step of the Way.” It became
the advertising tagline to symbolize the partnership with patients,
the expertise of the Baystate Health team and the cancer journey,
itself. All messages, artwork and advertisements were tested with
consumers.
Engaging the customer in the process proved successful. Patient
satisfaction for the last decade has improved to the 95th to 100th
percentile for patients rating their overall quality of care as “excel-
lent” when compared with other cancer programs throughout the
U.S. Programs established under the same model of care at other
Baystate facilities—Baystate Mary Lane Hospital and Baystate
Franklin Medical Center—also are in the 90th percentile for “ex-
cellent” ratings. Patients referred from Baystate’s owned medical
practice physicians to the cancer program jumped from 15% to
70%. Volumes for hematology/oncology services have grown by
43%. Area consumers rating the Baystate Regional Cancer
Program as “best” went from 48% to 70%.
Based on the success of the cancer program, the goal is to
ensure that the customer engagement process is in place for every
new facility and major marketing program. Last year, Baystate
Medical Center opened the Davis Family Heart & Vascular
Center based on the same principles of engaging clinical and
marketing leaders. This year, the process is in place for the
Baystate Breast & Wellness Center, a new patient-centered
medical home-ambulatory center in Northampton, Mass.,
and a children’s specialty center. mhs
✒ Suzanne Bharati Hendery is vice president of marketing and com-
munications at Baystate Health. Wilson C. Mertens, M.D., is vice president
and medical director of Baystate Regional Cancer Program at Baystate Health and
professor of medicine at Tufts University School of Medicine.
Above: The D’Amour Center for Cancer Care, part of the
Baystate Regional Cancer Program in Springfield, Mass.
Right: The D’Amour Center for Cancer Care’s linear
accelerator unit features clean lines enhanced by closets
that maintain unsightly clinical equipment “off-stage.”

W
hile Hawaii may be the last
state in the union, we leapt
ahead of the rest of the
country when the Hawaii Prepaid Health
Care Act became state law in 1974. We
have 40 years of experience with an
employer mandate that offers health
coverage to employees working 20 hours
or more per week. Prior to the 2009
recession, Hawaii enjoyed 98% coverage
and now it’s 92%.
Coverage alone does not guarantee a
healthy population. At University Health
Alliance (UHA), we believe that health
plans must do more for members and
their communities. Health plans have
received justified criticism for limiting
benefits, denying coverage and being the
nemesis of providers for not allowing
them to practice medicine as they see
fit. That’s why physicians who wanted
to improve health care quality in our
state formed UHA 16 years ago. It was
a refreshing change, and physicians
continue to guide the insurance
company’s policies and practices to
ensure optimal care.
Most UHA policies are counter-
intuitive. Instead of cutting back
on benefits or making eligibility
requirements more stringent, we
provide more benefits to support long-
term health and well-being. Instead of
maintaining an adversarial relationship
with providers and physicians, we
collaborate. Instead of shunning at-risk
individuals for high utilization of costly
services and procedures, we give them
special attention and tools to better
manage their health.
Even before health reform mandated
preventive benefits, UHA was at the
forefront by offering these benefits at no
cost. We continue this win-win approach
with extensive wellness programs starting
with our own employees.
We offer stipends to subsidize
employee participation in fitness
programs and paid time off for exercise.
We recently made a bold statement when
some UHA employees challenged the
local NBC/CBS Hawaii News Now TV
team in a weight-loss contest coinciding
with NBC’s The Biggest Loser.
UHA also invests in those who are
not healthy. Using predictive modeling
software, we identify individuals at risk
for diseases like diabetes. Our physicians
and nurses then collaborate with
members’ physicians, intervening early
to ensure that they get the extra medical
attention they need.
We make health plans work for our
members, rather than having members
figure out how to make their health plans
work for them. We educate members
about their benefits, rather than debating
why they cannot have a particular service.
We believe that this level of personalized
support is key for health plans in the
future.
Two years ago, UHA was among the
nation’s first health plans to introduce
concurrent care for life-limiting illnesses.
This “open-access model” allows mem-
bers to receive supportive care while
undergoing curative treatment.
Previously, to be eligible for hospice,
physicians had to certify a life expectancy
of no more than six months and patients
had to forgo active treatment. UHA’s
concurrent care benefit frees physicians
from making difficult judgments about
a patient’s prognosis. Earlier referrals for
supportive care enhance, and may even
extend, lives.
UHA also takes seriously its respon-
sibility to address issues negatively
impacting society. We became among
the nation’s first to tackle rising deaths
from prescription narcotics abuse,
implementing stringent quality and safety
policies that restrict opiate prescriptions
to one physician and pharmacy, ensuring
tighter controls and educating health
professionals on counteracting this
epidemic.
Health plans must continue innovations
to support, rather than impede, optimal
health. This is the only way to ensure
that we provide our members with better
health and a better life. mhs
✒ Howard Lee is president and CEO of UHA
(University Health Alliance) Health Insurance,
which provides medical, drug and vision plans to
employers in Hawaii. For more information, visit
UHAhealth.com.
Everyone Benefits
Spring 2013
UHA offers a counterintuitive
approach to health care
Executive Perspective expanded coverage
Howard Lee

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