endoflifemarketing2015

NESHCO WebinarThursday, December 10, 9 a.m.

Lynn Robbins & Doreen O’Toole, presenters

How to reach an often misunderstoodand under-served market.

End-of-Life Care MarketingThe Toughest Job You’ll Ever Love!

State of hospice care in U.S. and New England, in particular Relevant statistics

Your specific situation analysis/research around end-of-life care: Demographics Community’s culture/attitude Capacity/resources

Strategic marketing plan and corresponding tactics Evaluation Measurements

What We’ll Cover Today

According to the National Hospice and Palliative Care Organization (NHPCO), hospice is defined as follows: … for patients “facing a life-limiting illness, hospice provides

expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Support is provided to the patient’s loved ones as well.”

Hospice care focuses on caring, not curing. Care is mainly provided in the patient’s home but may also be provided in freestanding hospice centers, hospitals, nursing homes, and other long-term care facilities. Hospice services are available to patients with any terminal illness or of any age, religion, or race.

Just to be sure …

Current State of Hospice Care in the United States

Current State of Hospice Care in the United States (cont.)

According to the Centers for Disease Control – the statistics relative to deaths and mortality in 2013 were: Number of deaths: 2,596,993 Number of deaths for leading causes of death:

Heart disease: 611,105 Cancer: 584,881 Chronic lower respiratory diseases: 149,205 Accidents (unintentional injuries): 130,557 Stroke (cerebrovascular diseases): 128,978 Alzheimer's disease: 84,767 Diabetes: 75,578 Influenza and Pneumonia: 56,979 Nephritis, nephrotic syndrome, and nephrosis: 47,112 Intentional self-harm (suicide): 41,149

According to NHPCO in 2013, an estimated 1.54 million people received hospice care, while an estimated 1.1 million deaths occurred while under hospice care.


According to the National Hospice & Palliative Care Org. (NHPCO):Primary Diagnosis 20132012Cancer 36.5% 36.9%Non-Cancer Diagnoses 63.5% 63.1%- Dementia 15.2% 12.8%- Heart Disease 13.4% 11.2%- Lung Disease 9.9% 8.2%- Other 6.9% 5.2%- Debility Unspecified 5.4%14.2%- Stroke or Coma 5.2% 4.3%- Kidney Disease (ESRD) 3.0% 2.7%- Liver Disease 2.1% 2.1%- Non-ALS Motor Neuron 1.8% 1.6%- Amyotrophic Lateral Sclerosis (ALS) 0.4% 0.4%- HIV / AIDS 0.2% 0.2%


Characteristics of the Hospice Patient Population according to the NHPCO: 55% female 45% male 15% between the ages of 35-64 17% between the ages of 65-74 26% between the ages of 75-84 41% over the age of 85 81% were Caucasian 8.4% were African-American 10.6% Hispanic, Multi-racial or other


According to the NHPCO: The median (50th percentile) length of hospice

service in 2013 was 18.5 days1. This means that half of hospice patients received care for fewer than 18 days and half received care for more than 18 days.

The average length of service increased from 71.8 days in 2012 to 72.6 in 2013. Over the past several years the median length of service has declined while the average length of service increased.

Type of Hospice Care in 2013: Agency Type

The majority of hospices are independent, freestanding agencies. The remaining agencies are either part of a hospital system, home health agency, or nursing home.

Agency Type 2013 2012 Free Standing or Independent Hospice 58.3% 57.4% Part of a Hospital System19.8% 20.5% Part of a Home Health Org. 16.7% 16.9% Part of a Nursing Home 5.1% 5.2%


First, do your research and due diligence – Hospice Resources in Community?

Target Audience? Community Attitude(s) to

End-of-Life Care? Budget for Marketing?

Mediums Available for Marketing?

Specific situation analysis around end-of-life care

Snapshot of hospice providers in New England:

Specific situation analysis around end-of-life care

State Hospice & Palliative Care Associations: Hospice & Palliative Care Federation of Massachusetts Connecticut Association for Home Care and Hospice Maine Hospice Council New Hampshire Hospice & Palliative Care Organization Hospice and Palliative Care Council of Vermont Rhode Island Partnership for Homecare

Specific situation analysis around end-of-life care (cont.)

Who is your target audience for end-of-life marketing? Patient & Family/Caregivers

Female mainly? Some male? Ages?

Pediatric? Socioeconomic status? Ethnicity? Religion or spiritual affiliation?


What is the community’s cultural attitude toward end-of-life care and how it is addressed? It can be different from state to state, region to region,

county to county, town to town … It can be affected by politics, faith, personal experience

and more. Stories from Florida Stories from New Hampshire


Now that you have analyzed the research and the situation, it’s time to put together a plan … Budget and timeframe will inform your next steps, along with the size of the hospice provider

you serve. Development of an annual marketing strategy is very important.

If budgets are tight, develop small annual plans that can be built upon, making sure unpaid/earned media has priority positioning, i.e.: Year 1—Unpaid/earned media; development/printing of collateral materials* Year 2—Unpaid/earned media; social/digital/online presence, monthly print advertising

in community newspaper(s) Year 3—Unpaid/earned media; integrated social/digital/online campaigns, modest radio

and/or cable TV advertising campaign; ongoing print campaign in community newspaper(s)

Year 4—Unpaid/earned media; integrated social/digital/online campaigns, modest radio and/or cable TV advertising campaign; ongoing print campaign in community newspaper(s) and possible outdoor campaign

*Sometimes printing costs can be offset by agreement with printer for donated or discounted printing and allowing a sentence such as "Printing provided courtesy of Acme Printing." Get to know your local printer.

Strategic Marketing Plan & Corresponding Tactics

Media Relations: A good relationship with local media is of utmost importance and it should be built on

mutual need, trust and respect. Local media are always looking for newsworthy or human interest stories and you need to know and be familiar with the "personalities" of each community served by the hospice.

Meet with publisher/editor/assignment editor to establish solid relationships.

Educate them to what your provider does from general end-of-life care to specialty programs such as bereavement, caregiver support, as well as the full mission of your organization.

Ask them and make note of what they would like from you. If dealing with multiple outlets in more than one city/town, meet with every outlet in each area where your provider serves. Your clinical teams are a wonderful resource for identifying possible people/resources for story ideas.

You can never put a price on the value of positive unpaid/earned media—it only exists if there is trust and respect between the outlet and the provider.

Strategic Marketing Plan & Corresponding Tactics (cont.)

Community Relations: The area of community relations has the same value as unpaid/earned media –

inexpensive and very valuable as consumer education opportunities. Also very grass-roots and organic – often fitting the values of many in New England.

Establishing good and strong relationships within our communities can come back to a hospice provider two-fold. Partnerships with elder organizations, social, veterans and medical organizations as well as faith communities can greatly increase visibility and provide important patient/family education. Partner with appropriate parties in sponsoring health fairs, annual breakfasts,

luncheons or dinners, seminars and workshops, and even parades when appropriate. However, avoid anything controversial or political that can undo all the hard work and

time you've invested reaching out to your communities. Hospice providers should be “visible” members of their communities active in Chambers

of Commerce, Rotary/Kiwanis,/Lions clubs, etc. Members of such organizations become known, trusted and considered valuable members of their communities. Involvement should not be limited to a Marketing or Liaison Department – leadership team members of hospice providers should be represented, as well.


Government Relations/Advocacy: Government relations/advocacy can greatly benefit hospice providers so long as it is used

appropriately and for the right reasons. Provider CEOs, executive directors and appropriate board members/donors should lead

the governmental affairs charge while the communications professional must stay well read and knowledgeable about the issues. If a state legislator or an elected member of Congress knows and trusts people at the

local hospice, they will be more open to voting for legislation that has a positive impact on hospice care. Much like media relations, these are relationships built on trust, need and facts.

Communications professionals need to be knowledgeable in an effort to educate the local media. There are the times that a well-written letter to the editor from a CEO, executive director or board member can serve a hospice provider well. Beware the well-meaning volunteer, employee or board member who wishes to

craft such a piece without it being reviewed and approved by the appropriate members of the hospice communications and leadership team.


Online/Digital/Social: If your hospice organization or agency does not have an online or digital/social presence

of some kind, you are missing an effective means of communicating and advertising your “brand” that reaches an important part of your hospice demographic – the family member.

While the statistics show that most hospice patients are over 70 years of age, the average person looking for a hospice provider is a child or relative of the potential hospice patient. That “shopper” is usually looking online based on their own age and preferences.

Web sites and social media pages are easier than ever to produce and maintain. And, outside of media and community relations, they are your most cost-effective marketing tool. Plenty of web platforms to choose from Plenty of social channels to choose from: Facebook, Twitter, YouTube, Instagram, etc. Plenty of college and high school students willing to share their expertise on both web

and social should you need free or affordable help in putting together this digital strategy!

Don’t forget that e-newsletters or more cost-effective and green than the printed piece!

Online/Digital/Social campaigns are easy to track and are measurable and will give you feedback in real time! Just be ready to respond in real time!!


Advertising: Don’t forget to have a consistent call-to-action!! This is essential to evaluation and measurement.

Provider size and marketing budget makes a huge difference in advertising reach and frequency. Print - Advertising costs at smaller community newspapers can be affordable. Bi-

weekly or monthly ads in local newspapers shouldn't be cost-prohibitive and are often offered at non-profit rates as applicable. Most print outlets have designers on staff who will produce the ad. If you go that

direction, make sure to monitor the design, provide your own copy and embrace your logo!

Radio – costs for radio advertising can range from very inexpensive to highly expensive, particularly if owned by a national outlet. Meet with radio reps, get prices for their day parts (drive-time increases expense), non-profit rate possibilities, and of course, demographics. A brief, intense radio campaign can be very effective.


Advertising,(cont.) Public broadcasting – A good demographic for hospice providers, it offers specific

programming that targets the right listenership/viewership interest. Program underwriting costs vary widely, but are often affordable on both TV and radio. Unfortunately, public broadcasting does not offer geographic zoning opportunities.

Commercial or Cable TV Commercial television can be cost prohibitive without a significant advertising budget. Cable TV advertising is relatively inexpensive and designed to target specific

audiences in specific geographic zones. Every cable company has it's own premier and basic cable packages so you must inquire which channels are which package. Research or ask your cable provider which channels have the largest viewership for your demographic in the geographic area(s) you wish to target.

TV spot production can be very expensive. However, most cable companies have in-house production capabilities at varied costs, even including free for clients. Develop your own scripting and be actively involved in all aspects of production. Remember this video content is digitally something you can use on your web site, or on

your You Tube channel (s) or on Pandora or some other satellite or streaming service.


Advertising, (cont.) TV spot production can be very expensive. However, most cable companies

have in-house production capabilities at varied costs, sometimes they will produce a spot free for clients. Develop your own scripting and be actively involved in all aspects of production.

Remember this video content is digitally something you can use on your web site, or on your You Tube channel (s) or on Pandora or some other satellite or streaming service.

Outdoor and Transit: Not going to spend a lot of time on this advertising category, however, it’s an option (albeit expensive) depending on your budget, demographics and community culture … Billboards Digital boards Poster boards Wraps for buses and transit vehicles


Evaluation Really important to evaluate your yearly strategy and tactics on a quarterly or six-month

basis to tweak or modify based on feedback from your target audience and the community. If you are not getting direct feedback, solicit it! It’s relatively simple and inexpensive to survey your audience today through “Survey Monkey” and other online survey polls/tools or through a marketing or communications department of a local college or university.

Measurement This last step is critical and why you should always have a consistent call-to-action in your

advertising (paid and unpaid). It will help you determine where your audience is coming from and how they are connecting with your service. It will also help with demonstrating your return on investment for your campaign. Dedicated phone number/extension “for more information” Dedicated e-mail address or “contact us” address. Dedicated web site and landing page with tools to analyze visits and click-through

rates Dedicated FB event or business page

Evaluation of Marketing Plan and Measurement

What do you think?

Any questions or need for clarification?

Thank you for your time today!

Feedback and/or Questions?

endoflifemarketing2015

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