marketing oncology: service line strategies

Marketing Oncology: Service Line Strategies for Marketers

Live Webcast presented on:

January 25, 2010

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Live Webcast presented on:

January 25, 2010


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Presented by:

Karen Corrigan is chief strategy officer for Navvis & Company, a healthcare consultancy providing counsel on strategy, leadership and performance to health systems, hospitals and physician organizations. Karen is a leading proponent for value innovation in the health industry, and speaks and writes frequently on market-driving strategies to drive growth and transformation. She leads the firm’s Innovator’s Studio for chief marketing and chief strategy officers.

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Presented by:

Suzanne Hendery serves as vice president, Marketing and Communications for Baystate Health, a Top 100 Integrated Delivery System of three hospitals, including Baystate Medical Center, which is the largest hospital outside of Boston and the Western Campus of Tufts University School of Medicine. Baystate Health is honored to be the health care leader in Western Massachusetts and one of the largest employers with 300 employed physicians and almost 10,000 employees. At Baystate Health, Suzanne oversees an in-house marketing and communications agency of 23 professionals, providing market research and plans, patient satisfaction/service, marketing communications, photography, graphic design, writing, special events, employee communications and two large affinity programs (seniors, women) for the community. 6

Risk Segmentation

• As in many “industrialized” cities born along the river banks, there are high rates of cancer in Baystate’s area of western Massachusetts, particularly in the towns of Greenfield, Montague, Shelburne, Holyoke and Springfield (MA DPH Cancer Incidence report). Outreach programs were held in those cities and towns, to educate residents on how to identify signs and symptoms of common cancers seen in those areas, and when to seek treatment.

For II A. Segmentation (Karen)

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The Marketing Opportunity:Oncology Services Contributions to Volume and Profitability

For hospitals, the main categories for oncology-specific care are:

– Surgical oncology (outpatient & inpatient)

– Medical oncology (inpatient)

– Chemotherapy (outpatient)

– Radiation oncology (outpatient)

– Oncology imaging (outpatient)

Source: Future of Oncology: Growing Investment in Oncology Service Line, Advisory Board, 2005

48% of oncology revenue



10% and growing!

13% Inpatient Profits11% Outpatient Profits

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The Marketing Challenge:Oncology Services Are Embedded in Nearly Every Service Line . . .

• GI

• Urology

• Neuro

• Women’s Health

• ENT

• Thoracic

• Etc.

The Challenge of Marketing Oncology

Services: Coordinating Across Services Lines,

Specialties, Clinical Departments, and Sites

of Care

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Market Dynamics; Opportunities

AGING POPULATION DRIVING NEW CASES

• About 1.4 million new cases of cancer diagnosed each year

• Expected to grow 23% over next decade

• Three fourths of all new cancers – lung, breast, colorectal, prostate

IMPROVED SURVIVAL BOOSTING DEMAND FOR SERVICES

• 5 year survival rate increased from 50% to 63% over past 25 years

• Number living with cancer requiring medical care

INCREASING INDUSTRY INVESTMENT IN ALL ASPECTS OF CARE

• More oncology drugs in R&D pipeline than all other specialties

• Technology arms race

• Health system investments in cancer centers

Source: American Cancer Society, Cancer Statistics 2008

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OUTPATIENT SERVICES GROWING RAPIDLY

• Imaging: 59% projected growth from 2006 to 2011

• Chemotherapy: 42%

• Radiation therapy: 20%

• Outpatient surgery: 20%

ACCELERATED ADOPTION CURVES FOR NEW TECHNOLOGIES

• Rapid adoption by community hospitals

• Technological innovations by small centers

• Direct to consumer marketing

RISING CONSUMERISM CHANGING REFERRAL PATTERNS

• Oncology patients are increasingly self-referring

• Increasing importance of consumer marketing by cancer centers

Sources: Disruptive Trends in Cancer Care, The Advisory Board, August 22, 2008; Future of the Oncologist Workforce, American Society of Clinical Oncology, June 2007


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CHANGES IN REIMBURSEMENT DRIVING PHYSICIAN PARTNERING

• Interdisciplinary, multi-specialty practices

• Integrated health system-physician partnerships (clinical & business)

DISRUPTIVE TRENDS BREWING IN CANCER CARE

• Interventional oncology (minimally invasive means to access tumor site to destroy it) changing the future of oncology surgery

• Oral chemotherapy, multi-modality therapy

• Personalized medicine

Sources: Disruptive Trends in Cancer Care, The Advisory Board, August 22, 2008; Future of the Oncologist Workforce, American Society of Clinical Oncology, June 2007


Fully integrated, physician partnered models

Genetic medicine; customized care

Cancer prevention and cancer survivors

Specialty treatment centers (e.g. Breast Center)

Growth Vectors

Case Study: Suzanne HenderyVice President, Marketing & CommunicationsBaystate HealthSpringfield, MA [email protected]

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mailto:[email protected]

The Challenge:“from many pieces to one cancer program with a focus”

• 2001: Board approved construction of 65,000 square foot, $39 M facility for ambulatory components of Baystate Medical Center’s cancer program.

• New medical and administrative directors hired. CEO challenge, “we have many practices that deal with cancer patients, not a cancer program.”

• Like most hospitals, services were fragmented. Patients expected to “manage their own care.”

• Facilities were unattractive, patient-unfriendly, with poor way finding, clutter, and business and technical functions in full patient and public view.

• Result: Cold, unprofessional environment, uninviting to patients and families, unpleasant and inefficient for staff.

Cluttered radiation therapy reception

view from mammography gowning room

For section III: A. Launched a free-standing, all inclusive cancer center

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First Steps, Baystate’s New Cancer Program:

“Changing culture is challenging, time consuming, and totally worth while.”

1. Identified opportunities in efficiency, care, and cost.

2. Standardized patient supportive care measures. Resulted in positive, consistent messages from providers to patients and improved outcomes.

3. Interviewed referring MDs in the community regarding what they looked for in an oncologist/cancer program, perceptions of our program vs. local and regional offerings.

4. Discussed suggestions for improvement with faculty and administrators, instituted change, and reported back to the interviewees about improvements.

“Efforts quickly and significantly changed referral patterns, built visibility and credibility for the program and leadership.”


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Building the facility“No one was excited; so we changed the conversation”

1. Engaged patient focus groups in key areas (i.e. radiation, adult and pediatric hematology-oncology, breast services) to determine services valued, experiences (+/-), hopes for future experience;

2. Hosted retreats with staff, patients, advocates, architects, donors to design the program and experience for future patients.

3. Heard staff & patient’s POV; developed a theme; clarified staff roles; reorganized based on functions rather than MD-defined departmental silos.

4. Created subcommittees to design specific functional areas of the building. Patients or advocates with senior cancer leader reviewing and approving plans.

5. Reviewed by Core Group to ensure consistency with theme, program goals, budget and timing.

Strategy for growth: “An engaging customer experience.”


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Building the Oncology Brand . . .

– Valued segments: Who will we serve?

– Value proposition: How will we meet their needs better than anyone else?

– Value network: How will we design and align our operations, clinical programs, systems, processes, culture, and marketing investments to deliver on the value proposition every day?

Patient Experience is Strategy-Critical

ACCESS

EXPERTISE

PERSONALIZATION

EMPOWERMENT

COMPASSION

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Designing the Brand Experience

StrategyMarkets

Product PortfolioCapabilitiesInvestmentsPartnerships Oncology

Brand Alignment Framework

OperationsOperating Model

EnvironmentQuality/Safety

Customer ServiceBusiness Processes

CultureMissionBeliefsValues

Behaviors

MarketingTargetsProductsChannelsPricingR & D

The Power of a Theme: The Baystate Regional Cancer Program: “Partners on your Journey of Well-Being”

• “Cancer is a life-long and life-altering challenge with an uncertain destination, and while we cannot warrant that cure will be the outcome, we will partner with every patient to ensure optimal achievable outcomes, even if managing symptoms is the best modern cancer medicine can provide.”

• Theme was the most critical step in program transformation and facility design process. Touch point for every request to assure consistency of message and strategy.

• Partnered with everyone--patients: advocates, survivors, community cancer support groups, they advised us in facility design, shared resources, programming and patient referrals, feedback.

• Philanthropy was rejuvenated. Potential donors were inspired by the theme and partnered to design naming opportunities for loved ones whose life and legacy were celebrated by their gifts.

• Major equipment supplier also partnered as an “alphasight” for new patient-friendly technology.

For section III: B. Improving the Patient Experience at all touch points

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Personalizing the Patient Experience“Based on Listening and Learning from Patients”

• Multi-disciplinary consults; MDs work side by side.

• Social work support at every consultation, with re-inquiry at every visit.

• Detailed, 1 to 1 teaching appointment at end of chemotherapy or radiation treatment to discuss potential side effects of treatment and management.

• Individualized “side effect management manual” with patient’s specific treatment regimen.

• Individual satellite radio receivers so patients can customize music in radiation treatment unit (often from 10 to 30 minutes).

• Private gowning and private and ‘public’ waiting space for patients. This increased patient privacy, satisfaction, efficiency.

The D’Amour Center for Cancer Care’s Linear Accelerator Unit features clean lines enhanced by closets that maintain unsightly clinical equipment “off-stage” and artwork to relax patients while in treatment.


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Center Built by Patients, for Patients“architectural design and care to create harmony and comfort.”

• Brought “the outside in.” Reduced physical barriers (glass/desks).• Promote visual simplicity with all charts, phones, office procedures

and noise, off to a non-patient floor. • Clinical activities kept from patient and public view to enhance the

peaceful nature of the visit and ensure confidentiality. • Patients selected color schemes that appealed to them as they were

undergoing treatment. Used ecologically friendly materials. Cold food lounge-no hot food smells.

• Personal locker for belongings.• Bright, natural light for health and healing.• Area for advocate/community meetings, art therapy, demo kitchen.• Complimentary valet parking so patients do not have to struggle

from the parking lot to the front door.• Complimentary shuttle service to/from Baystate smaller community

hospitals to DCCC


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On the first floor concourse, visitors experience a dramatic change in feel and flow from the previous radiation

therapy reception area.

On the second floor of Baystate Medical Center’s D’Amour Center for Cancer Care, central arteries double as wayfinding and waiting areas.” Natural light pours in from the open ceiling above and the “living wall” with glass floor insert runs along the left.

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Developing a Strategic Marketing Framework Aligned to Business Priorities

Core positioning strategy to:

• Define and articulate the value proposition

• Select target markets and segments

Product and pricing strategies to:

• Adapt or design services to suit the needs of target customers

• Position, price and market the products to optimize profits

Channel and customer service strategies to:

• Enable access to services

• Optimize the delivery processes

• Cultivate loyalty and repeat business

Promotions strategy:

• Raise awareness and build recognition

• Stimulate demand for target services

• Create trial and/or referrals

Segmentation Targeting Positioning

Determine segmentation variables

Select high impact segments

Develop product positioning strategy

Marketing Strategy

PRODUCT PLACE

PROMOTION PRICE

SEGMENT TWO

SEGMENT THREE

SEGMENT FOUR

SEGMENT ONE

Size, income, age and ethnicityConsumption patternsProduct/brand loyaltyLifestylesNeedsAttitudes

Key Question Which segments have the greatest future potential to

drive oncology volume, revenue and profitability?

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Segmentation and Targeting

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Women – 1 in 3 over lifetimeBreast 32%*Lung & Bronchus 12%Colon & Rectum 11%Uterine Corpus 6%Ovary 4%Non-Hodgkin Lymphoma 4%Melanoma of the Skin 4%

Men – 1 in 2 over lifetime*Prostate 33%

Lung & Bronchus 13%Colon & Rectum 11%

Urinary Bladder 6%Melanoma of the Skin 4%

Non-Hodgkin Lymphoma 4%Kidney 3%

Source: American Cancer Society

Targeting by Gender

*new cancer site diagnosis

Targeting by Risk Factor

25% of Americans still smoke on a regular basis; there is some evidence that women at higher risk for tobacco related lung cancer

People exposed to second hand smoke; non-smoking spouses of smokers have a 30% greater chance of getting lung cancer than those of non-smokers

Workers exposed to cancer causing agents in the workplace (asbestos, coal, uranium, arsenic, talc, etc.)

Source: American Cancer Society

Smokers

Second HandExposure

OccupationalExposure

Creating a Targeted Marketing Plan for Oncology Services

“Patient in Critical Condition”

Problem

• Volume of radiation oncology patients, both treatment and new consults was stagnant.

• While outpatient market share is difficult to obtain, revealing metric: of adult hematology-oncology referrals from our affiliated MDs and insured by our own HMO, only 15% chose to see specialists in our cancer program.

• Of 8 centers of excellence at the hospital, the cancer program had the lowest recognition and awareness in the area, less than 50%.

Diagnosis

Goals: 1) Increase patient volumes for new

building—especially from our own practices;

2) Increase consumer confidence.

Strategy to build volume and confidence: Enhance relationships with all potential referring physicians/referral sources to grow specialty practices.

Message: “Experts in Cancer, Every Step of the

Way,” to establish awareness for the Baystate Regional Cancer Program, build credibility for the staff as “cancer experts,” and bolster consumer awareness.

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For section III: C. Creating a marketing plan

Market Analysis• Next 10 years, as population ages, the number of people

diagnosed with cancer is expected to double. • According to the American Cancer Society, cancer accounts

for 1 of every 4 U.S. deaths. Men have a one in two risk of developing cancer in their lifetime; for women it is one in three.

• The “Baby Boom” generation is in the middle of the incidence curve for cancer care.

• The volume of cancer services continues to grow. Radiation therapy by 3% percent; Infusion therapy by 7%; breast services by 10% (annually).

• With earlier detection, cancer patients will be identified earlier. With improvements in chemotherapy, patients will be able to tolerate more treatments, all of which will result in more treatments per patient and more lives saved.


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Strategic Marketing Objectives• Demonstrate leadership position through our actions. Take a leadership position

and act as the experts. Always take the high road. Never disparage local MDs--but don’t let their concerns sidetrack the promotional process.

• Enhance the credibility and reputation of the Cancer Program and its MDs and staff with cancer patients, the community and other audiences. Focus on the experience and reliability of our cancer team. Our providers establish positive relationships with their patients and their families. Present the cancer team as “the cancer experts at the forefront of cancer medicine,” with a focus on clinical trials, research, teaching and patient care activities.

• Establish and maintain positive partnerships within the cancer community and advocacy groups.

• Using key issues expressed through patient focus groups, develop messages that are “on target” with cancer patients and their families. Pre-test advertising materials and publications with patient focus groups. Use “patient- related” themes to connect all Baystate Regional Cancer Program and D’Amour Center for Cancer Care communications, assuring consistency and allowing for communication build. Be truthful and reality-based in our approach to communicating about cancer. “Stand for what’s real.”

• Generate press coverage for the cancer center that positions BH as a leader in cancer services regionally and nationally.

• Keep all key audiences informed, involved and aware of activities during construction of the Center for Cancer Care.


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Creative Campaign• Developed with BVK Advertising in Milwaukee.• Campaign depicts cancer as a journey, and stresses the

importance of choosing the right path and people to accompany each patient on their journey with the tag line, “Experts in cancer. Every step of the way”

• The advertising concepts (print, radio, billboard and television), text, and images were selected after testing with consumer focus groups.

• Narration was provided by actor Ed Begley, Jr. (who donated his services), and added to “world-class” branding efforts.


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http://images.google.com/imgres?imgurl=http://www.californiawomen.org/assets/Uploads/Ed-Begley-Jr.jpg&imgrefurl=http://adolfsson.dk/ed10282/%3Fpaged%3D2&usg=__aywm9Cslrfmuf1UXt7bebh4nG40=&h=306&w=306&sz=43&hl=en&start=8&um=1&tbnid=kDO-HafNYGvoiM:&tbnh=117&tbnw=117&prev=/images%3Fq%3Ded%2Bbegley%2Bjr%26hl%3Den%26rlz%3D1T4RNTN_enUS336US336%26sa%3DN%26um%3D1

ResultsBefore

Patient satisfaction60-70% “very good” (press ganey)

MD referrals: 15%(patients from BH affiliated MDs to

BRCP specialists)

Volumes: Flat

Consumer confidence: -50% said “best”

After

80-84% “Excellent”—also at small community hospitals, same care (PRC)– 100th percentile nationally70%

Hem/Onc +43%; overall +30%

70% “best”

Revenues: from facility fees (exclusive of drug revenue) grown by 35%.

Facility design, architecture and patient experience has won a number of national awards; including the 2008 Discovery Award for Best Patient Experience.

For section III: D. Measuring return on effort

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For section IIII: C. Transforming the employee culture and experience

Transforming Employee Culture & Experience

• Passivity “not an option.”• MD & staff engagement in each phase, with direct feedback from patients,

referrers.• Signing of “Baystate Promise” contract of care (see attachment)• Ongoing recognition and celebration, “why we’re here…what patients

appreciate about you.”

Evening prior to opening. Dedication ceremony, not of the building, but of ourselves, as we opened the doors to a new way of caring for cancer patients.

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Lessons Learned

• TBD

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marketing oncology: service line strategies

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