The ACA ChallengeMarketing Strategies for Success

Paul G. MatsenJuly 2013

Introductory Video

The ACA Challenge: Environment

• Slowing revenue growth

• Shift to outpatient care

• Purchasers demanding greater value

• Cost shifting to consumers

• Financial pressure and transparency

The ACA Challenge: Environment

• Shift to value-based care and ACOs

• Coverage expansion

• Physician alignment

• Constrained resources

• Rising competitive intensity

Uncertainty

Cleveland Clinic Imperatives

• Patients First

• Caregiver engagement

• Innovate the care and business model

• Financial

Readiness in Challenging Times

Strategic Direction

Striving to be the world’s leader in patient experience, clinical outcomes, research and education

• Referral center

• Regional provider

• Academic center

• New models of value-based care

Marketing Strategies for the ACA Future

• Access

• Alliances

• Targeting: know your patients

• Engagement

• Brand/Patient Experience

Access

“We believe that every life deserves world class care today, not a month from now.”2010 Patient Experience Summit

Delos M. Cosgrove, MDCleveland Clinic CEO and President

Value Proposition

• Cleveland Clinic delivers superior total patient experience in the form of outstanding clinical outcomes, innovative treatments and access (including same-day appointments), all in an integrated delivery system.

Cleveland Clinic provides world class care that is accessible to everyone in Northeast Ohio.

Situation: Early 2011

• Cleveland Clinic has universal brand awareness and strong preference versus key competitors

• Experiencing slight erosion in market share• Known for Clinical Excellence, but not considered

approachable or accessible

+30%Unaided AdAwareness

ResultsResults

+60%Same-Day Access

Awareness

0

250

500

750

1000

1250

2008 2009 2010 2011 20120

250

500

750

1000

1250

2008 2009 2010 2011 2012

Same Day Visits

4%

#Thousands

#Thousands

988988

Alliances

Alliances

• Leverage our core capabilities

- Clinical care

- Intellectual property – innovation

- Consulting and management

• National reach

• First heart surgery affiliation in 1994• 15* affiliations across the U.S. past 18 years• Designed to improve quality of care, provide

access to advanced research and technologies • Foster communication among caregivers• Provide unique market differentiator

HVI Affiliate Program Overview

1994: EMH Regional Medical Center 1997: LakeWest Hospital 1998: Hillcrest Hospital

MetroHealth Medical Center 2001: Cleveland Clinic Florida2004: Fairview Hospital

Rochester General Hospital2006: Chester County Hospital2007: Cape Fear Valley Medical 2010: Cadence (2 hospitals)2011: Novant (2 hospitals)2012: MedStar (5 hospitals)

Saint Vincent2013: Fisher Titus Medical Center

Bellevue Hospital

Cleveland Clinic Affiliation Growth

Cleveland Clinic National Network

Direct contract between large, self-funded employer and Cleveland Clinic

Program for Advanced Medical Care - Overview

Cleveland Clinic

Contracting directly with Cleveland Clinic allows you to:Realize Efficiencies and Savings

Avoid Variability in Outcomes

ANDOffer #1 Heart Care* to Employees

*Additional services available

Employer

Current Relationships

Current Innovation Alliance Partners

Targeting: Know Your Patients

AdviceGivers*43.7MM

Age 45+,HHI $100,000+

55.4 MM

Source: Nielsen Media Research, Net Ratings @Plan.

Affluent Advice Givers17.1MM - 8% of adults, 12% of Internet users

• Active networkers• Detail lovers• Opinion sharers

The Alpha Influencer

Why is Al ImportantPatients and Contribution Margin from Outside Ohio

6%

21%

0%

5%

10%

15%

20%

25%

N of Patients Contribution Margin

Why is Al ImportantPercent of Patients Admitted to Hospital

Where Does Al LiveCM per Patient by Region Indexed to Ohio

Engagement

Brand is Important to Prospective Patients

Source: 2012 Google/Compete Hospital Study. Q: “How important were each of the following features to you when researching facilities?” A: For each choose from 5 (extremely important) to 1 (not important at All). Percentage represents top two box responses.

“we need to make our brand experience – its message, actions and services-

TRUSTED, REMARKABLE, UNMISTAKABLE, AND ESSENTIAL”

Patient Experience

Brand Promise

Clinical Excellence

Innovation Wellness

How to Engage AlOwned | Earned| Paid

Digital Ecosystem

Social Media Ecosystem

Updated mobile site scheduled for April

Cleveland Clinic Today iPad AppLaunched in March

Daily interactive iPad source for the latest health and wellness tips to read, save, and share from the experts at Cleveland Clinic.

• Updated Daily with new Health & Wellness Content• Access to Health Hub• Interactive 3D Human Body• Interactive Timeline• Request Appointments• Find a Doctor• Find Locations• Access MyChart

Reaching Al ThroughEarned Media

• State of the Clinic –Media Highlights

Reach Al ThroughPaid Media

Content Strategy | PaidSea of Sameness

Paid MediaDigital

• Leveraging owned assets (clevelandclinic.org + landing pages) in display advertising

• “Reframed” concept focuses on three content areas: Innovation, Outcomes and Patient Experience with new calls-to-action

Service LineIn-Banner Search

Brand/Patient Experience

“Providing the highest quality patient experience is a primary goal of the Cleveland Clinic Organization.”

-Delos “Toby” Cosgrove, MD

• Safe Care• High Quality Care• Patient Satisfaction• High-Value Care

Patients First ...

Role of Leadership

Institutes

HospitalsOperations / Administration

Executive Team

Caregivers

Caregivers

Caregivers

CaregiversPatient

Experience

Home

Wellness / FitnessCenter

Retail Pharmacy

PhysicianClinics

Diagnostic /Imaging Center

Urgent Care

Family Health & Surgery Center

Community-Based Care

Continuum of CareAcute Care

Hospital

Recovery andRehab Care

Inpatient Rehab

Skilled NursingFacility

Outpatient Rehab

Home Care

Patients Choose Experience

“What factors are the influence on your choice of hospitals?”

Creating Caregivers

• Firing of all Our Employees

Pat

ient

Exp

erie

nce

Car

egiv

er E

xper

ienc

e

Cleveland Clinic Experience

Cleveland Clinic Experience Training

0

10

20

30

40

50

60

70

2008 2009 2010 2011

Percentile

01,0002,0003,0004,0005,0006,0007,0008,0009,00010,000

Complaints

Gallup Engagement HCAHPS RatingHCAHPS Recommend Complaints

CCHS

More Engaged Caregivers…More Satisfied Patients

Closing Thoughts

• Decisive Strategies

• Responsiveness to Change

• Trusted Brand