How and why you should build patient loyalty among healthcare decision makers
An increasing number of Millennials are making decisions for aging parents and grandparents. These first impressions for a generation who hasn’t otherwise been heavy users of healthcare can make or break brand loyalty. Listen to our conversation with Dan Ansel, CEO and President for Private Health News, to learn how health systems can establish brand loyalty from the very people who have never benefited from their direct care.
You can listen to the episode using the player embedded above, or you can read a full transcript below. Be sure to subscribe to Core Exchange on iTunes.
Stephanie: Welcome to the Core Exchange. I'm Stephanie Burton, Director of Healthcare Marketing for Core Creative. Today, I am joined by Dan Ansel who is the CEO and President for Private Health News. Thanks for joining us, Dan.
Dan Ansel: Well, thank you for having me.
Stephanie: Absolutely. So we first met at the forum for healthcare strategists in May and I pulled you aside and said, "This was one of the most insightful presentations I've seen in a long time." We were talking about senior care and I think that when most people hear senior care, we immediately go to the skilled nursing facilities. We think of skilled nursing facilities, we think of home care, we think of all of that, but we don't think of hospitals and health systems. Why is that?
Dan Ansel: Well, I think it fits into the overall concept of we're sort of an ageist society. It's a huge business. Millions, if not billions of dollars are made focusing now on the United States as a youth-oriented society. And I think that same ageism is reflected in healthcare systems when you think about that Medicare's their biggest payer. That some of the biggest financial penalties come around Medicare in terms of patient satisfaction, readmission avoidance, those types of things. Even though they are into the stat space with home health care, neurology, psychiatry, oncology, cardiology, the idea of really focusing on seniors and more importantly their caregivers seems to be something that hospitals, for the most part, have avoided.
Stephanie: Sure. So I think this is where the nickel dropped with me and it should have dropped with me many years ago. Medicare is in many cases, most hospitals largest payer.
Dan Ansel: Absolutely.
Stephanie: And we're not actively, in most cases, targeting the senior care market and their caregivers.
Dan Ansel: No, that's true. In fact, and yet the advisory group about two, two and a half years ago did a study that they found that the typical Medicare patient uses three or more healthcare systems in a five-year period, which demonstrates that not only does the Medicare patient not have much loyalty to most healthcare systems, it is also indicative that the caregiver doesn't have much loyalty to the health healthcare system. And when you think of the implications of that, that you've got 10,000 to 11,000 people aging in each day turn 65 and yet very few healthcare systems have done anything to distinguish themselves that, "Hey, we're focused on independence, safety, keeping you accident free, keeping your own home," yeah, it's pretty astounding.
Stephanie: It is pretty astounding. So what would you say to people, we're talking all about the Xennials, the Millennials now most of whom aren't using health care regularly and that's a good thing. That's how it should be. But a lot of us are focused on talking about this population. They are the future. They are up and coming. We need to focus on that. What do you say about that argument?
Dan Ansel: Well, there's been some studies out recently that showing ... Used to be thought that all caregivers of aging loved ones were probably in their 50s and 60s. There's been a lot of research lead recently that's showing that a lot of Millennials are caring for aging parents and in many instances aging grandparents. And if you think that they are now forming opinions about the way healthcare is delivered, the way people personalize healthcare, the respect that they show you when they're delivering healthcare, whether people see you as part of the team or see you as somebody who should just be kept off to the side.
Dan Ansel: I think that's going to have huge implications, and I think that if I'm a Millennial, and I'm taking care of my grandmother and grandfather, it's really likely that's at some point I might be taking care of my mom and dad and if you've done nothing to differentiate yourself that somehow you’re the healthcare facility that my mom or dad and my grandparents are going to be going to. And if you then think about the generalization as I start needing healthcare, if somebody forms a positive opinion, and I have a positive opinion of a healthcare delivery system, in my mind, I'm more likely to choose them.
Dan Ansel: It even drills down to, if you think about physicians, what, 72% of all primary care physicians are now employed by hospitals. Over 50% of all physicians are employed by hospitals and for a lot of people, that's the interaction with the healthcare delivery system, which then can ... So you've got to get down to even that micro-level of that those physicians need to be very sensitized to the needs of their biggest patient cohort. For most physicians, Medicare patients are their biggest patient cohort and yet there's a lot of a lack of sensitivity to the need of the actual patient, and many times the caregiver is sort of seen as a time eater because they have questions about their mom, their dad, their aunt, their uncle.
Stephanie: Sure, sure. So often times, for people in their 20s, 30s, 40s, the first meaningful experience they may have with a health system could be not their own, but a parent or grandparents.
Dan Ansel: Absolutely.
Stephanie: And that is making an impression that marketers need to be concerned about.
Dan Ansel: Absolutely. It's the idea that first impressions are pretty critical. I know that a lot of people who are older who are taking care of aging parents may have had very limited contact with the healthcare delivery system, but they get a call at two o'clock in the morning because dad fell, he's been into the emergency room and now he's been admitted and I'm thinking the last time I've been in a hospital is when my wife gave birth to our children that ... You're absolutely right. You can't overestimate the importance of when you interact with some somebody that is delivering care to someone that you care for. That may even be more important than when you're delivering care to me.
Stephanie: Absolutely. And I've heard you say that HCAHPS surveys are often being filled out by caregivers.
Dan Ansel: Which is so crazy that where you think where the financial penalties come about in terms for a lot of healthcare systems, it's HCAHPS and yet if you talk to most hospital marketers they have no idea that 30 to 40% of all Medicare patients, their patient satisfaction survey has actually been completed by a family member who is more likely to rate the hospital as well as the physician interaction in a more negative way because they're observing, "How did you treat my dad the third time he had to go to the bathroom in an hour? How did you treat my mom when she couldn't follow your directions? Did you repeat them or did you just move on?"
Dan Ansel: And then in terms of discharge, family caregivers are the first line of defense in terms of avoidable readmission because they're the ones getting the person to the doctor, are often making the appointment, getting the prescription filled, laying out the medication. They're the first ones to see if there might be some deterioration and most hospitals have done a terrible job in preparing that caregiver for that discharge. What to watch for, what to be careful about, when to ask a question. And it's such a huge opportunity and marketing, which should be the communication aspect ought to be jumping in and saying, "Look, we're going to deal with this."
Stephanie: Absolutely. Absolutely. So let's talk about differentiation. You had mentioned earlier three to five hospitals or health systems that the average senior, and I know we're not supposed to call them seniors, 65+. All right, a 65+ population goes to within a five-year range. Is that an opportunity for differentiation for health?
Dan Ansel: Oh, I think so. Absolutely. I think the ideas from the time of admission to the time of discharge and including treatment, the idea is there has the hospital ever done any sensitivity training for their staff in terms of what it means to not have your hearing aids in. What it means to have vision problems. What it means to be embarrassed because you have a continence problem. The way you treat and talk to the patient. Are you talking at them? Are you talking with them? One of the big problems, caregivers, if they're in the room often the doctor and everybody is talking to the caregiver rather than the older adult.
Dan Ansel: So I think there's a huge opportunity in terms of creating some sensitivity around specific needs, issues that that older adult population has, and to recognize that the family is usually under tremendous stress because they're not only dealing with the situation that's presenting, they're dealing with things that led up to that situation, "Should I have done something different? What's going on?" And most importantly now, they're just trying to decide, "Can mom go home?" "Who's going to help?" "Is this going to disrupt my schedule?" "Can Dad live alone anymore?"
Dan Ansel: There're so many dynamics, and candidly, a lot of it is just because there's a lack of information that's being provided to the older adult and the family caregiver to empower them so that they feel more in control of the situation because it's not an event for most older adults. Aging is a journey and once someone goes into decline, whether it's normal aging, whether it's an acute situation, whether it's a chronic illness, supporting that aging loved one is a long journey and most people need support because again, they're in an ageist society and a lot of times if you're caregiver, unless you're getting with other people caregivers, you don't get a lot of understanding and empathy.
Stephanie: Right? Right. So what do you say to this argument? You have the hospital exec team or marketer even saying, "Okay, we understand, Medicare is our largest payer, but we're not focused on getting Medicare patients in. They're coming to us anyways. We're focused on the private pay patients because that's how we're making money." What do you say to that argument?
Dan Ansel: What I'll say is, "Your time is coming because we know that Medicare Advantage is the preference of the government. If they had their way, the government would move everybody over the age of 65 into Managed Medicare. Well, when Managed Medicare becomes the major deliverer and where your patients are going to come from anything that impacts on healthcare costs is going to come under scrutiny; nutrition support, occupational therapy, the ability to function. And those healthcare systems that start to differentiate themselves in terms of knowing that market, knowing how to provide that care, knowing the uniqueness of the needs are going to be able to position themselves so much better with the Medicare advantage people. And if you're not in the Medicare space, how are you going to support your bricks and mortar? Because the only people coming into the hospitals in the next five to 10 years are people who are either frail, duh, elderly or people with lots and lots of health conditions, duh the elderly.
Dan Ansel: So if I'm an insurance company, I'm a Humana, I'm an Aetna, I'm a United, I'm an Anthem and I'm at financial risk for this population I'm going to look for providers who have some expertise and sensitivity to having those people. Because one, I want retention of my members. I don't want them to go into another plan. And if I'm sending you to a hospital that's not sensitive to your needs, your caregivers need, you may not join my plan when enrollment comes the next time because you're going to say, "This is a terrible hospital. They didn't take good care of my mom. They didn't treat me with respect. They didn't explain to me what's going on." So I would tell this hospital execs, "If you have that attitude, you can look in the horizon it and it's coming to an end."
Stephanie: That's right. And not to mention, and this is just my soapbox, most of our health systems missions are centered around keeping people healthy and helping them live well. So it's mission-based work and it should be. So what would you say to the healthcare if you were to give advice to a healthcare marketer today with the information that you shared with us today, what would you say?
Dan Ansel: I probably first say, "Look, if you have a CRM system if you're using one of the CRM vendors I talked to them is how are we gathering data or what kind of data are we gathering on the Medicare patient or the prospect, and how are we communicating with caregivers?" The audiences who are often making the decision of, "What happens to my aging loved one? "Where do they go? Where do they access services?" The other thing I would say is, "Think of the process from the time I see one of your doctors to maybe coming to the hospital, to my stay in the hospital, post-discharge. What are you doing? How are you demonstrating to me that you understand the unique needs of this population? If I'm a caregiver, how do you bring me into the fold? Understand that I'm part of the team. This isn't a one-week engagement, this is a lifetime engagement, and how do you provide me ongoing support so as I take care of my loved one and probably eventually myself."
Dan Ansel: It's the idea, "How are you supporting me? What kind of information are you giving me? What tools are you giving me," and I be constantly pushing to those people. This is why we have a specialty in taking care of people, and you don't have, the whole idea of seniors, the young, and old, the old, old. What I would say is stay with the message is, "Our healthcare system is dedicated to keep you independent, keep you healthy, keep you safe, keep you engaged in life and keeping your home as long as you want to be there."
Stephanie: That's it. That's the message. Tell us a little bit about Private Health News.
Dan Ansel: Well, Private Health News, I started in 2003, it started out with a program called My Healthy News. It's currently on about 160 hospital sites around the country. It's white labeled. It's a content marketing company where what we do is we get people through their interaction with our content to raise their hands, tell us what their interest are, and then we're able to interpret those interests so that our health care providers can target information specifically to the interest of an individual. For people who have CRM systems, which are based on propensity models, think of what we're adding to it is we're telling you what this person raised their hand, so you can target information about your programs or services to physicians who do that. 2008, we introduced another program called Med News Plus, about 230 hospitals do it. It's a physician communication program. We have currently about 75,000 docs, 55,000 nurses who get breaking medical news on a daily basis. We support 32 specialties, 200 sub-specialties.
Dan Ansel: Again, the doctors, the nurses, the PAs are raising their hand, they're saying "Here's my interest." We're sending them breaking medical news in those interests, but what it does coming from the hospital and the hospital's able to communicate based on what that subscriber has signed up for. And then about five years ago, we pulled the trigger on the program, Active Day Living. We spent four years developing the content, interactive tools, videos, et cetera. Rolled it out at the end of 2017, and it's totally focused on engagement and support for older adults and their caregivers with the primary goal of keeping you safe and keeping your in your own home.
Stephanie: Fantastic. Dan Ansel, we cannot thank you enough. Thanks for joining us on the Core Exchange.
Dan Ansel: It's been my pleasure and thanks for having me.