Reading an old profile in The New Yorker made me think about what Alice Waters can teach healthcare PR and marketing. Alice Waters, who today won the National Humanities Medal from President Obama, opened Chez Panisse in Berkeley, California in 1971, with the idea she and her partners would provide a dining experience like that of a dinner party at home, with generosity and attention to detail, and a commitment to seasonal, local and sustainable food sourcing. While all that might seem like a commonplace in today’s restaurant scene, the fact is unmistakable that Waters started a revolution against the bland, industrial food machine that held sway at that time.

But Water’s vision is larger than a great dining experience. As the article explains, “Her vision is rooted in the romantic Berkeley politics that she practiced before starting her restaurant, Chez Panisse, with a ten-thousand-dollar loan twenty-seven years ago. She believes in concentric circles of social responsibility, with the reformed carrot in the backyard garden insensibly improving the family around the dinner table, the reformed family around the dinner table insensibly improving the small neighborhood merchants they shop with, the reformed neighborhood merchants improving their city, and so right on, ever upward and outward, but with the reformed carrot always there, the unmoved (though crisply cooked) mover in the center.”

Can you imagine people posing in front of the hospital they got care in?

What does this have to do with healthcare PR and marketing? Hospital and health plans are falling all over themselves to tell us how patient-oriented they are, how they want to hear from us, how they are committed to the whole patient and community. They are, in some cases, doing a good job of communicating. And in some cases, they are really trying to deliver. But spend time getting care for yourself or a loved one and one becomes painfully aware of the shortcomings of the system – its insensitivity to individual need, its rapacious appetite for fees, the nonexistent customer service, the often sketchy connection to the best available treatments, and yes, the appalling hospital food.

PR and marketing can aspire, but must not outrun the reality of what you are promoting. The gap is too large, and it undercuts both the message and genuine attempts to provide truly better healthcare.

What’s that? A hospital cannot be run like Chez Panisse? It would cost too much, you say? Looked at a hospital bill lately?

Challenges, Opportunities in Store for ASCs in 2015

Ambulatory Surgery Centers (ASCs) face unique opportunities and challenges among healthcare providers in the coming year. For a healthcare system focused on controlling costs and improving quality, ASCs offer a high-quality, cost-effective alternative to surgical procedures conducted in the hospital. However, ASCs face significant challenges – including a maturing market, reimbursement issues and evolving regulatory policies – that can impact their bottom lines and continue to force them to play on an uneven competitive field.

On The Bright Side
The good news for ASCs is that volume growth is expected to continue as Medicare and private payers favor the lower costs of ASCs when compared to hospitals. In an investment report issued this month by Standard & Poor’s on AmSurg Corporation, a large, publicly held operator of ASCs, S&P cited strong demand stemming from an aging population and increasing use of outpatient services. This growth outlook was echoed in a report on ASCs by Moody’s Investor Services.

ASCs face challenges and opportunities in 2015.

Medicare and Medicare beneficiaries currently share in more than $2.6 billion in annual savings for procedures performed at ASCs when compared to what those procedures would cost in the hospital outpatient department (HOPD), reports the Ambulatory Surgery Center Association (ASCA). These savings are realized in what Medicare pays for a procedure and also in lower co-pays by the beneficiaries. The ASCA notes that if just half of the eligible procedures were moved from hospital outpatient departments to ASCs, an additional $2.5 billion dollars could be saved annually.

New payment models may also come to benefit ASCs. While Moody’s expressed concern that the shift to bundled payments may not be positive for ASCs, Jameson Pearlman, VP of Managed Care at Meridian Surgical Partners, says ASCs are well positioned to participate in accountable care organizations, patient-centered medical homes and population management initiatives.

“Payers are moving more and more towards shared savings models, which are ideal for ASCs because we can better control anesthesia, implant, supply, and labor costs and still deliver high quality within a single episode of care,” says Pearlman in an interview with Becker’s ASC Review. “Bundled payments are a great opportunity for ASCs to align incentives with payers to ensure greater patient access and participation within evolving narrow networks focused on greater efficiency and accountability.”

Maturing ASC Market Means Changes
Many ASCs, especially independent ASCs, face challenges as the ASC market matures, competition increases in their market area and more hospitals open or purchase ASCs. Moody’s points out that larger players, with economies of scale and joint ventures with hospitals and physician groups, are best positioned to benefit. High performing ASCs will also be those that concentrate on procedures that generate higher revenues per treatment, such as pain management and orthopedics, according to Moody’s.

Pearlman reports excessive competition for procedure volume is depressing private reimbursement rates. “There are some ASCs in saturated markets that are accepting rates well below market and in turn payers use those lower rates as a baseline when comparing other ASCs,” says Mr. Pearlman. “Then our rates are undercut and it’s difficult to show payers why we need the higher fees to cover our expenses.”

Low reimbursement rates from Medicare are also a major issue for ASCs, even with the increase contained in Medicare’s final 2015 ASC payment rule, issued on October 31, 2014. CMS adopted an overall payment rate adjustment of 1.4 percent for ambulatory surgical centers, up from the proposed increase of 1.2 percent. But HOPDs received a larger increase, widening the gap between what Medicare pays ASCs versus HOPDs for the same procedure.

According to the ASCA, Medicare pays hospitals 81 percent more than ASCs for the same procedure. As recently as 2003 Medicare paid hospitals about 16 percent more. As a result, says the ASCA, hospitals are purchasing ASCs, converting them to hospital outpatient facilities and charging the higher outpatient rates.

On the plus side, the final rule adds 10 spine codes to the ASC-payable list and defines ASC device-intensive procedures in a way that makes it more economically feasible for ASC to offer more procedures with high device costs. However, ASCA CEO Bill Prentice notes that despite the gains there are still numerous procedures that ASCs are permitted to perform but cannot because of inadequate Medicare reimbursement for the device.

The Misfit of Meaningful Use
Another challenge for ASCs is the “50-percent rule” contained in the Meaningful Use (MU) regulations. The Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of the American Recovery and Reinvestment Act of 2009 (PL 211-5), authorized incentive payments to eligible professionals (EP) and eligible hospitals to promote the “adoption and meaningful use of certified electronic health record technology (CEHRT).” The 50-percent rule requires that for EPs to qualify for EHR incentives, at least half of their patient encounters must be documented in a certified EHR. For ASCs, this creates a challenge since their doctors often practice at multiple locations and need to ensure that reports are sent to the location with the CEHRT.

ASCs were not included in HITECH, so many do not have certified EHRs in place because HITECH has not subsidized their purchases of EHRs as it has for physician’s offices and hospitals. This creates a potential disincentive for surgeons to bring patients to an ASC. It also seems to run counter to the stated goals of the CMS EHR Incentive Program to “improve quality, safety, efficiency, and reduce health disparities” and “to improve care coordination, and population and public health.”

ASCA is working with CMS and Congress on immediate and long-term solutions to this issue. In the meantime, since ASCs already receive lower reimbursements than hospitals for most procedures, it is very important for them to improve clinical documentation and embrace automated coding in order to receive the appropriate reimbursement. Our next ASC blog post will take a closer look at reimbursement issues specific to ASCs.
Learn strategies for maximizing revenue. Download our white paper, Positioning an ASC for the Future of Reimbursement: Best Practices for Revenue Capture.

(This post was authored by Snow for the ProVation Medical blog.)

Creating strong content for healthcare content marketing requires three things:

1. Focus on relevant pains, drivers and trends in the market.

2. Lead, don’t follow.

3. Integrate with your overall healthcare PR and marketing strategy.

As a Minneapolis healthcare content marketing agency, we follow a wide range of regulatory, legislative, industry analyst and marketing issues on behalf of our clients. Our job is to identify emerging trends and develop appropriate strategies, including content marketing. The best content is timely, relevant content that directly interests your customers and prospects. It positions you as an opinion leader and cutting-edge company.

Focus on relevant pains, drivers and trends in the market

Obamacare means big changes. Are you addressing them?

Healthcare is driven by government regulation. Check websites for HHS, CMS,FDA, etc., or the specialized media and blogs that follow them. Or, follow the Tweets of folks who watch these agencies. Look not just at what’s happening now but what’s coming down next year or later. Your customers and prospects are interested in ways to respond to new laws or regulations, or soon will be. Also, follow the healthcare analysts at Gartner, IDC, The Advisory Board and KLAS Research. Even if you don’t subscribe to these services, the leading analysts like Judy Hanover of IDC or  Tom Handler of Gartner are quoted in report summaries and news accounts. Big trends and drivers, like the move to mobile or the cloud, are being p0inted to years ahead by these analysts. Your customers are interested in how to respond to these trends. Why is your solution or expertise relevant? Share that. Often.

Lead, don’t follow

Per above, get ahead of the competition with some key drivers, regulatory issues and/or trends, and keep reminding customer and prospects that you are focused on helping them adapt and thrive in changing conditions. The Affordable Care Act and other changes are continuing to become legal requirements according to a set schedule. Insurance companies need to attract and engage individual customers on an unprecedented scale. ICD-10 will become a requirement for all providers next year. Now’s the time to share a vision for how to meet these new challenges.

Integrate with your overall healthcare PR and marketing strategy

Every selection of content you disseminate should reflect your overall PR and marketing strategy, and be integrated with all your other marketing tactics, including case studies, web content, trade shows, media placements, other social media. Have a few, important objectives and focus on them in every communication, including all content marketing.

Are oreos addictive as cocaine?

Yes, according to headlines from scores of news sources, including NBC, CBS, Time and The Wall Street Journal. No, if you read the otherwise decent reporting and learn that the study was on laboratory rats. The website at Connecticut College has it right in the headline, which clearly states the study was in rats.

Headlines suggest Oreos are addictive as cocaine.

Thanks again to Gary Schwitzer at HealthNewsReview.org for shedding light on the media practice of misleading headlines regarding scientific research. As a Minneapolis PR firm specializing in healthcare PR and food & beverage PR, we understand the need to tread carefully when promoting scientific research for our clients.

Even good reporters may have nothing to do with the headline written for their story, and the resulting issues can be thorny.

Could this have been avoided? Maybe not, as the addictive qualities of Oreos is a credible concept to anyone who has eaten them – they’ve got 34 million Likes on Facebook. And, the desire of headline writers to attract readers.

Good communications with the media always help, but for something like this it’s good to think through how the media will handle a story and plan accordingly.

As for me, I like Oreos but still miss Hydrox.

There are three keys to B2B content marketing for complex sales – corporate law firm marketing, healthcare information technology products and services, medical device, B2B food manufacturing and other B2B products and services. These are sales with longer sales lead times and higher price tags, and rely on direct meetings and contacts to build relationships and close the deal. As a Minneapolis B2B content marketing agency, we’ve always matched PR, marketing and other services to the actual sales process of our clients. With content marketing, the opportunities for engaging prospects and clients have become better – including social media and analytic methods. We’ve found that three keys to B2B content marketing for complex sales are:

1. Have a documented content marketing strategy.

2. Match content marketing to the sales process.

3. Measure and improve the strategy as needed.

Documented content marketing strategies are more successful

According to research sponsored by Brightcove, the marketers who reported having a documented content marketing plan were more likely to say they were effective – 66%, than those who did not have a documented content marketing plan – 11%. I’d make some allowance for selection bias here, as those who invest the time and resources in developing a documented strategy might be inclined to score their efforts higher, but the point is that serious marketing efforts generally stem from a fair amount of analysis and planning. Unfortunately, content marketing is too often the flavor of the month and done on a piecemeal basis, without a formal strategy or plan.

What’s in an effective, documented content marketing strategy? At a minimum, it should set out clear goals, identify team members (including outside resources) and responsibilities, contain a SWOT analysis, and lay out basic tactics and timetable. Ideally, it should also include a description and analysis of your sales and marketing process and spell out how content marketing will support – and in some cases, lead – that process. In addition, it should identify prime topics to focus on – topics that of are interest to your prospects and customers in ways that help build a case for ultimately buying your product or service. For example, a company trying to sell software to drive efficiencies in the hospital emergency department might publish white papers, case studies, blog entries, etc. on revenue, margin, cost and quality issues for hospitals. A law firm selling intellectual property services might focus on content that explores the implication of new laws, rulings, treaties and technologies that present challenges and opportunities to their clients and prospects.

Match B2B content marketing to the sales process

Three keys to B2B content marketing for complex sales start with fuzzy funnel.

As Joel York illustrates with this graphic in his excellent blog, the B2B buyer enters a “fuzzy funnel” that is built on content marketing and social media. Much of the old “solution selling” has already occurred before a sales rep has spoken with the customer. As Brent Adamson, Mathew Dixon and Nicholas Toman point out in their Harvard Business Review article:

“A recent Corporate Executive Board study of more than 1,400 B2B customers found that those customers completed, on average, nearly 60% of a typical purchasing decision—researching solutions, ranking options, setting requirements, benchmarking pricing, and so on—before even having a conversation with a supplier. In this world the celebrated ‘solution sales rep’ can be more of an annoyance than an asset. Customers in an array of industries, from IT to insurance to business process outsourcing, are often way ahead of the salespeople who are ‘helping’ them.”

The good news here is that the right mix of content marketing, matched to the actual sales process, will support your sales effort and boost inbound marketing. Careful attention to relevant government or industry standard setting developments, major trade shows, LinkedIn discussion groups, pain points and other factors will provide guidance on the mix and timing of content marketing initiatives (set out in the the documented strategy, of course). We had a patent law firm client where we focused on a key change in an obscure part of IP law. Two weeks after publishing a document on the subject, a prospect contacted the author and signed up for more than $1,000,000 in legal services.

Measure and improve the strategy as needed

In the old days of marketing, you did your best analysis, conducted effectiveness research of varying value, and prayed a lot. Today, the analytics permit fine and real time measurement of everything you’re doing in content marketing. Are you not currently measuring? You’re not alone. Only 15% of attendees as a recent content marketing conference reported good measurement. Yet, the tools are there already, via Google, your website, Twitter, etc. By tracking page views, downloads, shares, guest postings, lead generation and impact on sales, you can measure impact and ROI and make adjustments in real time. The important thing is to measure things that are critical to your actual sales process, and that offer insights of value. There’s no cookie cutter approach here. Customize it.

In addition, listen to what prospects and customers are saying in their posts, Tweets, blogs and to your sales people. If Regulation “Q” is on everyone’s mind, it makes sense to address content to that concern. With good measurement tools, and a close ear to what prospects and customer are saying, your content marketing will be relevant, timely, and most importantly, effective.

Questions? Comments?

We’d love to hear you questions or comments. Please contact me directly. As a Minneapolis B2B content marketing agency, we’re eager to keep learning and carrying on a dialogue with like-minded professionals.

Sex, lies and healthcare marketing go together all too often, but the good news is that few of the drug advertising claims on TV are actually false, according to a study published in the September 2013 issue of Journal of General Internal Medicine. Yet, as other studies suggest, drug ads may be encouraging gender bias as in the case of psychoactive drug advertising (see discussion below).

Thanks to Gary Schwitzer in HealthNewsReview.org, for writing about “Content Analysis of False and Misleading Claims in Television Advertising for Prescription and Nonprescription Drugs,” by authors Adrienne E. Faerber PhD and David Kreling PhD.

Journal article questions credibility of TV drug ads

In the study, the authors analyzed TV drug ads over a two-year period and found that over half of drug claims were potentially misleading. False claims accounted for only two percent of the prescription drug ads and seven percent of the nonprescription ads.

As Gary points out from the study’s findings, the average consumer may see up to 30 hours of drug advertising while spending 15-20 minutes per visit with their caregiver.

Adding to the potential problem is the gender bias reflected in some drug advertising. For example, psychoactive drug advertising portrayed women 62 percent of the time, according to a study published in a Brazilian journal. Judy Stone writes on the issue of women and drug advertising in the Scientific American blog.

As a Minneapolis healthcare content marketing firm, we care deeply about helping our clients engage their customers in credible, sustainable ways. Sex, lies and healthcare marketing may go together sometimes, but we’re also encouraged that most healthcare marketing avoids false claims. The misleading claims issue is something for the industry to work on.

Can healthcare PR be a crime? In the case of ex-InterMune CEO W. Scott Harkonen, the answer is yes – according to the U.S. government, a Federal jury and the Ninth Circuit Court of Appeals. David Brown writes in The Washington Post about how Harkonen was convicted for issuing a press release that, according to the U.S. government, willfully overstated the benefits of a drug made by his company.

InterMune ex-CEO prosecuted for statements the government said are fradulent.

InterMune is a public company focused on pulmonary and orphan fibrotic diseases. It markets a medicine for idiopathic pulmonary fibrosis (IPF) and is in product development and clinical trials on other drugs.

No Factual Errors

According to Brown’s article, there were no factual errors in the press release in question. It was the interpretation of the facts that was deemed criminal. This raises troubling questions for a Minneapolis healthcare PR firm like ours, and our clients. When does promoting a point of view become a crime?

From the Post article:

“If you applied this rule to scientists, a sizable proportion of them might be in jail today,” said Steven N. Goodman, a pediatrician and biostatistician at Stanford University who submitted a statement supporting Harkonen’s appeal. “The courts don’t quite realize the significance of what is in front of them or the furor that might erupt if this kooky precedent is allowed to stand.”

Ruling a word of caution to a Minneapolis healthcare PR firm

This ruling is a word of caution to a Minneapolis healthcare PR firm that works in healthcare PR and healthcare content marketing. Can healthcare PR be a crime? It can in some cases, but there is a free speech issue here that needs to be thought through carefully.

Ultimately, it gets down to what patients are entitled to know. They shouldn’t be deceived, obviously, but should they be prevented from knowing a company’s interpretation of research facts? I don’t claim to have the answer, but it’s a question worth asking.

Bringing clarity to medical device PR is a long standing goal of this Minneapolis healthcare PR firm.

Bringing clarity to medical device PR

MR Instruments is a producer of high-resonance MRI technology and developed the medical technology industry’s first 3T (Tesla) MRI coils for the most demanding MRI applications. The clarity of image MR Instruments helps produce for physicians was our inspiration for bringing clarity to MRI’s target audiences: MRI manufacturing companies, MRI users and buyers and key influencers.

MR Instruments hired Snow to increase visibility of this new technology and officially launch its flagship product at the RSNA Conference in Chicago. Snow Communications drew on its deep expertise and experience in medical device PR and medical device content marketing to bring about good results for MRI.

For more details, please see the case study.

Can you trust clinical practice guidelines? Thank you, Gary Schwitzer of  HealthNewsReview.org for an excellent blog post on the BMJ (British Medical Journal) article about conflicts of interest on clinical practice panels. The BMJ article details some of the types of conflicts common on the clinical practice panels that issue treatment guidelines.

As a Minneapolis healthcare PR firm dedicated to promoting the transformation of healthcare to a patient-focused, outcomes-based model, we believe it is vitally important that engaged patients receive evidence-based, unbiased information.

British Medical Journal

For example, in the controversial area of PSA testing, the article notes that The American Urological Association’s best practice update in 2009 and its 2013 practice guidelines reflected potential conflicts of interest in the context of association sponsorship, committee chair conflicts and multiple panel member conflicts. The article contrasts this with the conflict-free status of the U S Preventive Services Task Force in 2012.

Who do you believe?

While the U.S. Preventive Services Task Force found harm from routine PSA testing and no evidence of net benefit, the American Urological Association 2009 guidelines promoted routine PSA testing. In 2013, the Association revised its guidelines to reflect a more conservative approach to PSA testing.

As noted elsewhere, studies have found troubling patterns of conflicts of interest in practice guideline panels, and or lack of full disclosure of those conflicts. Part of the answer is the new Physician Sunshine Act, which we’ve written about previously, that requires the reporting of financial payments to physicians by pharmaceutical and medical device companies.

Avoiding Red Flags

The BMJ authors recommend that professional journals avoid the following red flags:

• *Includes a panelist with either or both a financial relationship with a proprietary healthcare company and/or whose clinical practice/specialty depends on tests or interventions covered by the guideline.

Please take note, healthcare PR professionals, healthcare marketing professionals and journalists. And for full disclosure, this Minneapolis healthcare PR firm works for the parent company of an online source of unbiased medical reference and clinical recommendations. The client had nothing to do with the writing of this blog post, and I take full responsibility for its contents.