Measure Up or Move On
and the
Marketing Crusader Playbook
Prepared especially for the
Wisconsin Healthcare Public Relations and Marketing Society
/ / 704-992-6005
50 Ways to ROI
The CEO is asking what’s the score
Did the campaign make admissions soar?
I know you’re thinking this ROI’s a bore
What to do Anthony tell me more
OK I hear you / I know you’re struggling to
How to do this when the dollars are few
I have some points that I would like to make
Then you can decide what to take
Decide what to take
CH:
It starts with a plan Stan
Determine priorities Dan
Make sure they align with the CEO
Audit the function
Get the right skills
You’re ready to climb the ROI hill
Build your campaign kit
So people respond quick
Get their info and start tracking too
Build the relation
Create experiences / elate them
Then word of mouth will add some fuel
VR
You built a marketing plan and it’s based
On tracking patients not brand awareness raised
The CFO takes notice of what you do
That’s gonna help when budgets are due
So now let’s take it to another tier
Create crusaders / find the influencers ear
Make experiences starting right with what you do
Your raise is long overdue / long overdue
Establishing Criteria from Which to Measure (Sample)
1=least important consideration when marketing a service
5= most important consideration when marketing a service
Impact on Market Share/Volumes / 3 / 0.088235294 / 0.09
(gain share/defend share)
Profit Margin/Financial Return / 4 / 0.117647059 / 0.12
Organizational Readiness / 3 / 0.088235294 / 0.09
(capacity/expertise)
Readiness to Deliver Exceptional Experience / 5 / 0.147058824 / 0.15
Satisfy a Community Need/Benefit / 3 / 0.088235294 / 0.09
Defend Exemption / 2 / 0.058823529 / 0.06
Contribute to Transparency / 1 / 0.029411765 / 0.03
Contribute to Brand / 2 / 0.058823529 / 0.06
Competition (amount/reaction) / 4 / 0.117647059 / 0.12
Level of Capital Required / 3 / 0.088235294 / 0.09
Level of Marketing Investment Required / 4 / 0.117647059 / 0.12
1 / 1.02
Rank the Service Against the Criteria
Ask:
Impact on Market Share/Volumes - will marketing this service decrease, maintain or increase market share?
Profit Margin/Financial Return - is this a loss leader or a money maker?
Organizational Readiness - do you have the capacity and expertise to handle volumes delivered by marketing?
Readiness to Deliver Exceptional Experience - is the environment, processes, training in place to "wow" the patient?
Satisfy a Community Need/Benefit - has this been defined as a need in the community?
Defend Exemption - will emphasizing this service help you when you fill out Form 990?
Contribute to Transparency - can you communicate your quality to affect "buying decision"? Can you quote a price? Can you furnishing needed education so service is understood?
Contribute to Brand - will marketing this have a negative or positive effect on brand?
Competition - what is the competition doing relative to this? If they are strong, your score should be lower. If they are weaker, then higher.
Level of Capital Required - is there an intensive amount of capital needed? If so rank lower? Less capital required rank higher.
Level of Marketing Investment Required - see previous explanation for capital.
Criteria / Impact on Market Share/Volumes / Profit Margin/
Financial Return / Organizational Readiness / Readiness to Deliver Exceptional Experience / Satisfy a Community Need/Benefit / Defend Exemption / Contribute to Transparency / Contribute to Brand / Competition / Level of Capital Required / Level of Marketing Investment Required
Service
Rank from -1 to +5 based on explanation
OB/ GYN / 4 / 3 / -1 / 4 / 3 / 0 / 5 / 4 / 4 / 2 / 2
0.36 / 0.36 / 0.09 / 0.6 / 0.27 / 0 / 0.15 / 0.24 / 0.48 / 0.18 / 0.24 / 2
Oncology / 3 / 3 / 2 / 2 / 3 / 1 / 3 / 3 / 1 / 5 / 4
0.27 / 0.36 / 0.18 / 0.3 / 0.27 / 0.06 / 0.09 / 0.18 / 0.12 / 0.45 / 0.48 / 3
Bariatric / 5 / 5 / 3 / 3 / 0 / 2 / 3 / 2 / 2 / 1 / 0
0.45 / 0.6 / 0.27 / 0.45 / 0 / 0.12 / 0.09 / 0.12 / 0.24 / 0.09 / 0 / 5
Joint Replacement / 3 / 4 / 5 / 5 / 2 / 2 / 4 / 5 / 4 / 4 / 5
0.27 / 0.48 / 0.45 / 0.75 / 0.18 / 0.12 / 0.12 / 0.3 / 0.48 / 0.36 / 0.6 / 1
Cardiology / 2 / 5 / 3 / -1 / 3 / 3 / 2 / 4 / 3 / -1 / 1
0.18 / 0.6 / 0.27 / -0.2 / 0.27 / 0.18 / 0.06 / 0.24 / 0.36 / 0.09 / 0.12 / 6
Wound Care / 2 / 3 / 4 / 2 / 4 / 2 / 1 / 0 / 1 / 3 / 3
0.18 / 0.36 / 0.36 / 0.3 / 0.36 / 0.12 / 0.03 / 0 / 0.12 / 0.27 / 0.36 / 4
Impact on Market Share/Volumes (.09) / Profit Margin/Financial Return (.12) / Organizational Readiness (.09) / Readiness to Deliver Exceptional Experience (.15) / Satisfy a Community Need/Benefit (.09) / Defend Exemption (.06)
Contribute to Transparency (.03) / Contribute to Brand (.06) / Competition (.12) / Level of Capital Required (.09) / Level of Marketing Investment Required (.12)
Apply a Final Ranking by Multiplying the Above by the Weight of
the Criteria
Oncology / 0.27 / 0.36 / 0.18 / 0.3 / 0.27 / 0.06 / 0.09 / 0.18 / 0.12 / 0.45 / 0.48 / 2.76 / 3
Bariatric / 0.45 / 0.6 / 0.27 / 0.45 / 0 / 0.12 / 0.09 / 0.12 / 0.24 / 0.09 / 0 / 2.43 / 5
Joint Replacement / 0.27 / 0.48 / 0.45 / 0.75 / 0.18 / 0.12 / 0.12 / 0.3 / 0.48 / 0.36 / 0.6 / 4.11 / 1
Cardiology / 0.18 / 0.6 / 0.27 / -0.2 / 0.27 / 0.18 / 0.06 / 0.24 / 0.36 / 0.09 / 0.12 / 2.04 / 6
Wound Care / 0.18 / 0.36 / 0.36 / 0.3 / 0.36 / 0.12 / 0.03 / 0 / 0.12 / 0.27 / 0.36 / 2.46 / 4
Establishing Criteria from Which to Measure – add your own, eliminate others or keep as is.
1=least important consideration when marketing a service
5= most important consideration when marketing a service
Impact on Market Share/Volumes
(gain share/defend share)
Profit Margin/Financial Return
Organizational Readiness
(capacity/expertise)
Readiness to Deliver Exceptional Experience
Satisfy a Community Need/Benefit
Defend Exemption
Contribute to Transparency
Contribute to Brand
Competition (amount/reaction)
Level of Capital Required
Level of Marketing Investment Required
Rank the Service Against the Criteria
Ask:
Impact on Market Share/Volumes - will marketing this service decrease, maintain or increase market share?
Profit Margin/Financial Return - is this a loss leader or a money maker?
Organizational Readiness - do you have the capacity and expertise to handle volumes delivered by marketing?
Readiness to Deliver Exceptional Experience - is the environment, processes, training in place to "wow" the patient?
Satisfy a Community Need/Benefit - has this been defined as a need in the community?
Defend Exemption - will emphasizing this service help you when you fill out Form 990?
Contribute to Transparency - can you communicate your quality to affect "buying decision"? Can you quote a price? Can you furnishing needed education so service is understood?
Contribute to Brand - will marketing this have a negative or positive effect on brand?
Competition - what is the competition doing relative to this? If they are strong, your score should be lower. If they are weaker, then higher.
Level of Capital Required - is there an intensive amount of capital needed? If so rank lower? Less capital required rank higher.
Level of Marketing Investment Required - see previous explanation for capital.
If you added other criteria then define the question you would ask as you weigh the service against it.
Volumes / Profit Margin/
Financial Return / Organizational Readiness / Readiness to Deliver Exceptional Experience / Satisfy a Community Need/Benefit / Defend Exemption / Contribute to Transparency / Contribute to Brand / Competition / Level of Capital Required / Level of Marketing Investment Required
Service
Add, subtract or keep service lines based on your situation / Rank from -1 to +5 based on explanation / Apply criteria weight for a final score
OB/GYN
Oncology
Bariatric
Joint Replacement
Cardiology
Wound Care
Impact on Market Share/Volumes ( ) / Profit Margin/Financial Return ( ) / Organizational Readiness ( ) / Readiness to Deliver Exceptional Experience ( ) / Satisfy a Community Need/Benefit ( ) / Defend Exemption ( )
Contribute to Transparency
( ) / Contribute to Brand ( ) / Competition ( ) / Level of Capital Required ( ) / Level of Marketing Investment Required ( )
Add, subtract or keep criteria above and in () put the weight.
List Your Service Lines by Priority
ROI Problem
Your hospital is buildings its first wellness center, a 50,000 square foot fitness center complete with lap and therapy pools, cardiac rehabilitation, indoor track, spa services, cafe etc. It is the only one of its kind in your primary service area. Based on its size, the center will reach capacity at 5,000 members. The target for the first year is 50 percent capacity. Each member generates $900 in incremental value in direct memberships, $250 a year in classes, $100 a year in café services, and $50 a year in merchandise and store purchases. For this example, indirect clinical services fed from this facility will not be considered. These would be indirect returns from our discussion. The hospital wants a 75 percent return on its investment.
- Determine Your Overall Budget for the Project
- What is the baseline from which you start tracking results? (P.S. this is a trick question.)
- You are located in a city of 200,000 people. A survey by Simmons Research Bureau Inc. found that of an adult population of 192,023,000, 22.5 percent exercise at home, 6.2 percent at private clubs, 1.7 percent at YMCA/YWCAs and 7.3 percent at other facilities. 6.2 percent represents a universe of 12,400 people in your community who could be likely candidates for membership. Of course, which 12,400 is it?
What is your overall cost per prospect?
- Here is the fun part. Remember prospects can not all be treated the same. How will you divvy up your budget to devote more resources to hot prospects and hospital loyalists? Here are some examples. Tell me others.
Your hospital database has identified people who have an interest in fitness and exercise.
You have researched the circulation of the top fitness magazines and have determined the number of people in your service area who subscribe. You buy a list.
Fitness centers attract a younger demographic. There is a large population of soccer and stay at home moms in your area.
Divide your audience into five equal segments of 2,480 people. I have randomly assigned an incremental value to each group. The third segment represents the baseline of $1300 that we said would be the typical value of a customer. The first and second tier prospects may bring more value through increased spending beyond the projection. The fourth and fifth segments might drop their membership during the course of the year. The overall value of the converted membership for this example would increase to more than $4 million.
Based on achieving the 75 percent ROI, what would you spend on each segment?
Segment / Membership Desired / Value / Spending per prospectTop 2480 prospects / 50 percent / 1250 members / $1900 / $547
Second 2480 / 25 percent / 625 / $1600
Third 2480 / 15 percent / 375 / $1300
Fourth 2480 / 6 percent / 150 / $1000
Fifth 2480 / 4 percent / 100 / $800
Here is the first answer.
The incremental value of 1250 members at $1900 each = $2,375,000 (1250 x 1900).
To achieve 75% ROI, use the formula previously discussed:
$2,375,000 / 1.75 = $1,357,142
$1,357,000 / 1250 members = $1,085 cost per new member
$1,357,000 spread over 2,480 prospects = $547
- Now it’s time to design your campaign. How will you spend the budget for each segment? Let’s take the most desired segment at $547 per prospect. Let’s look at how you might spend it, the likely return for the strategy and how the overall spend for each strategy gives you a 75% ROI. Let’s take three strategies. What would you spend?
Strategy / Likely Return / Amount to Spend
Direct mail postcard / 1% / $10.85
Direct mail postcard followed by call / 2%
Direct mail with offer for free executive physical and health appraisal / 6%
Here is the first answer.
A 1% conversion of 2,480 people will yield you 24.8 members with a value of $1,900 or a total of $47,120.
The incremental value ($47,120) divided by the ROI threshold (1.75) gives you $26,925.71 to spend to achieve a 75% return.
$26,925.71 / 2,480 prospects = $10.85
Of course you need to build ROI tracking into your strategies, have the databases set up to track and analysts ready to interpret the data.
What this example provides is a more in-depth look at allocating your budget to more effectively spend, target and track your initiatives.
Your Media Mix
1.Harvard and McKinsey say that two thirds of the economy is influenced by word of mouth. One word of mouth is equal to 600 advertising exposures. Consider this. The auto industry has increased its mass media spending by 1,378 percent over the last 20 years. Yet sales went up just 17 percent during that time and by the way those advertising costs added $4,000 to the price of your car! Here’s more. McKinsey says that in six years traditional advertising will be one third as effective as it was in 1990. And the market is so saturated with messages that there has been a 37 percent decrease in the effectiveness of advertising.
2.Makes you want to analyze your media mix perhaps.
3.Let’s see how we compare to one another. Take a look at the media mix below and assign percentages (totaling 100 percent) for how you spend your budget.
Television advertising_____
Print advertising_____
Radio advertising_____
Billboards_____
Direct Mail_____
Web/Interactive_____
Leveraging Crusaders_____
The Value Chain
1.Not every customer/patient/resident experience is valued the same. Let’s look at starting to assign a value to the experience you offer. Score each of the items below. If an attribute is a positive value differentiator, give it a score of one to three, three meaning it has the highest value in differentiating you and increasing value. Likewise if the attribute is negative, score it from a minus one to a minus three. Then add them up.
2.Overall quality ratings from CMS_____
Overall satisfaction ratings_____
Preference data ranking_____
Awareness ranking_____
Magnet status_____
Desired place to work_____
JCAHO Accreditation_____
Other industry standard awards_____
What alternatives do people have?_____
How easy is it to compare your organization to competitors?_____
Price Positioning_____
3.What other attributes would you add?
_____
_____
______
What is your score?_____
Data Collection
1.In today’s healthcare environment, many of the traditional quantitative measurement tools (and some of the qualitative too) are at such a high level that true, meaningful, specific data can not be culled. An awareness in perception or preference does not dig deep to find out the “why” behind it. Only with the “why” can you start to gauge emotions and the triggers from which to plan. That is why we recommend ethnographic research and one on one interviews.
2.When talking to anyone, listen and observe.
- What do people love about the facility? Specifically. Not just that the people are nice. What person? Why specifically? What do they do? What do they say? The key to knowing what people love about you is probing. The more detail, the more information you have to play up your strengths and define your unique selling proposition.
- Obviously the same applies for what they do not like about you. The key here is to find out and then have an answer for the person about what you will do to fix it and when.
- Observe the emotion. If someone dislikes something and says it passively, it is certainly different than if they are jumping up and down about it (sort of like Tom Cruise on Oprah’s couch!). Emotion, eye contact, hand gestures – these all say something about what the person is feeling and reacting.
- What do people value in what you offer?
- Where do you need to improve?
- What has angered them?
- Do they recommend you? In what forum? To whom? What specifically is said?
- Capture testimonials. If you like what I present today, I have asked you to fill out an evaluation and I specifically ask for comments that I can reproduce with permission on my web site. My business is no different than yours. I thrive on referrals and referrals come from word of mouth. Also keep in mind that people will open up more readily to third parties collecting the information. If I go to my car dealer for service and they call me afterward, I may be polite. If the corporate office calls, I may open up a little more. If a third party calls, I will let them know what I really feel!
Data Collection Tactics
- Inventory all of your feedback loops. How robust are they? How quickly can you gather and act on information? Incorporate hard data in your feedback loops. Seniors for example have been socially conditioned to not say anything to your face but will complain privately. They do however, “act with their feet.” Be on the lookout.
- On the web, instead of just having a short form to request information, collect detailed information. Are they the caregiver or the one in need of care? Collect basic health data observing HIPAA regulations. Collect information about their interests and activities. Do they have children, grandchildren? Have them opt into a newsletter. Provide an incentive for them to give you the detailed information. Surveys, test marketing, pop up surveys – all help you to interact with the prospect and collect information.
- Post portraits and emails of the executive staff on the web. It sends a strong message when someone knows they can communicate directly to the top of the organization.
- Observe people interacting with the brand. Often what people believe or think contradicts what they say when asked directly. Some of this happens when research is done in a focus group environment and there are group pressures at work. So at the very least consider in-depth interviews as a data collection method of choice. But then embrace the observation piece. Brave companies are arming consumers with hidden cameras and recording their interaction with the brand. Mystery shoppers are employed by retailers and even hospitals employ shoppers who actually check in for some basic testing.
- If someone transfers out of your facility to another that provides essentially the same services, conduct an extensive exit interview ideally with the patient or a caregiver. A patient liaison could assist.
- Likewise if someone is coming into your facility from another, spend extra time finding out why. These become competitive differentiators for you.
- Conduct executive director listening sessions in the community. Invite a select group of influencers to lunch or dinner and give them an update on what is taking place in your facility.
- Proactively interview liaisons to your facility from other agencies. As an ombudsman for nursing homes, I know there are facilities that distance themselves when you come in and others that embrace what you do and are thankful. If I am a liaison, who would I be buzzing about positively?
- Have regular brainstorming sessions with employees. They are the front line PR ambassadors for your facility and they know what is going on and what people want. Listen to their ideas and pick and support the best ones. This in turn contributes to employee satisfaction and staff retention.
- Use the change of shift strategically. Don’t just compare clinical notes but
experiences as well. - Careful observation can lead to on the spot customer service. Perhaps a son or daughter is visiting mom in CCU. They are having a particularly stressful day and mention some things they were not able to get done that day, say get the car washed or oil changed. Have a concierge get this done with that person’s permission and with the task completed by the time their visit is done. Surprise someone and see what happens.
- Collect information on visitors. Engage them as they come in. Many businesses – hospitals, car dealers, etc. – have adapted their environments to make it conducive for visitors to want to come and stay. For example, business centers are cropping up in these places, cubicles, wireless connections, copiers, faxes. Think of how more likely a caregiver may be to spend time with a loved one knowing they could also get some work done in the process.
- Know the patient’s story before they step in the door. Assign a concierge to that person.
- Take a few minutes now to list other ways to collect data to help sharpen and define customer experiences. Remember the more you collect, the better you can define the experience and when you offer a great experience, people talk about it. That is the strongest marketing you could possibly have.
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What To Do With The Data