Planning for a

8/14/2019 Planning for a

1/12


2/12

2 Spectrum | November-December 2013

Brand Strategy(continued from page 1)

you maximize your media buy? Tere isa reason the dasher boards in hockey andthe rotating signs behind home plate arethe highest priced: elevision viewing ishighest for both.

Are you doing this to drive business,brand, or both? It is difficult to deter-mine how much business you garnerfrom sponsorships, and we recommendevaluating ROI on other metrics, likeconsumer perception.

How else could such a partnership help

you?Sports sponsorships can aid yourorganization in community benefit, phi-lanthropy, and recruitment efforts.

Who will negotiate the teams medi-

cal care and advertising contracts?

Tere should be no correlation betweenthe teams medical contract and a spon-sorship. Te decision to select a medi-cal provider should be made, basedon physician experience and qualityoutcomes. he level of sponsorshipshould not factor into this decision.

You need to avoid any perception bythe players or the public, that the teamsmedical care is based on the value of thesponsorship.

Once you have decided that a sports spon-

sorship fits within your business strategy,then you need to decide if you will negotiatedirectly with the team or bring in a sportsmarketing firm to evaluate the opportu-nity and negotiate the contract. If you arein a large sports market and negotiate withmultiple leagues, we recommend bringingin a firm. It is too difficult to stay on topof all the rules regarding marketing assets,sports medicine, and the use of brandingelements, like logos.

Official Medical Providerto the TeamConsider the following points when makingyour assessment of a sports sponsorship. Tegolden nugget in any sports sponsorship isthe ability to use the designation OfficialMedical Partner of the ____________. Ifyou are not, then it is difficult to justifysponsorship dollars when a competitor ismaking the claim. For MedStar Health, thisis the go/no-go decision.

Relationship with Team OwnersTe relationship with the owners of a sportsteam is critical. You want a partner who wilenhance your brandwhich is differenfrom a strictly paid advertising relationshipIf you are a not-for-profit organization, youwant to align with others who have strongcommunity reputations. Sports sponsorship

relate to co-branding; therefore, you musbe selective about your partners.

Professional Versus Local TeamsTe difference between professional sportsand local sports is cost. Most professionaleague sponsorships begin at the six-figurelevel and go up. However, with these sponsorships, there are more media opportunitieand a higher visibility. All things consideredyou are part of a national organization. Onthe other hand, local teams may be your onlyoption. If so, then maximize your invest

ment beyond signage.Additionally, consider the amount of fan

or audience participation as it relates to youlocalmarket. For example, marathons providemany sponsorship opportunities, but popularlarge-scale marathons have high participationfrom out-of-town runners and spectators.

Maximizing the SponsorshipHealthcare organizations can maximizethe sponsorship for a number of purposesphilanthropy, employee engagement, and

community relations. Once you begin tonegotiate a sponsorship, leverage it for yourother business needs by:

Sponsoring free Baseball Basics clin-ics for 500 underserved kids to supporcommunity relations

Promoting player appearances for pa-tients, particularly children

Having access to tickets and suites fodonors or key recruits

Ringing bases with cancer survivors to

highlight breast and prostate cancerawareness

Being part of the NFLs A Crucial Catchcampaign on Monday Night Football foNational Breast Cancer Awareness Month

Offering a bank of tickets to hospital leadership for employee recognition

aking advantage of significant mediarelations opportunities

Society for HealthcareStrategy and MarketDevelopment

PresidentHolli SallsPrincipalSalls Group

Chicago, IL

President-electMark ParringtonVice President, Strategic Transactionsand DevelopmentCatholic Health InitiativesEnglewood, CO

Immediate Past PresidentMaria RoyceSenior Vice President, Planningand Community DevelopmentWellSpan HealthYork, PA

Executive DirectorDiane Weber, RNSociety for Healthcare Strategy andMarket DevelopmentChicago, IL

EditorMary P. CampbellSociety for Healthcare Strategy andMarket DevelopmentChicago, IL

Design and Layout

Spectrumis the bimonthly newsletter of and amembership benefit for members of the Society forHealthcare Strategy and Market Development.SHSMD welcomes unsolicited manuscripts, whichwill be used on a content and space-available basis.Preferred article length is from 1,200 to 1,500words, and graphics (figures, tables, photos) andsuggestions for sidebars are welcome. Please e-mailarticles to [email protected].

The editorial office is located at:155 North Wacker, Suite 400Chicago, IL 60606

Phone: 312-422-3888Fax: 312-278-0883E-mail: [email protected]: www.shsmd.org

Opinions expressed in these articles are those of theauthors and do not necessarily reflect the opinionsof SHSMD or the American Hospital Association.

2013, Society for Healthcare Strategy and MarketDevelopment. Reprinting or copying is prohibitedwithout express consent from SHSMD.


3/12

November-December 2013 | Spectrum 3

Case Study: ProfessionalSports Sponsorshipsand MedStar Health

MedStar Health has a strong sports medicineprogram that has provided team and venuemedical coverage for years. On a professionallevel, MedStar physicians provide medicalcare to the Washington Nationals and theBaltimore Ravens, as well as national sportsassociations, area college sports teams, andhigh school teams. Seminal concussion re-search among high school athletes, conduct-ed by MedStar Health Research Institute,helped ignite the national conversation onconcussions.2Community and media at-tention on this topic helped build MedStar

Healths strong sports medicine reputation,which is partly why so many sports teamsapproach us for sponsorships.

Market research in the Baltimore areaconsistently ranks MedStar as strong inorthopedics and sport medicine. Tis highlevel of awareness is a direct result of ourlongest sports sponsorship/relationship withthe Baltimore Ravens. Trough an exclusiverelationship, MedStars sponsorship includes

television, radio, online, and print advertis-ing, as well as the injury report and high-profile in-stadium signage. Te team hasalso collaborated with us on a concussionprevention program that is part of the NFLsinitiative in our market.

MedStar also has contracts for Ravensmedical care and venue coverage that arekept separately for ethical reasons. Tatsaid, MedStar would not enter into asports-team sponsorship if it did not includethe medical contract.

In 2011, MedStar partnered with theWashington Nationals. MedStar physicianswere already providing medical care for theteam, and we wanted to expand our relation-ship and enhance our reputation in orthope-dics and sports medicine in the DC market.Tis sponsorship focuses heavily on televi-sion-camera-visible signage and digital as-sets because of the 81-home game schedule.MedStar Health now has relationships withtwo professional teams, in two different

sports leagues that cover both our markets,year-round. All aspects of these sponsorshipsare integrated into orthopedic marketinginitiatives throughout the year.

Jean Hitchcock

Vice President, Public Affairs and Marketing

MedStar Health

Columbia, MD

410-772-6557

[email protected]

Marc Bluestein

President

Aquarius Sports and Entertainment

Gaithersburg, MD

240-547-3498

[email protected]. 2013 Sponsorship Outlook: Spending Increase Is Double-edged Sword, IEG Sponsorship Report, January 7, 2013,http://www.sponsorship.com/iegsr/2013/01/07/2013-Sponsorship-Outlook--Spending- Increase-Is-Dou.aspx.

2Andrew E. Lincoln, ScD, et al., Trends in Concussion Incidence inHigh School Sports: A Prospective 11-Year Study, The AmericanJournal of Sports Medicine39 (May 2011): 958963.


4/12


Here are six questions to gauge

your hospitals level of crisis

communication preparedness.

A Crisis CommunicatorsSelf-Assessment

By Patrick Donohue and

Christopher Lukach

We all have that dream. You knowthe one: Youre back in high school, andyou forgot to study for the big test. Youwake up in a sweat with the sensation of adumbbell in the pit of your stomach. It is,thankfully, a fleeting sensation, when yourealize it was only a dream.

Far less fleeting, but not entirely dissimi-lar, is the feeling communicators have when

C O M M U N I C A T I O N

they are unprepared to navigate a crisis.We subscribe to a simple precept: While

a crisis may be unexpected, it should nevercome as a surprise. At St. Mary MedicalCenter in Langhorne, PA, crisis communi-cation has earned priority status among thecommunication and leadership teams. Tesuccess of our crisis communication programexists because of a top-level commitmentto preparedness, regular updating, rigoroustesting, and unrelenting energy.

Moreover, we have high expectations. AtSt. Mary Medical Center, we periodicallyask ourselves six fundamental crisis-pre-paredness questions. Some are tactical, andsome are cultural. Some rest solely with the

communicators; others test the strengthof our multidisciplinary response team.

1. Does your organization have a crisis

communication plan? Tats step oneand its a biggie. A strong scenario-basedcrisis communication plan based on prob-ability and risk is the ultimate, versatilecrisis communication resource. For guidance on constructing a strong, actionablecrisis communication plan, see the sidebaDoes Your Crisis Communication Plan

Make the Grade?2. Do you have reasonable approva

processes that permit you to com

municate quickly?In todays demanding 24/7 media landscape, quicklyis an understatement. Communica-tion must be nearly instantaneous tobe effective. And its the first responseto a crisis that sets the tone. For manymodern crises, living down the first


5/12


statement lasts well beyond the eventsactual resolution. Communicators needto act quickly and without the delay ofa lengthy approval process. Te crisiscommunication plan helps this processby providing pre-approved, pre-vettedstatements that reinforce your values

without speculating. But communi-cators also need a certain amount ofleeway. Tis leads us to the next step.

3. Do you have the authority and con-

fidence to act in a crisis?Earning aseat at the table status is a persistentcultural challenge for hospital andhealth-system communicators. But hav-ing the ear and respect for administrationis a must for a successful program ofcrisis preparedness and response. Teconfidence of your leadership team canbe a challenge to cultivate. You earnyour seat routinely when you provide

Does Your Crisis Communication Plan Make the Grade?A crisis communication plan is an essential tool in thehealthcare communicators toolbox. Unfortunately,not every organization that has a crisis communicationplan has a useful crisis communication manual. Withtodays demanding media and social media landscapes,we do not have the luxury of hours or even minutes toformulate our first response. And as myriad modern criseshave demonstrated, if were not quick to fill the vacuumof information, someone else will do it for us.

First, be clear about what is considered acrisis. A no brainer, right? Not necessarily. For yourplanning purposes, a crisis is any event that has thepotential to negatively impact your reputation or ability tooperate. So while your crisis communication plan needs toconsider the conventional crises, such as natural disasters,terrorism, and on-site acts of violence, it must also includethose lesser crises and issues that carry the potential

for great impact: a mismanaged merger or acquisition;sudden change in leadership; OSHA or regulatoryviolations; poor performance in a quality and safety rating;an inadvertent release of patient-identifiable information,etc. Any of these incidents has the potential to come onsuddenly and to impact the organizations reputation and,therefore, its ability to operate.

Second, make sure your crisis plan hasactionable information.Too many crisiscommunication plans are policy repositories filled withcomplicated processes rather than actionable work

plans. Our crisis communication plan philosophy issimple: if it doesnt offer the necessary information andcommunication framework to respond within 15 minutes,it isnt prepared to do its job. Remove speed bumps bygetting the plans contents pre-approved by legal andadministrative teams.

Third, make sure it is accessible.A well-designedplan is worthless if you cant find it precisely when youneed it. Security and confidentiality are important, but notif they undercut the plans accessibility. Following a recent,innocuous bomb threat to our hospital, our response wasimpacted because the administrative first responderswere not clear about location of the nearest plan. Now,at St. Mary, aside from a hard copy with each memberof the leadership team, we keep multiple hard copiesnear the command center and key locations, and a copywith the hospitals switchboard operators. Modifiable,

interactive, intranet and thumb-drive versions are alsoavailable to the communication team.Fourth, train your crisis response team in using

the plan, then offer periodic refresher trainings.Spotlight the resources within the plan: the roles andresponsibilities of the crisis communication team andhow the plan can be accessed. And, most important,regularly test the contents using complex and difficultscenarios. Bend them. Stretch them. Break them. In theend, your plan will be stronger, and your hospital bestprepared to weather a storm.

counseling on a myriad of issues, demon-strating your clear and reasoned thinkingand your broad understanding of thehealthcare business. Leaders also liketo know that you have tested experienceand have been through some battles.

4.Are your spokespersons trained and

ready?In a crisis, it is ideal to have asingle, primary spokesperson to keepthe messaging consistent. But differentsituations require different backgrounds,skill sets, and levels of authority. At St.Mary Medical Center, we maintain astable of spokespersons comprising ex-ecutives (CEO, COO, CMO, and, ofcourse, the marketing and communica-tions director) and technical experts (di-rector of security, director of quality andpatient safety, CNO, CIO, HR director,foundation director, and vice presidentof mission). Each is trained to focus on

key messages in answering questions,and we provide periodic refresher train-ing. Even those organizational leaders

who may not be spokespersons inthe microphone-and-camera sense aretrained in the fundamentals, ensuringinternal and external messages are con-sistent. We reinforce the process throughpractice.

5. Can you access key systems during an

unusual event?As with many hospitals

and health systems along the Easternseaboard, Superstorm Sandy impactedSt. Mary. While stranded at home with-out power, much of our communicationteam was unable to access our networkand, therefore, put into action our crisiscommunication plan. Ensure your teamhas back-up processes to access the majorcommunication vehicles in the event of a

(Continued on page 10)


6/12


Aligning Strategic Vision to ConsumerEducation and Culture through BrandFind out how one health system

created a common identity that

supported the sum of its many parts.

M A R K E T I N G

By Erinne Kovi Dyer

In todays healthcare environ-ment, there is a great deal of change. Withchange comes confusion, drastic shifts inpriorities, and a general lack of clarity asto how to operate. For some, the unknownleaves them paralyzed. For others, it accel-

erates the pace of change. Yet, regardless ofthe pace, the destination remains unclear.

So what do we still have within our con-trol? Te answer is our fundamentals, ourcore values, our operational models, and ourpeople. With these elements, we can createour future and define what it is we want ourconsumers to understand about who we areand the value that we provide.

Carolinas HealthCare SystemAt Carolinas HealthCare System, we have

a unique story to share.As one of the largest public, not-for-profitintegrated healthcare delivery systems in thecountry, we are working every day to connectand transform care delivery in the Southeast.Our overarching goal is to provide seamlessaccess to coordinated, high quality health-careand to provide that care closer towhere patients live.

With 41 hospitals and 900-plus care lo-cations in the Carolinas and Georgia, thedepth and breadth of services we provideresult in a full continuum of integrated care.

It includes prevention and wellness, primarycare at more than 180 locations, specialty carevia several nationally recognized service lines,and one of the largest virtual programs in thenation. With more than 50 disease-specificcertifications from Te Joint Commission,we have one of the highest certification totalsin the country among comparable systems.

As a system, we have more than 7,800licensed beds, and in 2012 had more than

10.5 million patient encounters. We havemore than 3,000 system-employed physi-cians, 14,000 nurses, and 60,000 employees.In 2012, we had more than $8 billioninannual revenue and generated $1.25 billionin community benefit.

Despite our depth, breadth, and clinicalexcellence, Carolinas HealthCare Systemhas remained one of the best kept secrets inhealthcare. Consequently, our senior leadershave made a strong commitment to bettereducate consumers as to who we are and

how we can provide value to them.o do this, we needed first to re-evaluate

our corporate vision. At the same time, weknew that the organization needed a strongersense of common identity, one that wouldhave unifying power and enable us to movemore quickly from good to great.

A New DayWe embarked on a journey and emergedwith a new strategic vision: o be recog-nized nationally as a leader in the transfor-

mation of healthcare delivery and chosen forthe quality and value of services we provide.We have taken this vision to heart and

have committed to achieve it through thedevelopment of a single unified enterprise.In every area of our business, we have fo-cused on developing enduring relationshipswith patients, based on superior personalizedservice and high quality outcomesat everylocation, with every encounter, every time.

Seth Godin, author and entrepreneur,defines brand as the set of expectations,memories, stories and relationships that,

taken together, account for a consumersdecision to choose one product or serviceover another. In other words, brand =culture + experience.

Te culture of an organization and theexperiences of its employees and patientsdrive and define the brand.

Tere are several successful healthcaresystems that have seen opportunity in uni-fying under one brand and one name as

they restructured their business model toenhance customer value. Cleveland ClinicMayo Clinic, and Dignity Health are just afew of these. Te successes of these brandlies in their ability to transcend the partof their organizations and build a unifiedbelief or impression of their system amongeveryone it touches.

Carolinas HealthCare System is no dif-ferent. Like many systems that have grownup over the past 30 years, we have been builon a foundation of growth and integration

both in the acute and ambulatory spacesAlthough this growth lends itself naturallyto better coordination and integration, wehad not focused enough on understandinghow complex this house of brands ap-peared to our patients and communitiesespecially in a time of extreme industrychange and public confusion.

So we started with a new vision and beganour brand journey.

Figure 1: Brand Manifesto


7/12


Defining the Brand:Getting to OneTere were several key differentiators that

we knew we could take advantage of tomeet our new vision. However, our mostdistinctive feature is our comprehensivenessand connectedness across a dense geogra-phy.Trough a network of 900-plus care

locations in three states, we knew we couldprovide access at every point of care acrossthe continuum, with the highest level ofquality, in a unique way.

Our Corporate Communications, Mar-keting and Outreach department was tasked

of confusion about who we were and whatdefined us and our value to our patients andthe greater community.

What we uncovered was the widespreadperception that Carolinas HealthCare Systemwas everything but unified. We were seen asan amalgamation of many individual parts,many showcased with individual identities

that had little connection to the master brand.o become a nationally-recognized

healthcare system, we had to (re)definewhat integrated care at Carolinas Health-Care System looked like.

Becoming OneWe created and evaluat-ed several concepts, andfor the final campaigntheme to introduceour master re-brand,we chose One.

o initiate thecampaign design, wehad to create a unify-ing and conceptualmanifesto that helpeddefine and positionus as an integrated,connected organiza-tion working to im-prove the care of everypatient (Figure 1).

We focused on four

core principles: one sys-tem, one team, one belief, and one mission.One. Built for everyone, From the

knowledge of many, o bring health to all.We then built a multi-channel strategy

to share this identity.

Measuring the BrandTe overall plan will roll out in many phases,and at this point we have only just begun.Nonetheless, through a strong initial launchin outdoor, broadcast, radio, and collateralmedia, we have laid a strong foundation.

o measure success, we were initially in-terested in awareness as a key indicator.And while awareness is important, we real-ized that in todays competitive healthcarelandscape, awareness alone is not enough.

We knew we had to measure a deeper un-derstanding of brand attributes.

aking a more innovative approach, weanalyze our brand health in identifiedgeographies and measure additional items,

such as an understanding of connected-ness and level of trust and belief in ourability to provide higher quality.

Only six months in, we have seen in-cremental lifts in both un-aided and aidedbrand awareness, as well as some key brandhealth attributes.

Internally, adoption has been nothing

short of amazing. Te message of Onehas clearly resonated through language,executive adoption of the concept, and itsreiteration through all internal communica-tions channels (Figure 2).

Next StepsWhile we have been pleased with the ini-tial launch of the campaign, we have yetto fully transition our enterprise assets tothe brand name, color, and signage require-ments. Healthcare is a complex industry,and there are many legal and regulatory

requirements that directly impact thebrand and its success.

For example, many of our facilities are notcurrently licensed under our formal name,and this affects our transition to uniformsignage throughout the system. So while

we would like to use the brand name, weare unable to do so until we formally re-fileunder the new name.

o summarize, the master re-brandingand campaign launch provided an oppor-tunity for a fresh startan opportunity

to (re)define how our system provides careand to embed a new and important mindsetinto the corporate culture.

Te campaign has also allowed us theopportunity to educate consumers and ourown employees regarding complex conceptsin healthcare, particularly during a time ofrapid and profound change in our industry.And we are far from done. Over the next 18months, we are going to continue refiningour messages, focusing on what we do dif-ferently as a system, and earning the trust ofour consumers, patients, and communities.

Our future depends on it.

Erinne Kovi Dyer

Corporate Vice President

Corporate Communications,

Marketing & Outreach

Carolinas HealthCare System

Charlotte, NC

704-631-0951

[email protected]

Figure 2: Internal Portal Screenshot

with helping to re-define the culture of theorganization through a master re-brandingeffort and an accompanying campaignrollout. We had to get to know the orga-nization, and fast.

ogether with our agency of record,Campbell Ewald, we embarked on a commu-nications evaluation, while gaining buy-inand support from key internal stakeholders.We performed interviews with more than 90leaders throughout the system, administra-tive and clinical, to ensure we understood

the full scope of the organizations culture.Tere was one major surprisethe many

sharedbeliefs about the state of the systemand its goals. So unity of vision was actu-ally the easy part.

We then had to understand how theexternal world understood and perceivedCarolinas HealthCare System. Tis wasthe hard part, but findings validated ouroriginal suspicion: Tere was a great deal


8/12


S T R A T E G Y

By Monica L. Carbajal

and Daniel B. Walter

The Affordable Care Act,accountable care organizations (ACOs),bundled payments, population healthmanagement, and all of the other majorhealthcare initiatives currently underway areclearly changing the way organizations pro-vide service. While many health systems areevaluating their I systems, clinical servicelines, and physician alignment strategies, onecritical component that is often over-lookedis the post-acute care continuum. Unfortu-

nately, this may be a costly mistake. Althoughpost-acute care is not as high profile as manyother service offerings, the fact remains thateffective post-acute programs will be neededmore than ever to manage the highest acu-ity patients in any of the emerging shared-risk financial models.

What Is Post-acute Care?By definition, post-acute programs are thosethat patients may need to access followingtheir discharge from acute care. Tese areusually patients that no longer meet con-tinuing stay criteria for acute care, but whoare either not stable enough to return homeor have ongoing clinical needs that are toogreat to be managed on an outpatient basis.Historically, Medicare has defined post-acutecare as skilled nursing care (SNF), inpatientacute rehabilitation, long-term acute care(LCH), and home health care. (Medicaredoes not include hospice in its traditionaldefinition of post-acute care; however, many

Creating a WinningPost-acute Care

Continuum for the FutureMemorial Hermann Health System

demonstrates that creating the most

effective post-acute continuum

requires a thoughtful process

that is no different than creating

an integrated service line for any

clinical service.

in the industry do include hospice in thisdefinition because of the close link betweenhome health and hospice.)

Although post-acute programs admitmany patient types, because older popula-tions tend to recover more slowly and havemore chronic conditions than youngerpopulations, the most frequent users of allpost-acute programs include Medicare andMedicare Advantage patients. In fact, Medi-

care and Medicare Advantage patient popula-tions generally represent 60 to 65 percent ofall post-acute admissions. Te second largestgroup tends to be the high acuity (and highrisk) catastrophic patients and/or patientswith multiple systems failures. Tese patientpopulations generally incur long acute carelengths of stay and have multiple clinicalor functional needs upon discharge thatprevent them from achieving their desiredlevel of independence.

Market Size

Many health systems consider post-acutecare programs to be one off, since they aretypically small compared to the marqueeservice lines of cardiology, orthopedics, oroncology. In fact, far more patients need toaccess post-acute programs than most healthsystem executives realize. Figure 1 shows thatabout 40 percent of all Medicare acute caredischarges will need to access some level ofpost-acute care upon discharge. Additionally,best practice referral patterns among thoseproviders that have most effectively inte-grated their acute care and post-acute carecontinuums suggest that up to 50 percent ofall Medicare acute care dischargeswill requirepost-acute care! Tis, of course, is in additionto patients from all other payer sources thatmay also require post-acute care.

While the data in Figure 1 estimate thedemand for post-acute care under currentfee-for-service (FFS) models, recent analy-ses of several local markets with high pen-etrations of Medicare Advantage programs

suggest that, as providers assume more financial risk for patients, the utilization of postacute programs will remain at approximatelthe same levels as the current national dataIn these markets, while the use of higher cosservices, such as long-term care and acutrehabilitation are less than current FFS usrates in Figure 1, the utilization of lower cosservices (home care in particular) are substantively higher. Te total use of post-acute carin these markets is between 40 to 50 percenof all Medicare Advantage discharges, indicating that the demand for these programs wiremain high, even as reimbursement modelshift and providers assume greater risk.

The Burning Platformfor Post-acute CareMany health systems are beginning to evaluate their post-acute continuum today foseveral reasons. First, as previously discussed

the demand for post-acute care is high, and iis expected to remain high as the healthcarlandscape evolves. Second, with an episode ocare that extends 3090 or more days beyonthe acute care stay, health systems are ablto measurably improve patient clinical anfunctional outcomes over a longer period otime with post-acute services. Finally, theris recognition that as health systems assummore financial risk for clinical performancover a longer period of time, owning or having some control over these programs wilbe critical to the success of the organiza

tion. Figure 2 provides a summary of thmost recent Medicare operating margins foeach level of care.

Pulling It TogetherCreating the most effective post-acute continuum requires a thoughtful process thais no different than creating an integrateservice line for any clinical service. It requirethe input and support of the medical staffthe executive leadership, case managementfinancial services, and multiple clinical anancillary services. Te key steps in this process should include the following.

Market assessment. Since most postacute patients originate from the acutcare setting, it is important to know howmany patients from the target healthsystem require post-acute care today and

what the demand is by diagnosis. Additionally, providers must understand howthis demand will shift under shared-ris


9/12


Discharge All Best Practices2

Disposition Medicare1 Low High

Inpatient Rehab 3.2% 4.0% 6.0%

SNF 17.3% 12.0% 15.0%

HHA 16.0% 22.0% 24.0%

LTCH 1.0% 1.5% 2.0%

Hospice 2.1% 2.5% 3.0%

Total 39.6% 42.0% 50.0%

Level of Care Payment Basis Est. Margin

Inpatient Rehab CMG Per Discharge

8.0%

SNF RUG Payment Per Diem

14.6%2

HHA HHRG 60-day Episode 13.7%

LTCH LTCH-DRG Per Discharge

4.8%

Hospice Per Diem 5.1%

1MedPAC June 2008 Annual Date Book.2Walter Consulting.

1MedPAC March 2013 Report to Congress.2Freestanding SNFs only; does not include HB-SNFs.

financial models, including populationhealth management models.

Quality evaluation.A comprehensiveassessment should consider the abilityto improve the quality of patient care by

implementing a plan of care that includesa potential referral to post-acute services.Te impact on quality should then bemeasured through lower readmissionrates, improved clinical and functionalstatus, higher discharge rates to the com-munity, and other similar benchmarks.

Financial analysis.Te financial analysisshould assess both short-term and long-term financial impacts to the system. Pro-viders should understand the economicbenefit of establishing or growing certain

programs today, including the impact ofreduced acute care length-of-stay. Providersshould also assess the opportunity cost ofnot having these programs in the future,including increased utilization of acute careservices if post-acute care is not available.

Build or buy.While the bias for many sys-tems is to own their post-acute programs,for many systems, the best solution may beto partner with existing community pro-viders. Te correct approach will dependupon the critical mass of patients needing

these services, the anticipated financialreturn, the capital cost required, potentialCertificate-of-Need (CON) limitations,and other important factors.

Organizational structure. oo manyorganizations have failed in their imple-mentation due to less than effective orga-nizational structures. Although all partiesmay want the same outcome, without ac-countabilities for medical staff, post-acute

program managers, acute care case man-agers, and other staff, the risk of failurebecomes far too great.

Creating the Foundation

for SuccessMemorial Hermann Health System (MHHS)is a large 12-hospital system in Houston, ex-as, that discharges approximately 125,000patients annually. In addition to its acutecare services, MHHS includes two acuterehabilitation hospitals, four hospital-basedrehabilitation units, skilled care, and homehealth and hospice services.

In 2011, the leadership of MHHS decidedto complete a post-acute strategic plan, toensure that the organization was best posi-tioned for the new healthcare landscape for

all of its programs and services. Te key goalsof the process were to:

Ensure through-put efficiencies for bothacute care and post-acute care

Ensure patient placement in the most ap-propriate level of post-acute care

Capture all potential referrals availableunder current systems

Minimize outmigration

Understand network adequacy for theseprograms

Te planning team included representa-tives from senior leadership, planning, fi-nance, case management, medical staff, andeach of the post-acute programs. During theplanning process, the team recognized thatwhile today, under FFS reimbursement, thehealth system assumed little financial riskif patients did not stay within the system,or went to a post-acute program that might

be more intense than actually needed, thesepractice patterns would need to change asMHHS assumed greater financial risk underACOs and other risk-sharing models.

As a result of this planning effort ,

MHHS changed its organization structureto ensure appropriate accountabilities forprogram development, referral manage-ment, clinical outcomes, and financialperformance. Metrics have been establishedto monitor actual performance comparedto the plan, with reviews conducted on aquarterly basis. While the health systemenvisions even tighter integration in the fu-ture, the foundation has been put in place tostrengthen the post-acute continuum as theenvironment continues to change.

Like MHHS, many health systems are

seeing a need to re-think their post-acuteservice offerings. While many systems willfind significant opportunities in todays en-vironment, the real opportunity is puttinginto place a post-acute continuum that canbest serve the health system and its affiliatesunder any and all of the shared-risk finan-cial models that will dominate the futurehealthcare landscape.

Monica L. Carbajal

Director Strategic Planning

Memorial Hermann Health System

Houston, TX

713-242-4791

[email protected]

Daniel B. Walter

Senior Principal

Walter Consulting

Atlanta, GA

404-636-9700

[email protected]

Figure 1:Medicare NationalPost-acute Utilization Rates

Figure 2:Estimated FY 2012 MedicarePost-acute Operating Margins1


10/12


SHSMD DatebookJanuary 2014:Futurescan 2014released

October 1215, 2014:Connections2014, SHSMDs Annual EducationalConference and Exhibits, San Diego, CA

For more information on these and otherprofessional development opportunities,go to www.shsmd.org.

The SHSMDAdvantageContinuing its commitment toproviding members with practical,timely resources, SHSMD has justreleased the 2014Calendar of HealthObservances &Recognition Days.The easy-to-navigate onlinecalendarbackin PDF formatgives you quick,convenient accessto the dates anddescriptions ofmore than 250health-relatedobservances.Its perfect forplanning 2014health fairs,community

outreachprograms,and employeerecognition events.Member login is allthats required toaccess this greatbenefit of yourSHSMD membership. 2014 will be here before you know it, so visitwww.shsmd.org/calendar, and start planning today.

severe incident. Tis could mean any-thing from home generators, to mobiletethering software (to access the Internetfrom your mobile device), to a simple

list of local libraries with internet access.Or, designate a representative to staffthe hospital command center, wheregenerator access to power should beuninterrupted. And, as if we needed it,heres another way social media changesthe game your hospitals Facebookand witter presence may be all you areable to access with limited power andmobile access. Use them.

6. Do you have the plans and policies to

monitor and respond to social media?

St. Mary and Anne Klein Communica-

tions Group developed a proprietary and

focused Social Media Crisis Communi-cation Plan to complement the hospitals

broader crisis plan. Beyond assigningteam responsibilities, the plan takes the

guesswork out of social media activity,assigning an if-this-then-this workflowstrategy to evaluate influence and risk.

If you answered yes to these questions,

you are ready. (Be sure you update your cri-

sis preparedness plan at least yearly.) If youare in doubt regarding the answers to these

questions, its time to take a hard look at

your crisis preparedness strategy. And if you

answered, no, then its time to have

a heart-to-heart talk with your CEO.

Patrick Donohue

Marketing & Communications Director

St. Mary Medical Center

Langhorne, PA

215-710-6908

[email protected]

Christopher Lukach,APR

Senior Vice President and COO

Anne Klein Communications

Group, LLC

Mount Laurel, NJ

856-866-0411 ext. 15

[email protected]

A Crisis CommunicatorsSelf-Assessment(continued from page 5)


11/12


By Rick Wade

Wade, that isab-solutely the goofiestthing I have ever read.If youre going to writethese so-called casestudies, at least comeup with stuff slightly in

the realm of reality!Te voice on the phone was an old

friend, a senior executive in marketing andcommunications for a major health systemwith a renowned academic medical centeras its flagship. She was calling about one of

the early ightrope Walker columns astory about a pile-up of conflicts of interestin a mid-size, Midwestern medical center.

But its a true story, I shot back beforeshe could continue. I masked the namesand some details that might give the hos-pital away, but it actually happened.

No? Yes!Te following month I got a call from

the CEO of a rural hospital who accusedme of having a mole inside his organiza-tion. It seems that a scenario about physi-cian recruitment gone awry mirrored a mess

he had to clean up several months earlier.Te majority of ightrope Walkercol-

umns over the past four years were rootedin events that I encountered during my18 years as AHAs senior communicationsofficer. I was often directly involved as acounselor to the hospitals and healthsystems as they dealt with stickysituations in communications,patient privacy, communitytrust, mergers and acquisitions,screwy marketing, mis-leading advertisingand, well, youname it. Someother column

Stranger than Fiction

T H E T I G H T R O P E W A L K E R

to everyone who sees itabout the com-passion, mission, and ethic of the peopleand place behind it.

Job Oneearning and keeping thepublics trust and confidence is paramount.

Troughout the years I have watchedmany hospital and health systems pro-fessionals in communications, marketing,strategic planning, and similar disciplinesbe the leaders in ensuring their organiza-tions did the right thing when confront-ed with tough ethical and managementdecisions. Yes, they are part of the team,but their jobs compel them to probe, un-derstand, and respect the hospitals singularrole in the lives, hearts, and minds of itscommunity in a way that others may not.Tey spoke as the conscience of the institu-

tion and a steward of its reputation. Teymade the difference.

Te pace and depth of change in health-care today is breathtaking. I suspect the fu-ture will bring clinical and corporate moraland ethical issues that will make some ofthe things Ive written about seem simple.

You can be on the tightrope if youwant to be, influencing the future ofone of your communitys most impor-tant cornerstonesand ensuring thatit keeps the promise symbolized by theblue and white H.

Stay on the tightrope and thank you.

Editors note: On behalf of SHSMD, Ithank Rick Wade for the wisdom, insight,and wit that he has shared with Spectrumreaders over the last four years. Beginningwith the January/February issue, Spectrumwill feature select Q&As from the Societysonline communities. Mary P. Campbell

cases came from professionals in the fieldwho shared their experiences and the pain-ful choices that often came with them.

Spectrumwill be changing over the nextseveral months with new content and ap-proaches to the issues and challenges youface. Its new editor, Mary Campbell, andI have agreed to retire the column. Goodpublications are like citiesthey are notmeant to stay the same. Tey change andrebuild with the times.

While I enjoyed writing the column, thereal pleasure was the learning I gained fromyour responses, both directly and in thepoll that accompanied each scenario. Tere

never was unanimous agreement amongthe choices offered and respondents oftenchecked the other box, indicating thatanother solution was possible even if theycouldnt quite articulate it.

AHA President Emeritus Dick David-son often reminded staff and members thatevery failure of our society eventually endsup at the hospital door and every humantrait, both good and bad, can be foundinside. Hospitals are the places that re-ceive and care for the victims of poverty,violence, substance abuse, and crime. Tey

deal with our inability to care for our mostvulnerable people, lack of basic health ser-vices in the community, and the illnessesand injuries that come with life itself.

Hospitals also are where a communitysmost skilled and compassion-ate women and men work long

hours under emotionally andphysically stressful conditions.

Everything they do has an impacton the lives around them. And every

hospital is a powerful economic and cul-tural influence on the area it serves. It

generates jobs and supports dozensof businesses. What it says andhow it behaves can make peopledeeply proud or ashamed.

Te blue and white Hsign along Americas

highways and streetsholds out a host

of promises


12/12

Introducing Your 2014SHSMD Board of DirectorsThe SHSMD Board of Directors is responsible for defining the Societys visionand strategic direction. Te 17 volunteer-leaders pictured on this page donate countleshours guiding the development of policies, programs, and services to make the SHSMDmember experience the best it can be.

Leading the Board as president in 2014 will be Mark Parrington, vice president ostrategic transactions and development, Catholic Health Initiatives, Denver. Servingas 2014 president-elect is Christine Gallery,vice president of planning and markedevelopment at Emerson Hospital in Concord, MA. She leads the strategic planningand business development efforts of the organization, the physician recruitment and relations program, and the community benefits initiatives, including the Emerson HospitaHealthy Living Program. In 2012, the New England Society for Healthcare Strategynamed her Healthcare Strategist of the Year. A member of SHSMD since 2006, Galleryhas served on the Board of Directors since 2007.

Continuing Board members include:

Ben Dillon,(reelection)vice president andeHealth evangelist,Geonetric, Cedar Rapids,IA

Rose M. Glenn,APR,senior vice president,

Henry Ford HealthSystem, Detroit, MI

Ryan S. Gish,senior vicepresident, Kaufman Hall,Skokie, IL

Holly Sullivan,seniorvice president, HammesCompany, Grand Rapids,MI

SHSMD

Holli Salls,principal,SALLSGROUP, Chicago;SHSMD immediate pastpresident

Kriss Barlow,principal,Barlow/McCarthy,Hudson, WI

Nadine Bendycki,

director of marketresearch and decisionsupport, UniversityHospitals, Cleveland, OH

Jeffrey Kraut,seniorvice president strategicplanning, North Shore-LIJ Health System,Manhasset, NY

Carol Koenecke-Grant,chief strategy officer,Childrens Hospitals andClinics of Minnesota,Minneapolis, MN

Susanna Krentz,president, KrentzConsulting LLC, Chicago

Larry Margolis,managing partner,SPM Marketing &Communications,LaGrange, IL

Terri McNorton,assistant vice president,marketing, OchsnerHealth System, BatonRouge, LA

Ruth Padilla, principal,

Healthcare StrategyPartners, Inc., Nashville,TN

Burl Stamp,principal,PYA/Stamp, St. Louis, MO

Donna Teach,chief marketing andcommunication officer,Nationwide ChildrensHospital, Columbus, OH

The four Board

members below were

elected in September to

three-year terms beginning

January 1, 2014:

Mark Parrington, vicepresident of strategictransactions and

development, CatholicHealth Initiatives, Denver

Christine Gallery,vicepresident of planningand market development,Emerson Hospital,Concord, MA

President

President-elect

Planning for a

Documents