Marketing in Transition 12-05-20stackpoleassociates.com/resources/presentations/...Zaltman, G,...

Marketing in Transition

presented by Irving L. Stackpole, RRT, MEd

Financial DisclosureNeither Stackpole & Associates, Inc.

Nor Irving L. Stackpole has been paid anything by any person or organization in connection with this

presentation

Objectives

1. Identify potential scenarios for ACA2. Describe impacts of ACA 3. Describe ACOs most likely connections with

“post-acute” senior care services 4. List ways to assure relevance in the post-ACA

provider networks5. Draft and tactical steps for positioning for

success

Presentation Available

Marketing in Transition

www.StackpoleAssociates.com

1-800-844-9934

Stackpole & Associates, Inc.5

Who Are Our “Customers”

SNFs – demographics/ psychographics

What are their motivations / inhibitions? They “need to buy”

Payors / regulators – demographics / psychographics

Motivations / inhibitions? They “need to buy”


“Consumers”

Who are our consumers? Residents / Patients / Adult Children –demographics / psychographics What are their motivations / inhibitions? They “need to buy” Where are our consumers?

How bad is it??

• Consumers

• Customers

• Context

Challenge - Marketing

Matching Supply & Demand


“There are 7 ways to defeat. The first of these is the failure to count.”

Quiz #1

The aged cohorts are A. IncreasingB. DecreasingC. Some going up, some going downD. Staying about the same



2012Born 1930

82 yoa

2012Born 1935

77 yoa

2012Born 1940

72 yoa


2012Born 1925

87 yoa

2022Born 1935

87 yoa

2017Born 1930

87 yoa

87 yoa @ admission

“Dearth” by demographics

Quiz #2

The congregate senior care centers are

A. IncreasingB. DecreasingC. Some going up, some going downD. Staying about the same


The Supply Side

Nursing home occupancy rates declined from 85.5 percent in 2004 to 82.9 percent in 2010 showing excess capacity.• Long term residency of “young cohorts”

increasing to 14%• Despite the above, SNF patients are older &

sicker• ADL dependency increasing



Occupancy Data

The Supply Side

Of the 1.4 million residents in nursing homes: 64 % Medicaid, 22 % out of pocket / private payers, and 14 % Medicare

• The percent of residents paid for by Medicare has increased by about 16 percent since 2004 with a reduction in the percent paid by Medicaid.


More Supply Side

The number of for-profit nursing homes increased from 65.9 percent of all homes in 2004 to 67 percent in 2009, while the number of non-profit nursing homes and public homes declined slightly.

Nursing home chains were 54 percent of the total homes in 2009, showing a 3 percent increase over 2004.• Increase FPs in CCRCs


Demand for Arthroplasty

209 253 384572450 663

1520

3481

40.8 47.867.6 96.738.3 55.3 121

268

0

500

1000

1500

2000

2500

3000

3500

4000

2000 2005 2010 2015 2020 2025 2030 2035

Num

ber

of p

atie

nts (

x 1,

000)

Year

Primary total hiparthroplasty

Primary total kneearthroplasty

Revision total hiparthroplasty

Revision total kneearthroplasty

19

We are Here

Est. GAIN ~300,000

Joints will “save” us?

Alzheimer’s - Demand for ARD Care

‐

200

400

600

800

1,000

1,200

1,400

1,600

2010 2015 2020 2025 2030

Medicare/Medicaid Costs per year (billions of dollars)

Inflection Point

We are Here

Is the sky falling?

Another issue is the culture… Not only is LTC NOT thought of as the valuable

resource it is … They are seen as prisons – awful places

• The “F” word• “Don’t want to put / place mom in a

nursing home.”• “I’d rather be dead.”

Deep metaphor of negativity


Conclusion

To Quote Randy Newman

“It’s a Jungle Out There”


What is the ACA…

Ten (10) titles Three Principles:

• 1. Insurance Market Reform• 2. Individual Responsibility• 3. Insurance Purchase Subsidies

Title II - Double Medicaid Enrollment• The 25% old = 68% of spend• The 18% dual eligible = 46% of spend


Context

What is an ACO…

http://www.youtube.com/watch?v=lF8bK7AJyL0



Marketing Mindset

The Value Proposition Understanding what the customer /

consumer really wants / needs Is this consistent with what we are

selling? What are the difference between and

“Customers” and “Consumers”?

So what can we do?


Customers

SNFs / ALRs – demographics/ psychographics

What are their motivations / inhibitions? They “need to buy”

• Increase revenue (RUGS)• Reduce risk• Reduce costs• Reduce “unnecessary” hospital readmissions


Consumers

Prospective Residents / Patients / Consumers - demographics/ psychographics

Motivations / inhibitions? They “need to buy”

• The adult children need support• They are not highly willing to pay

Where are they?

Market Conclusions

Market size is declining most places• Losing ~170,000 LTC residents this year• Gaining Arthroplasty – not enough due to LOS

No big increase in the very old cohort until ~2027 Disability rates are There are more options – ALRs, HCBS

• State incentives for non-institutional care (ACA) Age + Acuity (ADLs & IADLs) for consumers


Faster, Better, Smarter

Ways to be fast

• Get upstream• Plan ahead • Technology


How to “Win”?

Ways to be fast

• Get upstream - Customers–Build Awareness

• Offer information / options of VALUE–Purchase decision cycle – Time?


Your Opportunity!


How to “Win”?

Ways to be faster

• Get upstream - Customers–Pull through

• Case Managers• Consumers• Doctors


How to “Win”?

Ways to be faster

• Plan Ahead–Disease burden = Opportunity–Contracting w/ MCOs / DMCs

• Match Strengths w/ Pain• Seek – Younger / Larger / Underserved

• Doctors


How to “Win”?

Ways to be faster

• Technology & • Decision Cycle Management


How to “Win”?

Ways to be better

SNF• Clinical outcomes• Handle transitions• Speak their language• Partner with your pharmacy & rehab providers

Consumers• Testimonials• Affiliations


How to “Win”?

Ways to be smarter

KNOW your Customers RESEARCH

Hospitals to SNF to Hospital• Re-admissions – Dx Categories

– Identify the PAIN

• Clinical outcomes – Value Formula

Stackpole &38

Stackpole &39

Stackpole &40


How to “Win”?

Ways to be smarter

Know your UPSTREAM Customers RESEARCH PAYORS

Managed Care• Dx Categories – Disease Burdens / Cost• Cost / Benefit - ROI• Clinical outcomes – Value Formula

Impact of ACA

Rx for Long Term Care Pharmacies

Marketing Messages• The metaphors are extremely negative• The words are bad – really bad• Images are often worse than the words!• The “F” word



How to “Win”?

Ways to be fast

• Get upstream• Plan ahead • Technology

www. StackpoleAssociates.com

1-800-844-9934

Cheap subliminal suggestion

Call today to see how we can help you!


BibliographyAlbrecht K. and Eke, R. Service America. New York: Warner Books, Inc. 1985

Bruner II, G.C. , James, K.E., and Hansel, P.J. Marketing Scales Handbook: A compilation of multi-item measures, volume iii. Chicago: American Marketing Association. 2001

Chase, R & Dasu, S. Want to perfect your company’s services?: Use behavioral science. Harvard Business Review June, 2001.

Cialdini, R. Influence: The psychology of persuasion. New York: Quill. 1993

Johnson, M & Gustafsson, A. Improving customer satisfaction, loyalty and profit: An integrated measurement and management system. San Francisco: Jossey-Bass. 2000

Reichheld, F The Loyalty Effect: The hidden forces behind growth, profits, and lasting value. Boston: Harvard University Press. 1996


BibliographyHillestad, S & Berkowitz, E. Health Care Marketing Plans: from strategy to action. Gaithersburg: Aspen. 1999

Parasuraman, Zeithaml and Berry. “A conceptual model of service quality and its implications for future research.” Journal of Marketing. 1985 Fall:41-50.

McDonough, JE, Inside National Health Reform. Berkeley University of California Press 2011

Patterson, P. & Spreng, R. “Modeling the relationship between perceived value, satisfaction and repurchase intentions in a business-to-business, services context: an empirical examination.” International Journal of Service Industry Management. Vol. 8 No. 5, 1997: 414-434.


BibliographyStackpole. I. & Ziemba, E. “Make Your Marketing P-P-P-P-Perfect”, Care

Management Matters, April 2008

Stackpole, I. & Ziemba, E. “It’s Not What Your Say – It’s What People Hear!”, Care Management Matters, June, 2008

Zaltman, G, Zaltman, L, Marketing Metaphoria: What deep metaphors reveal about the minds of consumers. Boston, Harvard Business Press 2008

Ziemba, E. “Email Campaigns that Work”. Care Management Matters, April, 2009

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