MARKETING & INSURANCE Strategic Management in Healthcare 24 MARCH 2009

MARKETING ESSENTIAL TO IMPLEMENTING STRATEGY AND FULFILLING MISSION

MARKETING “MARKETING IS AN INTEGRAL PART OF STRATEGIC PLANNING” DO YOU AGREE?

CENTRAL CONCEPT OF MARKETING VOLUNTARY EXCHANGE OF SOMETHING OF VALUE - CONSIDERATION DETERMINE WANTS, NEEDS, EXPECTATIONS, DEMANDS DELIVER GOODS OR SERVICES

ELEMENTS OF MARKETING PRODUCTSERVICE PRICECONSIDERATION PLACEACCESS PROMOTIONPROMOTION

TARGET MARKET PHYSICIANS PATIENTS INSURERS EMPLOYERS GOVERNMENT CHARITY GROUPS

EPIDEMIOLOGIC PLANNING MODEL DEMAND = POPULATION x INCIDENCE x USE x MARKET SHARE INCIDENCE –NUMBER OF NEW CASE OVER A PERIOD OF TIME PREVALENCE –NUMBER OF CURENT CASES AT A POINT IN TIME

SOCIAL MARKETING USE THE TOOLS OF MARKETING TO INFLUENCE VOLUNTARY BEHAVIOR FOR SOCIAL BENEFIT INSTEAD OF PROFIT HEALTH CARE ORGANIZATIONS? GOVERNMENTS & CHARITIES?

PAYORS FEDERAL GOVERNMENT STATE GOVERNMENT EMPLOYERS CHARITIES INDIVIDUALS

INSURANCE ARE THEY PAYORS? SINGLE PARTY PAYOR NATIONAL HEALTH

INSURANCE IS A CONTRACT PARTIES TO THE CONTRACT –THE PATIENT AND THE INSURANCE COMPANY HOW IS THE DOCTOR INVOLVED? HOW IS THE EMPLOYER INVOLVED?

INDEMNIFICATION INSURANCE WHAT MOST OF US THINK OF AS INSURANCE YOU HAVE A LOSS - THE INSURANCE COMPANY FIXES IT OR PAYS FOR IT

SELF INSURANCE GENERALLY INVOLVES THIRD PARTY ADMINISTRATORS LOOKS JUST LIKE INSURANCE USUALLY INCLUDES SOME TYPE OF CATASTROPHIC REINSURANCE

DIRECT CONTRACTING TAKES OUT THE INSURANCE COMPANY SAVES MONEY CREATES ISSUES FOR FOLLOW-UP

GOVERNMENT MANDATES PREGNANCY SCREENING PROGRAMS DIALYSIS

MANAGED CARE ORGANIZATIONS INTEGRATION OF FINANCING AND SERVICE DELIVERY INSURANCE COMPANIES WITH CAPTIVE PROVIDERS USE SOME SYSTEM OF GATEKEEPING

TYPES OF MCO HMO - HEALTH MAINTENANCE ORGANIZATIONS PPO - PREFERRED PROVIDER ORGANIZATIONS POS - POINT OF SERVICE PLANS

COST CONTAINMENT THE PURPOSE OF MANAGED CARE HAS IT WORKED? ACCESS TO CARE CONTROL OF PHYSICIANS PREVENTION

MEDICARE SINGLE PARTY PAYOR VERY EFFICIENT AND EFFECTIVE

MEDICARE COST CONTAINMENT DRGs PAY FOR QUALITY INCREASING NUMBER OF LIVES INCREASING SERVICES

NATIONAL HEALTH DO YOU WANT HEALTH CARE THAT RUNS LIKE THE POSTOFFICE? Takes a note from my hand in New York on Monday and puts it in my sister’s hand in California on Wednesday for 42 cents.

CASE STUDY # 3 GEORGE – pharmacist in rural Alabama for 40 years – lunch counter & sundries Mrs Murden – expensive arthritis medicine Options –Stay with her pharmacy –Local drug discount card –$4 plan at Wal-Mart or Walgreens –Mail-order