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MARKETING & INSURANCE Strategic Management in Healthcare 24 MARCH 2009
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MARKETING ESSENTIAL TO IMPLEMENTING STRATEGY AND FULFILLING MISSION
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MARKETING “MARKETING IS AN INTEGRAL PART OF STRATEGIC PLANNING” DO YOU AGREE?
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CENTRAL CONCEPT OF MARKETING VOLUNTARY EXCHANGE OF SOMETHING OF VALUE - CONSIDERATION DETERMINE WANTS, NEEDS, EXPECTATIONS, DEMANDS DELIVER GOODS OR SERVICES
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ELEMENTS OF MARKETING PRODUCTSERVICE PRICECONSIDERATION PLACEACCESS PROMOTIONPROMOTION
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TARGET MARKET PHYSICIANS PATIENTS INSURERS EMPLOYERS GOVERNMENT CHARITY GROUPS
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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
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SOCIAL MARKETING USE THE TOOLS OF MARKETING TO INFLUENCE VOLUNTARY BEHAVIOR FOR SOCIAL BENEFIT INSTEAD OF PROFIT HEALTH CARE ORGANIZATIONS? GOVERNMENTS & CHARITIES?
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PAYORS FEDERAL GOVERNMENT STATE GOVERNMENT EMPLOYERS CHARITIES INDIVIDUALS
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INSURANCE ARE THEY PAYORS? SINGLE PARTY PAYOR NATIONAL HEALTH
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INSURANCE IS A CONTRACT PARTIES TO THE CONTRACT –THE PATIENT AND THE INSURANCE COMPANY HOW IS THE DOCTOR INVOLVED? HOW IS THE EMPLOYER INVOLVED?
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INDEMNIFICATION INSURANCE WHAT MOST OF US THINK OF AS INSURANCE YOU HAVE A LOSS - THE INSURANCE COMPANY FIXES IT OR PAYS FOR IT
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SELF INSURANCE GENERALLY INVOLVES THIRD PARTY ADMINISTRATORS LOOKS JUST LIKE INSURANCE USUALLY INCLUDES SOME TYPE OF CATASTROPHIC REINSURANCE
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DIRECT CONTRACTING TAKES OUT THE INSURANCE COMPANY SAVES MONEY CREATES ISSUES FOR FOLLOW-UP
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GOVERNMENT MANDATES PREGNANCY SCREENING PROGRAMS DIALYSIS
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MANAGED CARE ORGANIZATIONS INTEGRATION OF FINANCING AND SERVICE DELIVERY INSURANCE COMPANIES WITH CAPTIVE PROVIDERS USE SOME SYSTEM OF GATEKEEPING
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TYPES OF MCO HMO - HEALTH MAINTENANCE ORGANIZATIONS PPO - PREFERRED PROVIDER ORGANIZATIONS POS - POINT OF SERVICE PLANS
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COST CONTAINMENT THE PURPOSE OF MANAGED CARE HAS IT WORKED? ACCESS TO CARE CONTROL OF PHYSICIANS PREVENTION
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MEDICARE SINGLE PARTY PAYOR VERY EFFICIENT AND EFFECTIVE
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MEDICARE COST CONTAINMENT DRGs PAY FOR QUALITY INCREASING NUMBER OF LIVES INCREASING SERVICES
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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.
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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
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