Caritas Carney Hospital in Boston continues to lose money and its owner, the Archdiocese of Boston, can't keep injecting cash to keep it afloat. Management is considering shuttering, selling, or drastically changing the hospital--and a decision is expected by the end of 2007.
Concerned that rising costs could jeopardize Massachusetts' landmark health insurance initiative, a state panel has voted to press insurers to hold premium increases to 5 percent next year for unsubsidized plans. The panel is proposing several ways insurers can hold down prices, including steering patients to doctors and hospitals that provide lower-cost, high-quality care.
A new advertising campaign seeks to promote a heart stent, the Cypher, to doctors and patients. The campaign has stirred criticism among doctors who oppose direct-to-consumer advertising of drugs and devices, and especially among doctors who contend that stents are being implanted too often in patients who might do better with other treatments.
Insurers UnitedHealth and Humana are betting heavily on the federal Medicare program. In the Medicare sign-up period now under way, Humana hopes to add at least 200,000 Medicare Advantage enrollees, while UnitedHealth already has 1.3 million Medicare Advantage customers and is pushing for more.
According to a study, antibiotics and nasal steroids work no better than a placebo in combating sinus infections. An editorial accompanying the article noted that sinus problems account for 25 million doctor's office visits in the United States each year.
No matter how many different ways I ask the question, I can never get a straight answer: Are hospital and health system marketing departments playing a more strategic role in operations and helping to make business decisions? For example, are they getting involved with the development of service lines, or simply being asked to create an ad campaign for the line prior to launch? Do they have a role in keeping the internal customer happy, of turning the work force into an army of brand champions, or are employee relations solely a role for HR? Are they gathering market intelligence and reporting back to the COO or CEO? Or are they at the bottom of the organizational chart, somewhere above the volunteers but well below anyone on the senior leadership team?
The 2007 HealthLeaders Media Annual Marketing Professionals Survey has some of the answers to these questions. Our annual CEO survey has some intel on the subject, as well.
As for whether or not marketing has a seat at the leadership table, it turns out that the answer, at least according to our surveys, is anything but decisive. Our CEO survey asked top leaders which positions are represented on the senior executive team, the inner circle that works together on strategic planning. A little more than 41 percent listed the chief marketing officer or director of marketing. That is slightly behind the COO's 47 percent and ahead of the Chief Information Officer's nearly 24 percent. Other titles, including chief nursing and chief financial officers, got much higher percentages. (Volunteers weren't one of the choices.)
Healthcare marketers, on the other hand, see things in a slightly different light. In our marketing survey (stay tuned, the full results will be released soon) we asked how involved respondents' departments are in working with senior leaders to make strategic plans and decisions for the organization. Sixty percent answered "very involved" and another 30 percent said they were "somewhat involved." Only 10 percent said they were not involved at all.
Of course, different organizations answered the surveys, which were conducted separately. And we all know that numbers can be misleading. But I think the numbers do illustrate the fact that hospitals and health systems are still working out what role marketers play in the business end of running a hospital. This trend is obviously in flux, and marketers and CEOs aren't quite on the same page as to the direction it's heading.
A Love/Hate Relationship
I've received some interesting feedback from last week's column,When Marketers Dream. Based on the e-mails you sent me, as well as the responses to our 2007 HealthLeaders Media Annual Marketing Professionals Survey, hospital and health system marketing and advertising professionals are in the same boat as everyone else when it comes to their jobs. Overworked. Underpaid. Too much to do and not enough time, budget, or staff to do it.
As one of my co-workers recently said, "Well, we're not doing a musical, here."
For the most part, though, the responses to last week's question (What do you most love and/or hate about your job?) are not ones that the authors would want me to share with the whole world. But with our fancy new Web site comes the ability for readers to simply click that little talk bubble at the bottom of the page and leave a comment in response to this column. Instant gratification--who doesn't love that?
Unnecessary expenses, fraud and lack of succession planning were some of the problems found in the survey of more than 100 local physician practices by Keane Insurance Group and AMD, a certified public accounting firm and consulting group.
A handful of articles has crossed my desk recently detailing a growing and somewhat troubling trend in workplace health benefits--one that could have long-term ramifications for the group and individual health plan markets.
The reports note that increasing numbers of workers are opting to forgo the healthcare coverage offered by their employer and instead find a health plan to cover themselves and their dependents on their own. The move is a reaction to the ongoing trend of more costs being shifted onto the end-user in recent years, which has increased the financial burden on working families.
A recent survey of employer sponsored health benefits by the Kaiser Family Foundation noted that the average monthly premium paid by a worker with individual coverage has more than doubled since 1999--rising from an average of $27 a month at the turn of the millennium to $58 a month this year. For family coverage the jump is even more significant, climbing from $129 a month to $273 a month over the same time span. The increase in large part has been due to the overall increase in healthcare premiums, not to specific changes in the benefit packages. The survey noted that the percent of premium paid by the worker has remained relatively stable at 16 percent for an individual and around 28 percent for family coverage over the past few years.
Still, the trend of dropping employer sponsored coverage--if it becomes widespread--could have negative consequences for employers and those workers who remain in company-sponsored health plans.
In light of the underwriting involved with individual health policies, it's safe to assume that those dropping their employer-sponsored coverage are among the healthier workers in the workplace--or at least not the ones with chronic conditions or a history of cancer. So the exit of these healthier bodies will degrade an employer's risk profile leading to higher premium costs and the employer possibly dropping coverage down the line.
Beyond employers, the trend has implications for insurers and politicians as well. A shift away from group health coverage means insurers will have to invest more on selling and administering these policies, including investing more in the underwriting process (see California's recent crackdown on post-claims underwriting and the slew of lawsuits over the practice). The trend also adds another variable for our elected representatives to consider as they continue the debate over healthcare reform.
Brad Cain is editor of California Healthfax and executive editor for managed care with HealthLeaders Media. He may be reached at bcain@healthleadersmedia.com.
Pennsylvania Gov. Ed Rendell has threatenedto withhold state aid to help doctors and other medical professionals pay malpractice insurance unless lawmakers act on his proposal to expand state health insurance.
