It’s not a decision to do either customer retention or customer acquisition. Instead, it’s a shift in focus and percentage of time and budget. With new entrants in healthcare, growing the overall share of health for each customer is key. After all, the easiest customer to get is the one you already have.
Listen to Don Stanziano, Chief Marketing and Communications Officer, at Geisinger, and Chris Hemphill, Podcast Host of Hello Healthcare, as they discuss next gen marketing strategies across building a team, internal advocacy, and growth.
This conversation is brought to you by Actium Health in partnership with the Forum for Healthcare Strategists.
Chief Marketing and Communications Officer
Don Stanziano (00:00):
I need thinkers, problem solvers. People who have good situational awareness. People who are curious and are willing to probe a little deeper, and not just take things at face value because the problem that we face may not be exactly what it appears to be if you dig a layer too deeper.
Chris Hemphill (00:27):
Hello Healthcare. I am joined today by the Chief Marketing Officer at Geisinger Health, Don Stanziano. And today we’re going to be discussing how to build the next generation marketing team. But a real question is why would we want to focus on that? And we’ve been having some great conversations with regards to not only the team building component, but what that team building is for, how we start addressing just the different mentality, the different cultural shift that it takes to focus on various aspects of patient retention, of up serve and cross serve across the various services and plans and opportunities that may be able to help and assist patients in their care.
So we’re going to be digging into all of that. We’re going to be digging into ultimately what that next generation of strategy looks like and growing the team to get there. I like to brag on our guests a little bit, and it’s extremely impressive that Don has been leading marketing efforts at Geisinger, and also has studied history at Scripps Healthcare. And I’ve admired both of those organizations, what they’ve been doing from a marketing leadership perspective, and it’s exciting to be able to dig deeper into what they see as the next five to ten years of healthcare. Don, any thoughts from you before we start jumping in?
Don Stanziano (01:52):
Well, I really appreciate the opportunity to be here, first of all Chris, and thank you for that warm introduction. I’ve been in healthcare a long time, and marketing in healthcare has certainly evolved pretty dramatically and particularly in the last few years. So I think we’re going to have a really interesting conversation over the next few minutes. I look forward to it.
Chris Hemphill (02:12):
No doubt. And you’ve been a part of that evolution for a very long time, and I’m really curious about what’s your calling to stick with healthcare marketing and watch and cause it to grow in the various ways? What was your call calling of… Why are you here, is the question.
Don Stanziano (02:30):
Why am I here? How did I get here?
Chris Hemphill (02:30):
Don Stanziano (02:31):
Yeah. So I started my career as a journalist, and if you had told me back then that I would end up running a marketing department for a health system, I would say, “You’re nuts.” That was never in the plan. But if I look back and really see all those pivot points in my career that took me from one opportunity to the next, the common thread was storytelling. I got into journalism to tell stories. And the transition to healthcare as I think about it and what our role is as healthcare marketers and communicators is we’re storytellers. We’re brand storytellers, and those stories need to benefit the people we serve.
And the other reason I’m here, and I know we’re going to talk about building the next gen team for marketing, is there’s a sense of mission and purpose in healthcare. We do good, we do work. Sometimes we don’t always get it right, and sometimes there’s always more we could do, but at the end of the day, we serve organizations that serve people and people in their most vulnerable situations, or we’re trying to proactively prevent them from having bad health outcomes. All that’s very noble work. And for me, that gives me a reason to get up every morning and do what I do.
Chris Hemphill (03:45):
Oh, excellent. And I like that kind of career path that you outlined, which journalist as an individual storyteller versus going all the way up to telling stories at scale and getting… Sounds like the right stories to the right people.
Don Stanziano (03:58):
And it’s fascinating that how much the industry has changed, and we’re able to actually target content that speaks to each individual and meet them where they are. And there’s their obviously channel strategies, content strategies, and I find that all fascinating. And the more that the technology evolves to help us do better with that, the more interesting it is to me.
Chris Hemphill (04:25):
We can’t talk about team building without talking about the industry, the type of change, and the pace of change because that then determines, “Well, who do I need in my positions to be able to meet that demand, meet the changing face of demand?” So one thing I referenced in a talk yesterday was that when I got into this career early on, the argument was about whether or not a health system should invest more in its website and things like that. So at the very basic level that we take for granted right now. Could you talk about not just the type of change that you’re seeing at the industry level, but really the change that’s happening within Geisinger that’s just indicating this need for a new team. What are some of the changes that are on the horizon or changes that are being inactive now that are like, “Hey, these are becoming a must have to be competitive.”
Don Stanziano (05:20):
Yeah. Well, so Geisinger is an interesting organization and it’s one of the reasons I was drawn to it when I joined four and a half years ago because we are a payer and a provider integrated from that perspective. But my role in 2018 when I came on board was to be chief marketing officer for the clinical organization, the hospitals and physician practices. The health plan had its own marketing team, that has been integrated over the last couple years. I’m the chief marketing officer for the whole enterprise. So one of the things that’s changed is breaking down those silos in our organization and understanding how the business is connected, and having a marketing and communications team that can serve the entire enterprise and a horizontal way versus in a vertical way.
So the interconnectivity of our strategy between our payer and our provider organization, it requires me to have a different level of set in the team that we’re recruiting, and filling these positions for it. And the team’s evolved. Obviously there’s also been a change in technology and the sophistication of the team. And so we have to continue to stay current. And I’m always looking for people who are digitally savvy, data driven, but more importantly, and I mentioned this in a talk here at the conference, that earlier in my leadership career, I was looking for people who had true expertise in their skillsets. I want good writers or I need good graphic designers, or I need someone who can really serve a client well. Now I’m looking at a broader level. I need thinkers, problem solvers. People who have good situational awareness, people who are curious and are willing to probe a little deeper and not just take things at face value because the problem that we face may not be exactly what it appears to be if you dig a layer or two deeper.
So we’re looking at a completely different type of skillset when you’re looking for people who can actually engage with others in the organization on a deeper level. Because when I took over this role, and really earlier in my career in other organizations, marketing and communications in healthcare was really a service bureau. It was a ticket counter. “Make me a website, make me a billboard.” And now we’re asking questions when a tactical request that comes in, “Well, let’s talk about why you think you need that. Who are you trying to reach? What are your objectives?” And from there we can actually build a more strategic approach to marketing and communications. It’s data driven and leveraging digital tools.
Chris Hemphill (08:11):
So the skills that you’re outlining, they go from just subject matter expertise and things like SEO content, data, web data, and really getting into, if you’re horizontally serving a bunch of different parts of the health system, then that opens the door for all kinds of conversations and perspectives that if you’re completely siloed, would make a lot of marketers uncomfortable. So the skills that you’re pointing to, they sound like people who are able to adapt to these various scenarios. And talking to, I’m going to say it, a lot of times I feel like the marketing side of the house is scared of the clinical side because there’s just a different perspective. But it sounds like part of that is opening the door to be able to have those conversations and sync up with those different parts of the organization.
Don Stanziano (09:02):
That’s absolutely true, Chris, that we need to be able to have conversations about the business. So one of the things that I’ve done at Geisinger, but I did it at Scripps as well, and we’ve really sort of ramped it up even further here, has been to have a team of folks who are really client facing to get out of that service bureau model. Having guys, here we call the marketing strategist, and you are the representative of our function to a piece of the organization. And so whether that’s, say, our orthopedics institutes and all things orthopedic services, I have marketing strategist assigned to that institute, that physician leader, that administrative leader. One of the things I heard when I came in was, “We don’t know who to work with.” Or “I’d talked to my team and I had six people working on the same client. Well, and there was no coordination.”
So one point of contact, one point of entry, but the responsibility of that strategist role is you are our internal team expert on all things orthopedics at Geisinger. I expect you to be embedded in the business, to be a partner to that piece of the business. And when we have questions about orthopedics, you inform us. And when they have questions about marketing communications, you’re informing them about how to best meet their needs and how to work with us. It requires a different skill set. It requires somebody who’s comfortable being a trusted advisor, a counselor who can think about the business, can say no without saying no, which is something that we encounter a lot when you get these tactical requests that maybe don’t really align with the overall strategies because each of these pieces of the organization, the work we do for them, our responsibility as an enterprise function is to make sure that that work aligns with the broader strategies of Geisinger.
And that’s not always the case because as I’m trying to eliminate silos within my small function, relatively small function in a big organization, the bigger organization has its own silos. And so one of the things that we have to do is when we’re talking to the Orthopedics Institute, is to connect dots to say the Surgery Institute and say, “Do you realize we’re working with them on this other thing over here?” We may want to connect these two dots and we might get more impact if we put these marketing campaigns together or somehow align them. And so it’s a evolution, but I think we’re on the right track. And a lot of the folks that we’ve put in these roles are folks who were doing other things. So there’s a lot of training involved and a lot of coaching involved. But the organization, I’m very thankful, the organization’s been very receptive to this, and I think we’ve demonstrated that it adds value.
Chris Hemphill (11:57):
So one thing I want to dig into is in the past when we’ve talked about multichannel campaigns, which we talked multichannel, omni channel, whatever we call it, we’ve been talking about for years, and whenever I see a diagram, it’ll show email, text, billboards, TV ads and things like that. But there’s a channel, what we call it a channel. There’s a line that’s much more impactful than all of those things, which is the actual point of care and what people are told and how they’re directed directly by their clinicians. Now the model that you’re discussing has marketing embedded with the business, with the service line leadership, with clinicians and things like that. So I’m really curious when we get into, “Hey, this new team mentality, it sounds like an application of that. That mentality is to influence the clinician as another avenue for influence.” Could you talk a little bit more about that?
Don Stanziano (13:03):
Chris Hemphill (13:04):
In terms of cross serve and up serve opportunities.
Don Stanziano (13:06):
Yeah, absolutely. And I think it’s completely underappreciated channel. And actually my head of marketing actually got frustrated with me because I’ve been saying this a lot lately that we have… Our most important audience is our internal audience. We have 24,000 colleagues at Geisinger. We call them Geisinger family. They are our best ambassadors for our brand, for our services and programs. We serve a lot of small communities. A lot of our market is rural. I joke, “We’re one degree of separation away from anybody in the communities we serve. I meet somebody and if I don’t know them, I know somebody who knows them.” So when you think about that and the people we employ, how influential they are, we need to make sure that every single member of the Geisinger family is well informed of our business, the services we offer, the strategies we’re trying to employ.
So part of that omnichannel approach is bringing internal communications into the mix. And that strategist model that I mentioned also sits in internal communications. So we have a strategist embedded in HR, we have a strategist embedded with Chief Medical Officer. So there’s partnerships there. So we have an orthopedics campaign that we need to partner with the chief medical officer’s office on. We have two people who can work together to bring those two pieces together. But back to your point of your question, one of the things that we’ve really been excited about is taking elements of these marketing campaigns and really creating a swim lane for internal communications in clinic.
And it’s a blend of internal communications and patient facing marketing because we realized we have customers, and I know not everyone likes that term in healthcare, but we have customers because we’re a payer and a provider, and we have a robust physician business… a pharmacy business. We’re trying to get that overlay as much as we can. We want our patients to be members, our members to be patients, and we want our members and patients to use our pharmacy. It’s good for the bottom line, but more importantly, it really improves their health. We’ve got studies that show that when our patients and members are on our pharmacy, they’re more adherent to their medications. They don’t miss their dosages, particularly if they get mail order.
So we need to educate them on that. And the best way to do that is when they’re in clinic getting care from our providers. So we’ve built this workflow, we’re actually using the electronic medical record. In Epic they have a feature called A Best Practice Alert that can fire and tell a nurse or a physician that this is a patient that you need to talk to them about something clinical. Well, we’re using that for marketing. And in both the pharmacy example and in the health plan example for Medicare Advantage. So Medicare Advantage is for folks who are 65 and older, when we see that we have a patient coming into an appointment who is not on our Medicare Advantage plan or on any Medicare Advantage plan, this best practice alert fires for the provider to say…
And we created this swim lane that this patient is eligible for a Medicare checkup, you should ask them about their Medicare checkup. And so we define this Medicare checkup program as a series of questions, four or five to just determine whether or not they would opt in for a Medicare Advantage conversation. And it’s really, “Are you having problems with your co-payments out of pocket costs for your healthcare? Are you able to get access all the care you need?” Those types of questions. And if the answer is no to any of those, or yes, depending on the question that qualifies them to be followed up on and they say, “Would you like to talk to somebody about this?”
The doctor doesn’t have to be a salesperson. All they have to do is get them to opt in to have a conversation with somebody, and then the marketing kicks in, and they end up on this nurturing journey where we send them an email and remind them that they opted in, and that they’d be receiving a call from someone shortly. We’ve seen a great uptick in growth as a result of this, but it requires a lot of training. It requires a lot of internal education. And it is a true partnership between the internal communications team and the marketing team.
Chris Hemphill (17:30):
Because the technology is already available within most people’s EMRs. We have this Best Practice Alert. It’s not a matter of somebody going on setting some guidelines and just turning that on because very likely some new widget pops up and says, “Hey, talk to your patient about this. There’s been no training, no communication, no partnership.” Answer, “No, I’d rather not.”
Don Stanziano (17:52):
Chris Hemphill (17:52):
So could you talk a little bit about what it’s taken to get your team to work with the clinical staff to get compliance? Because when you were describing it, I was like, “Well, how many leads are you generating from this? Are they saying no? Are they doing this?” I’m really curious on how you’ve worked with them to get the buy in to start doing that.
Don Stanziano (18:14):
It’s early days. We did it one for one year. So we’ve got a lot of learnings to apply to make improvements. A couple things that we did, we are tracking the performance of every clinic and every provider that we’ve launched this in. So there’s a bit of a report card that’s shared. And so we know who’s adopting it and who’s not, which allows us to follow up and figure out, “Well, why?” Because the provider you have to do this does have the option to skip it. And we can see if it’s being skipped. And that just requires us to go back and find out why.
Interestingly, there’s usually not a lot of variation within a clinic. The variation is clinic to clinic, which tells us it’s really more about administrative leadership, not provider engagement. So we’re going to those clinics that have not adopted to understand why. And so it starts with of leadership at the clinic level. Once the providers are aware and some… I mean, we have high performers and lower performers, no doubt. But when they are aware, they tend to adopt it pretty readily because I think they see the benefit, and it’s been all about appealing to them as a clinician that this is what’s best for your patients and making it super easy, not intrusive, and like I said, just a handful of questions.
Chris Hemphill (19:49):
And so it has been tried for specifically Medicare Advantage or are there other services that you’re… Well, you have kind of an experimental base right now, right? Like, “We’ve been trying this for a year.” Do you have expansion plans into this with other services and stuff?
Don Stanziano (20:07):
Well, pharmacy we’re doing it as well.
Chris Hemphill (20:10):
Don Stanziano (20:10):
Actually pharmacy was first. So we have a better track record with pharmacy, and that’s a broader audience. The Medicare Advantage is obviously limited to an age segment, but we started last year with just primary care. So our expansion now is to move that into specialty physician offices for Medicare Advantage. So that will be an interesting expansion.
Chris Hemphill (20:41):
So another big portion, what this really rings to is another big conversation that we’ve been having a lot, we’re seeing a lot is a lot of organizations that were previously focused on 100% patient acquisition, we have to find the new movers and things like that. This is clearly a retention focus because we’re focusing on people who are already within the four walls of the hospital. How are you discussing with leadership and discussing with potentially a culture that was more focused on acquisition in the past? And this might be more, I might be trying to tease out some things that help other organizations drive that retention focus. Could you talk just about balancing that? Well, obviously there’s a need for acquisition, but how do we get the conversation with our own internal leadership teams about retention?
Don Stanziano (21:34):
I’m glad you asked it, Chris. It’s a great question. And let me just be clear. This isn’t an either or, but I think it is a shift in focus and in percentage of time and budget. And the easiest customer to get is the one you already have. Less cost, less effort. But it’s really born, for us, out of a recognition that we’re serving communities that aren’t growing. And so to grow market share means we need to grow the share of wallet or the share of health. And some of that is also reactive. I mean, there are new entrants in healthcare who are coming after some of these pieces of our business. We have more competition in the Medicare Advantage space than we did three or four years ago in our markets.
We have more competition with pharmacy than we did three or four years ago. Amazon bought PillPack, mail order pharmacy is available to anyone through Amazon. Our folks can do that. Our customers could do that just like anyone else’s. So how do we lock them in? And banking or any other industry, the more deeper and broader the relationship you have, the stickier that relationship is, the less likely they are to leave. And we get more share of wallet. The leadership’s bought in because they recognize that strategy. But that doesn’t mean we’ve abandoned acquisition marketing. Acquisition marketing allows us to go after a new customer in any of those areas of business that we’re in as the gateway to open them up to all those other areas. But upselling cross marketing needs to be embraced, I think, by everyone in healthcare, regardless of your market situation because it’s the best way to build loyalty and retain your market share.
Chris Hemphill (23:28):
So I got a personal story about cross serve and up serve, but before we jump into that, I’m just curious about the key metric to discuss retention with leadership. What are some of the key metrics that you focus on that they’ve bought into and you work on optimizing and driving?
Don Stanziano (23:46):
So there’s few. So obviously each of these campaigns that I’ve met referenced have their own KPI so there’s a metric for growth for each of them. But then we look at Med-ed level on how many customers we have the dual or triple relationship with? How much overlap do we have? And looking at that percentage. And then there are brand metrics as well. And then we have on the health plan, it’s real easy, this enrollment. We have people coming in and people going out. I need fewer going out than are coming in. It’s that simple.
Chris Hemphill (24:29):
Well, thank you. That’ll help. Well, there’s a lot of talk about lifetime value and my question is always what comprises that? And I think that that’s really helpful to get leaders to think about. One thing that I wanted to bring up, I just heard you mention the names of a bunch of new entrance to healthcare. And as a little personal joke to myself, I was seeing if I could get through an entire interview without saying the word consumerism. I failed just now. But the experience I wanted to talk about was with Walmart Health.
I went to Walmart Health last year, A, just to see what Walmart Health was like because I wanted to kind of explore what was going on there. And B, because I underutilized my primary care. So I was like, “Okay. Well, here’s a good opportunity.” During the process, the physician who saw me for typical primary care visit, once he had run some tests, he gave me all kinds of suggestions on different labs and different things that I should utilize. And each time he gave the suggestion, he also gave the price of the service that he was indicating. So it was just a prime example of having a physician that’s bought into cross serve and up serve, has memorized the pricing function and things like that. It’s happening, the new entrants are focused on that consumer experience. So it’s really awesome to hear your focus there.
Don Stanziano (26:00):
Yeah. Well, and you raised a really interesting point and sort of an Achilles heel for our industry is price transparency. We struggle with it, and I just had an eye procedure a few weeks back, and while I was here at this meeting, received a bill for my out of pocket costs, I had no idea what that was going to be. And the number was surprising. It’s fine. I’m glad I had my eye taken care of, but it would’ve been helpful to have known that upfront. It wouldn’t have changed my decision, but it would’ve been helpful to have known that upfront. So I really appreciate the point.
Now, Walmart and others, let’s be clear, one of the big plays here with all of those new entrants is data. And so they want to know more about us so they can sell more to us, which gets back to this whole concept that we’ve been talking about for the last few minutes. So I’m sure the care was great, but they know a heck of a lot more about you now than they did before you had that visit. And they sell a lot of products that might be appealing to you based on what they now know about you. Healthcare organizations aren’t selling consumer package goods. So our motivations a little different, but we can learn some lessons from these new entrants in how to grow and retain customers.
Chris Hemphill (27:30):
Yeah, exactly. And that’s a deeper conversation to be had. For folks that want to have that conversation with you and reach out because obviously there’s a lot to be learned. You’re building out a case study that is proving out that, “Hey, within the hospital industry there’s examples of how we can kind of be a front runner of this cross serve up serve idea.” How can people reach out to you to discuss this?
Don Stanziano (27:57):
Oh, they can reach me at Geisinger. My email is firstname.lastname@example.org. I’m on Twitter and LinkedIn.
Chris Hemphill (28:06):
Well, appreciate your transparency. Appreciate you coming in and taking a few minutes to discuss this stuff with us. Appreciate everybody staying on with us, learning a lot about what Geisinger’s focus is on. Not only team building, but what’s the result? What are we trying to build these teams for. So with that, until we see you next time, hello.
Speaker 3 (28:28):
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