The Social Determinants of the Healthcare Consumer, ft. Matt Gove

Matt Gove (00:00):
I think it’s also important to point out though, that most healthcare organizations are still more focused on what they need from the customer rather than what the customer needs from them. And that’s the biggest challenge – is that we’ve built these systems, both physical and digital, around what the physician needs, around what the office needs, around what the system needs, and not really about what the customer needs.

Alan Tam (00:37):
Hello Healthcare. It’s to no one surprised that healthcare consumers are driven by convenience, access, cost, relationships, and flexibility, quite the demand and even greater in expectations. But are healthcare organizations today able to meet these expectations, and what kind of technology is required to do just that? I have the privilege and honor today of having Matt Gove, former chief marketing officer at Summit Health, joining me as we discuss and examine the intersection between what drives healthcare consumer behavior and the ongoing struggle healthcare organizations have in meeting their needs? Matt, it’s a true pleasure to have you here on the podcast. Welcome to the show.

Matt Gove (01:22):
Thanks for having me. Thank you.

Alan Tam (01:24):
As the former chief marketing officer at Summit Health, I’d love to understand,  what did you do?

Matt Gove (01:32):
What did I do? So, at Summit and City, (CityMD and Summit Medical Group were two companies that merged, private equity-backed merger in New York City) is the largest urgent care provider in New York City, and Summit is one of the largest independent, meaning non-health system affiliated practice, organizations in the country. So, the idea behind it was that you take this really high volume, low acuity engine in the urgent care that saw upwards of 100 patients a day in every urgent care, and you attach to it to primary and specialty care, which is usually the next step, or not usually, is often the next step for urgent care patients. You put those two things together, and you basically make a company that can be almost like a health system without hospitals. So, my role there as chief marketing officer was to help drive volume, drive revenue. Marketing’s job in any organization. I’ll just put in a plug for all people, should be to drive revenue.

Alan Tam (02:41):
Absolutely.

Matt Gove (02:42):
That’s their job. In healthcare, often people don’t realize that, but what we were there to do was to grow this company rapidly, and then, try to find a suitable exit, be it an acquirer or an IPO. As it turns out, we were acquired by VillageMD and closed in January of this year. As part of the integration and merger of the company, I’m transitioning out, which no one should cry for me. It was not only a successful exit, but I think a great opportunity to close that chapter and start thinking about what’s next.

Alan Tam (03:21):
Absolutely. And congratulations on that exit.

Matt Gove (03:24):
Thank you. Thanks.

Alan Tam (03:24):
You recently spoke about the social determinants of the healthcare consumer. Can you explain what those are and what does it mean to healthcare organizations?

Matt Gove (03:32):
Sure. Sure. This morning Brian Gresh, the president of a company called Loyal, and I talked about the five… And it’s funny, these are our opinions about how consumers make decisions in healthcare, convenience, access, flexibility, cost, and relationships. And I’m not going to take up all of our time together going in detail on each of these, but convenience, access, and flexibility really work together. Convenience, I tend to think of as location and speed. It’s one of those things that urgent cares in particular do really well. Blanket the market with locations and get people in and out within 30 minutes or so should be the goal. Access really is more about getting an appointment with a provider, with a primary care or specialty provider. And it’s something that health systems, generally speaking, do a terrible job of.

(04:34): One of the data points we shared today is it’s an average of about 26 days for a new patient to get in and see a primary care doctor right now. That’s entirely unacceptable. And related to the fact that urgent cares are continuing to see explosive growth in their volume because when you’re sick, you want to be seen. Flexibility speaks more to a willingness to be open at different hours and to be available for your customers, patients, consumers, whatever you want to call them. I don’t quibble over the language. It’s about being open after hours. It’s really funny that many of the people who are listening to this are watching this probably work somewhat sort of traditional 9:00 to 5:00-ish hours. Guess what? That’s also the time that doctor’s offices are open, instead of being open 7:00 to 9:00, 5:00 to 10:00, all day on the weekends, things like that. Just the flexibility isn’t there, so they’re not meeting the customers where they are, which is what you’re supposed to be doing if you’re truly a consumer-oriented business.

(05:46): Cost is especially interesting to me. I think that there’s a mistaken belief that exposing the charge master, which is really the price list that an insurance plan and a health system use to haggle, that exposing that to customers is going to make a difference in how they behave. It’s ridiculous and absurd, but legislators and other people who aren’t involved in healthcare keep pushing that idea. I’m more interested in what are we doing to meet the needs of people whose obligation under their health plan continues to grow? High deductible health plans mean that you could be on the hook for $5,000, $10,000 out of your own pocket before they really start covering you fully. What are we doing to help meet those patients’ needs with lower cost cash alternatives to the traditional doctor visit? I think it’s a fertile ground for innovation and ideas.

(06:50): And then, finally, relationships are a twofold thing. One, it makes me chuckle because I’ll take my hilariously bright shoes for instance. People don’t undertake purchases, basic simple purchases like shoes, without asking for friends and posting on three different social media platforms, “Hey, what shoes should I buy?” And so, when we talk about the importance of relationships and how a healthcare consumer makes decisions, they are talking to people they know about their experiences with doctors or health systems, and they’re using that to help make their decisions. So, as a health system, you should really be thinking about how do I harness the positive experiences and turn people into ambassadors for us as an organization so that you’re utilizing the relationships that they have? So, that’s one.

(07:52): And I think it’s also a reminder that the ability to “build a relationship,” quote, unquote, with our customers has changed significantly over the past 10 to 15 years with the introduction of CRM platforms, CDP, and really just more sophisticated thinking inside our industry to the point where, for instance, when I got to Piedmont in 2011, we literally sent no emails other than appointment transactional emails to our customers. Last year, at CityMD and Summit, we sent upwards of 100 million emails to our customers reminding them of important times of the year to have an appointment, for instance, annual physicals and all that. Or “Hey, it’s allergy season,” come to CityMD and get your symptoms checked.

(08:51): We didn’t do it in exactly this way, but anytime you have an upper respiratory thing over the last three and a half years, it was like, “Is this COVID? Come into CityMD and get tested.” We are in a position now where we really need to be trying to win every single transaction because you never know when that next visit turns into a longer care journey for someone that’s more revenue and more profit for your organization. And I’m not wishing anybody ill obviously, but that’s just the truth of our business. And you don’t want to be missing that opportunity to serve someone and have them end up at one of your competitors because you weren’t staying in front of them, you weren’t staying top of mind, you weren’t doing and using the tools that you have access to really motivate them. So, anyway, those are Brian’s and my opinions about the five most important factors in how healthcare consumers are making decisions these days.

Alan Tam (09:46):
I think it makes a lot of sense, and I appreciate you sharing some of your examples, especially with email marketing and how many people you’ve reached. What else are health systems doing today to adapt to these behaviors and meeting these healthcare consumers where they are?

Matt Gove (10:08):
Not enough, to be perfectly frank. I think health systems have a built-in advantage. They’re the only community hospital, for instance. And every physician in that community probably works for them because they have rights at the hospital. So, there’s not the same level of competition. And I’m not necessarily saying that competition should exist in every healthcare situation. I think it’s important that healthcare be available to everyone in a community. So, often, those single hospital communities are doing a really important public service. That said, there’s so much more that we could be doing to personalize the journey for people to really understand how they’ve interacted with our system to marry that with other data that you can pick up, from purchasing data to web history and get a clearer understanding of who they are and how they behave, so that you can start to tailor your outreach to them based on both their preferences and their conditions, to a certain degree. I think health systems have a real opportunity to really be more custom and personalized in the way they help their patients.

(11:32): Back up for a second. I think it’s also important to point out though, that most healthcare organizations are still more focused on what they need from the customer rather than what the customer needs from them. And that’s the biggest challenge is that we’ve built these systems, both physical and digital, around what the physician needs, around what the office needs, around what the system needs, and not really about what the customer needs. Which is another reason why an organization like CityMD, which I went to work for in large part because I understood them to be the best-run urgent care company in the country. That’s why they’ve been so successful is because they have figured out how to do two things really well.

(12:21): One, take the care to the people, in the neighborhoods down the street, easy access. And two, focus on location and speed, focus on what people really need out of a healthcare provider. 80-90% of the time, it’s not serious. Most of the time, it really is just a rash. It really is just a sprained ankle or a cold. And they can deal with that very, very quickly, give people peace of mind, provide an important service. And in doing so, are doing something that nearly any health system in America can’t do right now. And it puts them in real danger. I don’t think they fully realize it.

Alan Tam (13:12):
Right. You brought up a good point, and I think this is true amongst a lot of healthcare systems, unfortunately, which is it’s set in a way where it’s optimized for providers and a very internal audience focus versus classic marketing 101 mistake is who is your audience? Who is your customer? And turning the focus to that spotlight to optimize their processes and the way that their business model is set up. What are some of the strategy and tactics that you and your team employed at Summit and City to meet these needs of these healthcare consumers and bridge that gap?

Matt Gove (13:56):
Sure. It actually started, prior to City and Summit, when I worked at a health system called Piedmont Healthcare based in Atlanta. It’s the largest health system in Georgia. And a well-earned reputation for being innovative, both in consumer-centric marketing, but also experience design. And I was a part of creating all of that. And we undertook this work in 2014 and 2015, where we actually built a pretty simplified customer journey, and then, started talking to all of our customers, and talking to all of our caregivers, and making sure that we understood the pain points really well. And what we figured out fairly quickly is that there are two major issues with the healthcare journey: One is access – getting into to be seen, and the other is billing, wrapping up the experience.

(14:54): In between, there are hiccups, the care interaction, most people review very positively, almost always. It’s everything around it, but really starting on those two ends. So, taking that knowledge and the plans that we were executing there, adapting the approach to better serve the kinds of customers that we were serving at City and Summit. And what we really focused on was how do we make it easy to find us? Urgent care customers are a bit different. I think search is most important. It is the most important thing for all marketers in healthcare. But for us in particular, winning search for an urgent care was very, very important. So, really optimizing that front-end experience, and then, taking our owned assets on the web, mostly our websites, and other campaigns, and orienting that to make it easier to find what you were looking for. And then, starting down the line of online appointment scheduling, the blocking and tackling of getting people in to be seen.

(16:15): We made good progress. Of course, New York being the epicenter of the pandemic in the earliest parts made it hard for us to shift our focus from really taking care of that city, to how do we improve the overall experience, particularly in our own practices? But that progress was happening over the past year or so. And I think with their acquisition by VillageMD, it’ll progress even more quickly. But it’s really just about understanding the experience. And also, I should say, recognizing that your brand really is nothing more than the sum of a patient’s experience with your organization. So, you really need to focus on how do we smooth that experience out, make it enjoyable, make it work for the customer. And then, by doing that, you’ll get all of the benefits of them telling their friends of them posting about their great experiences and helping influence others to come that direction.

Alan Tam (17:19):
Right. What were some of the similarities and differences between these two brands? I think you were in a very unique position, not a lot of health… Well, a lot of health systems have urgent care centers, et cetera. They’re typically under the same brand. So, when you look at both Summit and CityMD, how did your strategies and tactics differ, and how were they alike?

Matt Gove (17:44):
What’s interesting is that you hear a lot about retailers getting into healthcare, the Walmarts, the Dollar Generals, CVS, and Walgreens, of course, and people believing that that’s some sort of interesting or innovative threat to the existing systems. The truth is, we have retail healthcare right now. They’re called Urgent Cares, and we marketed CityMD as if it were a consumer-focused business. So, traditional brand building campaigns were really important to us staying in front of our customers, and also using the digital channels that we owned or could have access to, to continue to stay in front. Email, as I mentioned a second ago, so important in terms of just staying in front of your customers. Healthcare is definitely one of those businesses where if you can just reactivate the same customer every time that they need something in healthcare, you can win. So, the main difference is that the consumer marketing tactics, which tend to be the most expensive traditional media spend and things like that, we only really did for CityMD.

(19:05): In Summit, we relied much more heavily on two things. One, direct response digital. We did a lot of that trying to identify audiences that would be interested in certain services that we were introducing in certain communities. And then, also, we have, at Summit, or they have a physician referral team that basically that goes out and visits with community physicians and Summit-owned physicians in communities where we’re building relationships and helps educate the physician community on why you should refer to this Summit ENT or to this Summit orthopod or, “Hey, here’s a new Summit primary care practice. We want to be able to refer to you in these communities. How do we do that?” That tends to be a really powerful way to drive volume in a practice, is just helping other physicians understand when, and how, and why you would refer to them. So, we spend more time doing that than we do the more expected marketing tactics.

Alan Tam (20:22):
Right. Yeah, that makes a lot of sense. I do want to focus a little bit now on the role of technology and data for healthcare marketers when it comes to engaging consumers, both on the acquisition side as well as on the, we’ll call it retention/nurturing side. How does this come into play, and what are the key components that you and your team have focused on to bring it all together and drive the outcomes that you need to drive for each of those brands?

Matt Gove (20:59):
We were, and they are, so you know Andy Chang. He’s still there and still pushing, very, very focused on attribution. So, how do we use data to better understand whether or not we’re achieving the goals that we set out? We tell the system, “Hey, we can drive this much into this service line. Did we do that? And how do we track that back to our marketing tactics and strategies? How do we actually show them this thing we did works?” So, that is a very data-intensive process, involves not only taking all of your EHR data in trying to match it up with some of this marketing data, but then, also getting really creative about how to drive that attribution piece. For instance, we worked with a company that had location data, so we would know if someone saw an ad, either digital or physical, we would know if they were in the presence of that ad, and then, within a certain amount of time, actually visited a CityMD, for instance.

(22:10): And that gave us an understanding of did we get incremental lift from the campaigns that we were doing? We also had some voice recognition technology that would help us understand which of our calls into the call center actually resulted in an appointment? You can count the appointments made in the call center, but it’s a little more complicated when the volume of calls we’re getting is also for billing, and for referral questions, and lots of other things. We could really dig into what phone number did they call? Because we customize all the phone numbers, obviously. And then, did that result in a main appointment? We really started to nail down that. So, I think the data side of understanding whether or not your marketing is working is super critical.

(23:00): On the front end, it was more about how do we take what we know about our customers in a CDP or other similar platform? How do we take what we know about those customers and start to build audiences, build more sophisticated and better-segmented audiences because we know a customer of this service looks like this. And how do we use that data then to be more efficient in how we spend money driving digital campaigns?

(23:50): It’s funny, it sort of speaks to both sides of a marketer to a certain degree. I love making pretty things. I really think that the creative process is really fun and exciting thing to do. And working with brand and creative agencies is so much fun. At the same time, it’s hard not to get excited about how you take your understanding of who your patients are and use that to build better audiences that allow you to drive revenue into your organization at a lower cost. It drives your return up, which is another thing we measured rigorously, return on ad spend, return on marketing investment.

Alan Tam (24:30):
Right. No, I think that’s the beauty of marketing is the intersection of the creative aspect and the data-driven aspect makes it, in my opinion, super fun. But I’m also biased to that.

Matt Gove (24:44):
Right. Me and you both.

Alan Tam (24:44):
So, where do healthcare marketers get it wrong? We’re all trying to do the same. We all know what we need to do. Some of us are more successful than others. What are some pitfalls or mistakes that you’ve seen healthcare marketers make here, and how can they avoid those pitfalls and mistakes?

Matt Gove (25:08):
I don’t want to make excuses for people necessarily because there are mistakes that we all make, but there are also very significant barriers inside certain health systems to doing the right thing. One of the things that is consistently frustrating to me in talking to healthcare system-based marketers in particular is the amount that they spend on what I would term vanity or ego-driven marketing. It’s the doctor who has to have a billboard, which everyone knows doesn’t work except for the doctor. But if you don’t do that, you end up in a really difficult position with the leadership of your organization potentially. And more than anything, just the argument itself is a distraction. It’s keeping you from doing the things you need to do. So, I recognize that there are significant barriers to people focusing on the right thing. And one of things we did at both Piedmont and Summit is to set aside a part of your budget to meet the needs of these vanity-driven either system leaders or physicians.

(26:20): It typically not a huge amount of money and can really open the floodgates for you to do the things you really want to be able to do. So, that’s one area where I’ve seen some mistakes, and also, some challenges for healthcare marketers. I think more than anything, we get consumerism in particular, it’s a pretty broad term. It can mean a lot of different things. The initial push into healthcare consumerism resulted in a lot of health systems pushing big brand campaigns, big rebrands, sports sponsorships that are millions of dollars a year. And none of those are really driving revenue into their organization or changing the performance, really improving the performance of the organization, and don’t do anything to actually make it easier for a customer to use their system, which is what they should be focused on.

(27:27): I’m as guilty as anybody of doing that. I think I may have done it earlier than many of them did, but I understand the desire to do it. But I think as much as you can, I’ve got to try to move away from that brand-only approach, especially for a health system, a hospital company, and move over towards more targeted direct-response digital marketing that is data driven and you can show is making a difference in the business itself. And then, taking another section of you or your team and focusing on the experience. I’ve always made the argument that healthcare organizations or marketing organizations inside systems are uniquely positioned to help influence the experience because we touch people far more often than the actual organization or the clinical staff does, through advertising, through email, through our websites. Through every owned or purchased touchpoint, we are really helping influence what people think about who we are. So, marketing is in a unique position to own more of that experience than they do currently.

Alan Tam (28:52):
That makes a ton of sense. And when will it stop? When will the billboard marketing stop? That is a example that is being brought up with every single healthcare marketer I speak with. And we all recognize and everybody knows it. When will this stop?

Matt Gove (29:11):
So, everyone doesn’t know it. The doctors don’t know it, and potentially, the CEOs don’t know it. Maybe all of the marketing people know it, but I think it is a reflection of marketing seat at the table in some organizations and whether or not they have the ability to own the marketing function and based on their expertise. And that’s a hard thing to do in an industry where marketing really hasn’t been or wasn’t important for decades. And then, starting in the ’90s, marketing became more of a… Beyond communications, comms was always around, but marketing became more of a understood discipline. But really, it wasn’t until 15 years ago that marketers started to actually have a seat at the table. And it takes a long time for that sort of trend to work its way through and for health systems to really accept that yeah, doctors go into clinical situations and use their expertise to deliver great results on behalf of their patients.

(30:25): And guess what? Marketers are also trained professionals who know what they’re doing and can help spend money in an efficient way to drive revenue in the organization. But that’s a difficult conversation to have and to convince people. It took me years at Piedmont to get to the point where people would listen when you’d explain to them why certain tactics were just not useful. So, I think when does it stop? It stops when everybody understands that. But when will that be? Never. Like legit, never.

Alan Tam (31:01):
Well, I think it starts with folks like yourself, thought leaders and other marketers in the industry continuing to push, and to educate, and to make sense and have everything be data-driven. There is showing that impact. And billboard, you’re not going to be able to show that impact. And I’m surprised that they didn’t learn this during the pandemic, during the shutdown. I don’t know if you guys were still putting billboards up then when no one else was going out, but I think that’s a classic example of maybe we should listen to marketing and start being able to track everything that we do.

Matt Gove (31:37):
It’s a really interesting challenge though. I talked to a lot of people about this during COVID. People stopped spending marketing money altogether, and the volume didn’t go away. I think the really interesting thing would be what if you just turned all your marketing off and see what happens for six months in your system? You may be surprised to learn that none of your marketing is actually moving the needle as much as you think it is. And that’s the… For me, personally, having this freedom right now and not being a part of any organization, I’m really going to be looking more deeply at how do we really understand the impact of marketing in healthcare organizations and how and when it actually moves the needle?

(32:35): Because I think we might be surprised to learn that a lot of the revenue and profit that we rely on as a health system, a hospital company, is kind of baked in. It’s 55, 60 plus patients who are already in relationships with specialists in our organization, and they have hospital episodes and need other services that really do generate a lot of revenue and earnings for the company. And you don’t have to do anything for them.

Alan Tam (33:06):
You don’t. But I also believe that healthcare marketers can control the mix of the patients that are coming in and can affect volume distribution based on the outreach efforts, the campaigns, and the audiences that you’re going after. So, having that ability to fine tune, I think is impactful. If I know that I have no space in OB, but you know what? GI is 50% empty, why don’t we shift our focus there and drive volume there? Without marketing, I don’t think that’s going to happen. You don’t have that ability to control that patient mix, whether it’s by service line, whether it’s by payer mix, et cetera.

Matt Gove (33:55):
I think there’s merit to what you’re saying. You got to be careful though. We don’t create demand. People just get sick, and we’ve got to win at that point. So, outbound marketing is only effective to a certain degree, and it’s really hard to break people out of established patterns of behavior and get them into a certain service line. So, I think there’s an opportunity there, but we got to be careful not to overpromise what we’re actually capable of doing for sure.

Alan Tam (34:35):
Yes. Good catch on that word choice, not the demand, but yeah, the influx and the composition perhaps.

Matt Gove (34:43):
Right. Right. Potentially. Yeah. It’s a theory worth testing.

Alan Tam (34:49):
Absolutely. So, Matt, always, always a pleasure to have a conversation with you. It’s been incredibly insightful. I want to thank you for your time coming on the podcast today and sharing more about what you have done so far. I think it’s incredibly valuable to our audience. I’m sure many that are listening want to continue that conversation. And if they do, what’s the best way for folks to get ahold of you?

Matt Gove (35:17):
Well, first, thank you for having me. I really appreciate it. I love talking about this stuff. For all of my criticisms of the industry and my fellow marketers, there’s so much opportunity here, and it’s an exciting place to be. Right now, the easiest way to get in touch with me is probably LinkedIn, and I’m wide open. Look at the camera, send me something on LinkedIn. I’m fine with that. I’m also trying to stay active in conferences and meeting people in those places as well. Look forward to talking to anybody who’s interested.

Alan Tam (35:53):
Wonderful. If this conversation hasn’t inspired you enough already, Matt is available. Do go find him on LinkedIn and reach out. He definitely has an amazing amount of insights, perspectives, and best practices to share. So, thank you for tuning in today to Hello Healthcare, and until next time, hello.

Speaker (36:17):
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