HEALTH PRACTITIONER RATINGS AND CONSUMER CHOICE
Relationship Marketing Report
Goals and Overview
The Relationship Marketing effort was defined to support the overall goals of the
Project:
1.
Create a national/regional consumer oriented translation and dissemination process for practitioner performance information (including ratings) that includes print, electronic and possibly other media publications, containing practitioner performance information.
2.
Distribute this information regionally in a coordinated fashion that effectively reaches both established Consumer Reports (CR) audiences and new audiences such as large employers, insurers and consumer groups.
3.
Develop pathways for additional regional groups to be included in future translation and dissemination processes.
4.
Create and test sustainability strategies to support the collaboration and the regional groups
5.
Evaluate options for creating and sustaining organizational infrastructure focused on regional health practitioner ratings.
Additional and specific Relationship Marketing goals included:
1.
Increase awareness of the mission and capabilities of the Regional Health
Information Collaboratives (RHICs) - leverage reach of CR insert at time of publication to increase awareness and build a network of business and community organizations in each region, willing to collaborate with each
RHIC to promote the distribution of practitioner performance information to consumers. Share best practices across sites.
2.
Promote development of other products derived from the CR insert
(repurposed content) for use by the customer network developed through relationship marketing efforts.
3.
Strengthen relationship building, community outreach and marketing experience and expertise at the regional level to support ongoing RHIC business and revenue generating activities.
Relationship Marketing activities for the Project were shared between CR and the
RHICs, with CR taking an oversight role and individual RHICs responsible for tactical implementation. CR and the RHICs collaborated in developing repurposed content.
CR created a marketing plan for each region, which was then fine-tuned by the

region’s marketing staff. Monthly marketing meetings, with attendance from each region’s marketing staff and CR Project leadership and marketing staff were held to discuss Project updates, track implementation progress and identify best practices across regions.
In the oversight role, CR was responsible for developing the initial marketing plan, support and mentoring of RHIC relationship marketing staff during implementation and overall coordination between all Project Partners. CR specific responsibilities included:
 Collaborate with each RHIC to develop a marketing plan
 Collaborate with each RHIC relative to media relations strategy as the inserts were produced and throughout the Project
 Support product development activities at the regional level
 Share market research
 Provide ongoing mentoring and support of the RHIC marketing efforts including staff orientation and training, cross-regional communications, materials development, sales calls, technical support, etc.
RHICS were responsible for the day-to-day tactical implementation (detailed below) of the regional relationship marketing strategy as defined by the marketing plan, engaging CR and other regions as necessary for effective implementation and measuring results. To achieve desired outcomes of the Project, RHICs agreed to:
 Identify and meet with 20 groups from the target audiences of employers, insurers, providers, business coalitions, and consumer groups.
 Identify a preferred consumer and healthcare advocacy list at the regional level that would publicly support the Project
 Identify a regional spokesperson
 Identify opportunities for repurposed content; facilitate distribution of these new products and measure results
Summary of Relationship Marketing Activities
Consumer Reports Oversight and Support*
Activity
Marketing plan collaboration
Marketing staff orientation
Facilitated monthly marketing meetings
CR participation in regional meetings and sales activities
MA
1
1
7
4
MN
1
1
8
3
WI
1
1
6
2
Email blasts to target audiences
Direct mail
Materials development/technical support
1
0
1
1
0
2
4
1
2

*CR staff provided one on one mentoring and support to RHIC staff throughout the
Project that is not specifically counted within these categories
RHIC Relationship Marketing Outreach to Target Audiences
Organization Type MA MN WI
Entrepreneur
Employer
Employer Coalition
Consumer Organization
Health Plan
State Org or Agency
Onsite Clinics
Retail Pharmacies/Clinics
Provider Systems
Transparency Vendors
Publications
Provider Membership Recruitment
2
3
1
2
3
2
0
1
0
0
0
0
0
14
1
1
4
0
3
3
3
4
0
0
0
0
2
4
3 (MD owned)
0
0
0
16
0
1
5
Total
Repurposing Projects
14 33 31
Plain language version of Patient Experience
Insert
One page summary of insert content
Direct mail promotion
Email promotion to CR subscribers
Animated videos
Distribution of insert, with or w/o the magazine
PDF of insert on target audience websites
MA
X
X
MN
X
X
X
X
WI
X
X
X
X
X
X X X
Implementation
CR produced a template marketing plan that was customized by region. The marketing plan was developed to serve two purposes. It functioned as a training tool for the regional marketing staff, as each RHIC outsourced the relationship marketing function (MN, MA) or assigned it to existing membership staff in an expanded role. (WI). The plan also served the purpose of a traditional marketing plan in outlining consistent goals, strategies, messages, tactics and measurement to be achieved by the marketing effort. The first three sections of the plan - Executive
Summary, Project Goals and Situational Assessment were identical in each region and included background on the Project and overall goals.

The body of the plan was similar for each region but goals, key messages and talking points were customized to reflect each region’s unique business needs. The goals and approaches taken by each RHIC were different, despite the similar plans and reflected the organization’s overall business strategy, culture, political environment and outreach goals.
Summary of Implementation by Region
MHQP
Prior to insert publication, MHQP executive leadership encountered unexpected concerns related to elements of the Project among a select physician groups and
Board members. As a result, the organization delayed implementation of the relationship marketing effort and eventually revised the original promotion-focused goals of the Project to take a more careful, research oriented approach, conducting a series of interviews with target audiences to gather feedback on their impressions of the CR insert, the appropriateness of content, audience interest in the content, suggestions on how to use, promote and distribute ratings.
MHQP’s primary goal became to better understand what interests, initiatives and communication characteristics existed currently or might be evolving in the near future in their region. The results of the survey will help MHQP identify business models, potential partnerships and opportunities they could pursue for the data they currently generate.
MHQP hired a local health care marketing consultant, David Constantine, to fill the role of Relationship Marketing Associate as defined by the Project. The relationship marketing role in MA was to develop a target list of contacts, conduct interviews and create a final written report. Throughout the Project, David participated in the monthly marketing discussions with other Project participants and collaborated with CR staff to craft the final marketing plan for MHQP. David also developed a final report detailing the results of his interviews.
MHQP Key Findings
MHQP conducted fourteen interviews with stakeholders including entrepreneurs, employers, consumer organizations, health plans, state agencies and retail pharmacies. These key findings emerged in their interviews:
 The CR insert, as published, was not deemed valuable by most organizations interviewed. There was also little interest in pursuing repurposed content.
The topic of Patient Experience was not viewed as compelling. One exception to this finding was Network Health Plan, a local plan, which developed a detailed plan for distributing and measuring the impact of the insert content in a variety of formats to their members. The extensive document contains many ideas for ways health plans can integrate content from other sources into existing platforms and processes. Attached in the document appendix.

 The MHQP raw data was seen as valuable to these organizations albeit useful in a form where they could integrate it for use in their existing technology platforms. Most organizations were interested in the data rather than the way in which it was presented in the CR article.
MHQP Repurposing Projects
After identifying the need for a plain language version of the CR insert content for consumers served in community health clinics, MHQP’s repurposing project was the development of the patient experience content in a version that would then be distributed to Network Health Plan and to a series of community health clinics. The document is also available to other RHICs to use when releasing patient experience data. Both MNCM and WCHQ have used the plain language content in their subsequent releases on patient experience.
MNCM
MNCM engaged Linda Davis, a health care consultant familiar with regional stakeholders, to fill the role of Relationship Marketing Associate for the Project.
Other MNCM staff also participated in providing feedback on the marketing plan and especially in developing repurposed content for the project. Both Amy LaFrance and Linda Davis participated in the monthly marketing meetings and were the authors of the final marketing report summarizing MNCM’s marketing activities.
MNCM identified three specific marketing goals.
1.
Direct more consumers to its website for assistance in choosing a clinic or medical group.
2.
Broaden the base of participating employers who understand the value of
MNCM data and actively promote MNCM to their employees through web links on their sites, promotional materials at open enrollments and through other employer sponsored activities
3.
Increase awareness of MNCM among employers and providers to further expand MNCM relationships and business collaborations with these audiences
MNCM conducted the most extensive number of interviews with target audiences
(33). Interesting findings from interviews conducted by MNCM are summarized by type of audience below, followed by key findings and recommendations. Additional detail is provided in the full MNCM Marketing Report and can be used to inform the next stage of development.
Employers
All employers contacted were supportive of promoting quality information to employees and had, as a strategic imperative, the goal of education and engaging employees in health care consumerism.
Employers also reported the following:

 Surprise that provider quality can be measured
 Surprise that the quality information exists
 Suspicion and questions about the motives of the organization producing the ratings
 Interest in seeing more information on patient satisfaction/experience performance.
Specific feedback from employers on the insert was extremely valuable and concern about the text dense nature of the insert led to the development of two additional products using insert content - a one-page summary of the insert designed to direct consumers to the MNCM website and two animated videos targeted to consumers.
Digital and print versions of the one-page summary were distributed to employees during open enrollment. At the end of the project, the videos were being tested with target audiences prior to full distribution.
Health Plans
Four health plans were interviewed. All recognized that they could not by themselves provide credible, trusted quality information to consumers. They appreciated the role of a trusted, neutral organization such as Consumer Reports or
MNCM as the delivery vehicle or endorser for this information and were interested in partnering relationships.
MNCM Key Findings
 Employers, health plans and transparency vendors are universally interested in providing more and better quality information to consumers.
 Employers are interested in providing consumer tools to support employees with HDHPs.
 Employers suggest promotion of quality information through videos , events and other communications vehicles as necessary to increase consumer awareness about quality information.
 Health insurance exchanges include health plan quality information to support consumer choices and are interested in supporting quality information related to physician selection.
 Minnesota health plans and transparency vendors are developing tools to reveal provider costs; they are competing to develop tools that are user friendly, personalized, engaging and intelligent about consumer shipping behavior and information needs.
Recommendations
Recommendations are included here as they relate directly to ideas for strengthening the business and marketing environment within MNCM and could be generalized to all RHICs as they move forward to create a business structure to monetize data.
 Develop marketing capability to promote ratings through multiple channels

 Develop new, engaging vehicles such as videos for employer and health plan websites
 Identify and develop more measures that are engaging for consumers – develop physician scores at the individual level where appropriate, e.g. patient experience, surgery. Develop and roll out specialty measures, particularly for those services that may be paid by consumers with HDHPs and in areas of overuse and variable cost.
 Develop account management relationships with employers
 Monitor and develop contacts at key exchanges
 Build business relationships with health plans and transparency vendors
WCHQ
Mary Riordan, Director of Member Engagement at WCHQ assumed the additional relationship marketing responsibilities to support this project. Mary was new in her role at WCHQ and had not been involved in the Project initially. Mary participated in developing the WCHQ marketing plan, attended the monthly marketing meetings and was responsible for developing the WCHQ final marketing report.
WCHQ identified three marketing goals.
1.
Direct more consumers to the WCHQ website
2.
Broaden the membership base of WCHQ
3.
Increase awareness of WCHQ among target audiences
WCHQ is a membership organization and approximately 50% of its revenue comes from membership dues. Increasing membership was a key goal for WCHQ during the project. The insert and corresponding CR readership survey as well as the media coverage associated with the insert proved valuable tools in attracting new members to WCHQ during the project with other groups in the discussion stages by the end of the project. Additionally, 100% of WCHQ members participated in the publication, even those members whose ratings were at the lower end of the scale.
WCHQ was gratified by this solidarity on the part of its membership.
WCHQ broadened outreach to existing partners and developed relationships with new partners as a result of the Project by using aggregator groups (see below) to reach out to target audiences effectively by sending links, the digital one page flier and emailed notices promoting the insert. These groups included:
 AARP Wisconsin, a key distributer of the magazine and insert, to staff, advocates and 66,000 members in Wisconsin
 Wisconsin Breast Cancer Task Force
 American Cancer Society in Wisconsin
 Business Alliance in Madison sent to 180 employer organizations
 Business Health Care Group in Milwaukee sent to 2,600 individual members in Wisconsin

WCHQ effectively leveraged a planned Practice Site Release, scheduled for May
2013, to extend the reach of the insert and broaden awareness of WCHQ to target audiences. An email blast to WCHQ and CR email lists was sent in May to increase awareness of WCHQ and promote visits to the website. Additionally, a card insert in the July issue of Consumer Reports magazine (at newsstands in May) promoted the website and encouraged subscribers to visit the website to view the new release.
WCHQ Key Findings
 Consumers are looking for quality information but do not know where to find it.
 Many viewed the partnership of WCHQ and Consumer Reports as a natural fit to share healthcare quality data
 Consumers are interested in seeing Wisconsin’s data at the physician level
 WCHQ staff learned a great deal from the staff in MN and MA. Having access to their experiences, insights and expertise were invaluable in the project.
Relationship Marketing Goals Evaluated
1.
Increase awareness of the mission and capabilities of the RHICs - leverage reach of CR insert at time of publication to increase awareness and build a network of business and community organizations in each region, willing to collaborate with each RHIC to promote the distribution of practitioner performance information to consumers. Share best practices across sites.
CR and RHICs developed productive, collaborative working relationships throughout the Project . Each region approached relationship building with external audiences differently, but overall the combination of the reach of the CR insert, attention from national and regional media, ability to showcase the RHIC product
(quality data displayed and explained) to audiences proved powerful and served to increase awareness of the mission and capabilities of the RHICs with external audiences.
2.
Promote development of other products derived from the CR insert
(repurposed content) for use by the customer network developed through relationship marketing efforts.
RHICs were effective at using initial feedback about the insert to create the first repurposing projects – one-page fliers to condense and summarize the contents of the insert in order to broaden the audience. Feedback on one-page fliers again indicated they were text dense and the content could find a broader audience by using other methods. This ultimately led to the development of videos and direct mail projects in an effort to find more effective ways of communicating creatively and concisely with audiences.

3.
Strengthen relationship building, community outreach and marketing
experience and expertise at the regional level to support ongoing RHIC business and revenue generating activities.
RHICs are primarily internally focused organizations adept at developing a very complex and reliable product. They have developed strong, collaborative business relationships with their data sources and infrastructure to assure the validity and reliability of the data they provide. This is a unique product! However, the ability to market the product effectively to broad audiences is a different skill set – one that
RHICs do not possess at this time and find it difficult to commit resources necessary to develop. Throughout this Project, it was evident that building a marketing infrastructure within these organizations was a task that could not be accomplished within the scope of the project. RHIC staff worked diligently in support of the relationship marketing activity but this was in addition to regular, also compelling responsibilities. Contract staff were extremely competent, but hired for a short duration. In subsequent projects, RHICs would be better served by outsourcing or partnering to gain the consistent, professional marketing and communications expertise necessary to promote their exceptional product.
Appendix of Documents
 Regional Marketing plans
 Final regional marketing reports
 Examples of repurposed content
 Network Health Plan distribution plan