Branding & Asset Design for Concierge, Direct Pay and Personalized Medicine Physicians

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Branding and Asset Design for Concierge, Direct Pay and Personalized Medicine Physicians

Maria K Todd, MHA PhD CEO & Founder Mercury Advisory Group Author, Handbook of Concierge Medical Practice Design As a physician who has decided upon on of these three models, Maria Todd provides seasoned guidance on planning, marketing and operating them to help you achieve success. To do this, she draws from more than a decade of experience helping concierge medical practices across the USA and abroad.

With one call, you can tap the knowledge of Maria and her collaborating experts to help you with every aspect of the transition to convert your practice: Choosing your location, marketing, branding, operations, membership sales, pricing, dealing with payer contracts, and more.

To begin, she uses a sophisticated and proprietary pathway that begins with a practice analysis

using data you supply from your practice management system and in in-depth interview to learn your goals, objectives and preferences for your new business model. The data she needs from you are simple, custom reports that anyone with knowledge of your software’s on-demand reporting system can create and downloaded without any special programming expense. These include straightforward reports such as patient zip code counts, age and gender counts, insurer and health plan counts, and diagnosis and procedure counts.

These reports have been easy to access in most every software package in the industry since as far back as the early 1980s. You’ll save them to electronic form as PDF files instead of print files so you can easily email them to her for review. They contain no PHI. She then adds in results from a query of data from over 1,500 granular datasets and other publicly sourced reports to identify and segment where your ideal customers are located in your community and service area. Maria and her team overlay data about your existing active patients with this other aggregated data to create a roll up report that is both recent and specific to your community and your current practice that highlights what is known about community demographics, traffic volumes, spending patterns, demand for what you are selling, market indexing, location comparison, competitors - if any, plus identification of service 2

voids and service gaps, and more. Her deliverable is a single, comprehensive profile of your practice and its position in the community and online reputation and presence analysis that is customized, confidential, and actionable.

The report shares the findings and her expert analysis and interpretation of what the data means in terms of: • potential to succeed in your chosen business model • pricing and value proposition recommendations • insights into the personas and consumer behavior of your ideal targeted customers and where to find them, and • how to create marketing and advertising and public relations messages that resonate with them.

These insights are also used to create your branding and asset design for your new re-

branded concierge, direct pay or personalized medicine practice.

What if you choose to skip all this?

Without this data you could proceed to plan marketing, branding, advertising and public relations campaigns to build brand awareness and recognition. But you might make several avoidable errors and risk resonating with very few potential buyers.

In turn, that could slow your practice growth and membership recruitment to unsustainable levels.

The initial on-site consultation that precedes the data analysis is to: 1. gather insights from you, 2. gather field data and 3. observe you and your staff

the on site visit and interview is to purchase the local market report for your address from her for $500 if you believe you’d rather do the rest yourself.

Strategies are road maps Execution is key When you begin to execute on properly developed strategies, you’ll be able to measure results and make refining adjustments to your strategy much the same way you deploy targeted drug therapies with your patients. In these three business models for a medical practice, not every physician has the same targets and objectives. Copy-paste marketing, advertising, public relations strategies and tactics developed for someone else cannot and should not be applied to your unique and differentiated new

means to convey the information to you in a logical and organized document to refer to it as needed.

You are ultimately the one who decides how to make use of the information in the report. What you decide to do and prioritize is the doorway to the next phase.

Maria’s first phase report should be viewed as a tool to help you choose the next steps to execute a targeted strategy.

The targeted strategy is a map that has been prepared to your specifications. To achieve the next steps, Maria can help you “drive” to your chosen destination but she cannot “drive it for you.” You must also provide the financial means to make the trip, the vehicle, the gas, and the time for the travel itself and choose the stops along the way. Without these other tools,

To prepare for marketing and business development, branding and asset design come second. at your location to assimilate the data into the report she prepares.

There’s no substitute for the site visit component of your first phase of the project. If this is not acceptable, she may recommend you contact another consultant.

Maria personalizes your output report by using your stated objectives and measurable goals and aspirations for your newly re-branded practice to create filters and to assign weightings to certain dataset categories. This helps her to identify targets and measurable objectives that inform your marketing strategy. This part is extremely personal.

The D-I-Y Approach Another option if you don’t want to invest in the first phase analysis and her recommendations and

practice. The analogy is that the custom data and recommended strategy is your architectural and interior design plan for the custom home of your dreams; the copypaste version is like a hotel room.

You can lay your head down in either one and sleep or take a shower, but they are not the same.

What happens when you don’t set targets or set the wrong targets?

If you don’t target correctly, you risk ineffective actions, investments and expenditures.

You lose time and delay results.

These errors and mistakes usually negatively impact chances for profitability and steady growth.

That’s actually what you are investing in with Maria and her team. The report is merely the 3

the report is a stack of paper that sits on a shelf or an electronic document on your hard drive.

Nothing else happens without prioritized choices, funding and action.

Consider these additional realities: • A targeted strategy will not work if the community lacks the targeted consumer base necessary to attract buyers of what you sell.

• Establishing a target does not mean the market will respond.

• The response to your targeted messaging may be curiosity at first but it may not be the product the market wants to buy. This results in a flurry of initial response followed by lower growth or resistance to proceed through the entire sales funnel and become your

patient. To overcome the stagnation, we look back at the data and the strategy to tell us “why” the strategy isn’t producing anticipated results and what to refine and adjust to meet your goals.

What if there are no existing patients? What if I am leaving an established practice and I have a non-compete restriction in my employment contract? What if I am fresh out of residency?

It is much more challenging to do all this with a new physician with no existing practice base to convert. You’ll find that many seasoned consultants will not accept you as a client. This is especially true if your goal is 600 patients in the first year and you decide not to participate with any insurance programs. Maria receives calls from physicians almost weekly who articulate these goals in their introductory call. From her experience, unless you’ve moved into a community with no other physician, such rapid growth is unheard of. Often, your best approach is to purchase the local market report for $500, study the information, prepare specific questions for Maria and schedule a brief telephone consultation invoiced for the time you need at her hourly rate. If you still want to move forward with a concierge or direct pay or personalized medicine practice, you’ll be far better prepared and informed about the realities you will face going forward. The amount you invested in the report and the preliminary consultation is credited towards the first phase assignment. As long as the start of the first phase assignment is within six months of the local market report, it can be used

without having to be redrawn.

The second phase assignment To prepare for marketing and business development, branding and asset design come second.

The first task in this second phase project is to determine “what to market” and “what to say in your messages” and to whom. This is done by first determining from the first phase research and analysis described above. The assumption required to move forward is that there is demand for what you want to sell and where the customers are located. We inform and guide your thinking bout what we believe to be your best strategy to connect your product and services to the marketplace.

Ultimately, the decisions about what to do, how and when are yours.

All this preliminary work up is categorized as “branding”.

Don’t fret if you weren’t aware of this aspect of branding. So many very intelligent people who studied professions other than marketing and business are under the mistaken assumption that branding is all about logo, imagery, packaging, fonts, colors, business card design and the like.

Let’s look at a few definitions to make a quick lesson of this: Marketing emphasizes the promotion of products and services for revenue purposes.

Marketing activities include • branding • advertising and • public relations.

Marketing employs a systematic process (the objective of Maria’s initial research and analysis on your behalf carried out by a sophisticated and proprietary process she’s refined over a more 4

than a decade of healthcare marketing project assignments and results) along with planning and execution for your promotional efforts. That is why targeting is so crucial.

Marketing is also a larger, often misapplied umbrella term that includes branding so that you can advertise and create a favorable, recognizable public image through relationship building with targeted individuals and reputation management.

Your brand’s creative assets provide the look, feel, sound, and messaging parameters to assist in the promotion of products and services you offer in order to drive sales.

Positioning is a term that refers to the place that a brand occupies in the mind of the customer and how it is distinguished from products from competitors.

Unlike her general business management competitors, Maria’s clinical background, training and expertise is leveraged to utilize and incorporate her knowledge of anatomy, physiology and consumer behavior affected by the limbic system and the neocortex. This approach is called neuromarketing.

Neuromarketing is a commercial marketing communication approach that applies neuropsychology to marketing research, studying consumers’ sensorimotor, cognitive, and affective response to marketing stimuli. In healthcare marketing, it is very effective because decisions are both logical and emotional.

You might not have given much thought to how sensorimotor, cognitive and affective responses to visual and auditory marketing messages all come together in

marketing healthcare services.

Most general business consultants haven’t studied this either, so they aren’t likely to use the same approach.

People discover your brand and then decide whether or not to trust your brand in a matter of nanoseconds from their prewired patterns of information and instinctive behaviors. Based on the emotional evaluation of a stimulus, the limbic system then decides to continue or stop certain performances. Academically, you get this, but applying the knowledge to marketing and branding is one of the ways Maria and her team can help you.

They use this information to target potential customers by first determining “who” are your ideal customer (patient buyer) personas and making their best recommendations about what colors, fonts, words, images and media (print, digital, audio, video, etc.) will resonate, feel “safe” and “trustworthy” and will appeal to innate instincts to enhance buyer interest and drive them through your sales funnel. She works to reduce the cold, aggressive sales tactics that are anathema to most physicians (and their support staff). The result is a more refined, upmarket feel that is elegant, tasteful, and distinguished rather than trite and platitudinous or pushy.

Advertising is a “purchased” communication tool used by marketers in order to get customers to call, email, or ultimately buy what you sell.

There is no “free advertising”. Not even word of mouth advertising is “free”; you earn every bit of it.

Social media marketing is not free by any means. Yes the accounts

are free to set up, but boosting your posts on social media costs money. Someone to maintain the social media channels costs money or time. Indeed, there are places where you can advertise for free by getting free listings and free visibility, but you still need creative assets (e.g., logo, messages, photos, videos, and other owned-content or curated content) to post on them. You need a computer or smart phone or tablet to do the posting, software to create the posts, etc.

And one thing to remember above all: If you aren’t paying for the product (in this case, the advertising space and reach), then you are the product. When you engage in free advertising on social media and Internet outlets, all the data you provide creates individual and business profiles to connect the dots to be repackaged and resold as data to create revenue for the free service to exist.

In order to place advertisements, a business owner first must hire creative agencies to design the message, image, font, and colors.

To give the creative agencies guidance, every agency requires a “creative brief”, ( a document produced by the requesting party (the customer). The goal of the brief is to define aspects of a creative piece of work, such as a print ad , website, advertisement, flyer, brochure, or other piece of marketing “collateral”.

Without knowing your customer, their preferences, needs, desires, aspirations, and fears (which happened in the first phase of Maria’s work) the creative experts cannot apply their best efforts to your projects to create the collaterals you need to prepare 5

to advertise. Their outputs will be used if you decide to buy radio and TV or newspaper ads, billboards, bus benches and bus placards, or to self-advertise by posting special offers and promotions on your social media channels.

You may also use these outputs to design the audio-visual presentations you’ll use at your “town hall” gathering to announce your transition from the practice you had to your new business model. Additionally, you’ll use the outputs to design your business cards, stationery, website theme, and any sales brochures and other printed product information, web content, membership sales scripts, membership contractual agreements, patient membership manuals, and other “branded” promotional items.

Once you have the basic collection of branded media you’ll use to support membership sales, it will be easier to grow your re-branded practice under the new cashbased or hybrid business model.

This is limited only by your budget and the means to connect to the consumer in the marketplace before or better than your competitor professional rivals.

This is where we’ve found many physicians at risk of “being sold” all kinds of advertising options by the creative agencies to generate “reach”. Reach is actually a pretty easy metric for any agency to deliver.

With your permission, we act as a buffer between you and these aggressive advertising agencies so you don’t get sold a bunch of media and advertising space that doesn’t directly drive up revenue and patient acquisition. We’ve found some physicians convinced

to sign contracts with ad agencies to spend as much as $45,000 a month on “reach” - a metric that refers to the total number of different people or households exposed, at least once, to a medium during a given period.

Reach should not be confused with the number of people who will actually be exposed to and consume the advertising. People were counted among those “reached” if they began watching a commercial and then stepped away to get a snack from the fridge. Frankly, Maria doesn’t place much value on “reach” unless it gets to the more relevant metric: “revenue”. What’s worse, these physicians were paying $4500 a month to the ad agency for the services of an account manager to coordinate the $45,000 a month ad spend, and also collecting 20% on average as a commission from the media suppliers!

Maria and her team deal in a metric different from “reach” . They prefer to focus clients on return on marketing investment (ROMI); what you got for what you invested in your marketing, advertising and public relations. The purpose of ROMI is to measure the degree to which spending on marketing activities contributes to profits.

The formula is as follows: Return on Marketing Investment (ROMI) = [Incremental Revenue Attributable to Marketing ($) * Contribution Margin (%) Marketing Spending ($)] / Marketing Spending ($) A necessary step in calculating ROMI is the measurement and eventual estimation of the

incremental sales attributed to marketing. This latency is often explained by the “12 touches theory”.

Microsoft and many others have reported that you usually need about 12 touches to close a deal with a customer.

1st Touch – Prospect encounters your brand for the first time. At this point, 50% of physicians give up and don’t try again.

2nd Touch – Prospect encounters your brand for the second time. At this point, 85% of the remaining 50% of physicians who decided to try again give up and abandon marketing efforts altogether.

3rd Touch – The prospect encounters your brand for the third time, but still don’t take action. At this point, 79% of the remaining 15% of physicians give up because their expectations were not met.

4th Touch – You add a new medium to the marketing and advertising or public relations mix.

While many of the physicians have already given up at this point, you start to harvest low-hanging fruit driven by the beginning of brand awareness and recognition.

What is it you offer? At this stage, prospects dig deeper to understand the “what”.

5th Touch – At this stage, you ave reached the earliest stage of awareness in your prospect’s mind. By nurturing slowly, your prospect gets to know you better.

They invest time to learn more about you.

6th Touch – It is at this stage that, if the prospect you “reached” is interested in what you sell, they may take the first step toward conversion. A conversion is an action that’s counted when 6

someone interacts with your ad (for example, clicks a text ad or views a video ad) and then takes an action that you’ve defined as valuable to your business, such as an online purchase or a call to your business or an email. One prospect of one of our concierge physicians even “tweeted” their inquiry!

7th Touch – Now that you have some engagement, and permission to follow up, you may decide to send an email to followup and remind them to continue through your sales funnel. At this point, you are earning top of mind awareness.

8th Touch – Your secretary or patient advocate may call and use a sales script to suggest the prospect stop by to meet you and discuss how your program can help them if no response was triggered thus far. Your prospect might not be available but he or she schedules another time. You are probably the only physician to make eight touches with this person.

9th Touch – Your staffer sends an email follow-up to confirm the day and time of your meet and greet appointment with the prospect. From this point, when your prospect is ready to buy, you will have a 90% chance of being chosen over your local competitive rival(s).

10th Touch – The meet and greet appointment or call is finally held. Your prospect is interested but wants information on some aspects of your product/service.

11th Touch – You send the information your prospect wants.

You can email brochure, sample contract, price list, or other midfunnel information related to your concierge, direct pay or personalized medicine practice.

12th Touch – You now have a more engaging talk with your prospect. He now shares his pains and needs, gives you access to their budget allowance, decisionmaking authority, need, and time frame (BANT) data. At this point, your prospect is now ready to buy a membership to become your patient.

Physicians who fail to account for the 12 touches over time often start out marketing their new concierge, direct pay or personalized medicine practice with unrealistic expectations.

In helping to formulate your conversion budget and marketing plan, you’ll hear Maria refer to the 12 touches as she explains how physician practices in these business models trend growth and revenues. You must also take this information into consideration when you begin back of the envelope calculations on your own about how many patients you need to pay for membership fees coupled with the number of visits and treatments you expect to provide in your first three to five years of operation.

You also need this information to critically analyze opportunities you may be presented by other consultants who offer free consulting to convert your practice for a percentage of the membership fee for the first five years. It is crucial that you read their contracts and understand what you risk if you don’t grow according to the schedule they project and they hold you accountable for any shortages each year. Often, these firms tell you that they cover “all upfront costs” but the definition of “all” rarely includes your 12-touch marketing costs, creative asset

design to be prepared to market your new brand, and the budget for advertising placements and social media marketing campaigns.

Why is all this marketing expense necessary?

Many physicians tell us they’ve survived without all this nonsense before, in their traditional practice.

What’s different?

Remember how you complained that the managed care plans and PPOs paid too little? Well, the discounted rates you negotiated as a “preferred provider” or “in-network provider” was an arrangement whereby the plan did the marketing, recruited the patients, and “steered” them your way. In a cash practice, all that steerage goes away. You are now in a different business model where you decide the price, the product, the amenities, the culture, the look and feel of your product. This autonomy comes with new responsibilities and accountability. Who will do all the marketing, branding and advertising, creative asset design, market research, planning, media buying, promotion, sales, membership billing, customer service, win-backs, social media marketing management, content creation, online and offline reputation management, your website, and getting you listed on GPS maps and apps, and analyze the results to report on ROMI? That’s right: You or someone on your staff, or an external contract freelancer you might engage.

And if you don’t do it, you’ll be a best kept secret. And if you do it wrong because you skipped the brand development and market research and practice analysis before buying ads and public 7

relations services, you risk wasting lots of time, money and losing opportunities to better prepared, faster acting competitive rivals who see what you are up to and copy the concept but who might execute more effectively.

How much will all this stuff cost?

It is almost impossible for Maria and her expert team of creative specialists to give you a first year cost estimate to transition your practice without first learning what you want to do, how you want to do it, and if there is a demand for your newly-rebranded concierge, direct pay or personalized medicine product and how to capture that demand.

There are too many unknowns on an introductory call to give you an estimate without certain preliminary research and data gathering and analysis.

For this reason, she gives an estimate of the cost and time for the preliminary services in the first phase as a flat fee plus travel costs.

After your data is compiled and analyzed, she can make recommendations about what to do next and estimate what it will cost.

Ultimately, it may be determined that there is no cost because the recommendation is that you not move forward with the transition in your current location or with your current reputation in the community or the product and services you wish to offer. When there is insufficient demand to sustain you and grow the business to the level you need and want the best option may be to wait, move or continue doing what you have been doing or improve what you’ve been doing. Improvements can come in the form of better contracts, better marketing,

training the staff to improve billing, collections, customer service, or add technologies and new services that produce new revenues to the mix. If that’s the situation you find yourself in, Maria can help with those improvements as well.

How long will all this take?

Once you’ve completed the preliminary analysis, you can expect the actual conversion to take between two to four months to plan, execute and launch your newly-re-branded practice.

Developing your unique conversion road map Maria and her team will develop your conversion plan, including staff training, prospective member education, and an integrated marketing and PR communications strategy to announce the news to your patient community. All the creative assets must first be developed and accepted by you in order to execute the strategy and begin to deploy campaigns.

Staff training and development Staff training of the point person(s), often referred to as “patient advocates” must be completed so that they are confident and prepared to meet one-on-one with patients, so that they can educate your prospective members and follow through on your 12 touches pathway to a closed sale of a membership.

Operational guidance Operations training takes place prior to commencement and continues through launch so that your practice operations are optimized. This often includes guidance on human resources decisions and functions, outsourcing, technology, software, and more.

Announcing the change Presentations must be developed and events scheduled and promoted and RSVPs collected to conduct your “town hall” meetings if that’s the approach that is chosen to announce the change to your patients and to the public.

Public relations Public relations experts are then engaged with the assignment to get local and regional press coverage of your story. Public relations experts we work with are tasked with creating a favorable public image for your professional reputation and your business. They interact not only with consumers, but also with the media and your staff to work their magic. They earn publicity for your business and your name through pitching and convincing local journalists and media to talk about you and include you in stories for the local television and radio news programs, the newspaper, blogs, and other opportunities to draw attention to your brand. They also divert attention away from public discussions that may be damaging or risk scandal. Some of the risks of brand damage and negative attention could arise because you quit a managed care plan and the displaced patients could not find a physician to accept them.

Or because a managed care plan sued for breach of contract you because you started a concierge or DPC program in spite of existing prohibitions stated in the contract you already signed and haven’t fully terminated prior to commencement of the newly re-branded business model. That is why review of any existing contracts is crucial before we begin.

Regulatory compliance 8

Another aspect of your conversion is to plan your marketing and advertising with regulatory compliance in mind. Physicians often think of regulatory compliance in terms of Fraud and Abuse issues. There’s human resources compliance to address, truth-in-advertising and other consumer protection laws. With the DPC model, you must design the product so that it does not appear to be an unregulated HMO that assumes untoward financial risk for the cost to deliver unlimited services for a monthly or annual fee. When you treat Medicare patients, there are also certain regulatory compliance requirements with regard to Concierge Medicine and Direct Pay business model practice design.

You may be forced to decide if you’ll continue to participate with Medicare. If you decide to cancel your participation with Medicare there are many serious ramifications to consider. These will all be discussed in your first phase consultation.

Contract compliance If you opt for a hybrid concierge practice and decide to remain “in-network” with some contracted payers, Maria reviews your contracts first during the preliminary assessment to ensure there are no conflicts in what you already agreed to. Many managed care plans object to or specifically prohibit participating providers to force their members to purchase a contract in a concierge medical practice. Based on the findings in the contracts you’ve already executed, you may be forced to decide to cancel the contracts or attempt to renegotiate an exception or develop a workaround in the business model you develop. Maria’s unparalleled

expertise with managed care contracts and payer negotiations is renowned worldwide. She is the leading author of the best-selling textbook on managed care contracting, now in second edition. You can trust her guidance in this area of concern.

Website and online marketing Your integrated marketing communications plan, including a basic practice website, web-based advertising campaigns, social media platform and presence and reputation monitoring and management, along with search engine optimization must be developed.

Again, without the creative assets, you won’t have brand image consistency through colors, fonts, imagery, slogans, tag lines, messages, and the like for use in website and social media and other web-based advertising campaigns. And if they are not consistent and congruent with your brand and its promise, you won’t effectively navigate the 12 touches.

Brand congruence and consistency At the heart of this concept of consistency and congruence is the strong belief that every single aspect of your patients’ brand experience must be uncompromisingly consistent throughout all touch points. From first exposure, to pre-purchase, to the transaction, to renewal the following year — every interaction must fully support the brand promise.

The “Brand Promise” is the promise you make and keep to you customers about everything you will deliver to them when

they purchase your products and services. The features, advantages, rewards, excitement, pride, satisfaction, fun, enjoyment, safety… the complete package of all physical and emotional benefits tied directly to your brand.

Brand promise is where the neuropsychology of your marketing, advertising and public relations efforts impact both initial and renewal decisionmaking by your customers. The emotional brain processes sensory information in one fifth of the time our cognitive brain takes to assimilate the same input. That’s how fast the patient you win today after all your hard work can be tempted to consider your competitive rival up the street or down the hall.

We hope that this detailed explanation of our services and proprietary pathway and methods of conversion to a concierge, direct pay or personalized medicine business model has been helpful.

We realize you may have additional questions for Maria, so once you’ve read this, jot down your questions and any clarifications you need in the space provided on the next page and schedule a brief call to get answers if you like.

To discuss any concerns, ask any questions we haven’t addressed, or discuss our availability to take you on as a client, please call us at (800) 727.4160 or email Maria Todd at cdpc@mercuryadvisorygroup. com.

We wish you the best of success regardless of if you decide we are 9

the right team to assist you or if you decide to choose another firm.

Ask us about additional services we offer for concierge membership, direct pay and personalized medicine practices: • •

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Local market demographic data reports Social media marketing management (Maria is certified

by Google) Listing your practice in online maps and GPS directories Online reputation management Website setup and web page design Podcast and video production Patient newsletter creation and management Outsourced membership billing and membership management Payer contracting and credentialing management CAHPS® score improvement Contracting with employers and corporate clients for Executive Checkups Special program additions (weight loss, implantable hormone therapies, stem cell injections, anti-aging, house calls, telehealth, and patientcentered, team-based primary care) Patient-Centered Medical Home accreditation preparation Physician, APRN and PA employment contracting (we are not recruiters) Membership sales staff training New Concierge Patient Membership Handbook Practice administrator coaching Low-cost EMR and Practice Management software Branded Rx discount cards

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