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MARKETING & INSURANCE. Strategic Management in Healthcare 24 MARCH 2009. MARKETING. ESSENTIAL TO IMPLEMENTING STRATEGY AND FULFILLING MISSION. MARKETING. “MARKETING IS AN INTEGRAL PART OF STRATEGIC PLANNING” DO YOU AGREE?. CENTRAL CONCEPT OF MARKETING.

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marketing insurance
MARKETING & INSURANCE

Strategic Management in Healthcare

24 MARCH 2009

marketing
MARKETING
  • ESSENTIAL TO IMPLEMENTING STRATEGY AND FULFILLING MISSION
marketing3
MARKETING
  • “MARKETING IS AN INTEGRAL PART OF STRATEGIC PLANNING”
  • DO YOU AGREE?
central concept of marketing
CENTRAL CONCEPT OF MARKETING
  • VOLUNTARY EXCHANGE OF SOMETHING OF VALUE - CONSIDERATION
  • DETERMINE WANTS, NEEDS, EXPECTATIONS, DEMANDS
  • DELIVER GOODS OR SERVICES
elements of marketing
ELEMENTS OF MARKETING
  • PRODUCT SERVICE
  • PRICE CONSIDERATION
  • PLACE ACCESS
  • PROMOTION PROMOTION
target market
TARGET MARKET
  • PHYSICIANS
  • PATIENTS
  • INSURERS
  • EMPLOYERS
  • GOVERNMENT
  • CHARITY GROUPS
epidemiologic planning model
EPIDEMIOLOGIC PLANNING MODEL
  • DEMAND = POPULATION x INCIDENCE x USE x MARKET SHARE
  • INCIDENCE
    • NUMBER OF NEW CASE OVER A PERIOD OF TIME
  • PREVALENCE
    • NUMBER OF CURENT CASES AT A POINT IN TIME
social marketing
SOCIAL MARKETING
  • USE THE TOOLS OF MARKETING TO INFLUENCE VOLUNTARY BEHAVIOR FOR SOCIAL BENEFIT INSTEAD OF PROFIT
  • HEALTH CARE ORGANIZATIONS?
  • GOVERNMENTS & CHARITIES?
payors
PAYORS
  • FEDERAL GOVERNMENT
  • STATE GOVERNMENT
  • EMPLOYERS
  • CHARITIES
  • INDIVIDUALS
insurance
INSURANCE
  • ARE THEY PAYORS?
  • SINGLE PARTY PAYOR
  • NATIONAL HEALTH
insurance is a contract
INSURANCE IS A CONTRACT
  • PARTIES TO THE CONTRACT
    • THE PATIENT AND THE INSURANCE COMPANY
  • HOW IS THE DOCTOR INVOLVED?
  • HOW IS THE EMPLOYER INVOLVED?
indemnification insurance
INDEMNIFICATION INSURANCE
  • WHAT MOST OF US THINK OF AS INSURANCE
  • YOU HAVE A LOSS - THE INSURANCE COMPANY FIXES IT OR PAYS FOR IT
self insurance
SELF INSURANCE
  • GENERALLY INVOLVES THIRD PARTY ADMINISTRATORS
  • LOOKS JUST LIKE INSURANCE
  • USUALLY INCLUDES SOME TYPE OF CATASTROPHIC REINSURANCE
direct contracting
DIRECT CONTRACTING
  • TAKES OUT THE INSURANCE COMPANY
  • SAVES MONEY
  • CREATES ISSUES FOR FOLLOW-UP
government mandates
GOVERNMENT MANDATES
  • PREGNANCY
  • SCREENING PROGRAMS
  • DIALYSIS
managed care organizations
MANAGED CARE ORGANIZATIONS
  • INTEGRATION OF FINANCING AND SERVICE DELIVERY
  • INSURANCE COMPANIES WITH CAPTIVE PROVIDERS
  • USE SOME SYSTEM OF GATEKEEPING
types of mco
TYPES OF MCO
  • HMO - HEALTH MAINTENANCE ORGANIZATIONS
  • PPO - PREFERRED PROVIDER ORGANIZATIONS
  • POS - POINT OF SERVICE PLANS
cost containment
COST CONTAINMENT
  • THE PURPOSE OF MANAGED CARE
  • HAS IT WORKED?
  • ACCESS TO CARE
  • CONTROL OF PHYSICIANS
  • PREVENTION
medicare
MEDICARE
  • SINGLE PARTY PAYOR
  • VERY EFFICIENT AND EFFECTIVE
medicare cost containment
MEDICARE COST CONTAINMENT
  • DRGs
  • PAY FOR QUALITY
  • INCREASING NUMBER OF LIVES
  • INCREASING SERVICES
national health
NATIONAL HEALTH

DO YOU WANT HEALTH CARE THAT RUNS LIKE THE POSTOFFICE?

Takes a note from my hand in New York on Monday and puts it in my sister’s hand in California on Wednesday for 42 cents.

case study 3
CASE STUDY # 3
  • GEORGE – pharmacist in rural Alabama for 40 years – lunch counter & sundries
  • Mrs Murden – expensive arthritis medicine
  • Options
    • Stay with her pharmacy
    • Local drug discount card
    • $4 plan at Wal-Mart or Walgreens
    • Mail-order