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MARKETING & INSURANCE

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

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  1. MARKETING & INSURANCE Strategic Management in Healthcare 24 MARCH 2009

  2. MARKETING • ESSENTIAL TO IMPLEMENTING STRATEGY AND FULFILLING MISSION

  3. MARKETING • “MARKETING IS AN INTEGRAL PART OF STRATEGIC PLANNING” • DO YOU AGREE?

  4. CENTRAL CONCEPT OF MARKETING • VOLUNTARY EXCHANGE OF SOMETHING OF VALUE - CONSIDERATION • DETERMINE WANTS, NEEDS, EXPECTATIONS, DEMANDS • DELIVER GOODS OR SERVICES

  5. ELEMENTS OF MARKETING • PRODUCT SERVICE • PRICE CONSIDERATION • PLACE ACCESS • PROMOTION PROMOTION

  6. TARGET MARKET • PHYSICIANS • PATIENTS • INSURERS • EMPLOYERS • GOVERNMENT • CHARITY GROUPS

  7. 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

  8. SOCIAL MARKETING • USE THE TOOLS OF MARKETING TO INFLUENCE VOLUNTARY BEHAVIOR FOR SOCIAL BENEFIT INSTEAD OF PROFIT • HEALTH CARE ORGANIZATIONS? • GOVERNMENTS & CHARITIES?

  9. PAYORS • FEDERAL GOVERNMENT • STATE GOVERNMENT • EMPLOYERS • CHARITIES • INDIVIDUALS

  10. INSURANCE • ARE THEY PAYORS? • SINGLE PARTY PAYOR • NATIONAL HEALTH

  11. INSURANCE IS A CONTRACT • PARTIES TO THE CONTRACT • THE PATIENT AND THE INSURANCE COMPANY • HOW IS THE DOCTOR INVOLVED? • HOW IS THE EMPLOYER INVOLVED?

  12. INDEMNIFICATION INSURANCE • WHAT MOST OF US THINK OF AS INSURANCE • YOU HAVE A LOSS - THE INSURANCE COMPANY FIXES IT OR PAYS FOR IT

  13. SELF INSURANCE • GENERALLY INVOLVES THIRD PARTY ADMINISTRATORS • LOOKS JUST LIKE INSURANCE • USUALLY INCLUDES SOME TYPE OF CATASTROPHIC REINSURANCE

  14. DIRECT CONTRACTING • TAKES OUT THE INSURANCE COMPANY • SAVES MONEY • CREATES ISSUES FOR FOLLOW-UP

  15. GOVERNMENT MANDATES • PREGNANCY • SCREENING PROGRAMS • DIALYSIS

  16. MANAGED CARE ORGANIZATIONS • INTEGRATION OF FINANCING AND SERVICE DELIVERY • INSURANCE COMPANIES WITH CAPTIVE PROVIDERS • USE SOME SYSTEM OF GATEKEEPING

  17. TYPES OF MCO • HMO - HEALTH MAINTENANCE ORGANIZATIONS • PPO - PREFERRED PROVIDER ORGANIZATIONS • POS - POINT OF SERVICE PLANS

  18. COST CONTAINMENT • THE PURPOSE OF MANAGED CARE • HAS IT WORKED? • ACCESS TO CARE • CONTROL OF PHYSICIANS • PREVENTION

  19. MEDICARE • SINGLE PARTY PAYOR • VERY EFFICIENT AND EFFECTIVE

  20. MEDICARE COST CONTAINMENT • DRGs • PAY FOR QUALITY • INCREASING NUMBER OF LIVES • INCREASING SERVICES

  21. 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.

  22. 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

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