Calming patient fears
Even as Los Angeles health systems face surging COVID-19 cases this summer, they have a consistent message to the community: Don’t delay routine or emergent medical care. The city’s six major health systems launched a campaign in early May—before Los Angeles became a COVID-19 hot spot again—letting the community know their doors are open and urging patients to keep up with their health during the pandemic. The systems—Cedars-Sinai, Dignity Health, Kaiser Permanente, Keck Medicine of USC, Providence and UCLA Health—are usually fierce competitors that don’t collaborate, but lower patient volumes had them all worried. Anecdotes from those on the front lines were consistent: Patients are avoiding needed healthcare services because they don’t want to enter a setting where coronavirus lurks. Patients also didn’t want to overwhelm the system with non-COVID-19 concerns.
“The second health crisis is people not getting care,” said Tanya Andreadis, chief marketing officer of UCLA Health.
The systems are still going full speed ahead on the marketing campaign even as L.A. sees a resurgence of COVID-19 cases, which caused the mayor to recently reinstate restrictions like the closure of bars and restaurants for dining.
“The messaging (of the campaign) is as important, or even more important, than ever before. While Los Angeles County experiences a spike in cases, the issue of putting your health first is critical to slowing the number of cases,” said Rhoda Weiss, a healthcare marketing consultant who is leading the campaign.
The systems dedicated their existing marketing assets—including billboards and advertising slots for print, TV and radio—to the campaign, which is called Better Together Health. The current assets run to the end of July, but the systems are working on how to continue the message
even afterward, Weiss said. A main slogan is, “Life may be on pause. Your health isn’t.” Weiss said she couldn’t offer cost figures on the campaign because the systems offered existing resources.
“We are saying, ‘We are here to take care of you,’ ” Weiss said. The L.A. health systems aren’t unique in their marketing efforts. Similar messaging is being deployed by health systems across the country as they see 2020 revenue plummet because of the pandemic. A recent American Hospital Association report estimated hospitals lost $200 billion between March and June, most of which was from canceled surgeries and lower volumes in outpatient clinics and emergency departments.
Given the strained finances, marketing departments are creating campaigns focused on encouraging patients to seek care, attempting to convince a scared public that a clinic and hospital isn’t a hotbed for the coronavirus. While marketing researchers say there are tactics health systems can deploy to convince many patients to schedule services, there may be a limit to how much of the volume providers can get back as long as there is no COVID-19 vaccine.
“For the people who really need care, they are going to come back in,” said Chris Bevolo, health systems practice lead at marketing agency ReviveHealth.
He said health system clients were seeing 60% to 80% of their volumes return in May and June, but it was mostly sick patients or those who had elective procedures and services postponed in mid-March when COVID-19 restrictions were first implemented. Generally healthy patients who need screenings or annual checkups are more likely to delay care, and they are going to be the hardest group to get scheduled for services, he added.
Establishing trust
For their part, health systems are being creative in how they are encouraging patients to return for care.
Market research—both internally by providers and externally by research firms—shows patients most trust their local healthcare organization to give them information relat
ed to COVID-19. Health systems have taken advantage of that by directly reaching out to patients.
For instance, the population health team at Loyola Medicine in Chicago has been calling patients to ask how they are doing and if they need to come in for any healthcare concerns. Right now, Loyola is focusing on patients with chronic conditions who are likely most in need of services, but it may expand the outreach to its entire patient population.
“I think they (patients) are surprised to get a phone call from us,” said Dr. Richard Freeman, Loyola’s regional chief clinical officer. “They are very appreciative, especially folks who have had difficulties.”
Keck Medicine has even asked doctors to call patients directly to let them know their practice is ready to see them, and protocols have been put in place to keep patients safe. “Having physicians and providers call their patients … has really brought people back,” said Jeana Rettig, chief marketing and communications officer for Keck Medicine.
During the peak of the crisis, Ochsner Health in New Orleans ramped up social media and blog posts related to the virus such as how to make a mask and safely plan a birthday celebration. Before COVID-19, the marketing team wrote about 30 blog posts a month. That’s jumped to roughly 30 a week since the pandemic started.
The constant stream of news helped Ochsner build trust with the community, which has paid off as messaging has shifted to encouraging patients to return for non-COVID-related care, said Cara Bergendahl, Ochsner’s vice president of marketing and communications.
Patients with patient portal access who postponed care received messages about scheduling appointments. Emails were also sent out. Ochsner has since regained about 80% of pre-COVID clinic and surgery volumes. Emergency department volumes have been slower to return, hovering around 70% compared with pre-COVID levels, so Ochsner is using direct mail and emails to patients urging them not to put off emergency services.
“People have fear and anxiety, and we are seeing that play out,” Bergendahl said.
Affordability
In addition to fears about being exposed to COVID-19, affordabilty is a barrier to some patients seeking care. The national unemployment rate hit 14.7% in April but dipped to 11.1% in June.
The Kaiser Family Foundation estimated that between March and May, 26.8 million people faced the prospect of being uninsured—or having to sign up for other coverage—due to the loss of job-based health insurance. About 157,000 people signed up for an Affordable Care Act health plan during April and May, taking advantage of the law’s special enrollment period for loss of coverage. That’s up 140% compared with April 2019, when 64,000 signed up. The trend continued into May, when 103,000 people signed up, an increase of about 43% over the same month last year.
“While the magnitude may be unclear, job losses due to COVID-19 have led to increased enrollments on HealthCare.gov,” CMS said in a June report releasing the numbers.
Indeed, amid the pandemic, the financial services group at MultiCare Health System in Washington state informed the marketing department that they were hearing from patients concerned they couldn’t receive care because they lost their insurance. MultiCare now has integrated messaging as part of its campaign efforts including financial assistance offered so patients won’t be deterred from seeking services, said Ben Hill, chief marketing officer at MultiCare.
ClearBalance Health is seeing more interest from health systems in its long-term payment plans for patients. Health systems partner with ClearBalance to refer patients who can’t afford their out-of-pocket medical bill. ClearBalance provides zero-interest payment options, which are appealing to health systems.
“We have seen an increase in interest in what we are doing,” said Pete Thompson, senior vice president of sales and revenue cycle strategist at ClearBalance Health.
Most health systems will offer ClearBalance for patients who received a necessary or emergent service, but Thompson said that since COVID-19 more providers are interested in offering it for elective procedures that would usually be paid out-of-pocket.
“They are trying to rebuild volume and they don’t want costs to be a barrier,” he said.
CentraCare in St. Cloud, Minn., has been a ClearBalance customer for a few years. While ClearBalance hasn’t seen an influx of calls from newly uninsured CentraCare patients, it remains a popular option for patients, said Sherri Liebl, the system’s executive director of revenue cycle.
Show, don’t just tell
Market research also reveals that patients want to be shown how health systems are going to keep them safe from COVID-19 when they are at their clinics and hospitals.
“You can’t just say we are keeping things clean and we are following social distancing practices—people need more than that. Show me what the waiting room looks like,” ReviveHealth’s Bevolo said.
Taking that information, Michigan-based Beaumont Health created videos demonstrating the new guidelines in place, such as requiring patients to wear a face mask, screening for COVID-19 symptoms at the door, limiting interaction with clinicians and staggering appointments to minimize the number of people.
“We needed to show people that we are open and safe,” said Jennifer Carbary, Beaumont’s director of marketing.
The videos are part of a larger campaign at Beaumont titled “Safe Care. Available Here.” The campaign involves a heavy emphasis on digital marketing through social media as well as TV, print and radio advertising. Direct mail has also been used.
While digital marketing is worthwhile for health systems, traditional radio and TV ads have also been leveraged with success during this crisis because people are home using these devices, said Jennifer Mugnaini, vice president of account management at marketing agency StoneArch.
Marketing departments are creating campaigns at a time when their employers are suffering financially. Even so, there appears to be a recognition by health system leadership that marketing is a vital investment during this time, Bevolo said.
While some marketing departments have been trimmed during COVID-19, they weren’t completely gutted.
“Leadership recognized we desperately needed marketing and communications to bring people back in,” Bevolo said.
Some health systems are still being cost-efficient in their marketing efforts. MultiCare has spent roughly $125,000 on its campaign, which Hill said is rather lean.
Money was saved by asking physicians to take photos and videos themselves to accommodate for social distancing guidelines. “We did a lot of DIY,” Hill said.
MultiCare also received discounted rates on advertising placements because other industries such as travel and food aren’t as eager to buy advertising right now, he added. Indeed, a survey of 237 brands by Influencer Marketing Hub found 69% expect to decrease advertising spending in 2020.
Need won’t go away soon
Health systems’ will likely need to keep sending the message that they’re safe and open for business for some time, Mugnaini said. “It might seem like a repetitive message, but it isn’t. It’s what consumers need to understand to get them back within the doors of a hospital.”
Several health systems said they anticipate COVID-19 messaging will be baked into their marketing for the foreseeable future. Many marketers also mentioned the pandemic taught their teams how to be nimble. The departments typically planned campaigns months and even a year in advance to advertise planned new services or facilities. COVID-19 has thrown that dynamic out the window.
“One of my philosophies going forward is let us continue to use the skills we learned in COVID-19,” Andreadis at UCLA Health said. “Instead of meeting once a month, we meet once a week. And we have a more nimble and agile process—we don’t plan six months ahead, we plan
a month ahead.”