A concept worth exploring: using clinical data to develop a marketing campaign

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Any skilled nursing facility competing to "win" desirable placements needs to look no further than the data residing at their fingertips. That's correct: Painstaking efforts to obtain accurate Minimum Data Set assessments and favorable OSCAR (Online Survey, Certification and Reporting Database) scores are surprisingly valuable beyond the realm of governmental compliance. Innovative SNFs are learning to dig deep into clinical data as a source for business strategy, marketing and the solid evidence needed to first identify and later promote their niche-of -excellence.

Not business as usual


While quality skilled nursing care remains tantamount to success, it's no longer the only determinant. With increased competition, thin margins, inadequate Medicaid reimbursement, declining private-pay census, staffing concerns and increased governmental scrutiny, many SNFs are facing uncertain times and difficult questions. One such question is: How can I differentiate my SNF from the competition? In response, many facilities are seeking clinical specialization as an opportunity to improve financial performance and increase census. To this end, facilities are borrowing a marketing strategy used heavily in other industries: evidence-based marketing.

Evidence-based marketing defined

Simply stated, evidence-based marketing is a successful marketing strategy that builds a solid base of factual evidence-from data sources, studies, research and trend analysis-to understand an organization's true performance relative to peers and with regard to both demographics and community needs. In contrast to a traditional marketing approach, evidence- based marketing takes one step backward to first determine what expertise exists upon which to build a marketing strategy. Yes, it's still important to know the competition, know the demographics and know the customer; however, it's even more important to identify internal areas of proven clinical excellence. After all, without superior expertise, any success attained by a flashy (and expensive) marketing campaign will be short-lived.

Fortunately, in the long-term care industry, the data necessary to perform evidence-based analysis are readily available. Together, MDS and OSCAR data offer a gold mine of rich information just waiting to be analyzed and understood from both a clinical and business perspective. The key, however, is to develop that virtual link between the routine compilation of clinical data and its relevance for strategic planning and marketing.

To illustrate, consider a facility that chooses to specialize in short-term rehabilitation based on traditional demographic marketing research. Even with a modern facility, sought-after amenities, state-of-the-art equipment and a dependable referral source, the program might still fail.  In fact, without proven expertise in short-term rehabilitation, the facility will be fighting an uphill battle. Evidence-based marketing incorporates clinical data into marketing strategies to create a more successful venture.

Get started: questions every SNF must answer

While proven expertise is essential for success, it needs to be balanced with both community need and financial viability. Accordingly, there are four essential questions for every SNF to consider: 

* What resident types are currently served in the facility? (cardiac rehab, dementia, ventilator, stroke, orthopedic rehab, custodial care, etc.)

* What resident types are served best? (outcomes data compared to both peers and industry benchmarks)

* Is there a market for this "niche" given community demographics and the current referral base?

* Is this niche market a financially viable option?

While many administrators and nurses develop an intuitive ability to answer these questions, few have the evidence readily accessible to support their claims and confidently demonstrate a proven clinical expertise. Even still, some staff might be very surprised at what is revealed about their facility once clinical data is subjected to rigorous analysis. Such analysis can be completed in a two-phase examination: internal and external.

Phase one: in-depth internal analysis


A good starting place for an internal examination is with outlier data. When carefully examined, outliers can often tell a facility interesting facts about the care they provide. For example, consider a facility with a high prevalence of ulcers as publicly reported on Nursing Home Compare. At first glance, this information is sure to generate concern for both potential residents and discharge planners alike. However, any assumption that this facility poses a risk for residents susceptible to ulcers may be wildly inaccurate. Upon calculation of an incidence measure, it may be discovered that ulcers are present upon admission and, comparatively, the facility-acquired ulcer rate is less than other local area SNFs. In fact, this facility (with the highest ulcer prevalence) may be the best place for a resident susceptible to ulcers given its expertise in healing each and every one.

Whatever area of expertise is identified-whether it's ulcer care, short term rehabilitation, bariatric care, hospice or cardiac rehabilitation-it's critical for each SNF to quantitatively demonstrate proven success with outcomes data. Today's buyers are sophisticated: They want facts; they want to compare, and they want to make good choices. While many buyers turn to CMS' Nursing Home Compare today and now utilize the Five Star quality rating, this information can easily mislead potential residents due to the weaknesses of the metrics that comprise these programs. Consequently, it is more critical than ever before for SNFs to know their expertise and use the evidence to educate and persuade tomorrow's buyers.

Phase two: external analysis

For simplicity, let's assume the area of expertise is determined to be ulcer care, and the facility has the facts to support that assertion. Now, it's time to examine the competitive landscape and evaluate the community's need for the service. A thorough examination of MDS information, Nursing Home Compare and the OSCAR database can reveal important facts about care provided at local area SNFs. For example, if a neighboring facility has very high rates of pressure ulcers reported in its outcomes measures, this may indicate that competition already exists. For further investigation, visit facility Web sites and search for advertised ulcer care programs. This will help differentiate between a clinical specialty for ulcer care versus poor care.

The next step is to understand the local market and determine whether the referral base is sufficient. In this case, survey local hospitals to determine whether or not patients are typically discharged with unhealed ulcers as a primary diagnosis. Engage discharge planners into meaningful dialogue that focuses on:

* Where patients are currently discharged to with unhealed ulcers

* Whether or not the skilled nursing facility generally has a wait list for this patient type

* How difficult it is to place patients locally with unhealed ulcers

* Whether or not re-hospitalization due to ulcers is an issue

Quantify the need by obtaining specific answers from as many referral sources as possible. Once assured that the need exists, move forward. Incorporate the evidence discovered during the internal analysis into a focused marketing strategy given the facts discovered in the external analysis.

Ongoing communication


Continuously look for opportunities to inform potential referral sources about the proven expertise. Develop fact sheets for post-acute facilities, hospital discharge planners and other possible referral sources. Also, consider physician involvement as an opportunity to add credibility to the strategy. Engage medical directors, attending physicians and other contacts with local area hospital staff to involve physicians. Compel them with evidence of expertise.

Evidence is powerful

Right now, potential residents and their families are perusing "marketing" data, courtesy of Nursing Home Compare and other public placement sources. Why? Because available evidence is both powerful and persuasive. Unfortunately, conclusions formed based on evidence publicly provided are often erroneous or incomplete. It's time for SNFs to engage their audience with relevant data so that prospective residents and their family members can make good choices. Dig deeper into the data, and discover the evidence that both demonstrates and supports what you intuitively know about your facility's performance. Again, evidence is powerful: Use it to gain a competitive advantage.

Steven Littlehale is executive vice President of healthcare and chief clinical officer at PointRight Inc., formerly known as LTCQ Inc. PointRight Inc. (www.pointright.com), based in Lexington, Mass., is a nearly 15-year-old company committed to improving the quality of care in long-term and post-acute settings by providing information-based clinical management tools and services to providers, payers, regulators, suppliers and consumers.

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