In February 2013, the executive team and board of directors of Novant Health, a 4-state integrated health system based in Winston-Salem, North Carolina, announced a strategic plan to formally join all programs, services, and facilities under one system brand. Through a series of mergers, acquisitions, and partnerships, the health system had grown to include 13 hospitals, 500 outpatient clinics, 1,300 employed physicians, and $4 billion in revenue — but the organization had been operating under more than 350 different brand names. The strategic plan, which was endorsed by executive, physician, and clinical leadership, was closely tied to the health system’s mission “to improve the health of communities, one person at a time.”
Our Goal: To Reinvent the Health Care Experience
As part of this strategic plan, leadership initiated a series of deliberate steps to concentrate the resources of the organization toward achieving the ambitious vision of doubling revenue in 5 to 10 years. Given the hypercompetitive health care landscape in our region, we believed that a goal of this scale was required in order for us to sustain quality and drive down operating costs while simultaneously delivering on our brand promise of “reinventing the health care experience to be simpler, more convenient, and more affordable.”
As the newly appointed marketing and communications officer for Novant Health, I recognized the need to swiftly and strategically drive the growth of our rebranded organization. To that end, the marketing team turned to concepts that have been used by many industries for several decades but are relatively new to health care — specifically, consumer segmentation and targeting.
The Path to Segmentation
Our goal of supporting the mission and briskly growing market share across our region called for a much deeper and more intentional analysis of the consumers and patients we serve. To become the leader in our primary markets — Charlotte, Winston-Salem, Wilmington, and Northern Virginia — which include approximately 9 million consumers 21 years of age and older, we embarked on a journey to use untapped data to identify and engage consumers in new ways. At the same time, we sought to broaden and deepen our expertise in analytics, web/digital marketing, public relations, social media, brand journalism, internal communications, behavioral economics, and consumer marketing. Our aim was to create measurable value and improve the patient experience by developing more relevant products and services.
Consumer segmentation was the first step. Segmentation is the grouping of people who share common characteristics in order to deliver messages, products, and services that match their unique needs. These groups are typically based on demographic characteristics such as age, gender, income, education, location, and ethnicity. However, we hypothesized that those elements alone would not provide the insights necessary to create new and enduring connections. Therefore, we added several dimensions to strengthen the study: attitudes, lifestyle and behaviors, caregiving status, life stage and health status, and desire for value-added services such as financial navigators, online scheduling, and same-day appointments.
Segmentation should inform decisions around three key factors:
- Focus: We cannot be all things to all people. If we don’t focus, the brand and the experience we are trying to create may become generic and diluted.
- Investment: We don’t have the financial or human resources required to meet every need of every consumer segment, so we must prioritize our investment opportunities.
- Value: Some segments value different aspects of the care experience, so we must gain better alignment with consumer preference and our offering.
Novant Health’s Segmentation Solution
To start, we talked with more than 30 stakeholders across our health system, including executives, physicians, and clinical leaders, to ensure that the segmentation exercise would inform our go-to-market strategies. Next, we conducted several consumer focus groups consisting of 250 existing and potential patients and then surveyed over 1,600 additional consumers, including patients and caregivers. This 9-month project culminated with several actionable insights in areas such as price sensitivity, smartphone penetration, time spent on the internet and with social media, and desire for new access points. We also gained intelligence on challenges and opportunities among our competitors in areas such as quality, value, technology, and trust.
On the basis of statistical analyses rooted in the social sciences (specifically, factor analysis, latent class modeling, and migration tables), we identified six unique population segments:
- Eager and Engaged Stewards are actively involved with health care, and many are in the “sandwich generation.”
- Savvy and Connected Patients enjoy taking care of their health and are looking to maintain and increase their involvement in health care.
- Healthy and Unconcerned Individuals want as few interactions as possible and engage with health care providers only when necessary.
- Cost-Conscious Guidance Seekers are generally frugal but will pay for access to services that they value.
- Responsible and Resolute Boomers prefer one-on-one care interactions with their providers and are averse to alternative and digital care.
- Uninterested and Unengaged Individuals attribute minimal value to an improved care experience.
Two of these segments — Eager and Engaged and Savvy and Connected — emerged as key priorities for Novant Health. Our marketing resources were more keenly focused on these groups (which account for nearly 50% of our target markets, or approximately 4 million consumers 21 years of age and older) because our mission and brand promise strongly resonate with them. These segments also comprise a high proportion of women, who are health care purchasers, caregivers, decision-makers, and hubs of thought leadership among family and friends. Our ultimate goal was to increase engagement and loyalty with these consumer segments while building familiarity and affinity with the other segments.
Translating Insights into Initiatives and Results
Our research uncovered some common needs among the segments, such as cost clarity, access, and digital integration. As a result, more than 40 cross-functional team members, comprising clinical leaders from across the health system, were tapped to design new products and services to better meet the needs of these consumers.
Our plan to deliver on cost clarity involves providing patients with personal guidance and navigation. For example, we developed a new online tool, Your Healthcare Costs as a way to help patients better understand their health care landscape by providing them content and video that explain premiums, deductibles, copays, and out-of-pocket maximums. We also strengthened our financial navigator program for patients who need help estimating their episodic health care expenses. Since brand launch in 2015, our 75 financial counselors have created more than 10,000 personalized price estimates for both inpatients and ambulatory-care patients using this new cost-assessment tool.
Our strategy to expand access includes providing our consumers with more appointments with the providers of their choice. Care Connections, our 24-hour virtual care hub, is staffed by more than 100 administrative and clinical professionals and includes nurse triage, scheduling, wellness coaching, discharge follow-ups, medication management, psychosocial consults, and class registration. Same-day appointment availability also was expanded through extended walk-in clinic and physician office hours, new care locations, and increased use of e-visits and video visits. The Care Connections team provides services for more than 800 Novant Health-employed and independent providers in 150 locations across North Carolina, South Carolina, and Virginia. In 2016 alone, approximately 10,900 patients were “seen” by clinicians through electronic visits. According to Epic, our patient portal vendor, Novant Health ranks #2 among the 125 clients who have turned on the eVisit module.
Our digital integration plan focuses on improving the ways in which we connect with patients through their computers, smartphones, and tablets. In 2015, Novant Health introduced online appointment scheduling. To date, over 7,500 patients have also used the Hold My Place feature to make reservations at our express and urgent-care facilities. Moreover, since the launch of Open Schedule, which provides online visibility into physician and clinic schedules, about 180,000 patients have made appointments through the web or the MyChart patient portal. Novant Health currently ranks in the top 5% of the 245 Epic clients that use the patient portal for direct scheduling. We are also integrating fitness trackers with care plans, and our online caregiver resource now includes recommendations from primary care providers.
Notably, over 725,000 patients currently use our MyChart patient portal, making Novant Health also in the top 5% of 330 organizations based on the absolute number of active patients. In fact, Novant Health was recognized as the first health system worldwide to receive the prestigious Health Information and Management Systems Society (HIMSS) Analytics Stage 7 Ambulatory Award for the implementation and advanced use of the electronic health record. Approximately 440 locations, including physician clinics, were revalidated as part of the award in 2016.
At Novant Health, we’ve learned that new tools and capabilities, especially in the areas of strategy, analytics, and social media, are essential. Progressive marketing models require speed, agility, and the courage to foster a “test-and-learn” culture.
As marketing leaders, we also must become close business partners with our clinical and operations team members. When we embed ourselves in their world, new conversations about redesigning approaches to care delivery and a better patient experience will be sparked. A deep understanding of consumer preference will also help guide and shape this work.