Thursday, July 10, 2014


What's in a brand?  Every organization, whether it is a hospital, a law firm, or coffee shop, has a brand - known, in various forms, to its employees, suppliers, investors, customers, and others who have been exposed to the product or service.

Defining a Brand

A brand is a name, word, symbol, logo, tag line, likeness, action or behavior that becomes associated with a product or service.  It is a brand which may or may not be registered as trademark. 

Not much different from the branding of cattle, to identify the owner.  The brand told potential buyers, who had a perception of the brand, something about how the calf, cow, bull, or steer had been raised.

Starbucks is a brand of coffee shop.  Mayo and Duke are names representing brands of healthcare systems. Marilyn Monroe is a brand for a beautiful, deceased movie star.

By seeing the name, logo, tag line, or symbol (such as the shape of a Coke bottle), we may have an image in our minds as to what the product or service is like.   If we're in Lagos, Nigeria and see a bottle of Coke in a store, we can be fairly sure that we know what this bottle of Coke will taste like and feel like in our mouths.

If we see the letters BMW, we think of a prestige automobile, known for precision German engineering.

Not everyone in the world, however, knows what to associate with the words Starbucks, Mayo, Duke or with the letters BMW.  

The association between a name, set of letters, symbol, logo or tag line is learned.  We learn through using a product or service, through hearing people talk about a product or service, or through our imagination of what a product or service is like.

Many hospitals, such as one we'll call Community Memorial Hospital, became branded, known for specific services and care, over the years as people used the hospital and heard about the hospital.  At one point, nearly every town or city had a hospital, a place where people could come for an emergency, to get care for an illness, or to have a baby.  The brand was created by the experience of doctors, nurses, patients, administration, business leaders, and residents in the community.  
But now Community Memorial Hospital wants to expand outside its county by putting physician practices in four adjacent counties. Community Memorial, we'll call it, also  wants to buy other hospitals in the area and call itself Community Health Care System.  Before and after the name change, CHCS had a brand, a reflection of experience people had with the hospital.

In order to document what the brand is for CHCS, we have to listen to people talk about the hospital, including employees (very important), physicians, patients, community leaders, and people who live in the communities where CHCS has hospitals and/or physicians.

Community Health System has a small but diligent marketing department.  They have heard that they need to "rebrand" their hospital system since it and its service area have changed.  There are some options.  One is to let the experience create or adjust the brand as people experience the hospital and visits to physicians, including putting the CHCS name on all hospitals and physician practices. Another option is to hire a "branding" company to fabricate a new name, logo and image of the system.

With either option, the hospital system's brand will be created by the people who use the system and by the people who hear stories about the new system.

Changing Roles for Hospital

Our hospitals have been, traditionally and intentionally, places that fix people who have health problems.  As a reward for the fix, hospitals were paid very well by insurance providers.  In the early days, many hospitals were paid 100 percent of what they billed.

Then Medicare came along and started paying based on what were called Diagnostic Related Groups (DRGs).  Procedures were carefully coded by the hospital to get maximum reimbursement for as many DRGs as could possibly fit the patient and the treatment.

Today, Medicare wants to pay hospitals based on the performance of the hospital, its success in treating a patient. If too many patients are readmitted to the hospital within thirty days of discharge, the hospital is penalized in  reimbursement for services rendered. Hospital are also penalized if their infection rates were above a certain level for infections from catheters and from central lines, such as intravenous tubes.

Tomorrow, hospitals will be reimbursed based also on the health status of the community, based on how long and how well people live as well as on obesity, smoking, and other health factors in the population.

Some hospitals have made this transition by being a part of an Accountable Care Organization (ACO). Other hospitals are doing what they can to make the transition.

Hospitals are not meant to take on the burden of community health status on their own.  They are a part of a team, including public health organizations, municipalities, major industries and businesses, schools, universities, restaurants, grocery stores, banks, and other organizations in the community.

For too long, hospitals and physicians have been the upfront players in health care.  They will still be on the stage, but need to have many supporting actors to improve health status, reduce obesity, and get smoking eliminated altogether.

Some see this as a "social" agenda or even as a "socialist" agenda.  It is simply people helping other people in their community to live long, healthy lives.