Executive Alignment and Organizational Buy-In Is Critical

The relaunch couldn’t have succeeded without the support of senior leaders: the CEO, the executive committee, and the board of directors. But it was most critical that we were able to achieve buy-in throughout the organization. That meant winning over many disparate groups of skeptical physicians, providers, and administrators.

Change management is difficult, so we held initial conversations with over 30 key leaders of the organization. They were highly accustomed to a style of marketing that was reactive rather than proactive, and they were used to making decisions based on what was best for providers, not consumers. Many believed that providing high-quality health care was enough. But to become relevant with consumers, we had to stand for something more. In early meetings, we had to help the organization’s leaders understand marketing from the consumer’ point of view, and help them realize that providing quality care, in today’s market, is simply table stakes. We had to teach using plenty of real-world examples—even comparing health care to brands such as Starbucks—to help them understand how authenticity, innovation, and relevance build brand equity and affinity.

We also focused on Novant’s goals, including the vision of doubling scale in 5 to 10 years. Once the leaders had a better understanding of the region’s hyper-competitive healthcare landscape, they realized that meeting the goals required restructuring the brand portfolio to sustain quality and drive down operating costs, while also delivering on the brand promise of “reinventing the healthcare experience to be simpler, more convenient, and more affordable.” We knew we were on the right track when some of our most skeptical physicians became early adopters of our thinking.

Invest in Smart Segmentation

Even as the internal branding efforts were underway, we knew we needed a much deeper analysis of the people we wanted to serve. To become the leader in our primary markets—Charlotte, Winston-Salem, Wilmington, and Northern Virginia, which include about nine million adults—we performed an extensive consumer segmentation.

Our starting point came from deep within Novant Health through interviews with important stakeholders, including doctors, clinical leaders, and executives. Our goal was to match emerging consumer demands and preferences with the product and service offering. We used several consumer focus groups, tapping 250 existing and potential patients, to shape our hypotheses. We then surveyed 1,600 additional consumers, including patients and caregivers.

While this type of effort is usually based on demographic characteristics such as age, gender, income, education, location, and ethnicity, we suspected that we needed more. So we added attitudinal dimensions about health, well-being, and lifestyle, as well as questions about caregiving, life stage, and health status. We probed the participants’ interest in value-added services that we hypothesized might make a big difference in their lives, such as financial navigators, online scheduling, and same-day appointments.

This deliberate and interactive process took nearly nine months. Using statistical analyses rooted in the social sciences, such as factor analysis, latent class modeling, and migration tables, we identified six unique population segments:

1. Eager and Engaged Stewards are actively involved with health care, and many are in the “sandwich generation.”
2. Savvy and Connected Patients enjoy taking care of their health and are looking to maintain and increase their involvement in health care.
3. Healthy and Unconcerned Individuals want as few interactions as possible and engage with healthcare providers only when necessary.
4. Cost-Conscious Guidance Seekers are generally frugal but will pay for access to services that they value.
5. Responsible and Resolute Boomers prefer one-on-one care interactions with their providers and are averse to alternative and digital care.
6. Uninterested and Unengaged Individuals attribute minimal value to an improved care experience.

One of the most exciting moments of our rebranding effort happened when we introduced these six segments to key stakeholders at an internal event where we brought the segments to life on stage using actors. The dramatization made it very clear that different people required a different care experience. Importantly, the segments were not meant to replace understanding and empathy at the individual level; instead, they allowed us to focus our efforts and investments with more confidence than ever before.

Of these six segments, we identified two—the Eager and Engaged Consumer and the Savvy and Connected Consumer—as our top priorities; they accounted for close to 50 percent of the target market, or approximately four million people. And these groups contained a higher proportion of women, who are more likely to be healthcare purchasers, caregivers, and decision makers. While our highest priority was to increase engagement and loyalty with these two groups, we could also begin building familiarity and affinity with the other segments.

Focus on Changes That Are Data Backed and Strategy Led

The segmentation work also began to fuel new ways of thinking and acting. We learned a great deal about customers’ price sensitivities within health care, about smart-phone penetration, and about how much time consumers spent online and on social media, for example. We got insights into how they saw Novant Health’s competitors in terms of value, technology, trust, and quality.

Three central issues emerged as critical in all the segments: cost clarity, access to care, and digital integration. To help translate those insights into initiatives, we sat down with over 40 cross-functional team members from across the health system. Our task was to generate an inventory of all ongoing activities, identify gaps, and ideate to generate new products and services to go to market.

A tangible result of these early meetings was a new online tool, Your Healthcare Costs, which was designed to help patients better understand the healthcare landscape by providing content and video that explained premiums, deductibles, co-pays, and out-of-pocket maximums. We also strengthened the financial navigator program for patients who needed help estimating healthcare expenses. Since the program’s launch in 2015, Novant Health’s 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 came directly from understanding how much consumers wanted to see their provider of choice at times that fit into their busy lives. Care Connections, Novant Health’s 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 clinics 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 employees 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, the organization’s patient portal vendor, Novant Health ranks number two in the nation among its 125 clients who have turned on the e-visit module.

Make Sure That Brand and Experience Are Synonymous

Today, meaningful customer engagement and experiences are essential if you hope to build a strong brand. If you can’t provide them, consumers will fire you, no matter how good the advertising or how compelling the brand promise. At Novant Health, experiences must genuinely and consistently bring the brand to life, giving people precisely what they need, when they need it, and in a format that’s easy for them.

Watching Novant Health insiders come alive with this realization—the radical notion that they need to think first about what is most helpful for the consumer, not the hospital or the physician—was and continues to be truly exciting and game changing.

Perhaps the best illustration of this new thinking is Novant Health’s digital integration plan, which focuses on improving how the organization connects with patients through their computers, smartphones, and tablets. In 2015, Novant Health introduced online appointment scheduling. 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 percent of the 245 Epic clients that use the patient portal for direct scheduling. The organization is also integrating fitness trackers with care plans, and the online caregiver resource now includes recommendations from primary care providers. Today, more than 800,000 patients currently use the MyChart patient portal, pushing Novant Health into the top 5 percent of 330 organizations based on the absolute number of active patients. In fact, Novant Health was the first health system worldwide to receive the prestigious Health Information and Management Systems Society’s Analytics Stage 7 Ambulatory Award for the implementation and advanced use of the electronic health record.

To Manage Well, Measure Well

Amid all these changes, Novant Health also committed to making sure it was measuring consumer preference in an ongoing and dynamic way. Currently, the organization monitors over 50 brand-equity metrics with key elements tracked on dashboards, including NPS at the system, market, and service-line levels.

Novant Health developed a marketing model mix that has the powerful ability to discern base volume from marketing-driven volume. The model performs simultaneous regressions of time-series data, which enables it to decompose and attribute total patient volume based on correlations with each pre-specified, independent variable.

These metrics also provide the evidence to invest further: based on initial success, the CEO felt confident about devoting an additional $7 million to an out-of-cycle ad campaign that further drove results and won a Cannes top 100 advertising award in 2016.