1 Living Well-Freedom From Tobacco HADM 559: Health Care Marketing and Market Research Methods Loma Linda University Running Head: LIVING WELL LIVING WELL 2 Table of Contents Executive Summary……………...……………………………………… 3 Organizational Profile……...…………………………………….........… 3 Industry Overview……...………………………………………............... 4 Demographics......................................................................................... 4 Laws and Policies................................................................................... 4 Technology.............................................................................................. 4 Smoking................................................................................................... 4 Regulations............................................................................................. 5 Service Overview……...………………………………………................. 5 Target Market……...………………………………………....................... 5 Competitive Analysis……...………………………………………........... 6 Marketing Plan……...……………………………………….................... 6 Primary Data Collection........................................................................ 6 SWOT Analysis...................................................................................... 7 BCG........................................................................................................ 7 Marketing Strategies............................................................................... 7 Operational Plan……...……………………………………….................. 8 Positioning Statement.............................................................................. 8 Goals, Objectives and Process Measures................................................. 8 Financial Plan……...………………………………………...................... 9 References……...………………………………………............................ 10 Appendix A…...………………………………………............................... 13 Appendix B.................................................................................................. 14 Appendix C.................................................................................................. 16 Appendix D.................................................................................................. 17 LIVING WELL 3 Executive Summary Kaiser Permanente Fontana Medical Center’s (KF) covered population has a disproportionately high rate of smokers as compared to similar facilities (Kaiser Permanente, 2014a). As a result of this high rate, the Kaiser Foundation Health Plan bears an estimated cost of over $114 million annually from increased service utilization (Appendix D). The present proposal seeks to mitigate some of this cost through an expansion of the current tobacco cessation program. This will be accomplished through expanded awareness campaigns and expanded services to participants. With current participation rates of 0.38% of eligible participants, even modest growth in participation will yield significant long term cost savings of over $2 million annually if participation rises to 1.75% (Appendix D). These benefits more than outweigh the proposed $100,000 per year cost in even the least likely of outcomes (Appendix D). This program will simultaneously improve the lives of Kaiser members and improve the financial performance of the organization. Organizational Profile Kaiser Permanente is the largest managed care organization in the United States. The Kaiser Foundation Hospitals operate medical centers in California and manage other outpatient facilities in the remaining Kaiser Permanente regions (Kaiser Permanente [KP], 2014b). The hospital foundations are not-for-profit and rely on the Kaiser Foundation Health Plans for funding; however, they provide infrastructure and facilities that benefit the for-profit medical groups (KP, 2014b). Each entity of Kaiser Permanente has its own management structure, but all are interrelated and require collaboration (KP, 2014b). Kaiser Fontana is a general medical and surgical hospital in Fontana, California. The hospital has 390 beds, accommodating 25,482 admissions in 2012 (US News & World Report, 2013). The hospital provides twenty-four hour emergency services, as well as a wide variety of outpatient services, including more non-traditional services such as preventive medicine. Their service area spans San Bernardino County (SBC) and parts of Riverside County. The patient population served by KF is compromised of a wide range of ethnicities, but the two predominant groups are White (34%) and Latino (35%)(KP, 2013). The age range is also widely dispersed. The largest group includes patients from birth to 18 years of age (31%), followed by those aged 19 to 34 years old (24%) and the 35 to 54 year old group (27%) (Garcia, Khamkongsay, Trinidad, Vela, & Wat, 2013). LIVING WELL 4 Industry Overview Demographics Thirty-one percent (31%) of the total SBC population is aged 18 or younger, which mirrors the significant proportion of patients this age served by KF (KP, 2013). By comparison, 25% of the population in the state of California is less than 18 years old (KP, 2013). The total population of SBC and Riverside County has increased by about 21% from 2000-2010, a growth trend that is expected to continue (KP, 2013). This translates into an expected growth in KF’s most significant age demographic. Laws and Policies The Patient Protection and Affordable Care Act (PPACA) is legislation that will impact KF. The PPACA will lead to more members, and more importantly, under the PPACA, the mandated health benefits include coverage for mental health services and treatment of substance abuse disorders. This paves the way for greater utilization of tobacco cessation programs (The Kaiser Family Foundation, 2013). Technology Another trend that will impact KF is mobile technology. Since 2010, smartphone ownership has been on the rise (Smith, 2013). According to the Pew Research Internet Project, in 2011, 35% of the US population owned a smartphone (Fox & Duggan, 2012). By 2013, the number was 50% and the percentage is expected to continue increasing over the next few years (Fox & Duggan, 2012). Additionally, the highest percentage of smartphone ownership is among those aged 18-29. Even more noteworthy is the increased use of mobile technology to access health information, from 17% in 2010 to 51% in 2012 (Fox & Duggan, 2012). Smoking Tobacco use costs $4,260 per smoker in direct health care costs, and it is still the number one preventable cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2008). In just four years, from 2009-2012, the United States spent at least $133 billion dollars in tobacco-related health care costs; in the same period it is estimated that smokingattributable economic costs, such as missed days of work, were over $289 billion (CDC, 2012). The main form of tobacco use in United States – cigarette smoking—has remained constant at 20%; one in five Americans are still smoking (CDC, 2012). The United States previously decreased its smoking use from almost 50% of the population in the early 1970’s to 30% in the LIVING WELL 5 1980’s to about 20% in the 1990’s (American Lung Association, 2011). Since then, however, further reductions have been minor (American Lung Association, 2011; Appendix A). Importantly, most smokers will start during adolescence and nearly all smokers (99%) start by age 26 (CDC, 2012). Sand Bernardino County has a higher percentage of adolescents than the rest of the state and it contains a larger number of smokers (Dignity Health, 2009). California has 13.5% current smokers, compared to almost 15% current smokers in SBC (Dignity Health, 2009; KP, 2013b). Compared to other Kaiser centers in the Southern California region, KF has the second highest number of tobacco dependent members, second only to San Diego (Kaiser Permanente, 2014a). Regulations Kaiser Permanente Fontana Health Center is licensed, regulated, inspected, and certified by agencies at the state and federal levels. The California Department of Public Health (CDPH) is responsible for ensuring healthcare facilities comply with state laws and regulations (California Department of Public Health [CDPH], 2013). Kaiser Fontana also has met the standards for Joint Commission as demonstrated by the awarding of their Gold Seal of approval (CDPH, 2013). While such accreditation is voluntary, choosing to participate in the accreditation process requires the fulfillment of relevant regulatory requirements (Blackmond, n.d.). The Health Insurance Portability and Accountability Act (HIPAA) defines and limits the circumstances in which patients’ protected health information may be used or disclosed, including for marketing purposes (Health and Human Services, 2003). Service Overview Currently, smoking cessation classes, called Living Well, are offered in seven sessions over six weeks at no cost to KF members. Their current marketing strategy is to rely on physicians to refer their tobacco dependent members to the classes (S. Turner, personal communication, May 6, 2014). The service we aim to provide is a more targeted, comprehensive marketing campaign geared towards the younger population of smokers in order to save KF money in the long term and meet benchmarking goals. We will accomplish this by creating incentives for physicians to refer their patients, and by providing patient-centered marketing strategies. Target Market Historically, the referrals to the smoking cessation program at KF have been primary care physicians (PCPs) (S. Turner, personal communication, May 6, 2014). Because of this, PCPs LIVING WELL 6 will likely remain one of the most significant sources of referrals. Therefore, one of the main targets of the marketing strategy will be to enlist PCPs as referrers to KF’s tobacco cessation programs. The second strategy will be to target young, tobacco dependent members. We will target those aged 18-24, as they are one of the largest age groups in SBC and KF, and are among the most vulnerable to developing a lifelong addiction to tobacco (CDC, 2012a). Furthermore, a campaign specifically targeted to this young age group will mean that KF will reap the most long-term rewards, both in their members’ health and financially. The total population of smokers within the KF member area is 27,611 individuals (KP, 2014a). Competitive Analysis When evaluating competitors for a managed care organization, it is often helpful to look at internal company benchmarking as well as to identify what similar organizations have done successfully. Since most hospitals collect Healthcare Effectiveness Data and information Set (HEDIS) data, this can be utilized is to compare hospital performance. Two tobacco related HEDIS measures were compared with the Loma Linda Veterans Affairs Healthcare System, and KF performed lower in both measures (Department of Veterans Affairs, 2009; KP, 2013b). In this comparison Kaiser had lower referral rates to smoking cessation as well as less offers for smoking cessation (Department of Veterans Affairs, 2009; KP, 2013b). This means that in comparison to other managed care organizations KF has significant room to grow with respect to smoking cessation (Appendix A). Most other non-managed care organizations are non-competes for a smoking cessation business line as they are currently not managing population health. However, this may change as the PPACA changes the trends in reimbursement schemes for almost all insurances, and thus emphasizes quality over quantity of care. Marketing Plan Primary Data Collection A short, six-question survey was administered to tobacco dependent residents of SBC to identify basic demographics and types of services smokers would like to have to help them quit tobacco (Appendix B). The tobacco users who participated in the survey varied in ages, from less than 18 to 61-70 age groups; most were ages 51-60. Three quarters had been using tobacco for over ten years; 13% used tobacco for six to ten years, and 12% had a two to five year history of tobacco use. No respondent had used tobacco for less than two years. The most commonly used form of tobacco was the cigarette (62%), second to cigars (25%) and the pipe (13%). All LIVING WELL 7 respondents stated that their primary care provider had talked to them about quitting tobacco. Qualitative data was gathered by asking what service from their physicians would be most helpful. This revealed four common domains: didn’t know; nicotine replacement, including the e-cigarette; emotional support; and a program. This data collection has limitations in its applicability to KF, however. The respondents were recruited from a smoking section outside of a Veterans Affairs hospital and were limited in the numbers of participants (n = 8). Given the external research and demographic data from KF, we anticipate that a greater number of tobacco users from the KF membership will be younger. SWOT Analysis A SWOT analysis was conducted in order to capitalize on KF’s strengths, minimize their weaknesses, take advantage of opportunities, and minimize their threats (Appendix C). Some of KF’s strengths are that they have a well-established education program located in a building that is dedicated to prevention and health education. The health education building is easily accessible with ample parking. The education classes are also conveniently timed with multiple sessions for members to choose from, at no cost to members. Some weaknesses are that the savings to KF are not immediate, and Living Well is not currently well advertised. Threats may come in the form of budget cuts, cuts to the whole program, and cuts to personnel time. Patients may also try other substances to substitute tobacco with, such as e-cigarettes; this may give people a false sense of safety and complacency about quitting tobacco. The many tobacco users in the KF service area provides them with a unique opportunity to reach many patients. BCG Portfolio Analysis (Appendix C) Tobacco cessation is one of four service areas in the KF preventive medicine department. The other three are obesity treatment (bariatric surgery), diabetes self-management education (DSME), and non-surgical weight management classes. Kaiser sets benchmarks by calculating what percent of eligible members are participating in each of the four programs. The obesity treatment program is outperforming the other departments, reaching about 7% of its eligible members; this program is the star (KP, 2014a). Weight management is reaching about 3.5% and the DSME is reaching 3.5%. Living Well has both a low growth and low market share, and is therefore is the program that would be typically considered a marketing dog (Appendix C). Marketing Strategies LIVING WELL 8 After our analysis, we decided to focus the marketing strategies to providers and to younger KF tobacco users. Provider-focused strategies include motivational reporting. Monthly reports will be given to physicians notifying them of how well they did in referring their eligible members to Living Well in comparison to each other. There will be referral incentives of a prime parking spot and recognition for the most referrals. Patient-focused strategies will also include a testimonial bulletin board, a testimonial video Kaiser Care Story, and a smartphone app to cater to the technology use in our target population. Other patient focused strategies might include peer-to-peer support – for example, hosting Nicotine Anonymous Groups. Operational Plan Positioning Statement Kaiser Fontana is dedicated to the prevention of premature deaths and diseases attributed to tobacco use. We will welcome patients to our Living Well program with compassion and provide the resources, strategies, and support needed to ensure patients quit tobacco for life. Goals, Objectives and Process Measures Our primary, three-year goal is to decrease the number of Kaiser members who are tobacco dependent. Secondly, we will reduce mortality and morbidity due to tobacco use. In addition, we will reduce long–term costs associated with tobacco use. The Living Well objectives include: decreasing the number of Kaiser members who are dependent on tobacco by 1.75% within the next 48 months; increasing enrollment to the smoking cessation program by 50% in the next 24 months; and increasing the number of physician referrals to the Living Well program by 25% in the next 12 months. The process measures are to increase the number of patients offered tobacco cessation strategies and medications from 54% to 57% and to increase the number of patients advised to quit from 70% to 73%. Human Resources Plan Currently, nine employees staff the Living Well program: a sponsor, a physician leader, an administrative leader and other support staff. This marketing plan will utilize positions already in place and hire an additional 1.5 FTEs in the positions of project manager and marketing advisor. The physician leader will also be re-tasked to be a physician liaison to encourage physician buy-in and increase referrals to the program. Due to the trends in mobile technology ownership and the focus on persons aged 18-29, we propose hiring an employee with a background in mobile technology marketing. This employee LIVING WELL 9 will be in charge of managing the KF Living Well program’s Facebook, Twitter, and Instagram accounts, and must also be able to learn any other new forms of social media that gain traction. We will also develop an addition to the KP mobile app. This app add-on will include a counter on a smartphone’s notification bar indicating the number of days a person has been tobacco free, a customizable folder of reasons why the smartphone owner wants to quit (photos of family, health, etc.), and other resources. A volunteer facilitator will be recruited from the population of former program participants. They will be placed in charge of recruiting and carrying out the volunteer program. Volunteers will be used to perform basic administrative functions, give their testimonials, and serve as peer counselors and nicotine anonymous group support. Financial Plan Within the preventive medicine department, tobacco cessation has the distinction of the marketing dog, as seen in Appendix B. While this low growth and low market share position is typically a disadvantage for many business lines, it is in fact an advantage for a tobacco cessation program. This is because tobacco cessation is predicated and funded on the idea that there should be the fewest number of smokers possible within a managed care organization. In estimating the financial viability of a tobacco cessation program it is important to understand two key metrics, the cost per smoker, and the cost of administering the program. By using these metrics, as well as estimating program participation, it is possible to calculate the break-even point and most likely financial outcomes of a given program. For the present analysis we used data recognized by the American Lung Association, which estimates the direct healthcare cost per smoker per year at $4,260 (Adhikari, et al., 2008). With a serviceable population of 27,611 and a current cessation participation rate of 0.38% (n=104), this large target market provides significant opportunity for savings growth (KP, 2014a). The initial estimated annual cost for the program expansion is $100,000, as seen in Appendix C. With this information we can estimate that the break-even participation rate for this program will be achieved with only an additional 23 adherent participants (Appendix C). A three way weighted average was conducted to assess the outcome in the most likely scenario. The result of this was an estimated participation ratio of 1.31%, which is short of the 1.75% goal, a realistic goal as it represents 175 participants. At this participation rate the net annual savings for KF are estimated to be over $1.5 million annually (Appendix C). LIVING WELL 10 References Adhikari, B., Kahende, J., Malarcher, A., Pechacek, T., & Tong, V. (2008). Smoking-Attributable mortality, years of potential life lost, and productivity losses—United States, 2000—2004. Morbidity and Mortality Weekly Report, 57 (45), 1226-1228. American Lung Association. (2011). Trends in tobacco use. American Lung Association Research and Program Services Epidemiology and Statistics Unit. Retrieved from http://www.lung.org/finding-cures/our-research/trend-reports/Tobacco-Trend-Report.pdf Blackmond, B. (n.d.). Hospital Accreditation – Alternatives to the Joint Commission. Retrieved from http://www.healthlawyers.org/Events/Programs/Materials/Documents/HHS09/blackmond.pdf Centers for Disease Control and Prevention. (2012a). Youth and tobacco use. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm Centers for Disease Control and Prevention. (2012b). Economic costs associated with smoking. Retrieved from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm#spendin g Community Hospital of San Bernardino. (2013). Community Health Needs Assessment. In Community Hospital of San Bernardino. Retrieved June 11, 2014, from http://www.dignityhealth.org/stellent/groups/public/@xinternet_con_sys/documents/webcontent/ 196180.pdf Department of Veterans Affairs Veterans Health Administration. (2009, October). 2009 VHA Facility Quality and Safety Report. In va.gov. Retrieved June 12, 2014, from http://www.va.gov/health/docs/HospitalReportCard2009.pdf Fox, S., & Duggan, M. (2012, November 8). Mobile Health 2012. In Pew Research Internet Project. Retrieved June 12, 2014, from http://www.pewinternet.org/2012/11/08/mobile-health-2012/ Garcia, A., Khamkongsay, R., Trinidad, R., Vela, M., & Wat, E., (2013). Community Health Needs Assessment. Retrieved from http://share.kaiserpermanente.org/wpcontent/ uploads/2013/09/Fontana-CHNA-2013.pdf Kaiser Permanente. (2013a). Community Health Needs Assessment. In Kaiser Permanente. Retrieved June 12, 2014, from http://share.kaiserpermanente.org/wp-content/uploads/2013/09/Fontana- CHNA-2013.pdf LIVING WELL 11 Kaiser Permanente. (2013b). MEASURING CARE QUALITY Southern California Region. In Kaiser Permanente.org. Retrieved June 13, 2014, from https://healthy.kaiserpermanente.org/static/health/pdfs/quality_and_safety/sca/sca_quality_HEDI S.pdf Kaiser Permanente . (2014a). 2014 SCPMG LOS Health Education Monthly. In J. Dang & . (Eds.), Regulatory Relations Performance Assessment.: Kaiser Permanent Kaiser Permanente. (2014b), Fast Facts, Retrieved June 11, 2014 from http://share.kaiserpermanente.org/article/history-of-kaiser-permanente/ Kaiser Permanente (2014c). Understanding the Affordable Care Act. Retrieved from http://healthreform.kaiserpermanente.org/ Klein, E. (2012). 11 Facts about the Affordable Healthcare Act. The Washington Post. Retrieved from http://www.washingtonpost.com/blogs/wonkblog/wp/2012/06/24/11-facts-about-the-affordablecare- act/ Smith, A. (2013, June 5). Smartphone Ownership 2013. In Pew Research Internet Project. Retrieved June 12, 2014, from http://www.pewinternet.org/2013/06/05/smartphone-ownership-2013/ Sohn, E. (2011, January 26). How Safe Are E-Cigarettes?. In Discovery News. Retrieved June 11, 2014, from http://news.discovery.com/tech/gear-and-gadgets/e-cigarettes-health-nicotine-tobacco- 110127.htm Suburban Stats. (2014). Current Fontana, California Population, Demographics and statistics in 2014, 2013. In Suburban Stats. Retrieved June 12, 2014, from http://suburbanstats.org/population/california/how-many-people-live-in-fontana San Bernardino County. (2013, July). Our Community Vital Signs: San Bernardino County. In Community Vital Signs. Retrieved May 29, 2014, from http://www.communityvitalsigns.org/Portals/41/Meetings/2013Stakeholder/CVS_data_report.pd f The Kaiser Family Foundation. (2013, April 23). SUMMARY OF THE AFFORDABLE CARE ACT. In FOCUS Health Reform. Retrieved June 13, 2014, from http://kaiserfamilyfoundation.files.wordpress.com/2011/04/8061-021.pdf United States Department of Labor. Occupational Safety and Health Administration. Retrieved fromhttps://www.osha.gov/law-regs.html LIVING WELL 12 US News and World Reports. (2013, July). Kaiser Permanente Fontana Medical Center Stats & Services. In US News Hospitals. Retrieved June 13, 2014, from http://health.usnews.com/besthospitals/ area/ca/kaiser-permanente-fontana-medical-center-6930737/details LIVING WELL 13 Appendix A: Competitors 48% 50% 52% 54% 56% 58% 60% 62% 64% 2/13 3/13 4/13 5/13 6/13 7/13 8/13 9/13 10/13 11/13 12/13 1/14 2/14 Tobacco Cessa*on: Offered/Meds (rolling 12 mo.) Fontana and Ontario Medical Centers % Region Best % 68% 69% 70% 71% 72% 73% 74% 75% 76% 12/12 1/13 3/13 5/13 6/13 8/13 10/13 11/13 1/14 3/14 Tobacco Cessa*on: Advised to Quit (Rolling 12 mo.) Fontana and Ontario Medical Centers % Region Best % LIVING WELL 14 Appendix B: Primary Data Survey Form Survey 1. How long have you been using tobacco? 􀀀 less than one year 􀀀 two to five years 􀀀 six to ten years 􀀀 over ten years 2. What type of tobacco product do you use most often? 􀀀 cigars 􀀀 cigarettes 􀀀 e-cigarettes 􀀀 chewing tobacco 3. How many times have you tried to quit tobacco in the last 12 months? 􀀀 never 􀀀 once or twice 􀀀 three or more times 4. Has your healthcare provider ever talked to you about quitting tobacco? 􀀀 no 􀀀 yes 5. What type of help from your doctor would be most helpful? 6. How old are you? 􀀀 less than 18 􀀀 18-25 􀀀 26-30 􀀀 31-40 􀀀 41-50 􀀀 51-60 􀀀 61-70 􀀀 70 or more LIVING WELL 15 Survey Results Age Distribu*on of Survey Respondants 0% 12% 13% 75% Dura*on of Tobacco Use two to five years six to ten years over ten years LIVING WELL 16 Appendix C: Market Positioning SWOT Analysis 25% 62% 0% 13% Type of Tobacco Used Most OHen cigars cigareEes pipe Strengths • Well established classes & education • HMO Report Card rated “Good” • Location excellent • New building • Better parking • Covered benefit Opportunities • Many tobacco users in service area • Modifiable risk factor Threats • Budgetary restraints or cuts • E-­‐cigarettes • Marijuana as substitute Weaknesses • Difficult to treat tobacco dependence • Currently little marketing • No immediate cost savings LIVING WELL 17 BCG Matrix Appendix D: Financial Statements Market Size Total Number of Smokers at KHF 27,611 Estimated Cost per smoker/Year $4,260+ Total Cost per year $117,600,000+ High Low Low High Relative Market Share Relative Market Growth Rate ? $ Obesity Treatment Diabetes Self Management Weight Management Tobacco Cessation LIVING WELL 18 Trial Balance Itemized Activities (in $USD) Debits Credits Tobacco Cessation Account 100,000 Labor 1.5 FTE 77,500 Print Advertising/ Flyers 1,000 Search Engine Optimization 3,000 Video production 2,500 Active e-mail campaign 2,700 Supplies for Group 2,000 Reserve Funds 11,300 100,000 100,000 LIVING WELL 19 Projected Benefit Net Benefit Participation Rate Number of Participants Current participation rate ($100,000) 0.38% 105 Breakeven Participation Rate $0 0.46% 127 50% of goal $1,029,200 0.88% 242 75% of goal $1,543,800 1.31% 362 100% of goal $2,058,400 1.75% 483 0 100 200 300 400 500 600 -­‐$500,000 $0 $500,000 $1,000,000 $1,500,000 $2,000,000 $2,500,000 Net benefit at various par*cipa*on rates Net Benefit