by Frank Hone

December 2012 – In recent years the American consumer has become a much more active participant in her own health and well-being. She’s generally better focused on nutrition and exercise and is more knowledgeable, proactive and aware of prevention and treatment options.

But even as she has taken on more personal responsibility, her role is still too often minimized in the broader world of healthcare as we know it.

It’s hard to make broad generalizations, but if we consider the dynamics of the major players that comprise the “medical marketing model” – pharmaceutical firms, health insurers, hospitals, pharmacies and physicians – they often tend to operate as though the consumer is not even part of the picture.

They make up the supply side of healthcare and rely on their interrelationships for business stability. Nearly all of the “reforms” we’ve seen in the recent past focus on trying to engineer incentives or policies to make the supply side more efficient and more accountable.

And consumers, representing the demand side, are generally forgotten, despite the role they could play in using the system more appropriately and by taking measures to be more diligent about their health. They are too often viewed as pawns that get moved around to generate revenue for the medical marketing model. While harsh, this does represent reality for many individuals across the country.

Contrast this to the experiences of consumers from another era, and in other buying circumstances.

During the great economic expansion that began in the 1950’s, brand marketers found unique and creative ways to promote to their target audiences. Slick television commercials and glossy magazine ads combined with eye-catching billboards and well-positioned sponsorships helped to drive sales of packaged goods, health and beauty aids, electronics brands, financial services, and so much more.

Consumer demand for goods and services created unprecedented economic growth and prosperity. In this golden age of marketing, consumer was king. Ad agencies flourished and worked creatively to create successful and sustainable brands. Market research uncovered consumer insights and explored buying habits. David Ogilvy famously challenged the industry to be more thoughtful in pitching brands, stating, “The consumer is not a moron, she is your wife.”

We can all recall some of the iconic ads and jingles from our youth which may have shaped brand perceptions and preferences and influenced our own buying habits.

In healthcare, however, consumer marketing is not nearly as well developed. Over the past two decades, we have seen prescription drug manufacturers turn to direct-to-consumer (DTC) advertising to stimulate interest and demand for their brands as one sector that did try to embrace the consumer.

Many brands such as Viagra, Nexium, and Plavix did generate billions of dollars in sales by stimulating consumer demand, yet they also experienced challenges in creating long-term consumer preference. Formulary restrictions, multi-tier co-pays, and generic competition all conspire against long term brand loyalty. Most pharmaceutical brands that invested in consumer advertising did not actually achieve a successful return on their investment, and the ads tended to lack the warmth or humor of memorable campaigns.

In fact, it’s a lot harder to do good advertising in healthcare, where we need to be thinking a little less about advertising – though the principles apply – and a lot more about consumer engagement.

How then, can consumers become more engaged to become better and smarter participants in their own health care?

We believe that employers are the business segment that truly stands to benefit from effective engagement. They actually have the most to gain and the most to lose in this game, at least in the private sector. Their health benefit costs have risen and will continue to rise. And if they don’t address health risks and system utilization, they face productivity shortfalls.

Most employers have begun to realize that they can and should play a proactive role in improving the health and well-being of their workforce.

It is in the employers’ best interest to provide relevant support – both directly and through vendor relationships – to engage their workforce with initiatives that help manage conditions, reduce health risks and promote improved health and well-being.

Many good vendors and capable health plans have designed smart programs that help encourage proper decision making, provide relevant interventions, and promote healthy habits and lifestyles. The problem with most of them is that they don’t get enough employee participation. There is a definite Engagement Gap.

Since this challenge with engagement is recognized as a top industry issue, we are beginning to see gradual improvement. Even though most employee benefits people are not marketers, they are learning more about what it takes to get their workforce to pay attention, understand, and take action. We see that the major elements of a successful employee engagement program should include:

1. Leadership that is committed and that cares about the people
2. Clear and well-articulated objectives, both to management and to the population
3. Smart and well-designed programs that promote accountability and reward effort
4. A team of wellness champions to help implement and guide
5. Effective communications that deliver key messages across multiple media
6. Elements of gaming, competition and achievement that activate peer influence
7. Measurement that is frequent, accurate and transparent

Those employers that make a serious effort to implement programs with these elements in place should see real results and positive outcomes.

We believe that employers can and will take a leading role in engaging their people to be more accountable and productive healthcare consumers. In doing so, they will go a long way to challenge supply side healthcare dominance and begin to tip the scales a bit more toward the demand side.

About the Author

Frank Hone is Managing Director at Healthcentric Partners, Inc., an engagement strategy and marketing consultancy for employee health and well-being improvement. The firm’s specialty is helping employers, both directly and through their vendor and health plan partners, to overcome the growing challenge of poor employee health engagement with company-sponsored programs.

His 2008 book, Why Healthcare Matters: How Business Leaders Can Drive Transformational Change, focused on the role employers can play in helping to improve health in the US, and led him to a position at Healthways where he served as their Director of Sustainable Engagement. Some of his other articles are posted at the Well-Being Strategy blog.


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