Download Marketing and Contracts - Collins O. Uzuegbu BSN, MSN, RN, ACNS

Presented by
Collins Uzuegbu RN, BSN
Erin Steele RN, BSN
Chris Fries RN, BSN
School of Nursing and Health
Wright State University
August 17, 2011
Purpose
• To explore marketing and contracting
strategies for Advanced Practice Nurses (APNs)
in light of traditional and contemporal marketing and
contracting concepts
Presentation
Outline/Objectives
• Marketing Concepts
• Marketing contract, models and
theories
• Marketing research: critiques
• **Application of marketing concepts,
models and/or theories to APN practice
discussed throughout presentation
• Criteria for evaluating effectiveness of
marketing concepts, model, or theory
Marketing Concepts
Five basic marketing concepts:
1. Product
2. Price
3. Place
4. Promotion
5. Partnership
(Hamric, Spross, & Hanson, 2009)
Product
• What the APN is offering to the market
– What are those products?
– Make the products “visible” to the
consumer
– Consumers should relate to the
products
– RNs as good marketers of the
product
(Hamric, Spross, & Hanson, 2009)
Price
• What is paid for the product
• What drives prices either way?
• Familiarity with local, regional and
national trend is important
• Capitalize on delivering excellent
products without emptying the wallet
• Do not be afraid to publish the
numbers – to compete!
(Hamric, Spross, & Hanson, 2009)
Place
• The “where” of marketing
• Safety and accessibility of locale are
important!
• Know the area: Location! Location!!
Location!!!
• The “place” of the information age
– APN in the consumers’ homes : ecommerce that meets the
consumers’ service needs
(Hamric, Spross, & Hanson, 2009)
Promotion
• Emphasis on the value of the product to the
public
• Awareness is key
– Visibility of APNs in practice settings
– Assessment of client’s knowledge of APNs
and clarification of roles upon first
visit/encounter
– Business card is a good asset
– Promote word-of-mouth dissemination
– Get involved at the locale level
– Patronize another APN
– Advertise
(Jear, 2009; Hamric, Spross, & Hanson,
2009)
Partnership
• Collaboration with other stakeholders
in the business
• Consumer centered approach
• Use of care transition coach
• Peer consultation
(Hamric, Spross, & Hanson, 2009)
Marketing and Contract
Theories/Models
• Pay-for-Professional Reimbursement (P4P) Model
• Top 10% will receive 2% bonus
• Poor performance –penalties
• $8.5 million awarded first year
• APNs must fit into this context of improved quality care.
• APNs not represented at the government level
(Hamric, Spross, & Hanson, 2009)
Theories/Models
• Brown & Olshansky (1988) - Research based model identifies
“Limbo to Legitimacy” transition
• Transition stages that new NP experience during the first
year in primary care practice.
• Stage 1 raises important marketing considerations.
• Stage characterized by period of recovery from school
• Finding employment
• Negotiating bureaucracies
• Worrying about meeting role expectations.
Theories/Models (cont’d)
• Bolles (2002) – suggested teaching new grads five approaches
to sustaining a positive outlook during transition
1. Keep physically fit
2. Deal with emotions as they happen
3. Monitor mental stamina
4. Utilize spirituality for support
5. Keep active by using time and talents in community.
(Hamric, Spross, & Hanson, 2009)
Theories/Models (cont’d)
• Customer Relationship Management (CRM)
• Entire market with goal of optimizing revenues with needs
and preferences
• Patient Relationship Management (PRM)
• Directed toward consumers.
• Both are data driven approaches to strategic planning and
consumer relationship building and strengthening
(Hamric, Spross, & Hanson, 2009)
Marketing Strategies
• Kalisch and Kalisch’s (1981) work on nurses and the media
• Recommend that nursing specialties work with media
• Media continues to speak negatively of APNs
• Center for nursing advocacy developed in 2001
• Addresses the negative portrayal of nursing by the media
• Purpose to increase public awareness
• APNs must be proactive in marketing the profession in a
positive way when inaccurate perceptions present
(Hamric, Spross, & Hanson, 2009)
Marketing Strategies
• Terminology
• Lack of consistent terminology across the states
contributes to confusion by the public
• Title of nurse practitioner in the 50 states include:
certified registered nurse practitioner (CRNP),
advanced practice registered nurse (APRN), advanced
practice nurse (APN), and certified nurse practitioner
(CNP).
• How can the public be expected to know what to call
APNs?
• Physician dominance in the health care market who
discredit APN practice can be obstacles to APN
marketing
Marketing Strategies (cont’d)
• Crucial that APNs support medical colleagues who do value
and understand the role of APNs.
• It is hoped that positive policy and legislative changes that
promote APN practice will increase with the advent of more
DNP-prepared APNs assuming leadership positions in health
care systems.
• Strategy to improve public image of nursing - disseminate
positive and cost-effective outcomes of care provided by APNs
in consumer publications as well as to professional journals.
Marketing Strategies (cont’d)
• Gandhol & Hirsch (2006) – seven deadly sins of private
practice marketing:
1. Spaghetti Marketing
2. Analysis Paralysis
3. Marketing Decision by Committee
4. Inadequate Training
5. Treating Marketing as a Cost Center
6. Insufficient Delegation
7. Inconsistency
Marketing Strategies (cont’d)
• Bupport (2007) – Summarized general principles of marketing
a practice that APNs need to consider.
• Repeat the marketing message over & over in order to be
heard.
• Create in client’s a sense of affiliation with the practice.
• Create an image of the practice & a marketing message.
• Strive to exceed the expectations of clients
• Remember that a new patient is worth the price of the
visit, whereas a patient who values & stays with the
practice is likely to generate more revenue
Brown, 2007
• Brown, D.J., 2007. Consumer perspectives on nurse practitioners and
independent practice.
– Purpose: To report the results of a survey conducted to
determine the feasibility of NP-managed health care centers in a
Washington county and to evaluate the acceptability of such
care.
– Methodology:
• Descriptive study
• Electronic survey
• Convenience sample of 206 employees of a large non-profit
organization in Washington
(Brown, 2007)
Brown, 2007 cont’d
• Findings:
– Women and younger respondents were significantly more
likely to say they would choose or change their care to an
NP center (p=.03, .06).
– Important factors in choosing health care:
• Wait times #1
• Explanations of diagnosis and treatment
• Respect by providers
• Personal needs considered in treatment plan
(Brown, 2007)
Brown, 2007 cont’d
• Conclusion:
– NPs must clearly articulate and market the niche in which they
excel: patient-centered care, reduced wait times, patient
education, and respect, particularly for women and younger
persons.
• Critique: Several limitations:
– 21% survey response rate
– No internal reliability data, only content validity addressed
with a pre-test
– Not generalizable, although sample taken from a diverse
population of genders, occupations, income, and education
levels.
(Brown, 2007)
Contract Negotiation Literature
• Kleinpell & Perez, 2006. Negotiation strategies for acute care
nurse practitioner practice.
– ACNPs employed with collaborate practices more commonly
than in years past
– Position involves diverse responsibilities, so negotiation skills
are important to ensure adequate compensation, benefits,
and position components in contracts.
(Kleinpell & Perez, 2006)
Klienpell & Perez, 2006 cont’d
• Negotiation Considerations:
– Base salary, scheduled raises
– Healthcare benefits
– Role-associated costs
– Continuing education or conference attendance
compensation
(Kleinpell & Perez, 2006)
Klienpell & Perez, 2006 cont’d
• Contract Considerations:
– Restrictive Covenants (“Non-compete Clauses”)
• ACNP cannot practice within determined number of
miles from employer’s business if ACNP is terminated.
– Termination Clauses
• Specify under what conditions the ACNP can be
terminated
• Should also specify under what conditions the ACNP
may terminate the contract with the employer
– Review with an attorney
(Kleinpell & Perez, 2006)
Klienpell & Perez, 2006 cont’d
• Communication of the value of ACNP care is important in
negotiation:
– Be ready with publications describing services offered and
substantiating impact and outcomes of ACNP care.
• Critique:
– Informative
– Expert opinion, not research or EBP
(Kleinpell & Perez, 2006)
Marketing Literature
• Dirubbo, 2005. Marketing 101: Setting your practice apart.
– So many practices, so many providers…
– Establish your professional image:
• Define your role and how you with to be viewed.
• Name your practice carefully
– Make measurable goals and decide on budget:
• Evaluate progress monthly, revise plan as needed.
(Dirubbo, 2005)
Dirubbo, 2005 cont’d
• Tips:
– Join local Chamber of Commerce
– Offer to be a guest speaker at events
– Table at a health fair
– “Tell-a-Friend” cards for new referrals from existing patients
• Critique:
– Good ideas
– Anecdotal, expert opinion, not research.
(Dirubbo, 2005)
Effectiveness of
Theories/Concepts
• APNs are getting jobs!
• Example of Dirrubo (2005) article: concepts in action
• Example of Brown (2007) article: APNs are more known and
acceptable now than in studies out of the 1980’s
Conclusion
• Effective marketing of the image and role of APNs, and also the
services one provides is critical to the survival of each APN and
the future of the profession!
(Hamric, Spross, & Hanson, 2009)
Discussion Questions
• What marketing tools/strategies have you seen used by APNs?
• What marketing ideas do you have for your future practice?
• Do you feel pay for performance plans will enhance the
quality of care?
Recommended Reading
• Kleinpell, R.M. & Perez, D.F. (2006). Negotiation strategies for acute care
nurse practitioner practice. The Nurse Practitioner, 31(5), 6-11.
• The Hamric text chapter 20.
• Jear, J. (2011). Make your marketing simple, customer-friendly. Denver
Business Journal, 2048. Retrieved from
http://www.bizjournals.com.ezproxy.libraries.wright.edu:2048/denv
er/print-edition/2011/05/20/make-your-marketing-simple.html
References
• Brown, D.J. (2007). Consumer perspectives on nurse practitioners and
independent practice. Journal of the Academy of Nurse Practitioners,
19, 523-529.
• Dirubbo, N. (2005). Marketing 101: Setting your practice apart. The Nurse
Practitioner, 30 (9), 18. doi: 10.1097/01.NPR.0000393429.20113.37
• Hamric, A.B., Spross, J.A., & Hanson, C.M. (2009).Advanced practice
nursing: an integrative approach. St. Louis, MO: W B Saunders
Co.
• Jear, J. (2011). Make your marketing simple, customer-friendly. Denver
Business Journal, 2048. Retrieved from
http://www.bizjournals.com.ezproxy.libraries.wright.edu:2048/denv
er/print-edition/2011/05/20/make-your-marketing-simple.html
References…
• Kleinpell, R.M. & Perez, D.F. (2006). Negotiation strategies for acute care
nurse practitioner practice. The Nurse Practitioner, 31(5), 6-11.
• Leeflang, P. (2011). Paving the way for “distinguished marketing”.
International Journal of Research in Marketing, 28(2), 76-88.
doi:10.1016/j.ijresmar.2011.02.004
• Manikas, T. (2011). QUICK TIPS. Chief Marketer, 3(3), 40.
• Peckham, S. and Wallace, A. (2010). Pay for performance schemes in
primary care: what have we learnt? Quality in Primary Care, 18,
111-116.
• Schumacher, S. (2001). Identity management - at the heart of
CRM. Health Management Technology, 26-28.