Health Services Marketing 1-3 Discussions
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chapter3slides.pptChapter 3
The Health Care Industry and Marketing Environment
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LEARNING OBJECTIVES
What are the major characteristics and weaknesses of the U.S. health care system?
What are the characteristics of an ideal health care system?
Who are the major active participants in health care systems?
How is the health care system changing demographically, economically, socially, culturally, technologically, politically, and legally?
LO1. What are the major characteristics and weaknesses of the U.S. health care system?
- Health care is not a declared right so common goals cannot be agreed upon.
- Benefit mandates are set without a true healthcare budget.
- A centralized technology approval process does not exist, driving higher health care costs.
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Key Words:
LO2. What are the characteristics of an ideal health care system?
- Private, competitive system
- Judged by the extent to which it helps citizens maintain or improve health over the lifetime
- Cost-benefit analysis to evaluate new technologies
- Health outcomes should be measured and reported
- Reports should be made transparent to patients, physicians, heath care providers, and employees
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Key Words:
LO3. Who are the major active participants in health care systems?
- Care providers - organizations that provide medical services and all the professionals that work in them
- Hospitals
- Nursing homes
- Hospices
- Rehabilitation centers
- Surgical centers
- Outpatient medical clinics
- Individual physician offices
- In-store medical centers
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Key Words:
LO3. Who are the major active participants in health care systems? (cont)
- Payers
- MCO - managed care organization
- HMO - comprehensive, coordinated medical service to voluntarily enrolled members on a prepaid basis
- Staff model
- Group model
- Individual practice association
- Network model
- PPO - gives more freedom of choice of provider
- POS -hybrid of HMO and PPO
- Medicare and Medicaid
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Key Words: managed care organization (MCO), health maintenance organization (HMO), preferred provider organization (PPO), point of service product (POS), comprehensive, maintenance, coordinated medical service, gatekeeper, primary care physician, prepaid, per member per month, capitation, staff model, group model, individual practice association (IPA), silent PPOs , Medicare, Medicaid
LO3. Who are the major active participants in health care systems? (cont)
- Employers
- Supply Organizations
- Pharmaceutical and Biotechnology companies
- Drug manufacturers
- Wholesalers
- Pharmacies
- Pharmaceutical benefit management companies
- Medical Device Supply companies
- Diagnostic
- Therapeutics
- Durable medical equipment (DME)
- Prosthetics
- Disposables
- Information systems
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Key Words: drug manufacturers, wholesalers, pharmacies, pharmaceutical benefit management companies (PBMs), detailing, sampling, direct-to-consumer (DTC) advertising, medical journal advertising, diagnostics, therapeutics, durable medical equipment, prosthetics, disposables, information systems
LO3. Who are the major active participants in health care systems? (cont)
- Medical and Trade Associations
- Providers - AMA
- Payers - Blue Cross Blue Shield Association
- Hospitals - AHA and the American College of Health Care Executives
- Suppliers - many
- Functional - HFMA, HIMSS, MMA
- Health Advocacy Organizations - non profits to improve health care in the nation such as ACS, AHA, ALA
- Federal Government’s Health Care Activities ie Department of Health and Human Services
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Key Words: social marketing, Stark laws, skilled nursing facility (SNF)
LO4. How is the health care system changing demographically, economically, socially, culturally, technologically, politically, and legally?
- Demographically
- Worldwide Population Growth - explosive
- Population Age Mix - aging
- Ethnic Markets - differences
- Educational Groups - 5 groups
- Household Patterns - no longer typical
- Geographical Shifts in Populations - location
- Economically
- Income Distribution - 4 types
- Health Care Costs - rising
- Savings, Debt, and Credit Availability - high debt-to-income ratio
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Key Words: world wide population growth, population age mix, ethnic markets, educational groups, household patterns, subsistence economies, raw-material economies, industrializing economies, industrial economies,
LO4. How is the health care system changing demographically, economically, socially, culturally, technologically, politically, and legally? (cont)
- Social-Cultural
- Views of selves
- Views of others
- Views of organizations
- Views of society
- Views of nature
- Views of the universe
- High persistence of core values
- Existence of subcultures
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Key Words: core beliefs, secondary beliefs, subcultures
LO4. How is the health care system changing demographically, economically, socially, culturally, technologically, politically, and legally? (cont)
- Technologically
- Accelerating pace of change
- Unlimited opportunities for innovation
- Varying R&D budgets
- Increased regulation of technological change
- Political-Legal
- Increase of business legislation
- Growth of special interest groups
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Key Words: certificate of need regulations
CONCLUSION
- US health care system needs improvement
- Must start by identifying and monitoring trends in six major environmental factors
- All must be grounded in an understanding of the stakeholders preferences among cost, quality, and access
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