TRI-CITY MEDICAL CENTER 1
Tri-City Medical Center
Tri-City Medical Center Strategic Marketing Plan
Aida Shadfan
Ryan Williams
Dmitry Tkach
Jyoti Loonia
TRI-CITY MEDICAL CENTER 2
Executive Summary ______6
Situational Analysis ______8
Internal Appraisal ______10
Company Background ______10
Mission ______10
Vision ______10
History ______10
4P’s (Price, Product, Place, and Promotion) ______11
Price ______11
Product ______12
Place ______13
Promotion ______13
5 C’s (Company, Collaborators, Customers, Competitors, and Climate) ______14
Company ______14
Collaborators ______15
Customers ______15
Competitors ______16
Climate ______17
Financial Analysis ______18
Service Area and Current Patient Demographics ______22
Area Population Summary ______22
Area Age Summary ______26
Area Ethnicity and Race Summary ______27 TRI-CITY MEDICAL CENTER 3
Tri-City Current Patient Visits by Location ______34
Tri-City Current Patient Visits by Race, Age, and Gender ______34
External Appraisal ______38
Industry Analysis ______38
Industry Life Cycle ______40
Industry Issues______42
Key External Drivers ______43
Current Performance ______43
Barriers to Entry ______43
Risk Factors and Competitive Landscape ______44
Competitive Analysis ______46
Palomar Health ______46
Major Services ______46
Scripps Memorial Hospital Encinitas ______47
Major Services ______47
Sharp Memorial Hospital ______47
Major Services ______48
SWOT Comparisons for all Hospitals ______48
Palomar Medical Center ______48
Scripps Memorial Hospital Encinitas ______50
Sharp Healthcare ______52
Tri-City Medical Center ______53
Competitors Operations and Competitive Advantages Comparison ______55 TRI-CITY MEDICAL CENTER 4
Hospital Utilization ______61
Inpatient Utilization ______61
Market Share ______66
Quality and Patient Experience ______68
Marketing Strategies by Competitor ______71
Social Media Comparison ______71
Scripps Memorial Hospital Encinitas ______71
Palomar Medical Center ______76
Sharp Health ______81
Tri-City Medical Center ______87
Scripps Memorial Hospital Encinitas ______94
Palomar Medical Center ______98
Sharp Health Care ______103
STP (Segmentation, Targeting and Positioning) ______107
Segmentation ______108
Targeting ______110
Positioning ______111
Marketing plan ______115
Marketing Objectives ______115
Marketing Strategies and Tactics ______115
Marketing Objective #1: Improve Brand Image ______115 TRI-CITY MEDICAL CENTER 5
Marketing Objective #2: Drive Patients to 3 Practices: Cardiology, Orthopedics, and Primary Care ______119
Marketing Objective #3: Increase Census ______119
Advertising Strategies and Tactics ______121
Strategy 1: Community Outreach ______121
Strategy 2: Community Engagement ______122
Strategy 3: Public Relations ______122
Strategy 4: Advertising ______123
Monitoring Plan Performance ______129
Budget & Paid Advertisement Strategy ______129
Strategy ______129
Responsibilities ______130
Conclusion ______130
Appendix A ______132
Appendix B ______133
Appendix C ______134
Appendix D ______135
Appendix E ______136
Reference Entry ______137
TRI-CITY MEDICAL CENTER 6
Executive Summary
Tri-City Medical Center is a community hospital that has provided quality healthcare in
North San Diego County for over half a century and has received numerous awards for being a staple for safety, innovation, and continuous top-tier service. With an increasing competitive landscape in the last 10 years, Tri-City’s market share has been threatened by new, larger hospitals in the region. These hospitals primarily include Palomar Medical Center, Scripps
Memorial Hospital Encinitas, and Sharp Memorial Hospital. California State University San
Marcos Fully Employed Masters in Business Administration program was given a proposal for a team to analyze Tri-City Medical Center internally and then evaluate its direct competitors. The analysis includes understanding the marketing strategies the other hospitals utilize and make recommendations for marketing objectives, strategies, and tactics Tri-City can leverage in order to maintain and expand their market share.
The internal appraisal of Tri-City displays a long-standing hospital with robust number of services, healthy financials, and strong relationships due to efforts and established tradition in the community. It is also obvious they not only dedicate an inordinate amount of resources to the services offered to their patients but also to the community as a whole as they are one of the most active supporters of the organizations and citizens of North San Diego County. Furthermore, there are a number of competitive advantages they can leverage and communicate to the community. The major deficiency factor of Tri-City found during the internal appraisal is the notion of the hospital being dated and with run-down facilities. Future construction plans, however, will be a staple of the new marketing messages to offset this perception. TRI-CITY MEDICAL CENTER 7
The external appraisal includes a SWOT analysis comparison, operations and competitive advantages, and marketing strategies used by each hospital. These areas illustrate what the hospitals’ points of emphasis are which indicate their position or targeted position in the market place. It was easy to see the direct competitors of Tri-City in North San Diego County are large, well-run hospitals. Therefore, Tri-City will need to be innovative in their approach to compete with them.
These sections describe all of the hospitals in great detail and allow for a thorough evaluation in order to determine strategies Tri-City can effectively develop. Once the
Segmentation, Targeting, and Positioning (STP) was established for Tri-City within the industry, marketing objectives, strategies, and tactics were developed. The marketing plan recommendations leverage the strengths of Tri-City Medical Center (people, community, innovation, and the hospital’s future). The tactics utilize a robust marketing mix and emphasize focusing on where the attention is for the specific target markets. Prior to rolling out the plan, it is highly recommended to develop a timeline, budget, and assigned responsibilities for the campaigns. The goal of this plan is to assist Tri-City Medical Center in reestablishing a strong hold within North San Diego County and all of Southern California.
TRI-CITY MEDICAL CENTER 8
Situational Analysis
Tri-City Medical Center is a public district hospital that has served the people of North
San Diego County since 1961, (Tri-City Medical center[TCMC], n.d.). It offers full-service care to its patients, including primary clinical healthcare, cancer treatments, cardiology, orthopedic procedures, emergency, and maternal health care to name a few. In addition to services, it is also one of the leading employers in the region of North County, giving jobs to nearly two thousand one hundred employees, (Tri-City Medical center[TCMC], n.d.). From these employees, Tri-City has over 700 medical practitioners working in approximately sixty fields. The Center is one of the top busiest emergency rooms in the county and operates the only Level III Neonatal ICU,
(Tri-City Medical center[TCMC], n.d.). It is identified as one of the finest wellness centers in
San Diego, and as mentioned in the 2016 Annual Report, it specializes in robotic surgery to operate at the most advanced levels of medical care. Tri-City Medical Center has received awards, such as the Gold Seal of Approval and Full Accreditation, which the center obtained in the fulfillment of its mission.
In recent years the San Diego County hospital competition has increased dividing the
North County market amongst Tri-City Medical Center, Palomar Medical Center, Scripps
Memorial Hospital Encinitas, and Sharp Memorial Hospital. These newer hospitals have modern facilities while Tri-City Medical Center’s building was last renovated in the 1980’s. The dated facilities have caused a negative public perception regarding Tri-City which has been difficult to overcome in a competitive, modern healthcare environment.
Tri-City has invested a significant amount of money and effort in maintaining their connection to the community through event sponsorships and involvement across North County TRI-CITY MEDICAL CENTER 9
as well as through paid, earned, owned, and shared media. Their competitors are also improving their marketing strategies and have been quite innovative in how they communicate their messages to the public through various campaigns. With the increase in competition, Tri-City now needs to analyze their brand and value proposition as well as all of their major direct competitors. Then, they need to determine a clear position in the marketplace and develop new messaging and innovative marketing strategies to communicate their brand and messages to their target markets.
TRI-CITY MEDICAL CENTER 10
Internal Appraisal
Company Background
Mission
The mission of Tri-City Medical Center is to advance the health and wellness of the community in which it serves, (Annual Report 2016). It aims to collaborate and cooperate with the community stakeholders who include nurses, general practitioners, employees, management, and the general medical staff in the achievement of this objective. Tri-City intends to decrease wait periods, improve the experience of the patient, and develop its infrastructure to improve delivery of healthcare.
Vision
Tri-City Medical Center seeks to be recognized as a healthcare system of choice in the community. It has received six consecutive Grade A ratings, one of the three hospitals to do so.
Its vision is to continuously achieve the highest safety rating through expanding and developing its emergency department. Additionally, it has a vision of developing its campus to improve delivery and care units and to accommodate extra community needs, (Annual Report 2016). Tri-
City looks to achieve this vision through cooperation with the community, as well as professional and financial stakeholders.
History
Tri-City Medical Center started fifty-six years ago through the cooperation of the political, business, and community leaders of San Diego County. It started as the Tri-City
Hospital District after an election as the leaders saw the need for a modern hospital in the area, TRI-CITY MEDICAL CENTER 11
because the county was quite rural with minimal medical healthcare. The existence of few services in the region compelled the idea of constructing a local hospital to serve the medical needs of the community. The voters approved a bond issue to finance the purchase of the land, as well as the costs of construction, (Tri-City Medical center[TCMC], n.d.). It opened its doors to the public in 1961 with only 42 medical staff members.
However, the demand for medical services was evident from the moment the hospital was established as the county grew in population size. Over the years the hospital expanded its healthcare services to meet the growing population in the area. In the seventies, it added a maternity unit, extra surgical rooms, a helipad, and a cardiopulmonary lab, (Tri-City Medical center[TCMC], n.d.). In addition to the medical equipment, it also added rehabilitation, dialysis, and mental health services.
The renaming of the hospital to Tri-City Medical Center in 1985 marked a change in its services as it depicted a modern facility that offered wide-ranging healthcare services. Today, the hospital boasts of robotic surgery methods, the only Level III Neonatal Intensive Care Unit, and one of the first to obtain the GE 512 CT Scanner in San Diego County. It became a model for serving the medical needs of the community through innovation and excellence in services provided.
4P’s (Price, Product, Place, and Promotion)
Price
Prices vary greatly depending on the services patients receive, however Tri-City Medical
Center is known to be the lowest cost healthcare provider in San Diego County. The hospital offers bill payment options online, by mail, or in person at the hospital finance section. The TRI-CITY MEDICAL CENTER 12
hospital bill covers medications, room expenses, surgical procedures and other medical services.
It provides an itemized account of your bill. The hospital offers advice concerning insurance schemes and additionally offers financial aid in the form of Charity Care for those unable to pay their bills, (Billing, Insurance, & Financial Assistance, 2017). The hospital understands the bill may be high, but it is a result of high-quality healthcare services.
Product
The hospital offers a wide range of medical services as well as pharmacy services. Tri-
City Medical Center provides surgical procedures, oncology services, emergency, and women's health among many others. Figure 1 illustrates the vast number of services provided on site at the medical center, many of which are rated at the highest quality in the region.
Figure 1. Tri-City Medical Center Services
Competitive Advantages
Tri-City has an advantage over its competitors by offering greater value through the following aspects of the hospital: TRI-CITY MEDICAL CENTER 13
• Highest safety scores in San Diego County
• 911 pit stop program
• Only hospital in North County with Level 3 NICU
• Most spine surgeries performed in SD County with Mazor robotic system
• Award winning wellness center with a medically integrated program designed to assist
exercise needs with certain diagnoses (ex: Cancer, Parkinson’s, Alzheimer’s)
• Only 5 Star Home Health in North County
• Continue to invest in latest technology
• Cutting-edge surgical procedures such as first Convergent Heart procedure
• Greater efficiency for physicians to get approvals regarding services
• Neighborhood feel vs big hospital feel
• Continue adding new services available (Bariatric, neurology focused surgeries, etc.)
Place
The hospital is located at 4002 Vista Way, Oceanside, California 92056. This is an advantageous location in North San Diego County due to the proximity to so many of the residents in the community. The increasing demand for their services has also caused the extensive growth of the hospital over the years. The infrastructure development serves to cater for the high number of patients visiting the hospital from the surrounding area. Furthermore, the hospital has one of the most engaged emergency areas which shows the hospital is strategically placed for the neighborhood residents.
Promotion TRI-CITY MEDICAL CENTER 14
The medical center engages in a variety of marketing methods to communicate with the community. This occurs through digital and traditional advertisements and Tri-City has become one of the most significant community sponsors in North San Diego County with over 100 events sponsored annually. Social media platforms such as Facebook, Twitter, Google+,
Pinterest, and YouTube serve as ways to provide the community with current events and information regarding developments of the hospital as well as valuable content that is not hospital related. Television commercials and radio ads also are utilized to communicate to the general public on larger platforms.
5 C’s (Company, Collaborators, Customers, Competitors, and Climate)
Company
Since its inception, Tri-City Medical Center has been a community hospital designed to serve the needs to the surrounding area’s residents. It has expanded its services when necessary and will continue to grow as the demand exists. While Tri-City Medical Center has a robust menu of services as described in the Product section of the 4P’s, their marketing department asked that this project focus on three primary departments: Cardiology, Orthopedics, and
Primary care. This is because Cardiology and Orthopedics are the most profitable areas of the hospital. Primary Care is the most important area strategically, because it is where patients are referred to all of the hospital’s specialties.
Three areas that are vital to remain competitive within the market of the healthcare industry are brand image, innovation, and technology. Tri-City has invested a lot of resources into these areas over the years through community engagement, marketing, equipment such as TRI-CITY MEDICAL CENTER 15
robotics, policies and procedures, and partnerships. The hospital should also try to attract leading physicians and retain highly experienced nursing staff.
Additionally, there is a tendency among healthcare organizations to establish more contracts with commercial health plan providers that could bring new synergies to the existing non-profit provider’s structure. There is a challenge to attract and retain high quality talent, and
Tri-City is trying to address it by creating a better overall working environment for physicians.
Collaborators
Physicians are the most important collaborator to Tri-City because none of them are permanent employees of the hospital. Therefore, they need to be recruited and kept satisfied.
They are attracted to the hospital based on salary, environment, policies and procedures, technology, etc. Hospitals in the area pursue relationships with physicians through a variety of different methods, including expanding medical foundations, affiliating with physician organizations, creating faculty practices, and aligning with IPAs.
Additional collaborators include local community organizations, key influencers, government entities, supply chain partners, research institutes, universities, other hospital networks. New joint ventures are created to promote clinical integration and data sharing. Stand-alone small medical facilities can also be helpful to build better presence for the organization, (IBISWorld Industry Report 62211). Lastly, especially for the purpose of the marketing department, media and advertising partners are extremely important to execute any marketing and advertising initiatives.
Customers TRI-CITY MEDICAL CENTER 16
The customer demographics for Tri-City vary greatly depending on the services the patient is accessing and can be detailed based on gender, age, location, and income level. These demographics are explained in more detail later in the report, however it is important to note that most of the existing patients for the entire hospital are by far within the age group 85 years and older.
As usual, most of the patients are from the surrounding area of the hospital. The North
San Diego County population has increased at a faster rate than the national average and is expected to continue growing over the next five years, partially due to the excellent climate and new jobs being available, (Scripps Memorial Hospital Encinitas. Scripps Hospital Disclosure
Report. OSHPD). This increase will cause an even greater demand for Tri-City’s services.
Competitors
There is a low probability a new competitor hospital would appear in North County, but current competitors are very strong and represent certain risk for Tri-City Medical Center. The direct competitors are Palomar Medical Center, Scripps Memorial Hospital Encinitas, and Sharp
Memorial Hospital. Indirect competitors include Kaiser Permanente which has a direct relationship and network with Palomar Health and UCSD Medical Center, with whom Tri-City has now established a formal partnership with.
Each of the current competitors are experiencing physician demand in excess of supply due to population aging and the implementation of the Affordable Care Act, thus the imbalance of supply and demand in the market for physicians could lead to higher physician salaries. Also, due to San Diego County large population, significant traffic congestion leads many to seek medical care close to home, contributing to the fragmented nature of the local healthcare market TRI-CITY MEDICAL CENTER 17
providers. More local health care providers also enacted strategies surrounding serving patients at nursing homes and at home, thus generating an even stronger competition among themselves.
Furthermore, all three direct competitors continue to invest in the same lucrative service lines like cardiovascular care, orthopedics, cancer treatments particularly in North County.
Additionally, some physicians affiliated with hospitals have started buying practices, and have shifted referrals from competitors to their individual businesses, (Palomar Health Hospital
Encinitas. Hospital Disclosure Report. OSHPD). Even though a large number of these independent practices remain in this region, there is still a definite push to move towards aggregation in this market. Size matters when it comes to financial performance and the large competitors like Sharp, Kaiser, Scripps represent a major competitive concern to Tri-City with respect to feasibility, (iExpert. IBISWorld 62211 - Hospitals in the US). All competitors are constantly attempting to strengthen ties with leading physicians and establish strong reputations within greater San Diego which ultimately impact Tri-City Medical Center’s abilities to maintain their share of the market.
Climate
Overall the financial climate is stable. The healthcare industry across the country is one of the fastest growing industries and San Diego County is no different. Most of the time, hospitals are established as nonprofit organizations and are of the largest employers in the North
San Diego County. In general, San Diego is considered a leader in health innovation, being a major hub for medical, healthcare, and biology research. Particularly, North Inland is affluent, well-insured, and has the fastest population growth in the county, (Palomar Health Hospital
Encinitas. Hospital Summary Individual Disclosure Report). TRI-CITY MEDICAL CENTER 18
There are multiple reconstruction hospital projects planned in the next 5 years. For instance, Kaiser plans to expand from a single hospital to three by 2030. Scripps and Sharp also have major upcoming construction and growth plans set to begin in the next few years. It is hard to predict what the outcomes of the hospital construction boom will be, but it’s possible that it can lead to excess capacity at least initially until the population growth catches up, (iExpert.
IBISWorld 62211 - Hospitals in the US). In anticipation of the excess capacity there is a strong tendency to increase outpatient services by hospitals. However, the number of outpatient care facilities remains stable and continues to be managed by Federally Qualified Health Centers
(FQHCs).
While provider capacity steadily increases in North San Diego County, the number of primary care physicians per capita also increases alongside the California state average. This means there will be a growing demand for qualified medical professionals.
Financial Analysis
For the year ending 2013, Tri-City Medical Center incurred deficiencies of revenues of
$11,360,429. The primary source of this deficiency was incurred from Tri-City Medical Center itself, which incurred losses of $13,615,081. This was offset slightly by revenues brought in by
Ambulatory Surgery Center Operators, the Cardiovascular Institute, the Orthopedic Institute, and the Real Estate Holding and Management Company. Still, the final numbers for the district were poor, and as previously stated, the total deficiency of revenues over expenses was $11,360,429.
Of particular note during the 2013 year were an excess of revenues earned by the Ambulatory
Surgery Center Operators of over $3 million. The share of the earnings that went to the District, due to its majority ownership of the organization, was roughly $1 million. TRI-CITY MEDICAL CENTER 19
Despite a rough financial period, the District put into place initiatives that were intended to bring in future financial benefits, which included i) technology for robotic spine surgery, ii) a recruitment effort to bring in physicians that could improve medical coverage for the community, and iii) computerized systems designed to streamline operations and bring in savings.
The outlook for the District improved in 2014, when it hit an excess of revenues over expenses totaling $4,385,063. This included $1,933,170 from its Tri-City Medical Center,
$1,984,218 from the Ambulatory Surgery Center Operators, $181,784 from its Real Estate
Holding and Management Company, $66,184 from its Tri-City Wellness Center, $143,891 from its Cardiovascular Institute, and $75,816 from its Orthopedic Institute. In other words, an excess of revenues over expenses was experienced by every one of the District’s subsidiaries. This was a marked improvement from 2013 and was essentially a turnaround of nearly $15 million.
The District itself recorded revenues from a number of programs, including $2 million from the Low-Income Health Provider Program and $4 million from the Intergovernmental
Transfer program. Yet another large earner for the organization was its Oncology infusion practice, which contributed $3.4 million in excess of revenues during the same timeframe.
However, the District also benefited from programs it had begun the year before, including some programs it continued to fund, including the recruitment of physicians to expand medical coverage. However, it also began new initiatives, including the development of responses to healthcare reform legislation, which was designed to help provide the infrastructure necessary for meeting the demands of the new legislation.
2015 saw yet another year of excess of revenues over expenses, with the majority of the
District’s subsidiaries again contributing an excess of revenues over expenses. The Ambulatory
Surgery Center Operators again contributed a large part of this, $1,751,315 in excess of revenues TRI-CITY MEDICAL CENTER 20
over expenses, while the majority of the rest of the subsidiaries contribute in varying amounts.
Programs that had previously contributed to the District’s recorded revenue continued to support ongoing revenues, including the Intergovernmental Transfer program and the ongoing implementation of electronic health records, an effort that had begun three years earlier.
As in previous years, specific programs continued to contribute to the district’s revenues, including its efforts to recruit physicians. However, it also opened the Tri-City Primary Care physician clinic in January 2014, which helped support the healthcare needs of the surrounding community through the four physicians who staffed the site. Yet again, they continued the implementation of the District’s electronic health records and received payments from Medicare for this program.
Unfortunately, 2016 marked a downturn in the District’s financials. Due to losses incurred mostly from the Tri-City Medical Center, the District’s total deficiency of revenue over expenses reached $1,692,933. Despite strong performance from the Ambulatory Surgery Center
Operators, which had delivered revenues in excess over expenses since 2013, the company was not able to overcome its deficiencies. Still, the Ambulatory Surgery Center Operators delivered
$1,709,276 in excess over expenses, while the majority of the District’s subsidiaries likewise delivered an excess of revenues over expenses. The only conclusion from this data was that the
Medical Center was the primary driver of deficiencies of revenues over expenses.
Despite its overall losses, the District continued to see strong performance from specific programs, such as the Intergovernmental Transfer program, which contributed $3.5 million in revenue. The Oncology infusion practice again contributed $1.6 million in excess of revenues over expenses. Also, despite the District’s losses, it remained proactive in initiating programs that would have a long-term payoff. It entered into an agreement with the County of San Diego TRI-CITY MEDICAL CENTER 21
to open a Crisis Stabilization Unit, continued efforts to finalize an exclusive affiliation agreement with the University of California San Diego Health, and again escalated its initiatives in implementing electronic health records. Although 2016 was a down year in terms of revenue, the organization nevertheless began or continued initiatives that may have long term payoffs.
Simultaneously, it is also important to recognize competitors in the area and how they may affect Tri-City’s market share which in turn affects their overall financial stability. Located in the same region, Palomar Health presents itself with a healthcare mission that is also oriented around serving the community and providing a health system that is patient oriented. In terms of medical services provided, Palomar Health provides bariatric surgery, urgent care, orthopedic and spine care, birth centers, and more. Therefore, it is positioned to provide many of the same community oriented services that the Tri-City District and its subsidiaries target.
Yet another organization in the region includes Scripps, a private, nonprofit, integrated health system. Scripps is nationally ranked as among the best hospitals in the country and as one of the top health systems in existence. It provides a range of services to people in the community, including home health care, traditional primary care, and both urgent and emergency care. Once again, the Tri-City District is faced with another integrated healthcare system that can provide many of the same services which would take away market share.
Despite strong competition in the region, the Tri-City District has resumed sound financial footing since 2013 and begun a number of initiatives that may have a long-term payoff.
Therefore, it is well positioned to continue competing in a region where there are many other healthcare choices for people in the community so long as they remain competitive overall.
TRI-CITY MEDICAL CENTER 22
Service Area and Current Patient Demographics The current patients Tri-City Medical Center serves and the service area demographics were evaluated to identify potentially new markets or existing markets that could be increased.
Demographic data was collected for Oceanside (zip code 92056) where Tri-City is located. Then, it was compared to the hospital’s current customer base demographics to establishing a base target audience and the ideal location for marketing purposes.
Area Population Summary
Figure 2. Population Summary of Oceanside, zip code 92056
Figure 2 evaluates the population summary of zip code 92056 in Oceanside. There is a total population of 53,585; 19,152 total households; and the total number of housing units is
19,990. Out of the total population of 53,585, there are 52,563 with health insurance coverage
(Environmental Systems Research Institute (ESRI), 2017).
The data in Figure 3 below provides a breakdown of the population within zip code
92056, where Tri-City is currently located. The categories within this analysis are age and types of health insurance coverage. Health insurance coverage spans across:
• Employer-based health insurance TRI-CITY MEDICAL CENTER 23
• Direct purchase
• Medicare coverage only
• Medicaid coverage only
• Tricare/military health coverage only
• VA healthcare only
• Two or more types of health insurance
• No health insurance coverage
Figure 3. Area Population Summary by Age and Types of Insurance Coverage
TRI-CITY MEDICAL CENTER 24
Of the 52,563 people that comprise the total population of the area, the following are important takeaways (Environmental Systems Research Institute (ESRI), 2017):
• 11,092 are under 18 years of age
o 9,931 have one type of health insurance
o 473 have two or more types of health insurance
o 688 of them have no health insurance
• 11,903 people are between 18 and 34 years of age
o 8,432 have one type of health insurance
o 741 have two or more types of health insurance
o 2,730 have no health insurance
• 20,524 is between 35 to 64 years of age
16,234 have one type of health insurance
1,457 have two or more types of health insurance
2833 have no health insurance
• 9,044 is 65 plus years of age with TRI-CITY MEDICAL CENTER 25
o 2,856 have one type of health insurance
o 5,960 have two or more types of health insurance
o 288 have no health insurance
TRI-CITY MEDICAL CENTER 26
Area Age Summary
Figure 4: Total Population by Age for Zip Code 92056
TRI-CITY MEDICAL CENTER 27
Figure 4 shows the total population by age for the years 2010, 2017, and projections for
2022 for zip code 92056 where Tri-City is located. Most of the population lies between 24 to 65 years of age (Environmental Systems Research Institute (ESRI), 2017). From Figure 3, it was observed that the majority of the population within this range does in fact have health insurance coverage (Environmental Systems Research Institute (ESRI), 2017).
Tri-City will be able to use this data in their marketing initiatives. When developing marketing strategies, Tri-City can leverage the numbers of residents in these age ranges and use the right advertising modalities targeted for their demographics. For example, if the objective was to drive traffic to the hospital’s yoga and nutrition classes, a social media marketing strategy targeted for this large population in the surrounding area may be a good tactic.
Area Ethnicity and Race Summary
Understanding the service area ethnicity and race details are crucial to marketing messages. Language, verbiage, and visual effectiveness rely heavily on relatability and empathy to the hospitals target demographics. This section first displays the overall ethnicity and race breakdown and then shows the details of each one individually.
TRI-CITY MEDICAL CENTER 28
Figure 5. 2017 Total Population by Race in Zip Code 92056
Based on data collected, the overwhelmingly largest population of Tri-City’s service area is White between 25 to 64 years of age. The next largest population is Hispanic also from 25 to
64 years of age. The below figures display greater details of each population.
Figure 6. 2017 White Population by Age in Zip Code 92056 TRI-CITY MEDICAL CENTER 29
According to Figure 6, the total White population in this zip code is 76,002. Most of the population lies between the age of 25 and 34 years of age and also 50 and 64 years of age. The overall median age is 42.4 years old with males being 40.4 years of age and female being 44.6 years of age (Environmental Systems Research Institute (ESRI), 2017).
Figure 7. 2017 Hispanic Population by Age in Zip Code 92056 TRI-CITY MEDICAL CENTER 30
Figure 7 shows that the total Hispanic population in the 92056 zip code is 36,818. The largest concentration of the population is between the ages 25 to 34 years. The median age of
Hispanics is 28.4 years (Environmental Systems Research Institute (ESRI), 2017). TRI-CITY MEDICAL CENTER 31
Figure 8. 2017 African American Population by Age in Zip Code 92056
Figure 8 indicates the total African American population is 3,967. Most of the population is between the age of 25 and 34. The median age is 33.9 years with males at 33.9 years and female at 33.9 years (Environmental Systems Research Institute (ESRI), 2017).
Figure 9. 2017 American Indian Population by Age in Zip Code 92056 TRI-CITY MEDICAL CENTER 32
From Figure 9, the total American Indian population is 925. Most of the population is between the ages of 25 and 34. The median age is 32.1 years with the male median age being
31.9 years and females 32.4 years (Environmental Systems Research Institute (ESRI), 2017).
Figure 10. 2017 Asian Population by Age in Zip Code 92056
TRI-CITY MEDICAL CENTER 33
Figure 10 shows the total Asian population is 6,916. Most of the population lies between the age of 25 to 44 of age. The median age is 40.9 years old with the median male age being 37.8 years and females 43.2 years (Environmental Systems Research Institute (ESRI), 2017).
Figure 11. 2017 Pacific Islander Population by Age in Zip Code 92056
From Figure 11, total of Pacific Islander population is 1,031. Most of the population is between the ages of 20 and 34. The median age is 32 years old with the median of males being
31.7 years and females 32.6 years (Environmental Systems Research Institute (ESRI), 2017).
TRI-CITY MEDICAL CENTER 34
Tri-City Current Patient Visits by Location
Table 1.
Tri-City Patient Visits by Zip Code (2013-2015)
Table 1 shows Tri-City’s current patient demographics data for years 2013-2015 based on frequency of patients visiting from various zip codes. There was a total of 244,120 patients who visited Tri-City for various services, and the top nine most frequent zip codes were concentrated on. As seen in Table 1, zip code 92056 has the highest frequency of patient visits (34,971) consisting of 14.33% of the total. Zip code 92028 has the lowest number of visits (6,473), which accounts for 2.65% of the total.
After analyzing the data, zip codes 92057, 92083 and 92081 may be optimal location for
Tri-City to target through marketing as they have the largest total populations and respectable existing customer bases, (Tri-City data base, 2013-2015).
Tri-City Current Patient Visits by Race, Age, and Gender
Table 2 below ranks Tri-City’s current patients’ frequency of visits depending on race, age, and gender from 2013-2015. White patients who were either male or female over the age of TRI-CITY MEDICAL CENTER 35
85 overwhelmingly visited Tri-City more than any other group. Their frequency of visiting the hospital was a combined 13,764 or 5.64%. The next most frequent patient group to visit Tri-City was White females between 25 – 29 years of age who visited 4,875 times or 2% (Tri-City customer base, 2013-2015). Table 2 verifies that White and Hispanic populations are the highest served within zip code 92056 (Environmental Systems Research Institute (ESRI), 2017).
TRI-CITY MEDICAL CENTER 36
Table 2.
Tri-City Patient Visits by Race, Age, and Gender (2013-2015)
TRI-CITY MEDICAL CENTER 37
In summary, Tri-City Medical Center’s zip code 92056 contains a total population of
53,996. The median age in this area is 39.1 and it is rich with residents who are either White or
Hispanic. Hispanics, in fact, represent 32.7% of the population in the identified area compared to
18.1% of the U.S. average. Furthermore, the vast majority of the population in the area has at least one type of insurance coverage making healthcare much more accessible.
After analyzing Tri-City’s current patient demographic data that examined the population based on age, gender, race and ethnicity, location, and types of insurance people use, the significant takeaways were clear. The majority of current patients are either White or Hispanic, over the age of 85, and primarily located in the zip code 92056. Research also showed there are strong opportunities to focus marketing initiatives also on residents who are between the ages of
24 and 65, and who live in zip codes 92057, 92081 and 92083. With these findings, Tri-City can effectively communicate to their target markets in order to achieve their marketing objectives.
TRI-CITY MEDICAL CENTER 38
External Appraisal
Industry Analysis
Healthcare is the biggest and most complex industry in the United States. As a share of the nation's Gross Domestic Product, health spending accounted for 17.8 percent in 2015 and is on the path to grow even higher as the population ages and health care inflation outpaces that of the rest of the economy. Some of the major push-and-pull factors affecting healthcare industry are strong lobbying groups. The American Hospital Association (AHA), a national organization that has more than 5,000-member organizations, is one of the major organizational bodies that help to lobby interests of different types of healthcare organizations, patients and health networks, (iExpert. IBISWorld 62211).
Even though the overall industry is in the growth phase and the industry value-added
(IVA) forecast averages 4.2% in annual growth to 2020 (annual growth of US GDP (2.5%), not all hospitals will be able to survive or continue their operations, and hospitals are moving towards consolidation of their operations, services and patient bases, though the playing field remains fragmented among the competition. No single hospital organization accounts for more than five percent of the local market. The primary reason for consolidation is cost containment
(See Appendix C) through better negotiating power with suppliers (See Appendix D), such as, insurance, pharmaceutical vendors, technology companies; and ability to win lucrative government contracts.
Per the US Census Bureau, most industry operators are non-profit organizations and for- profit hospitals, which generated only 10.8% of the industry’s revenue in 2015. Non-profit hospitals that do not have enough cash allocated for facilities improvement will be forced to TRI-CITY MEDICAL CENTER 39
search for merging deals with for-profit organizations. This may present a good opportunity for investors to expand their business, however, there is a risk that reimbursement rates may decrease, further squeezing the profit margins. Hospitals and physicians can receive federal funding for “meaningful use” of electronic health records (EHRs) but that is just a small additional contribution that is not going to make any significant impact on the bottom line.
Demand for industry services will likely continue to grow in the next five years. While there will be continued room for growth, hospitals must comply with the enormous number of federal, state and local conditions, regulations, and rules in order to maintain their license.
Additional factors that may impact the organization’s ability to increase its competitive position are that it is becoming harder to find qualified personnel, including physicians and advanced practice providers. There is also room for growth within the Medicaid patient population, however, hospitals may not benefit from more Medicaid patients unless these programs increase their reimbursement, which is often less than the cost of providing care. Medicare reimbursement varies by the designation of the setting. For example, the “sole community hospitals” and critical access hospitals (CAH) under Medicare on average have higher reimbursement rates, (iExpert.
IBISWorld 62211).
There is also a push throughout the industry to increase outpatient versus inpatient services (IBISWorld estimates outpatient services will account for 46.0% of total industry revenue). The trend is motivated by the cost minimization and elimination of overnight patient stays. It pushes hospitals to invest into innovations and advanced technologies that can reduce patient’s average stays. Another area of concern is the Emergency Medical Treatment and Active
Labor Act (EMTALA), passed by Congress in 1986, which requires most hospitals to provide emergency healthcare to anyone, regardless of ability to pay. Partially due to the effects of TRI-CITY MEDICAL CENTER 40
EMTALA, hospitals are not compensated for about 55% of the emergency care they provide.
Hospitals may have to serve more uninsured patients and still be able to recover some cost due to the PPACA (Patient Protection and Affordable Care Act (PPACA) healthcare reform, (SDME
Annual Medical Report).
The healthcare industry will face even more serious issues than it faces right now, including patient privacy, technological advancement, regulations, reforms due to the growth of aging population, demographics, policies, availability of health care, all of which the hospital will need to address in the near future. If the organization wants to remain viable in the industry and continue to be a main competitor in the market, it will need to work on continuous improvement in order to meet the primary external threats that are currently presented.
Industry Life Cycle
The U.S. population is aging, especially due to the Baby Boomer generation now reaching retirement age, which will significantly impact the healthcare industry. Demand for a wider array of services continues to grow, and emerging technologies need to be implemented to maintain competitive advantage. Unfortunately, new technology is hard to adapt to, and it takes some time to create and deploy new equipment. The nature of the technology means that in some cases if adoption and implementation take too long, the technology could be outdated quickly after it is implemented. All these factors impact the industry as a whole. For example, general demand is dictated by the population health and lifestyle balance. A hospital's primary revenue comes from different sources such as from federal government under Medicare program, state government under Medicaid, also from local communities and investors. The major groups of TRI-CITY MEDICAL CENTER 41
patients can be categories within three patient groups: Patients aged 65 and older, patients aged
45 to 64, and patients aged 15 to 44, (IBISWorld Industry Report 62211).
The valued added by healthcare industry has grown considerably in recent years and based on the IBISWorld and US census data will keep growing. At the same time, new technologies are expanding the array of services and increasing capital expenditure in the hospital sector, all of which can be difficult to navigate for hospital organizations within the industry. There is expectation that the number of insured people will be increased, especially if the PPACA is repealed and replaced, which can contribute further to various consolidation processes throughout the healthcare industry, specifically across the six major primary activities of the hospital industry (see Appendix C)
• Outpatient care (major service)
• Impatient care (major service)
• Anatomical pathology services
• Diagnostic X-ray services
• Clinical laboratory services
• Operating room services
Overall the healthcare industry is in the growth lifecycle, slightly contributed by the US industry gains after recession years. Most of the healthcare sub sectors have low revenue volatility (easier to forecast because of high industry government assistance) with medium capital intensity and low regional concentration. There is certainly the external pressure like healthcare reforms and others. There is tendency for major players to consolidate their businesses. Most of the hospitals adapted to the changing landscape by attracting the best healthcare professionals. But it still is not enough. Hospitals need to change their organizational TRI-CITY MEDICAL CENTER 42
structure and services offered to attract leading healthcare professionals, and healthcare prices are continuing to rise due to the lack of physicians and nurses in the industry, which increases the demand for services placed on an organization’s existing personnel, (iExpert. IBISWorld 62211).
The PPACA has allowed more individuals to receive health insurance coverage, though there are concerns that legislation regarding healthcare services will change in the future. Due to the low competition and high level of regulations within the industry, hospital organizations tend to avoid any drastic expansion into new geographical regions, with most of the hospitals staying in the same region and increasing their community oriented approaches.
Industry Issues
In the next year, federal funding for Medicare and Medicaid is expected to increase. Due to this, the hospital will not be able to sustain their operations following the same methodology they used in the past. Hospitals specifically in San Diego area can benefit from the fact that population age 65 and older is expected to increase, (see Appendix A), but the demand for services means that there will need to be internal changes to accommodate this rise in the aging patient population. With the close proximity to the number of retirement communities in
Carlsbad, San Marcos, and Encinitas, organizations within San Diego will be working to increase their services offered to attract patients of this growing age group. Industry demand is boosted by people with high income who want to have a better healthcare services as well, and based on the statistical data Carlsbad/Encinitas area is one of the wealthiest communities in California.
Disposable income is expected to increase in the upcoming years in the San Diego area, which will allow for more healthcare services to be sought after. Due to this, the ability to attract and retain quality medical, nursing, and administrative staff is going to be a crucial factor for the TRI-CITY MEDICAL CENTER 43
hospitals, especially if they need to service wider retirement communities. Larger hospitals can accrue cost savings and absorb more cost in a long run which can give larger hospitals like
Scripps or Sharp financial competitive advantage. As patients and their referrers prefer to go to hospitals with a perfect reputation, good facilities, high safety scores and good patient outcomes, hospitals are strongly motivated to keep their public profile in good standing, (Hospital Summary
Individual Disclosure Report. OSHPD).
Key External Drivers
The key external drivers that impact health care industry are federal funding for Medicare and Medicaid, hospital location and changing demographics, the number of individuals with private health insurance, disposable income, aging population, lobbying, and politics influence on health care, (see Appendix D)
Current Performance
The overall performance is dictated by the number of factors such as healthcare reforms on different sectors of health care industry, Joint Commission accreditation needs to maintain
Medicare patients and receive federal funding, availability of a skilled workforce like physicians and nurses which is facilitated by proximity to medical education establishments, and concentration of hospitals in the region. Patient demographics is one of the key criteria for a hospital location selection as well, and as labor costs continue to rise hospitals will need to increase their service offerings and community outreach to bring in a wider patient base to remain financially viable, (IBISWorld Industry Report 62211)
Barriers to Entry TRI-CITY MEDICAL CENTER 44
There are significant barriers to entry in the hospital industry because of the numerous regulatory requirements, strong competition and the complexity of hospital operations. The actual process of acquiring a license is quite tedious. Going through regulations, accreditation and licensing could easily take several years, which is a deterrent to entering the market. The major factors that new operators need to consider before entering the industry are competition, service concentration, the industry life cycle stage, having enough capital, technological advancement, local, state, federal regulations, and whether the new operator could obtain industry assistance, (see Appendix E)
Risk Factors and Competitive Landscape
Risk Factors
There are different types of risks for hospitals, including components made up of structural risk factors, growth, and sensitivity. Even though the overall risks for hospitals is projected to stay low between 2017 to 2020, hospitals still need to pay attention to risk sensitivity. Because competition stayed low in the past years the industry gained some growth momentum that could change the balance between nonprofit and for-profit types of hospitals.
• Structural Risk: Based on the IBISWorld report the structural risk is projected to stay quite
low due to the industry growth dictated by increasing demand through all types of health care
services - primary care, orthopedics, cardiovascular services.
• Growth Risk: IBISWorld forecasts that annual industry revenue will grow 3.6% to $969.2
billion. In comparison, revenue expanded 4.6% per year between 2012 and 2014.
• Sensitivity Risk: dictated by numerous external factors like policies, regulations, economic
stability, demographics, (IBISWorld Industry Report 62211). TRI-CITY MEDICAL CENTER 45
Competitive landscape
Healthcare reform dictates industry prices and enforces reimbursement models that create powerful incentives for hospitals to form large systems of care. As a result of these changes, reform is expected to increase both the number and size of industry mergers. A few hospitals have already closed due to the Medicare impact on their bottom line in San Diego area. The following are included in Appendix B. A few of the notable areas of concern within the competitive landscape are, (IBISWorld Industry Report 62211):
• Access to Highly Skilled Workforce: The ability to attract and retain quality medical,
nursing, and administrative staff will allow industry operators to provide quality service and
effectively manage hospital operations.
• Proximity to Key Markets: It is important to be located in a highly populated area, close to
other health service providers and nursing homes.
• Understanding Government Policies and Their Implications: Hospitals must have a good
understanding of regulations, costs, insurance providers and be a part of local communities
• Economies of Scale: Larger hospitals can accrue cost savings and other efficiencies.
• Optimum Capacity Utilization: Maximizing occupancy rates can promote revenue and
profitability. This is the major reason why outpatients’ services keep increasing.
• Having a Good Reputation: Patients and their referrers often seek out hospitals with a
reputation for procedural expertise, good facilities and good patient outcomes (i.e. investment
in marketing and promotions, local events, be part of local community, outreach).
TRI-CITY MEDICAL CENTER 46
Competitive Analysis
Palomar Health
The new Palomar Medical Center (PMC) opened in 2012, accredited by The Joint
Commission, and has 740,000-foot 11-story facility. The medical center features 288 private single-patient rooms, 44 emergency and trauma rooms, and 11 operating rooms. It is situated on the 56-acre campus that uses natural light. Among the natural features is 1.5-acre green roof that sits atop the second floor, lush with drought-resistant vegetation with a view for south-facing patients.
Major Services
• Bariatric Surgery - Surgical Weight Loss
• Flu Source
• Orthopedic and Spine Center
• Urgent Care
• Birth Centers
• Heart and Vascular Center
• The Patient Experience
• Women’s and Children’s Services
• Bypass Surgery
• Cardiovascular Surgery
• Diabetes Treatment
• Emergency Services TRI-CITY MEDICAL CENTER 47
• Knee Treatment and Replacement Surgery
Scripps Memorial Hospital Encinitas
Scripps Memorial Hospital Encinitas was established 1978 and offers a full range of clinical and surgical services, including North County’s first Primary Stroke Center, a regionally recognized brain injury program, state-of-the-art imaging center, 24-hour emergency room care and award-winning OB-GYN, maternal health and infant health services, (Scripps Memorial
Hospital Encinitas. Scripps Hospital Disclosure Report).
Major Services
• Prenatal Care Classes
• Labor and Delivery (Physicians and Midwives)
• Perinatal Care for High Risk Pregnancies
• NICU Services Provided by Rady Children’s Hospital
• Women’s Health Services
• Obstetrics
• Gynecology
• Maternity (Labor and Delivery)
• Breast Care
Sharp Memorial Hospital
Sharp Memorial Hospital in San Diego, CA was established in 1955 which is a 431-bed general medical and surgical facility. It is accredited by the Commission on Accreditation of
Rehabilitation Facilities (CARF), (Sharp Health Hospital. Hospital Disclosure Report. OSHPD) TRI-CITY MEDICAL CENTER 48
Major Services
• Emergency
• Cardiovascular
• Oncology
• Surgery
• Birthing Center
• Pediatrics
• Rehabilitation Services
SWOT Comparisons for all Hospitals
Palomar Medical Center
Analysis is based on the hospital disclosure report, (Palomar Health Hospital Encinitas. Hospital
Summary Individual Disclosure Report. OSHPD)
Strengths
• Multiple locations in North County: San Marcos, Poway, Rancho Penasquitos, and two
locations in Escondido
• Well established market service area and clientele (Military & High-Income Residents)
• Palomar Health Express Care Clinics provide off site hospital care
• Extra patient gross income & wider market service area
• Wide variety of specializations, care, and innovative technology (Visi, Behavioral,
Pediatrics, etc.)
• 60+ years of history within the community TRI-CITY MEDICAL CENTER 49
• Only Level II Trauma center in North County
Weaknesses
• Location - mostly in the North County
• Lack of certain services
• Financial issues (Revenue Deficient)
• Poor employee engagement
Opportunities
• Opportunity to expand new services
• Palomar health and Mayo-clinic
• Palomar health express care walk-In health clinics
• Innovation and technology
• Most medical and surgical facilities
• Improve collaboration with DOD/DVA
• Expand to Level I trauma center
• Enables patients in a community to get primary care services in a non-hospital setting,
avoiding potential ER visits and wait times (Albertson’s, Gelsons)
• Build partnership relations with Mayo Clinic Care Network for additional input on complex
patient care
• Expand services with Kaiser Permanente so that health plan members access to care from KP
doctors in multiple locations
Threats
• Potential change in market (e.g., ACA, new entrants, vendors) TRI-CITY MEDICAL CENTER 50
• Potential decrease in revenues
• Potential decrease in patient volume
• Potential increase in competition for specialty personnel (e.g., physicians, nurses, & allied
health)
• Increased competition from healthcare network
• Reduced government reimbursement
Scripps Memorial Hospital Encinitas
Analysis is based on the hospital disclosure report, (Scripps Memorial Hospital Encinitas.
Hospital Summary Individual Disclosure Report. OSHPD)
Strengths
• Multiple locations in North County
• Strong brand awareness in the community
• Strong cardiovascular care. Scripps treats 55,000 heart patients annually – more than any
other provider in San Diego. Scripps opened the $456-million Scripps Prebys
Cardiovascular Institute in 2016. The institute is the largest heart hospital on the West Coast
with 167 inpatient beds. Scripps has been the major provider of heart services in San Diego
Area (signed contract with Kaiser Permanente)
• Strong commitment to provide cancer treatment and related services. Has state-of-the-art
regional radiation therapy center. Has the region’s first proton therapy center
• Strong in providing diabetes care through outpatient education, inpatient glucose
management and community based programs
• The Scripps drug and alcohol treatment program is nationally recognized for excellence TRI-CITY MEDICAL CENTER 51
• Women’s clinical care line that is operated at multiple Scripps Health sites across the
inpatient and ambulatory continuum of care
• Offers a full spectrum of obstetrics and gynecology services throughout San Diego
• Scripps has been recognized for high performance in Neurology & Neurosurgery by U.S.
News & World Report (2014-2015)
• Strong Emergency and Trauma Medicine (operates two adult trauma centers)
• Provide extensive primary care (has more than 2,600 primary care physicians). Offers a
county-wide network of primary care with full range of services
• Provides hospice services (focus on quality of life, home health aide, physical therapy,
occupational therapy, nutrition)
Weaknesses
• Poor employee engagement
• Poor behavioral health services programs which provide inpatient and outpatient mental
health services in multiple Scripps locations
• Operations are quite complex. It is difficult to manage multiple Hospital locations and
provide the same quality services, it is hard to keep focus on the certain type of services
Opportunities
• Build better relations within community, improved safety scores
• Provide diabetes and endocrinology programs in Scripps Memorial Hospital Encinitas
Threats
• Strong competition for primary care TRI-CITY MEDICAL CENTER 52
• Lack of the latest equipment to provide advanced diagnostic services, surgical and non-
surgical treatments and rehabilitation care
Sharp Healthcare
Analysis is based on the hospital disclosure report, (Sharp Health Hospital. Hospital Summary
Individual Disclosure Report. OSHPD).
Strengths
• Multiple location in San Diego County: Chula Vista, Coronado, La Mesa (9 hospitals)
• Well established market service area and Sharp is the largest provider in the region serving
30% of population including south and north San Diego
• Excellent patient satisfaction and patient experiences (Sharp Culture)
• Recognized commitment to excellence (numerous quality awards)
• Long history of serving community, more than 65 years
Weaknesses
• Aging facilities
• Old Cardiovascular equipment
• Internal communication issues
• Facing reduction in labor force
Opportunities
• Potential technology improvement
• Clinical trials
• Better connection in San Diego health industry TRI-CITY MEDICAL CENTER 53
Threats
• Ever increasing competition from other healthcare providers. New state of the art specialized
cardiology hospitals
• Potential change in market due to the new providers entering the space
• Hard to predict patient volume in a short time frame
• More competition from some specialized personnel like nurses, physicians
• Reduction in government spending
Tri-City Medical Center
Strengths
• The Tri-City Medical Center is accredited fully by the Joint Commission, making the
hospital gain recognition in the region. The Gold Seal of Approval and accreditation
establishes the hospital as having one of the highest standards regarding quality healthcare
and safety, (Annual Report 2016). Therefore, it gives the hospital a respected identity in
control of infections, management of medication, and overall care of patients.
• It has exceptional care for patients with acute stroke. It has received two certifications
pertaining stroke care, being recognized as one of the eight hospitals in the county, (Annual
Report 2016). Therefore, the hospital has the required resources and proficiency for the
treatment of stroke patients.
• The hospital boasts of its efforts in the treatment of patients with breast cancer. The hospital
sets the pace in women's health through breast ultrasound, mammography, and ultrasound-
guided breast biopsy, (Annual Report 2016). The hospital ensures high quality of clinical
imagery, the safety of patients, and recruitment of highly qualified specialists. TRI-CITY MEDICAL CENTER 54
• The hospital stays ahead in the medical field through the purchase of advanced medical
equipment, for instance, the GE Healthcare Revolution™ CT scanner in 2015. The advanced
computed tomography (CT) scanner will enable radiologists to diagnose patients in the most
accurate and fastest manner possible, (Tri-City Takes Quantum Leap in Medical Imaging,
2017) This markets the hospital as a leader in the radiology filed in the region showing its
commitment to high-quality healthcare.
• Affiliations with UC San Diego Health that enhance the quality of medical staff, as well as
expand its services to the local community.
Weakness
• There is a delay in the emergency department, resulting in very high wait times due to the
hospital having one of the busiest emergency sections in the county (Annual Report 2016).
This has a negative impact on patient experience.
• Lack of a stable leadership structure, as it has had two CEO’s in three years, (Aguilar, 2016).
This is costly and weakens relationships with stakeholders of the hospital.
Opportunities
• Tri-City Medical Center can involve itself more in community programs such as health
awareness weekly programs, and annual free medical checkups. The checkups could occur
for a week, which goes in line with the hospital’s mission to be a health provider to the
community.
• Seminars and conferences on breast cancer, as the disease is so prevalent nowadays.
• Creating a motivational program for students in the medical field through incentives. This
can be used to increase their interest in the hospital programs. TRI-CITY MEDICAL CENTER 55
Threats
• The lack of a proper follow-up program for treated patients.
• Expansion at a high rate that eats up into the revenue of the hospital, as recent audits have
shown an operating loss into the millions of dollars, (Sisson, 2016)
Competitors Operations and Competitive Advantages Comparison
In order to understand better competitors’ marketing objectives and what they do in terms of operations, information was gathered related to competitors’ operations across Technology,
Human Resources, and Quality. Having this type of comparison can be instrumental in moving forward with identification of marketing strategies for Tri-City Medical Center and would be an asset in the organization’s positioning strategies within the market.
TRI-CITY MEDICAL CENTER 56
Table 3.
Competitor's operations – Technology
Sharp HealthCare Scripps Memorial Palomar Hospital Tri-City Medical Encinitas Center 1. Screening and Diagnostics MRI – Cardiac MRI - magnetic MRI - magnetic MRI - magnetic Magnetic resonance imaging resonance imaging resonance imaging Resonance Nuclear medicine Nuclear medicine Nuclear medicine Imaging; CT - computed CT - computed CT - computed CT – Computerized tomography tomography tomography Tomography Scan Non-imaging heart tests Non-imaging heart PET – Positron Blood tests, including tests Emission those to measure glucose Blood tests, Tomography Scan and lipids including those to TEE – measure glucose Transesophageal and lipids echocardiogram 2. Clinical Trials TRI-CITY MEDICAL CENTER 57
Sharp HealthCare Scripps Memorial Palomar Hospital Tri-City Medical Encinitas Center Clinical Trials Clinical trials of cutting- Treatment trials that Clinical Trials related to heart edge wireless biosensor test new treatments, related to heart systems; new combinations of Rapid pharmacogenomic drugs, or new diagnostic testing; approaches to surgery Apps and embedded or radiation therapy. sensors for predicting Prevention trials look and tracking certain for better ways to cancers, type 1 diabetes, prevent a disease in and heart attacks people who have never had the disease or to prevent the disease from returning. Better approaches may include medicines, vaccines, or lifestyle changes, among other things. Diagnostic trials determine better tests or procedures for diagnosing a particular disease or condition. Screening trials test the best way to detect certain diseases or health conditions. Quality of life trials (or supportive care trials) explore and measure ways to improve the comfort and quality of life of people with a chronic illness.
3. Mechanical Circulatory Support Systems TRI-CITY MEDICAL CENTER 58
Sharp HealthCare Scripps Memorial Palomar Hospital Tri-City Medical Encinitas Center Cardio west total Patient care in real time Left Ventricular Cardio west total artificial heart (smartphones, high IoT Assist Device artificial heart Extra Corporeal Health). Mobile wrist (LVAD) and Life Support sensors to monitor all Mechanical (ECLS) core vital signs and send Circulatory Support HeartMate 2 alert to the doctor. HeartWare Portable ultrasound Tandem Heart devices – which allows Ventricular Assist to check the heart Device muscles, blood flow, valves. Mobile MIM – MRA and CT scans.
4. Health Information Systems (San Diego Health Connect) Safely and securely Need to enforce better Need to enforce better Safety and securely share patient security and privacy security and privacy share patient information; policies policies. Secure information HER system with integration with complete records partners
TRI-CITY MEDICAL CENTER 59
Table 4.
Competitor's Operations - Human Resources (Goal - Attract and retain best human capital)
Sharp HealthCare Scripps Memorial Palomar Hospital Tri-City Encinitas Medical Center Human Resources Recruitment of Center of learning and Focus on retaining of Training, qualified personal, Innovation (CFLI) – qualified personnel such as development training and committed to create a physicians and nurses and development, retention, learning environment. recruitment of and turnover rates Offer full spectrum of physicians and nurses benefits: competitive pay, time off, retirement and saving options, work-life balance and more. Showing that care about employees
TRI-CITY MEDICAL CENTER 60
Table 5.
Competitor's Operations - Quality Control (safety)
Sharp HealthCare Scripps Memorial Palomar Hospital Tri-City Encinitas Medical Center Quality Control and
Safety Leadership, At Scripps, quality is a A HEIP program is Zero medical Training, Educating combination of formed when a hospital errors, high Collection of Patient philosophy and practice. contracts directly with a safety and Satisfaction data Scripps is committed to CIN to engage a subset of control, Employee/Physician continuously improving its participating monitoring. Satisfaction/ the quality of health care physicians to undertake a Retention we deliver. series of process, Zero Medical Errors From awards and performance, and/or Integrated Delivery accolades to patient clinical initiatives on the system satisfaction scores and basis of enhanced quality, National quality ratings, the results outcomes, and/or Recognition speak for themselves. efficiency improvements Data shows that on within the hospital. For average, we have higher the enhancements survival rates, fewer achieved through the medical errors and better HEIP program, the patient satisfaction than hospital provides the CIN the majority of health care a fair market value systems in the nation. (“FMV”) compensation which the CIN would use, in part, to both reimburse physicians for the time and effort and to provide performance- based incentives. While changes to patient care are developed and led by physicians, the hospital prioritizes where to improve and supports the program infrastructure.
TRI-CITY MEDICAL CENTER 61
Table 6.
Competitor's Operations - General Management
Sharp HealthCare Scripps Memorial Palomar Tri-City Medical Encinitas Hospital Center
General Management Goal for improvement and Increase primary Improved Focus on Safety and sustaining: safety, care, cardiovascular financial Brand recognition effective, efficient, timely and children care. management and within local service. Enhance Improve stability. community competitiveness and information marketability, continue to technology build trusted network integration throughout multiple hospital locations
Hospital Utilization
Data was collected to measure inpatient utilization organized by medical service and market share for Tri-City and the three major competitors, Palomar, Scripps, and Sharp. Below is the inpatient utilization by medical service data for the year 2017. Within these tables, the primary three departments (cardiology, orthopedics and medicine) were analyzed to discover how Tri-City was performing in comparison to the other hospitals.
Inpatient Utilization
Table 7, 8, 9, and 10 display the number of inpatients with Medicare broken down by services used. Below are comparisons of the hospitals’ Cardiology, Orthopedics, and Medicine departments (American Hospital Directory, 2017).
Cardiology
• Scripps treated 507 patients (Table 7) TRI-CITY MEDICAL CENTER 62
• Palomar treated 528 patients (Table 8)
• Sharp treated 553 patients (Table 9)
• Tri-City treated 434 patients (Table 10)
Orthopedics
• Scripps treated 257 patients (Table 7)
• Palomar treated 609 patients (Table 8)
• Sharp treated 199 patients (Table 9)
• Tri-City treated 125 patients (Table 10)
Medicine
• Scripps treated 1,029 patients (Table 7)
• Palomar treated 1,206 patients (Table 8)
• Sharp treated 1,312 patients (Table 9)
• Tri-City treated 989 patients (Table 10)
Based on the results, it is observed that Tri-City has less inpatients than the other three hospitals in all of these areas. While these patients are specifically those who used Medicare, these data points support Tri-City’s desire to increase the number of patients seen in these specialties.
TRI-CITY MEDICAL CENTER 63
Table 7.
Scripps Memorial Hospital Encinitas Inpatient Utilization Statistics by Medical Service
TRI-CITY MEDICAL CENTER 64
Table 8.
Palomar Medical Center Inpatient Utilization Statistics by Medical Service
TRI-CITY MEDICAL CENTER 65
Table 9.
Sharp Memorial Hospital Inpatient Utilization Statistics by Medical Service
TRI-CITY MEDICAL CENTER 66
Table 10.
Tri-City Medical Center Inpatient Utilization Statistics by Medical Service
Market Share
Tables 11, 12, 13, and 14 illustrate the market share data for inpatient origin based on the top three zip codes of residency for each hospital. Scripps is located in Encinitas and of their top three zip codes, it has the highest market share (51.6%) in 92009 (Carlsbad) and lowest (22.5%) in 92057 (Oceanside). Palomar is located in Escondido and has its highest market share (65.10%) in 92027 (Escondido) and lowest (61.5%) in 92025 (Escondido). Sharp is located in San Diego and has its highest market share (40.7%) in 92111 (San Diego) and lowest (27.8%) in 92117
(San Diego). Tri-City is located in Oceanside and has their highest market share (43.30%) in zip code 92056 (Oceanside) and the lowest (39.60%) in 92057 (Oceanside) (American Hospital TRI-CITY MEDICAL CENTER 67
Directory, 2017. Based on the data, it is recommended that Tri-City may focus more marketing efforts on 92057 and 92058 zip codes in-order to increase and balance its market share across its three top zip codes. Some of this territory is nearby Scripps Memorial Hospital in Encinitas which means they will be competing for that particular area’s residents.
Table 11.
Scripps Memorial Hospital Encinitas Inpatient Origin for Top 3 Zip Codes
TRI-CITY MEDICAL CENTER 68
Table 12.
Palomar Medical Center Inpatient Origin for Top 3 Zip Codes
Table 13.
Sharp Memorial Hospital Inpatient Origin for Top 3 Zip Codes
Table 14.
Tri-City Medical Center Inpatient Origin for Top 3 Zip Codes
Quality and Patient Experience
Another important comparative data point to observe is total quality score and patient experience ratings. Scripps’ total quality score is 38.75 and patient experience rating is 2 out of 5
(Figure 12). Palomar’s total quality score is 22.67 and patient experience rating is 3 out of 5
(Figure 13). Sharp’s total quality score is 27 and patient experience rating is 4 out of 5 (Figure
TRI-CITY MEDICAL CENTER 69
14). Tri-City’s total quality score is 21.5 and patient experience rating is 2 out of 5 (Figure 15),
(American Hospital Directory, 2017).
Based on this data Tri-City has the lowest total quality score and both Tri-City and
Scripps have the lowest patient experience rating. This shows there is a great need to focus more on customer service for inpatients. If Tri-City is going to compete with these major hospitals, patient experience and quality need to be at the forefront of their initiatives to increase their scores and thus improve their word of mouth reputation.
Figure 12. Scripps Memorial Hospital Encinitas Total Patient Quality Score
Figure 13. Palomar Medical Center Total Patient Quality Score
Figure 14. Sharp Memorial Hospital Total Patient Quality Score
TRI-CITY MEDICAL CENTER 70
Figure 15. Tri-City Medical Center Total Patient Quality Score
TRI-CITY MEDICAL CENTER 71
Marketing Strategies by Competitor
We analyzed different marketing strategies that Sharp, Palomar and Scrips utilizes in- order to create a strategic marketing plan for Tri-City. We found that each of the competitors utilizes different marketing strategies for example social media, press release, sponsorships, events, etc. Some of them are described below.
Social Media Comparison
Scripps Memorial Hospital Encinitas
Scripps has 28,131 total likes on their Facebook page, (Facebook, 2017). With informative videos and healthy tips, they seem to be connected with community. It was impressive to see that they did free heart screening at UCSD.
Figure 16. Scripps Health Facebook page example
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Scripps has 27.9k followers on Twitter which is very high. They mostly tweet about health, diabetes, etc. They also tweet about their new inventions for example tool to diagnose coronary artery blockage, (Twittre,2017).
Figure 17. Scripps Health Twitter
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Google Plus
Scripps has a total of 264,229 followers on Google Plus page, (google plus, 2017). Not only their home page has information about bladder disorder, diabetes, colorectal cancer, breast cancer, but also, they seem to be more caring and affectionate with patients.
Figure 18. Scripps Sponsor Events
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Scripps has 2,992 followers on Pinterest page, (Pinterest, 2017). Their home page has a lot of information about health and fitness.
Figure 19. Scripps Health Physician interview
Scripps has 2,613 followers on Instagram, (Instagram, 2017). They Instagram about their health system and how their high-quality patient care is helping communities in creating a better tomorrow.
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Figure 20. Scripps followers on Instagram
YouTube
Scripps constantly posts videos on its YouTube health channel about local patients and what’s new with Scripps Hospital. On average, each video gets about 200 views within a month,
(You Tube, 2017).
Figure 21. Scripps Health Videos
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Scripps has a LinkedIn profile as a company. It has more than 30k followers and has a lot of information related to different services and hospitals, (LinkedIn, 2017). This profile services as a recruitment portal, engages community and presents a general overview of what is going on recently with Scripps Health including Scripps Memorial Hospital Encinitas.
Figure 22. Scripps Health LinkedIn profile
Palomar Medical Center
Palomar has 4,049 total likes on their Facebook page. On their home page, one can find a lot of information on food habits. They also seem to be connected with the community by expanding their facility in North San Diego County, (Facebook, 2017).
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Figure 23. Palomar Health Facebook postings
Palomar has 2,361 followers on Twitter. They mostly tweet about health, obesity, diabetic, ulcers, etc., (Twitter, 2017). Their page is very colorful and filled with information about health and nutrition.
Figure 24. Palomar Health Twitter
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Palomar has 48 followers on Pinterest. Their home page has information about Palomar hospital and some advance technology they use. They also have health and wellness boards,
(Pinterest, 2017).
Figure 25. Palomar Health on Pinterest.
Palomar has 356 followers on Instagram. They Instagram about their health care delivery system in Northern San Diego County and how it is helping to build better communities,
(Instagram, 2017).
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Figure 26. Palomar Health on Instagram
YouTube
Palomar’s YouTube channel has more than 1,000 videos posted within one-year time frame covering different health care related topics. The number of average views per video varies from 50 unique visitors to thousands of visitors, (You Tube, 2017). For example, Palomar even gave a coverage of its journey to a new brand.
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Figure 27. Palomar Health YouTube Channel
Palomar has a LinkedIn corporate profile which services as a hub for all Palomar Health entities including Palomar Medical Center. The profile has more than 9,000 followers and a lot of recent news and updates related to Palomar Medical Center’s services, facilities, physicians,
(LinkedIn, 2017).
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Figure 28. Palomar Health LinkedIn Profile
Sharp Health
Sharp has 13,855 total likes on their Facebook page, (Facebook, 2017). They are really connected with community. People share their findings and experiences via public post at Sharp
Health Care which is quite impressive.
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Figure 29. Share HealthCare Story telling
Sharp has 11.9k followers on Twitter. They mostly tweet about innovative treatments, stories of sharp experience, AIDS, etc. (Twitter, 2017). Their page is very interesting because it is filled with variety of information.
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Figure 30. Sharp health Twitter
Google Plus
Sharp has 1,214 followers on Google Plus page, (Google Plus, 2017). Their home page is filled with all the information about treatments for uterine fibroids, hip replacement surgery, staying healthy tips, etc.
Figure 31. Share Health Care patient feedback
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Sharp has 1,551 followers on Pinterest page, (Pinterest, 2017). Their page is very colorful and contains information about cancer fighting recipes, stroke and neurology, transplant, fitness tips, etc.
Figure 32. Sharp HealthCare Advices
Sharp has 1,960 followers on Instagram, (Instagram, 2017). They instagram about employee moments, healthy recipes, healthy tips, and patients’ sharp experience.
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Figure 33. Sharp HealthCare Nutrition on Instagram
YouTube
Sharp Health YouTube channel has more than 5k subscribers covering a variety of health topics for example breast cancer, hip replacement, health and nutrition, etc. (You Tube, 2017).
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Figure 34. Sharp HealthCare YouTube Channel
Sharp Health LinkedIn corporate profile page has more than 25k subscribers and a lot of recent news, coverage of its facilities, medical staff, (LinkedIn, 2017).
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Figure 35. Sharp HealthCare LinkedIn Profile
Tri-City Medical Center
Tri-City has 6,849 likes on their Facebook page. Tri-City Medical Center, a leader in robotics, a Gold Seal-approved, full-service, acute-care hospital with two advanced clinical institutes. They emphasis more on information about surgeries for example joint replacement and how to change your habits into healthy habits.
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Figure 36. Tri-City Medical Center Promotion
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Tri-City has 387 followers. Their home page has a lot of information about joint replacement, surgeries, and staying healthy tips. They opened a wellness center for the people in community to make a difference.
Figure 37. Tri-City Twitter
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Google Plus
Tri-City hospital has 48 followers on their Google Plus page. Their home page is filled with information about robotics surgical system, cancer, diabetes, cardiology, etc.
Figure 38. Tri-City Media - Robotics
Tri-City has 44 followers on Pinterest page. Their homepage has information about cardiovascular and healthy eating tips.
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Figure 39. Tri-City Pinterest Followers
YouTube
The Tri-City Medical Center YouTube channel only has approximately 80 subscribers which is in comparison to other competitors too low.
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Figure 40. Tri-City Home page
In general, video coverage has similar number of views in similar comparison with competitor video channel visitors. TRI-CITY MEDICAL CENTER 93
Figure 41. Tri-City LinkedIn profile
Analysis of Social Medial findings.
After analyzing social media for Sharp, Scripps, Palmar and Tri-City, it seems Tri-City needs to invest and focus heavily on their social media because their followers or subscribers or likes are not good. In order to increase their social media numbers, for starters, they can engage with people, increase their PR, participate in variety of events etc.
Table 15.
Social media Sharp Scripps Palomar Tricity Facebook 13,256 followers 27,480 followers 3,988 followers 6,673 followers Pinterest 1,550 Followers 2,924 followers 47 followers 44 followers Twitter 11.9 k Followers 27.8 k Followers 2357 followers 754 followers Instagram 1,953 followers 2,603 followers 353 followers Not available you tube 5176 Subscribers 1484 Subscribers 81 subscribers 95 subscribers linked in 2,5389 followers 3,0814 followers 9,262 followers 3,397 followers Google + 1215 followers 264,297 followers Not available 49 followers
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Scripps Memorial Hospital Encinitas
While research showed Scripps Health was a highly regarded regional healthcare system with a notable history, it lacked a clear, compelling brand to distinguish it from its competitors and drive customer choice. Following an in-depth brand assessment and detailed research, they implemented a cohesive approach to unify the brand by defining a compelling brand story and expressing it consistently throughout the organization, all without changing Scripps’ well-known logo. Their approach demonstrates that creating a master brand strategy while honoring an organization’s heritage is not only possible but also can be remarkably successful.
Commercials and Videos:
There are variety of videos and commercial that are available online based on primary care, heart care, orthopedic etc. All the videos are very informative and while seeing the videos one may feel very safe. The patient experience that are being shared in the videos are very touching, (You Tube, 2017).
Figure 42. Scrips Commercial and Videos
E-Newsletter: TRI-CITY MEDICAL CENTER 95
One of the marketing strategy Scrips has is that people can sign up to receive emails on information about healthy life from Scripps. This monthly e-newsletter includes health and wellness tips from Scripps experts, inspiring patient stories, informational classes, engaging events and more, (Healthy life by Scrips Health, 2017).
Sponsored Events and Classes Open to the Public:
To connect with community, Scrips sponsor variety of events for example they offer
Yoga series, family-friendly yoga class etc. In addition, they also offer events such as Scripps
Encinitas gala, online childbirth preparation, Diabetes prevention program and many more. Some of the events are offered in Spanish language as well and at different locations, which is quite interesting (Eventbrite, Scripps Classes & Events, 2017).
Figure 43. Sponsored events by Scripps
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Corporate Sponsor Programs:
Scripps also offer corporate sponsorship program. This program is designed for partners who are interested in supporting more than one event per year. This program allows partners to enjoy recognition as a Scripps Health Partner with one annual commitment, (Corporate Sponsorship
Packet, 2017).
Figure 44. Scripps Corporate Sponsorship Programs:
Press Releases
Scripps has strong press release. They are in the news almost once or twice a month. Recently they in the news talking about are construction plans on KPBS - New construction plans” and
“Del Mar Times, (KPBS, 2017)
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Figure 45. Scripps Health Modernization Plan Includes New Hillcrest Hospital
Referral Networks:
Scrips Health do invest in many referral networks. They launched first LGBT (lesbian, gay, bisexual, transgender) Health & Wellness Referral Network. The network is a resource to members of the LGBT community who are looking to optimize their health and well-being by choosing practitioners who can provide care in a safe, and inclusive environment, (Greater San
Diego lgbt health & Wellness referral network,2017)).
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Figure 46. Scripps Health Referral Network
Palomar Medical Center
Billboards:
Palomar uses bus billboards for their advertisement which is very interesting. This type of advertising is an eye catcher as one can see Palomar anywhere anytime, (Google, 2017)
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Figure 47. Palomar Health Road Type billboard
Commercials and Videos:
Palomar health offers variety of videos for example health and nutrition, types of diabetes etc. In addition, in their commercial they also highlight their people, passion, and their purpose to serve the community (YouTube, 2017).
Figure 48. Palomar commercials
Newsletter:
Palomar offers a monthly e-newsletter for employees that provides them with up-to-date information from one of their Occupational Medicine experts, helping employees stay abreast of current issues and trends which is engaging (Palomar health, 2017). TRI-CITY MEDICAL CENTER 100
Blogs
Palomar Health has a blog section that offers information about variety of topics for example. orthopedics, family health, heart health, wellness etc. Some of other blogs talk about diabetic friendly cooking, cancer, weight, healthy diets, vegetarian delight, high blood pressure, diet desserts, guilt free holiday eating, and headaches which is very informative, (Palomar Health,
2017).
Figure 49. Palomar Wellness Blog
Press Releases:
Palomar has nominal press release. One of the PR media that was discussed was express care health centers, which are walk in centers located at Albertsons/ Sav-on pharmacy stores throughout San /Diego county, (Palomar Health, 2017) which is fascinating.
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Figure 50. Palomar Press Release
Classes and Events:
Palomar offers a variety of health and wellness classes and events throughout North County San
Diego for example, Heart Health, Women and Baby, Weight Loss and Nutrition, Bone and Joint,
Integrative Medicine, Diabetes Health, CPR, First Aid etc.(Palomar health, 2017)
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Figure 51. Palomar Classes and Events
Sponsored Events and Classes:
Palomar Health sponsors many community events throughout the year. Examples of past sponsored events are as follow: Rancho Bernardo Women Golfer, Partnering with RAD
Technology Medical to construct new crisis stabilization unit, Blood drive, Palomar Health Staff
Helping Kids Start School on the Right Foot, and much more, (Palomar Health).
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Figure 52. Palomar Sponsored Events and Classes
Sharp Health Care
Billboards:
Sharp has many bill boards throughout San Diego county. They are very colorful and eye catching. The color combination they have used in their bill boars is lovely
Figure 53. Sharp Billboards
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Sharp Experience Documentaries:
Sharp make documentary videos on their real-life patient life and these stories are told by patients, family members and caregivers. Those videos are very emotional and after watching those stories one feel connected to Sharp(You Tube, 2017).
Figure 54. Sharp Experience
Newsletter:
Sharp offer to sign-up to receive free email newsletters on expert advice, health and wellness information, news and updates, upcoming classes and events, and recipes, (Sharp Patient Self
Service, 2017).
Figure 55. Sharp News letter
Press Releases
Sharp stand very strong press release as they are in the news at least once a month for their latest news about Sharp HealthCare's innovative new programs, upcoming community events recent awards etc.,(Sharp Media Center, 2017)
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Figure 56. Sharp Press Release
Sponsored, Community, and Fundraising Events: Sharp sponsor many events throughout San Diego county for example Grossmont Hospital
Foundation 34th Annual Golf Tournament, estate and state planning seminars etc. which is quite impressive, (Foundation of Sharp Health care, 2017).
Figure 57. Sharp Sponsored, Community, and Fundraising Events
.
Hospital Classes Open to the Public: TRI-CITY MEDICAL CENTER 106
Sharp Health Care offers variety of health classes, educational seminars and support groups throughout San Diego for example, Medicare education, breastfeeding support groups, nutrition, exercise, stress management etc., (Sharp Classes and Events, 2017).
Figure 58. Sharp Hospital Classes Open to the Public
Analysis of social medial II findings
After analyzing commercial and videos, E- newsletters, press releases, sponsored events, blogs etc. of Tri-City’s competitors, we recommend that Tri-City should do a lot of community engagement, press releases, sponsorships etc. because the more exposure they get the more social media increases. Tri-City do invest heavily on sponsoring events throughout north San Diego county however, after analyzing commercial and videos, E- newsletters, press releases, sponsored events, blogs etc. of Tri-City competitors it seems they really need to work more on gaining attention and creating awareness.
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STP (Segmentation, Targeting and Positioning)
There is an opportunity to tweak Tri-City’s current positioning within the hospital market in San Diego County in order to gain more market share. Segmentation, targeting, and positioning together comprise a three-stage process that can be used as a tool to determine a potentially new position. First is to determine which kinds of customers exist, then select which ones are best to serve and, finally, implement the segmentation by optimizing services for that segment and communicating the message that the choice has been made to distinguish the hospital that way. This approach is more efficient, delivering the right mix to the same group of people, rather than a one size fits all approach for all customer types.
Figure 59. Segmentation, Targeting, and Positioning
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Segmentation
Segmentation involves finding out what kinds of consumers with different needs exist for a particular product or service. Niches can be identified with these specific needs and mature markets are able to find new customers in order to deliver more focused and effective marketing messages. For example, in the automobile market some customers demand speed, while others are more concerned about safety. In general, it’s fair to say “You can’t meet all of the needs of all of the people,” and time has shown that firms who focus on meeting the needs of one group over another tend to be more successful. Even with products or services that appear to serve all types of people, such as a hospital, effective segmentation can still be a strategic approach to capture a particular market, (Segmentation, targeting and Positioning, 2017).
With this in mind, there are generally three strategies to marketing: undifferentiated, concentrated, and differentiated. The undifferentiated strategy is when the company treats all consumers the same without tailoring products, services, or marketing messages to any specific group. This approach normally is used with commodities or when the product or service cannot distinctly differentiate itself from others. The concentrated strategy is when a company focuses on one of several segments and leave the other segments for competitors. For example, the segment that Southwest Airlines focuses on is frugal consumers who are willing to forego meals and assigned seating for cheaper tickets. On the other hand, many airlines utilize the last approach which is the differentiated strategy where they offer higher prices to travelers who aren’t as flexible with travel dates and purchase tickets less in advance. These customers, usually business travelers, pay higher fares but can only fill the planes up partially. Therefore, the airline also sells some of the remaining seats to more price sensitive customers who can buy tickets further in advance, (Segmentation, targeting and Positioning, 2017). TRI-CITY MEDICAL CENTER 109
Segmentation does not always mean that the product or service needs to be modified in order to cater to a specific group of consumers. This can also be done through branding and marketing. For instance, logos, colors, tag lines, and advertising campaigns can all assist in appealing to a segmented target market without modifying the organization’s product or service.
The first step in segmentation for Tri-City is to identify the major segments of patients that pertain to the hospital.
• Demographic variables: Since the hospital has a vast number of services, each of the
departments’ populations has a different set of demographics. For example, the types of
patients receiving care through the cardiology department will be vastly different than
Women’s Health.
• Behavior: Brand loyal patients who are heavy users of Tri-City versus others who lightly use
Tri-City and aren’t as brand loyal. They may be loyal based on a number of reasons such as
they like their physician, it’s close to home, the overall culture of the hospital, etc.
• Life stages: As previously stated, different departments will have varying types of patients.
Many of these patient groups can typically be grouped into relatively similar life stages such
as the Pregnancy and Newborn Care department having the majority of their patients in the
same early parenthood stage of life. Other departments service such a wide variety of patients
that they will not fit within the same life stages. Examples of this is Intensive Care and
Emergency Services.
• Geography: The majority of Tri-City’s patients are located relatively nearby the hospital in
North San Diego County with the bulk of them coming from Vista, Oceanside, Carlsbad,
Vista, San Marcos, and Encinitas. Some also travel from Orange County and Central and
South San Diego County. A significant reason patients choose Tri-City or another hospital is TRI-CITY MEDICAL CENTER 110
the proximity to their home address, however that’s not always the case. Some people have
been known to live North of Tri-City and travel to a competitor hospital further South.
• Benefits: Patients have different variables they value in a hospital. Some may place a high
importance on accuracy and efficiency (get what they need as fast as possible without any
extra bells and whistles) while others prefer to have more of a relationship with their nurses
and physicians during their visits. Some patients see Tri-City as a hospital where they can get
their care from a large hospital yet feel like they’re taken care of as an individual and without
the big hospital feel. Other benefits can include taking advantage of the innovative
technologies, visiting a hospital with comprehensive services, or utilizing highly ranked
specialty departments such as the only Level 3 Neonatal Intensive Care Unit in San Diego
County.
Targeting
The second step, targeting, involves selecting which segments from the above segmentation list to target. To decide this, all of the segments should be evaluated to determine how well the other competitors are serving them. The strategy is to attempt to identify a segment(s) that are not being serviced well and steer away from those that are. Next, how large is that segment, and can it grow? Then, it can be asked if Tri-City has the appropriate strengths as an organization to appeal to the particular groups of patients. This means not going against the strengths the hospital has already established in the community’s eyes, (Segmentation, targeting and Positioning, 2017).
The segments identified above that appear to be the most appropriate to target are: demographic variables, geography, and benefits. The three primary departments the hospital TRI-CITY MEDICAL CENTER 111
would like to focus on is cardiology, oncology, and primary care. Therefore, the demographic variables from the current patients using these three services can assist in determining the basic target market for the services with regard to age, gender, and location. This target market from the demographic segment (including location) can then be used in the geography segment to focus marketing efforts in the primary zip codes the patients and potential patients reside. Lastly, the benefits segment involves identifying the primary benefits patients value the most and including it in advertising campaigns and marketing messages. It is believed a major benefit Tri-
City Medical Center can leverage is the hometown feel that the culture exudes. It is a comprehensive hospital with major departments, yet it doesn’t feel like a big hospital where patients feel disconnected from the staff, nurses, and physicians. The other benefits the hospital can focus on are the highly regarded innovations such as the surgical robotics and leading specialties such as the Level 3 NICU.
Positioning
The last step is positioning, which is the implementation of the targeting. However before doing so, it is important to evaluate the different categories most organizations fall into and use them to strategize their position in the market.
• Operationally excellent firms: Operationally excellent firms focus heavily on efficiency
which allows them to reduce their costs due to lower operational overhead and reduced
waste. They emphasize on cost, reliable performance, and less value is placed on customizing
anything for the customer, (Segmentation, targeting and Positioning, 2017). An example of
this category is Wal-Mart. TRI-CITY MEDICAL CENTER 112
• Customer intimate firms: Customer intimate firms value meeting the specific needs of the
individual customer. Less emphasis is placed on efficiency, which is sacrificed for catering
more to the individual customer. Quality and reliability is also stressed. Nordstrom’s and
IBM are examples of this category, (Segmentation, targeting and Positioning, 2017).
• Technologically excellent firms: Technologically excellent firms develop the most cutting
edge products with the latest technology. They strive to always be a leader in innovation and
dedicate heavy resources to achieving that standard. These organizations don’t attempt to be
as efficient as others because they work with costly technology that requires constant
improvement. They also do not typically customize their products or services to the
individual customer. An example of this category is Intel, (Segmentation, targeting and
Positioning, 2017).
While firms attempt to excel in one of these categories, they still must have acceptable standards on the other two as well. If not, their customers’ needs will not be fully met and it could be detrimental to the organization. The strategy is to meet at least the minimum requirements in all three areas yet focus a higher level of dedication to one particular category,
(Segmentation, targeting and Positioning, 2017).
The category that most resembles Tri-City is Customer Intimate because they place the highest level of importance on being extremely patient focused down to each individual. This not only goes into the service or procedure a patient is receiving, but also how they’re welcomed and treated as family from the moment they walk into the facility to their departure. The users’ positive experience, in this case not only the patient but also their family and loved ones. Tri-
City does not fall into the Operationally Excellent category because they’re not a hospital that focuses on getting patients in and out as fast as possible. With that said, they do work to keep TRI-CITY MEDICAL CENTER 113
wait times and procedural standards within acceptable parameters. The hospital also puts a lot of resources into its technology to be cutting edge, however it cannot be said that the overall hospital is the most technologically advanced in the region except for a few areas such as some of their highly innovative surgical robots. Therefore, it is also not in the Technologically
Excellent category either.
To summarize the recommendation for Tri-City Medical Center’s positioning, the segments to target are: demographic variables, geography, and benefits which can also be explained as targeting the right type of people in the right area of North San Diego County who value the benefits Tri-City has to offer (comprehensive, cutting edge services with a hometown feel). When targeting these segments, Tri-City should use the Customer Intimate strategy to position the hospital by focusing their efforts in providing services and communication around the individual patient. This means the hospital needs to buy-in to the new position and align all internal practices around it. Employees should understand the mantra through clear internal communication and training, and management should assess current processes to determine if there are improvements that should be made to conform to the new position. While a strength of
Tri-City has been patient care, people should recognize an entirely new level of individualistic care they receive as they walk through the doors. Hospitals are not normally known to have extraordinary customer service especially in areas such as Emergency Services, and this is how
Tri-City can stand apart from other hospitals.
Next, marketing messages and advertising campaigns should communicate the position that the hospital is taking in the market. Tri-City’s current slogan is “Advanced care for you.” An example of new marketing messaging that still aligns with the slogan may be, “Tri-City Medical
Center, extraordinary hospital care without the ordinary hospital experience.” The messaging TRI-CITY MEDICAL CENTER 114
throughout various advertising platforms should stay consistent with this new mantra as well as highlight areas of the hospital that display the competitive advantages, new technologies, and the future of the hospital. These can include the Level III NICU, advanced surgical robotics, other innovations, high safety scores, new partnership with UCSD Health, and the new building construction.
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Marketing plan
Marketing Objectives
Marketing objectives are identified to serve as goals the hospital attempts to achieve in route to attaining the new positioning in the marketplace and ultimately increase its market share throughout North San Diego County. These marketing objectives include:
1. Improve Tri-City’s brand image
2. Drive patients to 3 practices: Cardio, Ortho, and Primary Care
3. Increase census
Marketing Strategies and Tactics
Marketing Objective #1: Improve Brand Image
As indicated in the survey conducted, the primary issue with the current brand is that the hospital is seen as old, dirty, and run-down. The physical aspects of the hospital give it a poor reputation in the community that is not representative to the exciting things going on inside the building nor the plans for the future. With older facilities, it is difficult to convey the high level of innovation and standards of the hospital. This is a major struggle that Tri-City has faced in recent years with the emergence of newer competitor hospitals. Therefore, it is recommended to focus heavy attention to improving the hospital’s overall brand in order to revive the community’s perception of Tri-City.
Update Visual Branding
A strategy that is commonly used when an organization is attempting to communicate that they are progressing in major ways, is to reimage themselves visually. The first TRI-CITY MEDICAL CENTER 116
recommendation to improve Tri-City’s brand is to evaluate the option of updating its logo, colors, and tag-line. These are the most significant branding tools because they are displayed in every aspect of the hospital. Since the current logo has been in use for decades, it has become fatigued in the eyes of much of the community which may call for a new and fresh look. When companies use this strategy, it triggers the idea that something big is changing and forces members of the community to pay attention.
Promote New Construction
Figure 60. Tri-City Future Construction Rendition
Another major feature Tri-City can leverage to improve their brand is to advertise the new construction plans for the building as much as possible. This is the single most exciting element about the hospital that will drive anticipation, create a buzz, and begin to change perceptions about Tri-City. As mentioned before, the Tri-City Wellness Center in Carlsbad has very positive reviews on Yelp.com mostly mentioning the facilities. The new construction will then match the wellness center’s quality and they will be aligned in all aspects of the brand. TRI-CITY MEDICAL CENTER 117
Engage Yelp Community
Yelp.com has become a powerful tool for people to see what previous customers say about a business or organization, and it has been known to make or break companies. Therefore, paying attention and reacting accordingly is vital. As previously explained, Tri-City Medical
Center’s Yelp score is currently 2.5 out of 5 stars which is the lowest North San Diego County hospital and leaves room for a lot of improvement, (Yelp, 2017). Tri-City’s team currently does a good job responding to all Yelp reviews both positive and negative. Any reviewer that gives a negative review is apologized to, sometimes given an explanation, ensured they will address the issue, and the patient is given a manager’s contact information to discuss the details. This is a great practice for the hospital to prevent negative comments, have them removed, and ultimately limit bad word of mouth from diminishing the hospital’s brand.
The recommendation is to continue these efforts and ensure to customize every review response so that it does not appear scripted which would go against the position of individualistic care. Another tactic is to have more than one person responding to the reviews as it may not feel genuine. Some may think if only one person does so, maybe they’re just be doing it because they’re paid to.
Offer Classes, Workshops, and Events to the Community
Since the best part of Tri-City Medical Center is inside the building with staff, nurses, physicians, services, and technology, the next strategy is to bring more of the community, even non-patients, into the hospital. One way Tri-City does this currently is to offer classes and workshops at the hospital such as breastfeeding, women’s cancer support group, and bereavement support. Many of these events are free to anyone in the community while others have nominal fees. TRI-CITY MEDICAL CENTER 118
The recommended strategy is to increase these offerings to more innovative and demanded classes and then advertising them more broadly. Examples of classes may be yoga, stretching, food nutrition, and even beginner exercise. Surveying the community at outreach events or other channels will give insight to the types of classes demanded. Many of these workshops can be offered on a regular schedule or in series, and they should be free or priced very cheap as the intent is to bring new members of the community into the hospital so they may see why they should be choosing Tri-City over other hospitals. The new Wellness Center can also be a part of this initiative to capture a broader range of the community.
Other than classes, another strategy is to coordinate events at the hospital to bring special interest groups to the hospital. Field trips from schools (K-12 through local universities) can be organized to expose students to Tri-City from a young age. STEM (science, technology, engineering, and mathematics) or Healthcare days where students or the community can gain exposure to either professionals within the hospital or learn about the latest technology such as the robotics, CT machines, and cancer treatments. These events will not only bring more people inside the hospital to counter their potentially negative perception about Tri-City, but the organizational partnerships gained throughout this initiative will be valuable long term.
Continue Community Sponsorship
Tri-City is arguably the leader in event and community sponsorship in North San Diego
County every year. This strategy is a great way to build or sustain brand recognition as well as improve the quality of the brand depending on the event. When people are attending the Carlsbad
Marathon which they are deeply invested in, seeing Tri-City Medical Center as a major sponsor gives that person the feeling that Tri-City is aligned with their personal values. TRI-CITY MEDICAL CENTER 119
It is recommended to not only continue the great work in this area, but also be strategic in finding new sponsorships. This includes analyzing the priority target markets for the hospital and identifying new highly visible events and organizations that align with these markets’ demographics.
Marketing Objective #2: Drive Patients to 3 Practices: Cardiology,
Orthopedics, and Primary Care
Tri-City would like to funnel patients to cardiology, orthopedics, and primary care. This is because cardiology and orthopedics are the hospital’s two most profitable departments, and primary care is where most patients are referred from to get to all of the other specialties. With that said, the second marketing objective is to drive patients into these three areas through advertising.
First, the demographics for each of the current patients in these areas should be carefully analyzed to determine what time of people use these services. If there are other markets to target, they should also be established. Then, a strategy to capture their attention through methodical advertising placement and value proposition messaging should be developed, executed, and evaluated. The marketing mix for a given target market must be carefully identified based on where their attention may be captured. For instance, an ad targeting a 25-year-old female mother for primary care should be placed in a very different medium compared to an 80-year-old male targeted for cardiology.
Marketing Objective #3: Increase Census TRI-CITY MEDICAL CENTER 120
The last marketing objective is to increase the overall census at Tri-City Medical Center.
In order to accomplish this, the suggested strategy is to develop three advertising campaigns that occur simultaneously: general awareness, informative, and action oriented.
General Awareness Campaign
The general awareness campaign will focus on maintaining brand recognition as well as improving the quality of the brand through advertisements. The messaging on these ads will be generic in nature (not for any specific department), yet still aligned with the new positioning described before which targets the right type of people in the right area of North San Diego
County who value the benefits Tri-City has to offer (cutting edge services with a hometown feel).
Informative Campaign
The informative campaign will be designed to educate the public that Tri-City is a leader in innovation and expose the exciting things coming in the future. These ads will highlight some of the latest technologies such as surgical robotics, the new CT machine, and the first convergent heart procedure performed as well as the upcoming building renovations. The goal of this campaign is to illustrate the excitement under the roof of the hospital and counter the stigma of a dated hospital.
Action Oriented Campaign
The last campaign is action oriented which will include calls to action for their audiences.
The calls to action will be deliberately organized to encourage patients or prospective patients to do things that may convert them into a patient receiving services which will ultimately increase the overall census. Examples of these messages may include enrolling during the open enrollment season, exploring primary care doctors, or signing up for a workshop or event. TRI-CITY MEDICAL CENTER 121
Advertising Strategies and Tactics
Tri-City Medical Center currently has a robust marketing mix around North San Diego
County that includes a variety of digital and traditional media platforms, community sponsorship, and outreach. Consequently, some of the following suggestions are already included in the hospital’s existing techniques however new messaging may be developed in order to assist in the hospital’s new positioning and marketing objectives.
Strategy 1: Community Outreach
Directly engage the community and inform them of various aspects of Tri-City such as the new construction, services available, enrollment periods, classes, and any noteworthy information such as innovative procedures and technologies being used. These can be tabled events and presentations at special interest groups’ locations. It may also include bringing groups from the community into the hospital for tours or presentations. Warm and extremely personable individuals should represent Tri-City at various events around town or be directly involved in anything coordinated at the hospital.
Tactics
• Attend Community Events: Participate in community events such as street fairs, expos, or
any other appropriate tabling event. Printed materials and freebies should not be generic
outreach items but tailored for the event.
• Develop Outreach Partners: education institutions (elementary schools, middle schools,
high schools, and colleges), community partners, local organizations, professional
organizations, special interest groups TRI-CITY MEDICAL CENTER 122
• Evaluate Collateral Materials: Adjust any necessary collateral materials and distribute
them at outreach events within Tri-City’s service area
Strategy 2: Community Engagement
Engaging the community is something Tri-City has done well for years through event sponsorships and they have become a leader in North San Diego County in this area.
Tactics
• Community Sponsorship: While Tri-City is an avid community sponsor, it is recommended
not only to continue this approach, but also to find new strategic sponsorships (large and
small) based on the objectives outlined in this plan. Focusing more on smaller events such as
community sport league tournaments will give the hospital the opportunity to not appear only
as a large, powerful hospital that sponsors marathons, but also a large hospital who cares
even about small co-ed softball leagues. Smaller sponsorships are also cheaper and can allow
a larger frequency of events.
• Special Events: In addition to sponsoring events in the community, Tri-City can also attend
special events throughout North County such as chamber of commerce meetings. These can
be great way to communicate the new things happening at Tri-City and to build brand value.
• Speaking Engagements: Lectures and expert speakers can be a way the hospitals employees
give back to the community as well as gain exposure and again assist with the new
positioning of the hospital. Displaying expertise is a great way for people to trust the quality
of services and overall care at Tri-City.
Strategy 3: Public Relations TRI-CITY MEDICAL CENTER 123
Public relations are a relatively inexpensive yet effective marketing strategy. Tri-City can be found in many publications around San Diego County.
Tactics
• Media Relations: Continuing to foster positive relationships with members of the media is
highly recommended.
• Press Releases: If strong relationships with the media exists, press releases can be much
more effective. The Public Affairs Officer of the hospital should be well informed
continuously about hospital updates, feel good stories, and newsworthy stories. They should
engage the media for potential coverage as often as possible.
• Internal Communication: There is nothing stronger than a quality referral and employees
are seen to be experts about their place of work. Equipping staff, nurses, physicians, and
administrators with adequate information so that they may be brand ambassadors and speak
intelligently about the benefits of Tri-City will be quite powerful. In order to do this, the
hospital should have intentional and regular communication to employees through training
and any appropriate communication methods like email.
Strategy 4: Advertising
Advertising is the costliest form of promotion, yet these tactics can provide the most significant impact toward achieving the marketing objectives. Digital media (social media, short video production, website design, email marketing, smartphone application, and internet-based radio), traditional media (billboards, television commercials, and print) are described in the below tactics.
Tactics TRI-CITY MEDICAL CENTER 124
Digital Media includes social media, video, website, email, smartphone application, and internet radio.
• Social media has proved to be extremely effective method to engaging audiences and in Tri-
City’s case, patients or prospective patients. It should be known that individual social media
platforms have different methods of communication and need to be customized strategically
through a robust social media marketing campaign that aligns with the other objectives
recommended in this plan.
o Platforms suggested to use are: Facebook, Twitter, Instagram, Google+, SnapChat,
Pinterest, and YouTube.
o Recommend using a variety of paid and unpaid ads and posts. Paid ads or promoted
posts on most platforms can be extremely targeted to a specific audience. This will be
very helpful with trying to reach a demographic specifically to promote the primary
care, cardiology, or orthopedics departments.
o Effective social media marketing etiquette should be followed: posting at the most
optimum days and times, messaging, pictures, hashtags, calls to action, and valuable
or interesting content posted versus simply asking people to do something for the
hospital’s benefit.
• Producing short videos (5 – 15 minutes) to be displayed on various digital media sources
such as the hospital’s website or social media platforms such as Facebook, Instagram,
SnapChat, and YouTube.
o The idea is to have video series or individual stories of behind the scenes at Tri-City.
This will let the community inside the hospital without forcing them to be a patient as
well as gain access to exclusive content that patients don’t typically see. All of the TRI-CITY MEDICAL CENTER 125
videos should be aligned with the new positioning and focus on showing extreme
attention to individual patients, innovative procedures, technology, and competent
healthcare providers. It will also develop rapport and trust between viewers and actual
employees.
o Sharp Hospital has “The Sharp Experience” video campaign where they showcase a
patient’s experience from beginning to end at their hospital in an approximately 30-
minute segment. The idea for Tri-City is to flip it and showcase the rock star
employees providing extraordinary service to patients. Instead of interviewing
patients, the segments can interview the employee where they describe their
experience, why they value helping patients every day, and how Tri-City empowers
them to do so.
o Example videos may include:
▪ “A day in the maternity ward” where nurses and physicians interact with soon-to-
be mothers and family members through the birthing process.
▪ “Alice the information desk receptionist” where the front desk employee “Alice”
is on display as she warmly welcomes all hospital patrons and gives them a great
first impression.
▪ “From the top – Steve Dietlin, CEO of Tri-City” which may display leadership at
its best as Mr. Dietlin attends meetings, visits patients, and gives insight to the
vision atop the C-Suite.
• Tri-City Medical Center website: www.Tri-Citymed.org
o Redesign some of the pictures throughout the site to improve the brand and display
innovation. For example, the home page’s primary photo is the current building TRI-CITY MEDICAL CENTER 126
which is the most negative thing about the hospital in the eyes of the community. It
can be changed to something that fits the new positioning such as an employee
engaging with a patient, smiles on their faces, and other positive visuals.
o The landing page of the site could also be upgraded to show videos as soon as you
visit the site. A modern and innovative website will be the initial thing people see and
gives a positive first impression.
• Email marketing can prove to be an effective communication tool. It is not recommended to
spam those who have registered to receive emails but rather focus email communication
around pertinent information. Otherwise, there is a risk to have people unsubscribe to emails
which defeats the purpose. Messaging should be methodical, timely, and valuable to the
recipient.
• A smartphone application can be valuable to minimizing confusion and red-tape for existing
members which can lead to return visits. Therefore, it is recommended that Tri-City explore
the option of developing a general app for all patients. Palomar, Scripps, and Sharp do not
have any quality apps for general use. However, Sharp has the Sharp Healthcare Video Visits
app that allows patients to video conference with their doctor and the Sharp Baby app that
tracks an expecting mother’s pregnancy journey. Kaiser Permanente has a robust app seen
below that allows users to email their doctor or member services, schedule appointments,
view medical records, review test results, and even refill prescriptions.
• Internet radio has become overwhelmingly popular and advertising options have become
quite customizable similar to social media paid ads. It is recommended to utilize platforms
such as Pandora, iHeart Radio, and Spotify to target the right demographics depending on the
advertisement. TRI-CITY MEDICAL CENTER 127
Figure 61. Kaiser Permanente Mobile Application
Figure 62. Pandora Internet Radio
TRI-CITY MEDICAL CENTER 128
Traditional Media includes billboards, television commercials, and print advertisements.
• Billboards were identified as the most visible advertisement from over 300 North San Diego
County residents surveyed recently. Therefore, incorporating billboard ads throughout Tri-
City’s service area is highly recommended. These ads are applicable to the mass population
and should be carefully designed around the new Tri-City brand and positioning.
o Modern billboards are secondary advertising mediums that support brand-building or
support a campaign but they should not provide vital information. Their designs
should be carefully considered since consumers do not look at them in the same way
they did twenty years ago due to smartphones taking much of their attention. Phone
numbers and websites are not necessary as drivers do not have time to write them
down, pictures are paramount with extremely minimal verbiage (six words or less),
and it should grab people’s attention and quickly get the point across.
• TV commercials have been used by Tri-City for a number of years. It is recommended to
continue using commercials however strategize the most effective and cost efficient method
of deploying their commercials. The demand of live traditional cable television has
significantly decreased compared to streaming and on-demand television such as Netflix,
Hulu, and others. Producing the commercials innovatively and using them on a number of
platforms such as the website, social media, YouTube, and streaming television services may
be a more effective strategy.
• Print advertisements in newspapers, magazines, and other mediums are not as visible as they
once were, but their effectiveness depends on the audience. For instance, 65+ years old are
known to still read the newspaper, buy magazines, etc. Therefore, if the ad’s target market is
in the appropriate demographic, print ads may still be effective. According to research in the TRI-CITY MEDICAL CENTER 129
demographics section of this report, the greatest number of patients at Tri-City are 85 years
and older which mean print advertisements may be a valuable investment. They’re also much
more cost efficient than they once were which means the minimum return on investment is
more likely to be attained.
Monitoring Plan Performance
The following are methods that the success or failure of particular marketing strategies and tactics can be measured.
• Any increase in traffic to Tri-City’s website (specifically any dedicated page to targeted
departments such as Primary Care)
• Engagement on social media account (likes, shares, comments)
• Open, conversion, and unsubscribe rates of email marketing
• Any change in census rates for the targeted departments and the overall census numbers for
the hospital
Budget & Paid Advertisement Strategy
Many of the tactics outlined in this plan may be done at little or no cost, however an overall advertising budget for the campaigns should be determined prior to initiating any paid advertising options. Once the budget is developed, the paid options and timeline within the plan can then be methodically planned.
Strategy
It is highly recommended to prioritize the paid options based upon the largest return on investment and conversion rates. These may be options that are either most visible (largest amount of impressions) to the target markets such as billboards, or they may be options that have TRI-CITY MEDICAL CENTER 130
a narrower focus while attaining higher conversion rates such as paid social media ads. Lesser visible ads based on the target markets should be considered a lower priority.
For example, if the objective for a particular ad is to reach 25-30 year-old females, it would not be as effective to pay for print ads within magazines or other publications compared to paid social media ads. However, if the objective is to reach 60+ year-old females, paid print ads within highly demanded publications that include messaging tailored for these people may be valuable. The basis of this strategy is to focus on ads that are placed where the target market’s attention may be captured.
Responsibilities
Once a plan for the various campaigns is decided upon, it is also recommended that duties and responsibilities communicated to those who should be working on various aspects of the campaigns. It is assumed that the marketing department will be leading the advertising initiatives, however it will be helpful if any other individuals or departments who will be responsible for working on the campaigns or involved in communicating aspects of the plan internally be made aware and included in the planning phases early in the process.
Conclusion
Tri-City Medical Center has an overall goal to increase their hospital census. In order to achieve this goal, research was completed regarding the industry, internal and external analysis, and the competitive landscape. The findings enabled the development of Tri-City’s positioning in the North San Diego County market that focuses on targeting the right people in the right area who value the benefits Tri-City has to offer using a Customer Intimate strategy. This new approach will give people a chance to recognize Tri-City in an entirely new way. TRI-CITY MEDICAL CENTER 131
In order to be successfully increasing Tri-City’s census, it is suggested to implement a new positioning strategy and then target three marketing objectives. These objectives are: improve brand image; drive patients to cardiology, orthopedics, and primary care; and increase departments’ census. The purpose for these objectives is to communicate the value propositions
Tri-City offers and educate the public about the great things going on within the walls of the hospital.
Four major strategies were developed to achieve the three marketing objectives and include various specific tactics. Community outreach will drive the hospital to be actively communicating the messages of the Tri-City in various appropriate platforms such as community events and education institutional partners. Community engagement will be an enhancement of the existing sponsorship activities. Public relations not only will focus on communication to media outlets but will also include a robust internal communication plan to employees. Lastly, the advertising strategy will be comprised of a hearty digital and traditional advertising mix tailored toward the target markets.
Finally, we would like to thank Tri-City for giving us this opportunity to be a part of their hospital for a brief time. It was our sincerest hope to provide a valuable strategic marketing plan that is worthwhile and filled with potential solutions. Tri-City’s marketing team was a pleasure to work with and provided clear guidance and assistance whenever necessary. Once again, thank you for your time, energy, and assistance in this project.
TRI-CITY MEDICAL CENTER 132
Appendix A
Major Market Segmentation
TRI-CITY MEDICAL CENTER 133
Appendix B
Key features in a growth industry
TRI-CITY MEDICAL CENTER 134
Appendix C
Hospital Supply Chain
TRI-CITY MEDICAL CENTER 135
Appendix D
Industry at Glance
TRI-CITY MEDICAL CENTER 136
Appendix E
Sector vs industry costs
TRI-CITY MEDICAL CENTER 137
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