Beyond the cookie jar: Hospice marketing requires a universal strategy

Hospice of the Valley boosts referrals with billboards, TV ads

Hospice of the Valley may not quite be a household name in central Ohio, but it’s not from a lack of trying. From billboards to television commercials, residents in the three-county area of Youngstown, OH, are confronted with subject of death, whether they like it or not. Their morning commute into town includes passing by a towering billboard with a simple message absent of any bright colors and extravagant graphics: "We Wish There Was A Cure. Until Then, We’re Here."

A television ad extols the benefits of hospice care: striving for the highest quality living possible during the final days and weeks, plus palliative care and an interdisciplinary team approach.

Public libraries serve as information sites where the public can pick up brochures on a host of hospice subjects, ranging from a detailed description of hospice and its interdisciplinary team approach to bereavement resources.

That represents only half of Hospice of the Valley’s overall marketing strategy, which also includes programs that educate and promote its services to a broad range of potential referral sources, including nursing homes.

Hospice of the Valley is a typical hospice, experiencing the same challenges that face other hospices around the country, such as reduced lengths of service. Perhaps its greatest challenge was to increase admissions in each of the three counties it serves.

In the year since the hospice adopted its global marketing strategy, admissions have increased in all three of the surrounding counties it serves, including a 50% increase in Columbiana County and a 30% increase in its base, Mahoney County, a market mistakenly thought to have been long saturated.

Hospice of the Valley has also seen its average length of service increase, which it credits in large part to its increased marketing to referral sources. Its latest figures show average length of service between 40 and 45 days, compared to an average of 33 days a year ago.

Search for name recognition

Traditionally, hospices’ marketing tack has been to use low-key approaches that didn’t require the nonprofit organizations from having to reach too far into their coffers. Hospices focused mainly on physicians and hospitals by sending out volunteers to tout the value of hospice and preach the hospice philosophy. Community marketing for many hospices is an exercise in fundraising with some hospice education sprinkled on top.

The marketing strategy now employed by Hospice of the Valley assumes that marketing hospice services in a competitive health care marketplace requires more than a jar of cookies being delivered to physicians’ offices and handing out black-and-white brochures at a local health fair.

"We needed to increase our name recognition," says Karen Hill, director of marketing for Hospice of the Valley. "We needed a professional marketing approach."

To begin, Hospice of the Valley officials discarded old notions of marketing hospice services. The focus of previous marketing to the community was heavily weighted toward persuading the public to donate money and attempts to educate the public about hospice care were inconsistent. Worse, it was indistinguishable from marketing efforts of competing hospices.

"Our brochures and ads all have a uniform look so that Hospice of the Valley will be easily identified and we made sure we were delivering a consistent message," says Kimberly Stoffel, RN, director of community education for Hospice of the Valley.

Yet the marketing approach isn’t simply a collection of brochures and television ads. It’s a methodical approach to achieving goals given local market demands. While each market is unique, there are lessons to be learned from Hospice of the Valley’s experience:

Identify your customers.

The word "customer" carries a broad definition that includes physicians, as well as their patients. For Hospice of the Valley, "customer" meant potential referral sources, patients, and the community it serves.

Among the list of referral sources were:

— physicians;

— discharge planners at physicians’ offices;

— hospital discharge planners;

— hospital-based social workers;

— nursing homes’ directors of nursing;

— nursing home-based social workers;

— assisted living facilities’ admissions coordinators;

— specialty hospitals’ (long-term care programs) case managers.

Home health agencies are conspicuously absent from the list. While Stoffel says home health agencies are likely referral sources for many hospices, their market is unique. The agencies in the market were either too small or owned a hospice of their own.

Nursing homes have always been a tough sell for many hospices. Differences in care philosophy and lack of understanding between the two disciplines have limited cooperation between the two industries. In the Youngstown market, some nursing homes incorporate palliative care as part of in-house services. For those nursing homes struggling to compete, Hospice of the Valley markets its services as a value-added care that they too can market to the public and potential referral sources.

The community is filled with potential customers — from patients to donors to corporate partners. In particular, Hospice of the Valley focused on educating businesses about hospice care. Stoffel and Hill singled out the benefits coordinators of local businesses.

The logic behind the move was to impress upon businesses the need for a hospice benefit as part of their employees’ health care plan. Union leaders were also approached. By doing so, union leaders might strive to include the hospice benefit during collective bargaining.

While the idea of identifying one’s customers seems elementary, Stoffel says it’s easy for hospices to focus on one or two without realizing there are others that need attention. "Up until the time we started looking at who are customers are, everything was spotty."

Refine your message.

Traditionally, hospices have used volunteers to call on referral sources. As a result, the message can be inconsistent from one volunteer to the next. Volunteers’ lack of clinical knowledge may discourage physicians and nurses from accepting the message, no matter well delivered.

Hospice of the Valley relies on one person, Stoffel, who has a nursing background, to call upon potential referral sources rather than risk the pitfalls of volunteers.

Along with a consistent voice there is a consistent message. "We realized that universally there is a lack of understanding of what hospice is all about," says Stoffel. "We assumed people knew nothing about hospice, even physicians."

From physicians to the general public, the message of hospice care is basic, stressing the value of palliative, spiritual, and emotional care. For physicians with advanced knowledge of hospice care, Stoffel states the message as an explanation of hospice care that physicians can convey to their patients.

The message to the public, Hill says, should stress what hospices do best, not why people should donate money. "We’re not in the business of raising money. We give hospice care."

Effective advertising.

While the message of hospice care is delivered by one person to potential referral sources and specific segments of the community, a more effective way to reach the community was needed. Like many hospices, Hospice of the Valley relied on print advertising and a small amount of television and radio. In addition, hospice representatives attended health fairs to help educate the public.

As hospice officials began formulating their marketing strategy, they re-evaluated their advertising approach. They found print advertising and public appearances at health fairs were not generating a buzz.

Billboards that once were home to Joe Camel and the Marlboro Man became the domain of Hospice of the Valley. Billboards are an effective way to reach a lot of people, says Stoffel. The cost, however, can be prohibitive to cost-conscious hospices.

In order to keep costs down, Hospice of the Valley has pre-emptive agreements with its outdoor advertising company, allowing the advertising company to remove the hospice ad if another customer wants the space. Unlike other hospices that use television to promote their services, Hospice of the Valley chose to pay for its advertisement time rather than rely on free public service time. "We paid for it because we didn’t want our ads just running at 3 a.m.," says Stoffel. "We were able to get time during the morning and noon news, and during shows like Touched by an Angel.’ We’ve gotten very good response from this."

Spend money, make money

"You can get a lot more accomplished in 30 seconds than you can in a print or radio ad," Stoffel says. "We know these things are working, unlike newspapers ads, where we got zero recognition."

Be willing to spend money.

Of course, all of this requires more money than hospices have traditionally spent. Hospice of the Valley spent about $65,000 on marketing and public relations last year.

Another example the hospice’s willingness to spend money is the series of brochures it developed to educate the public and referral sources. Written material in the past was black and white, cheaply produced. Recognizing that its brochures played an important role in projecting an image, hospice set out to create a set of brochures that not only tell its story, but one that is easily identifies it.

This is important because those same brochures, available in Youngstown area public libraries, are also given to referral sources. The brochures are expected to influence not only the public, but also referral sources.

"Don’t be afraid to spend a little money," says Stoffel. "But make sure you’ve pinpointed those area you want to reach."