YEARS IN THE MAKING: BRINGING VALUE AND SHOWING ROI FROM DIGITAL AND DIRECT MARKETING

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1 YEARS IN THE MAKING: BRINGING VALUE AND SHOWING ROI FROM DIGITAL AND DIRECT MARKETING Kellie Spellman Director of CRM Michael Fouratt Director of emarketing

2 About CHRISTUS Health CHRISTUS Health is a Catholic, faith-based, notfor-profit health system, headquartered in Dallas 350 services and facilities, including more than 50 hospitals and long-term care facilities, 175 clinics and outpatient centers, and dozens of other health ministries and ventures Located in more than 60 cities in Texas, Louisiana, New Mexico, Arkansas, Missouri, Georgia, and Mexico. The system employs more than 30,000 Associates and has over 30,000 associates 9,000 physicians on facility medical staffs.

3 About CHRISTUS Health

4 About CHRISTUS Health System marketing works primarily with 9 regions in Texas, Louisiana and New Mexico Range of single, community-hospital systems to multihospital metropolitan health systems Somewhat decentralized model, but becoming more centralized System handles web structure, vendor relationships and strategy Regions focus on strategy and implementation

5 Agenda Overview of interoperability Digital Marketing CRM Customer Relationship Management Attract high value patients using targeted efforts Capture and engage consumers using web forms to capture data, convert to patients and measure revenue How incentives drive response rates

6 OVERVIEW OF INTEROPERABILITY OR DIGITAL INTEGRATION

7 Marketing & Patient Acquisition Attract Communicate with current and potential patients to garner their business Engage and Connect Activate them through an event, web form, find a physician phone call Collect their demographic data Convert Becomes a patient Continue communication and marketing through cross-selling of relevant services and events

8 Attract! Direct Mail, Organic SEO, , Pay Per Click, QR Codes, Print Ads Photo Caption Arial 10 Pt. Bold, Italic

9 Connect! Engage potential patients by giving them something of value Find them a physician, send them a gift, offer a class their interested in Collect their data through a web form or call center Photo Caption Arial 10 Pt. Bold, Italic

10 Convert Track whether they become a patient Did they come to the service you were promoting? Did they have the procedure that was marketed to them? Did they visit that primary care physician to which they were referred? Use our Customer Relationship Database to track if we are converting patients

11 Interoperability

12 Digital Marketing Overview

13 Digital Touchpoints and Key Performance Indicators Website Blogs Digital Tools Patient portal Online advertising /E-newsletter Social Media Mobile Social media engagement Web analytics Search engine Rankings Click-through rates Conversions ROI!!!

14 Results Measurement Are they registering on the site or via the call center? Are they converting to new patients? What is the value of the web-acquired new patient? Formula (ideal) - divide the total cost of a campaign by the total number of patient acquisitions Formula (current) contribution margin for those that complete form and have a visit in that service line n Contribution margin = actual amount received minus direct and indirect cost

15 Customer Relationship Management (CRM) CHRISTUS has sent more than xxx direct messages through mail and since 2010 xxx of them have been Altogether, achieved a X to X ROI or over $X million in contribution margin Actual amount received minus direct and indirect costs

16 CRM ROI Mailed patient respondents: XX% response rate Holdout group respondents: XX% response rate Difference is marketing lift of X% or XXX patients attributable to marketing Take lift of XXXX patients times the prospects average contribution margin of $XXXX for the pre-marketing profit of $XXXXXXX, then subtract marketing cost for ROI FPO - table

17 CRM ROI Overall ROI for direct mail and

18 CRM Payer Mix This is the main reason we do CRM to target the best payers Improving profitability through better payers Direct marketing responders have a better payer mix than is typically seen at CHRISTUS hospitals FPO pie charts

19 CRM & Web Calls-to-Action Goal is to always drive people to an interaction What are you asking the person to do? Send them to a data collection point Web form Call Center Request an appointment Sign up for enewsletter Online contest Health Risk Assessment Personalized URL (purl)

20 ATTRACT USING TARGETED MARKETING

21 Targeting using , PPC & Direct Mail We use a variety of ways to target people to complete the forms Direct mail Pay per click (search engine marketing) Display ads (paid and click through ads on our homepages) n Re-targeting in play for some campaigns Social media

22 Cardiology Pay Per Click Business need: Drive profitable cardiology volume Pay per click campaign set for radius ZIP code area

23 Cardio Pay-Per-Click 36,8636,864 Impressions 4 Impressions 6,864 Impressions

24 Cardiology Conversion Funnel 28,633 Impressions 428 Visits to Site 24 Total Calls

25 Freestanding ER Campaign Business need: Build awareness in community for two new stand-alone ERs Build volume to aid with lift Used a combination targeted direct mailing and pay per click campaign Both used a radius ZIP code around the new facility

26 Freestanding ER

27 Freestanding ER Reporting Combined, Active ER, HH No ROMI but targets beating holdouts in all person types Profitability: responders were 55% commercial payers Combined, self pay and Medicaid were less than 10% SOURCE Mailing List Respondents Response Rate Charges Avg Charge # % # % Patients % % 10.9% $81,650 $949 Qualified % % 12.9% $88,822 $906 Prospects Prospects 13, % % 4.4% $526,685 $897 New Movers 2 0.0% 0 0.0% 0.0% $0 $0 Unique Total 14, % % 5.2% $697,158 $907

28 Freestanding ER New Braunfels

29 Freestanding ER Conversion Funnel 68,379 Impressions 929 Clicks 192 Calls

30 History & Reporting Started ing in 2011 mostly enewsletters In 2012 regions started ing more one time campaigns or s associated with a multi-media campaign

31 History & Reporting FPO need new numbers Regional counts by source (not all are " able" addresses) Data Source - Cumulative (01/01/ /31/2012) Source ALT s CLA s SWLA s NLA s Gulf s SETX s Spohn s Santa Rosa s Call center , ,841 3, ,013 Marketing List ,529 3, ,519 Utilization 2, , , Total Unique 3, ,213 2,048 5,210 9, ,782

32 History & Reporting FPO Need new info Quan&ty Sent Views Bounced Unsubscribes Clicks 1,467, ,148 6,975 2,018 37,061 CHRISTUS Percentages 22.81% 0.48% 0.14% 2.50%

33 History & Reporting Reporting ROI of campaigns Reporting on nearly 200 s, including enewsletters s sent to 13,949 individuals, 5,526 have had a visit for 39.6% response rate No ROMI, but slight lift for patients

34 CONNECT AND ENGAGE USING WEB FORMS

35 Web Forms/Data Collection Started using web forms extensively in 2011 with the tie into CRM enewsletter forms up in July 2011, fed directly into CRM database Bariatrics campaign driving appointments Required data for forms to validate in CRM database Name Address DOB (optional)

36 enewsletter Business need: Bring brand loyalty with women Used one opt-in , placed form on each regional web site, and occasionally used as a call-to-action Completed form information is sent to: CRM database for sending enewsletter CRM has tool built into it n Handles opt-ins, opt-outs, ties address to a person in the database n Only to valid people in database that have a physical address

37 enewsletters Women s

38 enewsletters - Pregnancy

39 Woman s Affinity Groups

40 Monthly Women s enewsletter Began sending monthly in July of 2011 Includes a control group Sent by corporate on behalf of all regions

41 Monthly enewsletter Reporting Have sent enewsletters to 9,446 women 3,184 have had a visit for a 33.7% response rate for a visit any any service, any location No ROI yet, but patients slightly beating holdouts In women s services visits, 868 have had a clinical encounter for 9.2% response rate

42 Monthly enewsletter Stats

43 Bariatrics Business need: Physician was looking to drive qualified leads into the office for appointments Used pay-per-clicks, and direct mail to drive to an appointment request form Completed form information is sent to: Practice manager to set an appointment CRM database for tracking via Call Center

44 Bariatrics Online Promotion

45 Bariatrics Conversion Funnel 36,864 Impressions 1,509 Clicks 320 Consults 161 Enrollments 92 Surgeries

46 Bariatrics Direct Mail Monthly mailing in addition to a pay per click campaign; both drive to a seminar

47 Bariatrics Results for one Southeast Texas region: $84,000 spent on campaign 92 surgeries at approx. $18,000 per procedure $1,656,000 in gross revenue Results for Santa Rosa region: SOURCE Mailing List Respondents Response Charges Avg Charge Rate # % # % Patients 5, % % 0.3% $333,094 $19,594 Qualified 8, % % 0.0% $13,550 $6,775 Prospects Prospects 8, % 0 0.0% 0.0% $0 $0 New Movers 0 0.0% 0 0.0% 0.0% $0 $0 Unique Total 21, % % 0.1% $346,645 $18,244

48 Obstetrics Business need: Create awareness around the birthing center Used xxx to promote the form Completed form information is sent to: Marketing department for fulfillment CRM database for tracking

49 Obstetrics , direct mail, ppc examples Banner at the mall

50

51 Obstetrics Of the 196 women that have completed the form for the free tote bag and OB info packet, 68 have had some type of OB visit Contribution margin is $106,934 thus far SOURCE Mailing List Respondents Response Rate # % # % Charges Avg Charge Contribution Margin Avg. CM Patients % % 54.7% $429,080 $14,796 $35,653 $1,229 Qualified 1 0.5% 0 0.0% 0.0% $0 $0 $ $ Prospects Prospects % % 27.5% $607,986 $15,589 $71,281 $1,828 Unique Total % % 34.7% $1,037,066 $15,251 $106,934 $1,573

52 Men s Health (work/life balance) FPO Business need: Used direct mail and xxx to promote the HRA Completed form information is sent to:

53 Men s Health FPO , direct mail, ppc examples

54 Health Risk Assessements

55 Health Risk Assessements

56 Men s Health FPO tracking

57 INCENTIVES TO DRIVE BUSINESS

58 Incentives to Drive Business The use of incentives helps cut through the clutter and gets the person s attention May also help the person keep the piece or flag the for later follow-up Typical response rates to incentives is 1-2%, so if you re sending out 5,000 , you may only have people get the gift Bottom line: it s worth the expense!

59 Surgical Robot Naming Business need: branding and awareness engagement campaign Incentive: ipad

60 Contest with Incentives

61 Surgical Robot Naming 320 completed the form Sent follow-up with new name

62 Capture Campaign Business need: Increase the number of s Couldn t rely on s from Admissions Take on a system-wide campaign and test incentives Sent a direct mail postcard in November 2012 with a PURL to 10,000 women in each region Total quantity: 90,000 Call-to-Action: visit a PURL to share your address to either get our monthly enewsletter or to join the women s affinity group for that region Incentive: Every region had a different incentive from none at all to retail gift cards

63 Capture

64 Capture

65 Capture Incentives Region ALT St. Michael s CLA St. Francis Cabrini GC Gulf Coast (St. John and St. Catherine) NLA Shreveport- Bossier SETX Southeast Texas (St. Elizabeth, St. Mary & Jasper Memorial) Incentive N/A no incentive Sent Mailer Completed Purl Response Rate 10, % Spa discount 10, % First-aid kit 20, % Walmart gift card* 10, % Spa discount 10, % SPN Spohn (Corpus H-E-B gift card* 10, % Christi area hospitals) SRH Santa Rosa Sea World (San Antonio Area discount hospitals) 10, % SWLA St. Patrick Yogurt coupon* 10, % 90,000 2, % Totals: *Some of the offers were only given to the first responders.

66 New Movers Business need: Welcome newcomers to the market Direct mail sent monthly Form online or phone number for contact/call center Both go to marketing dept for fulfillment Both sent to CRM for tracking via call center

67 New Movers

68 New Movers Reporting - FPO

69 Why Integrated Results Measurement Matters? It directly measures the economic value of: Traditional marketing investments Online marketing investments Measure results not activity

70 Future Marketing Operations/Automation CRM Multichannel Campaign Management Digital Asset Management Enterprise Content Management System Brand Monitoring Solutions Web Analytics Marketing Service Providers Needs to be less clunky and flow without us thinking about it!

71 THANKS!

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