Post details: Hospital Competition: The Unusual Suspects

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Hospital Competition: The Unusual Suspects

August 28th, 2006

I was telling one of my friends about my new hospital job, and he was surprised, "hospitals have competition??"

I tried explaining all the usual suspects - those physicians who open up their own shops, other hospitals trying to woo patients away from us, all of these new stand-alone quickie-surgery & diagnostic chains popping up left and right. When hospital execs across the country present to their boards, these are fierce competitors we show in the presentation appendices.

Then, our conversation got more interesting. I told him that because healthcare is changing so rapidly, hospitals have competitors we've never dreamed of until now. Here are 10 competitors that aren't traditionally considered, but shouldn't they be?

1. Hotels - Consumerism in healthcare creates patients who ask, "why can't I be treated in the hospital the same way I'm treated at a hotel?" And truly, many hospitals are starting to implement hotel-like amenities to drive satisfaction and loyalty.
2. US Preventive Medicine - they are planning on building 150 "Centers for Preventive Medicine" in the next 5 years. They will be partnering with hospitals, but if they don't partner with yours, then guess what - they're competitors. Their emphasis on preventive health and executive physicals (for everyone) is right on target. We hospitals suck at taking care of healthy people. And even if we are superb at it, people don't think of hospitals as a place for healthy people to go.
3. Insurance Companies - they have patient data - A LOT of it. Where there is data, there is the potential to build relationship. And that's what they are doing right now. If they own the patient record, who knows how else their reach into the hospital can be furthered?
4. Pharmaceutical Companies - If your hospital has a research institute, then you know what I'm talking about. Part of attracting the best doctors to our health system is to give them the latitude to conduct the best research in their field. So, big (and small) pharma are competing for the same brilliant docs.
5. Walgreen's / Target / Retail - The Mini-Clinic Revolution is imminent. Folks are still learning a lot about how it should exactly be done, but the money and the demand is pouring in. Expect 1,000+ mini-clinic locations without 3 years. All those millions of people who don't have a PCP and will realize they need one after a Target Clinic check-up - which hospital will they be referred to? Yours or your competitor?
6. Revolution Healthcare - This new healthcare VC led by Steve Case (founder of AOL) is a black box. They've got money, and they've hired some big guns. And they're marketing genuises. What in the world are they up to? What disruptive healthcare idea are they brewing up?
7. Coca-cola - Coke is an example of one the world's most powerful brands. We compete with Coke in the sense that we are competing for mindshare in people's brains. There is only room for so many brands, and the ones who spend the most $$ on brand-building (and then follow through with the experience / service / product) enjoy the most loyal customers. Sure, Coke isn't in direct competition with us in healthcare (in fact, Coke probably indirectly brings in patient volume!), we must understand that consumer's brains are getting more and more fragmented, trying to remember more and more brands. We are thought of less and less, and thus, we are less and less relevant.
8. Resorts - More and more resorts are combining the best of the resort experience with sophisticated medical equipment. Lots of "self-payers" are putting up big bucks for what amounts to an executive physical.
9&10. CNN & Google - I'm mentioning CNN & Google as examples of prominent information outlets. Just as we are competing for mindshare for our brand, we are competing for mindshare in terms of providing health information. Where do people turn to when they want to look for good health and medical information? Is it your doctors, your website, WebMD, or CNN? While information like this doesn't generate direct profit, those hospitals who know how to get into people's heads with credible, relevant information are the winners.

I'm sure someone will argue that the line between competitors and collaborators is essentially non-existent in healthcare, and I would agree. But I think you see where I'm headed with this - If insurance companies own a large part of the patient relationship, if media companies own the consumer's mindshare through their brand, if the retails get all the easy stuff, if the resorts and medical spas get all the high-end stuff, if VC money finds a model to motivate healthy living, and if this preventive medicine chain really does prevent... what's left for hospitals?

Comments, Pingbacks:

Comment from: Donald E. L. Johnson [Visitor] · http://www.businessword.com
Good post. This a continuation of trends begun back in the 1970s, when hospital lengths of stay began to shorten under pressure from new technologies and regulations.

The point is that hospitals are downsizing and refocusing on being hospitals. Having failed as insurers, preventive health care and wellness clinics, health clubs and medical group practices, they're back to being the centers of acute care.

That's where they should be and where they'll be most effective. And it's where they'll face relatively little competition because they've created local monopolies.

Those monopolies were formed in the 1990s in response to demands from insurers, employers and politicians—the very people who are complaining about them now.

How ironic.

Nice blog.
Permalink 08/28/06 @ 21:29
Comment from: Ron Whiting [Visitor] · http://www.rcwhiting.com
I don't see these as "competitors", in that they are not really competing for the same market (the one true competitor you left out are the physician run specialty hospitals). Rather these are forces in the market that are pushing hospitals to adapt and grow their businesses. Consumer expectations change and businesses must be able to adapt. The dreaded "change" thing.

In addition, many hospitals continue to act as though physicians and insurance companies really don't control the vast majority of their market. As long as their is fragmentation between the three, consumers will never get the kind of quality care you dream about. A complete alignment of interests particularly between hospitals and physicians is required to effect real change in hospital care.
Permalink 08/29/06 @ 12:05
Comment from: hospitaltony [Member]
good points. I think the jury is still out on whether hospitals can really compete along the entire continuum of care. from what I understand, all of the cases of hospitals trying to get into the insurance business end badly. so most still go for horizontal integration instead of vertical.

I think hospitals have a chance to "redefine" the market. If we really are about healthcare, we shouldn't just be a building with a bunch of programs - shouldn't it span much farther than that?
Permalink 08/29/06 @ 12:12
Comment from: Ron Whiting [Visitor] · http://www.rcwhiting.com
Ultimately you are right about hospitals trying to be insurance companies - but I think that's precisely the problem. Hospitals trying to be something they are not. Hospitals can't (and shouldn't) run physician groups either. But that doesn't mean you can't find models where there is an alignment of interests.

I also agree that hospitals shouldn't be just a "building with a bunch of programs". Quality care happens along a continuum. Hospitalizations represent a small fraction of the overall health encounters. Most healthcare happens in a doctor's office or on an outpatient basis. Many hospitalizations represent a failure of care somewhere else.

Framing some of these issues in terms of competition is also a problem. Because of "competition", the hospitals in my town can't cooperate to provide a better level of pediatric care. So they fight each other and the community loses.

Thanks for the blog and the chance to discuss these issue!
Permalink 08/29/06 @ 12:49
Comment from: Ram [Visitor]
Hi Tony,

I think those are pretty good points and every hospital is always compared with many different industries than only within healthcare. Our patients who walk into our facilities have a lot more expectations than just providing care to their problems. They want our environment to be as appealing as it could like hotels, banks, grocery stores; hospitals are constantly benchmarked/compared against several other industries and not just healthcare partners.

Because of that the expectations of our patients is increasing constantly and in a way we definitely are competing with every other consumer industry out there.

Besides that we also have huge challenges based on productivity, RVU targets and provier challenges to name few of numerous challenges industry is facing today. Besides all these we have constant changes from CMS about cutting our reimbursements. I really dont see in the near future or may be forever if the healthcare industry have a smooth/constant management ability at all. Everybody in this industry would have new challenges coming to their desk almost everyday right from CEO's CFO's to nurses, providers and also for our patients.Just some of my thoughts!

Thanks for really interesting blog and a chance to discuss almost every kind of issue here, Keep up the Good Work.
Permalink 08/30/06 @ 10:11
Comment from: Flowers UK [Visitor] · http://www.serenataflowers.com/
I read your post and I really liked your points. If hospital managers will see the competitors, we will have better health services for sure.
Permalink 09/13/06 @ 14:37
Comment from: Flowers UK [Visitor] · http://www.serenataflowers.com/
I read your post and I really liked your points. If hospital managers will see the competitors, we will have better health services for sure.
Permalink 09/13/06 @ 14:38
Comment from: Flowers UK [Visitor] · http://www.serenataflowers.com/
I read your post and I really liked your points. If hospital managers will see the competitors, we will have better health services for sure.
Permalink 09/13/06 @ 14:40
Comment from: Nicholas Donovan [Visitor]
It's an interesting perspective to be sure and it makes a lot of sense. Anywhere you have competition, you have increased quality of service provided certain balances are maintained.

There is a strong need as well for an increased presence of GP's, especially those practicing more conservative medicine.

These new breed of doctors, designated as DCMs are typically trained as DC's then serve their 3 year hospital residency/internship and take the USMLE.

It's a growing trend and we're seeing doctors that have more well rounded approach to treatment that also promotes fiscal responsibility.

It will be interesting to see what happens in the next few years.
Permalink 01/03/07 @ 19:19
Comment from: Interflora Flowers [Visitor] · http://www.interflora.co.uk
I think you missed one major competitor - the bureacracy that is tearing apart the NHS. I have family who work in medicine who see it every day, and it's a great shame.
Permalink 08/09/07 @ 12:31
Comment from: Michael Barber [Visitor] · http://www.CyrusOnline.com
Some good points relative to competition, especially in the case of insurance and preventative medicine. However, I believe some of the real competition to hospitals lies with outpatient surgery centers, urgent care centers, and the rise of concierge physcians.

I believe that hospitals are eventually just going to be buildings that lease space to these other entities within the medical industry.
Permalink 09/13/07 @ 14:58
Comment from: Wedding Photographer Cambridge [Visitor] · http://www.invogueweddings.co.uk
All hospitals need better management and more money. They do such wonderful work. The nurses really need to get some credit as do the doctors.
Permalink 11/11/07 @ 03:06
Comment from: Baby TShirt [Visitor] · http://www.babytshirt.co.uk
I just wish that preventative medicine didnt have so many side effects.
Permalink 07/03/08 @ 06:59

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