Retail Medicine Models: Lessons Learned

SHSMD

September 4, 2003

Retail Medicine Models: Lessons Learned

SHSMD

September 4, 2003 Geoff KaufmannGeoff Kaufmann

V.P. Clinical DevelopmentV.P. Clinical DevelopmentCenter for Diagnostic ImagingCenter for Diagnostic Imaging

Janet GuptillJanet GuptillPresidentPresident

KM at Work Inc.KM at Work Inc.

Steve Pew, PhDSteve Pew, PhDClinical TransformationClinical TransformationTexas Health ResourcesTexas Health Resources

What Is “Retail”?What Is “Retail”?

A NounA Noun• Selling of goods and services directly to customers -Selling of goods and services directly to customers -

• I work in I work in retailretail

An AdverbAn Adverb• Purchased at customer price - Purchased at customer price -

• I bought it I bought it retailretail

A VerbA Verb• Selling goods and services –Selling goods and services –

• This This retailsretails for $10 for $10

What Is “Retail Medicine”?What Is “Retail Medicine”?

Demand driven Demand driven payor demand in the pastpayor demand in the past patient demand moving forwardpatient demand moving forward

Consumer focusedConsumer focused patients increasingly willing to pay for things patients increasingly willing to pay for things

that their insurance might not coverthat their insurance might not cover Partnership healthcare modelPartnership healthcare model

Patient, Family, Professionals share knowledge Patient, Family, Professionals share knowledge and decisions about care, and the customer will and decisions about care, and the customer will pay “retail” to have more control of their pay “retail” to have more control of their healthcare experiencehealthcare experience

What Are Examples Of Retail Medicine?What Are Examples Of Retail Medicine? Body scans as birthday presentsBody scans as birthday presents Drive-through pharmacies for strep testsDrive-through pharmacies for strep tests Dermatologist selling “beauty”—botox, facial scrubs, cosmetics Dermatologist selling “beauty”—botox, facial scrubs, cosmetics

distributed solely through physician officesdistributed solely through physician offices On-line doctor consults and appointment scheduling. On-line On-line doctor consults and appointment scheduling. On-line

pharmaceuticalspharmaceuticals Massage as an option with physical therapy routineMassage as an option with physical therapy routine Laser eye surgeryLaser eye surgery Weight loss/surgical/procedural/behavioralWeight loss/surgical/procedural/behavioral Body sculpting plastic surgery and other methodsBody sculpting plastic surgery and other methods Dental cosmetics, whitening, braces for adultsDental cosmetics, whitening, braces for adults Herbal remedies. Homeopathic remediesHerbal remedies. Homeopathic remedies Stress testingStress testing Sonograms of the “baby” in the malls (baby pictures)Sonograms of the “baby” in the malls (baby pictures)

Are you thinking Are you thinking retailretail??

Is Retail Medicine “Cash Based”?Is Retail Medicine “Cash Based”?

Are we moving toward a 3 tier system of care? Are we moving toward a 3 tier system of care? Shift from “entitlement to excess”—”right vs. Shift from “entitlement to excess”—”right vs.

privilege” levels of careprivilege” levels of care1.1. What the governmental payors cover (the What the governmental payors cover (the

basics)basics)2.2. What the commercial payors cover (benefits What the commercial payors cover (benefits

vary)vary)3.3. What people will buy that isn’t covered at allWhat people will buy that isn’t covered at all

Perhaps “Retail Medicine” is trying to selectively Perhaps “Retail Medicine” is trying to selectively grow in areas where greater net margins are grow in areas where greater net margins are possible… possible… FOLLOW THE MONEYFOLLOW THE MONEY

Learning ObjectivesLearning Objectives

1.1. Understand which services are more likely to be Understand which services are more likely to be delivered in a retail modeldelivered in a retail model

2.2. Share lessons learned from hospitals that have Share lessons learned from hospitals that have incorporated retail models into their businessincorporated retail models into their business

3. Learn a process for transforming key services 3. Learn a process for transforming key services into a retail delivery modelinto a retail delivery model

What Will You Get From Us?What Will You Get From Us?

A decision making framework for hospitals to A decision making framework for hospitals to use when considering entering the retail use when considering entering the retail marketmarket

Lessons learned from hospital providers that Lessons learned from hospital providers that have made these shiftshave made these shifts

Critical success factors for a retail medicine Critical success factors for a retail medicine modelmodel

Tools for managing and measuring Tools for managing and measuring successful transitions successful transitions

Sales ContinuumSales Continuum

WholesaleWholesale DiscountDiscount Mainstream RetailMainstream Retail Upscale RetailUpscale Retail BoutiqueBoutique

Sales ContinuumSales Continuum

WholesaleWholesale DiscountDiscount

MainstreamMainstream

RetailRetail

UpscaleUpscale

RetailRetail BoutiqueBoutique

WarehouseWarehouse

Focus on Focus on DistributionDistribution

InstitutionalInstitutional

HVAC HVAC WarehouseWarehouse

Arranged for Arranged for convenience of convenience of

handlershandlers

Little if any Little if any service except service except

minimum minimum required by required by

lawlaw

Large building Large building strategically strategically located in located in

shopping areashopping area

Customer Customer FriendlyFriendly

Service is as Service is as important as important as

product qualityproduct quality

Brand NamesBrand Names

ConvenienceConvenience

Exceptional Exceptional facilityfacility

Spa-like Spa-like atmosphereatmosphere

PrivacyPrivacy

Custom Custom Service Service

Personal Personal ServiceService

AmenitiesAmenities

UpsellsUpsells

Single Single specialty specialty serviceservice

Focus on Focus on highest qualityhighest quality

Highest Highest personal personal serviceservice

Personal Personal relationship relationship

with customerwith customer

Repeat Repeat businessbusiness

Sales Continuum: Grocery ExampleSales Continuum: Grocery Example

Wholesale:Wholesale: Allen FoodsAllen Foods Sells products to grocery storesSells products to grocery stores

Discount:Discount: Costco, Sam’s Club Costco, Sam’s Club Sells products to public in volume but at a reduced priceSells products to public in volume but at a reduced price

Mainstream RetailMainstream Retail: : Albertsons, Kroger Albertsons, Kroger National chain that sells products to public at standard pricesNational chain that sells products to public at standard prices

Upscale Retail:Upscale Retail: Central Market, Whole FoodsCentral Market, Whole Foods Offers specialty products to the public at premium pricesOffers specialty products to the public at premium prices Provides exceptional service, has reputation for outstanding serviceProvides exceptional service, has reputation for outstanding service

Boutique:Boutique: Omaha SteaksOmaha Steaks Offers specialty products to the public within a particular category at Offers specialty products to the public within a particular category at

premium pricespremium prices

Sales Continuum: HealthcareSales Continuum: Healthcare

Wholesale:Wholesale: VendorsVendors Sell products to hospitals and GPOsSell products to hospitals and GPOs

Discount:Discount: Hospitals Hospitals Provide services for Medicare, Medicaid, HMO, PPO participants at Provide services for Medicare, Medicaid, HMO, PPO participants at

discount pricesdiscount prices

Mainstream Retail:Mainstream Retail: Pharmacies, Urgent Care CentersPharmacies, Urgent Care Centers Offer standard services to customers at standard retail pricesOffer standard services to customers at standard retail prices i.e. Services for customers who do not need “larger volumes”i.e. Services for customers who do not need “larger volumes”

Upscale Retail:Upscale Retail: Specialty Clinics/Hospitals, Menningers, ATCs (Betty Ford), Specialty Clinics/Hospitals, Menningers, ATCs (Betty Ford), MayoMayo

Provide specialty services at premium pricesProvide specialty services at premium prices Possess a reputation for premium care, customer service, or experiencePossess a reputation for premium care, customer service, or experience

Boutique:Boutique: Cosmetic/Plastics, Dermatology, Laser Eye, Weight LossCosmetic/Plastics, Dermatology, Laser Eye, Weight Loss Offers specialty services to the public within a particular category at Offers specialty services to the public within a particular category at

premium pricespremium prices

Location: Marketing Tactic OrRetail Strategy??Location: Marketing Tactic OrRetail Strategy??

Changing the location of a hospital to suburbia without changing the Changing the location of a hospital to suburbia without changing the delivery/business model is simply a marketing/location tactic.delivery/business model is simply a marketing/location tactic.

Operating in a new location using institutional delivery methods, Operating in a new location using institutional delivery methods, institutional pricing, and providing little service is really just the same institutional pricing, and providing little service is really just the same snow but a different drift. It does not make retail medicine.snow but a different drift. It does not make retail medicine.

Retail medicine is a different business model and care delivery model Retail medicine is a different business model and care delivery model than traditional hospital medicine.than traditional hospital medicine.

To enter the retail medicine market, hospitals must think in a To enter the retail medicine market, hospitals must think in a completely different way and conduct business in a completely completely different way and conduct business in a completely different manner.different manner.

Retail Medicine-What it isn’tRetail Medicine-What it isn’t

Retail Medicine-What it isRetail Medicine-What it is

The New EconomyThe New Economy

““Customers and employees will be empowered in new Customers and employees will be empowered in new ways..and essentially calling the shots”ways..and essentially calling the shots”

““Information is free, Insight is not.”Information is free, Insight is not.”““The biggest problem for senior executives will be facing The biggest problem for senior executives will be facing

the fact that they are no longer in charge…the the fact that they are no longer in charge…the customer is”customer is”

““No competitive advantage is sustainable. We wil have No competitive advantage is sustainable. We wil have to continually create new competitive advantages”to continually create new competitive advantages”

C.K. Prahalad, Professor of Business C.K. Prahalad, Professor of Business Administration, Administration,

Michigan Michigan Business School,Business School,

Consumer-Centric ViewsConsumer-Centric Views

It’s this desire to participate that drives the retail healthcare

demand

It’s this desire to participate that drives the retail healthcare

demand

ConvenienceConvenienceTimelinessTimelinessCost/payment optionsCost/payment optionsWeighed against other purchase options e.g. a Weighed against other purchase options e.g. a vacation in the tropicsvacation in the tropicsA collaborative care model A collaborative care model

“Retail” Puts The Customer In The Driver’s Seat “Retail” Puts The Customer In The Driver’s Seat

Patient Centered Model 1980’sPatient Centered Model 1980’s

PatientPatient

FamilyFamily

CaregiversCaregivers

KnowledgeKnowledge

Collaborative Model of HealthcareCollaborative Model of HealthcareThe FUTUREThe FUTURE

Traditional Healthcare Model 1900’sTraditional Healthcare Model 1900’s

Customer Service Model 2000’sCustomer Service Model 2000’s

Copyright: The Center for Collaborative Health and Patient Advocacy 2003Copyright: The Center for Collaborative Health and Patient Advocacy 2003

Trends Affecting Retail ShiftTrends Affecting Retail Shift

Consumer ownership over health care buying Consumer ownership over health care buying decisionsdecisions

Technology shifts that encourage ambulatory Technology shifts that encourage ambulatory treatmenttreatment

Delivery system more fragmented, more consumer Delivery system more fragmented, more consumer choicechoice

Consumer ShiftsConsumer Shifts

Consumers are sharing the cost of health plan Consumers are sharing the cost of health plan coverage and more consciously deciding how to coverage and more consciously deciding how to spend health care dollars (benefit sets, medical spend health care dollars (benefit sets, medical spending accts, deductibles, other out of pocket)spending accts, deductibles, other out of pocket)

Consumers are creating medical savings accts with Consumers are creating medical savings accts with pre-tax dollars to create disposable income for pre-tax dollars to create disposable income for health care serviceshealth care services

Consumers are seeing that they can buy health Consumers are seeing that they can buy health care services without going through physicians care services without going through physicians

More information and direct services are available More information and direct services are available on the interneton the internet

Consumers As Healthcare BuyersConsumers As Healthcare Buyers

Are you watching the Are you watching the advertisements???advertisements???

Examples of Retail MarketingExamples of Retail Marketing

Technology Enablers Of The Retail ShiftTechnology Enablers Of The Retail Shift

Easier to useEasier to use SaferSafer CheaperCheaper DisposableDisposable More widely availableMore widely available Internet makes is easier to promoteInternet makes is easier to promote

Enabling TechnologyEnabling Technology

Implantables (spine supports, dissolving chemo, Implantables (spine supports, dissolving chemo, shunts and pumps, organ stimulators, monitors) shunts and pumps, organ stimulators, monitors) for at home treatmentfor at home treatment

Minimally invasive surgery; robotic surgeryMinimally invasive surgery; robotic surgery Ultrasound replacing selective surgeries for Ultrasound replacing selective surgeries for

breast cancer, uterine fibroids and prostate breast cancer, uterine fibroids and prostate cancer; Imaging replacing procedures cancer; Imaging replacing procedures (colonography)(colonography)

Portable, digital patient recordsPortable, digital patient records Drugs replacing treatment (heart conditions)Drugs replacing treatment (heart conditions) The promise of gene therapyThe promise of gene therapy

Enabling Technology ExamplesEnabling Technology Examples

Mobile MRI—the size of a desk chair (arm, leg)Mobile MRI—the size of a desk chair (arm, leg) Swallowable camerasSwallowable cameras Laparoscopic proceduresLaparoscopic procedures Botox treatmentsBotox treatments Early pregnancy testingEarly pregnancy testing Defibs in airplanes, factories (AEDs) Defibs in airplanes, factories (AEDs) Blood sugar testing pens or strips (non-invasive)Blood sugar testing pens or strips (non-invasive)

Technology Impacts UtilizationTechnology Impacts Utilization

Shifts inpatient to outpatient to…retail?Shifts inpatient to outpatient to…retail? Decreases intensity of serviceDecreases intensity of service Creates new demandCreates new demand Focuses on earlier detectionFocuses on earlier detection Decreases the time required for careDecreases the time required for care CAD assists providers in looking for CAD assists providers in looking for

pathologypathology Turf battles will erupt between physiciansTurf battles will erupt between physicians

Specialty Niche Retail CompetitionSpecialty Niche Retail Competition

Plastic surgery centersPlastic surgery centers Screening services (Body CT, genetic testing, Screening services (Body CT, genetic testing,

chiropractic evals.,chiropractic evals., OTC drugs (allergy, Viagra, internet ordering)OTC drugs (allergy, Viagra, internet ordering) Health clubs/massage/spa servicesHealth clubs/massage/spa services Complementary/integrative providersComplementary/integrative providers Drug store “providers” (urgent care, mammo)Drug store “providers” (urgent care, mammo)

Impact Of Internet On Retail StrategiesImpact Of Internet On Retail Strategies

Increasing number of websites for health information and Increasing number of websites for health information and adviceadvice

More physician on-line consultsMore physician on-line consults

On-line pharmacies with minimal physician involvementOn-line pharmacies with minimal physician involvement

Sites for second opinions (“get 3 medical opinions Sites for second opinions (“get 3 medical opinions anonymously for $14.95”)anonymously for $14.95”)

Report cards that compare provider cost and quality scoresReport cards that compare provider cost and quality scores

Examples From Your MarketsExamples From Your Markets

Hospital “hotel” services (meals, rooms)Hospital “hotel” services (meals, rooms) Inpatient Brand Identity extended to retailInpatient Brand Identity extended to retail Brand restaurants in hospitalsBrand restaurants in hospitals ““Scan vans”Scan vans” Lasic centersLasic centers ““Personal” physicians for annual feesPersonal” physicians for annual fees DTC medical device marketingDTC medical device marketing GNC and other supplement storesGNC and other supplement stores E-health sites and storesE-health sites and stores

Solucient Survey: 82% of hospitals offer off-campus servicesSolucient Survey: 82% of hospitals offer off-campus services

6%

6%

6%

9%

9%

15%

24%

24%

26%

26%

26%

29%

44%

47%

59%

0% 10% 20% 30% 40% 50% 60%

Laser center

Retail pharmacy

Health resource center

Clinical trials program

Sports medicine/rehab clinic

Specialty hospital

Spa or health club

Integrative providers (massage, accupuncture, etc.)

"Health-plex" mix of outpatient services

Reference lab

Mental health clinic

Durable medical equipment (DME) and supplies

Urgent care center

Diagnostic imaging center

Ambulatory surgery center

Solucient Survey: 68% say these services increase pt satisfaction plus…Solucient Survey: 68% say these services increase pt satisfaction plus…

5.04

5.19

5.35

5.76

5.88

6.03

6.72

7.09

8.06

8.53

8.87

0 1 2 3 4 5 6 7 8 9

Average Score

Higher level of control for the physicians

Response to payer or employer demands

Higher quality setting

Response to the same services offered by a key competitor

Convenience for the physicians

Opportunity to partner w ith key physicians

Less costly setting

More eff icient operating model

Opportunity to capture new revenue sources

Opportunity to serve new markets

Convenience for the patients

Solucient Survey: Only 35% saw improved MD relations, 44% increased market share, plus…

Solucient Survey: Only 35% saw improved MD relations, 44% increased market share, plus…

15%12%

45%

12%

15%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Lost money Broke even Incrementalincrease in

margin

Substantialincrease in

margin

Unknow n

Solucient Survey: Physicians still the primary partnering strategySolucient Survey: Physicians still the primary partnering strategy

3%

9%

12%

33%

42%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Fully ow ned by physicians

Partnership w ith health carecompany

Management agreement

Fully ow ned by hospital

Joint venture w ith physicians

Solucient Survey: Retail marketing strategies have been limitedSolucient Survey: Retail marketing strategies have been limited

21%

21%

38%

47%

56%

56%

79%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Marketing in physician off ices

TV

Customer new sletter

Radio

Direct-to-consumer

Web-based promotion

Print

So What Are You Going To Do?So What Are You Going To Do?

What clinical services do you want to move to a retail What clinical services do you want to move to a retail setting?setting?

What are your options for delivering these services in What are your options for delivering these services in a retail model?a retail model?

How much has “retail medicine” already begun in How much has “retail medicine” already begun in your market?your market?

What do you want your retail position to be—a What do you want your retail position to be—a leader, a follower, or a non-player?leader, a follower, or a non-player?

How will you have to reinvent yourself to go from How will you have to reinvent yourself to go from a discount hospital to a retail provider?a discount hospital to a retail provider?

Anticipate The FutureAnticipate The Future

““If you went back 100 years and asked a farmer If you went back 100 years and asked a farmer

what he wanted he would likely tell you he what he wanted he would likely tell you he

wanted a bigger horse that ate fewer oats.wanted a bigger horse that ate fewer oats.

He would not tell you he wanted a tractor.”He would not tell you he wanted a tractor.”• CEO Hewlett PackardCEO Hewlett Packard

Find out what’s on the technological cutting Find out what’s on the technological cutting edge…invest in future technology…beat the edge…invest in future technology…beat the customer to the market…but not by too much. customer to the market…but not by too much. Don’t be an also ran in the retail businessDon’t be an also ran in the retail business

Decide Where To Go RetailDecide Where To Go Retail

Specialties to consider: Specialties to consider: Plastic Surgery (aesthetics)Plastic Surgery (aesthetics) Dermatology (chemical peals, dermabration, permanent Dermatology (chemical peals, dermabration, permanent

makeup)makeup) Emergency Medicine (24-hour free-standing ERs)Emergency Medicine (24-hour free-standing ERs) Urology (impotence)Urology (impotence) Occupational Medicine (work hardening) Occupational Medicine (work hardening) Podiatry (orthotic and running clinics) Podiatry (orthotic and running clinics) Dental (smile appeal) Dental (smile appeal) Ophthalmology (lasic) Ophthalmology (lasic) Anesthesia and Radiology (pain management)Anesthesia and Radiology (pain management)

Decide Where To Go RetailDecide Where To Go Retail

Services to consider:Services to consider: Complementary to IP but uncovered by health Complementary to IP but uncovered by health

plansplans MDs won’t/can’t provide in their officesMDs won’t/can’t provide in their offices Support but don’t compete with MDsSupport but don’t compete with MDs Easy, cheap technologyEasy, cheap technology Chronic conditions: diabetes, pain, arthritis, Chronic conditions: diabetes, pain, arthritis,

heart diseaseheart disease Diagnostic services: imaging, lab Diagnostic services: imaging, lab Don’t overlook the obvious: flowers, gifts, foodDon’t overlook the obvious: flowers, gifts, food

Decide Where To Go RetailDecide Where To Go Retail

Cultural issues to consider: Cultural issues to consider: Build in extensive training program: how to Build in extensive training program: how to

cross-sell, customer service, accepting paymentcross-sell, customer service, accepting payment Utilize contracted, part-time, and temp Utilize contracted, part-time, and temp

positions; may require HR policies separate positions; may require HR policies separate from the hospitalfrom the hospital

Choose an entrepreneurial manager; create Choose an entrepreneurial manager; create incentives for both individual and team incentives for both individual and team performanceperformance

Have dedicated marketing supportHave dedicated marketing support

Do Your HomeworkDo Your Homework

Analyze market demand by product line, both Analyze market demand by product line, both inpatient and outpatient, assess the competition, inpatient and outpatient, assess the competition, calculate physician supply for related specialtiescalculate physician supply for related specialties

Interview physicians in the market, ask about Interview physicians in the market, ask about referral patterns, ascertain revenue potential of referral patterns, ascertain revenue potential of alternative retail strategiesalternative retail strategies

Estimate potential impact on inpatient business Estimate potential impact on inpatient business and reactive strategies requiredand reactive strategies required

Figure out organizational structure, operating Figure out organizational structure, operating policies, etc.; don’t “hospitalize” the servicepolicies, etc.; don’t “hospitalize” the service

Get Close To The CustomerGet Close To The Customer

Focus on convenience; Focus on convenience; ask them what they want; ask them what they want; survey regularly; survey regularly; analyze current customer baseanalyze current customer base

InnovateInnovate Understand how to cross-sell related Understand how to cross-sell related

servicesservices

Be CredibleBe Credible

Don’t risk your reputation on marginal Don’t risk your reputation on marginal technology by overpromising results that technology by overpromising results that are not yet proven.are not yet proven. E.g.. “Virtual” colonoscopyE.g.. “Virtual” colonoscopy Penis enlargementPenis enlargement Hypnotic breast enhancementHypnotic breast enhancement etcetc

Understand How To Run A Retail BusinessUnderstand How To Run A Retail Business

Focus is on building revenues and generating Focus is on building revenues and generating add-on salesadd-on sales

Less focus on how to do what you are already Less focus on how to do what you are already doing cheaperdoing cheaper

Need HR policies and culture distinctly different Need HR policies and culture distinctly different from the hospital; emphasize both individual and from the hospital; emphasize both individual and team sales successteam sales success

Local “ownership” is criticalLocal “ownership” is critical Ability to make quick decisions is also criticalAbility to make quick decisions is also critical

Marketing In Retail Is DifferentMarketing In Retail Is Different

Quick, customer responsive (seasonal discounts, Quick, customer responsive (seasonal discounts, competitor reaction, reflects local market attitude competitor reaction, reflects local market attitude and happenings)and happenings)

More salesy than a typical hospitalMore salesy than a typical hospital Think carefully about branding decision; hospital Think carefully about branding decision; hospital

or independentor independent Utilize local market data on marketing Utilize local market data on marketing

effectiveness: radio, billboards, direct mail, effectiveness: radio, billboards, direct mail, newspapers, magazines, etc.newspapers, magazines, etc.

Remember to sell to the intangibles—how people Remember to sell to the intangibles—how people will feel about themselves as a result of using your will feel about themselves as a result of using your serviceservice

Consider Your Partnering OptionsConsider Your Partnering Options

PhysiciansPhysicians FranchisesFranchises Local businesses that serve a similar Local businesses that serve a similar

customercustomer Technology companiesTechnology companies Related services companiesRelated services companies

Example: Open Off-site Pain Management CenterExample: Open Off-site Pain Management Center

Who is your customer? What will they want?Who is your customer? What will they want? What services would you offer?What services would you offer? What would differentiate you from your What would differentiate you from your

competitors?competitors? How will you market?How will you market? How would you go about setting up the How would you go about setting up the

program?program? How would you “sell” your approach to the How would you “sell” your approach to the

hospital?hospital?

Solucient Survey: Lessons LearnedSolucient Survey: Lessons Learned

Market research is crucial to assuring success. You have to Market research is crucial to assuring success. You have to understand how the customer wants to receive services. understand how the customer wants to receive services.

Need to be more aggressive in market promotion.Need to be more aggressive in market promotion. It has been very difficult to integrate these services with our It has been very difficult to integrate these services with our

campus based …services from many perspectives: campus based …services from many perspectives: integration/continuum of care, uniform Human Resources, integration/continuum of care, uniform Human Resources, Administrative and Billing practices, etc. Administrative and Billing practices, etc.

These things take time to grow. Also, market surveys don't These things take time to grow. Also, market surveys don't always tell the whole story. always tell the whole story.

Market assessment is vital. Physicians play a strong impact Market assessment is vital. Physicians play a strong impact and can't be ignored. Physician ownership/commitment and can't be ignored. Physician ownership/commitment critical.critical.

Address operational and patient satisfaction issues Address operational and patient satisfaction issues continually.continually.

Critical Success Factors for RetailCritical Success Factors for Retail

Offering fits local market demand and supply Offering fits local market demand and supply characteristicscharacteristics

Business is incredibly attuned to consumer Business is incredibly attuned to consumer

preferencespreferences

Retail brand and model is separate from hospital Retail brand and model is separate from hospital

culture yet consistent in its valuesculture yet consistent in its values

Partnering approach matches the market strategyPartnering approach matches the market strategy

Critical Success Factors for RetailCritical Success Factors for Retail

Choose the right partnerChoose the right partner

Need to “share” profitsNeed to “share” profits

May need to walk away from inpatient bricks and mortar May need to walk away from inpatient bricks and mortar investmentinvestment

Work through legal complexities and costsWork through legal complexities and costs

Adequately address operational risksAdequately address operational risks

Have a back-up plan for unwinding at any moment in timeHave a back-up plan for unwinding at any moment in time

Other Lessons LearnedOther Lessons Learned

Need experience in retail marketing—go buy itNeed experience in retail marketing—go buy it Make sure you don’t under fund the marketing effortMake sure you don’t under fund the marketing effort Invest in consumer surveys, customer usage Invest in consumer surveys, customer usage

analysis, and continual market recognizanceanalysis, and continual market recognizance Be flexible and innovative; respond to market Be flexible and innovative; respond to market

dynamics instantlydynamics instantly Run it like you personally own it—or give people Run it like you personally own it—or give people

incentives to do soincentives to do so Don’t confuse “partner” and “customer” designationsDon’t confuse “partner” and “customer” designations

Questions?Questions?