jewish community studies

If You Ask, We Answer: Part 2 – Healthcare

Continuing our series about the common questions that our clients ask us:  our first post focused on the higher education sector.  We now turn our focus to healthcare.

When my kids ask me what I do all day, I respond with, “We answer questions.”  I give pretty much the same response to adults, because while it sounds simple, it captures the essence of my work.  That’s why The Melior Group is in business.

So when it comes to our healthcare provider clients like hospitals and health systems, what kinds of questions is Melior answering, and how are they using the information?

If we build it, will they come?

Investment in facilities, programs and services is costly, and our healthcare clients need data about consumers to support their decisions.  Hospital planning departments and their consultants provide the market information (how many people live in the area, insurance status, etc.); Melior’s work focuses on gathering insights into consumer attitudes and behavior. We ask questions of the market such as:

  • Is there a need in your community for said initiatives?
  • When making decisions for this type of program/service, what are your criteria for selection?
  • If the program/service offers these menu items, how likely would you be to consider using it?
  • What would make you more likely to use it?

With the answers given, Melior is able to guide clients to make “go/no go” decisions, and, if the decision is “go”, to develop a product that is responsive to consumers’ needs and preferences.

Is our consumer-directed marketing and outreach accomplishing what we want it to accomplish, and if not, what can we do to make it better?

We often work with clients when they are developing their consumer marketing strategy.  They may need to evaluate their current brand status, as well as elicit input for future marketing campaigns.  We ask questions of consumers such as:

  • What is important to you when you are making decisions about healthcare?
  • What are your impressions of the different providers in the market?
  • How do you gather information about healthcare providers?
  • What is your reaction to current advertising and other messaging from healthcare providers?

The answers help our clients to develop marketing communications which are believable, distinctive and have the potential to resonate with desired audience segments.

How can we better serve our surrounding community? 

This is an important question for our nonprofit healthcare clients, which are usually mission-driven.  They take their missions seriously, and want to hear, from the audiences they are committed to serving, how they are doing.  As such, we ask questions of those audiences such as:

  • Do you perceive this provider as the “go to” resource for your family’s health needs?
  • Does this provider treat all patients with the compassion and respect that they deserve?
  • Is this provider doing all that it can to improve the overall health of the community?

Though sometimes the findings can surprise, and even hurt, they can provide a starting point for improvement and rededication to meeting mission goals.

In addition to the questions we ask, our rigorous approach to figuring out who we need to reach in order to gather the information we need, and determining the best methodology for gathering information, is central to our work.

Our research can help healthcare providers explore all of these issues and more.  Give us a call or shoot us an email and let us know how we can help.

For more information please contact Elizabeth Cohen at [email protected]/215-545-0054 ext. 103


Impact of EMR on Patient Experience: Qualitative Review and Impressions

There is general agreement in the healthcare field that Electronic Medical Records (EMR) will eventually enhance quality of care, achieve cost savings, and improve the patient experience.  But, so far as consumers are concerned, the general feeling is… “are we there yet?”  Have the benefits of EMR trickled down to the point where patients understand what all the fuss is about?

In my role as a qualitative researcher hired by hospitals, healthcare systems, and insurance providers for the past 20+ years, I have had a front row seat for discussions about healthcare.  While so much in the sector has changed, consumers’ expectations for how they will be treated, and their satisfactions and disappointments, have remained constant.

Undoubtedly, most consumers are aware of EMR adoption; haven’t we all had the experience within the last few years of being asked to be patient (no pun intended) while our providers transition?  Of filling out lengthy healthcare forms which will be attached to our medical records? Of periodically updating acknowledgement of HIPAA policies?  Many of us even use hospital portals to communicate with our physicians, make appointments, request prescription refills, and see test results.

So overall, what has been the impact of EMR on the patient experience?

In the positive column, many consumers are aware of, and have come to appreciate, the benefits of having a centralized healthcare record that all providers within a system can refer to.  It is efficient (fewer questions when seeing a new provider within the same system), and makes people feel safe (“they know my medical history”) and cared for.  Having experienced these benefits, patients are more likely to request and accept referrals to providers within the same system.  In the words of one focus group participant…

“No matter what location you go within (health system), they can see your records…and then I can go into the portal and see all of my records from every location (within the health system) that I have been to.”

Have any other benefits of EMR trickled down to patients?  In our experience, not so much.  In focus groups, interviews and surveys, consumers continue to tell us about the delays and glitches in healthcare communication and service that providers blame on their EMR conversion processes.  Additionally, lots of emergency rooms – even those connected to providers that consumers often use for their healthcare – still don’t have access to full patient records.  The need to gather health information in the ER from patients and families reduces efficiency and exacerbates stress –  definitely not consistent with a better healthcare experience.  And finally, we hear a lot of complaints from people who say, “my doctor spends most of the appointment on the computer, and doesn’t even look at me while talking.”

In sum, while EMR is no doubt here to stay, at this point in time, many of its advantages remain elusive to those who it is supposed to help the most: patients. Hopefully the next time I write about this topic, when consumers ask “are we there yet?”, the answer will be, “we’re getting closer.”

For more information please contact Elizabeth Cohen at [email protected]/215-545-0054 ext. 103

I Don’t Care What You Think Until I Think That You Care

“I don’t care what you think until I think that you care.”

I heard that quote and I can’t stop thinking about how perfectly this applies to health care, specifically to consumers’ thoughts and attitudes about the kind of health care they are seeking.

Over the years, The Melior Group has conducted thousands of focus groups with consumers about their decision-making and preferences for providers. The word “quality” gets used a lot. We hear some version of the statement “I want to go to a hospital/doctor/other provider that is known for delivering high quality care”  in every single focus group.

So what does “high quality healthcare” mean?

I’ve asked this question in more ways than I can count, searching, searching for clarity.

Because every time I would ask that question, I would get what I believed was a naïve answer – something like:  “A quality doctor is someone who listens to me,” or, “ I want to go someplace where I can really talk to my doctor.”

After hearing some version of this for the umpteenth time, I told myself that if I could only ask the question right, then I would get a “better” answer, like “quality healthcare means there are good outcomes”  or “quality means practicing evidence-based medicine.” 

I told myself that the consumers who were focused on doctors’ communication skills and “bedside manner” were missing the point:  to my mind, healthcare “quality” had nothing to do with interpersonal skills.

And then I heard that quote.

It was really an “ah ha” moment.  Of course!  As a patient, why would I value what a doctor was recommending to me – even if he/she was amazingly credentialed, the leading doctor in that field, educated at Harvard, yada yada – unless that doctor seemed to care enough about me to attempt to really get to the bottom of my particular problem, and my goals for treatment?

So what does caring in the medical setting mean? Does it mean…

Wearing a button that says “Ask me”?
Making small talk in the examining room?
Claiming, in advertising, that each patient is more than a number? 

I don’t think so.  Rather, I think that my focus group participants have got it right:  by listening — really listening,  restating the information to make clear that they have heard what their patient is saying, and asking the right questions — medical providers convey caring.  In so doing physicians are  better able to diagnose the real problem, and to suggest a treatment approach that a patient will be more likely to comply with.

Now that sounds like high quality healthcare.

Elizabeth Cohen is Vice President of The Melior Group, and our lead consultant in our work in the health care sector.

For more information please visit our Healthcare page or contact Elizabeth Cohen at [email protected] / 215-545-0054 x103.

Referring Physicians

How Much Influence Do Referring Physicians Really Have?

A patient goes to their primary care physician (PCP) for a new medical problem. The PCP believes that the patient should go to see a specialist. What happens next?

The Results Can Be Confusing

The Melior Group conducts numerous studies for hospital clients who have a vested interest in understanding how referrals are made. The results these studies generate, however, can be confusing. On the one hand, the majority of PCPs tell us that they always make specialist recommendations, and that their patients “almost always go where I recommend.” Yet on the other hand, patients tell us that their physicians are only one source among many (friends and family, internet research, etc.) of information about which specialists to use for a given problem.

What’s Really Going On?

After years of conducting qualitative and quantitative research for healthcare clients who want to insure that their institutions, and the physicians affiliated with them, receive their fair share of recommendations, we think we have an answer. Despite the apparent contradiction of what consumers and physicians say about selecting specialists, they are both right.

Defining the Decision-Set

Our work for several specialty hospitals and academic medical centers reveals that in the vast majority of situations, referring physicians provide one or several names of specialists for their patients to consider. In so doing, they provide the “decision-set.” Patients, in turn, use that list as a starting point: they might ask their friends and family (sometimes using social media) to learn what others think of the specialist(s), and they also might conduct some internet research to… learn about the specialist’s education, length of time in practice, etc.; see a picture (does he/she look friendly?); and/or read online reviews. Information gleaned during this process informs the ultimate action: the call to make an appointment, which is entirely in the consumer’s hands.

Using Information Developed from Research to Inform Physician Referral Strategies

There are a number of steps that specialty providers can take to insure that…

1) their physicians are included on the referring physician’s list of recommended providers; and

2) consumers ultimately select one of these recommended providers.

Such strategies can be informed by market research. For example, an evaluation of the referral mechanics of referring physicians can guide development of documentation, work flow, and referral forms: How – in writing or verbally, with pre-printed or handwritten information – do referring physicians prefer to give names of specialists? How, and how frequently, do they want to receive communications about individual patients that they have referred? On the consumer side, knowing what they expect can provide guidance for website development (what kind of information should be available about individual specialists), search engine optimization, social media presence, and overall positioning and messaging strategy about specialty physicians and services. In sum, understanding more about existing referral dynamics can inform both marketing strategy and tactical solutions for building referrals.

For over 30 years, Melior has specialized in conducting market research on behalf of hospitals and health care systems.  Please visit our Healthcare page to learn more.

For more information please contact Elizabeth Cohen at [email protected]/215-545-0054 ext. 103 or Linda McAleer at [email protected]/215-545-0054 ext.104.

Referring Physicians

Hospital Regional Appeal Improves Using Market Research

Without the resources to out-spend its competition, an in-city hospital sought a market research partner who could help them improve their image in their local community. In order to maximize the spend, they were in need of smart and efficient direction.

The Melior Group targeted both consumers and primary care physicians to uncover how to convey the hospital’s unique story and build its patient base. Research results helped to direct the hospital towards a new partnership plan, an improved referral process and a deeper focus on the people whose lives were changed for the good…read the full article here.

Elizabeth Cohen is Vice President of The Melior Group, and our lead consultant in our work in the health care sector.  For more information please visit our Healthcare page or contact Elizabeth Cohen at [email protected] / 215-545-0054 ext 103.

Healthcare Providers Face New Brand And Spend Challenges As Some Medical Procedures Become Commoditized: PART 2

If a given service line and/or procedure generates high patient volume and is profitable, hospitals and healthcare systems can be sure that there will be stiff competition for those patients. So, how do providers attract their fair share of volume?

In the previous post, Melior identified three broad question areas that healthcare marketers should consider before finalizing a marketing plan. Successful hospital marketers know that marketing research can answer those questions. In this follow-up blog post, we recommend some approaches to consumer research that can provide guidance for development and execution of marketing strategy.

Focus groups

To really understand how patients make decisions and their impressions of and willingness to consider area hospitals/health systems, Melior continues to recommend focus groups with consumers as a first step. In this intimate forum, where participants can be screened to insure that all have had some experience with, for example, cardiac care, we can ask questions such as “which hospital in your area is best for a given procedure/service line,” and “where did you/your loved one actually go for this procedure.”

As it so happens, the answers to the above questions are often contradictory. One of our clients — a regional tertiary care provider that has invested heavily in its cardiac service line — learned through focus group research that despite many consumers’ recognition of its capabilities and reputation, other factors such as perceived better access, and their personal physicians’ recommendations, trumped these positive impressions and drove patients elsewhere for cardiac services. Rather than going to what they perceived was the “best” option, many consumers chose a provider that was “good enough” to meet the need…and more advantageous in other ways.

In a focus group, we can explore these contradictions in a free-ranging line of inquiry, and develop evidence-based hypotheses to explain what we’re hearing. In a typical telephone or online survey – with predominantly closed ended questions – we would just have to accept these contradictions and rely on conjecture to understand them. After a series of focus groups, our client decided to focus more of its localized messaging on ease of access to specific physicians.

Quantitative survey of catchment area consumers

Many of our clients do need quantitative data in order to understand the prevalence of what was heard in focus groups, and to satisfy internal audiences who control marketing dollars. Qualitative findings can be used as the basis for a quantitative survey of consumers, the purpose of which can be to measure and track the standard concerns – e.g., awareness, impressions, decision-making priorities and inputs, etc. – as well as to test the hypotheses that were developed in the qualitative phase. Some clients even try out positioning statements or other creative approaches in such a survey.

This quantitative data can provide the additional confidence needed to formulate positioning and messaging strategy for the service line. These findings also allow for development of market segments – based on demographic, experiential, attitudinal, and other data – which can help providers identify specific groups to target based on common characteristics.

To learn more, visit our previous postHealthcare Providers Face New Brand And Spend Challenges As Some Medical Procedures Become Commoditized, PART 1.

In our next healthcare post we’ll explore the role of physicians in consumer decision-making, and make the case for why physician relations are an integral component of consumer marketing strategy.

For inquires, please contact The Melior Group at (215) 545-0054 or by email [email protected]

Healthcare Providers Face New Brand And Spend Challenges As Some Medical Procedures Become Commoditized: PART 1

In the face of so many changes in healthcare, competition among providers for healthcare dollars continues to mount. It makes sense that providers are targeting some of the most profitable service lines — e.g., Cardiology, Orthopedic and Oncology — in their quest to assure their competitive positions going forward. In order to win their “fair share” of patient revenues, providers ranging from community hospitals to academic tertiary care centers have developed the capability to perform once cutting-edge procedures such as cardiac catheterizations and joint replacements. The result is a leveled playing field, achieved through widespread training and the development of relationships with affiliated specialists.

In the eyes of consumers, there is a perceived “commoditization” of certain tried and true, no longer leading-edge services. Through focus groups and quantitative research, The Melior Group has learned that while consumers have a clear perception of which hospitals are “best” in their region — usually, large tertiary care centers with academic affiliations — they often prefer having these “commodity” procedures done at a hospital they may not perceive as the best, but as “good enough” to get the job done. Their preferred provider may also appear more advantageous in other ways, e.g., more convenient, cost-effective, familiar, etc. If their referring physician recommends the hospital, all the better and more confident patients often feel about their choice. The result is that medical pioneers in these now commoditized services can find themselves competing with community hospitals for the same patients and procedures.

The Melior Group believes that, given these new realities, all provider institutions — regardless of whether they are large multi-specialty healthcare systems, specialty hospitals, or small community hospitals — need to ask themselves the following questions in the lead-up to marketing planning:

  • Do I understand enough about my patients’ decision-making for healthcare services, overall and for individual service lines? Do I understand how priorities, impressions of providers, and information gathering about healthcare services have changed — or not — over the past few years?
  • For these high volume service lines and commoditized services, has my hospital identified the patients that we want to attract? Have we made the case, operationally and in terms of our marketing messages, for why we are the best option for those target markets?
  • Is my institution getting its fair share of patient referrals from the medical community, whose opinions can drive patients to or away from my hospital? Have we made the case, in terms of quality of care, ease of referrals, etc., – for sending referrals our way?

In light of the tightening competition for what are now readily available, standardized procedures, it is incumbent upon healthcare providers to gain a deeper understanding of their patients’ decision-making process.

A Startup Weekend Experience: Teamwork & Innovation

Much of our research at Melior has shown that healthcare and technology are the leading industry sectors of the future. To speak on this topic, we’ve invited our first guest blogger to The Minds @ Melior, Deborah Wyse. Deborah is a project management professional with public policy and technology expertise.  An enthusiastic networker and eternal student, she enjoys connecting and learning in Philadelphia’s dynamic tech community.


What happens when 6 strangers work together for 54 hours to transform an idea for a health IT product into a business plan and demo? To find out, I participated in UP Global’s Philadelphia Startup Weekend Health 3.0, hosted by Venturef0rth, a co-working space for startups.

Several factors motivated me. I wanted to meet new people, learn more about the health technology sector and gain a better understanding of entrepreneurship. I finished the weekend with all that and more.

Organized by UP Global, Startup Weekends use entrepreneurship to inspire, educate, and empower. At the end of the weekend, a panel of judges evaluates the presentations. The winners receive a package of services and expertise designed to help launch their business. Philadelphia Health weekend’s grand prize was a fast track application for the health IT accelerator:  DreamIt Health Philadelphia; and a year’s subscription to Netrepid’s virtual private server hosting services.

The Process

At Startup Weekend, all attendees are welcome to pitch their startup idea in 2 minutes or less. You are the message – no props allowed.  However, no one is required to pitch an idea. At this year’s Philadelphia Health Startup, about half of the participants came with an idea for a health technology business.  The rest, myself included, were interested in learning by doing.

We listened to about 30 pitches and then voted to select the 12 top ideas for the weekend’s work. Team recruitment came next. Having sold their idea to the group, the 12 successful entrepreneurs worked the room to put together a team. The Philadelphia Health weekend attracted many people with business and health care expertise.  Developers and designers were in short supply and not every team was able to recruit this essential expertise.

The teams formed and went to work right away. Friday night, Saturday and Sunday, they created business models, designed web sites, coded prototypes, researched the competition and validated market demand. Established entrepreneurs in health care technology volunteered as coaches. They asked tough questions that often resulted in a project pivot.

At the end of the weekend, each team gave a 5 minute presentation to a panel of local entrepreneurial leaders – another opportunity for critical feedback.

The Outcome

I experienced the weekend as a member of the HouseKeeping team.  Our business plan was to create technology to support fast, easy, low-cost patient tracking. After 54 hours together, the HouseKeeping team agreed that we had created a winner.  Here’s what contributed to our success:

  • Breadth and depth of subject matter expertise:  healthcare provision, business, industrial and software design, and information technology.
  • A leader who accelerated team formation by being receptive to and aware of different personalities and work styles.
  • Diversity. Composed of three women and three men, HouseKeeping included undergraduate, graduate and post-graduate students and mid-career professionals.
  • Committed and adaptive team members.
  • Positive interactions with the coaches.


Our final presentation was dynamic, within time and included a demonstration video – with team members in the roles of patient and hospital staff – of the business concept.  To me, the applause sounded especially enthusiastic.  But when the results were announced, HouseKeeping did not come in first, second or third; two other projects shared an honorable mention.

After 54 hours together, the HouseKeeping team, 6 former strangers, agreed that HouseKeeping was a winner and that we had shared an amazing experience.  HouseKeeping’s creator has taken the concept to San Francisco and is working hard to grow the business.

Whether or not you consider yourself an entrepreneur, I highly recommend the Startup Weekend experience.  Bring an open mind, enthusiasm and a desire to learn.  You too can come away with a win!

Resources and Additional Information

HouseKeeping –

Start Up Weekend –

Lean Start Up Weekend –

Philadelphia Health IT Circle –


The Healthcare X Factor: Easing Anxiety over Provider Choice & ACA

healthcare decisions and provider choice

By Elizabeth Cohen

In our marketing research for healthcare providers, I continue to be stymied by the same contradiction:  Why is there such a disconnect between healthcare preferences (e.g., which hospital would you prefer for a certain service line if needed), and actual healthcare usage (which hospital did you use when you or a loved one needed care)?

In our work for healthcare providers, we spend a lot of time trying to determine how consumers make decisions about their care for specialty healthcare services, so that our clients can plan marketing strategy and messaging appropriately.  We ask questions such as, “if you needed a referral for healthcare services, how important are the following characteristics in your selection of a provider?”  Additionally, we explore the kinds of information and resources that consumers say they would turn to when making healthcare decisions.

We get a lot of sensible information from these lines of inquiry, both in qualitative and quantitative forums.  Most consumers say that if they needed additional care for a specific condition they would conduct research using the internet, consulting sites such as or; and/or they’d ask their friends.  In  sum, they’d really take a considered approach to determine where to go.  They say that their doctor’s recommendation would be only one factor among many to consider.

However, when we change the question to “take me through your decision-making process the last time you needed specialty services,” the answers change dramatically.  Despite the ready availability of information online and from friends, the majority of consumers immediately say that they went where their doctor told them to go…even if they actually believed that someplace else provided better care for that need. 

What’s going on?  Why are intentions around healthcare decision-making so different from actual behavior?  I believe that part of the answer lies in behavioral science.

Healthcare, by its very nature, is a negative purchase.  Though it might help us to get and feel better, we wouldn’t need it if our health was fine in the first place.  (Contrast that, for example, with the purchase of a candy bar or a vacation, which are all about enhancing pleasure – icing on the cake.)

So…how do we feel in a doctor’s office?  Anxious.  We’re there because something is, or might be, wrong with us or a loved one.  A close doctor friend of mine always talks about “white coat syndrome,” which causes some patients to experience elevated respirations, blood pressure or heart rate simply because they are in a doctor’s office.

I believe that it is this very anxiety that can, to a certain extent, explain the contradiction between what consumers say they will do and what they actually do when faced with the need for specialty healthcare.  As demonstrated in a series of experiments by Francesca Gino of Harvard University, and Alison Wood Brooks and Maurice E. Schweitzer of the University of Pennsylvania, “…by eroding self-confidence, anxiety motivates individuals to reduce uncertainty and both to seek and to rely on advice from others” (click here for the full PDF article).  In other words, when a doctor gives a referral, most patients and families are not in the best frame of mind to be able to say, “thanks for your opinion, but I need to go home and do my research to determine where is the best place to go.”

What does this mean for our healthcare clients?  First and foremost, it necessitates acknowledgement that the consumer behavior model for healthcare is quite different from “positive” purchases.  And, with the shaky launch of the Affordable Healthcare Act – complete with political drama and technological disappointments – consumers have even more reasons to feel anxious today than in the past.

For those larger healthcare systems with the full range of service lines, this anxiety and resultant willingness to rely on a doctor’s advice may, in fact, have positive implications for keeping consumers within the system.  However, for smaller community or specialty hospitals with weak (or nonexistent) ties to a healthcare system, the marketing priority remains referring physicians, whose recommendations to anxious patients and families will often be greeted with acceptance.

Please join the discussion in the comments section below!  Acknowledging that healthcare is often a negative purchase that can be fraught with anxiety, what does this mean for consumer marketing of healthcare services?

Health Plans Preparing for “Visible” Customers

health plans insurance form

By Elisa Foster

The landscape of health care will see drastic changes in the coming months.  As commercial health plans start selling to consumers directly through exchanges under the Affordable Care Act, consumers will have a lot to learn as they navigate through the maze new health care policies.  As a result, insurers are ramping up advertising and popping up at brick and mortar locations to enroll and educate consumers.

Medicare and Medicaid plans have been selling direct to consumers for years – how can commercial health plans benefit from the lessons learned in Medicare/Medicaid health plan marketing?  And how can they ensure that consumers will make informed decisions?