Maria K Todd, CEO at Mercury Healthcare Advisory Group looks at the influences on the medical tourism product and service offering, and how a healthcare organization can build and manage its product mix and its product lines.
The article considers how to differentiate medical tourism products and services and suggests tools for distinguishing medical tourism product offerings from competitor offerings.
As you begin development of your medical tourism and hospital's general marketing plan, you need to design an offering that meets your target customers’ needs or wants. Customers will judge your offering by looking at four basic elements:
the included features of the package price
the quality of your service as the patient perceives it
the services mix that you offer
and the price you charge.
Marketing medical tourism and other health care services is somewhat different than offering retail products that are often considered tangible goods. In the most general sense, a product is anything that can be offered to the market to satisfy a patient's need or want. As such, this can include physical goods, such as walkers, wheelchairs, canes, crutches, braces, stem cells, organ transplants, pharmaceutical drugs and supplies. It can also include services, such as a surgery, executive check-up, golf swing analysis, diagnostic test, or even a consultation.
For a medical tourism facilitator, a product could be defined as a wellness check up combined with a cruise, winery tour, amusement park, a cooking class, or any other combination experience that can be paired with a medical service such as a massage or spa visit. It could also be interpreted to mean something like a hen night mammography group experience, where a group of women get together, have their mammograms, and then go out for a spa getaway, a night on the town a weekend away or some other experience that they share together. In medical tourism, many times we see this type of activity when a group of executive women get together and decide to go off to an exotic place to have a Botox® weekend.
Your medical tourism product
In order to appeal to customers whether they are consumers, health insurance plans, employers, or some other type of end user, your hospital or medical group needs to address five different product levels.
The most basic level is the core benefit that the customer is really seeking. For example, a patient with knee pain visiting the hospital or physician simply wants to get rid of the pain and also to make sure that whatever intervention they elect is going to mitigate further pain, debilitation, and perhaps joint degradation. The core benefit sought is pain relief. As the hospital market its services, it needs to see itself as a benefit provider.
Working from the bottom up, the second level is where the provider must convert the core benefit into a basic product. For example, the core benefit of pain relief is translated into the basic product of a therapeutic or analgesic injection, or surgery.
The next level up is where the facility or medical group develops unexpected product, such as a set of attributes or conditions that buyers normally expect when they purchase your product. As a U.S. patient, no matter what country I'm admitted to hospital, it's not unreasonable that I would expect that if the hospital planned for my arrival and my admission, that when I turn on the television I should expect to find English-language programming. After all, what else am I supposed to do while I'm sitting in a hospital bed? I should also expect a clean fresh hospital gown or pyjamas daily, I should expect to be fed nutritious food that tastes good, and if there are no dietary restrictions to the contrary, I should expect to be able to have a cup of coffee whenever I want to, and I should expect the nurse to be able to communicate with me in English.
If medical tourism program developers think through the entire episode of care, in order to sell their expected product and anticipate a high level of patient satisfaction, and if the hospital is expecting significant volume from patients from the United States, they should ensure that the hospital staff on the floor where the patients are treated have adequate English language fluency, signage, and other amenities to meet and or exceed those expectations. In order to do this, the hospital might commission some research to be carried out, to find out exactly what those expectations might be, before marketing the product to the purchasers and referring facilitators.
Continuing along this chain, the facility might also offer an augmented product, one that exceeds customer expectations with perhaps additional amenities such as a VIP suite, an extended menu from the dietary department, concierge service level, and other amenities available at an upgraded price. For hospital in developed nations, these amenities are often included in the basic service level at which the hospital competes. In other nations the competition occurs mainly at the expected product level.
Product differentiation in medical tourism
In medical tourism, product differentiation takes place mainly at the level of product augmentation and leads facilities to look at the patient's total consumption system - the way that the patient performs tasks of getting and using products and related services. This means that the hospital needs to research who is buying their medical tourism services, by what means they are locating the provider, and by what benchmarks they evaluate the providers perceived quality, value, and price. The research alone adds cost to the augmentation level, as does each of the amenities. If the amenity is not communicated clearly to the purchaser, it may not be considered in the value proposition. Hospitals outside of the United States that are not used to presenting marketing and promotional copy in their hospital brochures and other marketing materials without appropriate idiomatic translation for an American, British, or other reader, may clearly include all of the amenities but fail to bring them to the top of the mind. This could lead to the provider being passed over in favor of a facility or medical provider of lesser technical quality that simply does a better job of telling the story of their benefits.
Another concern that facilities and physicians need to be mindful of, is that as these amenities soon become expected and necessary competitive points-of-parity, providers will have to continue to add to those amenities in order to remain competitive. Since adding amenities adds to the cost structure, at what point do the amenities become excessive? Further, how much value will the patient place on certain amenities over other amenities? And what happens to the provider who selects the wrong amenities to offer, or places the wrong emphasis on an amenity that the patient neither expects nor values? What happens if the purchaser fails to learn about the values which align with the core benefit sought but didn't notice due to space, promotional copy and message limitations or idiomatic translation errors? Finally medical tourism providers need to be mindful of the fact that as they raise their price for the amenity-based package, their competitor will likely offer a stripped-down version of the core service at a lower price to attract the price conscious purchaser.
The highest level of the product, the potential product, encompasses all of the possible augmentations and transformations of the product or offering that it might undergo in the future. For example, at the basic level, a provider may offer an executive physical that is appealing to accounting, architectural, law firms and other high net worth individuals. The potential product might also include a spa relaxation massage, and for those executives who make real business deals on the golf course, a golf swing analysis designed to identify swing anomalies caused by pain, muscle contracture, weakness, or some other reason such as vision anomalies, inability to concentrate, or poor training and lack of practice. At this level, the provider seeks a different way to distinguish their offering to medical traveler.
The medical tourism product mix and product line management
A medical tourism hospital in Korea might offer a cancer service line consisting of diagnostic imaging and lab services, chemotherapy, radiation therapy, patient and family counselling, and a variety of therapeutic interventions that might include organ transplant, excisional resection, or grafting procedures. The product mix that that hospital offers to patients might include a variety of service lines and other independent standalone services.
In healthcare administration we learn that hospitals use product line management to offer a comprehensive range of clinical services. These providers set their priorities to feature specific clinical specialties. As I tour most medical tourism hospitals, it seems they always include the "big three": Cancer care, orthopedics, cardiac services and often a fourth, bariatrics. Many times these are labelled as the hospitals' "Centers of Excellence". In the United States the term center of excellence has specific meaning, determined by quality outcomes, and adherence to other evidence-based medicine guidelines. In other nations, the term "center of excellence" is more loosely defined by the user who simply states it is so.
In health administration master's programs, students are taught that a hospital's product mix has width, length, depth, and consistency. The width of a product mix refers to how many different product lines the hospital or clinic carries. For example, a large teaching hospital is going to have a stated product mix with many service lines such as cancer, children services, cardiac, emergency services, orthopedics, and diagnostic imaging services. By comparison, an ambulatory surgery center may only include outpatient surgery, and pain management services. The width of the outpatient surgery offering may be further restricted if the ambulatory surgery center is not licensed to accommodate overnight patients.
The length of the product mix refers to the total number of items in the mix. Health services product mix length assessments are complex as there can be many hundreds of items with many overlaps per item. For example, the children's' services product line may be drawn from a mixture of all of the services offered by the Department of Pediatrics, its clinical programs if it is a teaching hospital, surgical services, neonatal intensive care services, primary pediatric care, and satellite specialty clinics within the community or extended as outreach in other nearby communities.
The depth of a product mix refers to how many variants of each product in the line are offered for example cancer care could be subdivided into three layers of depth if the cancer care can be distinctly managed for adults children and perhaps da Vinci minimally invasive robotic prostate surgery for men.
Last, the consistency of the product mix refers to how closely related the variety of services are in such features as how the patient uses them, how the service line is developed, or how it might be sold or promoted to medical tourism patients.
The way in which a medical tourism hospital organizes its product mix allows the hospital or ambulatory surgery center to expand its medical tourism business in four different ways: first, it can add new product lines and widen the product mix. Second they can extend the length of each product line to include many items that overlap in their service offerings. Third they can add more varieties to each product or pursue more consistency, such as adding additional services that are easy for medical tourism facilitators to sell.
Maria K Todd is CEO at Mercury Healthcare Advisory Group and she serves as the President of the Council on the Global Integration of Healthcare, a nonprofit association that supports program development and education in international health and medical tourism. She is a consultant, speaker, and author of 10 books, and over 28 years of healthcare administration including integrated health delivery systems development, health plan provider contracting, healthcare organization life safety and disaster recovery planning, and managed care and global healthcare program development in several countries.