Hospitals and health systems are taking a leading role in population health, by packaging healthcare solutions — from employee wellness services to full-service health plan management — and selling them to companies and businesses in their market area. This article details four healthcare systems – all succeeding with different employer programs.

1. Harkins Associates
Healthcare Selling
A D D R E S S I N G T H E N E E D S O F M A N A G E M E N T A N D I N D I V I D U A L S S E L L I N G I N T H E H E A LT H C A R E A R E N A
THE NEWSLETTER FOR EXECUTIVES,
MANAGERS AND SALES PROFESSIONALS WHO
WANT TO REALIZE THE TRUE VALUE OF A SALES
DISCIPLINE IN RETAINING AND GROWING THEIR
HEALTHCARE SERVICES.
In This Issue
Cutting out the Middle-Man:
Opportunities for Hospitals to
Partner Directly With Employers . . . . . . . . 01
Manager’s Corner
Is your organization’s physician
liaison team centralized? . . . . . . . . . . . . . .02
Companies in almost every sector of business offer Then and now What do hospital-to-employer
some kind of healthcare services to their employees. Decades ago many of the nation’s businesses hired services look like?
They can access employer health services via many so-called “corporate” doctors, nurses and PAs. They Many hospitals offer some form of wellness service to
outlets, including private “wellness” companies, their held regular office hours to serve employees, handling employer groups. The range of options is limited only
managed care plan and even via large consulting firms everything from pre-employment physicals to yearly by the hospital’s areas of clinical expertise, the needs
offering “employer healthcare solutions.” checkups, drug testing and workplace injury triage. of the community or employer group, the resources
Even today, some companies like software giant SAS available for each service and the business expertise
However, with local hospitals and health systems
Institute in North Carolina offer staff — and even their to plan, launch and sell the programs to employers.
increasingly networked with outpatient treatment
families — on-site healthcare. Also today on the In other words, it is not as easy as it may look.
facilities and multispecialty providers, who better than
provider side, health systems are partnering with local
they to provide the greatest array of employer services? Start with what you know
businesses to become direct providers of a range of
Today, many hospitals and health systems are taking a At its simplest, a hospital can model a hospital-to-
similar services.
leading role in this arena, by packaging solutions — employer service after its existing community wellness
from employee wellness services to full-service health For the employer, programs like these hold the programs, for example. You could offer employers a
plan management — and selling them to companies potential to lower their overall healthcare costs, health fair for their staff or classes about prevention of
in their area. lessen employee absenteeism, enhance common ailments or high-cost injuries, for example.
productivity and build employee morale. For the
There is a wide range of options a hospital or health “That’s how we usually get our foot in the door,” says
hospital, these programs can generate revenue
system has for providing business-to-business Stuart May, director of CorpCare Occupational Health
on many fronts, including serving as feeders
(hospital-to-employer) services. In this article, we Services, the corporate health arm of Eastern
into their (vs. a competitor’s) health system
explore several successful service models, what to Connecticut Health Network, a two-hospital health
services, and creating the potential for significant
consider in establishing a program and what it takes to system based in Manchester, Conn.
downstream revenue.
create lasting success. For forward-looking healthcare
(continued on page 2)
providers, there are options worth exploring.
Healthcare Selling is for those who work with hospitals and health systems, freestanding diagnostic and treatment facilities, homecare services Harkins Associates
and senior living facilities. The Newsletter focuses on a variety of selling environments, such as the physician and the employer markets, and will www.harkinsassociates.com
address challenges facing management, and the beginner, intermediate and advanced sales or liaison staff.
info@harkinsassociates.com
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Healthcare Selling | Copyright 2010 Harkins Associates | All rights reserved.
1

2. Healthcare Selling
(Cutting out the Middle-Man: Opportunities for Hospitals to
Partner Directly With Employers continued from page 1) Case Study: Missouri’s Cox HealthPlans
A step beyond that might be an umbrella of employer
services, such as new-employee screenings, workplace
A big (ad)venture Getting off to a great start
injury care, employee assistance programs, employee
physicals and prevention and early detection programs. When it comes to selling health services to As with any venture where a hospital is providing
Like other health systems we discuss here, CorpCare employers, none is more unique nor perhaps, services to businesses, success comes with commitment
more challenging than the health system selling a and careful planning. Mr. Bond says the plan has enjoyed
offers those services, and more.
health plan. Though it’s a complex service to create unwavering support and commitment from the system’s
Success with niche services and to sell, Cox HealthPlans, part of CoxHealth in senior management, through good times and struggles,
Morristown, N.J., Atlantic Health System, is an Springfield, Mo., has been succeeding for well However, CoxHealth placed a substantial administrative
example of a health system that takes advantage of its over a decade. “firewall” between itself and the health plan, which has
metropolitan location. With 1,308 beds in the system, Jeff Bond, president and CEO of Cox HealthPlans, allowed the health plan to contract with hospitals and
says that a key to success has been the commitment other providers outside of CoxHealth. Additionally, to
its Corporate Health Department coordinates health and minimize expenses, the plan calls on consultants with
of the parent organization. “They committed
wellness services for several hundred clients and a total specific areas of expertise, rather than hire full-time staff
research, resources and a long range plan,” he says.
of approximately 50,000 employees. “We’re now in our sixteenth year in business.” (for example, for actuarial review and legal counsel).
In addition, Atlantic Health System offers employers an Cox HealthPlans provides companies in the region Another key to the plan’s success, according to Mr. Bond,
Executive Health Program, a flat-fee medical evaluation its expertise as a full-service medical insurance is the fact that the health system and the health plan
carrier, providing medical management, claims work as partners, not in the adversarial way that many
for corporations’ top executives. This assures companies
processing, underwriting, member services and a providers and insurance companies operate. The plan
that their highest paid employees are going to stay and the hospital share key statistics about quality and
provider network. With approximately 45,000 lives
healthy and productive. under contract in both fully insured and self-insured costs, giving each an opportunity to improve patient care
“Atlantic’s Executive Health Program is what we refer agreements, Cox HealthPlans offers employers of and to cut costs.
to as a ‘smart physical,’” says Damion Martins, MD, the every size a competitive line of products — HMO/ Looking ahead
POS and several options for PPO — to meet every Because Cox HealthPlans is not a publicly held company
system’s medical director for the program and Atlantic’s
employer need. with extensive overhead and shareholders to please,
sports health services, as well as director of internal
As part of CoxHealth’s on-going commitment and they are able to hold the administration expenses to
medicine for the NY Jets. “Our unique program includes
planning to this endeavor, the leadership team met employers to a rate substantially below the larger
conducting genetic testing, lab work and health history recently with Dr. Glenn Steele, president and CEO of carriers in their market. Looking ahead, Mr. Bond says
profile in advance of the patient visit. Every test and Geisinger Health System in Danville, Pa., which has the plans should readily meet medical loss ratio
assessment we do is tailored to the individual’s unique several health plan products. “In a meeting just last requirements set by the healthcare reform law.
physical blue print and current health status. Each exam year, he told us that the most important thing we For CoxHealth, the strategic decision to stay in the health
we conduct and each subspecialist seen is for a specific did was not to sell our health plan,” says Mr. Bond. plan business should pay off more than ever in the years
finding that emerged from our analysis of the client’s “The result is that today, Cox HealthPlans, like ahead. The same factors that have helped the plan thrive
pre-evaluation, a good deal of which we get from the Geisinger’s successful plan, is better positioned to 15 years in the rocky healthcare industry will surely help
navigate and benefit from current changes in the them navigate the current and coming changes the
client’s genetic test results.”
healthcare industry. industry is experiencing.
This approach allows the executive to complete the
comprehensive exam in one-day, without the hassle of CoxHealth is a three-hospital organization with more than 60 physician clinics
booking and waiting for appointments, waiting for test in the Springfield, Mo. region. http://bit.ly/nv67Ue}
results or return visits to specialists to discuss findings.
Success for smaller markets
One assumption in the industry regarding corporate worksite and also provides onsite wellness clinicians/ full-time onsite health clinics for employees and their
health is that larger hospitals/health systems in health coaches to share the confidential results with the family members.
metropolitan areas will be more successful when selling participants as well as summary reports (aggregated) to
According to Krista Thomas, wellness consultant for
services like these to employers in their area. But we the employer showing changes and improvements.
GFGH, “the outcomes were so positive after a few years
see smaller hospitals succeeding in this arena, too. A unique offering from Goshen is how they work with that employers approached me to see if there was more
For example, Indiana University Health Goshen in current employers under contract to take the next step we could do to further the health of their employees.
Goshen, Indiana, with about 125 beds, offers area in providing employees the most convenient access to The on-site clinic has turned out to be just the right
employers its “Get Fit, Get Healthy” employee wellness care. After several years of impressive health-related service, and we have many other progressive employer
program. It includes health risk appraisals such as behavior changes, along with improved health results, solutions coming in the future.”
standard blood tests and screenings at the employer employers now contract with Goshen to provide them (continued page 4)
Harkins Associates | office 845.295.9076 | fax 845.295.7077 | www.harkinsassociates.com | kharkins@harkinsassociates.com
Healthcare Selling | Copyright 2010 Harkins Associates | All rights reserved.
2

3. Healthcare Selling
Case Study: Connecticut’s You’ve seen it somewhere, either in your own
MANAGER’S
CorpCare Occupational Health organization or elsewhere: a service line hires the first
physician liaison, or physician sales representative, to
increase market share. Over time, the number of
From annual worker physicals to customized liaisons grows in a somewhat organic way either via a
injury prevention programs physician relations department or other service lines.
CORNER
Is your
A hospital in Connecticut rolled out an occupational health Sometimes, leadership creates a hospital-wide team
service for area employers in the late 1980s. Today, the to support system-wide sales. And, some hospitals
services are still part of a growing hospital system and have both independent and centralized liaisons. organization’s
provide care to a client base of 35,000 workers in about
200 businesses and organizations.
Here are some facts and observations to consider
when evaluating the effectiveness of your
physician
“Our business philosophy is to manage the entire organization’s physician liaisons. liaison team
continuum of corporate health care for our clients’
employees,” says Stuart May, director of the service,
De-centralized, independent liaisons for
service lines: When a service line or department
centralized?
called CorpCare (pronounced Corp Care) Occupational
Health. “We offer many [occupational health] services in our
hires a dedicated physician liaison, it’s usually If not, could it be?
freestanding facility. But any services that we don’t offer
(perhaps even solely) because those services are
here, we send to one of the hospitals in our health system.” high-revenue producing. By reporting to the service
line manager, these liaisons often have great freedom
CorpCare’s clients range from manufacturing facilities to
to create marketing and sales processes unique to
municipalities. Workers run the gamut, from those on
the specific needs and goals of the service. The
factory floors, in firefighting units and in executive offices.
department as a whole is often able to budget with For example, when lab, imaging and surgical care are
Building on a relationship a little more freedom based on the secure revenue integral to a patient’s comprehensive care, and the
CorpCare traditionally begins working with a company by stream supported, in part, by the liaison. However, health system has three distinct liaisons for each of
performing their employee physicals, hearing or eye tests by working independently, they might be missing out these services, providing up-to-date information on
and DOT random drug screens, Stuart says. Workplace on synergies of working with a broader focus. new capabilities and expertise can be difficult.
injury care, rehabilitation and return-to-work readiness
evaluations often follow. If a hospital leadership creates a system-wide Is a centralized model better?
physician liaison department, often times In our experience, even dotted line reporting is better
Taking advantage of the resources of the hospitals in the
the service line-specific liaisons remain, and than this disjointed model. A more coordinated model
system, CorpCare clients who have an employee with a
continue functioning independently . When this brings benefits for each service line, physicians and
second- or third-shift injury go to the health system’s
urgent and emergency care facilities.
occurs, the system and sometimes even patients the healthcare system. Bringing physician liaison
experience several potential inefficiencies. Either: efforts together, either in a loosely coordinated or
The business model ensures that CorpCare can connect
workers with a full range of healthcare within the health - Centralized liaisons focus mainly on lesser known or officially centralized way creates the opportunity to
system. There’s potential to care for those workers’ family lesser-utilized services—those with a smaller or broaden the focus of each physician liaison. It also
members, as well. even negative revenue stream. Related, funds are makes it possible for each to present an umbrella of
“We want to be a partner with our clients in the business spread across a number of services. services to a specific physician.
community,” Mr. Stuart says. “So we also approach them or If you do decide that a centralized department is
with injury trends that we’re seeing and then offer best for your health system’s goals, reorganizing or
- The work of centralized liaisons overlaps the
pro-active, preventive training to their employees.” reconstructing a current system can’t happen
efforts of service-line-specific liaisons, resulting in
Adding value disjointed, uncoordinated outreach and sales efforts. overnight. Liaisons will resist as will the service
Mr. Stuart reports that their clients appreciate the fact that For example, physicians receive visits from two lines. If you are charged with this unifying effort,
CorpCare coordinates all steps of employees’ care and billing different representatives from the organization, it is important that you understand the value the
for them. “Many also like the fact that we can track the total both of whom at times will discuss the same service line managers are experiencing from “their
cost of managing a specific patient, all employees or a services. With each liaison’s more narrow focus and own” liaison and their concerns about losing a
subset of injuries, too.” responsibilities, the system also misses revenue dedicated resource.
To broaden its reach, CorpCare has also joined a network opportunities, such as the potential to cross-sell You will have to be sure the program receives the
of other hospitals that offer occupational health services. related services like diagnostic services and same level of support and better than it did with
This increases the number of locations for care, which is a homecare. And, this model causes cost-inefficiencies a dedicated liaison. If the re-structuring is planned
benefit that larger employers and those with multiple such as duplicate staffing and marketing materials. and managed effectively, each individual service
locations value. line should see better results. A key is to make the
Further, as we all know, it’s challenging enough to
CorpCare is a wholly owned subsidiary of Eastern Connecticut interface with people within our own specialty areas. transition slowly and demonstrate to the liaisons
Health System, Manchester, Conn., and employs just fewer the value they’ll experience both professionally
But this model makes it even more difficult to connect
than 20 staff members, including a physician, nurses and and personally.
with all the other key departments across a system.
other mid-level practitioners. http://bit.ly/pZr1sw
Harkins Associates | office 845.295.9076 | fax 845.295.7077 | www.harkinsassociates.com | kharkins@harkinsassociates.com
Healthcare Selling | Copyright 2010 Harkins Associates | All rights reserved.
3

4. (Cutting out the Middle-Man: Opportunities for Hospitals to Partner Directly With Employers continued from page 2)
Full service, mature market
Perhaps the most unique of all offerings that a provider can sell to area employers are the services of a health management entity, or health insurance plan. An example of this
is a subsidiary of four-hospital, 786-bed CoxHealth in Springfield, Mo. Cox HealthPlans offers employers of every size fully insured products — HMO/POS and several options
for PPO — and complete administrative services for the self-insured.
“It’s important to realize that having your own health plan is not a guaranteed money maker,” says Jeff Bond, CEO of a health plan developed by CoxHealth. “
But if it’s done right, everybody wins — patients, businesses, hospitals and the health plan.”
Potential and pitfalls of hospital-to-employer sales
As the examples above illustrate some hospitals sell health services to employers as a way to create a new revenue stream. Others use them as “feeders” into other hospital
services. As such, the key to success in these ventures is to consider and clearly define early on what you want your hospital to be for area employers. Do you see a specific
area of need where your hospital is uniquely qualified to increase screening access for employees at-risk, or perhaps, reduce specific disease incidence that can lead to reduction
in healthcare premiums? You may see the employer business objective set purely to drive downstream revenue to the hospitals in your system where occupancy rates have
fallen below a certain level.
Words to the wise
Once the hospital is clear on purpose and establishes program objectives, be sure the objectives — whether in the form of revenue, units of sale or costs — are truly
achievable by the team assigned to meet those objectives. The greatest risk we see is when inexperience in sales forecasting drives expectations far beyond what is achievable.
Conversely, if expectations are too low, your program may sputter along without ever truly launching.
Equally debilitating is a sales staff that does not get clear sales goals because the responsible hospital manager wasn’t clear about setting projections for hospital-to-employer
services. In addition, there can be a risk to your professional reputation and to whatever investment in capital and staff that the hospital has put into the endeavor.
There have been cases where the hospital-to-business programs did not get the resources required to build the infrastructure for an employee wellness program because the
attitude was, “if business development sells it, then we’ll put in personnel to fulfill the agreement.”When that “sell” day came, the hospital staff scrambled to assign the
personnel and to provide staff necessary training in the provision of wellness services. Needless to say, the program didn’t have the required lift to get it off the ground.
In Part II, we will explore the business development / sales models required to create success in selling to employer groups.
And we will provide two more case studies of different services: Atlantic Health System’s Executive Health Program and Goshen Health System’s “Get Fit, Get Healthy.”
Our consultants and trainers have a combined experience of 60 plus years in sales strategy, sales training and
management. We initiated one of the first Physician Liaison (sales) programs in the country in 1986. Our experience
in several industries—capital equipment, manufacturing, health insurance/managed care, information technology,
Harkins Associates and pharmaceutical—is a powerful asset to our focus in healthcare services. Over the course of our careers, we
have dedicated ourselves to bringing the successful sales strategies and methodologies of top-performing sales
organizations to healthcare services. Our intention is to help healthcare organizations gain the knowledge,
strategies and experience of these top performers. Over the years, we have developed beginner, intermediate and
advanced level sales programs, as well as sales management programs.
Kathleen Harkins
Kathleen Harkins, principal of Harkins Associates, has over 20 years experience in healthcare sales, strategy and
management. She has worked with hospitals, outpatient treatment facilities, managed care, homecare, capital
equipment, medical products and pharmaceutical companies. Prior to forming Harkins Associates in 1997,
Ms. Harkins served as Chief Marketing Officer for Internet Healthcare System, overseeing sales and marketing
for a managed inpatient and outpatient provider system. As Vice President of Sales and Marketing for Westmeade
HealthCare, Ms. Harkins was responsible for the sales organization, new service launch and market strategy. From
1983 to 1988, Ms. Harkins served as Director of Marketing for MEDIQ Consulting Group and as Director of Corporate
Brand Identity for the parent, MEDIQ Incorporated, which held 15 subsidiary companies serving the healthcare
industry. Ms. Harkins worked in the pharmaceutical industry for a number of years in sales, and sales training.
Ms. Harkins has a BA degree in health education from Rowan University in Glassboro, New Jersey.
For more information, please visit our website at: http://www.harkinsassociates.com
Harkins Associates | office 845.295.9076 | fax 845.295.7077 | www.harkinsassociates.com | kharkins@harkinsassociates.com
Healthcare Selling | Copyright 2010 Harkins Associates | All rights reserved.