The idea of strategy- a plan designed to achieve a goal – originated in the military. Strategy is often confused with tactics, which are specific actions taken to achieve a goal. Strategy is also often confused with objectives. Objectives are long-term performance and outcome goals. Strategy is more comprehensive than tactics and objectives; it is an over- arching plan. Strategic planning can and should occur in an organization at many levels. For example, marketing strategy is an overarching plan that enables an organization to concentrate its limited resources on its greatest opportunities to increase sales, attain its goals, and sustain a competitive advantage (Baker 2008, 3). It is informed by careful analysis of the organization’s internal and external environments by the organization’s marketing research process. Finally, strategies at all organizational levels must align with and support the organization’s mission, vision, and values. This chapter begins with a discussion of mission, vision, and values in healthcare organizations and concludes with an explanation of the important role that healthcare marketing plays in achieving an organization’s mission and vision and living its values. Mission and Vision An organization’s mission statement is essential to its ongoing success (Bart and Tabone 1998). At the least, an organization’s mission statement should help to distinguish it from other organizations (Griffith 1988). At its best, a mission statement is the embodiment and self-image of an organization. The mission expresses the highest goals of an organization and provides strategic direction (Wiggins, Hatzenbuehler, and Peterson 2008). An organization without a clear, achievable mission is like a traveler without a road map. You seem to be making good time, but you don’t really know where you are going to end up. In today’s increasingly competitive healthcare industry, it is imperative that mission-driven healthcare organizations—whether hospitals, physician practices, long-term care facilities, durable medical equipment distributors, or pharmaceutical companies—be able to achieve and maintain a clear, identifiable reputation; name recognition; and competitive advantage. What, if anything, distinguishes one hospital from all other hospitals, one pharmaceutical firm from another, or one group of physicians from any other group of physicians? For many decades, this need to set one’s organization apart from all other organizations of a similar nature was greatly hampered by the healthcare industry’s misunderstanding of—and disdain for—marketing. Indeed, a 2005 study of hospital mission statements found that nearly all contained similar language and claims regarding their commitment to the provision of high-quality care (Bolon 2005). In a 2008 study, researchers searched a random sample of hospital mission statements for key words associated with interest in and commitment to education and found that the missions of 21 of the 81 (26 .

1. The idea of strategy- a plan designed to achieve a goal –
originated in the military. Strategy is often confused with
tactics, which are specific actions taken to achieve a goal.
Strategy is also often confused with objectives. Objectives are
long-term performance and outcome goals. Strategy is more
comprehensive than tactics and objectives; it is an over- arching
plan. Strategic planning can and should occur in an organization
at many levels. For example, marketing strategy is an
overarching plan that enables an organization to concentrate its
limited resources on its greatest opportunities to increase sales,
attain its goals, and sustain a competitive advantage (Baker
2008, 3). It is informed by careful analysis of the organization’s
internal and external environments by the organization’s
marketing research process. Finally, strategies at all
organizational levels must align with and support the
organization’s mission, vision, and values. This chapter begins
with a discussion of mission, vision, and values in healthcare
organizations and concludes with an explanation of the
important role that healthcare marketing plays in achieving an
organization’s mission and vision and living its values.
Mission and Vision
An organization’s mission statement is essential to its ongoing
success (Bart and Tabone 1998). At the least, an organization’s
mission statement should help to distinguish it from other
organizations (Griffith 1988). At its best, a mission statement is
the embodiment and self-image of an organization. The mission
expresses the highest goals of an organization and provides
strategic direction (Wiggins, Hatzenbuehler, and Peterson
2008). An organization without a clear, achievable mission is
like a traveler without a road map. You seem to be making good
time, but you don’t really know where you are going to end up.

2. In today’s increasingly competitive healthcare industry, it is
imperative that mission-driven healthcare organizations—
whether hospitals, physician practices, long-term care facilities,
durable medical equipment distributors, or pharmaceutical
companies—be able to achieve and maintain a clear, identifiable
reputation; name recognition; and competitive advantage. What,
if anything, distinguishes one hospital from all other hospitals,
one pharmaceutical firm from another, or one group of
physicians from any other group of physicians? For many
decades, this need to set one’s organization apart from all other
organizations of a similar nature was greatly hampered by the
healthcare industry’s misunderstanding of—and disdain for—
marketing. Indeed, a 2005 study of hospital mission statements
found that nearly all contained similar language and claims
regarding their commitment to the provision of high-quality
care (Bolon 2005). In a 2008 study, researchers searched a
random sample of hospital mission statements for key words
associated with interest in and commitment to education and
found that the missions of 21 of the 81 (26 percent) teaching
hospitals examined made no reference to teaching or education.
More
More than 25 percent of teaching hospitals’ missions were
indistinguishable from nonteaching hospitals’ missions
(Wiggins, Hatzenbuehler, and Peterson 2008).
Certainly all healthcare organizations and providers are
committed to providing quality care, but when their mission
statements are homogenized and interchangeable, they cannot
build a unique reputation or communicate a competitive
advantage. Thus, if an organization’s strategies must align with
and actively support its overarching mission, and if its mission
statement is indistinguishable from the missions of other
healthcare organizations, how can marketing strategy
adequately and ethically steer the organization’s limited
resources to the most appropriate opportunities for attaining and

3. sustaining competitive advantage and achieving its mission?
An organization’s vision statement is similar to its mission, but
it extends beyond
What the organization is into the realm of what the organization
wants to be. An organization’s vision is its ideal future state. It
is the best that an organization can aspire to be. It describes the
direction an organization wants to take and the desired end
result of that journey (McConnell 2007). Put another way, if an
organization were a person, what would it see when it closes its
eyes and dreams? Healthcare organizations’ visions can be
inspiring and, perhaps, audacious. Consider, for example, the
vision of a small community hospital in southern Idaho to “be a
standard of excellence and cooperation in making Mountain
Valley the healthiest place in America” (McGinnis et al. 2003).
Seeing itself as the healthiest place in America certainly is an
audacious dream, but it is a worthy vision to work toward.
It is not marketers’ place or responsibility to badger their
organization into redrafting and rewriting its mission and vision
statements, although from a marketing point of view it might be
a useful and productive endeavor. However, whether or not an
organization’s mission is bland and similar to those of other
organizations of its kind, and whether or not the organization’s
vision is exciting, specific, and dynamic, it is the responsibility
of the marketer to dig deeper into the statements and examine
the organization’s values.
There is a lot of talk in healthcare about values. Organizational
values are standards that govern the behavior of individuals in
an organization. In an enterprise that encompasses almost
innumerable professions, patients, providers, and customers,
one needs to under- stand that each of these constituencies, as a
group and as individuals, has its own value system. Without a
common understanding and acceptance of established values,
health- care organizations would have to conduct business and
deliver care while immersed in a veritable sea of opposing,

4. contradictory, overlapping, and clashing values.
Values can be very personal and deeply held. In an industry in
which each profession has its own code of ethics and patients
and consumers have vastly diverse ethnicities, religions,
backgrounds, and cultures, it is imperative that health
organizations be clear, internally and externally, about the
values on which they stand. In addition, healthcare leaders must
understand that simply writing or posting a code of values does
not mean that the people in their organization will actually
embrace and live those values. Thus, it behooves healthcare
organizations to become perfectly transparent value-wise as
they strive to achieve their mission and fulfill their vision. The
Teal Trust, a former leadership organization most known for its
leadership style indicator, suggested that the following five
activities encourage people to uphold behavioral norms that
support the achievement of their organization’s mission and
vision:
1. Communicate values clearly and constantly both within
and outside of the organization. Everyone inside and outside the
organization knows what you represent.
2. Enroll new members of the organization in the culture of
values immediately. Value-focused information and
indoctrination should start with the selection process.
3. Revisit and refresh your values periodically. Healthcare is
constantly changing; you must ensure that your organizational
values have kept pace.
4. Confront contradictory behavior. Provide feedback to those
who do not live the organization’s values.
5. Periodically solicit feedback. Ask people, both inside and
outside the organization, what they believe the organization’s
values are.
Clarity of values and a mission and vision that clearly delineate
and set the organization apart from others of its kind are the
lenses through which marketing can look to understand and
align itself with the organization’s internal and external
environments.

5. Healthcare Success and Marketing Research
Healthcare marketing is driven by the need for current and
accurate information crucial to achieving an organization’s
mission and vision. Strong marketing research guides health-
care organizations to make sound decisions in all areas (Fell
and Shepherd 2008, 1):
Good market research defines areas of concern for a healthcare
organization, helps frame strategic decisions, and connects the
management team with its customers and stakeholders . . . . If
making good business decisions is the key to market growth and
sustainability in healthcare, then market research should be
considered a critical element in that decision-making process.
Two fundamental conditions in the healthcare industry are
constant change and increasing competition. For most of the
twentieth century, healthcare was internally focused, paying
attention primarily to the needs of physicians, hospitals, and
payers. The assumption was that when the needs of these three
groups were met, the needs of patients also were met.
A healthcare organization’s survival now depends on having a
clear understanding of both its internal and external
environments. Furthermore, a successful healthcare organization
differentiates itself—separates itself from the pack, as it were—
not only to attract patients but also to recruit and retain high-
quality employees. No longer is a hospital just a hospital; no
longer is a physician practice just a group of doctors that might
as well be any group of doctors. Healthcare organizations need
to understand, nurture, and trumpet their distinct competencies.
Healthcare organizations must be consciously competent—no
luck or accident is involved. They need to know what works,
with whom it works, and why it works. In addition, a successful
organization understands that healthcare provides two kinds of
value: visible and invisible. In this sense, value does not refer
to the cultural standards of behavior discussed earlier. This
time, value refers to the economic concept of worth, of cost

6. versus benefit. Visible value is value that a customer can see.
Invisible value is value that a producer builds into its product
(Berkowitz 2011, 53). Both are fundamental to aligning an
organization’s marketing efforts with its mission, vision, and
values. When conducting market research, the healthcare
marketer needs to determine what customers/patients need and
desire. What will make their experience with the health- care
organization memorable and make them want to return?
Interestingly, it is not always what marketers think it will be.
Internally, organizations know they add value by using
electronic medical records, credentialing caregivers, and
providing continuing education for all staff—but most patients
don’t care about those things. Patients that do care about these
features assume they are givens; their value is invisible.
Patients want high-quality care, compassion, respect, and
convenience—all visible values. Only by deeply under- standing
their organization’s patients, customers, markets, and internal
and external environments can marketers support and align their
efforts with its mission, vision, and values.
Marketing that Supports the Mission
Healthcare organizations need to be both mission based and
market driven; the two concepts are intertwined. Mission-based,
market-driven organizations (Brinckerhoff 2010, 17-18)
◆ understand their markets;
◆ treat everyone like a customer;
Include everyone on the marketing team;
◆ ask, ask, ask, and then listen;
◆ innovate constantly;
◆ promote and protect their brand; and
◆ use every communication medium available.
These characteristics are not as straightforward in healthcare as
they are in other industries. For example, healthcare markets
comprise not only customers, consumers, and patients. They
also include insurance companies; equipment and technology

7. interests; and a huge assortment of health professionals, from
physicians and nurses to accountants, lawyers, suppliers, and
vendors. In an industry that is often uncomfortable using the
word customer, how does an organization treat everyone as
such? How can it treat physicians as customers? Healthcare
professionals traditionally think of themselves by discipline, not
by employer. A nurse is a nurse who happens to work at St. Rita
Hospital, not an employee of St. Rita who happens to be a
nurse. And almost universally, health professionals don’t see
themselves as marketers in any sense of the word.
The principal–agent relationship may no longer rule supreme in
today’s health- care industry, but it still exists: The principal
(patient) gives consent for the agent (care- giver) to have the
authority and power to make appropriate decisions on her or his
behalf (Berkowitz 2011, 52). It is assumed that patients rarely
understand their own healthcare wants and needs, and thus the
idea of ask, ask, ask, and then listen may be a foreign and
perhaps frightening concept for caregivers. After all, regardless
of what patients may think they want or need, providers have
care protocols, regulations, and professional standards they
must uphold.
In a world where most hospital mission statements are
incredibly similar, what is a hospital’s brand? Does the word
brand even have meaning in healthcare? These questions are
rhetorical, of course, and are addressed in later sections of this
book. The point here is that market-driven concepts such as
those presented in these questions must be at the core of a
mission-driven organization, and healthcare organizations
present unique challenges in this respect.
In particular, it is important to understand that marketing in
healthcare is far more than just advertising or attracting patients
and customers to a facility. Some experts argue that marketing
has evolved through three stages. Marketing 1.0 was product-
centric and focused on sales, and Marketing 2.0 was focused on
corporate positioning and satisfying and retaining customers.
Marketing 3.0 emphasizes that consumers are no longer isolated

8. individuals; they are empowered and connected via any number
of media channels, and their knowledge and behavior change
organizations and products (Kotler, Kartajaya, and Setiawan
2010). Consider the urban clothing store Gap. When Gap made
minor changes to its original logo, the negative customer outcry
via social media was so strong that Gap quickly returned to
using the original (Parr 2010). Another example is the Susan G.
Komen Foundation’s decision to change its funding of Planned
Parenthood. Like Gap’s experience, the strong negative pressure
exerted through social media caused the foundation to reverse
its funding decision (CNN Wire Staff 2012). The cautionary tale
and les- son learned are that any organization that does not
know its environments and markets, does not listen to its
customers and stakeholders, and acts as if its business decisions
are best made in the vacuum of the corporate offices often
suffers and finds itself retrenching.
Peter Drucker (1989), who is often called the father of modern
management, said that successful businesses don’t start their
planning with financials; they start by defining their mission,
and performing their mission brings financial returns. Thus, the
understanding of markets and customers garnered through
marketing research is the foundation on which mission-driven,
mission-achieving organizations are built.
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global
Healthcare Comparison Matrix and Narrative Statement
Global Healthcare Issue
Description

9. Country
United States
Describe the policy in each country related to the identified
healthcare issue
What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the
specified global health issue. (Be specific and provide
examples)
How has each country’ government addressed cost, quality, and
access to the selected global health issue?
How has the identified health policy impacted the health of the
global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on
the role of nurse in each country.
Explain how global health issues impact local healthcare
organizations and policies in both countries. (Be specific and
provide examples)

10. General Notes/Comments
Global Health Comparison
Grid Template
© 2018 Laureate Education Inc.
2
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global
Healthcare Comparison Matrix and Narrative Statement
Global Healthcare Issue
Description
Country
United States
Describe the policy in each country related to the identified
healthcare issue

11. What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the
specified global health issue. (Be specific and provide
examples)
How has each country’ government addressed cost, quality, and
access to the selected global health issue?
How has the identified health policy impacted the health of the
global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on
the role of nurse in each country.
Explain how global health issues impact local healthcare
organizations and policies in both countries. (Be specific and
provide examples)
General Notes/Comments
Global Health Comparison
Grid Template

12. © 2018 Laureate Education Inc.
2
Conclusions
Marketing plans and strategies are developed in the context of,
and in response to, the broader macro environment. Although
the environment cannot be controlled, organizations must
recognize ongoing trends and factors that will likely affect their
market success. Because the environmental factors are dynamic,
a health care organization must maintain a continual monitoring
process and adjust its marketing plans accordingly.
CHAPTER SUMMARY
1. Marketing strategy must be developed in response to and in
concert with the broader macro environment. Economic,
technological, social, competitive, and regulatory forces can all
determine the effectiveness of any organization’s marketing
program.
2. In recent years, U.S. spending for health care has been
highest among developed countries. However, per capita costs
in the United States have slowed in recent years. The slowdown
has been due to the economic recession, the Affordable Care
Act, and drops in some major prescription drug costs.
3. Health care is a technologically driven industry that impacts
quality, cost, information, and behavior. New technological
advances dramatically affect the institutions and providers who
deliver health care and determine how that care is delivered. In
the short term, technological introductions have been found to
have a complex effect on health care costs. Greater information
power is now available in health care due to technology, and it
has changed clinician and consumer behavior.

13. 4. Technology is affecting consumer behavior. Consumers are
now utilizing the Internet in ever-greater ways to access health
information. Coupled with this use of the Internet for
information is a greater level of transparency of health
information regarding price and quality data on health care
providers.
5. Transparency in health care is now a major factor. There are
three forms: regulatory, which is either state sponsored or
federal; self-motivated, in which the health care organizations
are providing data on their own prices and/or quality; and third-
party transparency sites, which are for-profit entities that
provide information on health care organizations for the
marketplace.
6. The changing demographics of the U.S. population represent
significant opportunities for health care providers. Older
consumers—a fast-growing segment—are major utilizers of
health care services and products. Today, the over-65-year age
segment is increasing at a faster rate than the population at
large. Health care organizations are responding to capture their
loyalty as well as to meet their clinical needs by restructuring
the system in a population health environment.
7. Changing marketplace demographics related to gender,
ethnicity, family composition, and race require health care
providers to be more responsive to the needs and concerns of
women. Hispanics are now the largest minority group in the
U.S. population. In many metropolitan areas, Hispanics and
African Americans represent a significant proportion of the
market.
8. The competitive market can be defined as a pure competition,
a monopolistic competition, an oligopoly, or a monopoly. The
differences represent the number of sellers in the marketplace.
9. As the population has shifted to become more suburban, the
number of hospitals in urban locations has declined at a
dramatic rate, while new hospital openings have been primarily
in wealthier suburbs.
10. As women become an increasing percentage of the

14. workforce, the health care system has to respond with changing
its service mix. There is a corresponding increase in the number
of women in medical schools and among the health professions.
11. The percent of Americans availing themselves of
complementary alternative medicine (CAM) has increased to
almost 40 percent. Many health plans as well as Medicare and
Medicaid cover some CAM treatments.
12. The Department of Justice uses the Herfindahl–Hirschman
Index (HHI) of Competition as a measure of the overall
competitiveness of a market. This measure is used to assess the
impact of a merger of two firms on a particular market. The
largest value that this index can take is 10,000, when there is a
single insurer or organization in a market.
13. The prior movement to managed care is now shifting to the
possibility of accountable care organizations, which model the
structure of large health care systems, such as the Cleveland
Clinic, Mayo Clinic, and the Geisinger Clinic, in which
physicians are aligned under a single organization’s structure
with the same set of incentives and fixed assets and whose goal
is the delivery of quality care at the appropriate place in the
system.
14. More Americans are turning to medical tourism. Although
historically medical tourism implied going abroad to seek lower
prices, in recent years it has also meant seeking care elsewhere
within the United States, which is referred to as domestic
tourism for similar reasons. In either case, many corporations
have provided companies to seek care at other institutions
through contracts that are established with other facilities or by
providing incentives for their employees to travel to lower-cost
facilities for treatment.
15. A wide variety of federal and state regulations exist that
affect each aspect of the marketing mix. In recent years, major
federal regulatory attention in health care has been paid to
mergers and acquisitions of hospitals and providers by
competitors. The government has provided some guidelines
pertaining to health care mergers and acquisitions. In recent

15. years, within the area of distribution and the increase of
telemedicine, many states have begun to introduce legislation
attempting to restrict its use.
16. The issue of provider referrals has also come under scrutiny
of federal regulators. Although the laws are not exact, in
general, it is illegal for physicians to refer to a facility in which
they have a financial interest.
17. HIPAA regulations, which were passed to primarily affect
the portability of patients’ insurance, also impact the marketing
activities and communications that can be conducted without a
patient’s consent.