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Challenges and Successes: Entering a Competitive Market

In 2014, Atlantic Health System’s (AHS) Business Development team entered a contiguous market, infiltrated with fierce competition, despite having no infrastructure. Seven years later, implementing data-driven decision making, best practices and a cutting-edge approach, AHS has built a strong network. Despite confronting challenges, AHS established a robust physician network, opened a multi-specialty building, DE Novo practices, vascular surgery center, ancillary services and launched a joint venture including an ASC. AHS is dedicated to fostering healthier communities across New Jersey replicating this model to further expand the footprint into additional markets.
Challenges and Successes: Entering a Competitive Market
Featured Speakers:
Naomi Savitz, MPH | Linda Carifi, MHA
An experienced professional in the health care industry, Naomi Savitz uses her communication, outreach, leadership and analytical skills to identify and develop meaningful physician relationships ensuring efficiencies and satisfaction. Naomi joined Atlantic Health System (AHS)  in 2019 and was recently promoted to Director of Business Development in the Southern Market. Naomi leads with data-driven decision making and an authentic desire to connect with others yielding improved integration and market share. Naomi has built and lead coalitions, advocated for women and children’s health issues, and worked to eliminate health disparities while achieving sustainable community impact. Naomi holds a B.A. from Rutgers University, and a Masters in Public Health from UMDNJ/Rutgers, with a concentration in Health Care Organization and Administration. 

With over two decades experience, Linda Carifi is a proven leader driving hospital business within New Jersey hospital systems.  Linda joined Atlantic Health System (AHS) in 2012 and now serves as Director, Business Development for AHS’s flagship hospital market and first non-hospital market. Linda establishes and develops trusted relationships with physicians using best practices and innovative strategies. She leads by increasing market share and improving integration in a competitive environment. Linda earned a BS Health Policy and Administration, Penn State and MS Health Administration, Seton Hall.
Transcription:
Challenges and Successes: Entering a Competitive Market

Intro: The following SHSMD podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD podcast, so how do you enter a competitive market and succeed? Everybody wants to succeed. Competition is tough. So, having some strategies and tips on how to do that would be really important. Aha. Good news. We have got Linda Carifi and Naomi Savitz from Atlantic Health Systems.

They are co-presenting a session at this year's SHSMD Connections, in-person annual conference in San Antonio, which is coming up September 19th through the 21st titled Challenges and Successes Entering a Competitive Market. Oh, this is going to be a good one. So, let's learn how to take on the competition and succeed, shall we? We shall. So, let's do that right now.

This is the SHSMD podcast, Rapid Insights for healthcare strategy professionals in planning, business development, marketing, communications, and public relations. I'm your host Bill Klaproth. And in this episode, we talk with both Linda Carifi and Naomi Savitz. Both are Business Development Directors at Atlantic Health System. They are co-presenting at this year's SHSMD Connections in-person annual conference held in San Antonio, September 19th through the 21st. The title of their session is Challenges and Successes Entering a Competitive Market. And that's what we're going to learn about. Linda and Naomi, welcome to the SHSMD podcast. We start every episode of the SHSMD podcast with Rapid Insights, one quick tip someone can use to make their marketing communications better today. Linda, you're going to give us the Rapid Insight today. So go ahead and give us your Rapid Insight.

Linda Carifi, MHA (Guest): Well, thanks Bill. Thanks for having us today on the show. As you know, we are business development Naomi and I, and so we're not marketing. So for us, it's important to collaborate with our marketing team who are our business partners. They are the marketing experts. So, we always make sure that they have a seat at the table.

And on the flip side, since we own the physician relationships, marketing calls on us to the table, when a plan needs to be put together and the physicians are the audience. So, collaboration is key Bill and just be open to each other's ideas.

Host: I love that Linda, so good. Collaboration is the key. And I think, especially during the pandemic, we've really learned how important that is. So, thank you so much for that Rapid Insight. We appreciate it. So, Naomi and Linda, this is going to be a session at the SHSMD Connections in-person annual conference coming up in San Antonio.

So, Naomi, let me start with you and ask you this. And I know you're going to go over all of this in great detail in your session, but if we could just get a quick feel for what your session will be like, we would certainly appreciate that.

So, seven years ago, in 2014, when you entered a competitive market, you say through implementing data-driven decision-making best practices and a cutting edge approach that you were able to build a strong network. So, can you briefly break down each one of those for us? Naomi, let me ask you first about data-driven decision making.

Naomi Savitz, MPH (Guest): Thank you. Of course, for having me. At Atlanta Health Systems our experiencing building over BUS network in a fiercely competitive ambulatory market is truly the synthesis of many factors. In addition to the few that you've already mentioned, other factors that we explore in our presentations include the time to market, leadership buy-in and dedicated capital investment. Although the list could go on and on and on, ultimately at the core of all of these things, is data-driven decision-making. Our leadership and planning teams partner with business development to ensure that strategic decisions are made thoughtfully after diving deep into the facts. We review models and project the aging population, for example, in order to plan to meet their needs and to place adequate primary care and specialist assets to care for this growing cohort. We also review population density. As you may know, New Jersey is the most densely populated state in the country and identifying the right location for our assets is the key to our success.

We ensure that if the local physician market is aging out, for example, we want to anticipate this and have adequate new providers to fill those gaps. We review income impairments. Our region contains one of the wealthiest counties in the state and in the country for that matter. So, on an ongoing basis, we monitor and map our intensely competitive landscape and take all of these other things into account. But all of this doesn't happen in a strategic bubble. At Atlantic Health, data-driven decision-making is done in conjunction with a thorough market knowledge, including the local physicians and the team members that are out in the field.

Host: So, understanding your market allows you to make data-driven decisions based on facts, which I would imagine greatly increases your success rate. That is really good stuff. And then when you start creating your strategy and vision, following the facts and the data, that really makes a lot of sense. So Linda, tell us about some of the best practices that you also used.

Linda: Sure. We don't want to give away all of our best practices today, but, here's a few that could be applied universally. For example, one is what we call an electronic contact card. So, it's very simple. It's a matter of just, pre-populating a physician's contact information into your cell phone. And then in real time, when we introduce one physician to another physician, we push the cell phone, contact cards back and forth between the providers live, you know, while they're talking, while they're interacting and meeting, just to ensure that they can communicate with one another and share patients, as soon as they walk out the door.

I mean, we just know that physicians don't have the time to take someone's business card and pre-populate their cell phone. So we say, done there. Now you have his, now you have hers. You guys are good to go, you're ready to share patients. So, that's one thing that we do, in real time. Another is something that we call a custom medical neighborhood. So, based on geography and a practice's needs, we create a tailored list of providers that meet the needs. For example, if a practice is closer to one of our hospitals, let's just use Morristown Medical Center as an example, then we'll have in that custom medical neighborhood, we'll have services that are weighted more towards that geography, just because we know how important drive time is and how care is local and people don't want to go that far for care. So again, we customize these for each practice to make it easy when they need to make recommendations and referrals to other providers and I'll let Naomi just give a few as well.

Naomi Savitz, MPH (Guest): So, then what we've also done is taken that concept of the custom medical neighborhood and we've tweaked it a little bit. And we've made something that I think is really unique to Atlantic Health System called the Palm Card. And we call it that because it's a list that literally fits in the palm of your hand.

So, yes, there are applications available that they can download and use, but this is more traditional. It's a list that is made on a medical grade plastic that fits into the pocket of a lab coat. It's a larger catchment area. It's a larger list that when the physician is standing in front of the patient and needs the name of a person to refer to, they can pull out this list, flip through it by specialty, pull out that name and share it with the patient in real time.

When the patient gets to the front desk, they can ask specifically for that name that was shared with them. Something else that we really do, which we're very proud of is building a culture of community. We work really hard on creating innovative networking events that make our physicians feel very tied to one another.

In addition to having lunch or breaking bread, we do evening networking events that are really outside the box. Things like speed dating, or we just recently had a great event that had food trucks in a parking lot. So, we were COVID friendly and allowing the physicians the time to get to know one another. Because we really believe fundamentally that when a patient is in front of a physician and asks should I go to this doctor? Do you know them? Would you send your mother to them? We want our doctors to be comfortable and to be able to answer honestly, and we believe that it's our responsibility to create the opportunity for our network to get to know one another and to build trust with one another so that they can build that confidence out to the patients when making a referral.

Host: Those are really great ideas. What great best practices. I love the real-time business card. That is so cool. And then you also talked about the custom medical neighborhood and the Palm Card. That's pretty cool too. And then of course building a culture of community. Those sound like cutting edge approaches already, but I wanted to ask you about those too Linda. So on top of those things, tell us about this cutting edge approach that you took.

Linda: Sure. Well, we believe that taking a multi-pronged strategic approach is cutting edge. And what we did in this scenario, was we chose to be the competition and join the competition. So, let me paint a scenario for you. This is a hospital market and we chose to enter this market without a hospital of our own. That number, that's number one. Number two, this market that we entered has several other existing systems within approximately a 15 mile radius of one another. Now hospital A for lack of a better term right, hospital A was a small unaffiliated community teaching hospital, that today is part of a large statewide system. Hospital B in the neighboring county to hospital A, is 178 bed teaching hospital that we have many existing clinical affiliations with, like for example, pediatrics and cardiology, et cetera. But in our case, what we chose to do was to be the competition for hospital A by coming into their market and simultaneously we chose to joint venture with hospital B in hospital A's market. That was a risk. So again, we chose to be the competition and at the same time joined the competition in another competitor's market.

Host: Be the competition, join the competition. So, as you call it a multi-prong strategic approach. That's pretty cool. Be the ball, be the ball. I know there's a movie. Thank you. It comes from, I don't remember what it is that when you said. So what I thought of be the ball, but be the competition, and join the competition. Well, that is a cutting edge approach. And thank you for sharing that with us, Linda. And Linda, I'm sure you're going to go into more of this in detail during the session. Is that correct?

Linda: That's correct.

Host: And then Linda, I also want to ask you about the physician network that you've built. Why is building a physician network important or how was that important to your success?

Linda: Well, before I answer, let me remind you that Atlantic Health System does not have a hospital located in this market, as I just said. And again, our two nearest medical centers are approximately 20 miles away and here in Jersey, that's a 30-minute drive. So, a physician network is really important because without building a clinically integrated network, Atlantic Health System would have had no presence.

So, today our physician network is over 200 strong with a formidable primary care base of 10 employed practices and a multi-specialty building, home to more than 20 specialties. I would be remiss Bill, if I didn't mention that our accountable care organization, our ACO, served as the foundation to this network. We were very fortunate years ago to have a group of visionary physicians who understood that they needed to partner with an exemplary healthcare system that focused on patient centered care and cost effectiveness. And that, that was us. And this was fundamental to acquiring market share in this ambulatory market.

Host: So, it sounds like this all came together nicely. The physician's goals matched up with Atlantic Health System's goals. Is that right?

Linda: That's correct, yup.

Host: And I know you'll share a lot more details during the session. So, Naomi, let me ask you this. You also opened a multi-specialty building. De novo practices, vascular surgery center, ancillary services and launched a joint venture including an ASC. Can you tell us about those?

Naomi: Yeah, I'd love to. I just want to separate out the joint venture component from all of the other services you mentioned. The multi-specialty, the de novo practices, vascular surgery, and the ancillary, because it sort of has to be dealt with in its own bucket. But Atlantic Health System strategically placed these services and were offered by our competition, but we were confident that we were able to provide the same services and compete in their market.

The JV, our other strategic play was joining the competition, as Linda mentioned before. Hospital B the 170 ,teaching hospital from the neighboring county that we had existing relationships with already, helped to reduce our time to market and allowed us to share the cost for the ambulatory surgery center, physical therapy, occupational therapy, and a comprehensive imaging center.

It's interesting to note that our joint venture is located in an adjacent building to ours, which is a competitor's building. So we literally sit next to each other. And in order to go into our joint venture, you have to cross the threshold of our competitor's building.

Host: Well, I guess if you want to get up close and personal with the competition, you are definitely doing that. That is pretty darn interesting. So, let me ask you this, all of this that you've talked about is this something that other health systems can duplicate?

Linda: Well, I don't think it's about duplicating our model. Rather it's taking away our key successes and being prepared for their own challenges and making sure that they customize their solutions based on their market knowledge, engaging strong physician leadership in order to be successful.

Host: So taking some key principles and then applying it to your specific market situation. Right?

Linda: Yeah, every market's different, but I think there's some takeaways for sure that you can apply, but it's not going to be exactly like a cookie cutter. You're going to have to manipulate it and massage it based on your market.

Host: For sure. And then Naomi, getting back to the session, what are you hoping session goers will learn or walk away with?

Naomi: I think one thing that we've come to appreciate is the importance of physician leadership. And attendees will leave understanding from our lens, the importance of the position leader, their role, and the characteristics that serve as the backbone of our clinically integrated network in this competitive market, again, without a hospital.

Host: Well, as we wrap up and thank you both for your time, I really appreciate it. Just wanted to get your final thoughts. Linda, anything else you'd like to add?

Linda: Yeah. I have to say, we wouldn't have been able to do this without our leaders, you know, they're forward-thinkers and they were very supportive of this. We came to a point where we didn't know where to go or grow because New Jersey has a plethora of healthcare services.

I mean, if we go to the east, we're up against New York, right? If you go out west, you know, it's not as densely populated in Pennsylvania, but we found an opportunity down south of us. And really we set these intentions that we wanted to capture new market share. We wanted to increase covered lives. We wanted to build our own clinically integrated network. And at the same time we wanted to drive integration, which ultimately resulted in net new revenue for us. And we're very fortunate.

Host: So there's some good takeaways there. I like how you said you had forward thinking leaders and I love how you said we set intentions to capture market share and increase covered lives. That is really good stuff. And then Naomi, any final thoughts you'd like to add?

Naomi: I just want to add that Linda and I are just two girls from Jersey. And at the end of the day, New Jersey has a lot of stereotypes that are out there about us, but there's real substance here. And we have cutting edge medical facilities. We have phenomenal physicians and we are leading by example, and we are really proud of what we've accomplished by creating a new market in a competitive space.

And there were challenges. Yes, but there were also tremendous successes. And we're excited to share with everyone, all of the successes we've had and for them to take our example and to go back and think about it strategically for themselves, how to apply it to their markets and to see what they can yield for themselves.

Host: Absolutely. It's going to be a great session. It's titled Challenges and Successes Entering a Competitive Market. And I know you're going to show us some great examples and give us some great value and things we can take away with back to our own healthcare institutions, Linda and Naomi, thank you so much for your time today. We appreciate it.

Linda: Thank you, Bill.

Naomi: Thank you.

Host: And once again, that's Linda Carifi and Naomi Savitz and registration for this year's SHSMD Connections in-person annual conference is open now, just go to shsmd.org/education/annualconference. And if you found this podcast helpful, come on, you know, the line and how could you not please, make sure you share it on all of your social channels and please hit the subscribe or follow button to get every episode. This has been a production of Dr. Podcasting. I'm Bill Klaproth. See you in San Antonio.