The scene is shadowy, and the background music foreboding. On the TV display screen, a stream of beleaguered people stand in an endless line.
“If you’re waiting patiently for a liver transplant, it could cost you your life,” warns the narrator.
One man pulls one other out of the queue, signaling an escape. Both smile.
Is this a dystopian online game? Gritty drama? Neither. It is a commercial for the living-donor liver transplant heart on the University of Pittsburgh Medical Center, an instructional hospital embroiled in a high-profile battle with the area’s dominant well being plan and now making a play to a nationwide viewers.
Hospitals are utilizing TV spots like this one to draw profitable sufferers into their hospitals as well being care prices and business competitors escalate. Some establishments use them to construct nationwide and worldwide manufacturers on area of interest however high-priced well being companies. They’re usually procedures involving costly expertise that profit solely a sliver of the inhabitants. But they might lure rich sufferers searching for high-end care and can even give hospitals some leverage with insurers.
“Hospitals are competing, just like any other business,” mentioned Mark Fratrik, an economist at BIA Advisory Services, a media consulting agency.
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UPMC’s advert has been airing nationally this 12 months throughout cable information exhibits. Advertising analysis firm iSpot.television estimates the marketing campaign’s price at greater than $three million because it first aired in early September. The industrial is aimed on the estimated 14,000 individuals on the United States liver transplant checklist, hospital officers mentioned.
But some analysts fear that these hospital ads are incomplete or deceptive.
“We have choices about where we seek medical care,” mentioned Yael Schenker, a palliative care physician at UPMC, who has researched hospital promoting however was not concerned with the liver transplant advert. “We want to spend our money wisely, and need information about the quality and cost of health care services. Health care advertising — which purports to offer that information and fill that need for consumers — really doesn’t.”
Last 12 months, hospitals nationwide spent greater than $450 million on promoting total, based on figures from Kantar Media, a agency that displays advert spending. That comes on the heels of a surge between 2011 and 2015, throughout which era hospitals and well being programs upped their advert spending by 41 p.c, based on figures revealed by Advertising Age, which tracks advertising and marketing developments. By 2015, hospital advert spending accounted for near 1 / 4 of all well being care-related promoting, based on the Advertising Age report.
The UPMC advert is only one taste. New York City’s Hospital for Special Surgery, an orthopedic hospital, launched its personal nationwide marketing campaign this 12 months — a minute-long spot that includes jaunty digital music and other people of all ages dancing, jogging and doing yoga and gymnastics. “How you move,” the textual content asserts, “is why we’re here.”
John Englehart, the hospital’s chief advertising and marketing officer, mentioned the marketing campaign is supposed to introduce potential sufferers to HSS from across the nation, however he mentioned it needs to be seen with different informational supplies, corresponding to unbiased rankings. He wouldn’t touch upon how a lot the hospital has spent on its advert, although iSpot locations its worth at about $325,000.
A nationally broadcast advert for Yale New Haven Hospital, in Connecticut, exhibits a most cancers survivor at a bicycle race telling viewers the hospital “did give me my life back.” That spot had a far shorter marketing campaign life, and iSpot estimates its worth round $11,000. The hospital didn’t present remark, regardless of a number of requests.
Until now, hospital-to-patient advertising and marketing has stayed out of the highlight, as politicians are targeted on excessive drug prices and warn they’ll crack down on promoting by the pharmaceutical business. (Pharma adverts make up the majority of paid well being care advertising and marketing, although hospitals represent nearly all of well being care spending.)
Unlike pharmaceuticals, whose commercials require particular approval from the federal Food and Drug Administration, adverts for hospitals and well being programs are regulated by the Federal Trade Commission, which oversees the advertising and marketing of client items.
Or as Schenker put it, “We’re treating them the same way we treat ads for cars and cereal.” But in terms of well being care versus different commodities, “it’s not as easy to figure out if we’ve made a good choice,” she mentioned.
Direct advertising and marketing from hospitals and well being care facilities is not at all a brand new phenomenon. Billboards and TV adverts for spinal surgical procedure and most cancers remedies date again years.
But “there’s more money in hospitals’ coffers these days to [market services] more. And why not?” mentioned Robert Berenson, a well being care skilled on the Urban Institute, a assume tank in Washington, D.C.
An advert like UPMC’s highlighting its live-donor liver transplant program alerts status.
It caters to sufferers from across the nation and even overseas who are sometimes wealthier, or out-of-network, or coated by higher-paying personal insurance coverage, famous Paul Ginsburg, a well being economist on the University of Southern California. All are extra worthwhile audiences. (UPMC mentioned it has offered reside transplants to sufferers of all stripes, together with these coated by Medicaid, which insures low-income individuals and pays hospitals much less.)
Gerard Anderson, a Johns Hopkins well being coverage professor and skilled on well being care pricing, mentioned the advert can also talk to native customers that, in the event that they join with UPMC — versus a competing hospital — they’re extra prone to get higher care.
“You’re differentiating yourself from everyone else by saying, ‘I can do this very sophisticated thing that no one else can do. Therefore, sign up with me,’” Anderson mentioned.
Or as Berenson put it: “There are not that many people with liver transplants. There’s some halo effect. They’re trying to get people to recognize the name and go for other services.”
But there isn’t any proof to counsel that excelling in a single specific, complicated process tracks with offering excellent care total.
UPMC casts its marketing campaign as an outreach effort meant to tell individuals who want liver transplants of a doubtlessly lifesaving choice. It will not be meant to suggest something additional, hospital representatives mentioned. “This is truly an awareness educational campaign,” mentioned Dean Walters, UPMC’s chief advertising and marketing officer. He mentioned 14,000 individuals within the United States want a liver transplant, and that quantity grows yearly. “This is about making sure consumers are aware of this option.”
Walters wouldn’t disclose how a lot UPMC has spent on this specific marketing campaign, although he acknowledged the hospital has made a “financial commitment” to selling this service. According to Kantar, the advertising and marketing agency, UPMC spent greater than $four million on promoting within the first six months of 2018.
Englehart mentioned HSS’ advert is supposed to dispel any phantasm that the hospital is catering to rich sufferers solely — although he additionally mentioned their marketing campaign is supposed to boost HSS’ popularity each nationally and internationally.
Many well being economists steered the payoff can lengthen properly past tapping into the market of potential American or international sufferers. A marketing campaign like this one helps hospitals achieve negotiating energy of their ongoing wrestle with insurers over reimbursement charges.
A hospital that efficiently manufacturers itself as wonderful or prestigious — even in a single process or specialty — can leverage that identification when bargaining with insurers.
“They want Hospital A in their network even more, which means Hospital A can extract more from insurers — mainly in the form of higher prices,” mentioned Martin Gaynor, a well being care economist at Carnegie Mellon University and former head of the FTC’s Bureau of Economics.
Shefali Luthra: ShefaliL@kff.org”>ShefaliL@kff.org, @Shefalil