The Hidden Risks of Capacity Complacency

[00:00:00] Stephanie Wierwille: Welcome to the No Normal Show, brought to you by BPDA marketing services firm that delivers the future to healthcare’s leading brands. This show is where relieve all things status quo, traditional old school, and boring in the dust, and celebrate the new, the powerful, the innovative, the bold, all focused around the future of healthcare, marketing and communications. I’m Stephanie Ell, EVP of Engagement here at BPD, and I’m joined by Chris Buffalo, chief Transformation Officer. Hello and happy Friday Chris.

[00:00:28] Chris: Hello? Hello, hello. Happy Friday is right

[00:00:31] Stephanie Wierwille: Hello. Echo. Echo.

[00:00:35] Chris: echo.

[00:00:36] Stephanie Wierwille: so we have quite a, well you were saying hello, hello, hello. I felt like I

[00:00:40] Chris: Pinch hitting for Pedro Boone. Manny Moda. Moda Moda. Some people will get that reference, but I bet you don’t, Stephanie. It’s fine.

[00:00:49] Stephanie Wierwille: I

[00:00:49] Chris: should move on.

[00:00:49] Stephanie Wierwille: excited

[00:00:50] Chris: Okay.

[00:00:51] Stephanie Wierwille: who will. Okay. Um, so we’ve got a lot to cover today. We have a

[00:00:56] Chris: I.

[00:00:56] Stephanie Wierwille: of some new news happening both in healthcare and marketing [00:01:00] on the healthcare side. We’ll talk about how Walgreens has finally gone private after a lot of news and rumors that they would, but more interestingly, they’ve separated into five disparate brands and groups. Our second headline on the marketing side is that brands are beginning to test out CMOs and chief marketing officers, um, before hiring. So that fractional CMO is, is really becoming an increasing trend. And then we’re gonna get into our main topic. We’re gonna go more deeply into a blog post that we have referenced several times, but I can’t wait to get into it. Um, Chris, you are the mastermind behind this. Um, this. This blog post, which digs into a really important trend that we’re seeing. Um, we’re calling the blog Post Your Full, but are you growing? And it digs into the fact that so many health systems are at capacity, but maybe there’s things that haven’t been considered. So we’ll get into that. So just a few quick notes before we get into those items. First of all, quick reminder, we’ve said it a few times. Um, we’ll say [00:02:00] it some more ’cause we’re so excited. But the Joe Public retreat is coming up in February of 2026 and you can register now. We’ll drop that in the show notes so you can click the link. Um, as a reminder, the 2026. Theme is the AI Dream, and we’re going to be there when the future is written, um, on the lovely, beautiful South Beach in Miami. Second of all, catch us at the Illinois Society for Healthcare Marketing and Public Relations. They have a fall conference happening very soon on September 18th, and our very own Kate Cabernet, VP of communications at BPD will be hosting this. this report out. So we’re really, really excited for that. a few more details around that is that, uh, we’re, we’re really speaking to this report that we’ve published lately called Tomorrow’s Too Late Time is running out for health systems to validate their value. um, so for more information you can click the link in our show. then last, if you can’t get enough of the no normal show, you can always subscribe to the no [00:03:00] normal Rewind. It recaps all the things we get into. Gives you the sources for what we’re talking about, share some extra insights and you can follow along. And then last, I’ll pass it to you, Chris, for a note you had around, um, an episode that we shared recently.

[00:03:14] Chris: Yes, we have to make a correction. Um, and this, this is embarrassing because we had it two episodes ago. We talked about ROI and. We made great pains to talk about how easy it is to confuse language around ROI and the definition of ROI. And then I went ahead and misstated something and so I’m sure most people didn’t even catch it and wouldn’t even know, but it makes me feel awful, so it.

In the episode I talked about why you, why people should use contribution margin instead of net patient revenue. Uh, net patient revenue being the revenue that’s generated from a marketing effort. Contribution margin is the money that’s left over after expenses, and my error was saying. Um, it’s the money left over [00:04:00] after the marketing expenses for that investment, uh, or for that initiative.

Actually, contribution margin is the money left over after the direct costs. For the business you brought in. So if you brought in a million dollars in net patient revenue and orthopedic surgery for through a campaign contribution margin is what’s left over. After you take out the expenses for actually delivering those surgery, so that might be physician fees, it might be facility fees, that might be cotton swabs.

Who knows? The money that’s left over is contribution margin. Then you take into consideration the marketing expenses using the formula formula that we talked about. So, uh, that is the appropriate definition of contribution margin and I just had to get that off my chest. So we can move on. Now everybody can go back to the regular scheduled ROI calculations.

[00:04:57] Stephanie Wierwille: Yeah, that sounds like the formulas are keeping you up [00:05:00] at night. Chris, you’re sitting there thinking through financial formulas. There’s an Excel sheet in your brain that’s just happening.

[00:05:05] Chris: Well, it just shows why we should be listening. Like I don’t really listen to our show on some kind of like cadence because we’re recording it unless I’m not on it. Um, so had I listened to it right after it came out, I would’ve caught it. We could have addressed it last week, but no, there it is.

[00:05:22] Stephanie Wierwille: Okay.

[00:05:22] Chris: We shall move on.

[00:05:24] Stephanie Wierwille: Yeah. Uh, well I will say we are going to probably get, you know, touch on a little bit of the, um, the finance details in our main topic today. ’cause we are gonna get into the fact that, um, how can CMOs think about financial impact? So it’s kind of a good, good little tie in here. Um,

[00:05:40] Chris: Yeah.

[00:05:41] Stephanie Wierwille: get into all the things, Chris, you were sharing, um, you know, it’s been a minute since we’ve, I think, shared what we’re watching, what we’re seeing.

Uh, we used to talk a lot about. The white lotus, you know, of the world. I think you’ve been, you’ve been on the documentary train recently, right? What have you been tuned into?

[00:05:59] Chris: [00:06:00] Well, I mean, I was at the vanguard of viewership for perhaps the most popular, talked about documentary since, um, oh gosh. What was the name of the tiger or something? What was the name of that in the pandemic? Tiger King.

[00:06:20] Stephanie Wierwille: Yes, the

[00:06:21] Chris: King.

[00:06:21] Stephanie Wierwille: King. I think

[00:06:22] Chris: Uh, this doesn’t sound right.

[00:06:23] Stephanie Wierwille: my memory.

[00:06:25] Chris: I dunno what it was. Uh, but anyway, the unknown, uh, the, the documentary is called Unknown Number, the High School Catfishing, um, story.

I, I guess like if I say what it’s about, I will be spoiling it. All I will say is one, you have to watch it. Because it’s, it’s just mind blowing in a lot of ways. And then two, what’s also interesting about it is not just the story, but you start to think about how they created this documentary given the story.

And that opens up a [00:07:00] whole other room of doors that you’re like, how, how did that work? And why is that happening? And, um. The way they, the way they film the documentary is good because it’s kind of like a mystery and you don’t know the answer till the end and the way they’ve shot the documentary makes that more of a surprise.

Uh, but it is insane. It’s insane. And it’s not just like an individual case of insanity, but as you read more about it, you learn like, oh, this is going to be happening more and more. Uh, which is uber scary. Uh, it already is happening. Um, the thing that, that is behind it, and now there’s a new form of it.

Again, I guess I can share the new form of it. If, you know what Munchhausen syndrome is, Stephanie, right?

[00:07:48] Stephanie Wierwille: yes. Yes.

[00:07:49] Chris: this is kind of munchen by proxy, which means, you know, well, I’m giving away, I can’t say what it’s,

[00:07:57] Stephanie Wierwille: I

[00:07:57] Chris: but it’s Munchen.

[00:07:59] Stephanie Wierwille: it by the way. [00:08:00] So you, you

[00:08:00] Chris: Okay,

[00:08:01] Stephanie Wierwille: things

[00:08:01] Chris: I’m sorry, but it’s basically cyber munch housing, which means it’s a new form that’s happening using social media and digital.

So anyway, I may have just teased it accidentally, but um, you could have, yeah, I may not have given it away. You don’t necessarily know the answer because I said that it might give you a hint, but that’s it Anyway, what about you? What about you? What have you watched?

[00:08:24] Stephanie Wierwille: after you mentioned it. You I did. And, um, it was intense. I, oof, it was

[00:08:30] Chris: Did you know it was coming?

[00:08:31] Stephanie Wierwille: hard. I,

[00:08:32] Chris: Did you?

[00:08:33] Stephanie Wierwille: Well, you said there was. Going to be some kind of twist. So I was, we, I was sitting there and I watched it, um, with my, with my partner and we were both trying to guess and we had really fun time guessing, you know, what was going to happen. Um, so that part of it, the mystery part was really exciting, but

[00:08:52] Chris: There was. I will say,

[00:08:53] Stephanie Wierwille: tough.

[00:08:54] Chris: I. I will say like, I don’t know, 15 or 20 minutes in, there was like a [00:09:00] scene where people were introduced and I immediately said out loud, oh no, because I just was like, okay, what’s the worst possible outcome? I was like, oh no, and my wife’s like, I don’t wanna hear it. I don’t, she hates it when I try to be guessing what’s going on?

She’s like, I don’t wanna hear it, I don’t wanna hear your opinion. Like, she paused the documentary. So I, I, I didn’t really actually. It just hit my head like, Ooh, what if it’s that? And then later it was still, it was still a shock, especially given the story gruesome. Anyway,

[00:09:32] Stephanie Wierwille: Okay. Okay.

[00:09:33] Chris: So you watch that, so everybody should watch that.

Is that a recommendation?

[00:09:38] Stephanie Wierwille: I

[00:09:38] Chris: That’s a recommendation. Okay.

[00:09:39] Stephanie Wierwille: going in, like to be a little, it’s just a little intense, but, um,

[00:09:43] Chris: Mm-hmm.

[00:09:44] Stephanie Wierwille: Okay. Well let’s go into our headlines. Um, that was, that was fun. I love when we, I love when we talk about shows, I just think it’s fun. It’s a nice little deviation from some of the healthcare intensity.

[00:09:57] Chris: that one’s, that one is not a deviation [00:10:00] from either negativity or health,

[00:10:03] Stephanie Wierwille: Or

[00:10:03] Chris: it was still entertaining. Entertaining.

[00:10:06] Stephanie Wierwille: or tech or um, culture. But anyway,

[00:10:09] Chris: Uh, yeah.

[00:10:10] Stephanie Wierwille: alright, so let’s shift into our headlines here. So we really wanted to just reference that, you know, some of the Walgreens saga has. Has begun to play out. We’ve been talking about Walgreens quite for quite some time now. We’ve been watching this, we’ve been monitoring this because of course, Walgreens had promised that they were moving into the full continuum of care. Retail health was going into full scale healthcare. And so we’ve been watching this. Um, and the new news is that they are, they’re finally officially going private and specifically splitting into five companies. So those five standalone companies are Walgreens, the Boots Group Shields, health Solutions Care. Yeah, I,

[00:10:48] Chris: I,

[00:10:49] Stephanie Wierwille: I was

[00:10:49] Chris: I can’t,

[00:10:50] Stephanie Wierwille: Chris

[00:10:51] Chris: didn’t even pause for me to sing The Boots Group Boogie.

[00:10:56] Stephanie Wierwille: There you go. There you

[00:10:57] Chris: I’m sorry. Keep going. I can’t help it.[00:11:00]

[00:11:01] Stephanie Wierwille: Um, CareCentric and Village md. So that’s the list. Um, these are now five standalone, completely just great companies and, and, uh, and brands and, um. I’ll just pause there. Chris, I think we, we both have, have different and, uh, interesting takes on this, but what, what was your reaction seeing this play out?

[00:11:24] Chris: Yeah, I think it’s more, um, unfortunately, well, I guess not unfortunately. Um, but it’s more evidence that the funnel wars really collapsing on itself, and it was of the predictions we made in the Joe Public 2030 book. While there’s still a chance that the funnel wars play out in some way, where it started and where, you know, like what’s that famous meme like, where it began and where it, where it’s at today.

Um. This is just more evidence of that, I think. Uh, but what it, what it’s what I don’t know, and I don’t know that anybody, unless you’re on the inside knows, is, is this a sign [00:12:00] that you really can’t pull together assets like this, um, with a vision and disrupt healthcare? Or is this a sign that Walgreens couldn’t pull together the assets and disrupt healthcare?

Right. Um. Because in theory, the things they were trying to do made theoretical sense, um, given Walgreens footprint and the different assets that they, they acquired and built. Um, so theoretically it made sense, but it did not work for one reason or the other. And so now they’re just kind of like, okay, we’re just gonna, we’re just gonna keep these things separate, um, and not really try to build on the synergies between them, at least as far as you can see.

So. It’s super interesting and I also wonder how much of this is just makes it easier for them to sell off parts, um, moving forward because now there are distinct companies that you could put up for sale. As before, it was just a kind of an [00:13:00] integrated mess. So that’s my take.

[00:13:04] Stephanie Wierwille: It’d be interesting Village MD for one, I think, you know, that’s like an Amazon or you know, or an Apple. I mean, back to our joke, the, you know, the original kind of discussions that we were having thinking about the top of the Acuity funnel and um, and where that would go. I’m still a believer in the funnel wars.

I continue to stand strong on that. I think that we just see. You know, the volatility of it, the up, down, back and forth, it’s not an easy thing for, um, retail or consumer brands or tech brands to enter healthcare, especially at the top of the acuity funnel. And there’s been a lot of failures, but I think that the vision still stands and many still believe in the vision and, um, they’re gonna keep trying.

So I would say for health systems and legacy providers, don’t stop pushing forward on your side. Um, however, it is really good to learn from all of these. You know, ups and downs and back and forth.

[00:13:57] Chris: Yes. Yes it is. We’ll keep an eye [00:14:00] on it. We’ll keep watching.

[00:14:01] Stephanie Wierwille: We will. Okay. Onto number two. Um, so we saw this really interesting article that came out of, um, adage around how more brands across industries are testing out chief marketing officers before hiring them full time. Sort of this idea of dating, um. Before you hire consulting fractional interim CMOs, uh, some examples are JC Penney is a big one, Airbnb and, uh, and others.

So I think, you know, what’s interesting about this to me is this, this has been a trend for a little while, this idea of. Fractional leaders really popped up after the pandemic. Um, but seeing these high profile brands, really hiring, consulting or interim chief marketing officers, and not even just before hiring them right, but just even as a long-term play lot plays into a lot of what you’ve been really highlighting, Chris, in terms of Rome’s burning and what the future of the CMO looks like.

[00:14:58] Chris: Yeah, it’s, it’s, it’s, it’s a [00:15:00] very interesting twist on, um, kinda the future of the CMO and it, it, and I actually think it’s a positive, right? So in some ways you might go like, wow, if we’re moving from everybody’s, everybody’s seeking a full-time gig to, well, no, you might have to go through this dating kind of thing.

Or you might, you know, you might have more organizations that aren’t looking for a full-time, at least immediately they’re gonna. They’re gonna bring you in, fractionally, part-time, test you out, whatever. Uh, but I actually think that that’s not a bad strategy, that’s a good strategy for everybody involved.

Uh, for one, I just think it’s, you know, fit in an organization that’s super important and that’s impossible to determine before you take a job. You can do all the vetting you want, but once you get in there, the reality is the reality. And so. You know, making sure the organization’s comfortable with the individual and vice versa makes sense.

I also think there are different people are good at different things, so if you’re trying to transform a marketing [00:16:00] function in some way, uh, the person you bring in for six months or a year might be fantastic at that, but may not be the best. Manager long term of the marketing function. So I, I think in general this is pretty positive.

Uh, so hopefully that’s how people who are out there, you know, in CMO roles feel that too. But it’d be interesting to talk to a few, ’cause we know that there’s been some of this in the health system space as well.

[00:16:28] Stephanie Wierwille: Yes, yes. Yeah, there absolutely has been. And I think it’s just one of many trends that’s reshaping the future of, uh, marketing leadership. So with that, why don’t we get into our main topic today? I’m really excited to dig into this because like I mentioned, we’ve teased it a couple times, but, um, there’s a new blog post that, um. have published called You’re Full, but are you Growing? And it really is a continuation of the future of the CMO report where we’ve outlined these five opportunities for CMOs to pursue. And the fifth one is maybe the most obvious you’d think, [00:17:00] but one of the hardest, which is the fact that money still matters and CMOs need to continue to pursue financial impact.

So of course, financial growth is a priority, right? Of course, ROI is a priority, but it’s really difficult to achieve. It’s really difficult to prove. It’s really difficult. For all kinds of reasons. And one of the reasons is the fact that health systems are largely quote at capacity, right? They’re full. Um, there may be a backlog of patients, many service lines, especially think cardio, think ortho might be, you know, have very long wait lists.

Chris, you’ve shared your experience trying to get an appointment for a screening that took six, nine plus months. So we have this historic demand that’s really piled up, um, among baby boomers. Um, this pig through the snake type of, uh, metaphor. And so demand is really outpacing supply. So that’s kind of the landscape. Um, I’m gonna pause and see. Chris, I know you’ve been really touting this, you’ve been watching this, you’ve been seeing this landscape play out. Is there anything, I just hit that very high [00:18:00] level before we get into what it means to be full and at capacity, but, um, anything landscape wise you wanna add that’s, that’s driving this.

[00:18:08] Chris: Yeah, I just, I think you hit it all. Well, and when we first started looking at this, it really was almost like, uh. Uh, boy is this, is it possible this dynamic might hit us? It was a confluence of like, conversations with the CMO. Some of the feedback we’re getting from clients were like, oh, we’re not really, we’re, we’re, we’re kind of shutting down any, like, we’re shutting down our primary care panels ’cause we can’t handle anymore, or we’re gonna stop promoting this one service line because it’s full.

Uh, and then my own personal experience, I pulling all this together, that was like two years ago. Uh, and now. We actually hear from CMOs and from their leaders. Um, CMOs aren’t really saying this. They’re, they’re reflecting it back from what they’re hearing from their leaders that, Hey, we’re full. Um. You know, we are, we have heard [00:19:00] as a, as a marketing leader, I’m no longer being prioritized with new patient acquisition.

I’m focusing on say, the experience. Uh, my boss is telling me why do we need to increase marketing budget? We’re full. Uh, so we’re hearing it and we believe that a number of CMO roles that have been eliminated, have been eliminated. If not, in some part, a large part because of this dynamic, which is if we’re full, why do we need marketing?

Why do we need to invest in marketing? Or certainly, why do we need to invest in the level that we have, which may include the roles at the, at the most senior level. So, um, it is. It is true, and I will, um, I’m just here to say like, we did not manifest that this is not something we want or agree with. Uh, don’t shoot the messenger.

Uh, but I think like we’re hearing more and more of it, which leads us to, um, kind of our take on on okay, your full, but.

[00:19:59] Stephanie Wierwille: [00:20:00] Yes, yes. So let’s get into that. So what does it actually mean to be full? Um, and often you’re right. You know, it is really just a blanket statement. It’s like either blanket across an entire service line or blank blanket across the organization to be like, oh, this. Biggest challenge that we have is access.

The biggest challenge we have is patients have long wait times. We don’t have capacity that we need. Um, as opposed to, I think what I really liked about your perspective here, Chris was digging into the nuances of it. So I’ll just kind of maybe turn it back to you and say, unpack a little bit, what does it mean to be full and what are the various nuances and different ways to think about that.

[00:20:38] Chris: Yeah, and I think when we get this feedback, it’s just as you described it, and again, this is coming through our marketing, you know, connections, uh. And it, and it’s basically like we’re full, the hospital is full inpatient usually is what we mean by full. It might be, um, it might be primary care is full, it might be a less specialty care, right?

[00:21:00] Like, oh, it takes forever to get, see a, a dermatologist, like good luck to get, get and see a dermatologist or a neurologist or something like that. Um, but it’s kind of applied to this. We’re full and I, you know, I, I can’t. Guarantee this is true, but I’d bet a lot of money on it. In every single one of these situations, the odds are very good that you may be full net net.

So if you look across all the different service lines or all the different ways you deliver care and you just kind of like total it all up, you may have capacity issues. Certainly the capacity and and access is a huge issue, but, but that’s, that is the net, right? So there’s probably very few systems that are full.

Across the board equally. Um, by equally, I mean to the degree they shouldn’t be marketing or, or, or seeking new patients, right? So even if you could be, you could have an overall, I’m just making this up. I don’t think anybody ever measures it, but let’s say that like the average wait time [00:22:00] across all of your services as a health system is three weeks.

Alright? Well, in some cases it might be three months, and in other cases it might be same day we got openings, right? ’cause we’re talking about the net, we’re talking about the overall average. What that means then is. It is very likely that there are whole service lines or services or subspecialties or physicians that are not full.

We’ll just start with that because it even goes further than that. Right? Um, but just. Thinking about, do we need new patients or not? Odds are good. You still need new patients in some areas. So that’s the first kind of pushback on the we’re full. Because if you just accept that, um, you’re not necessarily maximizing your ability to grow.

And that’s the point of the, the blog post, that’s the first one.

[00:22:51] Stephanie Wierwille: I think. I, I think that’s really, really critical of, and, and in many ways it’s okay, how do you then dig into the data around the various service [00:23:00] lines around, um, you know, services, inside the service lines. And also what does the patient even need in that moment, I think is an interesting question because maybe what they’re trying to get into, maybe something else could serve them that is, that has availability, um, that could be a, a workaround or perhaps there’s other levers to pull from a marketing standpoint to say, okay. This service or this service line is full. So now let’s, let’s drive people over here. Um, you, I just have to sidebar. You mentioned dermatology and it just, I literally just three weeks ago tried to get into dermatology and, um, I mean, it was a four month wait. And by that point it’s like, what are we even doing?

So I pivoted and found a telehealth totally outside of my regular, you know, uh, provider I would go to, and just went the telehealth route and. This is a little bit, you know, more on the operational side, but I was just at a, at a group of, um, of strategy and operators and marketing leaders talking about the importance of telehealth and [00:24:00] partnerships and thinking, okay, if our physicians can’t see someone. How do we have the right things in place to ensure that we get their problem solved through other means? Um, whether it’s partnerships or whether it’s telehealth or whether it’s locum tenants, right? So I think it’s my biggest point out of that is having marketing connected to operating and service line leaders to make those decisions that you’re talking about.

[00:24:23] Chris: Yeah, a hundred percent. And I, you know, without getting too gruesome, this is only going to get worse, um, in a sense that it’s just going to be, capacity issues are going to become more of a challenge given some of the financial things that are, that are coming. Um, and so you, if, if, if it’s a, if it’s a. Uh, kind of a point of view or a sacred cow that we’re full, therefore we shouldn’t invest in marketing.

One, you’re probably not full everywhere, but you’re gonna get more of this. Um, I think you’re gonna get more of these issues going [00:25:00] forward. Uh, the snake through the pig. So the, the pig’s gonna get bigger and in the ways that are probably not helpful to you, and the snake is always gonna be a challenge, which is the labor that you have.

So.

[00:25:12] Stephanie Wierwille: Right, right. Because everybody knows we need more physicians. That’s like, duh. But the solution of how to get more physicians or how to create more access, it’s not easy. It’s so, so it’s, I think the answer is not go hire more physicians. Right. The answer is not open up access. The answer is all the things we’re about to talk about.

So I think you

[00:25:30] Chris: Yeah.

[00:25:30] Stephanie Wierwille: kind of the first pick point. Um, maybe let’s move into our, uh, in your mind, what is, what is the second area of this?

[00:25:37] Chris: Yeah. So the second one is, and again, it kind of speaks to the issues we just mentioned, which, which are gonna cause challenges in many ways, but from a marketing and a growth standpoint there, it’s never been easy. To drive revenue, but it’s just going to become more important that you’re, what’s the couch cushion?

Coin metaphor? I don’t know what [00:26:00] it’s like. You’re turning over every couch cushion, right? Because you’re going to need every coin. Um, and so

the second reason why you shouldn’t just, uh, kind of stand pat when you hear we’re full is related to the financial issues we see people having. Um, and kind of this idea that you’re, you know, you’ve already had to really try to.

Make sure that you’re uncovering all opportunities to grow. Now, every couch cushion is fair game. You gotta find every coin that you can, and what we’re talking about here is you may be full, but are you full of the right patients? And what we mean by that, of course, is all patients are great. All patients should be treated equally.

You should be delivering care to all patients, accepting all patients, depending on your mission. All that good stuff we’re talking about. Payer mix. And that can be a very sensitive thing. But like it or not, the reality of our healthcare system in the United States depends on cost shifting. And what I mean by that is the patients who have a better reimbursement [00:27:00] rate help fund care for the patients that don’t.

We may not like that. We may not think that’s fair. There’s all kinds of arguments against it. We’re we’re not here to have those arguments. It’s the reality. And so if you are going to. Really survive, let alone thrive and grow. You’ve gotta make sure that it, with your marketing dollars, you are maximizing the right.

Patients from a payer mix standpoint that you’re bringing in. Um, and so when we hear we’re full, that just feels like, okay, we can just wash our hands of needing to make sure that we have more commercially insured patients, um, that we’re attracting in, because those are the ones that are gonna help you underwrite all of the care that you deliver.

So that’s the second one.

[00:27:48] Stephanie Wierwille: Yes. And the thing I’ll add there is just the importance of, um, having the right data to really highlight that, having the claims data, having it, you know, connected to on the back end of who, who actually ended up [00:28:00] coming in. And so that’s the really exciting and nerdy marketing attribution discussion, but also the targeting discussion of how are, how are we ensuring that we are targeting the right folks?

Finding them where they are. not just a, you know, you’re not doing that through meta targeting, right? You’re doing that through your own data or through, um, through the right data to ensure that you’re, you’re getting that and then being able to merchandise that back, I think is so key. And what I, one thing I loved about the future of the CMO report is just the importance of, of marketing showing up as that business leader, of that finance partner of sitting down with finance and saying, let’s dig into this.

Let’s look at this claims data. Let’s look at what we’ve driven. Does that align with what you’re seeing on your side? And how do we really connect the two? So.

[00:28:40] Chris: Yeah,

[00:28:41] Stephanie Wierwille: exciting, but not traditionally how marketing, you know, outside of healthcare works.

[00:28:46] Chris: Yeah, and we talk with, with clients and, and systems all the time because we have a, we have a solution called Precision Marketing, which uses an incredibly powerful data set to find the right patients. And it’s [00:29:00] always interesting to me, potential patients I should say. Um, so in addition to whatever you’re doing with your CRM, we’re able to go out to market and say, Hey, we can find you 20,000 cardiology patients at a average contribution rate of x.

Um, we’re gonna pull those in. What’s interesting to me is sometimes people, when they, when we talk to ’em about, say like, well, can you, can you target by payer mix? And we’re like, I mean, does, does the, I don’t know, does the, I’m coming up with a really bad metaphor. Does the Pope wear a funny hat there?

That’s a better one, because why would you even do that? Why would you even do that if you can’t target the right payer mix? Right. Yeah, a hundred percent. That’s the first thing we’re looking for. It’s, it’s, um, propensity for a, a specific kind of disease or care need, and then it’s right, the right commercial mix.

Um, not that we don’t wanna serve people who are on Medicare or Medicaid or self-pay. A hundred percent we do, but a lot of those folks are gonna come. When they, when they need to, we need to go out and make sure we’re pulling in [00:30:00] those folks with the right payer mix to, again, to fund all of this for right or for wrong.

Right. Um, don’t shoot the messenger on how our, the US health system is built. Um, it’s just one more reason, um, that it’s kind of funky and weird, but it’s the reality. So, uh, when you’re going out there, you’ve gotta make sure you’re targeting those people.

[00:30:21] Stephanie Wierwille: Yeah, don’t hate the player. Hate the game.

[00:30:23] Chris: Right, that’s right.

[00:30:24] Stephanie Wierwille: What’s number three? Chris? I’m really, so you’ve teed up number one. Number two, which is payer mix. What’s, what’s number three?

[00:30:31] Chris: The, the third one is, um. And we see some clients really taking action on this, and it’s, it’s one of the more exciting ones to me, which is we’re full. So let’s, let’s take your example of the dermatology appointment, right? And it’s four months to get in and at what point, what are we talking about? I had this similar experience last month when I, or actually this was July and I had to do a GI checkup and the soon as I could see my GI was February.

And I’m like, boy, can I see a nurse [00:31:00] practitioner or something? Um, so just imagine how much that happens where patients just don’t make the appointment. Maybe you didn’t make your dermatology appointment, Stephanie, because it was too far out. Uh, maybe you did make it, but maybe you found an alternative in the meantime and you switched.

Maybe you got to what’s four months from now? That’s December. Is that December? Oh my God.

[00:31:23] Stephanie Wierwille: Yes.

[00:31:24] Chris: appointment. And you’re like, oh shoot, I gotta travel. I gotta travel, I gotta miss my appointment, so I’m gonna have to schedule another four months out. What is the system doing with all those holes that are being created by, we’re full, meaning our, our panel is full, our appointments are full, but we all know that those don’t, I don’t know what the attrition rate is, but it’s gotta be 10%, 20% of appointments that, that go by the wayside for whatever reason.

What are you doing in the very, very short term? To be able to refill those because you may look full, but if you’ve got a 10 to 20% attrition [00:32:00] rate, that means you’ve got 10 to 20% of your fullness that goes, and once it goes, it’s gone. You can’t go back in time and fill that appointment. So what can you do to make sure you’re doing everything to fill in those gaps as they appear?

That’s very difficult, but there are certainly steps that you can take.

[00:32:19] Stephanie Wierwille: This is where I get really excited. ’cause this is where I think actually marketing can play a huge role and, and marketing should play a huge role in the first two that we talked to as well. Right. But for this one. let’s just take that example. So in that example, I did, I, I pivoted outside of my provider and found a he telehealth solution through my health plan. But I also leaned into chat, GBT. I went to Google, you know, YouTube, like all of that. Imagine if my provider had automatically seen on the website because I’m logged in, that I was looking for an appointment and I didn’t complete it. And immediately, automatically an email comes to me. That says, Hey, we noticed you might have need something.

Is there somehow we can help you? And it’s an automated response. Imagine then if they had some kind of [00:33:00] automated, actually sophisticated good chat bot, that could then help me imagine then if it, if it came to some kind of nurse navigator who could then have a discussion. That’s one example of something you can do.

Let’s just make sure this person doesn’t have skin cancer. You know what I mean? Let’s actually see if they really need something. How can you use patient communications? How can you use your website, your digital experience, your email, all of that. That’s one example. I’m sure there are a hundred more we can

[00:33:25] Chris: Yeah.

[00:33:25] Stephanie Wierwille: And Chris, I think this is where you and I get really excited about, you know, rethinking things, um, maybe than how they traditionally are.

[00:33:34] Chris: Yes, and I think like my provider, and I’m sure a lot of systems do this, has a waiting list, for example, so let’s say they had offered you a waiting list and say like, Hey, sorry, the first appointment that we can see that’s open is in four months, but we’ll put you on a waiting list and we’ll automatically slot you in the first one, let you know when it is, and if you can’t make it, then we’ll let you know if there’s any others available.

Would you just go back in your same position? On the waiting list, um, that [00:34:00] can all be automated. And so I don’t know how much of it is on the backend. I know that, um, when I call to make an appointment and I’m like, gee whiz, it takes till February. They’ll say like, well, we can, if we have a cancellation, we can call you back.

The trick with that is normally they’re go like, Hey Chris, it’s your GI doctor. We had a cancellation today at two o’clock. Can you make it? And you’re like, uh. Most of us are not in a position to just drop everything. I might not even be in town. So there needs to be, you know, maybe some people are willing to do that.

Yeah. I can come gimme an hour notice, like maybe there’s some setting that you can say like, as long as you give me two hour notice, I would like to know. Right. And I can just set that or a day notice or something, right. So all of this to me, seems to be utterly doable with data, ai technology. Uh, but just again, it, this is a, this is a, um, three yards and a cloud of dust kind of scenario we’re in.

Uh, you know, all the metaphors flip over all the couch cushions. [00:35:00] Look for all the coins. Do not leave any stone unturned. I, I know I’m running out of ’em. Um. But don’t just accept that we’re full because the odds are there’s still work you can do to ensure that you’re going to maximize your capacity and and grow as much as you can.

[00:35:17] Stephanie Wierwille: Yeah. Yeah, I think it’s exciting. It’s like a little investigative journey to say. Okay, we’re full, but like, let’s, let’s really dig in. And I love, I love that you’ve outlined in this, in this blog and just in this conversation, all the ways to go think about it. Um, thinking about it with your operating partners, thinking about it with your finance partners, thinking about it through the patient experience, patient journey, calms all of that. Um, so

[00:35:44] Chris: share one story. Can I share one story? I think, like you said, it’s an investigative journey. I think if you go on this investigative journey, you might find some, even like, going through through the Amazon and be like, whoa, there’s a bird that nobody’s ever seen before. Um, without sharing any of [00:36:00] the, the organization or the people involved.

Um, I, I can’t remember if you were with me when we heard this story. I think you might’ve been of a system. That had automatic scheduling so you could go online and, and actually put in your appointment. And they were uncovering that a lot of those appointments were falling off so people weren’t showing up or whatever.

Uh, and so they went to investigate it and they found out from listening to. The communications from the schedule coordinator that the culprit wasn’t the patients, the culprit was the practice that was proactively canceling patient scheduled appointments because they believed that those appointments.

We’re like 50 50. And so if I need the time, I’m gonna cancel somebody who made this appointment online because the odds are higher, there will probably cancel because of that. Um, woo. That’s a bird of a different color. Uh, when we heard [00:37:00] that, we were just like, holy. Um, so think of the things that you’re gonna find behind all of the wonkiness that is your, that is your capacity and, and solving for some of those and how that could help you open up opportunities.

[00:37:16] Stephanie Wierwille: Oh yeah, I remem I remember that story and it was just such a fascinating thing to find because I don’t think, you know, if you had, if there wasn’t that investigation of the investigative journey, wouldn’t, you wouldn’t have found that. And you probably would’ve just assumed like, God, no-show rates are so high, man.

What’s up with the culture these days? People aren’t showing up. They’re not. Keeping their promises. And you know, I think no-shows as a whole, we haven’t even talked about that really at large. But that’s a whole separate category of ways to use behavioral science and

[00:37:43] Chris: Mm-hmm.

[00:37:44] Stephanie Wierwille: the no-show gap. I mean, even something as simple as a reminder message, which most systems have in place, that’s like total table stakes. But what are the very, very small minor nudges that you can do to ensure that you’re closing no-show gaps? And then can you be sophisticated enough like. Dare I say like [00:38:00] airlines. I’m not saying you overbook your plane, no one likes that. But if you have the right data and you know what the no-show radar, then you can really prioritize that wait list.

You can, you know, you can pull all these different levers on the backend and then imagine if you are really, you know, your cm CRM is that strong, that you’re able to communicate those kinds of personalized messages. So you could have an entire strategy just to close the no-show gap.

[00:38:23] Chris: Yeah. Yeah. And we, I mean, I.

[00:38:25] Stephanie Wierwille: I don’t know.

[00:38:26] Chris: I think, I think this might be, I don’t wanna give credit where credit isn’t due, but this might be an, an epic innovation. But I noticed that with my own appointments, um, I no longer just get a confirmation or, or a reminder, I see the adoption of what restaurants have had to do because they also suffer from no shows.

And it’s a big problem. They ask you to recommit. So, hey, you’ve got a, you’ve got a reservation tomorrow night. Are you still planning on coming? Yes. Why? For Yes, and for no. That [00:39:00] makes you stop. Right. And most of the time you’re like, yeah, I’m still coming. Yes. But it does make you pause. And if you’re like, oh, like now, if I say yes and I canceled, now what does that mean?

Like now they’ve really got me twice. I’ve signed up for this thing and I’ve confirmed it. So there’s kind of social pressure in that. There might be financial implications to that, and it’s all behavioral. Right. Mostly it’s a psychology thing. Uh, and it’s the same thing with your doctor’s appointments.

So if you, if you don’t have that ability or it’s a switch, you need to, to switch on at Epic. I don’t know if that’s really where it comes from. It seems like it would be. Um, ’cause that’s the, that’s the system my, my, uh, provider uses. That’s a, that’s an example of a very small thing that would help with no-shows.

Like who knows, 5%. Who knows what that would help with. But, um, there are plenty others, and you and I geek out on this, so, uh, maybe we save it all for a different show.

[00:39:57] Stephanie Wierwille: Well, it’s, it’s fun. I think it’s super fun [00:40:00] and you know, we, there’s so many ra rabbit holes, we haven’t gone down. You’ve referenced Epic and I think absolutely there’s so many things Epic has in play and is developing and back to the point of marketing, collaborating, you know, partner with Epic and really put that, um, you know, journey together to say like, what else, what other features can we put in place along with your chief digital officer or whoever else. So we could probably go on and on about something as seemingly small as. We’re full. Um, but thanks for the convo, Chris.

[00:40:30] Chris: Yeah, that was a good time and definitely watch, uh, unknown number. I would also recommend Katrina as a great three part documentary. Um. I mean, I think anybody that was around during that remembers how incredible it was. If you’ve, if you’ve read or seen Five Days at Memorial, I think is the name of it.

Holy crap. I mean, that’s about a hospital five, was it Memorial? Five days at Memorial? I think so. Um, that is like a horror novel to [00:41:00] read. The, the poor people, the workers, and the patients. Um. But seeing the documentary again and seeing all what went down, um, wow. Wow. That’s all I’ll say.

[00:41:17] Stephanie Wierwille: one, so I’ll have to, I’ll have to, I have, I’ve watched five days at Memorial. Um,

[00:41:21] Chris: Just have your, have your rage squeeze. Have your rage, squeeze ball. ’cause you’re gonna be squeezing in rage multi multiple times. You’re gonna be like, no way did this happen. Sorry, I’m just being fair.

[00:41:34] Stephanie Wierwille: like,

[00:41:34] Chris: your recco?

[00:41:35] Stephanie Wierwille: and fuzzy doc

[00:41:36] Chris: That’s not warm and fuzzy. No

[00:41:39] Stephanie Wierwille: I know. Um, well hack your health. The secrets of your gut on Netflix is my reco. It is a little warm and fuzzy. It’s, it’s talking about the microbiome and all the great things that are guts do. Speaking of, uh, gi you know, the gut is the, the brain of the body actually, and it, I, I have always

[00:41:58] Chris: wait isn’t the,

[00:41:59] Stephanie Wierwille: the [00:42:00] microbiome.

[00:42:01] Chris: isn’t the brain, the brain of the body?

[00:42:03] Stephanie Wierwille: The second brain, I’m sorry, the gut is

[00:42:05] Chris: Oh, okay.

[00:42:06] Stephanie Wierwille: I should, I missed a

[00:42:07] Chris: Okay.

[00:42:07] Stephanie Wierwille: important word. But anyway, you’ll learn. It’s just, it’s so fascinating and it will make you really want to eat your greens. So that’s my recommendation

[00:42:15] Chris: Does it allow me to like judge people’s health as I walk by them in the airport?

[00:42:21] Stephanie Wierwille: You know, I think you can already, I, I give you permission to do that anyway. I do that at the grocery store. I probably shouldn’t say that, that’s to terrible, but I did that at the grocery store. I look in people’s carts.

[00:42:32] Chris: Oh my gosh. That is, that is a, am I the blank, blank? You know what I’m talking about there, right? Have you ever heard of that? Am I the.

[00:42:42] Stephanie Wierwille: No. No.

[00:42:43] Chris: A-hole. There’s a whole thing. It’s kinda like an A MA, but it’s am I the A-hole? And then somebody describes something and then, and then whoever’s doing it, like discusses, is this person right or wrong?

So that would be a perfect one. Am I the a-hole for judging people by the contents of their [00:43:00] grocery cart? I think you would be, especially if you said something.

[00:43:03] Stephanie Wierwille: so. I would never say anything. No, I just, I just go down a rabbit hole in my brain of thinking about the food system more so than the individual human. Um, but anyway, it’s a fascinating little, I shouldn’t have said that out loud. Look at me having a vulnerability hangover.

[00:43:22] Chris: It is fine. It’s fine. That was a little bit of fun at the end of our episode, so a different kind of you, you’re full. You’re full of Doritos and ice cream.

[00:43:31] Stephanie Wierwille: full. Yeah. Okay. Well with that, we’ll, uh, we’ll, we’ll leave it here. Thanks for listening. And as always, um, we love for everyone to listen. So give this a share if you enjoyed it. Um, let us know if you have any specific tactics that you like to put in play when you hear the we’re full type of, um, type of, uh, discussion. Give us a review if you would like to. And until next time, don’t be satisfied with fullness. Don’t be satisfied with the [00:44:00] no normal push that no normal, and we’ll talk to you next week.

[00:44:03] Chris: Bye-bye.