For this episode of E-Coffee with Experts, Dawood Bukhari interviewed Peter Cunningham, CEO of Evolve Healthcare Marketing, a data-driven healthcare marketing agency, located in Chicago, Illinois. Discover the intricate art of achieving measurable ROI, overcoming marketing missteps, and optimizing patient acquisition performance. Uncover the rising significance of online booking systems and proactive patient engagement strategies. Explore the ingenious approach to transforming negative reviews into opportunities for enhancement.
Watch the episode now!
Dawood Bukhari: Hello everyone. Today we have with us Peter Cunningham, CEO of Evolve Healthcare Marketing. Evolve is a result-driven digital marketing agency focused exclusively on potential acquisition performance improvement for multi-site medical practices. Peter, welcome to the show. Thank you. Appreciate it. Peter tell us about your journey, and how you decided to start a healthcare marketing agency.
Peter Cunningham: So originally this is my third business, but originally I had a corporate PR firm. So a lot of that was in private equity and real estate and then circled back to marketing and specifically set up a consulting practice to be an outsourced chief marketing officer for private and equity-backed healthcare businesses. And what happened over time, what began as a consulting business morphed in 2017 into a full-fledged digital agency specializing in patient acquisition.
Dawood Bukhari: How big is the team right now? We have about 20 people. It’s also impressive. You have served organizations across 17 different specialties. Can you discuss the challenges that arise when you’re marketing for, such diverse healthcare sectors?
And so I would say in January this year, things started opening up again into the new normal, right? And it’s been a bit. Gangbusters since then. Now, with that said, I would say during that period, things shifted a bit and there’s been a lot of private equity in the space. Before COVID, it was about, there were sources, industry sources would say about 1.4 trillion private equity dollars were sloshing around in Sierra Leone. Consolidation of medical practices and that type of thing. Post-COVID, it’s over too, it’s almost two and a half trillion because a lot of monies that were maybe allocated for other industry sectors moved over to healthcare, which is deemed recession-proof.
So you’ve got a lot of money going in. And I would say between the money and the private equity dollars investment, the changes in the market dynamics with COVID, I’d say the hot areas behavioral health is huge. Treatment of anxiety, depression IOP programs, addiction programs, all those areas.
Pretty significant as well as specialty practices like allergy, ENT, orthopedic, and so on. Each has its different animal. There’s also a saying that medicine is local. Every market has a different, competitive landscape is very different in New York City Metro than it is in Des Moines, Iowa.
Yeah. Yeah. The cost of a click is very different. And so on. So the big thing to answer your question is, how do you customize? The campaign by service line by market relative to the competitive landscape. And that’s the needle that needs to be threaded.
Peter Cunningham: I would say a few things in terms of specific compliance issues with health care. There’s a general 1, which is the American disabilities act, which is beyond health care. So now, the American disabilities act does apply to websites. And unfortunately, basically what happened is. Someone who was legally blind sued Domino’s Pizza and won a lawsuit for 30 million since then, tens of thousands of lawsuits have been filed against organizations that have consumer-facing websites for lack of compliance and it’s pretty easy to fix with some widgets like accessibility, for example, to make a website compliant.
But then, on average, the settlements on these lawsuits are about 50, 000. I have a client, a newer client that settled 1 last year for quarter of a 1,000,000. And it’s pretty insane. So there’s that and a lot of medical practice websites as well as other industry websites are not compliant. Then there’s healthcare specific. So HIPAA compliance. So CMS, a government agency, issued on December 22, new guidance around HIPAA compliance as it relates to websites and data collection of websites, digital applications, like Google ads, Facebook ads, and so forth. And the short of it is it’s made things a good bit more stringent.
And then the additional thing is because we can do that, we can develop performance to educate them on if they invest X. They should expect why in terms of the number of new leads and then based on other attributes, such as what’s the estimated value of a new patient? What’s their front desk conversion rate estimate or reality?
We can predict how much money they should be making. On average, our programs generate about a seven to 10 X return on investment in the first four months of a pilot program. So that’s what we do. That’s a little different.
Peter Cunningham: Yeah. And I would also say meaningful reporting. So unfortunately a lot of the reporting with the practices that we talked to. For those who are looking to make a change 1 of the biggest complaints aside from not being able to articulate an ROI and their spend is actual meaningful reporting. It’s meaningful where they can clearly understand this is what was invested. This is what they got from it from a return on investment standpoint. And I think that a lot of agencies have reporting. Some have very little reporting.
So the technical SEO is sound. That the on-site SEO is sound from a foundational standpoint and then we jump into paid digital ads, which is the cash register. And so that, SEO is a longer-term proposition, the paid ads, that’s the cash register, right? They invest this, they’re going to get that in a fairly short period.
Once we are executing, we lay a strong foundation for everything. And because that website’s critical, making sure that sound is critical for the digital ads to perform. We execute the digital ads, and then we let that incremental revenue help fund the journey to enhance the website where we can start getting into expanding on-site as needed. On-site content, start getting into off-site SEO and those types of things.
Like any suggestions, any good ones?
Then when it comes to actual patient engagement they’re looking for an orthopedic surgeon, just making us up. They’re looking at different sites or Google My Business listings. Hey, look, they see, oh, they have favorable reviews. Let’s go to the website. Okay. These guys look like they specialize specifically in my ailment.
And then they looked at broken employment. The question is how quickly, and efficiently can they get in. Now, one of the challenges with big hospitals and health systems is there may oftentimes be this big bureaucracy you have to go through and a long waiting list. One of the benefits of an independent medical practice is that they typically have more flexibility to enter more nimble and can get them in quicker.
So that’s an advantage. Unfortunately, a lot of these practices haven’t fully capitalized on that. So when you call in to make an appointment, do you get right in to talk to someone or are you lost in a phone tree? Yeah, that’s a big issue. And then people just hang up because they’re frustrated.
Can they book online? For an appointment pick the day and the time and then book it. Bam, right there. I don’t know the exact figure, but it’s probably less than 10 percent of the medical practices have that ability. And there are a lot of different systems for being able to do this. Text message messaging, so 2 way texting again that’s something that would help people be able to book more appointments. Yeah, takes the friction out again, less than 5 percent of the folks out there have that capability. Now, who are the different vendors? There’s a million of them. There are a lot of different practice management systems and HR systems. They are broad-based across specialties, and that one’s specific by specialty.
They all have the pros and cons. There are no silver bullets. At the end of the day, it just comes down to what works best for that particular organization. It’s internal workflows and so forth to get the most juice out of the woman if that makes sense.
It makes it more important, not only to book appointments but then also to engage and retain your customers. So you need to have separate campaigns. Going on for that as well, as any particular strategy follows for that.
The world’s changed the number. PCPs primary care providers out there shrinking big time and have been so trying to live by referrals only is a kiss of death. And ultimately what happened is we ended up exiting the relationship because although the CEO was all about consumer-driven health care, the doctors worked and they didn’t want to change their way of doing things in terms of getting patients from and the world just doesn’t work that way anymore. So I think they will have a really tough time in the next couple of years until they fix that. So the point is that we have to look at everything holistically. How do people source? Evaluate and choose specialty care, and there are different choke points in each of those steps. So the idea is to identify those choke points and try to alleviate them, whether it’s recalibrating or retraining yours. Internal staff who answer the phones are customer friendly and answer the phone with a smile on their face and do not care that they are self-referred embrace it to the phone system, not having a complicated phone tree that irritates people.
Established two-way text messaging and online scheduling capabilities on the website to have appropriate content to support their decision-making. And all those types of things. Again, we look at it more holistically. So it goes beyond. Digital marketing tactics go broader to that technology stack and operational effectiveness.
Peter Cunningham: My favorite client story that’s a great question. I would say, There’s a current client we have that’s a behavioral health practice that when we first began talking and essentially what they do is they have therapists to provide treatment for depression and anxiety, that type of thing, and they’re good size practice and 2 locations. And when we did an assessment, they were doing digital marketing previously.
He didn’t, he wasn’t getting the results he wanted. He just didn’t know why. And nor should ease. He’s a clinician. So when we assessed what was being done, a long story short is that they had a sub, I think it was like a complete 2 conversion rate on their PPC ads. And there were a variety of reasons for this. The goals were not set up properly in Google ads. The landing page was non-existent. They had the wrong phone numbers. Just a whole series of problems and net is a cost of a lead was costing them over nearly 1,800 dollars for the cost of a lead for a patient that, you know, 1, 500 dollars, not a good business case. So we went in, we did our proforma, and we started executing it. And today he’s down his cost of a lead. His lead system is predictable and profitable. His cost of a lead is under 50 and dropping further, probably get it down to 25 or 30. And he’s given demand for what they do. He’s been able to grow.
I think he’s added, almost 20, actually 20 new providers just this year, because because we’ve helped fix this process for him. And so he’s a happy camper and he’s and the great part of it is as an independent practice. They’re really good providers and they’ve earned the right to be independent, but there’s a lot of competition. And so we’re helping them solve that problem and they’re growing predictably and profitably, and I think it’s great, right?
Dawood Bukhari: Your advice to a medical practice, once, they get negative reviews or negative publicity, like how to handle that.
Peter Cunningham: Sure. And I have a person on my team that’s one of the things that they do and counsel on. So I’ll try to speak high level. I know enough to be dangerous on that particular topic, but I would say that it’s having the right technology. It begins with having the right technology. For getting reviews, there’s Google reviews, which everyone knows, and this is the first thing people look at with, Google, my business listing, of course, and you want that over 30 reviews and 4 stars. So you want technology that can create some automated workflows so that you can proactively grow that number over time? Texting folks after a procedure, emailing them, have it all automated so that you can crank that number up big time. So that’s number one. Number two is it’s not just about Google. It’s also about health grades, vitals, and some other platforms where you put reviews specifically for healthcare reviews and providers. So having in that system to be able to do the same thing and allocate those reviews. Both clinical as well as Google, right? So I think that’s important. And then lastly, I think it’s, and they call it service recovery is having the ability to flag when someone is complaining online so that some, it’s a flagged and B can be addressed immediately in some cases, maybe it’s, Someone’s upset because of mistake with their bill through and health care being able to flag that and reach out and address the situation in many cases helps turn around the relationship, use the negative and create it, and make it an end to an opportunity to build a better relationship with that person and get them to come back. When you don’t jump on it, you don’t address it. You don’t resolve it. You just have an unhappy person who then, of course, as they say, marketing goes and tells 10 other people that they were unhappy with you, which is not good. So at a high level, that’s what I would recommend.
Dawood Bukhari: What are some challenges and opportunities you foresee in, healthcare in the next five years?
Peter Cunningham: Challenges and opportunities. As I said earlier, I believe You know, breaking this down about 60 percent of our clients are private equity backed they’re doing, private equity firm buys a larger practice, a platform practice. They invest money into growing it organically as through as well as through additional acquisitions. That’s happening costs across specialties. That is going given the amount of dry powder out there, that just that’s going to continue over the next number of years. So there the pros and cons of that for the providers themselves. The pro is number 1 if you’re a really good provider, clinician, or physician, you’ve earned the right to be independent. And so there, this is a great time to be that. There are challenges in owning a private practice. But, there’s a lot of opportunity, so if they want to grow it and sell it to 1 of those private equity firms to cash out, they can do that in an unprecedented way today. The negative is if they want to continue to be independent, they have to compete with those folks who are doing the private equity deals. But in there, there’s also opportunities to on how to compete against them and so forth. So I think, again, there are a lot of pros and a lot of cons, but at the end of the day, if you want to be an independent provider, you’re a really good provider. You have earned the right to do that. There are lots of opportunities to differentiate yourself from the hospitals and health systems. And that’s getting easier and easier to do by the way as well as be able to build something up and get capital investment if and when you want to do it.
Dawood Bukhari: Perfect. Coffee or tea?
Dawood Bukhari: Your last Google search If you remember?
Peter Cunningham: My last Google search, It was just the best steak house, in Chicago.
Peter Cunningham: Thank you. I appreciate it.
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