I broke my leg. Take me to Columbia.
That plea would be music to the ears of marketing gurus at Columbia/HCA Healthcare Corp., which is striving to equate its name with accessible, quality healthcare.
Like Xerox, Kleenex and Coke before it, Columbia wants to instill its brand name in the American lexicon. The Nashville, Tenn.-based giant is well-known in the trade, but it's hardly a household word like Mayo Clinic or Johns Hopkins.
This week Columbia introduces a national advertising blitz believed to be the largest ever by a healthcare provider. The "healthcare has never worked like this before" campaign-produced by the Richmond, Va.-based Martin Agency-will appear on network and cable television, and in news and women's magazines, USA Today and The Wall Street Journal.
A Columbia insider pegged the cost of the campaign at $26 million, but the company declined to confirm that figure officially.
The ads are meant to familiarize viewers with Columbia, which at last count had 347 hospitals, 133 outpatient surgery centers, 75,000 affiliated physicians and 500 home-care locations. It operates in 38 states, but plans to expand into all 50.
The ads try to put an approachable face on the goliath. In a series of eight documentary-style TV vignettes, an absurdly curious field evaluator (played by actor Daniel Jenkins, who stars in the Broadway version of Big) interviews Columbia employees and consumers.
Scenes in which the main character refers to a device that records vital signs as a "gizmo" and asks a farmer where he would go if he were pregnant might strike some viewers as rather flippant for healthcare.
John Adams, Martin Agency chairman and chief executive officer, doesn't see it that way. He views it as a response to consumers' uncertainty. "The ability to portray a (company) that welcomes the questions and attempts to provide responses in a way that is very approachable seemed to be a good thing," he said. "I don't think anyone in the healthcare industry has done that."
The campaign should better cultivate consumers than Columbia's initial attempt at national advertising in January 1995. In that TV spot, which aired for just a few weeks, CEO Richard Scott told America his company was seeking to "contain costs-not a little but a lot." He urged viewers (presumably those more curious than frightened by the statement) to write for more information. The ad, which generated 1,000 letters, was meant to reinforce the healthcare reform message to payers and the financial community.
Columbia has taken numerous additional steps in recent months to promote its brand, including renaming facilities with the word Columbia first, opening a national call center and aggressively developing its on-line services (See box, opposite page).
But the company faces a long road. Asked to name a hospital, less than 1% of people surveyed nationally by the company in the last 18 months mentioned the Columbia name, said Lindy Richardson, vice president of marketing and public affairs.
In fact, Humana, which divested its hospitals in 1992, registers higher brand recognition in hospitals than Columbia, Richardson said. Only one hospital, in Lexington, Ky., still carries the Humana name.
Columbia believes it must bolster its brand to compete against regional systems with strong marketplace identities. As with most ambitious marketing campaigns, the ultimate goal is to build recognition, sales volume and profits.
Columbia "acquired a variety of facilities, but those facilities don't enjoy a common image or reputation," said Alvis Swinney, chief marketing officer at Baylor Health Care System, Dallas. "I think Columbia's weakness today is they don't enjoy perceptual leadership in their markets."
The Baylor system developed its brand a decade ago, before Columbia even existed. The name, taken from the prominent flagship Baylor Medical Center, is attached to six acute-care hospitals and numerous outpatient facilities. Although Columbia has 17 hospitals there, Baylor leads the seven-county Dallas market in terms of consumer perception. Some 40% of consumers considered Baylor as having the top reputation vs. 17% who chose Columbia, according to Lincoln, Neb.-based National Research Corp.
Likewise in the Atlanta market. Columbia owns six acute-care facilities out of 24 in the market, yet no Columbia facility appears in the top 10 hospitals named by consumers in a brand-recognition survey conducted by an Atlanta ABC-TV affiliate last fall.
Regional providers with strong brands interviewed by MODERN HEALTHCARE didn't seem overly concerned about Columbia's branding strategy. In fact, one welcomed it as a way to lessen confusion among consumers.
"One of our messages to our community is they will still get the same kind of service they've always (received) from us," said Cheryl Iverson, director of system communications for Promina Health System, a group of 11 established Atlanta-area hospitals. "We're still local, and Columbia is an out-of-state company."
By and large, healthcare is still a local product except when it comes to health plans, which, enjoying the fruits of their recent consolidation binge, find national branding the way to go. United HealthCare Corp. and Aetna, for instance, each launched national ad campaigns this summer.
"In terms of a health plan, consumers may feel there is an asset to being part of a big national company in terms of stability and reserves," said Kathleen Lewton, senior vice president of Porter/Novelli public relations in Chicago. "But when it comes to care, there's a `my doctor, my hospital in my town' feeling. There's no intuitive reason as to why having my hospital as part of a big chain is effective."
Iverson agrees: "Big is bad to many consumers who want personal care. Big is good to business and industry who want to contract with someone who can cut costs."
Columbia diffuses this argument by stressing ways in which its national scope will benefit consumers. The new ads mention Columbia's goal to survey its hospitals for the best methods of care and the fact that it has more locations than any other provider in the country.
Columbia said it targeted employers, health plans, senior citizens and frequent travelers-all of whom shop for care in multiple markets-as well as physicians.
"We're a far more mobile society," Richardson noted. If someone is traveling and needs care, "there will be a name they know, a quality they know."
Columbia expects to stretch its marketing resources by advertising nationally and pooling resources from its 36 divisions. It also intends to reap the benefits of a unified message.
A marketing council with representatives from each division was assembled last year to coordinate national and regional content and promote sharing of materials. To that end, the Martin Agency will produce some ads for local divisions.
Columbia wants its divisional marketing forces to rely less on local ad agencies. However, local divisions will still direct their own marketing and promote special services, Richardson said.
"We're not trying to create a police force or a centralized system that doesn't have flexibility," she said. "They know their markets better than we do."
During a speech at the Montgomery Dorsey Symposium in Beaver Creek, Colo., in July, Jeff Dorsey, president and CEO of Columbia-HealthOne, the company's Colorado division, said the branding strategy would cost $26 million to launch. He said the large expenditure demonstrates Columbia's long-term commitment to the communities it serves.
It's certainly an investment in long-term profitability. In the view of analysts and marketing experts, the ultimate rewards of branding are stronger name recognition, a boost in revenues and a lofty profile on Wall Street.
Columbia has enjoyed overall single-digit growth in admissions and revenues at its existing facilities, while hospitals in general see admissions declining. Branding could help Columbia's growth continue or even accelerate as consumers, doctors and employers become more familiar with the name.
A strong image also could beef up its price-to-earnings ratio, resulting in a competitive advantage when it comes to making acquisitions using stock. Many strong brands such as Microsoft Corp., Procter & Gamble Co. and Gillette Co. trade at premiums; their price-to-earnings ratios exceed their growth rates by as much as 49%, according to a recent analysis by Robinson-Humphrey Co. in Atlanta. At the time of the analysis, Columbia's price-to-earnings ratio on estimated 1997 results was 14, slightly less than its estimated earnings growth of 15% in 1997.
A 1994 study by researchers at University of California-Berkeley and the University of Washington also showed that brand-building efforts pay off with bigger stock returns down the road.
Branding is a long process. It could take up to five years for Columbia to build a solid identity, and it will be at least a year before Columbia can expect to measure the results of its new ads, the Martin Agency's Adams said.
But Columbia is committed to building its brand and will follow up the initial four-month ad blitz with less intense marketing designed to promote particular services, Richardson said.
There will be potential pitfalls along the way. For one, successful branding requires focus-not easy given Columbia's penchant for dipping into many pots. Its foray into insurance, with the pending acquisition of the assets of Cleveland-based Blue Cross and Blue Shield of Ohio, might confuse consumers, in the view of marketing consultant Al Ries. "My prediction is (the acquisition) won't work. That's a mismatch," said Ries, author of the bestseller The 22 Immutable Laws of Marketing.
Also, negative publicity can tarnish a strong brand. Louisville, Ky.-based Humana spent millions of dollars in the late 1980s developing its brand, only to find its hospitals hurt by a 1991 PrimeTime Live television report that accused a handful of Humana hospitals of excessive pricing. The following year, Humana spun off its 78 hospitals into a new company, Galen Health Care, and turned its focus to managed-care insurance products. Columbia acquired Galen in 1993.
Columbia's Richardson refused to speculate on potential problems. Analysts believe Columbia would be foolish to avoid branding. In competitive markets, which healthcare is becoming, companies with a clear, consistent message win over consumers.
The ultimate power of consolidation, Ries said, "is external, in your ability to get into the consumer's mind."