HA 605 Unit 4 Assignment - Application of Marketing Principles and Techniques

Unit 4 Application 1
Running head: UNIT 4 APPLICATION OF MARKETING PRINCIPLES AND
Unit 4 Application of Marketing Principles and Techniques
Selwyn Paul
St. Joseph's College
Health Care Marketing
HA 605
Stuart Lane
June 10, 2008

Unit 4 Application of Marketing Principles and Techniques
New Product/Service Identification
1. Submit a marketing analysis of:

(a) A service/product described in recent healthcare publications that is of interest to you but you
would not recommend adding to the current offerings of your HCO;
One recent interesting healthcare service that I researched but would not recommend to
be added to Maine Medical Center current offerings as an HCO is the emerging medical
specialty of Hospitalist. Though MMC utilizes independent doctors to function in the capacity as
Hospitalists, there is no formal Hospitalists specialty at MMC. An interesting article surfaced in
1999 in the February issue of Annals of Internal Medicine which sparked an argument about
whether the Hospitalist should become a separate specialty. (Kelley, 1999) This debate has
continued on to the present time even when Hospitalists are well established professionals. One
of the most recent articles on the subject can be found in the December 20 2007, issue of the
Journal of the American Medical Association (JAMA).
A marketing analysis of adding Hospitalists as a fulltime specialty include the following:
Market Analysis
Product or Service Analysis:
Hospitalists are MD’s who are specialized to take care of hospitalized patients. These
doctors focus primarily on general medical care of hospitalized patients. Hospitalists are
involved in patient care, teaching, research, and leadership roles that focus on patent care.
Hospitalists are skill professionals who bring a world of knowledge and experience to the
hospital setting to help in the treatment and management of acute illnesses. Hospitalists work
closely with and collaborate with the patient’s primary care physician (PCP) and bring much
needed relief to family physicians by managing their patients through the continuum of hospital
care. Hospitalists work in virtually every department of the hospital; at times they can be seeing
patients in the ED, and then follow them into the critical care unit. They are also involved in
organizing post-acute hospital care. (Wikipedia Free Encyclopedia [WFE], 2008)
Market Segmentation:
 All primary care physicians
 Hospitalized patients
 Hospital staff/administration
 Healthcare marketing firms
 Advertising Agencies
 Television/Radio/Newspaper
Target Market Segment Strategy:
Focus functions:
 Focus on hospitals that are short-staffed and spread thin (as far as Hospitalists work is
concerned)
 Focus counterparts in specialties such as neurosurgery, orthopedics, nephrology and
oncology who need co-managers for a wide range of their patients.
 Focus on family practice physicians and clinics in the region
 Focus on hospitals with large ICU, CCU, and ED departments
 Focus on hospitals that manage palliative care or hospice services

Market Needs:
 Rural regions to urban centers
 Academic teaching institutions
 Suburban community hospitals or special facilities
 ICU, the CCU and the ED
 Pre-op and post-op settings
 Pediatrics centers
 Counterparts in specialties such as neurosurgery, orthopedics, nephrology and oncology
who need to co-manage a wide range of patients
Market Trends:
Hospital medicine is a in a Transitionary period as residents emerge with hospital
experience the need to remain in the hospital environment has help to add to the already growing
workforce of Hospitalists. The growing patient population is putting added stress on hospitalists
who are working hard to work harder and longer to care for an ever-increasing patient volume in
hospitals around the nation. Hospitalists are challenged even more today because they work with
mostly all departments within the hospital. (WFE, 2008)
Market Growth:
The Hospitalists market is growing at an unbelievable rate. The field of hospital medicine is
opening up many new opportunities for hospitalists in the area of quality and safety within the
institution. As the market grows, so does the need for hospitals to live up to local, state, and
national standards. (Society of Hospital Medicine [SHM], 2008) The need to live up the high
standard has opened up yet another door for the Hospitalist to walk into, as they position
themselves as public health specialists within the hospitals, and as quality and safety directors.
The growth of the market however, is concentrated around family practice. As more family
doctors (who are in shortage in the USA) are added so does the need for Hospitalists. (Wachter &
Goldman, 2002)
Distribution Patterns:
Hospitalists specialize in the management of patients who are hospitalized and provide
continuity of hospital care from admission to discharge, which makes the pattern of distribution
unusual as far as product/services are concerned. However, the following factors should be taken
into consideration when reflecting on distribution patterns regarding Hospitalists:
 Hospitalists that are in great need of reducing average length of stay patients welcome
hospitalists
 Primary Care Physicians (PCP’s) who need more time to focus on their patients are hiring
hospitalists.
 In response to diverse incentives, many Hospitalists are being integrated into
multispecialty groups, or hospitalist-only groups.
 Hospitals that need to contain cost without compromising quality are hiring Hospitalists.
 Development of hospital-based hospitalist programs in both teaching and nonteaching
facilities is attracting Hospitalists. (WFE, 2008)
Main Competitors:
The major competitor in the region is Mercy Hospital in Portland, Maine.
(b) Another service/product that you think your HCO should consider adding to its product portfolio;
I believe that the Scarborough Surgery Center should consider adding Cosmetic Surgery
to their list, the reason being the sudden rise of a segment in Maine that are seeking this service.
With an increase in life expectancy many Americans also wish to improve or enhance their looks,
and such a clinic could increase profits, plus Cosmetic Surgery can be used to integrate both
body and mind to promote overall health and self-image and can include the following:
 Breast Enhancement
 Liposuction and Tummy Tuck
 Facelift and Necklift
 Botox Cosmetics
 Facial Fillers
However, this is a very controversial subject because there is a school of doctors who
don’t believe that the healing arts should be “reduced” to include surgery just for good looks in
the absence of illness. Nonetheless, in can be a profitable enterprise, and the clinic would be
conveniently located in one of the best spots in the State of Maine. (Research and Markets [RM],
2007)
Market Analysis Summary
Plastic surgery is currently undergoing a dynamic transition within the United States of America.
As a result many administrators and healthcare professionals are hesitant to enter into the field
and are quickly moving to the field of cosmetic surgery. Many Surgeons are moving their
practices away from reconstructive procedures and increasing their cosmetic cases. Increasing
insurance difficulties for reconstructive procedures, coupled with technological advancements
and cultural acceptance of cosmetic procedures, are driving this change. (RM, 2007)
There are currently a number of leading companies that dominate the various product categories
within plastic surgery. In addition to being used by a majority of surgeons, these companies also
have the highest satisfaction, highest loyalty and clearly defined positions within plastic surgery.
The initial target market is the Scarborough and Portland areas. The Cosmetic Surgery will be
run from the Scarborough Surgery Center. The critical data to establish potential customer base is
obtained from the Scarborough patient database, Maine Medical center, zip codes of current and
potential customers and their families, MaineHealth employees to name a few. The curve to
attainment of critical mass is one of education, media, and contact. (RM, 2007)
The market segment data is presented in the next section.
Market Segmentation
Within the targeted ZIP codes defined by the agreement with Maine Medical Center, the
management of Scarborough Surgery Center will identify potential customers based on the
following factors:
 Geographic location – To gain advantage by location
 Demographics/culture/religion – Ethnicity, Cultural practices, Faith etc.
 Gender – Product preference for men vs. women etc.
 Age – To market the right product to the right age group
 Social status – Country club memberships, philanthropic contributions, etc.
 Accessibility – Segment by region, example; urban versus rural, train commuters, etc.
 Need for specific information – Based on features or content of product offered specific
market segment will be targeted through, interviews, seminars etc.

 Need for customization – Consumers choice in the process
 Need for quality – Consumers seeking the best in the market
Scarborough Surgery Center and MMC the parent organization has a clearly defined and
identifiable market niche that enables highly targeted and efficient marketing of its services.
Market Analysis
A recent research by CNNMoney highlighted the future of the Cosmetic Surgery industry in the
United States, and found that even in the face of a lagging economy, Cosmetic Surgery is still a
profitable specialty. (The American Society for Anesthetic Plastic Surgery [TASAPS], 2004) The
Cosmetic Surgery market is very lucrative in the State of Maine, and New Hampshire. Careful
analysis of the industry on a national level, coupled with recent market trends point to a robust
market in the future. Currently, most cosmetic surgeons prefer surgery centers for operations that
do not require an overnight stay which makes the Ambulatory Surgery Center in Scarborough the
ideal place for this project.
National Trends:
(TASAPS, 2004)
(TASAPS, 2004)
Distribution Patterns
The Scarborough Ambulatory Surgery Clinic has an experienced and effective marketing
team, and together with Maine Medical Center they both employ media marketing and company
sales forces to good effect. By customizing the service based on market segmentation they will
not be able to provide cosmetic surgery not only to consumers in Maine but also from
surrounding states. New techniques and procedures have fueled market growth; as a result
consumers can expect superior results that are less invasive, with fewer side-effects and more
rapid recovery times. Though the market has become more competititive on a national scale, the
State of Maine remains open for the next wave of success in the industry. (TASAPS, 2004)
(The American Society for Anesthetic Plastic Surgery [TASAPS], 2004)

Data from the American Society for Anesthetic Plastic Surgery strongly suggests that Cosmetic
Surgery will continue to be a profitable field. The following charts provide further statistics and
trends from a national standpoint.
(TASAPS, 2004)
Competition:
At present Mercy Hospital is the only potential competitor in the State of Maine.
(c) A service/program currently offered by your HCO that you would recommend discontinuing or
cutting back.
Use of Maine Medical Center Facilities by External Organizations should be cut back due
to wear and tear and destruction of MMC’s facilities caused by external organizations usage.
Maine Medical Center has established these policies to allow external organizations to benefit
from its facilities, within reasonable guidelines, as a contribution by Maine Medical Center to the
community. These policies apply to all Maine Medical Center facilities, and to any group or
organization other than a Maine Medical Center or MaineHealth department, committee, or
group engaged in official hospital business. However, many of these external organizations are
using MMC’s facilities to conduct business that is not integrally related to the healthcare mission
of MMC, and is some cases such usage of facilities by external organizations have interfered
with MMC’s internal activity. Other reason to cut back or discontinue this service includes the
stress it places on MMC’s cleaning and maintenance team. (Maine Medical Center [MMC],
2008)
Beyond the "Four P's": Customers and Competition
2. The changing nature of health care delivery requires a constant check of the opinions of the
customers served. Polls of customer preferences and word-of-mouth comments about hospital
experiences have an impact on the public perception of a HCO. A survey by the American Hospital
Association in 1996 (reported in Modern Healthcare) found that public lack of confidence in the
health care system is largely due to the perception by consumers that HCO's are more interested in
making money than caring for patients:
They seem to place a priority on profit above a commitment to care.
Hospitals could provide higher-quality care at more reasonable prices and still earn fair profits if
waste, fraud, and abuse were removed from health care.
As hospitals lose the image of making medical decisions based on what is best for patients, they lose
public legitimacy to exercise authority over priorities and allocation of resources in the health care
system.
What is your reaction to these consumer viewpoints, and how would you try to establish a better
public perception of the HCO in your community? How could this be addressed by strategic
marketing management? What specific strategies/tactics would you employ?
Many people live in a world of make belief when it comes to having a full knowledge of the
dynamics of the US health care system. I agree that there needs to be change, however before
change can happen there needs to be a complete diagnostic analysis of the healthcare system,
which from the onset should be totally committed to restoring accountability and identifying
liability within the system. The current economic philosophy that gives credence to some entities
within the private sector, such as the insurance companies, and law firms to actively and
successively control the machinery of managed care must be radically invaded and altered. This
course of action must be carried out not only to restore financial integrity to health care
professionals such as doctors, but also to reestablish the true meaning and original intent of the
medical profession. (Bodenheimer, Lo &, Casalino, 1999)
The current financial philosophy must be replaced with one that would provide economic
empowerment to the system in order for the disenfranchised patient population to receive the
best health care services. The prevailing entrepreneurial philosophy and approach towards
healthcare and the medical profession takes away the true meaning of healthcare and medicine.
The mission of medicine should always be the first reason of medicine, and the true mission of
medicine can only be understood within the context of patient care. (Healthy People 2010 [HP],
2004) Strategically, hospitals should focus on minimizing errors, improving care delivery,
monitoring performance, and creating integrated system management teams. Strategic
management teams should focus on limiting waste and abuse within hospitals by setting internal
controls and monitoring systems, and by rerouting resources to departments and areas that are
truly in need. (Maine Medical Center [MMC], 2008)
I firmly agree that there is a need to improve patient safety in the healthcare system, and to
reduce healthcare cost, however, I do not believe in the mechanical entrepreneurial approaches
that are often employed to remedy the system. To eradicate the problem of high health care cost
is a desirable outcome; however, it can only become a true reality when it becomes the central
focus of the whole healthcare system, and the federal government. For this change to occur
however there must first be integrity, honesty, and empathy, which are often missing from the
toolbox of performance improvement. These elements of trust and care should be included in
order to achieve the goal of truly caring for patients and improving their safety. (Robinson, 2001)
Each day the sun rises and falls, and darkness, and silence is ushered in, and the problems
disappear, but as the sun rises the next day so does each problem. With the rising of the sun
comes the chance of rain which may appear as a problem, but is really an opportunity for a tree
to grow so that wood can be provided so a house can be constructed to keep one in the shade
away form the danger of the sun. The task of providing low healthcare cost and adequate patient
safety is much like the sun and rain, each one creates a situation for something better to happen.
In the case of healthcare cost and patient safety, each challenge is an opportunity for performance
improvement, an opportunity to create a cost-effective healthcare system that is open and
transparent, with a positive culture of safety management. It is also a chance not just to
implement entrepreneurial systems, but to monitor and improve safety and quality and to clarify
accountability, responsibility and reporting. A chance to ensure that each patient will be seen by a
physician and none turned away, a chance to address serious clinical issues that can set the stage
for performance improvement in patient safety not just to make more money. (HP, 2004)
The Strategic Marketing Plan (SMP)
3. Prepare the Strategic Marketing Plan as outlined or modified based upon the instructor's
comments on your proposal. The systematic framework presented in the required text on writing a
marketing plan for HCO's should be followed. The enclosed instructor's Guide to the Strategic
Marketing Plan follows this framework and describes each section of the SMP, its purpose and
contents. Some students add extra information to "spice up" the SMP; others leave out a few basic
ingredients. Until you have had some experience in putting together a SMP, it is best to stick to the
recipe. Try not to get ahead of yourself or take shortcuts. All the components of the SMP relate to one
another, and they are there for a purpose. They should also be listed in a Table of Contents. The
body of the Strategic Marketing Plan should not exceed 25 pages in length. It should demonstrate a
thorough marketing orientation and logical analysis of how to successfully market the chosen
product/service/program. A research Bibliography should be developed for the SMP, including any
HCO or local area documents and explicit references to the texts, supplementary readings, or other
course resources.
Strategic Marketing Plan
Table of Contents:
Executive Summary and Background

Organizational and Marketing
Marketing Goals and Objectives
Marketing Audit
THE MARKET AND MARKET SEGMENTS
THE ORGANIZATION
Table 1.0 - Hospital Finances
Table 1.2 - MMC’s Quantifiable Community Value in Fiscal Year 2006
Table 1.3 - Payments That MMC Foregoes, Which Some Hospitals Count as Community
Value
How has it been capitalized?
Capital Structure Ratios
Liquidity Ratios
Profitability Ratios
Other Ratios
Table 1.4 - Services Promoted/Success
Medical facilities
Table 1.5 – Medical facilities, Location, Strength and Weaknesses
Management capabilities
Organizational Chart – Maine Medical Center Senior Leadership
Table 1.6 - Maine Medical Center Contracts - Clinical Services
Medical staff
Technical facilities
Table 1.7 Reputations
Image
Reporting relationships
Table 1.8 – Reporting Relationships
Decision-making power
Table 1.9 A. Releasing Protected Health Information under the Public Good Exception for
Federal Laws and Regulations and Health Oversight Organizations
Table 1.9 A – Abbreviations

Table 1.9 B. Releasing Protected Health Information under the Public Good Exception for
Maine State Laws and Regulations – Citation List
Table 1.9 C. Releasing Protected Health Information under the Public Good Exception for
Maine State Laws and Regulations – Conditions
External Controls:
COMPETITORS
PRODUCTS AND SERVICES
Table 1.10 – List of Services
Table 1.11 - General Outstanding Characteristics Products and Services
Table 1.12 - Maine Medical Center Hospital Finances (Note: MMC finances the Ambulatory
Surgery Center in Scarborough) Financial Performance - FY07
Table 1.13 - Snapshot of MMC Hospital Finances
PRICE
Competitors
Regulators
PROMOTION
CHANNELS OF DISTRIBUTION
"SWOT" (Strengths, Weaknesses, Opportunities, Threats) analysis
Audit Conclusions
References
Class Discussion Question: Course Evaluation
4. This is your opportunity to critique and contribute to the further development of the Health Care
Marketing course. Has it met/exceeded your expectations? How could it be improved? What new
course resources have you discovered? Would you recommend this (elective) course to other
students? Any other comments?
Health Care Marketing is one of the most enriching and informative courses that I have ever
taken at St. Joseph’s College. This course helped me to think deeply about the reason why we do
what we do in healthcare. It helped me to better understand the process of becoming
critically aware and how to think of concepts without making negative
assumptions before first looking at the entire landscape of the matter before
me. I am grateful for this great opportunity to learn about marketing and how it works in the
healthcare industry. This course provided more than what I expected and I would definitely
recommend it to other students.
Strategic Marketing Plan
Executive Summary and Background
This Strategic Marketing Plan main objective is to explore the cost effectiveness and
expansion of Maine Medical Center Surgery department in the Scarborough area. The
Ambulatory Surgery Clinic at Scarborough would make the services more accessible to patients
who for one reason or another cannot spend much time at the main hospital, and who only
require minor surgery. Ambulatory Surgery will serve the Scarborough and Portland area
communities, by providing a more centralized surgery program with a primary focus on to
become more productive, while lowering their overall costs with innovative wellness programs
and strategies. (Maine Medical Center [MMC], 2008)
The Ambulatory Surgery Center in Scarborough was started to serve the growing
outpatient population and is equipped with the latest technology and ten operating rooms. The
Center improves MMC’s surgical capacity by centralizing ambulatory surgery in Portland,

Scarborough and surrounding areas which would allow MMC to focus on more complex
emergency and trauma cases. (MMC, 2008)
The Ambulatory Surgery Center seeks to achieve the following goals:
 Patient and family centered and compassionate pre and post surgical care.
 Respect for the individual and for human life.
 Service quality and continuous improvement.
 Fiscal responsibility.
 Honesty, integrity, ethical conduct, and legal compliance.
 Cooperation and collaboration.
 Efficiency and effectiveness.
 Interdisciplinary team approach complemented by individual initiative.
 A spirit of inquiry and a scholarly attitude.
 Access to care regardless of ability to pay.
 Diversity.
 Leadership.
 Responsibility to our community.
 Excellence.
Staffed with the region’s best board-certified surgeons and specialized surgical nurses and staff,
the center is equipped with the most advanced surgical technology and surgery-related
advancement known to medicine, which will draw potential patients from every area of Maine
and beyond. (MaineHealth Organization [MHO], 2008)
Organizational and Marketing
The Ambulatory Surgery Center is controlled and operated by Maine Medical Center a
community owned and governed health services organization. The Ambulatory Surgery Center
which will:
 Serve as the principle provider of surgical care services for Scarborough, Portland and
surrounding areas.
 Offer services that are responsive and sensitive to the needs of patients, families, staff and
physicians.
 Be the surgical center of choice for patients, payors and providers.
 Work cooperatively with Maine Medical Center, and other institutions and providers as part
of a fully integrated continuum of care.
 Maintain its financial viability and effectively manage risk.
 Foster innovative, mutually beneficial economic and professional relationships with
physicians and other providers in the region.
 Play a central role in developing MaineHealth’s integrated delivery system for central and
southern Maine with particular emphasis on its clinical and administrative integration
initiatives.
 Recruit and retain the most qualified and motivated employees by creating an environment
that makes it the surgical center of choice. (MHO, 2008)
Marketing Goals and Objectives
Maine Medical Center Ambulatory Surgery Center hopes to achieve the following goals and
objectives:
 Become the premier Ambulatory Surgery Center in the State of Maine.
 Enhance primary, preventive, and other ambulatory care coverages for uninsured
individuals
 Contribute to the overall health of the community.

 Demonstrate a caring and respectful behavior towards patients and
their families
 Enhance the relationship between existing community organizations that provide health
care and services for the uninsured in Scarborough and Portland.
 Increase access to affordable Ambulatory Surgical care, for uninsured individuals in
Scarborough and Portland.
 Increase public awareness of available and affordable Ambulatory Surgical services and
resources in Scarborough.
 Reduce the risk of unnecessary hospitalization and emergency department utilization by
uninsured patients with selected ambulatory sensitive conditions.
Marketing Audit
THE MARKET AND MARKET SEGMENTS
How large is the territory covered by your market?
MMC Ambulatory Surgery Center serves the people of Scarborough a total area of
55.3 square miles (143.3 km²). As of the census of 2000, there were 16,790 people, 6,462
households, and 4,678 families residing in the town of Scarborough. The Ambulatory
Surgery Center also serves the City of Portland which has a total area of 55.3 square miles
(143.3 km²). According to the United States Census Bureau the City of Portland population
was 64,249 as of the 2000 Census. (MMC, 2008)
How have you determined this?
The market was determined through a series of steps such as:
 Identifying the needs of customers with respect to the services offered.
 Identify why customers would want to obtain the service.
 Segmenting the market to identify special needs of potential customers

 Using segmentation criteria to segment the target market, example: geographic,
demographic, psychographic or behavioral etc.
 Conducting a Market Research to determine the profitability and feasibility of each
segment
 Dividing larger market segments into smaller segments
• How is your market grouped?
The Scarborough Ambulatory Surgery Center has a multisegmented market
— Is it scattered? YES
— How many important segments are there?
There are approximately five (5) important segments, they include:
A. The Population with following surgical needs -
1. Bariatric Care and Surgery
2. Pediatric Surgery
3. Patient and Family Services for those needing surgical care (Social Work)
B. Physicians in the community and surrounding areas.
C. The Department of Health and Human Services (DHHS)
D. The local media and television network companies.
E. Other healthcare and referral organizations.
— How are these segments determined (demographics, service usage, attitudinally)?
Segments are determined on the basis of demographics and service usage as necessary.
• Is the market entirely urban, or is a fair proportion of it rural?
The market is a mixture of urban and rural, but is mostly urban based on target consumer
statistics.
• What percentage of your market uses third party payment?
Third Party/Insurance 46%
Medicare 40%
Medicaid 6%
Self-Pay 7%
Other 1%
Note: These are approximate percentages
— What are the attitudes and operations of third parties?
Because of growing pressure for third party administrators to come to terms with the
conditions of the current healthcare marketplace, and to respond to stakeholders and
client requests for a more capable and cost-effective marketplace where subscribers or
members can have all their healthcare needs met, the attitudes and operations of third
parties have been changing. Third parties are now taking a critical and quantitative
approach as far as the assessment of the market is concerned. They handle the accounting
details of the medical organization by providing various services including charge entry,
production of claims, patient bills, payment posting, and account receivables
management. Other functions and operations include compliance, and financial reporting.
Third parties are now focusing on data and transaction processing in the areas such as
electronic payment processing, and healthcare transaction processing to trace services,
market trends, consumer trends, and to discover competitive strategies that drive the
growth of the market. (MMC, 2008)
— Are they all equally profitable?

No, they are not always equally profitable, hence the reason MMC and the Ambulatory
Surgery Center in Scarborough conduct frequent reviews, and set internal controls to
determine the current profitability based on market trends. (MMC, 2008)
• What are the effects of the following factors on your market?
— Age – important due to an ageing population (Baby-boomers)
— Income – important due to a declining economy and an increased of the uninsured
— Occupation – Not as important, but has an effect based on the changing economy
— Increasing population – Important, but not an immediate concern of the market
*demographic shifting
— Decreasing birthrate – Important, but not an immediate concern of the market
• What proportion of potential customers are familiar with your organization, services, and
programs?
Nearly 100% of potential customers are familiar with MMC’s as an organization, but the
percentage of potential customers for the Ambulatory Surgery Center in Scarborough is about
79% due to location and lack of information.
— What is your image in the marketplace?
MMC’s Ambulatory Surgery Center in Scarborough has a great reputation in the market
place especially when take into consideration that it is the only one of its kind in the region.
— What are the important components of your image?
Caring for the community
Providing high quality services
Providing cost-effective health services
Educating tomorrow’s care givers

Researching new ways to provide care
Patient Safety Policy
THE ORGANIZATION
• Short history of your organization:
— When and how was it organized?
Maine Medical Center Ambulatory Surgery Center was started in 2007 as a project to
combine the Bramhall and Brighton Surgery Centers into one. The center was stated to
increase the overall operating capacity of MMC and to serve as an out patient surgery center
so that MMC can focus on complex emergency and trauma surgeries which is on the rise.
The centralizing of ambulatory surgery in Scarborough also addresses over-utilization which
has been identified as a potential patient safety issue which the new Ambulatory Surgery
Center is expected to address. (Maine Medical Center [MMC], 2008)
— What has been the nature of its growth?
The Ambulatory Surgery Center in Scarborough has maintained stable growth since its
opening in 2007. The project has proven to be an economic solution for Maine Medical
Center, which as the parent organization has experienced increased growth as a result of the
centralization of the surgery departments in Bramall and Brighton in to one center in
Scarborough. (MMC, 2008)
— How fast and far have its markets expanded?
MMC’s Ambulatory Surgery Center in Scarborough has had steady market growth since its
opening in 2007. The market has attracted consumers from other states New Hampshire, and
Massachusetts.
— Where do your patients come from geographically?

MMC’s Ambulatory Surgery Center in Scarborough serves the community Scarborough and
the people of greater Portland, and has attracted patients form other states such as New
Hampshire, and Massachusetts and from different places in northern New England.
— What is the basic policy of the organization? Is it on "health care,' 'profit"?
The basic policy of Maine Medical Center Ambulatory Surgery Center is based on the
organization’s philosophy of providing high quality medical care to all patients. The
Ambulatory Surgery Center adheres to MMC commitment of enhancing the culture of safe
patient and family centered care in order to achieve the highest standards of excellence
through planning, delivery, evaluation of health and mutually beneficial partnerships among
health care providers, patients and families. (MMC, 2008)
— What has been the financial history of the organization?
Maine Medical Center Ambulatory Surgery Center financial history is directly tied to MMC’s
financial history. Surgery was centralized at MMC to help increase capital gains; therefore, to
Hospital Finances (MMC, 2008)

MSC Consolidating Income Statement
2002 Gain/(Loss)
Practice ($ in thousands)
Maine Pediatric Specialty Group $ (2,018)
Greater Portland Medical Group (1,446)
Maine Center for Endocrine and Diabetes (712)
Greater Portland Pediatric Associates (696)
OB/GYN Associates (434)
Lakes Region Primary Care Services (408)
Scarborough Family Practice (190)
Surgical Associates (165)
Maine Children's Cancer Program (120)
Epilepsy Program (29)
Medical Services Corporation 6
$ (6,212)
appreciate the Ambulatory Surgery Center’s financial state one must gain an appreciation of
MMC’s financial state. The following data highlights some of MMC’s financial dealings.
MMC and its subsidiaries including the Ambulatory Surgery Center at Scarborough is part of a
multi-million dollar health system which is reflected in the following financial summary for fiscal year 2006.
MMC’s Quantifiable Community Value In Fiscal Year 2006

SERVICES DOLLARS
Community-Based Clinical Services 237,890
MaineHealth Clinical Services 1,528,340
Health Care Support Services 880,492
Community Health Education 40,290
Medical Education 22,523,000
Nursing, Technical, Other Students 80,000
Subsidized Health Services 7,711,485
Research 3,468,000
Financial Contributions 267,400
Community-Building Activities 93,500
Workforce Enhancement 286,470
Charity Care 10,464,000

TOTAL 47,580,867
Payments That MMC Foregoes, Which Some Hospitals Count As Community Value
Bad Debts 13,452,000

Shortfalls in government payments 29,528,000
(Medicare, Medicaid, Champus)

TOTAL 42,980,000
(MMC, 2008)
• How has it been capitalized?
Maine Medical Center is capitalized by private investment.
A1 Teaching
YTD Hospitals Major COTH
FY99 FY00 FY01 FY02 FY03 '01 Moody's '99 HCIA 1999
CAPITAL STRUCTURE RATIOS
Debt to Capitalization 27.8% 26.9% 25.8% 23.0% 21.9% 34.1% 39.0% n/a
Debt Service Coverage 4.3 4.2 4.0 4.2 4.3 5.4 3.5 n/a
Capital Expense Ratio 6.9% 7.4% 7.4% 7.6% 7.6% 8.8% 6.7% n/a
A1 Teaching
FY00 FY01 FY02 FY03 '01 Moody's '99 HCIA 1999
LIQUIDITY RATIOS
Current Ratio 2.4 2.5 3.0 2.6 2.0 1.7 1.7
Days Cash on Hand 166.5 161.3 153.7 164.1 193.3 n/a n/a
Days in Accounts Receivable 43.8 31.9 23.5 20.9 66.4 71.0 n/a
(MMC, 2008)
A1 Teaching
PROFITABILITY RATIOS
Operating Margin 1.7% 0.8% 1.3% 1.6% 1.9% 2.2% 0.8% 0.9%
Total Margin 6.9% 4.8% 4.2% 4.2% 3.8% 6.2% 2.0% 2.1%
Return on Assets 4.6% 3.5% 3.2% 3.5% 3.1% 4.6% 1.5% n/a
(MMC, 2008)
A1 Teaching
OTHER RATIOS
Average Age of Plant 7.0 5.8 6.0 6.2 6.2 8.6 9.3 9.1
Cost per Adjusted $5,657 $5,846 $6,213 $6,784 $7,068 n/a n/a n/a
Discharge
FTE per Adjusted Average 6.4 6.2 6.1 6.4 6.4 n/a 6.6 6.1
Daily Census
(MMC, 2008)
— Have there been any account receivable problems?
The Ambulatory Surgery Center at Scarborough have not had any significant account
receivable problems, however, based on fluctuating market trends MMC’s has had some
slight problems with ROI. In other cases the account receivable balance remains fairly
stable for extended periods. Some patients just don’t settle their bills at the time of
service; and this also holds true for the Ambulatory Center at Scarborough, hoverer, the
margin is insignificant that it is not reflected in the larger picture, this is where problems
with the insurance companies come into the picture. The major problem with this account
receivable balance is that the money owed earns no interest as it is a non-performing
asset, but the main problem at MMC is the length of time the payment is owed.
Sometimes the hospital writes the debt off but this does not really solve the problem.
(MMC, 2008)
— What is inventory investment?
Inventory Investment is the difference between production and sales for a fiscal year. It
takes into account what is produced and what is sold as it relates to profit.
— What has been the organization's success with the various services promoted?
Services Promoted Organization's Success

Ambulatory Surgical Services Provides better service for the increasing volume of outpatient surgery in one location
10 new Operating Rooms for day surgery attracts many new patients
Advanced anesthetics and procedures allow over 9000 surgeries annually
An effective response to the trend of more and more patients getting care in an outpatient
setting and going home the same day
Scarborough Surgery Center (SSC) The most modern surgery facility in New England – with nearly every surgery related
advancement known to medicine.
Surrounded by every convenience, comfort, and amenity one can ask for.
Specialized Ophthalmology (Surgery)
Effective response from patients and their families
Specialized Pediatric Surgery
Increased the volume of outpatient pediatric surgery in one location
Private doctor/patient consultation
Improved the quality of care through doctor-patient interaction
Café and outdoor patio
Attracts more patients and families to the center – used as an advertising tool for center
Convenient physician parking
Well organized parking – increased physician satisfaction
(MMC, 2008)
— How does your organization compare with the industry?
The Ambulatory Surgery Center in Scarborough is the only one of its kind in the region, and
as part of Maine Medical Center it is classed as a major outpatient surgery center in the State of
Maine and in the nation. It receives all the recognition and ratings that MMC receives as a
healthcare institution in general. (MaineHealth Organization [MHO], 2008)
— Is the total volume (gross revenue, utilization) increasing, decreasing?
The total volume (gross revenue, utilization) is increasing.
— Have there been any fluctuations in revenue? If so, what were they due to?
There have not been any fluctuations in revenue because of the demand for the market based on
the demographics and geographical area it serves. As a result of market demands revenues have
been increasing
— What are the objectives and goals of the organization? How can they be expressed beyond
the provision of “good health care”?

The Ambulatory Surgery Center is dedicated to maintaining and improving the health of the
communities it serves by:
 Caring for the community by providing high quality, caring, cost-effective health services
 Educating tomorrow’s care givers; and
 Researching new ways to provide care.
The Ambulatory Surgery Center and Professional staff continually focuses on comprehensive
and ongoing measurement of the following quality areas:
 Operative and other invasive procedures that place patients at risk, including major
discrepancies between pre- and post-operative (including pathologic) diagnosis
 Use of medications
 Use of blood and blood components
 Appropriateness of admissions and hospital stays
 Patient satisfaction
 Use of restraints and seclusion
 Autopsy results
 Organ tissue donation
 Risk management activities, including analysis of undesirable patterns in
performance, critical events, and root cause analysis of sentinel events
 Joint Commission core measures
 Quality control activities
 Safety indicators, including patient safety
 Infection control
 Research
 Staff opinions and needs
 Resuscitation and its outcomes
 Patient Flow
 Medical records
— What are the organization's present strengths and weaknesses in:
— Medical facilities
Locations Services/Activities Strengths Weaknesses

at this location
Ambulatory Board-certified radiologists are always on-site to Needs a more robust advertising program.
Scarborough Diagnostic Services interpret and oversee the imaging evaluations
Campus Ambulatory Services The Chronic Pain Unit attracts a large and growing Needs a more robust advertising program.
100 US Route (Chronic Pain Unit, outpatient population in the region and beyond
1, Scarborough Pre-Admission
Testing, Vascular
Access Services)
FirstCare (Urgent No emergency is minor at FirstCare which attracts Understaffed – Needs new Physicians.
care) many patients on a daily basis which introduces
them to the organization as a whole and its various
services. FirstCare serves as an advertising tool
Ambulatory Board-certified radiologists are always on-site to Needs new transport vehicles and better coordination between
Diagnostic Services interpret and oversee the imaging evaluations – MMC’s Physicians.
Great cooperation with other MMC facilities.
Scarborough Surgery The most modern surgery facility in New England – Better advertising
Center (SSC) with nearly every surgery related advancement
known to medicine.
Surrounded by every convenience, comfort, and

amenity one can ask for.
(Maine Medical Center [MMC], 2008)
— Management capabilities
The Ambulatory Surgical Center in Scarborough Maine is operated and governed by Maine
Medical Center. The following is and organizational chart of MMC’s leadership.
(MHO, 2008)
Part of MMC’s Ambulatory Surgery Center’s strength and management capability is directly related to the strength
of its Medical directors and they involvement with MMC’s Clinical Services Contracts. The following table lists some of
MMC’s Clinical Services Contracts:
Maine Medical Center Contracts - Clinical Services

April 2008
Contractor Services Selection Criteria Medical Director involved in
selection
American Red Cross Blood and blood products (contract term:10/1/07 – 10/1/08 National standard supplier; AABB Tim Hayes, MD, Blood Bank Medical
with auto renewal for successive 1 yr periods) standards met and FDA licensed Director
HealthSouth Management Services Management of MMC Rehab Services with contracted JCAHO accredited, Joint Venture Mary Macy, MD, Medical Director &
personnel. Partner with NERHP. Division Chair
Hemacare (Coral) Blood and blood products (contract term: 10/1/06 – 9/30/08) National standard supplier; AABB Tim Hayes, MD, Blood Bank Medical
standards met and FDA licensed Director
Hemacare (Coral) Outpatient Therapeutic Apheresis (contract term: 10/1/06 – Outsource decision; FDA licensed Jacqueline Hedlund, MD, Medical Director
9/30/08) & JCAHO standards met. & Hematologist
Insight Mobile MRI Services provided at Brighton & Scarborough Complies with JCAHO standards. Charles Grimes, MD, Chief, Department of
Campuses, supplies equipment, maintenance and technical Meets MMC Department of Radiology
staffing on a flexible basis up to 3 days/ week (contract term: Radiology requirements for
11/1/04 - 10/31/09) quality, standard imaging
protocols and compatibility with
PACS
Maine Orthotic and Prothetic Rehab Orthotist services including assessment, fabrication and fitting Orthotists must be certified, meet Mary Macy, MD, Medical Director
Service of custom devices. standard MMC contractual
requirements.
Maine Artificial Limb and Orthotics Orthotist services including assessment, fabrication and fitting Orthotists must be certified, meet Mary Macy, MD, Medical Director
of custom devices. standard MMC contractual
requirements.
Maine Molecular Imaging Mobile PET scanning services at the MMC Brighton Campus Complies with JCAHO standards. Roger Pezzuti MD/Michael Quinn,
(contract term: 1/07 - 1/10) Meets MMC Department of Physician Director PET scanning
Radiology requirements for
quality, standard imaging
protocols and compatibility with
PACS
Maine Lithotripsy LLC Lithotripter Services 7/14/06 – 6//09 Competitive contract; complies Thomas Kinkead, MD, Chief, Division of
with JCAHO standards. meets Urology
Urologists requirements for
equipment and service
Navix Diagnostix Vein Ablation Services 5/18/07 – 5/17/09 Sole supplier P. Bloch, MD, Jens Jorgensen, MD, Chief,
Division of Vascular Surgery
New England Organ Bank NEOB responsible for hiring new staff, provide orientation, NEOB is the Organ Procurement John Vella, MD
plan quarterly oversight sessions, assist with HR reports, Organization (OPO) for New James Whiting, MD
collaborate on budgets and maintain on line access England and is mandated by
CMS. There is no alternate
provider.
NorDx Laboratory Clinical Laboratory and Anatomic Pathology services for MMC Sister corporation; CAP, Michael Jones, MD, Chief of Pathology
MMC inpatient and outpatient settings AABB accredited; Monthly
inpatient and outpatient quality
scorecards; selected data reported
on MMC balanced scorecard.
Northeast Mobile Health Service Medical Transportation Contractor for Pedi and Neonatal M. Gibbs, MD
Transport Team ambulance
service; principal provider of
ambulance services in the area;
negotiated favorable terms for
uninsured pts.
Other key Contractual Arrangements include: Spring Harbor Mental Health Administration Services, and Spectrum Radiology, Pathology, Anesthesiology services.
Some weaknesses of management include lack of timely coordination and information shearing, and slow response to some critical marketing deficiencies.
(MMC, 2008)
— Medical staff
Strengths: MMC’s Ambulatory Surgery Center and Health Professional Affiliate Staffs are
organized for the purpose of providing high quality surgical care to all patients. The clinical
work of the staff is guided by the principles of continuous performance improvement (PI),
peer review and professional ethics. The Medical and Professional Staff Performance
Improvement Plan is approved annually by the MMC Board of Trustees. Through its
Executive Committee, the medical staff reviews and acts on the reports, requests, and
recommendations from the Medical Staff Committees and/or members of the professional
staff as well as from the Credentials Committee regarding applicants to the medical staff and
others seeking privileges. Among its assigned responsibilities, the Medical Staff Executive
Committee makes recommendations to the Board of Trustees regarding appointments and
reappointments to the Medical Staff. (MHO, 2008)
The Medical and Professional Staff PI Plan outlines the role of the Medical Executive
Committee, the Quality Council, as well as the Pharmacy and Therapeutics Committee, the
Medical Records Committee, the Utilization Review Committee and the Transfusion
Committee. The Medical and Professional Staff PI Plan also outlines the departmental
activities that focus on performance improvement. Detailed information on responsibilities,
composition and reporting relationships of the medical staff departments and committees is
found in the Medical Staff Bylaws and the Medical and Professional Staff Performance
Improvement Plan.
A key component of the Medical Staff is the Clinical Service Groups which include the
following:
• Cardiology:
– Statewide AMI Collaborative
– CHF Disease Specific Certification
• Discharge Instruction Program Enhancements
• General Surgery
– Surgical Site Prevention Efforts
– Scarborough Surgery Center
• General Medicine
– Primary Stroke Certification
• Obstetrics
– Women and Infants Construction Project
– 3rd and 4th Degree Lacerations
• Pulmonary Medicine
– Pneumonia Core Measures
– VAP Team
Part of MMC’s strength can also be attributed to management’s effort to conduct Periodic
Performance Review which includes:
• Monthly reports to the Operations Leadership Team on status of the Hospital and
Behavioral Health PPRs and measures of success.
• Joint Commission Scorecard in SAS
• Accreditation Readiness Committee
• Reports to the Nursing Practice Council
• Internal Tracers
• Planning and Prioritization
• Annual Implementation Plan
• Priority scoring system
• Assessment and Measurement
Weaknesses: of the Medical Staff include:
• Slow response time when dealing with reported deficiencies
• Insufficient data gathering
• Lack of coordination and information sharing

• Improper allocation of resources to the department needing it
— Technical facilities
The Ambulatory Surgery Center is equipped with some of the best modern facilities and
technology in the region and shares in all the benefits of MMC and is supported by the following
modern facilities at MMC. (MHO, 2008)
The Special Care Unit/Intensive Care Unit (SCU/ICU) which is a 45-bed unit is divided into
a General Surgical ICU, Cardiothoracic ICU, Pediatric ICU, and a 22-bed Medical ICU. MMC is
fully equipped with Cardiology, Nephrology and Hematology/Oncology units with the most
modern facilities. The Cardiology/Coronary Intensive Care Unit (CICU) is a 12 bed ICU where
patients are cared for through the most advanced monitoring systems. The unit is fully equipped
with all the technology for maintenance of patients with cardiovascular and respiratory
emergencies. The Hematology/Oncology Unit (Gibson Pavilion) is a 26,000 square feet facility
with 37 patient rooms equipped to provide care for the most critical patients. MMC’s Emergency
Department is one of the only three trauma centers in the state of Maine, MMC’s is the only one
with Level I designation by the American College of Surgeons. It is staffed round the clock.
MMC’s Ambulatory Clinic also fully equipped with the latest technology and also serves as
training unit for residents. The Radiology department is one of the best in the region and
provides MRI, CT scanning, ultrasound, nuclear medicine, and radiation therapy. (MHO, 2008)
— Reputation
The Ambulatory Surgery Center at Scarborough shares in the great reputation of MMC. The
following is a list of awards and recognition MMC received as an organization and in
different departments:
Organization Year Recognition Review

U.S.News & World 2007 America's Best Hospitals The first time it or any Maine hospital received such review. Only 173 medical centers out of the
Report #45 in nation for orthopedic care 5,462 evaluated made any of the lists.
America's Best Hospitals

2007
#50 in nation for heart care & heart surgery
U.S.News & World
Report
2007 Named Level I Trauma Center Maine Medical Center has become one of less than 100 verified adult Level 1 trauma centers in
Committee on Trauma the United States. The Committee on Trauma of the American College of Surgeons reviewed the
of the American
College of Surgeons program and verified its status in March 2008.
2007 Primary Stroke Center - National Quality Approval The Neuroscience Institute's Stroke Program was designated a Primary Stroke Center by the Joint
Joint Commission Commission in 2007, making us the first hospital in Maine to earn such an honor.
HealthGrades 2006 Top 10% in nation For overall cardiac services
Top 5% in nation For cardiology services
Top 5% in nation For coronary interventional procedures
Five-star rating In overall cardiac services, cardiology services, coronary
intervention procedures, treatment of heart attack, and treatment of heart failure
Top 10% in nation For overall orthopedic services
Top 5% in nation For joint replacement
Five-star rating In overall orthopedic services, joint replacement, spine surgery, total knee replacement, total hip
replacement, and back and neck surgery.

2006 Safest Hospitals in the Nation
The Leapfrog Group Top 50

Top Hospitals
Hospitals & Health 2006 100 Most Wired Hospitals 100 Most Wired Hospitals
Networks Magazine 25 Most Wireless Hospitals 25 Most Wireless

American Nurses 2006 Magnet Recognition for Excellence in Nursing
Credentialing
Committee
Solucient (formerly 1999 Top 100 Cardiovascular Hospitals Top 100 Cardiovascular Hospitals
HCIA) 2001 100 Top Cardiovascular Hospitals 100 Top Cardiovascular Hospitals
2002 100 Top Hospitals 100 Top Hospitals
2004 100 Top Cardiovascular Hospitals 100 Top Cardiovascular Hospitals

Consumer's Digest 2005 #4 on list of "50 Exceptional U.S. Hospitals" (based on Leapfrog/NQF safety practices)
Child Magazine 2003 Top 25 Children’s Hospitals Top 25 Children’s Hospitals
National Research 2004- Healthcare Marketing Guide Healthcare Marketing Guide
Corporation 2005 “Consumer’s Choice #1, Overall Quality and Image” “Consumer’s Choice #1, Overall Quality and Image”
United Way of Greater 2004 “Leading the Way” Award Ronald McDonald House - Portland, Maine
Portland
Northeast Health Care 2000 Certificate of Recognition Certificate of Recognition
Quality Foundation 2003 Certificate of Recognition Certificate of Recognition

Mayoral Proclamation 1997 Mayoral Proclamation Award Mayoral Proclamation recognizing MMC’s value to community
Pine Tree Council, Boy 2004 Distinguished Citizen Award Distinguished Citizen Award to Vincent S. Conti
Scouts of America
U.S. Department of 2007 Medal of Honor for Organ Donation Success Maine Medical Center is one of only four New England hospitals to receive this recognition for
Health & Human organ procurement success. Only 42 hospitals in the country received this first-ever medal. The
Services minimum donation rate for the recognition is 75%; MMC's is 86%.
—Image
MMC’s Ambulatory Surgery Center is looked upon by the community as a unique center where
people are cared for, educated, and where ongoing research is at its cutting edge. The Center is
looked upon as a center dedicated to maintaining and improving the health of the communities it
serves. The Ambulatory Surgery Center’s is seen as a place where the fundamental commitment
to patients is safety and quality, rooted in a rich tradition of ethical decision making, and
commitment to treating each individual with dignity and respect
— What is the labor environment for your organization?
The labor environment is one where mutual respect, understanding, and trust are combined to
form a culture of positive relationships. It is based on a protocol of Joint consultation between
labor and management, which is responsible for improved labor management relations.
— For medical staff (nurses, physician etc.)?
The labor relations between medical staff, i.e. nurses, physicians etc, is one that is built on the
foundation of two way communication with equal representation from both labor and
management. The medical staff’s concerns such as employee health and welfare, morale,
production and safety are dealt with quickly and for the most part effectively.
— For support personnel?
Support personnel are fully supported within the organization. There is a labor director who
handles labor policies, oversees, and negotiates on behalf of the support personnel. Matters such
as collective bargaining, grievances/complaints, and disputes are handled by the labor director
who operates form the human recourses office. The human resources department through its
reprehensive interprets and administers changes with respect to grievances, wages and salaries,
employee welfare, health care, pensions, union and management practices, as well as other
contractual stipulations.
— How dependent is your organization upon conditions of other industries (third party
payers)?
The Ambulatory Surgery Center at Scarborough is very dependent on third-party. The hospital
recommends that the state be the primary payer for the uninsured and those enrolled in publicly
funded healthcare plans such as Medicaid, and Medicare etc. MMC as the parent organization
also recommends that private employers and other third-party payers remains the key sponsor for
those enrolled in programs covered by private healthcare benefit plans.
— Are weaknesses being compensated for and strengths being used? How?
Yes, weaknesses are being compensated for and strengths are being used by constant review and
internal controls. Through this review process weaknesses are discovered and resources are
routed to the appropriate areas. The Center for Performance Improvement (CPI) at MMC the
parent organization is the department that supports the successful achievement of the
Performance Improvement Plan. Within the Department of Medical Affairs, and under the
leadership of the Associate Vice President of Medical Affairs and Patient Safety Officer, the
Center has strong working relationships with the Department of Risk Management, Department
of Accreditation and Regulatory Affairs, Department of Ethics/Patient and Guest Relations, and
Nursing. CPI provides the following functions:
 Staff and support for Board Performance Improvement Committee, Patient Safety
Team, and Performance Improvement Team

 Administration of the SAS Business Intelligence software as well as data collection
and data analysis support
 Project Management support for major institutional strategic goals
 Teaching of the MMC performance improvement toolkit
• How are the following areas of your marketing function organized?
— Structure
The structure of The Ambulatory Surgery Center at Scarborough market is based on patient flow;
therefore the physical radius of the market is variable. Though the market caters for patients
within a given radius defined by miles, the market itself is structured in such a way that takes
into account statistical data based on zip codes, and the dynamic flow of patients based on
current trends. Therefore, the market structure should not be thought of as static but rather
dynamic.
— Manpower
The Ambulatory Surgery Center at Scarborough marketing function is organized around the
power of team involvement (Manpower). As new programs or services are designed, key
processes or services are reviewed. This design is based on the MMC mission, vision, values and
strategic goals, and the needs and expectations of customers. MMC marketing department works
in close contact with the Quality Improvement department (QID) The QID details the
organizational structure for performance improvement, including membership on committees
(Manpower). The Board of Trustees Performance Improvement Committee has been charged
with the oversight of systems for assessing and improving quality at the Medical Center,
including programs for the management of risk and liability and plans to promote the safety of
patients, visitors and employees.

The management of the medical center has established a committee structure to
strengthen the function of its manpower base. They include the interdisciplinary Quality Council
(reporting directly to the Board of Trustees Performance Improvement Committee), the
Performance Improvement Team, The Marketing Team, and the Patient Safety Team. Roles,
relationships with other hospital committees, departments and individuals, and leadership for
each of these committees has been determined and defined in charter. In addition, the Nursing
governance structure includes a Nursing Quality Council, a Marketing Director of Nursing,
and unit-based marketing committees. Each marketing Unit, therefore, has representation on
the overall Council.
— Reporting relationships
Mark Harris Vice President, Marketing & Communications, MaineHealth & Maine Medical Center
Wayne Clark Associate Vice President for Communications and Marketing
Martha Davoli Public Information and Media Services Manager
Abby Greenfield Community Relations Manager
(MHO, 2008)
The Ambulatory Surgery Center at Scarborough Marketing Department is directly linked to the
Vice Presidents who are responsible for the performance improvement of their assigned non-
clinical departments. Clinical Service Teams (management troika of operations executive,

physician chief of service, and nursing executive) are responsible for the performance
improvement of their frontline clinical areas and are required to report twice yearly to the
Quality Council on their progress towards achieving performance goals. These teams are
encouraged to hold regular service or departmental quality forums, at the discretion of the
leadership team. There are multiple avenues for bringing performance improvement
opportunities up through the structure from online (anonymous) event reporting system to
email/telephone access to performance improvement staff, to formal presentation and discussion
at Quality Council.
— Decision-making power
The Ambulatory Surgery Center at Scarborough marketing decision-making is done by the Vice
President of Marketing and Communications and his staff who reports directly to the Chief
Operating Officer who reports to the President. The President reports directly to the Board of
Trustees of MMC. It should be noted however that “smaller” marketing decisions are made
within each department within the organization; these decisions must be approved by the Vice
President of Marketing and his team.
What kinds of external controls affect your organization?
The Ambulatory Surgery Center at Scarborough is committed to complying with all applicable
Federal and Maine laws and regulations, including the False Claims Act. The False Claims Act
prohibits the hospital and its employees and physicians from knowingly submitting a false claim
to a federal health care program, such as Medicare, or to MaineCare. This policy identifies
MMC’s responsibilities under the False Claims Act and the steps that an employee may take to
address Fraud, Waste and Abuse and a potential or actual false claim. These and the following
external controls greatly affects the way MMC market its products and services.
The Ambulatory Surgery Center at Scarborough will use and disclose a patient’s Protected
Health Information (PHI), without patient authorization, as required by law, or public policy
considerations. These shall be referred to as the public good exception. (Depart of Health and
Human Services [DHHS], 2007)
Policies:
1. It is the policy of The Ambulatory Surgery Center:
a. To use and disclose a patients’ PHI as required by city, state or federal agencies,
and as mandated by judicial or administrative requests, and subject to the
procedures stated below; and
b. That the content, posting and distribution of MMC’s Notice of Health Information
Privacy Practices shall meet all legal requirements to advise patients of public
purpose releases.
Procedures:
1. The Ambulatory Surgery Center at Scarborough shall use or disclose PHI in accordance
with federal and state laws and regulations. The required steps are:
a. Review and follow applicable requirements for federal laws and regulations and
health oversight organizations, as specified in Table A below.
TABLE A
Releasing Protected Health Information under the Public Good Exception for Federal
Laws and Regulations and Health Oversight Organizations
Type of Disclosure Clarification Examples

(as needed)
1.  Cancer registry state reporting
Required by Law  State reporting
 Court Orders
 Organ donor services chart review
 Peer review organizations - DRG/Utilization chart
reviews

(as needed)
2. To a public health authority that is  Child abuse, neglect, or domestic violence reporting to
Public Health Activities authorized by federal, state, or local Social Services or Protective Services agencies--unless
law to collect or receive such the covered entity (CE) in its professional judgment
information for the purpose of: believes informing the individual may cause serious
 preventing or controlling disease; harm or if the CE believes the individual is responsible
 reporting of disease or injury; for the abuse, neglect, or injury.
 vital events, such as birth or  Communicable/infectious disease
death;  Head Injury/ Traumatic Reporting
 the conduct of public health  Medical Device reporting
surveillance, public health  Birth certificate and death certificate tracking
investiga-tions, and public health  Sentinel event chart reviews
interventions; and  FDA regulated product or activities (adverse events,
 at the direction of a public health product defects, etc.)
authority, to an official of a
foreign government agency that
is acting in collaboration with a
United States public health
authority.
3.  FDA JCAHO, CARF, ACOS, AHCA accreditation
Health Oversight surveys or on-site record reviews and sentinel event
Activities reporting
 CMS – Medicare surveyor chart reviews
4. Judicial and  Seek supervisor’s direction Court order
Administrative subpoenas without an order of the Administrative tribunal
Proceedings court or administrative tribunal.
4. a. MMC may use or disclose PHI if Subpoenas without court order or administrative
Subpoenas without a MMC receives satisfactory tribunal
court order or assurance from the party seeking Discovery request or other lawful process without a
administrative tribunal the information that they have court order to administrative tribunal
made reasonable efforts have been
made to 1) ensure that the patient
has been given notice of the
request, or 2) secure a qualified
protective order.
Or, MMC may use or disclose
PHI if MMC makes the
reasonable effort to provide notice
to the patient or seek a qualified
protective order.
5.  Court order or court-ordered warrant
Law enforcement  Grand jury subpoena
purposes  Reporting as required by law, i.e. child abuse, gunshot
wounds (see Table B-1)
 Crime on premises
 Reporting crime in an emergency
6. Decedents  Coroners or medical examiners to identify a deceased
person, determine cause of death, or other duties by law
 Funeral directors to carry out lawful duties
7.  Organ procurement organizations or other entities
Cadaveric organ, eye or engaged in procurement, banking, or transplantation
tissue donation
8.  If an IRB or Privacy Board issues a waiver of
Research Purposes authorization for research studies with 50 or more
individuals
9.  FDA inquiries
To avert a serious threat  Terrorism alerts for medical or safety threats
to health or safety  Communicable disease organizations

(as needed)
10.  Military and veterans activities.

Specialized government  Protective Services for the President and Others
functions
11.  Agencies assisting in notifying family members of
Disaster Relief disaster victims.
12. For workplace medical surveillance  Workers’ compensation disclosures for claims
Workers’ Compensation and work-related illness/injury: processing requests, workplace medical surveillance
 Provider must give copy of a and work related injury verification
written notice (informs
individual that PHI will be
disclosed to employer) at
time care is provided.
(MHO, 2008)
Table A - Abbreviations:
ACOS - American College of Surgeons

AHCA - Agency for Healthcare Administration
CARF - Commission of Accreditation of Rehab Facilities
CMS - Centers for Medicare and Medicaid Services
FDA – Food and Drug Administration
IRB – Institutional Review Board
JCAHO - Joint Commission of Accreditation of Healthcare Organizations
(MHO, 2008)
b. Review and follow applicable requirements for state laws and regulations, as
specified in the Tables B-1, 2, and below.
TABLE B-1
Releasing Protected Health Information under the Public Good Exception for
Maine State Laws and Regulations – Citation List
Maine law requires MMC to report information as required in the following Maine State Laws and Regulations. MMC workforce members will
utilize these citations in conjunction with Table B-2.
1. Suspected child abuse or neglect. MMC personnel will meet the requirements of 22 M.R.S.A. §§ 4011-A, 4012, and 4015.
2. Suspected adult abuse, neglect or exploitation. MMC personnel will meet the requirements of 22 M.R.S.A. § 3477. Promptly after
making the report, MMC personnel will inform the patient about the report, unless MMC personnel believe that informing the
patient would place him or her at risk of serious harm, or MMC personnel would be informing a personal representative that
personnel believe is responsible for the abuse or neglect and that it would not be in the patient’s best interests to inform the personal
representative.
3. Abortion and miscarriage data. MMC personnel will meet the requirements of 22 M.R.S.A. § 1596.
4. Birth and death registration. MMC personnel will meet the requirements of 22 M.R.S.A. §§ 2761, 2841 and 2842.
5. Blindness. MMC personnel will meet the requirements of 22 M.R.S.A. § 1418-E.
6. Cancer. MMC personnel will meet the requirements of 22 M.R.S.A. § 1402 and, 10 C.M.R. CH. 255.
7. Infant eye inflammation. MMC personnel will meet the requirements of 22 M.R.S.A. § 1531.
8. Gunshot wounds. MMC personnel will meet the requirements of 17-A M.R.S.A. § 512.
9. Head injuries. MMC personnel will meet the requirements of 22 M.R.S.A. §§ 3086 and 3087.
10. Trauma registry data. MMC personnel will meet the requirements of 32 M.R.S.A. § 87-B.
11. Medical examiner reporting. MMC personnel will meet the requirements of 22 M.R.S.A. §§ 3026 and 4013.
12. Newborn metabolic disorders. MMC personnel will meet the requirements of 22 M.R.S.A. § 1532 and 10-144 C.M.R. Ch. 283.
13. Birth defects. MMC personnel will meet the requirements of 22 M.R.S.A. § 8942.
14. Agency access to records, facilities and persons with disabilities and required reporting. MMC personnel will meet the
requirements of 5 M.R.S.A. § 19506.
15. Workers’ compensation reporting. MMC personnel will meet the requirements of 39-A M.R.S.A. § 208.
16. Sentinel events. MMC personnel will meet the requirements of 22 M.R.S.A. § 8753.
(DHHS, 2007)
TABLE B-2
Releasing Protected Health Information under the Public Good Exception for
Maine State Laws and Regulations – Conditions
Condition Reported By Reported To Within Citation

Abortion, Induced Physician DHS 10 days 22 MRSA § 1596
Adult Abuse All caregivers DHS STAT 22 MRSA § 3477
Birth Hospital City 7 days 22 MRSA § 2761
Birth Defects Hospital DHS, Bureau of Health TBD 22 MRSA § 8941

Blindness (20/200 or All caregivers Director of the Division Within 30 days 26 MRSA § 1418-E
worse) for the Blind and Visually
Impaired
Burns resulting from All caregivers State Fire Marshall May report 25 MRSA § 2415
Arson
Cancer Hospital DHS 30 days 22 MRSA § 1402; 10-144,
Ch. 255
Child Abuse All caregivers DHS/DA STAT 22 MRSA § 4011-A
Child Death from Abuse All caregivers Medical Examiner STAT 22 MRSA § 4013
Death Physician City 24 hours 22 MRSA § 2842

Eye inflammation, Midwife/Nurse Physician STAT 22 MRSA § 1531
newborn
Fetal Death > 20 weeks Physician City 5 days 22 MRSA § 2841
Gunshot Wound Physician Police 24 hours 17-A MRSA § 512
Head Injury Hospital/Physician DHS, Bureau of Health May report 22 MRSA § 3087
Impaired Driver All caregivers Law enforcement official / May report 29-A MRSA § 2405; 29-A
Secretary of State MRSA § 1258
Lead Poisoning 22 MRSA § 1319
Requirement repealed (repealed)
1999
Medical Examiner Case All Persons Medical Examiner STAT 22 MRSA § 3026; 22
MRSA § 4013 (child death
from suspected abuse or
neglect)
Medical Errors – Sentinel Hospital Bureau of Med. Services, Notification by 22 MRSA § 8751
events (effective 5/1/03) Div. of Licensing & Cert. next bus. day; [Refer to Table A, #3
report in 45 Health Oversight
days Activities]
Condition Reported By Reported To Within Citation

Miscarriage < 20 weeks Physician DHS 10 days 22 MRSA § 1596
Motor Vehicle, ATV, Boat Physician/Nurse Police May report 29-A MRSA § 2405
or Snowmobile Accident
due to Intoxication
Notifiable Diseases (See Hospital/Physician & DHS STAT reports for 22 MRSA § 802, 821;
Table B-3 below for Physician Assistants / Bureau of Health Category 1 and DHS rules
Notifiable Conditions Labs within 48 hours
List) for Category 2
Occupational Diseases Physician/Hospital DHS 30 days 22 MRSA § 1493; DHS
rules
Infant Screening Hospital DHS 1 work day 22 MRSA § 1532
Infant Screening – failure Hospital/Birthing Ctr/ Maine Newborn Screening 5 work days 10-144, Ch. 283
to screen Birthing Attendant Program, Div. Of (parental refusal
Community and Fam – 14 days)
Health
Sexual Crime victims Caregivers Law Enforcement May report for 30-A MRSA 287
prosecution
purposes
Trauma Hospital EMT Board May report 32 MRSA § 87-B
Worker’s Compensation All providers Employer/ 5 days 39-A MRSA § 208

Injury Employee
(DHHS, 2007)
c. For additional clarification on the applicable requirements, seek clarification from
one’s Department Director or MMC’s Center for Performance Improvement.
(Depart of Health and Human Services [DHHS], 2007, 45 C.F.R., M.R.S.A.: 5,
10, 17-A, 22, 25, 26, 29, 30, 32, 39-A)
- Local?
The Ambulatory Surgery Center at Scarborough is obligated by Local, State, and Federal law to
use and disclose a patient’s Protected Health Information (PHI), without patient authorization, as
required by law, or public policy considerations. This is referred to as the public good exception.
(Berkowitz & Flexner,)
- State?
Maine False Claims law: Maine law also prohibits any person from knowingly submitting a false
claim, making a false statement in support of that claim, or otherwise attempting to defraud the
state. A violation of this law could result in criminal or civil liability of the greater of $2000 per
claim or 3 times the amount of damage, plus restitution, interest, costs, and attorney fees.
Employers are also prohibited from terminating a person solely for whistleblowing.
- Federal?
Staff may report grievances directly to the federal Department of Justice via email at
oig.hotline@usdoj.gov or call 800-869-4499.
Whistleblower protections: Federal law prohibits an employer from discriminating against an
employee in the terms or conditions or his or her employment because the employee initiated or
otherwise assisted in a false claims action. The employee is entitled to all relief necessary to
make the employee whole.
Other important regulations include the Anti-Referral Laws. A federal law
known as the “Stark law” applies to any physician who has a financial
interest in an organization or business and prohibits referrals by that
physician to that organization for most health services reimbursed by
Medicare and Medicaid. The Stark law also prohibits entities from billing any
patient for services performed as a result of a prohibited referral.
- Self-regulatory?
MMC Compliance Program: In an effort to comply with Federal and State laws MMC created
The Maine Medical Center Compliance Program which is designed to prevent illegal or
inappropriate activities from occurring at Maine Medical Center or affiliated entities. This
includes regular auditing conducted by both individual departments and Audit & Compliance
Services, and reporting of findings to the Organizational Ethics Committee and the MaineHealth
Audit Committee. Although auditing is a significant part of the compliance program, to be

successful the compliance program relies on individual employees coming forward with
information about inappropriate activities that they become aware of, or suspect.
Maine Medical Center (MMC) obtains a patient’s authorization before using or disclosing the
patient’s Protected Health Information (PHI) for marketing purposes unless an exception exists.
(MHO, 2008)
Policies:
1. It is the policy of The Ambulatory Surgery Center at Scarborough that patients will have
the option to authorize being sent marketing material, in accordance with the procedures
stated below.
Procedures:
1. Patient's prior written authorization is obtained for the following purposes:
a. For marketing to the patient.
b. For marketing that results in The Ambulatory Surgery Center receiving direct or
indirect remuneration from a third party. This fact will be specified in the
authorization form.
2. Patient’s written authorization is not required if the communication is:
a. A face-to face-to-face meeting with the patient.
b. A promotional gift of nominal value provided by The Ambulatory Surgery Center
at Scarborough.
3. Patient’s written authorization is not required if the information provided does not meet
the regulatory definition of marketing. It is not considered “marketing” when the
communication is for the following purposes:

a. To describe a health-related product or service (or payment for such product or
service) provided by, or related to the patient’s plan of benefits;
b. For treatment of the patient; or
c. For case management or care coordination for the patient, or to direct or
recommend alternative treatments, therapies, providers, or settings of care to the
patient.
4. The Ambulatory Surgery Center at Scarborough may not use or disclose highly
confidential information for marketing purposes or other communication, as indicated in
section 3 above, unless otherwise permitted by law or patient’s written authorization.
Procedures:
Staff who become aware of, or suspect Fraud, Waste or Abuse, or become aware of, or suspect,
that a false claim has been submitted to a Payor or to a patient, or a false statement in support of
a claim, are required to report these activities to:
a. Their manager, supervisor, or senior management

b. Audit & Compliance Services department
c. The Ethics Helpline: 662-4646 (this can be done anonymously)
What are the trends in recent regulatory rulings?
The trends in recent regulatory rulings clearly show a movement towards stricter rules to protect
patients. For example public laws of Maine, chapter 678, S.P. 419 - L.D. 1363 were passed as
recently as 2001 at the 2nd Regular Session of 120th Legislature. This is an Act to reduce
medical errors and improve patient health. §8751 deals with Sentinel Event reporting. There is
established under this chapter a system for reporting sentinel events for the purpose of improving
the quality of health care and increasing patient safety. §8753 deals with mandatory reporting of
sentinel events and states that a health care facility shall report to the division a sentinel event
that occurs to a patient while the patient is in the health care facility. §8755 deals with
compliance and clearly states that a health care facility that knowingly violates any provision or
rules adopted pursuant to chapter 678, S.P. 419 - L.D. 1363 is subject to a civil penalty payable
to the State of not more than $5,000 per unreported sentinel event to be recovered in a civil
action. Funds collected pursuant to this section must be deposited in a dedicated special revenue
account to be used to support sentinel event reporting and education. (MHO, 2008)
COMPETITORS
• How many competitors are in your industry?
There is only one major competitor which is Mercy Hospital and its affiliates in Portland and
surroundings.
- How do you define your competitors?
The Ambulatory Surgery Center and MMC as the parent organization defines it competitors
by first looking at the following:
The total size of the market that competitors must cover:
 Addressable size
 Segment sizes
 Market geography and competitive landscape
 What kind of technology competitors have
 Key products and economic trends in the market

 Market penetration capital requirements
 The price level they offer (Example: discount, regular, premium etc.)
 The communications media and means of exchange they use
 Kind of demand which the competitor aims to satisfy
According to the above, the Ambulatory Surgery Center defines it competitor (Mercy Medical
Center), as a relevant force that creates conditions that lead consumers find value in the brands of
goods and services that they offer.
— Has this number increased or decreased in the last four years?
No, the numbers of competitors have not increased or decrease in the last four years, however,
the challenge has become harder as the competitor expands its base and adds new products and
services.
• Is competition on a price or nonprice basis?
Competition is on both a price and nonprice basis, but has to do more with nonprice, such as time
available for certain services, location, customer service, perks patients receive as part of the
whole package etc.
• What are the choices afforded patients?
- In services?
The Ambulatory Surgery Center at Scarborough comprehensive network of health, medical and
social services, spanning various levels and sites of care, exists to lessen the burden of illness and
improve the health status of individuals, population groups and the community at large. In
partnership with the patient and family, services are planned, coordinated, provided, delegated and
supervised by professional health care providers who recognize the unique physical, psychosocial,
cultural and spiritual needs of each person. The Ambulatory Surgery Center’s mission is to
provide care to all who seek it. Access to the numerous components of the center’s continuum of
care is available to all and is limited only by the availability and appropriateness of the care
required.
All patients are asked before admission if they have any unusual needs, e.g. need for interpreters,
special assistance or specific concerns about their discharge. This information is passed along to
the patient's caregivers. All patients are also asked to sign a consent form that indicates that they
understand their responsibility to participate in their care. Such participation includes an
understanding of their responsibility to address the financial costs of the care.
- In payment?
The Ambulatory Surgery Center at Scarborough Financial Policies are given to each patient
before admission and the patient and family are offered assistance in meeting their financial
obligations. At no time is care compromised; if a patient needs care, the patient receives the care.
The Ambulatory Surgery Center at Scarborough cooperates with insurance company, health
maintenance organizations, third party review organizations and other entities responsible for
payment of bills or review of appropriateness of care. Should no payment source be identified
patient care is unaffected.
The Ambulatory Surgery Center at Scarborough has a long-standing policy of providing care to
patients without regard for their ability to pay for the care. Consistent with this policy of Maine
Medical Center, The Ambulatory Surgery Center at Scarborough will not only offer initial
treatment to patient, it will also continue to render care when reimbursement is denied by a third
party (such as managed care organizations) WHEN the care is deemed appropriate by the
relevant caregivers.
• What is your position in the market – size and strength - relative to competitors?
PRODUCTS AND SERVICES
• Complete a list of your organization's products and services, both present and proposed.
List of Services (MMC, 2008)

Anesthesia
Blood Bank
Cardiology (adult, pediatric, cardiac cathertization/intervention)
Cardiac Rehabilitation
Disease Specific Certification (Primary Stroke Certification, CHF)
Echocardiography
EEG
EKG
Electrophysiology (adult, pediatric)
Endoscopy
Laboratory (including anatomic pathology, cytology, cytometry)
MRI
Nutrition & Food Service
Pain Management
Pediatric surgery
Pharmacy
Post Anesthesia Care
Radiology (diagnostic)
Respiratory Services
Social Work
Surgical Services (cardiac, general, neurosurgery, orthopedic, ENT, eye, plastic, urology, trauma, GYN, pediatric, vascular, oncology, critical care, podiatry,
dental)
Urgent Care Center (pre and post surgical)
Vascular Surgery
Wound Care
• What are the general outstanding characteristics of each product or service?
Products and Services General Outstanding Characteristics Products and Services

Ambulatory Surgical Services Provides better service for the increasing volume of outpatient surgery in one location
Up to 10 New Operating Rooms set in a day surgery environment
Advanced anesthetics and procedures will allow for over 9000 surgeries annually
Scarborough Surgery Center (SSC) The most modern surgery facility in New England – with nearly every surgery related
advancement known to medicine.
Surrounded by every convenience, comfort, and amenity one can ask for.
Bariatric Surgery Clinic (Outpatient Services) Designated as a Center of Excellence by the American Society of Metabolic and
Bariatric Surgeons.
Casco Bay Surgery weight loss surgeons Roy Cobean, MD and Renee Wolff, MD have
performed over 1,000 weight-loss operations, since 1999.
Multidisciplinary Team Approach -

• Certified Bariatric Nurse
• Registered Dietitians specializing in bariatric Surgery
• Licensed Social workers specializing in eating behaviors
Safety –
• Pathways for patient safety
• Operating rooms designed for obese patients
• Dedicated floors for patients having bariatric surgery
• Specialized bariatric equipment for patient care/treatment
Department of Vocational Services The Department of Vocational Services employs skilled Employment Specialists to
help people with a wide variety of physical and mental disabilities achieve employment
of their choice in the community through Assessment, Career Development, Job Search
Support and Job Keeping Support.
(MMC, 2008)
• What superiority or distinctiveness of products or services do you have, as compared with
competing organizations?
 The most sophisticated and up-to-date Ambulatory Surgery Center in Maine and northern
New England.
 Advanced anesthetics and procedures with the capacity to allow more than 9000 surgeries
annually.
 Ten Operating Rooms set in a day surgery environment with the most advanced
technology.
• What is the total cost per service (in-use)?
The total cost per service (in-use) for MMC the parent organization of the Scarborough
Ambulatory Surgery Center is approximately $485.0 million dollars. No financial dada is
available at hand for the Scarborough Ambulatory Surgery Center at the moment.
MMC through its capital budget has allocated $16,200,000 for routine capital expenditures for
FY ’08. However, MMC’s financial and marketing department has requested $42,000,000 for FY
’08 compared with the FY’06 request of $36,300,000. Also, this year’s cyclical replacement
budget amount of $10,200,000 is a 19% increase from FY ’06. This means that there will be
more capital items competing for less available dollars. (MMC, 2008)
Maine Medical Center Hospital Finances (Note: MMC finances the Ambulatory Surgery Center in Scarborough)
Financial Performance - FY07
(In Millions)
Purchased Services 51.2
Medical Supplies 80.0
Other 135.8
Operating Expense $485.0
Operating Income (Loss) $ 7.8
Non-Operating Income _13.5
Net Income (Loss) $ 21.3

Snapshot of MMC Hospital Finances
(MMC, 2008)
Is service over/underutilized?
The service is not under or over utilized, it is on a stable level in this regard, but market demand
is increasing.
• What services are most heavily used? Why?

Common outpatient surgical procedures are utilized the most. The reason being that;
“Ambulatory or “day” surgery is becoming more common, as more procedures that used to
require an inpatient stay can now be done on a same-day basis”. (MMC, 2008)
— What is the profile of patients/physicians who use the services?
Scarborough Ambulatory Surgery Center Physicians take a team approach to treatment; they are
dedicated and committed to the task of providing quality patient care and work hard to insure all
patients get personalized, compassionate care in the most efficient and appropriate manner. Each
patient’s treatment plan is individually designed to meet their specific goals. The Physicians at
Scarborough Ambulatory Surgery Center also maintain good communication with patients and
try to educate them their families to improve the quality of their lives to build good lasting
relationships which helps to enhance the healing process. The Physicians at Scarborough
Ambulatory Surgery Center are consistent in: (MHO, 2008)
 The care they offer

 The office services they provide
 The provision of competent and caring support staff
The Patients – who visit Scarborough Ambulatory Surgery Center, come from varying
backgrounds, from Scarborough, Portland and the towns and villages of New England, and
Boston etc. They include Caucasians, Children, and a growing Sudanese population in the State
of Maine of Sudanese patients over the last five years.
— Are there distinct groups of users?
Yes, there are:
Elderly Whites
Somali and Sudanese refugee communities in Portland

Pregnant mothers
A great number of uninsured children
• What are your organization's policies regarding:
- Number and types of services to offer?
The Number and types of services that Scarborough Ambulatory Surgery Center offer is based
on the organization’s (MMC’s ) mission, vision, values, and the needs of the communities its
serves. It is supported by the organization’s strategic plan, budget process, and policies. The Plan
of Care further describes organizational and management structures and the systematic processes
designed to ensure the delivery of safe, effective, and timely care and treatment.
— Assessing needs for service addition/deletion?
Scarborough Ambulatory Surgery Center maintains an establish set of policies and processes
regarding the number and types of services to offer. Policy establishes the organization’s
expected performance of clinical and administrative processes and practices for the enhancement
of safe, quality patient care. These policies and processes are based on analysis, review and
approval of projects. The following guidelines are taken into consideration before adding or
deleting services. (Note: these are the same for MMC the parent organization)
The need to add or delete a service is important when:
a. It impacts the actions of more than one department or discipline and reflects a
fundamental direction of the organization (considered institutional)
b. It is sponsored or recommended by the individual/department most appropriate to the
issue.
c. It is developed with and reviewed by the appropriate clinical and administrative
individuals or groups prior to submitting to the appropriate review committee or
subcommittee.
Projects must be related to patient care practices and services that are of an institutional and
interdisciplinary scope. The committee/subcommittee responsible for making these decisions
provides leadership for and oversight of the policies and processes. Many of the following
factors are taken into consideration when adding or deleting services at Scarborough Ambulatory
Surgery Center:
Scarborough Ambulatory Surgery Center Financial Agenda
 Environmental Assessment
 Surgical and Clinical Financial Structures
Environmental Assessment - National Trends
 Increasing Federal deficit
 Strength of the economy
 Federal and State initiatives to reduce healthcare expenditures
 Increased fixed reimbursement
 Increased consumer activism
 Tight labor markets
 HIPAA
 Increased concern for quality/patient safety
Environment Assessment - State & Local Issues
 Demand for services
 Aging population
 Competition between Maine hospitals
 State of Maine budget shortfall
 Strategic Master Facilities Plan
Environment Assessment - Cost of Care Drivers
 Technology
 Pharmaceuticals
 Acuity
 Labor shortage
 Competitive wages and benefits
• History of products and services (complete for major products and services):
The Ambulatory Surgery Center in Scarborough was started in 2007. The major product/service
includes a wider range of common outpatient surgical procedures that can be done outside of
Maine Medical Center (please see table above).
- How many did the organization originally have?
The Organization originally had 10 major products and services as reflected in the table above.
- How many have been added or dropped?
Products/Services Added Products/Services Dropped
Bariatric Surgery Clinic (Outpatient Services) No product or services have been dropped.
- What important changes have taken place in services during the last ten years?
Important Changes Have Taken Place In Services During The Last Ten Years
1999 - Implantable vagus nerve stimulator available at MMC for first time
2000 - MMC one of the first centers to offer intravascular repair of aneurysm
2002 - First pancreas transplant in Maine done at MMC
2003 - Back to back Presidents of New England Surgical Society from MMC
- Has demand for the services increased or decreased?
Demand for services have increased
- What are the most common complaints against the service?
 Waiting room time is too long
 Situation involving shearing of information and privacy in some departments
 Scheduling of appointments is a “nightmare”
- What services could be added to your organization that would make it more attractive to
patients, medical staff, nonmedical personnel?
 Optimize use of inpatient/ED capacity for outpatient services.
 A smooth surgical schedule.
 Reduce practice variability using evidence based approach/pathways.
 Create teams including doctors, nurses, and other caregivers that work together on quality
improvement in their areas and report to an oversight council.
 Provide education to frontline caregivers on how to include patients and families in their
care.
- What are the strongest points of your services to patients, medical staff, and nonmedical
personnel?
 A structure for accountability and a process for prioritization of performance
improvement projects; performance measurement and transparency.

 Maine Medical Center's comprehensive network of health, medical and social services,
spanning various levels and sites of care, exists to lessen the burden of illness and improve
the health status of individuals, population groups and the community at large.
 Maine Medical Center provides patient and family education specific to the patient's and
family’s needs and abilities and according to the care, treatment, and services provided by
the health care team.
- Have you any other features that individualize your service or give you an advantage over
competitors?
 The only Ambulatory Surgery Centers in the state of Maine that is backed by a major
hospital that is on the top of the list among hospitals in the nation.
 MaineHealth named among nation’s top 40 integrated health networks (the parent
organization).
PRICE
• What is the pricing strategy of the organization?
The Ambulatory Surgery Centers provides free care to individuals who are unable to pay for
hospital services adhering to the Department of Health & Human Services Free Care Guidelines
and Federal Poverty Income Guidelines. The free care program is based on family size and gross
annual income.
- Cost-plus
The cost of production plus a fixed rate of profit is based on the following prices:
- Return on investment
Strategy:
Define the problem
Be mindful of the organization’s needs
Strong support infrastructure
Data systems to track trends
Improve Clinic Productivity
Have a Business Plan
Billing & Claims Adjudication

Feedback
- Stabilization
Stabilization can be achieved through the following:
 Good reporting – to eliminate errors in billing
 Medical Malpractice Reform
 Electronic transmission of transactions
 Eliminate ER Diversions and overcrowding
 Better use of Medicaid
 Get rid of duplicative regulatory requirements
 Standardize reporting requirements
 Better administrative participation
 Create internal controls to manage underlying process constraints
• How are prices for services determined?
By complying with external regulations and internal policies that directly or indirectly affect the
following:
 The Ambulatory Surgery Center’s Chargemaster – which is a list of the hospital’s prices for
every procedure performed in the clinic and all the supplies used during those procedures.
 Medicare Hospital Payments – U.S. hospitals receive 31% of their net revenues from
Medicare. 88% of the total payments are designated for inpatient services; the remainder for
outpatient services.
 Medicaid Hospital Payments – Medicaid accounts for approximately 17% of total national
spending on hospital care.
 Private Insurance – Hospitals receive about one-third of their net revenues from private
health insurers.
 Uninsured Patients – Many receive discounts

Hospitals therefore depend heavily on trends in above mentioned factors to guide the process of
setting prices.
- How often are prices reviewed?
Prices are reviewed based current prevailing market trends, but are scheduled to be reviewed
quarterly.
- What factors contribute to price increase/decrease?
 Increasing Federal deficit
 Weak economy
 Federal and State initiatives to reduce healthcare expenditures
 Increased fixed reimbursement
 Increased consumer activism
 Tight labor markets
 HIPAA
 Increased concern for quality/patient safety
 Demand for services
 Aging population
 Competition between Maine hospitals
 State of Maine budget shortfall
 Technology
 Pharmaceuticals
 Labor shortage
 Competitive wages and benefits

What have been the price trends for the past five years?
Prices have been rising due the rise in costs of care and insurance and many of the factors listed
above.
• How are your pricing policies viewed by:
– Patients
Most patients view prices as being too high
– Physicians
Physicians for some reason don’t complain much about MMC’s pricing policies or the increasing
healthcare costs.
- Third party payers
Third party payers work hand in hand with the Ambulatory Surgery Center and MMC for a
common understanding of the pricing policies; this is due to a long-term relationship.
- Competitors
The Ambulatory Surgery Center competitors have similar pricing policies therefore there have no
major problem with the center in this regard.
- Regulators
The Ambulatory Surgery Center complies with all applicable Federal and State laws and
regulations therefore MMC’s regulators have no immediate problems with the origination’s
pricing policies.
PROMOTION
• What is the purpose of the organization's present promotional activities (including
advertising)?
The purpose of the organization’s present promotional activities is to raise community awareness
regarding the unique opportunities the Ambulatory Surgery Center provides. There is a consistent
advertising campaign through TV, brochures, radio, newspapers etc. to get the message of
mission and vision out.
— Protective
the Ambulatory Surgery Centers has introduced a system where executives, patients, and families
walk rounds which have helped to create a culture of safety. This action was first based on the
premise that leadership must carry the banner of safety and visibly endorse and encourage staff
involvement in improving patient safety.
Each hospital and associated other facilities have inherent safety risks associated with providing
services for patients, the performance of daily activities by staff, and the physical environment in
which services occur. It is important that each MMC facility identifies these risks and plans and
implements processes to minimize the likelihood of those risks causing incidents. Safety
Management activities assess and control the impact of environmental risk, and to improve
general environmental safety.
Scope: The Safety Management Plan applies to all Maine Medical Center facilities.
Responsibilities: The Safety Director is responsible for implementation of the Safety
Management Plan.
1. Risk Assessments: The Safety Director will facilitate a risk-assessment that proactively
evaluates the impact of buildings, equipment, occupants, and internal physical systems on
patients and public safety. Risk assessments may utilize accident data, hazard survey
data, regulatory agency inspection reports, consultants or other sources of safety data
when available to implement procedures and controls to achieve the lowest potential for
adverse impact on the safety and health of patients, staff and other people coming to the
Ambulatory Surgery Center facilities.
2. Incident Reporting: Staff are expected to report all incidents of property damage,
occupational illness, and patient, personnel, or visitor injury in accordance with the
Human Resources Policies (see Ref.1). Incidents selected for investigation, will be
investigated according to the table below:
— Educational
The Ambulatory Surgery Center facilities provides patient and family education specific to the
patient's and family's needs and abilities and according to the care, treatment, and services
provided by the health care team.
 Patient and family education is a partnership between patients and families and members of the
health care team. This partnership assures that the educational needs of patients and families
are met as they move through the continuum of care.
 Patient and family education is defined as a process of enhancing patient and family knowledge
and skills needed to participate as full partners in making informed decisions about their health
and care.
 Evaluation of the effectiveness of patient education occurs on an ongoing basis utilizing
organization-wide indicators and quality processes.
— Search out new markets
The Ambulatory Surgery Center is constantly searching for new markets; this is done through a
review process. Through this process the following is looked at: population trends,
demographics, demand for services, competition between Maine hospitals etc.

— Develop all markets
No data available at this time.
— Establish a new service
The Ambulatory Surgery Center facilities as an organization will establish a new service if it
can:
 Serve as the principle provider of care services for a specific geographical area;
 Offer services that are responsive and sensitive to the needs of patients, families, staff and
physicians;
 Be the provider of choice for patients, payors and providers;
 Work cooperatively with other institutions and providers as part of a fully integrated
continuum of care;
 Maintain its financial viability and effectively manage risk;
 Foster innovative, mutually beneficial economic and professional relationships with
physicians and other providers in the region;
 Play a central role in developing MaineHealth’s integrated delivery system for central and
southern Maine with particular emphasis on its clinical and administrative integration
initiatives;
 Recruit and retain the most qualified and motivated employees by creating an environment
that makes it the health care employer of choice;
 Design and size its educational programs to meet the needs of the students and residents
taking into consideration the needs of its clinical programs, the manpower needs of the
region, and its particular clinical and educational strengths;
 Focus its research initiatives to make in a cost effective manner substantive contributions to
the advancement of care in MMC’s major clinical programs.

• Has this purpose undergone any change in recent years?
The purpose has not changed, only the methods to make the purpose known have changed. For
the most part the Ambulatory Surgery Center facilities purpose is still based on:
 Patient and family centered and compassionate care;
 Respect for the individual and for human life;
 Service quality and continuous improvement;
 Fiscal responsibility;
 Honesty, integrity, ethical conduct, and legal compliance;
 Cooperation and collaboration;
 Efficiency and effectiveness;
 Interdisciplinary team approach complemented by individual initiative;
 A spirit of inquiry and a scholarly attitude;
 Access to care regardless of ability to pay;
 Diversity;
 Leadership;
 Responsibility to our community;
 Excellence.
• To whom has advertising appeal been largely directed?
— Donors – are always informed of what is happening
— Patients – advertisement is largely directed to patients and their families
• Former or current – Both former and current, but a special effort to reach former
• Prospective – Physicians, patients, payors, donors etc.
— Physicians – are offered attractive benefit packages and incentives

• On staff - Staff members are integrated into the promotional campaign and work as a team to
communicate the Ambulatory Surgery Center facilities products and services, and mission and
vision to new customers etc.
• Potential – One of the Surgery Center facilities marketing mottos is: “everyone is a potential
customer”, this is in keeping with the core values of MMC the parent organization. This motto
reminds each staff that each person, patient, or family member should be treated with respect and
as a customer at all times.
• What media have been used?
Internet pod cast, Internet banners, Television, Radio, Newspaper, Brochures, Billboards,
Business Cards, Magazines, Newsletters, reviews, seminars, conferences, and lectures.
• Are the media still effective in reaching the intended audience?
Yes, the media is by far one of the most effective channels of advertisement.
What copy appeals have been notable in terms of response?
 Always wearing ID badges – in keeping with MMC’s values
 Always dressing neatly and appropriately for safety and customer comfort – in keeping with
MMC’s values
 Always committing to odor-free hygiene – in keeping with MMC’s values
 Always Answering and responding to messages promptly – in keeping with MMC’s values
What methods have been used for measuring advertising effectiveness?
 Advertising Effectiveness Surveys

 Patient tracking
 Statistics
 Return on Investment
 Patient and family feedback
• What is the role of public relations?
Public Relation is a function of management for the establishment and maintenance of mutual
lines of communication, understanding, acceptance, and cooperation between the organization
and the public. It is a vital part of the Ambulatory Surgery Center at Scarborough.
— Is it a separate function/department?
Yes, at the Ambulatory Surgery Center at Scarborough public relations is a separate function.
— What is the scope of responsibilities?
Research – determine attitudes and behaviors of public etc.
Media Relations – work with the mass media to create opportunities for publicity
Publicity – promote products/services
Employee/Member Relations – strengthen it
Community Relations – keep abreast and strengthen
Public Affairs – develop effective involvement in public policy
Development/Fund-Raising – gain public support for organization
Marketing Communications – to sell products, services, or ideas
CHANNELS OF DISTRIBUTION
• What are the trends in distribution in the industry?
Health care utilization rates: These are good indicators of what general types of care specific
populations seeking.
Surgical procedures and malpractice: The market has changed in such a way that many surgeons
are unwilling to take on certain patient cases due to an increase in malpractice lawsuits by the
public.
The trends at the Ambulatory Surgery Center at Scarborough regarding healthcare distribution
are reflective of national trends.
— What services are being performed on an outpatient basis?
The Ambulatory Surgery Center at Scarborough is an out patient clinic; therefore all surgeries
are done in an out patient setting. (See table of out patient surgery above)
— What services are being provided on an at-home basis?
The Ambulatory Surgery Center at Scarborough is an out patient clinic.
— Are satellite facilities being used?
No, satellite facilities are not being used at the moment.
• What factors are considered in location decisions? When did you last evaluate present
location?
 Needs of customers with respect to the services offered.
 Why customers would want to obtain the service.
 Market Segmentation: geographic, demographic, psychographic or behavioral etc.
 Market Research to determine the profitability and feasibility
Evaluation of present location was done in 2006; the location was carefully chosen based on
economic and marketing trends. There are no plans to relocate at the moment.
• What distributors do you deal with?
(e.g., medical supply houses, etc.)
Maine Medical Center Distributors (Not Exhaustive List)

HealthSouth Management Services
American Red Cross
Navix Diagnostix
NorDx
American Hospital Solutions
Green Valley Medical Supply
MPM Medical Supply
(MMC, 2008)
— How large an inventory must you carry?
The Ambulatory Surgery Center at Scarborough is based on Maine Medical Center’s patient
referral. Much of the surgeries performed at the Surgery Center at Scarborough are referrals from
MMC, therefore the inventory i.e. supply/demand, jobs etc are to a large extent based on
workload which is mostly determined by MMC.
Surgical Care Improvement at Maine Medical Center – A Reflection of Referrals for Scarborough Surgical Center
(MMC, 2008)
The Ambulatory Surgery Center at Scarborough was created to take the load off MMC’s as far as
surgeries and hospital room recovery is concerned, therefore a look at MMC’s Surgical Care
Improvement status can furnish vital information about the workload that is referred to the
Surgery Center at Scarborough. (MMC, 2008)
MMC Financial Performance – 07 A Reflection of Overall Inventory (Note: Outpatient Revenue)
Hospital Finances
(In Millions)
Inpatient Revenue $511.5
Outpatient Revenue 204.5
Gross Patient Services Revenue $716.0
Free Care 11.4
Contractual Allowances 223.3
Net Patient Services Revenue $481.3
(MMC, 2008)
"SWOT" (Strengths, Weaknesses, Opportunities, Threats) analysis
Situational Assessment (SWOT) Analysis of MMC – Scarborough Ambulatory Surgery Center
Strengths Weaknesses
One of the most efficient, and productive surgical centers on the East Coast
The center is too far from the potential patient population
Patient and family centered and compassionate care
Transportation is lacking in some areas
10 Operating Rooms
Shortage of Anesthesiologists
Specialized Ophthalmology operating rooms
Customers wait too long to be attended to
31 private pre/post-op rooms
Lapse in immediate follow-up
6 modern overnight rooms
Some areas of budget shortfalls, or potential shortfalls
State-of-the-art video conferencing
No clear plan to redirect resources to departments that need it most
Café and outdoor patio
Separate pediatric recovery area
Latest in surgical equipment and technology
Fiscal responsibility
Honesty, integrity, ethical conduct and legal compliance
Cooperation and collaboration
Efficiency and effectiveness
Interdisciplinary team approach complemented by individual initiative
A spirit of inquiry and a scholarly attitude
Access to care regardless of ability to pay
Diversity
Leadership/Excellence
Opportunities Threats
Capacity to continue to care for a growing population needing surgical Lost of established patients because of change in service location
services.
Improper and wasteful use of MMC resources.
Capacity for expansion of healthcare services and technology
Unauthorized use of records.
Enhance the culture of safe patient and family centered care. Unauthorized alteration or manipulation of computer files.
Unauthorized use of the MMC logo, trademark, copyrights, etc.

Opportunity to respond to the trend of a majority of patients who receive care
in an outpatient setting and go home the same day.
Falsification of reports to management or outside agencies.
Exceed national benchmark performance in all JCAHO National Patient Improper handling or reporting of financial institutions.
Safety Goals.
Authorized or receiving compensation for goods not received or services not performed.
Launch new interactive surgical website to enable physicians to view and
compare patient data with MMC. Authorized or receiving compensation for hours not worked.
Ensuring that the organization provides care and service in a timely manner Willful violation of laws, regulations, or contractual obligations when conducting MMC business.
to meet patient care needs
Falsification or unauthorized alteration of time or leave records.
Setting performance improvement priorities and identifying how the
organization will adjust its priorities in response to unusual or urgent needs
Ensuring that each department has written scope of service and provides
care according to its goals and scope of service
Collaborating with other relevant personnel in decision making
(MHO, 2008)
Audit Conclusions:
Through this audit a clear understanding of the relevant internal controls issues were
obtained. The audit was able to yield vital information regarding the nature and extent of
MMC’s operations and point to areas where pertinent changes needs to be made. From this audit
MMC was able to ensure confidentiality and integrity, to investigate possible lapses in internal
operations. The marketing team had the opportunity to investigate incidents and ensure
conformance to MMC policies. The audit also included tests of compliance with provisions of
applicable laws and regulations. The entire process provided reasonable, but not absolute,
assurance regarding the reliability of financial reporting, effectiveness and efficiency of
operations, and compliance with applicable laws and regulations.
The Audit & Compliance Services Department (ACSD) will provide management with
written evaluations of each area reviewed, including recommendations designed to strengthen
and improve the effectiveness and efficiency of management controls. The ACSD will provide
“draft” copies of its Audit & Compliance Services report to each department Director and
Manager affected by its findings in order to verify that facts are accurately presented.
Management will provide written responses to all audit findings within ten days of the receipt of
the draft report. Responses should include a discussion of any actions undertaken or planned to
address all findings, including a timetable for those activities. The ACSD will provide the Vice
President responsible for each affected department with the adjusted draft copy of its report. The
adjusted draft will include all responses. The Vice President is expected to consent to the
adjusted draft report within ten working days. Final reports will be issued to the MMC President
and other affected parties. All audit reports will be made available to the members of the Audit
Committee of the MaineHealth Board of Trustees and others, upon request. (MHO, 2008)
References
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http://www.mainehealth.org/mmc_body.cfm?id=564
Berkowitz, E. N., & Flexner, W. (). "The Marketing Audit: A Tool for Health Service
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Coordinators, Not Gatekeepers. The Journal of the American Medical Association, 281,
2045-2049. Retrieved June 10, 2008, from http://jama.ama-assn.org
Comprehensive Accreditation Manual for Hospitals: The Official Handbook (2004). . , PC6.10
and 6.30, .
Depart of Health and Human Services (2007). Maine state rules. In (Ed.), DHHS Rules (pp. 10-
144). : Department of Health and Human Services.
FamilyDoctor.Org (2008, June 1). Alcohol Abuse: How to Recognize Problem Drinking.
Retrieved June 10, 2008, from
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Healthy People 2010 (2004, January 01). Healthy People in Healthy Communities. Retrieved
June 06, 2008, from http://www.healthypeople.gov/publications
Hospitals Moving Foward with Family-Centered Care, Seminar Proceedings (2004, April 22-
25). . , , .
Kelley, M. A. (1999, February 16). The Hospitalist: A New Medical Specialty?. Annals of
Internal Medicine, 130 Issue 4 Part 2, 373-375. Retrieved June 10, 2008, from
http://www.annals.org/cgi/reprint/130/4_Part_2/373.pdf?ck=nck
Kelley, M. A. (1999, February 16). The Hospitalist: A New Medical Specialty?. Retrieved June
11, 2008, from http://www.annals.org/cgi/reprint/130/4_Part_2/373.pdf?ck=nck
Kotler, P., & Armstrong, G. (2004). Principles of Marketing (10th ed.). Upper Saddle River, NJ:
Pearson Education.
Maine Medical Center (2008, April 17). MMC Financials. Retrieved April 17, 2008, from
http://www.mmc.org/workfiles/mmc_financial/Dirigo_Bramhall.pdf
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2008, from http://www.mmc.org/mmc_body.cfm?id=3493
Maine Medical Center (2008, April 17). Products and Services. Retrieved April 17, 2008, from
http://www.mmc.org/mh_homepage.cfm?id=1
Maine Medical Center (2008, April 26). History of Maine Medical Center. Retrieved May 5,
2008, from http://www.mainehealth.org/mmc_body.cfm?id=564
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Prioritization Scoring Scales. Retrieved April 10, 2008, from
http://quality.mainehealth.org/SiteSubmain.aspx?LocationID=4
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2008, from
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20060905TheEvolvingFourPsOfMarketing.html
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from http://www.netmba.com/marketing/mix/
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HA 605 Unit 4 Assignment - Application of Marketing Principles and Techniques

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Unit 4 Application 1

Running head: UNIT 4 APPLICATION OF MARKETING PRINCIPLES AND

Unit 4 Application of Marketing Principles and Techniques

St. Joseph's College

Health Care Marketing

June 10, 2008

Unit 4 Application of Marketing Principles and Techniques

New Product/Service Identification

1. Submit a marketing analysis of:

Hospitalists, there is no formal Hospitalists specialty at MMC. An interesting article surfaced in

Journal of the American Medical Association (JAMA).

A marketing analysis of adding Hospitalists as a fulltime specialty include the following:

Product or Service Analysis:

organizing post-acute hospital care. (Wikipedia Free Encyclopedia [WFE], 2008)

 All primary care physicians

 Healthcare marketing firms

Target Market Segment Strategy:

 Focus counterparts in specialties such as neurosurgery, orthopedics, nephrology and

oncology who need co-managers for a wide range of their patients.

 Focus on family practice physicians and clinics in the region

 Focus on hospitals with large ICU, CCU, and ED departments

 Focus on hospitals that manage palliative care or hospice services

 Rural regions to urban centers

 Academic teaching institutions

 Suburban community hospitals or special facilities

 ICU, the CCU and the ED

 Pre-op and post-op settings

 Counterparts in specialties such as neurosurgery, orthopedics, nephrology and oncology

who need to co-manage a wide range of patients

Hospital medicine is a in a Transitionary period as residents emerge with hospital

mostly all departments within the hospital. (WFE, 2008)

into consideration when reflecting on distribution patterns regarding Hospitalists:

 In response to diverse incentives, many Hospitalists are being integrated into

multispecialty groups, or hospitalist-only groups.

 Development of hospital-based hospitalist programs in both teaching and nonteaching

facilities is attracting Hospitalists. (WFE, 2008)

The major competitor in the region is Mercy Hospital in Portland, Maine.

Market Analysis Summary

insurance difficulties for reconstructive procedures, coupled with technological advancements

The market segment data is presented in the next section.

 Geographic location – To gain advantage by location

 Demographics/culture/religion – Ethnicity, Cultural practices, Faith etc.

 Gender – Product preference for men vs. women etc.

 Age – To market the right product to the right age group

 Social status – Country club memberships, philanthropic contributions, etc.

market segment will be targeted through, interviews, seminars etc.

 Need for customization – Consumers choice in the process

 Need for quality – Consumers seeking the best in the market

ideal place for this project.

(The American Society for Anesthetic Plastic Surgery [TASAPS], 2004)

trends from a national standpoint.

organization other than a Maine Medical Center or MaineHealth department, committee, or

Beyond the "Four P's": Customers and Competition

They seem to place a priority on profit above a commitment to care.

medical profession. (Bodenheimer, Lo &, Casalino, 1999)

monitoring performance, and creating integrated system management teams. Strategic

truly in need. (Maine Medical Center [MMC], 2008)

improvement, an opportunity to create a cost-effective healthcare system that is open and

The Strategic Marketing Plan (SMP)

Strategic Marketing Plan

Executive Summary and Background

Table 1.9 A – Abbreviations

Class Discussion Question: Course Evaluation

what we do in healthcare. It helped me to better understand the process of becoming