National Health Service Corps: Putting Members First Drives Essay Enrollment.

Background and History of the National Health Service Corps

‘National Health Service Corps: Putting members first drives enrollment’

The National Health Service Corps (NHSC) was started in 1972 in response to the healthcare crisis that emerged in the United States in the 1950s and 1960s. Older^; physicians were retiring, and young doctors started to choose specialization over general practice, leaving many areas of the country without primary care medical services.

The NHSC attracts medical students and recent graduates who are committed to helping those with limited access to primary healthcare. It offers scholarships and student loan repayment to providers for their commitment to work at least two years in an NHSC-approved health center or clinic in an underserved community. NHSC clinicians - primary care doctors, dentists, nurses, physician assistants, mental health professionals - also earn a salary from their sites. In 2009, 3,600 healthcare providers were members of the NHSC. 

In 2009, the Health Resources and Services Administration (HRSA), the government agency that runs the NHSC, funded FHI 360, a nonprofit social marketing and health promotion organization, to rebrand and market the program to increase its national visibility and recruit 3,300 primary healthcare providers into the program.

Historically, demand for the NHSC exceeded available funding. More recently, with increased attention on the issue of healthcare and a growing primary care workforce shortage, the American Recovery and Reinvestment Act of 2009 provided $300 million to support 4,000 new NHSC providers by 2011. With an influx of funding, this program - which had never much needed to market itself - was suddenly faced with having to more than double its size in just two years.

FHI 360 first conducted a market analysis to better understand the NHSC program, including internal operations, available resources and audiences. The inquiry also sought to examine what HRSA was currently doing to promote, manage and support the program, as well as to learn about the external market environment, including target audiences and NHSC competitors. Activities included intercept interviews with new members; observation and attendance at key NHSC events; key informant interviews with NHSC program staff, partners, ambassadors, alumni and advisors (e.g. National Advisory Council members); a review of background documents and data; an audit of existing NHSC promotional materials; and a consumer experience innovation workshop. These activities were designed to illuminate the current NHSC program's key strengths and successes, weaknesses and gaps, and opportunities.

The analysis revealed that the NHSC was primarily being positioned as a government-run financial program. This positioning was diminishing the value of the NHSC among its most important consumers - its own members and the healthcare providers it was seeking to attract. In addition to the impersonal and bureaucratic way the program was being defined, the 'Corps' in the NHSC did not exist. Once providers learned they were accepted into the program, most said they never heard from the program again, or anyone else in it.

NHSC's Approach and Programs

Students haven't heard of [the NHSC]. When they do, they think it is like uniformed service. They might just equate it with another branch of the government.

NHSC [is] not [a] key recognizable phrase. If I went to the new physician reception in my town they would say 'what is that?' But they would know the loan repayment program.

The 'product' being sold - membership in the NHSC - was confusing, required navigating a complex application process, and had no values associated with it other than money. Yet, the analysis also showed that, for most current and potential NHSC members, money was just one part of the attraction of the program. Many NHSC members were already working in underserved communities before they applied for the program and most continued to serve beyond their two-year commitment - and had powerful stories to share. Furthermore, the personal values of providers who were most likely to work in communities with a shortage of health professionals had little to do with money. They valued service and social equity, as well as other benefits such as work/life balance, flexibility, meaningful patient relationships, and the opportunity to learn and practice different skills.

In terms of an emotional connection with the brand, input from members and others involved with the program suggested that the NHSC had a split-personality. Many contradictory words were mentioned to describe the NHSC (e.g. ‘cold’, 'faceless' and 'demanding' vs. 'dedicated', 'genuine' and 'caring'). A varied picture emerged of the NHSC depending on participants' association with the program and their length of involvement in it. This contradiction may have been attributed to participants feeling one way about their commitment to the social mission of the program, and the fact that they are able to do this work, in part, because of the NHSC, and feeling another way about the impersonal way the program was being run.

Some promotional materials did exist, including a website and a wide social media presence, but their effectiveness was undermined by an overall lack of focus, clear benefits, visual interest and an emotional connection. The findings also revealed an incredible opportunity to capitalize on the considerable assets that HRSA had in place for a revitalized marketing effort, including a commitment to program success at the highest levels, experienced and committed staff, and extensive relationships and resources throughout HRSA - including regional offices, and internal and external partners - that could be leveraged to market the program and its benefits. These assets, coupled with the significant goodwill that existed around the social mission of the program, primed it for success.

Challenges and Barriers to Enrollment in the NHSC

In order to help the NHSC recruit the large number of providers it needed to bring into the program quickly, and lay a foundation for future marketing of the program, the product needed to be repositioned in a way that:

1- was responsive to member needs and values; and

2- communicated NHSC members’ core values to the target audience in a clear, consistent and authentic way.

FHI 360 created and helped implement a rebranding effort and marketing campaign to:

o Reframe the NHSC - through the voice of its current members - as relevant, responsive, compelling, exciting and more personal

o Begin to build the 'Corps' in the NHSC and position this network of like-minded, dedicated professionals as a member benefit

o Develop a suite of NHSC identity products and promotional tools and materials that communicate a revived NHSC brand - both for current and prospective members

o Drive prospective members to register on the NHSC website - the first step to completing the required application (and re-engage those already registered who had not yet applied).

FHI 360 also reinforced with program staff that the current application process was going to be a choke-point for the influx of new applicants expected as a result of a marketing campaign. The process needed to continue to be improved to allow for a smoother entry into the program.

Building on the market analysis, brand elements, messages and materials were developed to achieve the objectives. These brand and materials concepts were tested through focus group discussions with potential members - soon-to-be, and current, primary healthcare providers in NHSC-eligible disciplines - all of whom were either accumulating or still repaying student loans. The research revealed a very low awareness of the program among prospective members, as well as preferences for and questions surrounding various brand elements and messages.

After brand elements and materials were tweaked, FHI 360 fielded an online survey (n=201) with secondary audiences already involved in the NHSC, which aimed to confirm the brand and materials testing outcomes from prospective members; get buy-in for the new brand and materials; and elicit any previously unidentified concerns with the new brand and materials.

On October 13, 2011, a US Department of Health and Human Services pre-release announced that the largest number of NHSC providers in history - more than 10,000 - are providing healthcare to communities across the country. This is neatly three times the number of NHSC providers there were three years ago, and nearly double the number of providers FHI 360 was tasked with helping: to recruit¹.

Specific outcomes included:

• A 208 per cent increase in the number of visits to the NHSC website homepage (456,836 more visits) from February to July 2011, when compared to the same time period in 2010
• A 2-3 per cent response rate on the tailored direct mail campaign, higher than the industry average of 1-2 per cent, which resulted in 800 to 1,200 new loan repayment program registrants 
• An average click-through rate nearly twice the national average (0.15 per cent vs. 0.08 per cent) for the banner advertisement portion of the paid media campaign 
• A 72 percentage-point shift from negative to positive online sentiment expressed about the NHSC online (from 18 per cent to 90 per cent), primarily via the NHSC Facebook page and Twitter, from September 2010 to September 2011.

The key factor in the success of the NHSC marketing campaign was HRSA's commitment to fix the product, namely the NHSC brand, program and features. Too often, social marketers are asked to promote poorly designed programs or poorly delivered services. Once HRSA began to address the major barriers of NHSC personality, entry and engagement, the program almost sold itself.

Focusing on the ‘consumer experience' - that is, what did the NHSC look like from the clinicians' perspective - helped reframe the marketing challenge for HRSA managers.

NHSC clinician members proved to be the best sales force. They simply needed a venue to express their passion, commitment and enthusiasm about the life-changing opportunity offered by the program.

Question 1

Discuss the difference between market segmentation and targeting. Analyze audience segmentation in relation to the case study. Word count:

Question 2

Explain the factors that contributed to the higher-than-average response rates and the final results of the marketing effort in the case.

Question 3

Discuss the marketing mix employed by NHSC, including its merits and demerits. Analyze how the marketing mix led to success or failure in achieving its objectives.

Background and History of the National Health Service Corps

Meaning of Market Segmentation

Market segmentation is the division of a large product or company market, usually consisting of current and potential customers, among consumer categories (recognized as segments) centered on some kind of particular characteristics. Investigators typically look towards common features such as mutual desires, common interests, identical lifestyles, and even similar demographic characteristics when separating or fragmenting markets (Correia et al., 2015). Market differentiation is followed by targeting, which would be related to finding the industry segment that is successful.

Meaning of Targeting

Market targeting is a method in which the target market is chosen from the whole audience. Target market comprises of tribe/communities of customers to whom the company wishes to appeal or for whom the item is created, prices are set, marketing efforts are made which the distribution network is ready. Nonetheless, there is a distinct line amongst them (Sheth, 2018), people generally misunderstand market segmentation as well as market targeting mechanism.

Difference between Market Segmentation and Targeting

Market segmentation is the method of classifying the market by geographical, regional, behavioral including psychographic characteristics into different groups. The target demographic is the segment of the market which a specific item or advertising strategy is centered on by the company. This is the greatest difference between these two huge marketing approaches (James, 2016). The company initially opts for the method of market segmentation wherein they split the population into different segments it is defined as market segmentation, and afterward, the company identifies one or more segments as their objectives to determine their needs and produce products as per them. The segmentation, or even business selected activities, was considered to be crucial to any industry. Just like in the case, the industry is segmented into different groups based on certain factors that were targeted by NHSC for the correct segment.

Analysis of Segmentation of Customers or Audience in the Case

Market segmentation in healthcare determines the target audience of the healthcare unit, says what motivates you to achieve the goals of the care facility, and thus allows you to establish persuasive positioning and advertising for the services and products which the healthcare unit offers (Heuvel et al., 2010). In the HRSA case, user segmentation was guided by HRSA data that recognized the NHSC healthcare facilities and clinics with the highest demand for specific clinical disciplines. The entire healthcare provider industry in that area is divided by contrasting them with rural requirements and needs on the grounds of the healthcare provider's desire, capacity, and need (McKinley, 2012).In these areas, the strategies of marketing centered on those current as well as upcoming physicians with a motive of helping those with minimal scope to healthcare. It is considered the primary goal behind the HRSA program's consumer segmentation because it can help achieve the right customer category at the right moment. The target audience included doctors, assistants to physicians, nurse practitioners, dentists including dental hygienists. In this targeted audience, all the possible healthcare experts are viewed as the target, which in turn will help people in key rural areas to provide effective care services. Such audiences have to sought and addressed in such a way which can be the NHSC brand and membership benefits were clearly communicated.

NHSC's Approach and Programs

Higher Response Rates (in the case)

The NHSC brand has been re positioned to include the clinician representatives of the system. It is done with the help of grant of $ 300 million given by government agency to FHI 360, which is a nonprofit marketing organization, to help the NHSC in getting marketed and reestablish their services as well as products in the market. The campaign started and managed by FHI 360, which showed many positive results. The response rate for the NHSC initiative is raised at higher rates after the initiative as the value proposition gives customers the ability to promote service as well as professional training. They have influenced NHSC's customization marketing of facilities, which is the repayment of loans and scholarships to application members.

History of Improved Results (in the case)

According to the report of US Department of Health as well as Human Services, the biggest amount of NHSC facilitators in history more than the 10,000 are discussing the healthcare to the communities across whole country. It was almost the three times the number of NHSC facilitators which were 3 years before (deWit & Williams, 2013). A beneficial response rate of 2-3% to the customized campaign of direct mail, that is more than those of the industry’s average of 1 to 2%, culminated in 800 to 1,200 new loan reimbursement registrants (NHSC). The number of trips to the NHSC webpage (456,836 more visits) rose by almost 208 million from February to July 2011, corresponding period in 2010. These all factors showed that the final results opt from the re-establishment of product of NHSC for its members and client so that they can get more attracted towards the program, helped the organization in getting more deserving healthcare service providers in rural areas.

Contributing factors forImproved Results

There are many factors which contributed higher rates and positive results for the NHSC program. It is done with the help of a well-managed and designed marketing program. FHI 360, the NHSC application marketing company, modified the NHSC logo as well as all application elements to reflect the current personality of the brand. Among the success contributing factors there were many ways that company’s marketing partner followed such as short video stories were introduced that expressed the values of brand via the voices of the members (Gillespie, 2015). The marketing and re position of the NHSC products took place in the market by considering the needs and wants of its probable clients, which in turn helped the company in identifying and attracting more members for the program and their wiliness to cater healthcare services to rural people (Lumen, 2019). FHI 360 can also use targeted mails that are direct including paid campaigns of advertising for micro-targeting the main groups of clinicians. Earned media activities referred to a national media tour as well as public selling for local newspapers (Suki, 2010). The work of the NHSC Ambassador has been recognized to support as well as encourage the program more explicitly. Plans have been in the works for an education program.

Challenges and Barriers to Enrollment in the NHSC

NHSC's marketer also opts for social media marketing through the Facebook page of the NHSC, which has been turned into an active service for customer platform as well as has became a developing major section for current as well as future members. Refurbished orientation competitions reflect the new company as well as add more time for networking process. FHI 360 modified the NHSC website to preview members, highlighted the Corps Experience by providing members as well as prospective members with relevant resources and content, and offered a platform for participation. The digital marketing as well as general marketing helped the NHSC in reestablishing the brand name and its services. The advertising program's goal was to make it easier for NHSC clinician member to prove to be the best seller. They also wanted a forum to share their passion, engagement and excitement about the program's life-changing potential.

Marketing mix of NHSC

A promotional mix directs to the series of actions as well as strategies that a business uses to advertise its brand or service. It mainly includes some marketing components denoted by P. There have been basically 4 P's in either company's overall marketing combine strategy, but there are also 7 P's (Jackson & Ahuja, 2016). The strategic mix of the NHSC software and services advertising campaign driven by FHI 360 involves many important elements that work together in a way that brings profitability to the strategic plan and its eventual success. The marketing mix of NHSC is as follows:

Product: The product of NHSC is the grant for education loan as well as the scholarship to boost up the moral of the members.

Price: According to the case there is not any price for buying the offer of NHSC or becoming its member. The main price the members have to pay is to serve the underserved healthcare region for at least two years in order to avail the products of NHSC.

Place: The place was the underserved healthcare regions, where the high-profile doctors are not reaching or cannot reach. The program focused on serve the people living in those areas with a view to attract doctors, nurses, etc. as members of the Program.

Promotion: Before the FHI 360 marketing campaign the NHSC was using its website, print media as well as some digital media tools to market themselves, however they were not putting efforts in it (Chong, et al., 2016). They needed a well-defined and managed marketing plan which was later facilitated by FHI 360 programs.

Rebranding and Marketing Efforts by FHI 360

Merits and demerits of marketing mix of NHSC

The marketing mix needs a great deal of awareness, market analysis and interaction with multiple individuals, from end users to manufacturing to buying and selling and several others (Moriarty et al., 2015 d). In this way there are some merits as well as demerits of marketing mix of NHSC according to the case, such as:

Merits

• This helped improve the NHSC process by putting together different marketing principles into one, making it easier to do and handle marketing.
• It permitted NHSC's marketing activities to be separated from other business activities as well as marketing tasks to be delegated to the FHI 360 consultant.

Demerits

• NHSC's Marketing Mix sees customers as situational. It does not enable interaction and is unable to capture their relationship with the scheme.
• NHSC items are shown in a unique form, but they do not produce a product in isolation. It can take the manufacturer's mind to the wrong linkage.

Influence of marketing mix NHSC’s objectives and Company’s Success

The effect of the advertising mix on the successes and failures of NHSC's goals lies in its ability to help a company assess a product or agency's suitability for a specific target consumer base. All marketing mix components influence one another (Singh, 2012). We make up a company's strategic plan and treated it correctly, which will give it a great success. Yet wrong done and it could take years for the company to recover. It is not only the collection of marketing tools to business uses to sell its targeted customers' products and services (Venkatesh, 2011). NHSC's marketing combination elements allow it to make successful marketing decisions at all rates. These decisions help in successfully accomplishing the NHSC’s objects.

• Develop strengths, as well as weaknesses
• Build competitiveness and market adaptability
• Improve successful collaboration among departments as well as partners

While working through the components of NHSC's marketing mix, the FHI 360 will be able to create a plan that will efficiently attract buyers, make sales, and quickly and effectively expand NHSC's customers.

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