Healthcare Claims Data: The Secret to Effective Consumer Targeting with Definitive Healthcare

Announcer: Welcome to the Ignite Podcast, the only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Rich Briddock: Welcome to another episode of the Ignite podcast. We have a very exciting guest joining us today, Mike Julian from Definitive Healthcare. Welcome, Mike.

Mike Julian: Thanks for having me, Rich. Happy to be here.

Rich: We actually met getting locked into an aquarium together. That’s another story for another day, but maybe if we have time at the end of that podcast, we can get into a little bit of that, but definitely a fun way to meet. In this podcast, we’re going to be talking a little bit about the work that Mike does with his team at Definitive Healthcare. They are a HIPAA compliant data solution that essentially allow you to implement an audience targeting strategy to engage with the right patient populations.

I’ll let Mike explain it a whole lot better than I can, but push that to the sort of digital marketing channels that you use on a daily basis, like paid social and programmatic display, et cetera, OTT, CTV. A fantastic way to expand the capabilities that you probably already have in terms of your digital marketing efforts on search, organic paid search. Without further ado, give us a little bit of an overview of Definitive Healthcare, Mike, and what value you really bring to the healthcare space and the healthcare marketing world.

Mike: Yes, thanks. I think a lot of people might be familiar with Definitive Healthcare as the reference and affiliation provider and a publicly traded company. I am fairly newer to Definitive by way of acquisition. I was vice president of sales at a company called Populi. I was employee number four. Prior to that, I was VP of healthcare marketing at Evariant, which got acquired by Healthgrades and Mercury Health. All along the way, customers told me, “Hey, we don’t want to buy another app. We don’t want to– Whether it’s claims data or consumer data, we’re now putting our patient data in systems of record, data warehouses, CRM. We don’t need another application. We just want access to the data.”

That’s what was the premise of Populi and why it was founded. I joined as employee four, like I said. We were in operation for less than two years. We had rapid growth, and that’s why Definitive Healthcare acquired us. Really, they acquired us for a couple of key reasons. Number one is the strength of our all-payer claims database, the ability to understand everything that’s rendered on a claim. Think, who’s doing what, where, volumes, procedures, ICD-9, 10 codes, what the market share looks like, what the service line and aggregate looks like from a growth perspective, the referral patterns that happen patient to provider, or I mean provider to location or location to provider, or any amalgamation.

All of this was typically trapped behind black boxes, whether it was claims or clinical propensity models. These were expensive solutions. They took 9 months, 12 months to deploy, and all required the first-party EHR data of the customer. I tell you this because that was really one of the key fundamental premises of what Populi and now the new Definitive, as I call it, brings to the table. Really, speed to value by being able to deploy, de-identify claims analytics for strategic planning at scale, at a lowest total cost of ownership. That it’s not about having more data. Everyone talks about more data, this and that. It’s about having more usable data.

The old way for claims was, I tell someone my requirements, I wait three weeks, I get something back, and it looks like an Excel PivotTable, and that’s for strategic planning. For marketers, they barely have access to claims data a lot of the times, and for understanding what their market share looks like when running a campaign, say like, Orvo, Women’s Care, Cardiology. Then, the second piece that Populi brought to the table, and Definitive really wanted the claims asset, but we also bring the consumer targeting piece, which as you know, is a hot topic.

Some of the challenges that I saw over the years, and what’s resonating with customers today look like this. All are trying to do more with less. They have 20% reduction in budget, and there’s no amount of limit you can spend in search, social, any of these channels. Number two, risk mitigation and the changing compliance and laws, whether it’s HIPAA or OCR compliance, and how do you deal with the cookie-less future? I always think that there’s a blog post with a cookie monster involved whenever I start talking about this topic. Aside from that, it’s targeting people to get the best return on ad spend, and doing this in a way that is risk adverse to the organization.

Historically, all of the solutions out there that do propensity models, whether it’s one that I worked at or some of the others of the world, such as the Clarifies or the Optums, they build propensity models, again, off of that first-party EHR data feed. That makes it expensive to the organization and time consuming. Look, there’s nothing wrong with building models off your first-party data set from a population perspective and risk stratification perspective, but it starts to get dicey, and you open yourself up to risk when you use models that are based off of real first-party patient data.

It’s really, how are they able to enable this capability and still get within the bounds of HIPAA, and also with the mission of getting everyone care that they need? Our propensity model and our consumer data solution really targeted that approach with, because we have this all-payer claims database, we’re building our models off of that third-party database, de-identified. It spits out personas, and then we apply it to our consumer data set, which is an identified consumer data set of everyone that’s 18 and above.

Rather than having to buy consumer data yourself and stage it, or go to a Crossix or an IQVIA or a Purple and buy a segment and trust that that’s what the segment is, we are giving you every element in the consumer universe to be able to build segments that are complex. Such as things like channel where you’re most likely to respond, insurance coverage, commercial, Medicare down to the plan, risk factors for tertiary and quaternary care. Things like specific cancer types or even behavioral health. We get new model requests all the time.

The secret sauce really for Populi Definitive, now we go and we support the supply and demand side, the entire lifecycle of the ecosystem. We save customers’ money on having to buy multiple data sources. We mitigate risk by having that sort of separation of church and state. We really can start small and grow, regardless of the use case. In marketing, so to speak, really test and prove out things like, does this data targeted provide incremental uplift, AD testing at scale, as well as enrichment? Everyone has existing patient data in their EHR, but we can tell you more about those existing patients by appending our data set, which helps with personal development and content strategy.

I know that was just a brain dump of all the things that we’re doing, but too long didn’t read. It’s a brand new Definitive Healthcare. Now that they’ve acquired Populi, we have advanced claims analytics for strategic planning, and we have a plug and play third party HIPAA approved propensity model solution that is consumption based. It allows organizations to do better targeting, and to get better return on ad spending, and allows agency partners like Cardinal Health to really deliver better results for their clients by not just being an awesome agency with really fun people, because they totally are, but by also having being actually truly data driven.

I think that’s the offering of what we’re doing, and that’s a paradigm shift. It really resonated with our customer base, given the state of play with all the CRM acquisitions and consolidations, as well as the changing regulations and the changing competition landscape.

Rich: The thing that I’ve really noticed from the agency side is, especially coming from an agency that has historically been heavy on the search side, is that when you get into some of these verticals, what you see is search can perform well, but in terms of the lead quality that it drives, a lot of that lead quality could be the wrong payer. They might not progress through and become a patient because they’re not clinically suitable. There’s a number of reasons why search can drive very cost efficient leads that then just don’t turn into patients.

I think what this allows for is it allows for a much more sophisticated approach to not only how do I find people who are seeking out my services and my treatment offerings, but how do I find the right people? Because dollars are often finite. That’s another thing that we notice, right? Is that, to your point, you can spend infinite amounts on these channels. The equation is not, can I spend enough? It’s, how should I spend the dollars that I have to maximize that return?

A lot of the conversations that we have with marketers on our side, I don’t think they’re even really thinking about their payer strategy and how to engage with people with the right plans or the right payers to maximize that return. Even some of them don’t even know the difference in the reimbursement rates that they’re getting from different payers. This allows you to really dig into that, and really focus on those highest value prospective patients that you can bring in the door to make sure that marketing is as effective as it can be in driving revenue for the organization.

Mike: Totally agree. It allows us to have better quality conversations, and hold ourselves and our customers accountable. Claims tells us historical, but predictive marketing tells us future. Many people have access to their own patients, but it’s the rest of the market. To go back to what you were saying about search, it’s never going to go away, and it is a great lead producer. Of course, we want to be omnichannel, but what is the best use of that spend by channel as we orchestrate our efforts? How can we divvy this up in a way? Can we get a better result?

A lot of it comes down to, especially when you talk about the change in regulation, if cookies are going away and we can no longer anonymously track and store information on people, and collect that data and retarget them and remarket them, understand what pages you, Rich, or I am going to. I’m approaching 40, maybe I’m looking for a colonoscopy. I have two kids that are getting older, things like that. If you’re not able to do that anymore with pixels and tracking, it becomes super important to be able to leverage a third party data partner, and an agency that knows how to be a practitioner of this data. It takes people, process, and technology to get a result.

Search will never go away, but I like solutions. Target programmatic is great, but things that also help us understand where they are in context with their journey. For example, health risk assessments, whether they’re clinical or not, like a multi-step form on the landing page to understand, “Hey, is this for you or somebody else? Where are you in your journey?” Asking four or five questions, maybe, or even a true health risk assessment, like a Wellsource or Medicom, HealthAware, that give you a score that you can then follow up and triage appropriately.

So someone that is like, “I’m looking for a second opinion for breast mammo cancer,” versus, “I’m just trying to get information about annual screening.” We can triage and engage these people appropriately, and in turn optimize our spend. I always say, I have seven siblings, I grew up in Maine, rural Maine, I like to spend the money like it’s my own. It’s about being good stewards of the organization, and also getting people the care we need. To know is to serve. We want to help our customers know and better understand their current patients, as well as future patients, so that then we can also understand how to maybe drive capacity.

A lot of the discussions aren’t just drive more leads, it’s, “Hey, we’re a market leader in our area, we have 80% market share.” It’s when I have capacity that bubbles up in core service lines like bariatrics, oncology, et cetera, that I need to be able to fill it smartly. Filling it smartly doesn’t mean, oh, we only want commercially insured people. We want to get everyone the care that we need. We have social determinants of health data, too, but if there’s no margin, there’s no mission. As marketers, they have a limited budget that they spend.

If we can show them they’re getting 3X or 5X for every $100,000 that they’re spending in a campaign, they’re going to get $300,000 or $500,000 in contribution margin or lifetime patient value. Educating them on how to go beyond clicks and impressions, and to have that level of competition is how you up-level marketing to be a cost center to a true revenue generation hub. That covers a lot of the search, the HIPAA, and the actual quality of targeting. It also goes down to also referral targeting physicians, too. We don’t want to waste money. We want to do things that are going to drive the biggest impact.

If marketing campaigns perform super well, and they’re generating revenue for the organization, that opens up opportunities to invest in things like access to transportation campaigns and partner with Lyft or Uber to get people last mile to make sure they’re showing up, or to healthy food initiatives so that we’re actually giving children in underserved communities good healthy meals so that they don’t grow up with comorbidities. As someone who grew up in Section 8 housing and under impoverished area, that’s like super important to me.

I’m on a board of a nonprofit that helps folks succeed through college, that are first gen or have been in foster care or emancipated. I like to take that lens in healthcare as well, not to go off topic from search. It’s not just about driving leads and driving a calculus of some sort of formula to see we’re going to spend and this is going to be the result. These are lives that are involved in this, and how can we be good stewards of systems brand as well? [unintelligible 00:12:43] you there, Rich. So– [chuckles]

Rich: No, no. I appreciate that. I think you’re absolutely right, in terms of, it’s about connecting the right people with the right care, and making sure that all populations get the right care, and that we’re allowing healthcare providers to engage with the right patient base. That’s what this is all about, right? In some instances, yes, there are going to be providers out there that are seeking commercially insured patients where they get higher reimbursements, which is what we just spoke about. Other providers are going to be seeking to better reach a Medicaid or a Medicare population, where they can really help them and do great things for them.

All very, very important things, and the ultimate mission of why we’re here. The other thing that’s great about your product is, and I know we’re talking about more of the supply side piece, but ultimately, you guys are an analytics product at the end of the day, or at least what you guys do is predominantly an analytics product, and it can be used. You mentioned a number of different use cases here, but can really help you zoom out and see the landscape, and see what’s going on. One of the things that you could be thinking about here is things like de novo strategy.

I’m a healthcare platform, I’m a multi-location healthcare platform, where should I open my next location? Definitive is a great solution for that, right? Because you can see where those patient populations are, you can get pretty granular in terms of the geographies, you can understand where competition is, how saturated a market is. There’s a lot of benefit here, right? In terms of not just beyond– I know this is a marketing podcast, and we’re talking about marketing, but even beyond that for operational use cases as well, there’s a huge benefit in terms of what you guys offer with the data.

Mike: Yes, I would totally agree with you. Real world use case. For example, we engaged with a customer in Florida that does cancer centers, and they said, “We have two locations located within 5 miles of each other. Which one should we close and why?” Other types of engagements are, like you said, “Should we acquire this practice? Is the money that they’re asking for, do their historical volumes actually justify this? Do we think it’s going to be a good acquisition?” As well as, “Where should we open up primary urgent care locations?” Whether it’s acquire or build, it’s all about understanding the population and historically what the market share landscape looks like.

It’s important, and it does dovetail into marketing. Obviously, we think about direct to consumer and the service line marketing that you and I know and love every day, but a lot of these organizations, they’re national at scale or have national ambitions. So the legacy solutions and the million dollar price tags are not going to work for them. All of our data sets are national, so you can see down to the zip code level nationally, state market areas, and scale by service line, whether it’s the claims data use case, but it’s all about really helping people not just have more data, get the actual insights.

What we do is we have a series of workbooks and templates that understand our service lines growing in aggregate, provider views, patient origin views. We’re coming out with a demand forecasting tool here soon. It really is, it’s people, process, technology. We have claims experts that are much better at talking about this than me, but they’ve been practitioners their whole lives. We do proof of concepts for our customers as a proof of value for no charge, where we collect their requirements, like the ones I shared, come back and present the data and show them how they would use it in the same dashboard with live data that we provisioned within seven days.

That’s ultimately connected to a Google BigQuery database. Not to get technical, but for the same subscription, they can also bring the claims or consumer data into a data warehouse, like a Snowflake. If they have an EMPI, like a patient mastering initiative, they can use it in that context. It’s really, it’s not just for marketers, it’s about for IT, CIOs. It’s about lowering the cost because all the other business units, popHealth, everyone is buying their own solution, which they have to support. Then there’s the cost of that. Streamlining efficiency gains there, having strategic planning and marketing.

Actually break that system down and connect it to what they’re doing, is excellent. I’ve talked to, I have a client in Michigan, Henry Ford Hospital is a claims data solution. They do strategic planning work and mind the gap analysis. Looking to understand by service line where there’s opportunity, and we had a conversation at the last HMPSS after their presentation, which was strategic planners aren’t really looking at consumer data. They might do a study with Buxton or have some data. They’re looking at the claims and looking at that granularly, but they’re not considering future demand and what that looks like.

I think that’s an important for marketers, because I hear capacity is a challenge all the time. You can fix capacity through last mile solutions like Care Sherpa or through Vitals, where AI and their new matching, and you should absolutely look at solutions for capacity as well, but understanding, “Hey, do we need to hire more people within a service line because behavioral health is growing 51% year over year at a national level, and maybe we only have two people for this, we are underwater now. Maybe we need to grow this strategically, or maybe we need to open up a new ambulatory center.”

That then dovetails within the marketing strategy of, how do we do the persona development? Who are we trying to market to? What’s our brand messaging? What is the value? That’s all the stuff that Rich and Cardinal Health do. It’s being able to make that brand message come to life and also execute. I think that’s the whole value of the ecosystem and chain, but for marketers, having access to claims data to really justify to administrative professionals, as well as physicians who oftentimes want their faces on billboards, or they want the radio spot.

To say, “Hey, Dr. Britik, you’re here, in terms of volumes for total hips and knees, and actually we’re seeing the patient population looks like this, and they’re engaged in these channels. Direct mail, digital, LinkedIn, Twitter, Facebook.” It’s that data that we allow you to then build a more fire goal or an audience to fill the top of a funnel in a more qualified manner. Again, I rambled on, and I just had too much coffee before the podcast.

Rich: Mike, if you’re coming to me for a hip or a knee replacement, you need better insurance. That’s what I’m going to say on that one. The other thing, just quickly, because I know we are getting close on time here, that is also about claims data, right? Is not only do you have the claims data for the client that you’re working with, but you have claims data for all these other provider groups, too. In terms of a bit of competitive intelligence, this allows you to not only understand where the patients that are coming to you, but it also allows you to understand where patients are going if they’re not coming to you. Correct?

This is a great way to do a little bit of competitive intelligence and understand who might be eating your lunch in certain markets, and help you as marketers to figure out what’s going on there. More so than just anecdotal insight, thinking that this provider group might be the one where you’re losing business to.

Mike: Yes, you bring up such a great point, because it’s strategic planners look at this all the time, but as marketers, they’re so focused on executing a campaign that they miss the opportunity to mine what you just talked about for insights, whether it’s competitive, maybe there’s a center or competition closing down, and also give set expectation. My favorite quote, expectations are the mother of misery, right?

When you run a campaign, you want to set radical expectations with your administrative stakeholders, executives, of what good and great looks like, and doing so says, “Hey, look, maybe we had 10% market share in orthopedics today. Now here’s what our patient population looks like. We know our patients historically, because of our EHR data and maybe state data. Now we can see what the rest of the market looks like, as well as who was really crushing it from a referrals perspective.”

Maybe it’s not about trying to boil the ocean and get all the patients, but there’s pockets of opportunities where there’s splitters or where there’s patient populations in growing areas that are overlooked. Consider places like in San Antonio, or places that are growing at such a rapid pace. When you look at new movers data in Florida where systems are seeing that there’s bigger opportunities outside of their traditional core market.

Rich: Mike, I feel like we could talk about this all day. I think maybe at one point we need to have you come back on the podcast and potentially, because we have video, we can even show some of the screenshots from Definitive and how cool the platform is. If you’re not aware of Definitive, please go check them out. Mike will be there to steward you and answer any of your questions, I’m sure. It’s been an absolute pleasure having you on the pod, Mike. Where can people find your stuff?

Mike: You can find me on LinkedIn, Mike Julian. You can look at Definitive Health’s website, at definitivehealthcare.com. Look under population intelligence for consumer, or look under claims analytics. Reach out to me or Rich if you want to explore doing a proof of concept on the claims or understand predictive consumer counts in your market, happy to do that. It costs nothing to look at data. Nothing happens in one call. I’m not even the sales guy. I just get easily excited about this.

I know I dominated the pod. I’m sorry. We didn’t get a chance to tell the locked in the museum story, but I’ll just end it by saying it was an awesome event that was sponsored by Cardinal and Freshpaint, which is an awesome HIPAA solution if you’re producing lots of content as an organization. It was at the Georgia Aquarium, beautiful dinner, excellent time, come to leave and we were locked in there, and it took us about an hour to get out. Rich had the unfortunate pleasure of sitting next to me, and that is how you got this verbal flow podcast today. Looking forward to doing it again. Happy to help. Thanks for having me today, Rich.

Rich: Of course. Always a pleasure to have you, Mike. Thank you so much for your contribution to Ignite. Goodbye, everyone. Next time you’ll be joined by your usual host, Alex Membrillo, who has been locked in a room developing dad jokes for his LinkedIn profile. He will be back to join us shortly. All right. Thank you, everyone.

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