Redefining Healthcare Marketing Through Accountability, Agility, and Alignment with Monu Kalsi, Millennium Physician Group

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.

Alex Membrillo: What’s going on, everybody? It’s been a minute. I’m excited to be back with all of you guys. I know you were waiting, counting down the minutes so we could be back. We had to put on Scaling Up, which is two days. I don’t know. What do we have? 50 speakers, 40 sessions, something crazy like that. Hope you guys could all attend Scaling Up. This is going to be fun. We’re kicking off the new year in a great way. We’ve got Monu with us. Welcome to Ignite. What’s going on?

Monu Kalsi: Hey, Alex. Good to be here. Nothing much. Trying to fight the cold in Chicago.

Alex: [laughs] I love it, man. Go get some deep-dish and then you’ll be going to take a nap for about five hours. I love deep-dish, but that is absolutely brutal. We’re going to have fun. Tell them a little bit about Millennium. They don’t know what I already know, and this is why they’re going to have so fun. Tell them what you’ve been up to there.

Monu: Yes. For folks who don’t know Millennium, Millennium Healthcare is a premium primary care organization in this country. We go to market with almost about 800-plus providers in 200-plus locations spanning across multiple states. The focus really is to drive top-notch healthcare to our patients and really help them through their entire sort of lifespan, right? Make sure that they’re in good health and basically provide excellent customer experience.

Alex: Y’all are mostly in the Southeast, right?

Alex: Correct.

Alex: I looked at the MPG website and it seems like immediate care, but also a variety of service lines. The model is get them in with an acute issue and then hopefully be able to service everything around it.

Monu: It’s actually primary care. It’s a PCP organization. The idea is that we want to be your primary care provider. We also definitely have other opportunities and other services that we provide. We have immediate care services, we have labs and biology, et cetera. The focus is really PCP, primary care.

Alex: Monu, how has 2024 been? I actually believe we’ll go live before ’25. This is going to be fun. How did 2024 go for y’all?

Monu: I think 2024 is great. We see a lot of progress. We see a lot of shift that is happening in the healthcare space. Healthcare is moving out of big hospitals to primary care locations, more and more offsite locations are coming up out there. People are looking for proximity of care. They’re looking to make sure that they have convenience, they have easy access to providers, easy access to ancillary services. I feel like the trend exists and I believe that we are on the forefront of this trend. That has been great.

Alex: Yes, that’s good. 2024, a good year as a private equity finance bros would say lots of tailwinds because hospitals, insurance, they want to kick everybody out to outpatient and keep people safe and healthy and wellness ahead of sickness saves insurance companies a lot of money. They want people going to the PCB. I just went to my PCB last week. Do you guys do blood work in-house? This was a sticking point for me that frustrated me.

Monu: It depends. Some locations get outpatient.

Alex: All right. 2025– Ooh we’ll get to 2025 in a minute. You head up the whole marketing function. Tell us about your team structure and what y’all’s focus usually is B2B, the referral size or direct acquisition, but let’s talk team structure first. What is the model? What does your team look like?

Monu: Yes. We have a fairly small team, small but mighty, I would say. The structure of the team is no different than any other team that would be in a business like us. We have a team that is focused on three or four functions. There is obviously organic growth at demand gen, which is very important to us as a consumer business. We are the business of driving additional patients to our locations, making sure that our providers have the panels that they need.

Patient engagement education is paramount for us. We exist to make sure that our patients are getting the services they need, they’re getting the education they need, they know exactly where to go when for care. One of the biggest mandates for marketing is to drive patient engagement and education. Patient experience measurement. Making sure we’re measuring every point of contact and every point of service to our business, customer satisfaction service, whether it’s NPS, what have you. We are definitely measuring that, but that really forms a core closed loop for us to continue to upgrade our technology, upgrade our services.

Then finally, digital. Digital is a big focus for us, like every other health care organization out there. Making sure we are meeting our patients where and how they want to meet us, whether it’s through the website, mobile app, social channels, what have you, and making sure that that whole experience is seamless and frictionless as much as possible. That’s how we are structured in terms of functions and our mandates.

Alex: Monu, you said focus on digital like every other health care organization. I wish that was the case. You’d be shocked how many are still relying on referrals out there and new to digital and need a digital transformation. Just finding out PCP less so because it’s the entry point. Very much not referral driven, so you have to be firmer on acquisition. Tell us about the technology. You mentioned technology. You have a mobile app. Is that used? Is it like a portal? Are we using that for booking? What technology? What has helped you get more patients?

Monu: All of the above. We obviously have patient portal. We have a mobile app. It’s all available to our patients. They can go download it online, et cetera. We also have a website, which is something that we’re focusing on to make it better, more slicker, more faster, more user friendly, I would say, from a self-service standpoint. Yes, I think going back to your earlier point, yes, I think every health care provider has a intent or a vision to do more things digitally, to be more self-service, et cetera. Everybody’s on a different stage in terms of their maturity to get there and the momentum. I would say we’re on that journey as well.

Alex: It’s never done, but at least having a focus on it and, okay, a few questions on patient experience. You guys have online scheduling?

Monu: Yes.

Alex: Okay. Is it actually tied to schedules or is it like every 15 minutes and we’ll get you in when we get you in? Is it actually to integrate with the [inaudible 00:05:50].

Monu: The schedule?

Alex: Oh, awesome. Okay. You’d be surprised how many like, vanity online schedules we have, phone, email, all that stuff?

Monu: All of the above.

Alex: Is it tracked? You have good lead tracking system and appointment schedule tracking?

Monu: More so for some channels than the others. Yes. I would say that we are on such a journey where we have the channels tracking and attribution of something that every organization like us is trying to crack that nut. How do we make that better? How do we do that every time and then how do we tie all that back to some sort of ROI?

Alex: Monu, that was the theme of Scaling Up. The very first session with all the CMOs, we did a poll out there. What is every marketer focused on going into 2025? Number one was measuring ROI, tracking it back to our efforts, because I think everyone is getting a ton of pressure right now. What are our dollars– Inflation is up. The interest rates are up. What are our dollars doing? I’m going to cut this budget. We feel the pressure. Never enough leads. We’re like, convert more. Everyone is feeling the pressure on ROI. I get that.

Monu, when you sit down with your leadership team, how are the discussions going into 2025? Are you saying we just need more leads or is it a wider conversation about where do we need them? How do we need them? How do we reactivate? Are there business metrics? How do you guys look at 2025 for people? Are you just handed a mandate? Do we need to grow top line? Get me more leads. How does that look?

Monu: I think it’s more collaborative than that. It’s definitely more full funnel discussions. The last thing you want to do is be having a lead discussion with your senior. It’s not about leads. It’s not about conversion. It’s really about, hey, where do we want to grow as an organization? Where is the need in the community to provide the right care? Who do we need to hire in terms of providers, care teams, what have you? What do we need to do from a marketing standpoint to actually make sure that our communities and our patients are getting the care they need?

I think they’re very full of state discussion. Of course, we are a big business, so we have to make sure we also look at this from a financial lens. I would say it’s a very collaborative discussion between the marketing team, the finance team, the operations team, and everybody else comes together to almost find a form like a RevOps team.

Alex: RevOps. We also did a poll of what marketers should be called. Number one was Chief Growth Officer. I don’t think we want to be called marketers anymore because we are in charge and have to think about so much. What you just heard Monu say is really important. You don’t want to have a leads discussion with your CEO. That’s what I was trying to get at. Too many marketers are focused on, I need to drive more leads, I need to lower CPL, get appointments up. It’s actually not how your CEO is thinking. We need to drive more top line revenue.

Monu, is it just experience? How do we get more marketers or growth wizards, whatever we’re called now, comfortable with sitting at the table and having top line, actual financial discussions, revenue, where do we need it? What’s going to drive EBITDA? How do we get to where you are?

Monu: I think it starts with– a couple of things come to my mind. One is as simple as it sounds, understand the business better. Understand how you make money. Where does the money come from? What are the channels? Patients, in our case patients, but let’s just genericize it. Which customer segments are driving the revenue best? Which patient segments or customer segments are profitable versus not? You’ve got to spend enough time with your finance buddies to really understand those metrics. What they mean? How they calculate? How do you make money?

I would take that then and bring it back to the marketing organization and say, “Okay, here’s where we want to go as an organization. What percentage or portion of that growth can be something that marketing can own and drive?” Own and drive doesn’t mean we just own the lean numbers. No, you own the actual final number. There’s accountability there and then you’ve got to be open to that accountability. There’s another game. A lot of marketers don’t want to have this game in the game. That’s where you don’t get to sit at the table if you don’t have strength in the game.

Alex: That’s fair. A lot of marketers don’t want to have it. We want to drive leads. Guys, that’s marketing associate manager type stuff. If you want to be director VP, CMO, like you have to be comfortable tying your name to the business result. What you did not hear Monu say was you need an MBA or a master’s in finance. No, he said you need to go sit down with your finance buddies and figure out how this business makes money. It’s so dirty in healthcare. How does the business make money? We’re here to serve patients. Yes, but no margin, no mission.

Figure out even in PCP, like getting them then in young for a physical is the LTV longer, et cetera, et cetera. Just examples, but please learn how the business makes money or you’re never going to get out of the marketing position. That’s your rate.

Monu: I think that’s customer base. Not every customer is right from a needs standpoint, from a behavior standpoint, a new for profitability standpoint. Nobody else in the C-suite is mandated or owns this more than the marketing that the CMO is to understand the market, understand the customer segments, understand the needs. Basically, I think the last thing you want to do, the biggest point of failure just seen is trying to be everything to everyone right out there. You don’t want to go after all the customers the same way or maybe not even go after all of them at the same radar. How do we get more targeted and do things well and measure them at the right level? I think that’s what is going to make it successful.

Alex: It’s the enigma that we all love trying to figure out how to solve that never fully gets solved. When you said like learning the communities because we were saying how do you know where to place emphasis? How do you learn the community? You guys have 800 provider. How many locations?

Monu: 200.

Alex: 200 locations. Are they all Millennium-branded or they all have their own PCP names?

Monu: Millennium brand.

Alex: That makes it a little easier. It’s not house of brands. How do you get to know 200 community? What are you looking at to figure out where to place emphasis? Is it demand rural, urban, is it providers? How many job recs we have? What do you look at to figure out Q1?

Monu: I think as a marketing team and organization like us, you have to have really good open lines of communications with your people on the ground. You have to spend time in those clinics and with those teams you have to interact with those, I would say lack of better term, operational folks, your operational leadership because they know their communities better. No market research, no survey is going to get you the data and the insights that people who actually work in the community will get you.

This is where in our world our providers are physicians who really understand their patients. They’re so critical to our marketing success because we might sit in a corporate office and try to paint everything with the same brush and that’s never the case. Every community is different, every county is different, every region is different, every state is different.

Alex: Monu, we just found out he is a Diamond Medallion member at Delta because he is traveling to these 200 communities all of the time. You have to get up there and meet up.

Monu: [inaudible 00:12:09] miles of the car.

Alex: You got a lot of miles. I hope you have a Honda because my Fords break down all the time and there’s no substitute for getting out there and physically talking to the providers in the front office and they’re going to tell you the roadblocks that they’re encountering. Oftentimes there’s a competitor right down there that what you wouldn’t know sitting at the corporate office running PPC the same way for 200 locations or these type of people, heavy smokers because they all had this you don’t know. You don’t know unless you get out there. Monu, I love that advice. Now I’m going to ask you some quick-fire questions. The 25%, 30% whatever the percent is that’s coming digitally. What’s your favorite patient acquisition tactic?

Monu: Yes, it’s paid media.

Alex: You guys are, I’m assuming heavy on search. Do you guys also focus on SEO reviews? Is it Meta ads? What has worked? What makes 2024 work?

Monu: Of the above, they all play a role. When you’re putting together the marketing mix, they all play a different role in basically enabling demand gen. I would say definitely we are in the regular paid channels that every other competitor is on. There’s definitely emphasis more and more so of making sure that we focus not just on the short-term tactics but also long-term tactics. Content optimization, aid testing. It’s huge for us. That’s something that we’re going to continue more of.

Alex: A lot of people don’t do that in low acuity type stuff like primary care, urgent care. They just say, “Eh, no they’ll convert.” It’s like there’s five within two mile, five PCPs in urgent care to media care within two miles. You do need to be different. That’s smart of you guys to invest in the demand generation, not just the cap, the short term stuff. We ran experience with a variety of large PCP groups where we ran paid social and you would think that it’s going to crush CPL. It actually assisted the overall CPL dramatically against the markets that we’re just doing PPC.

When the CEO was saying, “Ah man, what was the value of all those Meta ads that we run and we spent 100K on? It’s like, “Yes, well the overall lead volume went up and the appointment costs went down, buddy.” It’s harder to prove those things now. Technology, I know you love regulated industries, you’ve been in finance.

Monu: Oh yes.

Alex: They’re good job security because no one else can do it. What’s one of your favorite pieces of technology you’ve used to help reach patients better?

Monu: I don’t know if it’s favorite but I would say the most important piece of technology investment I’ve made is a customer data platform. A lot of things we do marketing today is so heavy data and analytics-driven. Without a very robust customer data platform, it’s going to be literally impossible for us to do the things we’re doing today running multiple campaigns, pulling data out, building the dashboards and drilling. At the end of the day, it’s all about attribution. Attributing the investments we make to be ROI, to be to the revenue, et cetera. CDP or as they call it, is I would say the most important investment and probably the hardest implementation.

Alex: I was going to say, I want to caveat because the smaller groups, they need like a small engineering team sometimes. What size is right? What has it helped you specifically do? What size provider grow? When do you think it’s appropriate to go get a CDP or you’ve reached this maturity stage in tracking your advertising, what’s the roadblock and you said we need a CDP now?

Monu: That’s still very tough question to answer. I don’t know if I have a real answer for that but I think once you are a, let’s just say a hundred-plus location provider and you have a need to drive additional customers and you are running on also investment sense, you’re doing lifecycle marketing with your patients, you’re doing customer acquisitions, you’re doing events, et cetera, and you want to tie all that together and really come up with an attribution model or even if you want to create some predictive models in my previous stores I have created.

Using the CDP data we have created a propensity to buy, a propensity to churn, and all those different models which are predictive and telling us exactly where marketing needs to go, spend its dollars, and limited resources. All those rules point back to creating a CDP or something like that. You don’t have to go purchase a multi-billion-dollar platform off the shelf but can you start to build some warehouse for marketing to house its data with the right data structures and the right software mechanisms to push data and pull data out?

Alex: I love it. The predictive modeling and then you look at that and you say, we need to reach Sally Smith. She hasn’t been back in at eight months and we know she had this condition. It’s like a lot of groups– and I can answer my own question. I think now a lot of groups aren’t even doing the demand capture stuff that well. Get your demand capture correct and then you’re going to start evolving into demand generation and upper funnel and advertising and TV and billboards and then you’re spending a ton of money and you’re like, “We don’t know what else to take this.” It’s the next iteration. If you don’t mind me asking, everybody wants to know what tech everybody’s using. What CDP did you guys use at Millennium or are you using?

Monu: At Millennium, they’re still working on getting one. We’re still earning money.

Alex: We’ve got great recommendations. Our friends love [00:16:56]

Monu: [unintelligible 00:16:59].

Alex: Absolutely. Real quick. We’ve got a lot of marketing directors that listen to this and are looking to make their next hire. You have a unique opinion on hiring. What do you look for in your colleagues?

Monu: For me, I think I have a little bit of a different view of how I hire people, and a lot of people hire based on pedigree and skills and have you done this three times, create awesome, come do it for me. That’s important. That’s really important. If you’ve done the work, say for example from looking for data and data has done work in the healthcare space, that’s a big plus. For me, it’s a combination of the children skills. I almost hire 50% on attitude and 50% skills. Sometimes that’s a little bit controversial because I can teach you skills all day, no problem, I can do that but if the person I’m bringing in does not match the organization in terms of culture and attitude and pace, we’re going to have a big problem.

I focus a lot more on the drive and the ability to operate independently. The ability to learn all the hunger in the belly, to learn the curiosity, for me is paramount. I would say I’ve made hires in the past where they’ve not really checked all the boxes from a skills and experience platform, but they’ve checked all the boxes from the [unintelligible 00:18:08] to ability to learn that curiosity.

Alex: I like that you said pace. That’s actually an issue. I’ve seen it’s harder to detect whether this person’s going to have the urgency or not but because Cardinal runs so fast, that is a roadblock for a lot of people that have the pedigree. I’m with you, you actually taught me something. We have Cardinal values for pace attitude, urgency, extremely important. They can pick up the marketing skills in six months. I think what we do is not rocket science. Other than there’s-

Monu: There’s a framework that I use which I just coined a few years back and I’ve used it to not just measure new people coming onto my team but also myself and my own teams. It’s called the Triple-A. It’s basically accountability, agility and alignment. Are we moving with accountability? Are we owning the numbers, the metrics that targets? Are we moving fast enough? Breaking things, trying new things up because marketing is all about experimentation. That’s it. I mean I don’t have the answers to everything. Alignment, I’ll be bringing everybody along because marketing is such a cross-functional team. I will tell you on a daily basis, I need to tap into at least three to five teams within the organization to get my goals. To meet my goals, to get everything done. I’ll be bringing everybody along and making sure that there’s pure alignment across the organization. I call it the Triple-A framework and I use it daily to measure ourself and my team members.

Alex: Accountability. What was the second and third?

Monu: Agility.

Alex: Agility.

Monu: And alignment.

Alex: And alignment. I love bring everybody along with me. That’s good. We call it MOA, Marketing and ops alignment that’s a better sentence for it though. Bring everybody along with you because you’re going to need them and they’re going to vote on whether you’re going to be useful. You need them to figure out where to place the marketing emphasis and you need their help to convert the leads and everything else, we’re driving. If nobody wants to, that’s good. That’s important. We heard that a lot and a lot of marketing leaders now are working on shared dashboards with their leadership team so they can see what we see. Less questions, more buy-in, all of that kind of stuff. You heard the three As from Monu. He’s coiny. He’s giving us headlines. I love it, man. This was fun. One more last question, because I’ve got you over time. I broke my promise of getting you out of here at 11:30 Central Chicago deep-dish pizza time. In 2025, what is the one area you’re going to place more emphasis than you did in 24.

Monu: Still?

Alex: Yes, looking more for which means what sacrifice is carrying slightly less about?

Monu: I don’t know if there are any sacrifices, but I think it’s a fine balance. You got to grow the organization. At the same time, you want to make sure that you’re not overseeing the needs of your existing customers, the engagement that we need the lifecycle marketing. I would say just making fine balance on a daily basis. Definitely it’s going to change our media mix quite a bit in terms of where we invest, how we invest, et cetera. It’s definitely going to make us much more agile. We have to move at a higher speed than we have in the past. I think the things we do at core in terms of marketing still is still stand up. That’s the [unintelligible 00:20:57]

Alex: It’s almost like shifting focus. Even if we don’t do a ton of tactically different things and shifting focus like guys and, Monu, you probably put in the framework, great website, great scheduling, great tracking, pretty like good enough. Now we can focus more on driving more demand into the machine that we built because you spent– [unintelligible 00:21:13]

Monu: Measurement. I forgot to mention measurement with key because all of us in marketing have way more data, we have very little information, and we have extremely few insights on that information. It’s about how do we take that data and create it into something into insights and then drive actions on those insights. That’s going to be a big focus. That’s not like something you do overnight. It’s going to take us time. It’s a journey we are on. It’s going to probably take us another year to get [unintelligible 00:21:40]

Alex: Data democratization, getting the data clean to where you can use it and then monitor if any of us marketers have job security, when AI tries to take it over the next few years, it is on analyzing data and coming up with what we do next, like the robots are going to take all of the PPC button pushing and SEO content writing already are, but the strategy and where do we go next will hopefully be done by humans for a long time. You heard it from Monu.

Monu: Oh, man, I hope so. I hope AI doesn’t, mature to a stage where they can do that as well. Oh, do that. Do that. Correct.

Alex: It’s going to be a while, but I’ll see you in the mountains when it does. We’ll both just be hiking every day because we will be out of jobs. Monu, thanks for joining us on Ignite. We appreciate it. We love it. Thank you.

Monu: Thank you so much.

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