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Journal of Marketing Special Issue: Marketing in the Health Care Sector

Journal of Marketing Special Issue: Marketing in the Health Care Sector

Editorial: Christine Moorman, Harald J. van Heerde, C. Page Moreau, and Robert W. Palmatier, “Marketing in the Health Care Sector: Disrupted Exchanges and New Research Directions

Health care is vital to our interconnected world, and society benefits from its successes and is challenged by its failings. Disruptions on both the demand and supply sides are impacting the creation, provision, and consumption of health care in fundamental ways. However, the role of marketing in this dynamic health care industry remains only partially understood and is often frozen in a very conventional set of business-to-business (e.g., detailing or advertising to doctors) and business-to-consumer (e.g., direct-to-consumer advertising) strategies. While important, the Special Issue editors argue that this view ignores the new actors, roles, and exchanges—the flows of value, information, influence, resources, and rivalry between actors—that are occurring in these disrupted health care exchanges. With this Journal of Marketing Special Issue on “Marketing in the Health Care Sector,” the editors introduce a set of articles that offer novel contributions regarding marketing’s role, and they offer a research agenda outlining more opportunities for marketing scholars to examine and understand how these disrupted exchanges are improving health, empowering choice, and fostering competition.

Benedict G.C. Dellaert, Eric J. Johnson, Shannon Duncan, and Tom Baker, “Choice Architecture for Healthier Insurance Decisions: Ordering and Partitioning Together Can Improve Consumer Choice

Making good health insurance decisions is important for health outcomes and longevity, but consumers’ errors are well documented. The authors examine whether targeted choice architecture interventions can reduce these mistakes. The article examines the interaction of two choice architecture tools on improved consumer insurance decisions in online health care exchanges: (1) ordering the options from best to worst based on a high-quality user model and (2) partitioning the total set of options. Although ordering and partitioning do not always improve choices separately, the authors use one field study and three experiments to identify the conditions that allow the combination to greatly improve health insurance decisions.

Findings indicate that when options are ordered such that the best options appear at the beginning of the presented list, partitioning nudges consumers to focus on the best options. However, if the best options are not at the top of the list, partitioning discourages search and can impair consumers’ discovery of the best options. Process data show that these effects are achieved by focusing consumers’ limited attention on higher-quality options. These results suggest that wise choice architecture interventions need to consider the joint effect of choice architecture tools as well as the quality of the firm’s user model.

J. Jason Bell, Sanghak Lee, and Thomas S. Gruca, “Bringing the Doctor to the Patients: Cardiology Outreach to Rural Areas

Clinical outreach is a crucial but understudied health care service delivery model. Physicians staffing rural outreach clinics must allocate a limited resource (i.e., their time) between caring for patients at their main sites and outreach locations. Using a unique 30-year data set of decisions made by cardiologists, the authors estimate a constrained utility maximization model of time allocations across home and outreach locations. The results show that travel distance, potential competition, and patient demand for cardiology services significantly influence allocation decisions. This structural model is used to simulate the impact of a predicted reduction in cardiologist supply. The expected impacts are unevenly distributed, with some rural locations experiencing large decreases in access.

The authors evaluate two policies to restore rural access: targeted immigration and a subsidy program. A subsidy program with an estimated annual cost of $406,000 can restore outreach after a 10% reduction in cardiologist supply. This option should be preferred to recruiting and supporting five additional cardiologists under a targeted immigration strategy. This research demonstrates the value of marketing modeling in addressing limited access to health care services and evaluating alternative policies for maintaining access in the face of coming physician shortages.

Sarang Sunder and Sriram Thirumalai, “Hospital Portfolio Strategy and Patient Choice

Specialize? Diversify? Do patients care? The authors investigate the demand-side effects of a hospital’s portfolio strategy, which entails decisions about the depth and breadth of its service offerings. Positing that both depth (focus) and breadth (related focus) signal expertise, the authors use both archival and experimental evidence to examine these effects. The archival study is based on Florida’s State Inpatient Databases for 2006–2015 and spans all major departments in health care delivery. The empirical analysis exploits plausible exogenous variation from other health care markets and reveals that patient choice is positively influenced by a hospital’s depth (focus) and breadth (related focus) of expertise in a department.

Complementing the archival evidence, the authors also conducted online experiments to examine the signaling effects of hospital portfolio strategy on patient choice behavior. The results provide support for the idea that hospital portfolio strategy influences patients’ perceptions of hospital expertise in focal and related areas and, subsequently, their choice behavior. The authors also highlight potential synergistic effects between focus and related focus and heterogeneity in the effects across departments, payer types, and hospital profit status. These findings underscore the need for managers to adopt a targeted approach to portfolio decisions in health care.

Yiwei Chen and Stephanie Lee, “User-Generated Physician Ratings and Their Effects on Patients’ Physician Choices: Evidence from Yelp

Patients increasingly rely on online physician ratings to select their physicians and make health care decisions. However, it is unclear whether online physician ratings signal physician quality information and affect patients’ physician choices. By combining physician rating data from Yelp with data from Medicare, which covers a large elderly patient group, the authors find that ratings are positively associated with important measures of physician quality, including physicians’ credentials, adherence to clinical guidelines, and patients’ health outcomes. They introduce novel instrumental variables, where reviewers’ leniency in rating other businesses is employed as an instrument for physicians’ ratings. They find that an increase in physicians’ average rating increases physicians’ patient flow.

To understand the quality signals that patients respond to, the authors also use the latent Dirichlet allocation model and extract topics from review texts. Patients respond differentially to different information and respond most to information about physicians’ interpersonal and clinical skills. In addition, rating credibility, accessibility, and strength of other existent signals moderate the positive effects of online ratings on patient flow. Overall, online physician rating platforms can promote efficiency by disseminating important quality information to patients and directing patients to higher-quality physicians. 

Tae Jung Yoon and TI Tongil Kim, “The Role of Advertising in High-Tech Medical Procedures: Evidence from Robotic Surgeries

Hospital advertising has grown more than five-fold in the past two decades. However, unlike detailing and advertising for prescription drugs, the topic of hospital advertising has been understudied. This research introduces a customer-centric view to this market by investigating the role of advertising in patients’ choice of high-tech medical procedures, with a focus on robotic surgery. The authors analyze approximately 140,000 individual patient records and television advertising data from Florida during 2011–2015 to investigate how hospital advertising of robotic surgery affects patients’ choice of robotic surgery over more conventional laparoscopic and open surgeries.

Using a variation of a designated market area border identification strategy, the authors find that this advertising leads to more robotic surgery choices. The advertising effect is especially strong for Medicaid patients, whose socioeconomic status tends to be lower. While robotic surgery is associated with a short-term health benefit (i.e., reduced length of hospital stay), it does not affect long-term health benefits and comes at a higher cost than other forms of surgery. Thus, understanding the effect of advertising robotic surgery has significant health, cost, and marketing implications for different stakeholders in the health care industry, such as patients, health care providers, surgical robot manufacturers, insurance providers, and policy makers.

Demetrios Vakratsas and Wei-Lin Wang, “Scientific Evidence Production and Specialty Drug Diffusion

Specialty drugs treat complex, severe diseases and offer significant therapeutic advances. Despite their potential to transform patient care, little is known about the drivers of their diffusion. In this study, the authors develop a framework for the diffusion of specialty drugs that is motivated by the drugs’ novelty, complexity, and importance, with a focus on the role of scientific evidence production. They propose that the effects of scientific evidence on specialty drug diffusion are multifaceted and generated through the three stages of the scientific evidence production process: unpublished clinical studies, publications in medical journals not cited in clinical guidelines, and clinical guidelines.

The findings from the empirical analysis of two specialty drugs validate the framework, supporting the idea of multistage scientific evidence effects. In contrast, marketing activities do not have a significant effect. Although this could be attributed to specialty drug prescribers discounting information from commercial sources, it may also be due to limited marketing support. An additional analysis on a nonspecialty drug further validates the proposed framework. Calculations of scientific evidence contributions to trial prescriptions indicate that scientific evidence production can generate returns beyond the publication stage, which should provide specialty drug manufacturers with strong incentives to commit to quality and innovation.

Reece George, Steven D’Alessandro, Mehmet Ibrahim Mehmet, Mona Nikidehaghani, Michelle M. Evans, Gaurangi Laud, and Deirdre Tedmanson, “On the Path to Decolonizing Health Care Services: The Role of Marketing

Despite considerable investment, health outcomes for First Nations people are well below those of the rest of the population in several countries, including Canada, the United States, and Australia. In this article, the authors draw on actor-network theory and the case of Birthing on Country, a successful policy initiative led by First Nations Australians, to explore the decolonization of health services.

Using publicly available archival data and the theoretical guidance of actor-network theory, the analysis offers insight into how marketing techniques and technologies can be deployed to achieve improved health outcomes and implement decolonized approaches. The insights provided have theoretical implications for marketing scholarship, social implications for understanding and implementing an agenda of decolonization, and practical implications for health care marketing.

Manuel Hermosilla and Andrew T. Ching, “Does Bad Medical News Reduce Preferences for Generic Drugs?

Policy makers and insurers promote the use of generic drugs because they can deliver large savings without sacrificing quality. But these efforts meet resistance from the public, who perceive generic drugs as inferior substitutes for brand name counterparts. Building on literature showing that negative emotions reduce risk-taking, the authors hypothesize that receiving bad medical news (i.e., negative information about one’s health) prompts patients to favor brand name over generic drugs as means to safeguard their health. The evidence exploits low-density lipoprotein cholesterol test results, where a discontinuity from clinical guidelines enables the authors to estimate the causal effect of bad medical news.

Using data covering patients’ prescription drug choices across drug classes, the authors find that patients receiving bad medical news become 8% more likely to choose the brand name alternative. The findings are reinforced by a secondary analysis incorporating the similar context of hemoglobin A1c (blood sugar) testing. The authors also find that bad medical news reduces preferences for generics most strongly among drugs of direct clinical relevance for each test, but the effect also manifests among non–clinically relevant drugs.

Full Articles Can Be Downloaded from Sage Publishing

Special Issue Editors

Christine Moorman
Duke University
Harald J. van Heerde
University of New South Wales
C. Page Moreau
University of Wisconsin–Madison
Robert W. Palmatier
University of Washington

Christine Moorman is the T. Austin Finch, Sr. Professor of Business Administration at the Fuqua School of Business, Duke University. Her research examines the nature and effects of learning and knowledge utilization about marketing by consumers, managers, organizations, and financial markets. Professor Moorman’s research has been published in a range of top journals, including the Journal of MarketingJournal of Marketing ResearchMarketing ScienceJournal of Consumer ResearchAcademy of Management Review, Academy of Management Journal, and Administrative Science Quarterly and has been supported by grants from the National Science Foundation and the Marketing Science Institute.

Professor Moorman served as the Editor-in-Chief of the Journal of Marketing from 2018–2022 and she has served as an Associate Editor for the Journal of Marketing Research and the Journal of Marketing as well as on the Editorial Review Boards of both journals, Marketing Science, Journal of Consumer Research, and the Journal of Public Policy & Marketing. She was named the 2018 AMA-Irwin-McGraw-Hill Distinguished Marketing Educator, the 2022 AMA Foundation William L. Wilkie “Marketing for a Better World” Award, the 2022 Gil Churchill Award for Lifetime Contributions to Marketing Research, an AMA Fellow in 2017, the 2012 Paul D. Converse award for significant contributions to marketing, and the 2008 Mahajan Award for career contributions to the field of marketing strategy. At Duke, Professor Moorman was awarded the 2006 Bank of America award, the highest honor a Fuqua faculty can receive from professor peers.

Professor Moorman is the founder and managing director of The CMO Survey where she collects and disseminates the opinions of marketing leaders in order to predict the future of markets, track marketing excellence, and improve the value of marketing in organizations and in society. She blogs about survey findings at Forbes, Harvard Business Review, Sloan Management Review, Marketing News, and The CMO Survey. Professor Moorman is author of the books, Strategy from the Outside In: Profiting from Customer Value with George S. Day (which was awarded the 2011 Berry Book prize for the best book in the field of marketing) and Strategic Market Management with David A. Aaker.

Professor Moorman has served as an Academic Trustee for the Marketing Science Institute, as a member of the Board of Directors of the American Marketing Association, Chair of the Marketing Strategy Special Interest Group for the AMA, and as Director of Public Policy for the Association for Consumer Research. She has served as area chair, Chair of Dean’s Search Committee, and on the University’s Academic Priorities Committee at Duke.

Professor Moorman’s teaching focuses on marketing strategy with an emphasis on building the organization and capabilities for customer focus. She has taught this class to undergraduate, MBA, and Executive MBA classes and has received numerous teaching awards, including the 2016 Best Elective Teaching Award from the Fuqua School of Business. In 2020, she co-developed a new core class for Fuqua focused on the “Entrepreneurial Mindset” with Manuel Adelino. In all her teaching, she is passionate about helping companies more effectively form strong relationships with customers and views this connection as the key to both firm profitability and the free market system. A former Junior Achiever, Professor Moorman strives to inspire managers to innovate and manage their companies with the passion of entrepreneurs.

Harald van Heerde (Ph.D., University of Groningen, the Netherlands) is a Research Professor of Marketing at the University of New South Wales (UNSW), Sydney. Harald specializes in econometric models to improve marketing decision making. His wide-ranging research interests include the marketing mix, social media, mobile apps, digital marketing, loyalty programs, strategies to build brands and brand equity, retailing, and sports and entertainment marketing. His research has also contributed insights on marketing in times of disruption caused by product harm crises, price wars, and booms and busts in the business cycle. Van Heerde’s research uses a variety of state-of-the-art methods to tackle substantive marketing problems, including dynamic linear models, Bayesian estimation, error correction models, nonparametric models, operations research methods, endogeneity correction, and text mining.

Van Heerde has widely published in leading marketing journals such as the Journal of Marketing (JM), the Journal of Marketing Research (JMR), and Marketing Science. Harald is the recipient of nine paper awards: the MSI / H. Paul Root Award (JM), the William O’Dell Award for Long-term Impact (JMR), the Paul Green Best Paper Award (JMR), 2 x Informs Society of Marketing Science Long-Term Impact Award, the Jan-Benedict Steenkamp Long-Term Impact Award of the International Journal of Research in Marketing (IJRM), and 3 x IJRM Best Paper Award. His papers were Best Paper award finalists at the premier journals on 22 more occasions. Harald was selected as the recipient of the 2021 Churchill Award for Lifetime Contributions to Marketing Research. He was also elected as a Fellow of the Australian Academy of Social Sciences in 2022.

Van Heerde has served as an Editor of the Journal of Marketing from 2018–2022. He has also served as an Associate Editor at the Journal of Marketing Research, at Marketing Science, and IJRM. He serves on the AMA Publication Committee and on the Informs Society for Marketing Science Board. Van Heerde has chaired major international marketing conferences, including the Marketing Dynamics Conference, three times the Marketing Analytics Symposium Sydney (MASS), and will chair the 2024 ISMS Marketing Science conference in Sydney. Van Heerde is also part of the leadership team of uDash, the UNSW-funded research center focusing on the use of data science for improved insight and decision-making.

Van Heerde has attracted AU$ 1.9M as Lead Chief Investigator in international research grants. He was the Chief Investigator on an AU$ 705k Marsden Fund grant from the Royal Society of New Zealand, a Chief Investigator on a Netherlands Organisation for Scientific Research Grant worth AU$ 1.11M, and an investigator on an Australian Research Council Discovery grant, multiple Marketing Science Institute grants, and International Fellow on a German DFG Research Unit Grant. Van Heerde is the Vice-Chairman and Program Director of the Marketing Science Hub of AiMark, a nonprofit global community of prominent academics, several of the world’s largest data providers (Europanel, GfK, Kantar, IRI), and captains of industry. Its mission is to study consumer behavior and translate cutting-edge academic marketing research into practical insights. Van Heerde’s industry engagement includes sales promotion effect measurement tools for Germany’s largest retailer (Edeka), one of the world’s largest consumer product manufacturers (Unilever, the Netherlands), one of the largest dairy companies in the world (Fonterra, Australia / New Zealand) and marketing research firm Nielsen (the Netherlands). Van Heerde worked with global marketing research firms IRI and GfK on measuring the effects of marketing strategy on brand sales.

Page Moreau is the John R. Nevin Professor of Marketing at the Wisconsin School of Business, University of Wisconsin–Madison. Page’s research focuses primarily on innovation and creativity, with the goal of understanding the demand for and creation of new products.  Specifically, she is interested in how and why consumers learn about, purchase, and create new products. Moreau’s work has appeared in the Journal of Marketing, the Journal of Consumer Research, the Journal of Marketing Research, the Journal of Consumer Psychology, and the Journal of Product Innovation Management. Her work has been honored with a JCR Best Article Award, and she has been recognized as a Fellow of the Marketing Science Institute.

Moreau served a four-year term as Co-Editor of the Journal of Marketing, and she served as an Associate Editor at the Journal of Consumer Research for six years prior to that appointment. She has served as a member of the editorial review boards at the Journal of Marketing, Journal of Marketing Research, the Journal of Consumer Psychology, the Journal of Product Innovation Management, and the International Journal of Research in Marketing.

Robert W. Palmatier is Professor of Marketing and John C. Narver Chair of Business Administration at the Foster School at the University of Washington where he founded and serves as the research director of the Sales and Marketing Strategy Institute (SAMSI). He earned his bachelor’s and master’s degrees in electrical engineering from Georgia Institute of Technology, as well as an MBA from Georgia State University and a doctoral degree from the University of Missouri, followed by post-doctoral research at Northwestern University’s Kellogg School of Management. Prior to entering academia, Professor Palmatier held various industry positions, including president and COO of C&K Components and European general manager at Tyco-Raychem Corporation. He also served as a US Navy lieutenant on board nuclear submarines.

Robert’s research interests focus on marketing strategy, relationship marketing, customer loyalty, privacy, marketing channels, and sales management. His research has appeared in Harvard Business Review, Journal of Marketing, Journal of Marketing Research, Marketing Science, Journal of Academy of Marketing Science, Journal of Retailing, and Journal of Consumer Psychology. He has also published over 10 books including “Marketing Channel Strategy” and “Marketing Strategy: Based on First Principles and Data Analytics.” His research has been highlighted in Nature, New York Times Magazine, Economist, and LA Times, as well as on NPR and MSNBC.

He has served as Editor-in-Chief of the Journal of Academy of Marketing Science and coeditor for Journal of Marketing. His publications have received multiple awards, including the Maynard, Sheth, Davidson, Buzzell, and Stern awards. He also has received the Mahajan Award for Lifetime Contributions to Marketing Strategy and the Interorganizational Research Award for Lifetime Contributions. He has received multiple awards as a teacher of marketing strategy in the doctoral, EMBA, and MBA programs at the University of Washington.

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