Highmark markets its new Allegheny Health Network brand, logo

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From signage to stationary, billboards to personnel badges, Highmark Inc. will have to invest tens of millions of dollars and up to five years to convince Pittsburghers of the existence of the Allegheny Health Network, let alone the merits of the new brand, experts say.

The Allegheny Health Network is Highmark's new seven-hospital provider wing, made up of the former West Penn Allegheny Health System, Jefferson Regional Health System and Saint Vincent Health System in Erie. The insurer bought controlling stakes in those health systems as part of a strategy to save WPAHS from bankruptcy and build a competitor to UPMC.

But there's more to branding a new health network than rolling out a bunch of TV ads. Settling on a name and logo can take up to a year -- brainstorming, whittling the list, running everything by focus groups and employees, tweaking colors and font sizes.

The first decision to make?

"What is the equity in the existing name?" said Steve Rivkin, founder of Rivkin & Associates, a New Jersey marketing firm that specializes in hospital branding.

Highmark decided that, despite WPAHS's financial troubles, there is indeed some value in its name, retaining the "Allegheny" portion of AHN's West Penn Allegheny network and of the Allegheny General Hospital.

"Candidly, that brand and name had equity" that we wanted to keep, said Steven Nelson, Highmark's senior vice president of product, marketing and strategy.

Highmark, working with branding firms Marshall Strategy Inc. and Lippincott, contemplated other geographically descriptive names -- playing on three rivers, bridges and more. And it considered variations on the ultimate winner -- would focus groups, for example, prefer Allegheny Health Network or Allegheny Health System? (They preferred "Network.")

In the end, the word Allegheny had recognition and "equity in areas we didn't expect it to, [far] outside the region," Mr. Nelson said, including New York and Ohio, states from which Allegheny Health Network hopes to draw patients, even though Highmark's insurance arm doesn't have a major business presence there.

Built-in brand recognition is a double-edged sword: The new network could retain some of WPAHS' baggage, but it also will have an easier time getting customers to make the mental jump from the old name to new. An all-new name usually takes longer to sink in.

Still, health systems take the gamble. When Methodist Hospital, Indiana University Hospital and Riley Hospital for Children merged in 1997, the hospitals tried a wholly fabricated name, Clarian Health. It never really stuck, and even a decade later, the name "Clarian" didn't mean much to Indiana patients. So in 2010, system directors changed Clarian's name to Indiana University Health.

Advocate Health Care in Chicago, on the other hand, doubled down on its own fabricated name, created in 1995 when Evangelical Health Systems Corp. merged with Lutheran General HealthSystem. The 13-hospital network is now one of the most recognized in the Midwest, but that recognition costs millions a year -- and 18 years later, many people still refer to the system's flagship hospital as Lutheran General, not Advocate Lutheran.

"Every case is different," said Rob Rosenberg, president of Chicago-area Springboard Branding, another hospital marketing firm. "Some hospitals have a poor reputation," and in those cases, it might make sense to fully sever the old name from the new one. Either way, it can take five years or more for a new brand to sink in, he said.

Getting customers to accept the a health network name is just part of the job, though; the next part is getting them to understand which hospitals are part of it. There are two main approaches -- system dominant and system subordinate.

UPMC is an example of a health network that uses the "system-dominant" approach, slapping the UPMC name in front of nearly every hospital it acquires (most recently, Hamot Medical Center in Erie became UPMC Hamot in 2011, and this year, Altoona Regional Health became UPMC Altoona).

A system-subordinate branding effort, on the other hand, allows the hospital to retain more of its institutional identity and goodwill, which can take years or decades to build. In such cases, branding is built around logos, color themes and common fonts, but the health network name plays only a supporting role -- as in Centennial Medical Center, part of TriStar Health, to use a real-life example out of Tennessee.

This is the approach Allegheny Health Network is taking for now, scrubbing the former golden laurel wreath logo from the WPAHS website, and describing the relationship thusly: West Penn Allegheny Health System, a proud part of the Allegheny Health Network.

That doesn't preclude Allegheny Health Network from shifting to a system-dominant, UPMC-style approach in the future, but right now, putting the letters "AHN" in front of West Penn would mean little to Pittsburghers. "Maybe 10 years from now, it will," Mr. Nelson said.

Whichever approach, long memories can vex the best of marketing campaigns.

In marketing focus groups, "it's amazing the people who, top of mind, unaided, will refer to [a] hospital by its old name," Mr. Rosenberg said, even years after a name or brand change.

Which goes to show that, for all the hours and millions of dollars invested in branding, few hospital network brands amount to much, said Dan Beckham, a hospital branding expert and head of The Beckham Co. in South Carolina. Mayo Clinic and Cleveland Clinic are probably the best examples of brands that count, and that didn't happen overnight.

"They've built those brands over 100 years. And they stand for something. It's not just an empty name and logo," he said. In the case of the Mayo Clinic, the monetary value of the brand actually exceeds the value of the health system's physical assets.

"It's one thing to come up with a new mission and put it on the walls. But consumers and physicians are going to do a sniff test" and try to figure what differentiates the new brand and logo from the old ones, Mr. Beckham said.

The new brand must also differentiate itself from brands that already exist in the market -- in Allegheny's case, that's UPMC. And when one brand already claims the mantle of top dog, in a clinical sense, that leaves rivals with few options.

One is to brand around patient experience. The other, new to this industry (but common in most others), is to brand around value. "With the changing economics of health care, [some] organizations might be able to win on the basis of" marketing equivalent care at a cheaper price, Mr. Beckham said. It's a tack that Highmark is taking, making the case that UPMC is the high-cost player in the market, driving up the cost of care -- and health insurance -- for everybody.

As Highmark markets the new brand to potential customers, Belinda Yeager Carter, co-founder of Pittsburgh branding and ad firm Simply Fluid, said the company would be wise to focus on the internal audience, as well. When a merger or acquisition occurs, "you really have to bring [employees] along ... make everybody feel comfortable with it, and think it's a positive thing."

That's because employees -- Allegheny Health Network has about 17,000 of them -- have the potential to be the health system's best ambassadors, delivering the hospitals' new messaging to neighbors, friends and relatives. It's more than just an awareness campaign; it's also about engagement, training employees to recruit patients to the new system, and then keep them there.

That requires buy-in from specialists on down to clerical staff at physicians' offices.

"Once you deliver the name, you have to deliver the promise," Mr. Nelson said. "Culture will eat strategy for lunch."

And if staff doesn't buy in, the public may not either; clashing corporate cultures can lead to lingering ill-will.

Exhibit A might well be the 1999 merger of West Penn Health System and Allegheny General Hospital, to create the West Penn Allegheny Health Network. The corporate merger took nine years to complete, and even 14 years later, the stain of the Allegheny Health, Education and Research Foundation bankruptcy was never quite erased.

WPAHS had been a "struggling health system for so long, so that has a stigma to it," Ms. Carter said. "Sometimes it never goes away."

She also noted that the challenge before Allegheny Health Network is somewhat different than the one faced by UPMC whenever it acquires a hospital. UPMC already has an established brand identity, so that set of values and preconceptions -- good or ill -- is transferred instantly.

Highmark, on the other hand, must simultaneously market the new brand, as well as communicate the values and philosophy behind that brand. It's more of a revolutionary branding technique than an evolutionary one, taking place "across multiple hospitals and health networks" at the same time. "It is going to make it more difficult," Ms. Carter said.

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Bill Toland: btoland@post-gazette.com or 412-263-2625.


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