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In 2008, the California HealthCare Foundation (CHCF) released an update to a periodic survey of Californians on how consumers use the Internet to manage their health care. CHCF found that in 2007:

• Of those surveyed, 23 percent had seen hospital rating information.
• Only 4 percent of those had considered a change in hospital choice.
• Only 1 percent made a change based on the ratings.

An analysis of usage statistics from CHCF’s Web site with comparative information on hospitals, then called CalHospitalCompare.org, revealed a substantial number of visits. But because about half of the traffic came from visitors who had “bookmarked” the site on their Internet browsers, CHCF suspected that industry insiders might have been responsible for as much traffic as consumers.

Goals of the Campaign

To address this concern, CHCF launched a campaign to increase consumer awareness of its Web site, hoping to drive more consumers to the site and increase their use of the data in hospital-choice decisions. A second objective was to convey to hospitals the benefits of participating in this voluntary reporting effort by showing the hospitals that consumers visited their Web sites as well as CalHospitalCompare.org.

Focus on Maternity Care

The campaign focused on maternity care, which is considered a “shoppable” condition—i.e., a condition for which consumers or patients have the time, health, and motivation to “shop around” for the best option. They targeted expectant mothers in the San Francisco Bay Area as a distinct media market. The aim was to tap into mothers’ desires for information and to reassure them that the ratings on CalHospitalCompare.org were unbiased and independent.

The strategy for this primarily online campaign was to place display and text ads on local news Web sites, community participation sites, and online networks like Google^™ and Yahoo!^®. CHCF purchased key words from search engines, including the names of Bay Area hospitals, the term “hospital reviews,” and terms relevant to maternity and pregnancy, such as “C-Section” and “NICU.” The campaign also employed branded e-mail messages and event sponsorships.

What CHCF Learned

Ads drive traffic.

• The campaign’s display ads led to more than 14 million “impressions,” or page views by individuals, and some 12,000-plus new “clicks,” or visits, to the CalHospitalCompare.org Web site.
• Selected search terms resulted in fewer impressions, only 1.3 million, but more clicks (over 13,000).
• Branded e-mails were not nearly as effective, resulting in 10,000 impressions and only 100 clicks.
• The awareness campaign succeeded in driving traffic at the Web sites of Bay Area hospitals. Page views during the campaign were six times higher than average page views of major hospitals elsewhere in the State.

Placement matters. Costs for online ads are based on “per million impressions” or the number of “clicks” that result from the ads.

• The cost for both of these actions was lowest for ads placed on search-engine sites and much higher for ads on the Web sites of local newspapers.
• The ads most successful in generating traffic at CalHospitalCompare focused on C-Section rates at different hospitals and on “finding the hospital that is best for you.”
• Ads that were less direct—such as those that spoke about how one typically gets more help choosing baby names than in picking a hospital—were less successful.

Read more about this marketing project in the California HealthCare Foundation’s report .