In the healthcare industry, powerful demographic, economic, societal, technology and legislative forces are converging to change the underlying basis for competition. For health systems, new economic models, disruptive technologies and transformation of care delivery systems are front and center – challenging marketing executives to better understand and anticipate the impact of this change.

Here are five forces marketers must watch:

One – the new economics of health care reform.

While it is difficult to predict with certainty the future of legislated mandates for reform, the wheels of change have been set in motion. Reimbursement models featuring bundled payments and warranties to deny payment for errors, rework and readmissions are being developed and implemented. If health insurance exchanges survive political challenges, they are set to roll out at the state level in 2014. Insurance mandates could result in many more insured individuals and providers worry whether they have capacity for the newly insured, particularly at primary care access points.

Marketers can play a critical role in how health systems better understand and relate to consumers under these new structures. And must know not only the top line revenue implications of customer acquisition, but also the bottom line impact of key customer segments.

Two – market restructuring and emerging delivery models.

Consolidation and alignment among health systems, hospitals, physician groups and post acute care providers will continue as organizations move to create the critical mass, economies of scale and geographic coverage to improve market leverage. Competition for physician alignment remains fierce in many markets and employment is the primary model for integration. These strategies are core to creation of accountable care delivery models where financial performance hinges on care coordination, quality outcomes and cost effectiveness, and will command executive attention for some time to come.

When it comes to market restructuring and emerging delivery models, marketers will be challenged on many levels, including brand building across a diverse portfolio and in multiple markets, and developing marketing systems to support multiple SBUs.

Three – evolution of brand in physical and virtual environments.

As in other industries, healthcare is seeing a rise in brand driven competition. Brands that align core elements of competitive positioning, operational design, brand architecture, and service experience, will begin to establish value that ultimately equates to brand loyalty, growth and expansion. Other critical aspects of brand evolution for healthcare marketers will be brand building and brand management for multi-facility, multi-market and multi-service health systems and standardizing brand experience across health system-branded, employed physician groups.

Additionally, as organizations invest in clinical information systems such as electronic health records, and embrace web, social and mobile technologies, marketers will find that the complexity of building and managing brands in the digital space also increasing.

Four – technologies that disrupt and transform.

We’re witnessing an amazing shift in terms of how people are relying on web, social networking and mobile technologies, and that’s changing everything for how providers engage with customers. The rise of smart phones and tablets such as the iPhone and iPad have put information, communications and commerce just a click or voice command away. Digital strategies have to move beyond the hospital website and Facebook page to a fully integrated approach for reaching and engaging consumers, supporting patients with care management, facilitating workplace communications and promoting clinical decision-making.

A comprehensive web, social and mobile capability, integrated with clinical IT systems such as EMR and patient portals, and embedded in physical environments, is no longer optional for organizations that want to remain relevant.

Five – growing, changing, graying, connected consumers.

The United States is experiencing a dramatic increase in the numbers of people who live to old age, challenging Americans of all ages as they cope with retirement funding, health care, lifestyle and other issues that are important to an aging population. People 65 and older numbered 39.6 million in 2009, representing 12.9% of the U.S. population – or about one in every eight Americans. By 2030, there will be about 72.1 million older persons, more than twice their number in 2000 and will count for nearly 20% of the population (Administration on Aging, DHHS).

For demographers, 2011 was significant in that it marked the first year that baby-boomers began turning 65; and for the next 15 to 20 years, about 10,000 people will turn 65 years old every single day. They will be a driving force for healthcare services in the coming decades – not just for ‘what’ is delivered, but ‘how’ it will be delivered.

So, what’s a marketer to do?

In the short term, one of the most important roles chief marketing officers can play is helping organizations understand and address the competitive dynamics of restructuring markets and intensifying competitor activities. Longer term, the over-arching objective is to create a future-ready, high-performing marketing capability that can address the changing basis for competition and drive growth, innovation and better business performance.

In a future post, I’ll address five critical roles for healthcare marketing executives to embrace in this new era. Please let me know if you have ideas and examples that you’d like to share.