Effective Medical Billing Strategy Targeting: How to Define Your Ideal Market
Many organizations have asked me about medical billing strategy targeting as a critical component of their overall marketing approach. While budgeting might come first in your planning process, identifying the specific market segment you’re pursuing—rather than trying to “boil the ocean”—is one of the most important strategic decisions you’ll make.
Despite discussing this concept numerous times, many revenue cycle management (RCM) businesses still struggle with narrowing their focus. They fear missing out on opportunities or simply don’t know how to create an effective framework for medical billing strategy targeting. Let me provide some examples and considerations to help you define your ideal target market.
Beyond Specialty: Multiple Dimensions of Targeting
Most people think of targeting simply in terms of medical specialty—and yes, that’s certainly one component. But effective medical billing strategy targeting involves multiple dimensions:
Provider Type
- Are you targeting healthcare provider groups?
- Small groups or large groups?
- Independent practices or hospital-affiliated groups?
- Hospitals and health systems?
These are fundamentally different markets, even when you’re offering similar services. For example, you might specialize in orthopedic billing, but selling to hospital-acquired orthopedic practices differs significantly from marketing to independent orthopedic groups.
Service Recipient
Go even broader in your thinking:
- Are you targeting providers or payers?
- Are you going direct to healthcare organizations or selling to other RCM companies?
Some companies have expanded into “the dark side,” providing services to health insurance companies. While payers have massive budgets, the sales process and value proposition are entirely different from provider-focused services.
According to MGMA’s healthcare revenue cycle benchmark report, organizations that focus their RCM services on specific provider segments see 23% higher client retention rates than those with generalized approaches.
Services vs. Products
Another targeting dimension is whether you’re offering services or products:
- Staffing solutions (billed hourly)
- Automation services
- Software products
These distinctions affect not just what you’re selling but also who you’re selling to. With products, you might target CTOs or technology teams; with services, you’ll likely focus on operations leaders. In hospital environments, these different departments often operate in silos.
Specialty and Sub-Specialty Targeting
We’ve discussed specialty targeting in other articles, but it’s worth emphasizing that you can target sub-components of specialties. For example:
- Instead of “surgical practices,” target specific surgical specialties
- Within cardiology, you might focus specifically on interventional cardiology
Many specialties overlap—interventional cardiology connects to interventional radiology, which connects to general radiology. Be careful not to spread yourself too thin by claiming expertise across too many related areas. This dilutes your message and makes the market perceive you as unfocused, which won’t help your medical billing marketing strategy.
Geographic Targeting Strategies
Geography is an often-overlooked aspect of medical billing strategy targeting, but it’s critically important. While you might accept referrals from anywhere with passive marketing, active outbound marketing allows you to be more selective.
Consider these geographic targeting approaches:
- Focus on 1-2 populous states (or 6-7 smaller states)
- Target only states where you have existing reference clients
- Focus on providers within driving distance (especially for high-touch specialties)
- Select states based on client size and travel economics
One client of mine focuses exclusively on providers within driving distance because their target specialty requires frequent in-person visits for both winning and retaining business. Another client targets specific states scattered across the country, as the economics of occasional flights make sense for their larger deal sizes.
Creative Niche Targeting
I encourage you to consider less conventional targeting criteria:
- Teaching hospitals vs. community hospitals
- Providers with specific payer mixes (e.g., workers’ compensation specialists)
- Out-of-network providers
- Cash-based practices
Here’s a creative example: targeting urban surgeons with high percentages of Medicaid or indigent patients. To find them, you could focus on specific zip codes within metropolitan statistical areas (MSAs), as patient demographics typically drive insurance populations. Surgeons in less affluent urban areas will have higher percentages of Medicaid and indigent patients.
You can create highly specialized niches by combining multiple targeting dimensions. For instance, according to Healthcare Finance News, revenue cycle companies that combine specialty and payer-specific expertise achieve 31% higher clean claim rates than generalists.
Finding Your Targeting Sweet Spot
Spend time identifying what your clients find difficult, what challenges you’ve successfully overcome, and what your organization excels at. I guarantee that the resulting niche will be large enough, especially considering we’re operating in a $5 trillion U.S. healthcare system.
Look for the sweet spot where:
- You have demonstrable expertise
- The market has clear pain points
- Your approach differs meaningfully from competitors
- You can clearly communicate your value proposition
Once you’ve defined this targeted approach, your downstream marketing campaigns will become much more focused and effective. For additional help implementing this approach, check out our guide on developing proper RCM KPIs that align with your targeted segments.
Successful medical billing strategy targeting isn’t about limiting opportunities—it’s about focusing your resources where they’ll generate the greatest return.
