Comparative Analysis: Threats and Opportunities for Small and Large Hospitals

A young and happy family consisting of a young man, a beautiful young woman, and their child. This is a family metropolitan and community hospitals would advertise to in order to win their trust and commitment for healthcare business.

The New Rules of Engagement: Competing in the Age of Mobile Healthcare

Part 5

Discover how metropolitan and community hospitals can adapt in a changing healthcare landscape with our comparative analysis. Learn about the threats, motivations, assets, and opportunities that these hospitals face and how they can formulate their unique 'digital front door strategy' for success. Read on to understand how they can win the hearts of patients or expand their empire.

Cody Strate
Comparative Analysis: Threats and Opportunities for Small and Large Hospitals

Cody Strate


With 20+ years of experience, Cody Strate is a go-to expert for hospitals looking to improve their digital presence and patient experience.

July 21, 2023

Article Published


In our previous articles in this series, we've traced the evolution of the healthcare sector, unpacked the implications of digital innovation, and highlighted the financial disparity between large health systems and smaller community hospitals. We now delve into a comparative analysis of these two distinct classes of hospitals, setting the stage for a 'David vs. Goliath' scenario within the contemporary healthcare landscape.

This piece, "Comparative Analysis: Threats and Opportunities for Small and Large Hospitals," will scrutinize the threats and motivations unique to both, understand the assets at their disposal, identify the opportunities they could harness, and propose strategies they might adopt moving forward. Our aim is to weave a narrative that presents both sides of the coin and illuminates the way forward in an industry transformed by the digital revolution.

So, whether you're a healthcare professional, administrator, policy maker, or a concerned member of a community who relies on local healthcare services, we invite you to explore these insights and join us on this fascinating journey through the intricacies of the modern healthcare sector.

Constants in the Healthcare Landscape

In this dynamic era, the healthcare industry is also shaped by a set of unwavering constants that apply to both large metropolitan hospitals and smaller community hospitals alike. Let's delve into these shared factors and understand their significance:

A. Increased Smartphone Use and Digital Competency Among the Population

The ubiquity of smartphones has been one of the defining features of the past decade. It has transformed every aspect of our lives, healthcare included. Coupled with this, we've seen a significant increase in digital competency among the general population, a trend accelerated by the COVID-19 pandemic, where digital became a lifeline to access essential services. These factors have equipped a broad segment of the population with the ability to interact with businesses, including hospitals, in a new, remote, and digital way.

Pew Research Center | Mobile Fact Sheet

B. Shift in Consumer Expectations Towards Convenience and Remote Access

Consumer behavior has witnessed a paradigm shift towards convenience. Patients, like consumers in other sectors, now expect to access healthcare services conveniently, anytime, anywhere. This sea change in expectations necessitates a corresponding shift in healthcare delivery models, a reality both large and small hospitals must grapple with.

McKinsey & Company | The great consumer shift: Ten charts that show how US shopping behavior is changing

C. Emotional Basis of Decision Making in Patients

Our third constant hails from the field of psychology. As we explored in our blog on Prospect Theory, people don't make decisions solely based on logic. Emotion plays a critical role in our decision-making processes. This insight is particularly pertinent in healthcare, a field replete with high-stakes decisions and deeply personal narratives. Hospitals, regardless of their size, need to appreciate this facet of human behavior and incorporate it into their patient engagement strategies.

The Upward Spiral | Turning Loss Into Gain

Comparative Analysis: Metropolitan vs. Community Hospitals

Let's dissect the unique circumstances, assets, opportunities, and recommended strategies for both metropolitan and community hospitals.

A. Threats

1. Metropolitan Hospitals: Revenue Erosion by Specialty Services

Metropolitan hospitals, despite their size and influence, are not immune to challenges. One significant threat is the erosion of their revenues by specialty services. These niche service providers, such as specialty surgical centers and pain clinics, offer targeted healthcare solutions that often surpass the quality, value, and patient experience provided by general hospitals. This has led to a significant siphoning of revenue that these hospitals cannot ignore.

2. Community Hospitals: Crumbling Geographical Boundaries due to Telehealth Expansion

For community hospitals, the expansion of telehealth represents a double-edged sword. While it enables them to offer services more conveniently, it also diminishes the protective geographical boundaries they have relied upon for so long. Larger hospitals can now reach out to their patient base remotely, presenting a significant threat to these smaller entities.

B. Motivations

1. Metropolitan Hospitals: Revenue Recovery and Brand Dominance

Driven by the desire to recoup lost revenue and solidify their brand as the dominant player in the healthcare landscape, metropolitan hospitals are motivated to leverage their resources and adapt to changing patient expectations.

2. Community Hospitals: Proactive Patient Retention Strategies

Community hospitals need to devise and implement proactive strategies to retain their patient base to prepare for what will invariably be an increase in competition from larger healthcare systems.

C. Assets

1. Metropolitan Hospitals: Financial Strength, Technology Investment, Marketing Capabilities, and Prestige

Metropolitan hospitals have significant assets at their disposal. Their substantial financial resources allow them to make significant IT investments and fund robust marketing campaigns. Furthermore, their prestige and reputation often serve as an attraction to patients seeking 'world-class' care.

2. Community Hospitals: Community Ties, Intimate Patient Knowledge, and Localized Care

On the other hand, community hospitals, while lacking in comparative financial muscle with their metropolitan hospital counterparts, have their unique strengths. Their deep ties with the community is evident and should be leaned on heavily. More often than not the DNA of the town and that of the hospital are often directly linked as they've grown together through the years. Furthermore, community hospitals enjoy being humanized in that their employees are comprised from real people within the community and as such the brand of the hospital is carried forward in a distinctly human way that large faceless metropolitan hospitals simply can't match. Of course the convenience of localized face-to-face care is an invaluable asset that still heavily works in their favor of substantiating why local patients should continue to choose this hospital. The challenge lies in leveraging these strengths and harnessing a intentional marketing strategy to efficiently win the trust and commitment of their patient base effectively.

D. Opportunities

1. Metropolitan Hospitals: Power Projection beyond Geographic Boundaries through Telehealth

Metropolitan hospitals have the opportunity to project their power beyond traditional geographic boundaries using telehealth and targeted marketing. This allows them to provide the perception convenient access to their world-class care and direct various services to their larger institutions.

2. Community Hospitals: Strengthening Patient Commitment through Superior Localized Care, Convenience, and Trust

Community hospitals have the opportunity to strengthen patient commitment by delivering superior localized care that leverages the interconnection of their hospital with that of the community, and the humanized care that anyone would want in their time of need. Leveraging the convenience of telehealth and easy to navigate patient portals, they can ensure that their patients, who have traditionally trusted and relied on them, remain loyal.

E. Recommended Strategies

1. Metropolitan Hospitals: An "Expand your Empire" Strategy

For metropolitan hospitals, the way forward could lie in adopting an "Expand your Empire" strategy, much akin to the aggressive expansion tactics of historical figures like Alexander the Great or Genghis Khan. Use technology and marketing to project power.

2. Community Hospitals: A "Win Hearts and Minds" Strategy

Community hospitals, on the other hand, could adopt a "Win Hearts and Minds" strategy. By focusing on fostering emotional connections, engendering trust, and personalizing care, they can secure their future in an increasingly competitive landscape.

View Sample Ads for Metropolitan & Community Hospitals on


In this complex and evolving healthcare landscape, both metropolitan and community hospitals are faced with unique threats and opportunities. We've explored how metropolitan hospitals, armed with ample resources and prestige, face the challenge of specialty services cutting into their revenue. In contrast, community hospitals grapple with the crumbling geographic boundaries that previously protected their patient base.

While their motivations may differ - with metropolitan hospitals striving for revenue recovery and brand dominance, and community hospitals aiming for proactive patient retention - they each have unique assets to leverage. The challenge lies in effectively utilizing these assets to maximize their opportunities. For metropolitan hospitals, this means projecting power beyond traditional geographic boundaries through telehealth, while community hospitals must focus on strengthening patient commitment through superior localized care.

As strategies emerge, metropolitan hospitals might look to an "Expand your Empire" approach, drawing from historical tactics of aggressive expansion. Community hospitals, however, might consider a "Win Hearts and Minds" strategy, focusing on fostering emotional connections and trust within their community.

But, as we know, every hospital is unique, and their strategies must be tailored to their specific circumstances and goals. That's where our next blog post will come in. We'll delve into specific strategies and tactics each type of hospital system can employ to meet their unique challenges and leverage their opportunities effectively.

In the meantime, if you're looking for personalized strategies to navigate these challenging times, don't hesitate to reach out to Novel Koncept. With our expertise in healthcare marketing and a deep understanding of the evolving landscape, we can help guide your hospital system towards a more secure and successful future.

Cody Strate


With 20+ years of experience, Cody Strate is a go-to expert for hospitals looking to improve their digital presence and patient experience.

Cody Strate

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