Primary care practice marketing: free preventive care wording, reminders and honest claims

Family medicine and primary care practices market differently from most specialties. Patients usually choose a primary care practice once and then stay for years, so the marketing that matters most is often aimed at people who are already patients: annual visits, screenings, vaccines and follow-ups. New patient marketing tends to come down to plain facts, such as whether you are taking new patients, which insurance you accept, how soon someone can be seen and where you are.

That makes primary care marketing look simple, and most of it is. But three areas cause trouble more often than the rest: advertising preventive care as “free”, deciding when a reminder becomes marketing under HIPAA, and making health or screening claims. This guide covers those three, plus copay waivers, patient stories and reviews, and the marketing that tends to work inside the rules. Related topics have their own guides: marketing to Medicare patients, concierge and membership medicine, pediatric practices and nurse practitioner practices. Cholesterol clinic wording is covered in lipid clinic marketing.

Start with what new patients actually ask

Someone looking for a family doctor is usually trying to answer a short list of questions before they call. Your website, your Google Business Profile and your front desk should all give the same answers.

• Are you taking new patients? Say so on the home page and on each clinician’s page, and update it when it changes. A listing that says “accepting new patients” when the schedule is closed wastes the patient’s time and yours.
• Which insurance do you accept? Name the plans, not just the insurance companies, because a practice can be in network for one plan from an insurer and out of network for another. Our guide to the insurance accepted page covers how to keep this accurate.
• How soon can I be seen? If you hold same-day sick visit slots, say so. If new patient appointments are booked weeks out, say that too. A wait time claim is an advertising claim and has to be true.
• Who will I see? List each physician, nurse practitioner and physician assistant with their exact credentials and any board certification they actually hold, stated the way the certifying board states it.
• Where, when and in which languages? Address, parking, hours, telehealth options and languages spoken. If you serve Spanish-speaking patients, see our Spanish-language marketing guide.

Most of this lives on your Google Business Profile as much as on your site. Our guide to Google Business Profile for doctors covers practice listings and individual practitioner listings.

“Free” annual physicals and preventive care: say what the rule says

“Free annual physical” and “no-cost preventive care” are among the most common primary care ad lines. They come from a real rule, but the rule is narrower than the ad usually is.

Under 45 CFR 147.130(a)(1), most group health plans and health insurance issuers must cover certain preventive services without cost sharing, meaning no copayment, coinsurance or deductible. The covered list is defined by reference to other bodies:

• Evidence-based items or services with a rating of A or B in the current recommendations of the US Preventive Services Task Force, for the individual involved.
• Immunizations for routine use in children, adolescents and adults recommended by the CDC’s Advisory Committee on Immunization Practices and adopted by the CDC director.
• Preventive care and screenings for infants, children and adolescents in guidelines supported by the Health Resources and Services Administration.
• Additional preventive care and screenings for women in guidelines supported by the Health Resources and Services Administration.

The same regulation then sets limits that a blanket “free” claim leaves out.

1. The office visit may still cost something. Under 147.130(a)(2), if a preventive service is billed separately from the office visit, the plan may charge cost sharing for the visit. If it is not billed separately, the plan may charge cost sharing when the primary purpose of the visit was not the preventive service. The regulation’s own example: a patient has a covered cholesterol screening at an in-network visit, and the plan may not charge for the separately billed lab work but may charge for the separately billed office visit.
2. Follow-up care is not part of it. The regulation’s next example says that if the screening leads to a diagnosis and a course of treatment that is not on the recommended list, the plan may charge cost sharing for the treatment.
3. Out-of-network care is not required to be covered. Under 147.130(a)(3), a plan with a provider network does not have to cover these services from an out-of-network provider, and may charge cost sharing if it does.
4. Some plans are outside the rule. Under 147.130(d) and 147.140, these preventive coverage rules do not apply to grandfathered health plans.
5. Only the listed services count. The rule covers the specific services, populations and ages on those lists, not everything a patient may think of as a physical.

So an ad that promises every patient a free physical will be wrong for some of the people who read it: patients whose visit also covers a new problem, patients in plans where you are out of network, patients in grandfathered plans and people without coverage. Section 5 of the FTC Act, 15 U.S.C. 45(a)(1), prohibits deceptive acts or practices in commerce, and a price claim that is not true for the people it reaches is the kind of statement that rule is about.

Wording that stays closer to the rule:

• “Many health plans cover recommended preventive services with no copay when you see an in-network provider. Check with your plan about your coverage.”
• “If you bring up a new health concern during your preventive visit, that part of the visit may be billed to your insurance and you may owe a copay.”
• “We are in network with the plans listed on our insurance page.”

Medicare has its own preventive benefits and its own wording issues, including the difference between the Medicare annual wellness visit and a routine physical. Our guide to marketing to Medicare patients covers those. If you advertise a self-pay price for a physical, also see our guide to advertising cash prices.

Screening campaigns: cite the Task Force as it is written

Screening reminders are some of the most useful marketing a primary care practice does, and they are also where it is easiest to overstate. The US Preventive Services Task Force publishes a list of its A and B recommendations, which the Task Force describes as the services it most highly recommends for preventive care, with a high or moderate net benefit for patients. Each entry names the service, the population and the grade.

Illustration: the list includes two colorectal cancer screening entries, both released in May 2021. Screening for adults aged 50 to 75 is graded A. Screening for adults aged 45 to 49 is graded B. A campaign built on these should use the same ages, link to the recommendation and say what the practice offers, without adding claims the recommendation does not make.

• Match the population exactly. If the recommendation is for a defined age range or risk group, the ad should say so. A message that tells everyone to get screened can reach people the recommendation does not cover.
• Check the current version. The Task Force updates recommendations, and the list shows the release date of each current one. Recheck before each campaign rather than reusing last year’s copy.
• Do not add outcome promises. “Catch it early and you will be fine” is a health outcome claim. The FTC Health Products Compliance Guidance says health-related claims need competent and reliable scientific evidence, and a promise about a patient’s outcome is hard to support for any individual.
• Keep it a reminder, not a scare. Fear-based copy tends to make claims about risk that the practice cannot support for the person reading it.

Reminders, recalls and newsletters: when HIPAA calls it marketing

A primary care practice sends a lot of messages to its own patients. HIPAA treats most of them as part of care, not marketing, but not all of them.

Under 45 CFR 164.501, marketing means a communication about a product or service that encourages the recipient to buy or use it. The definition then excludes communications made for treatment, including recommending alternative treatments, care providers or settings of care, and communications describing a health-related product or service that the practice itself provides. Those exclusions do not apply when the practice receives financial remuneration from a third party whose product or service is being described.

Where a communication is marketing, 45 CFR 164.508(a)(3) requires the patient’s written authorization before protected health information is used or disclosed for it, with two exceptions: a face-to-face communication, and a promotional gift of nominal value provided by the practice. If the marketing involves financial remuneration from a third party, the authorization has to say so.

In practice, that sorts primary care messages like this:

• Usually not marketing: a reminder that a patient is due for a recommended screening, an annual visit or a vaccine you give; a message about the practice’s own new services, hours or clinicians; a recall for follow-up care.
• Usually marketing: a message promoting another company’s product or service when that company pays the practice to send it, or anything sent using patient information for a third party’s benefit.
• Ask before sending: messages about elective, self-pay services the practice offers, sponsored newsletters, and anything a vendor or partner offers to fund.

HIPAA is only one layer. Text messages also have FCC consent rules, and email has CAN-SPAM. Our guides to running a patient recall system, text message appointment reminders and healthcare email marketing cover those rules, and our HIPAA marketing rules guide covers the authorization in more detail.

Practices that add remote monitoring for patients with chronic conditions face a narrower set of rules on who to invite, how to describe the device and what federal watchdogs have flagged, covered in our remote patient monitoring marketing guide.

Copay waivers, gift cards and other offers

“We waive your copay” or a gift card for a new patient visit can look like ordinary competition. For patients covered by Medicare or a state health care program, they can be a legal problem.

42 U.S.C. 1320a-7a(a)(5) allows civil monetary penalties against anyone who offers or transfers remuneration to a Medicare or state health care program beneficiary that they know or should know is likely to influence the beneficiary to choose a particular provider for items or services those programs pay for. Under 1320a-7a(i)(6), remuneration includes waiving coinsurance and deductible amounts. The statute excludes a waiver only if it is not offered as part of any advertisement or solicitation, is not routine, and follows a good faith determination of financial need or failed reasonable collection efforts.

So an advertised copay waiver does not fit that exception, because the first condition is that the waiver is not advertised. The same statute and its regulations contain other exceptions, including one for incentives tied to preventive care, each with its own conditions. Our guide to marketing to Medicare patients goes through them. Commercial insurance contracts and state laws may add their own limits. Community health centers have a separate coinsurance waiver exception and sliding fee rules, covered in our guide to community health center marketing.

Patient stories, reviews and ratings

A family practice that has cared for three generations of one family has good stories to tell. The rules on using them are the same as for any practice.

• Patient stories are claims. Under 16 CFR 255.2(a), an ad using consumer endorsements is read as saying the service works for the purpose shown, and the practice needs the same support as if it made the claim itself. Under 255.2(b), a story about a key result is read as typical of what patients generally achieve, unless the ad clearly discloses what patients can generally expect.
• Patient stories need permission. Using a patient’s name, photo or health story in marketing generally needs a HIPAA authorization. Our guide to patient testimonials covers the authorization and what it must say.
• Do not buy reviews. 16 CFR 465.4 prohibits giving compensation or other incentives in exchange for, or conditioned on, reviews expressing a particular sentiment. Staff reviews have their own rule: under 465.5, an officer or manager writing a review of the business needs a clear disclosure of that relationship.
• Reply without health details. Replying to a review is still a disclosure if it confirms someone is a patient or mentions their care. See our guide to replying to negative reviews under HIPAA.

What tends to work, inside the rules

None of these depends on a promise about outcomes, and none needs a gimmick.

1. A new patient page that answers the questions above. Accepting new patients, insurance plans, first visit steps, forms, and what to bring. Our medical practice website checklist covers the rest of the site.
2. Clinician pages that are accurate and current. Credentials, board certification as held, languages, and whether each clinician is taking new patients.
3. Preventive reminders to existing patients. Built from the current recommendation lists and your own schedule, sent through channels the patient agreed to.
4. Accurate local listings. One practice listing and, where eligible, individual practitioner listings, all with the same hours, phone number and insurance information.
5. A phone line that answers. A patient choosing a family doctor often calls more than one practice. Our guide to the new patient phone script covers what the first call should cover.
6. Community presence. Health fairs, school and sports physical days, and local talks, run within the rules in our guide to health fair and screening event marketing.

Practices that see patients with gout flares can follow our guide to gout and arthritis clinic marketing, which covers flare pages, same-day and 911 lines, diet and cherry claims, and follow-up reminders.

How we help

We help independent primary care practices with websites, local search and patient inquiry paths that answer the questions above clearly, with wording checked against the rules in this guide. We do not promise rankings, patient numbers or results. Our tools are built with HIPAA in mind, and we confirm in writing what a BAA covers before any patient information flows through a tool; if it is not covered, we do not route patient information through it. See our medical lead generation and healthcare SEO services for how we work.

Sources

• eCFR: 45 CFR 147.130, coverage of preventive health services (paragraphs (a)(1) to (a)(3) and (d))
• US Preventive Services Task Force: A and B recommendations
• eCFR: 45 CFR 164.501, definitions (marketing)
• eCFR: 45 CFR 164.508(a)(3), authorization required for marketing
• 42 U.S.C. 1320a-7a, civil monetary penalties ((a)(5) and (i)(6))
• eCFR: 16 CFR Part 255, Guides Concerning the Use of Endorsements and Testimonials in Advertising (255.2)
• eCFR: 16 CFR Part 465, Use of Consumer Reviews and Testimonials (465.4, 465.5)
• FTC: Health Products Compliance Guidance (December 2022)
• 15 U.S.C. 45, unfair methods of competition and deceptive acts or practices

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