The study analyzes marketing strategies adopted by large (over 150 beds) private general hospitals Brazilian. This is a qualitative study of multiple cases with data collected from semi-structured interviews. Includes five hospitals in the city of São Paulo, classified into three groups from the binomial property model (with or without profit) and clientele (beneficiaries of insurance and health plans and the SUS): Group 1, hospitals (H1, H2, H3) nonprofit cater mainly beneficiaries of operators of private health care, Group 2, hospital (H4) for profit, serves primarily beneficiaries of operators of private health plans, Group 3, hospital (H5) nonprofit, serves primarily the SUS. Three or more managers were interviewed in each hospital, seen as key informants and able to answer questions about the strategies adopted. The results show that strategies are developed from a combination of assessments of external and internal environments, according to the resource-based view. Hospitals H1 and H2, Group 1, adopt the combination of differentiation strategy, better positioning in product and in the way to offer total solutions to the client; H3 (Group 1) adopts the combination of differentiation strategy with cost leadership, greater adherence to the better positioning in product than the offer of total solutions to the client; H4 (Group 2) adopts the combination of differentiation with cost leadership, and even closer to the better positioning in product than the total solutions to the client; H5 (Group 3) adopts the strategy of cost leadership, and better positioning in product. Hospitals Group 1 feature high density technology and care of more complex cases, the hospital group 2 presents an intermediate situation in the density of technology and in the care of more complex cases, the Hospital Group 3 has a low density technology and in care to more complex cases. Given the health insurance, hospitals H1 and H2 have quality positioning and higher prices, the H3 features compatible prices for products delivered, H4 follows the market average (classes B and C patients), the H5 operates with the SUS and for private with lower prices. The combination of an aging population with a lower birth rate, growth of chronic diseases, hospital revenues primarily related to fees and services may be related to a broader model of care, with greater market concentration among operators of private health plans and also hospitals, greater complementarity between public and private networks and organizations working in more integrated. Delivering greater value to 'customers' will be key, with payments based on this delivery and not only in the quantity, and new relationships models with physicians.
