Ian Petty, Author at Jarrard Inc

A First Quarter to Remember…Or Forget

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: UnitedHealth Posts Higher Quarterly Revenue, Raises Earnings Guidance

“The healthcare and health-insurance giant, the first industry heavyweight to report first-quarter results, posted double-digit revenue growth at both its Optum and UnitedHealth care units.”

Must be nice.

The State of Play

While insurance companies appear to be doing well, our hospitals are staring at some bleak Q1 numbers. Why? Well, consider that:

COVID-19 relief funds are drying up.
Patient volumes for many services are below pre-pandemic levels and may or may not recover in Q2.
Demand for staff exceeds supply. When there’s not enough staff, some patients needing care can’t get it (feeding the problem above).
The cost of the staff hospitals do have is through the roof and unsustainable.
Inflation is clocking in at 8.5 percent. That’s producing multiple ripples. Cost-conscious patients may be reluctant to spend to get the care they need – especially for preventative care. And staff pay raises are unlikely to keep up with the cost of living, making retention all the more difficult.

What to do? A traditional response by health systems to these pressures would be to cut costs through layoffs or service closures.

But many systems already cut services and staff deeply during the pandemic. Few today will let go of staff in such a competitive marketplace.
The high cost of care is a barrier to all but the most urgent patient volumes. This only becomes more acute during periods or massive inflation, when, pound for pound, everything costs more – whether ground beef or gasoline or medical equipment.

One possible source of at least partial relief is renegotiated payer contracts. We’re hearing from more provider organizations in our network that they’re considering – or undertaking – new negotiations. Payers will likely respond aggressively, and with increasing tension between the two, patients are at risk of getting caught in the middle. And that’s never good.

However, some payers are willing to come to the table in recognition that we’re all in this together and the distinction between payer and provider is merging. Where those constructive conversations can take place, it serves as an example of the wider opportunity for partnerships of all stripes – which also include joint ventures with private equity back partners, shared-service alliances with other systems or outright sales for scale and financial stability.

For health system communicators, get ready for change. Again. Here’s how to brace for it:

Be at the table. Find the time and the path to being part of the strategic conversations happening in your health system today, across executive leadership, operations, finance, legal and government relations.
Know your story. In times of stress or change, leadership teams can have multiple stories they want to tell. The perspective of communications chiefs is invaluable to helping leadership stay focused on the core messages while maintaining the agility to respond to the changing environment.
Be responsibly transparent. Times are still hard. Change will continue. Know that you will need to tell this difficult story and explain some hard truths to the community you serve. But it’s better that you tell the story first than letting someone else twist it for their own purposes.
Have coffee with a reporter. Build relationships with local media as much as you can. Reporters these days often have wide mandates and cover a lot of topics. That means the nuance inherent to big issues facing the local hospital or health system isn’t always reflected in coverage. Be a year-round resource for local business reporters who may have a byline on the story about your next payer battle.
Be ready for the fight. The stakes have increased, and payers are pushing hard. Provider organizations want to focus on delivering care, not arguing about money. But that, unfortunately, is necessary.
Keep the conversation going. Whereas payers are constantly negotiating contracts – it’s their business model – any given hospital is only doing that every few years. Ensure your team is keeping an eye on trends, communicating to stakeholders about what you’re doing as an organization and updating your playbook for the next negotiation.
Don’t accept a turnkey approach. Payers are working from a thick, and broadly consistent playbook. Still, every story, every negotiation, every community served looks a bit different. As payers are becoming increasingly aggressive, you need to ensure that your plan reflects your unique needs.
Be grounded. Bring everything back to your mission, your calling and your duty to serve.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, Quick Think, Strategic Positioning

Comprehensive Re-Evaluation

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: The CDC will undergo a comprehensive re-evaluation, the agency’s director said.

“The move follows an unrelenting barrage of criticism regarding the agency’s handling of the pandemic over the past few months. ‘The lessons from the COVID-19 pandemic, along with the feedback I have received inside and outside the agency over the past year, indicate that it is time to take a step back and strategically position the CDC to support the future of public health,’” Director Dr. Rochelle Walensky said.

What it means for provider organizations:

(3-minute read)

The story of the CDC matters because:

A good strategic review never goes out of style (and it’s overdue at the CDC).
An “unrelenting barrage of criticism” is a strong indication that it is a good time to “step back,” as Walensky said, and evaluate what you do and how you do it.
Even if your organization has survived the pandemic without slings and arrows, it’s the right season for every healthcare voice to take a breath and candidly review the content and effectiveness of your communication efforts and course-correct as need be.

What happened: The CDC has been sharply accused of offering conflicting, inconsistent, confusing and politically charged messages that undermined the public’s trust in it during a global pandemic. And that’s putting it mildly.

Sometimes it was simply a matter of not clarifying that scientific findings and the realities of public health were changing rapidly, and the guidance needed to do the same. Sometimes it was a matter of public health authorities being a bit too definitive about what was known, which became problematic when the current understanding or best practices changed.

Regardless: This was a moment for public health to shine. Coordinating a national response to a pandemic requires a coordinated communications plan. The CDC didn’t completely fail, but it certainly didn’t come through with perfect marks. Hence the “comprehensive re-evaluation.” Good for them.

Therefore: If you’ve come under fire, are under fire, think you might come under fire or simply want to prepare to avoid the mistakes that brought the CDC under fire (we think this list now includes everyone), here are points to ponder as you bring your team around the table.

Mission must be first. In the race to move quickly, the agency seems to have lost the connection to its mission – not in practice but in how it’s communicated. They were still “conducting science” – incredible science, we might add – and “providing health information.” But that work wasn’t tied tightly enough to the overarching story of how the agency was trying to fight the pandemic. It wasn’t that the information was bad or misleading but that it wasn’t connected to a clear story that people could follow and so it sounded bad or misleading.
- The question: Does the way in which we present information demonstrate – explicitly or implicitly – how that information connects back to our mission and goals?

Everyone in healthcare is transforming. You know the drill: the pandemic accelerated change in stunning ways. Even the CDC is taking a hard look at things and, hopefully, evolving as needed. But a hard look isn’t enough. Commitment to and action towards deep change is necessary. If you’re not already, it’s time to examine your systems and processes at every level from the system down to your team.
- The question: Are our conversations leading to quantifiable commitment of resources towards necessary change or simply to more conversations?

Business as usual is gone. Everyone is transforming because expectations have changed and the spotlight’s grown brighter. Criticism of healthcare entities is everywhere, for reasons real and perceived. People are more aware of healthcare than ever before, which comes with pros and cons.
- The question: Are we taking a defensive posture or are we listening and, critically, hearing people’s concerns so we can use that feedback to improve?

Good change is, well, good. The cliché is that the pandemic hasn’t so much exposed the flaws and opportunities for healthcare as it has distilled them. The other cliché is that healthcare providers can see that as an opportunity to build something better or to try and withdraw towards the old status quo. We all want the former, but human nature draws us towards the latter. It takes intention and energy to change thoughtfully and appropriately.
- The question: How do we disrupt ourselves in uncomfortable ways in order to fulfill our mission and are we willing to do that?

Take time to save time. We suspect that some of the struggles the CDC faced were due to inertia – once the crisis ramped up it felt like there was no way to pause and take stock even though leaders were aware of the confusion and criticism. Still, it’s often better to slow down than double down.
- The question: What might happen if we don’t slow down for a moment? Can we afford that outcome?

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, , Quick Think

Vaught Verdict

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: Healthcare workers fear for the future after ex-Vanderbilt nurse found guilty in 2017 death of patient

“A local trial focused on a former Vanderbilt University Medical Center nurse has sparked nationwide interest. RaDonda Vaught was found guilty on Friday of criminally negligent homicide, after accidentally giving a patient a fatal dose of the wrong medication. ‘I’m terrified that I’m now in a profession where, God forbid, I do make a mistake,’ said one nurse outside of the courtroom.”

Where We Are Today

2-minute read

That quote serves as an intense summary of the concern felt by caregivers across the country, and it adds another layer of pressure on provider organizations already struggling to fill nursing roles. A joint statement by the American Nurses Association and Tennessee Nurses Association says, “The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent. Like many nurses who have been monitoring this case closely, we were hopeful for a different outcome. It is a sad day for all of those who are involved, and the families impacted by this tragedy.”

The whole situation is awful. The tragedy of Charlene Murphey’s death and everything surrounding it. The worry this adds to an already exhausted healthcare workforce, many of whom were considering their future in the profession before the verdict. And it adds to the trouble that no provider organization needs with staffing the number one concern across the country.

We will continue to watch and discuss this situation and potential fallout. It’s a tense moment that will further strain the relationship between staff and administration. It’s also one that could exacerbate existing challenges both for individuals and healthcare institutions. For now, a few brief thoughts for leaders of provider organizations:

Your radar is on. Keep it up. This verdict and the circumstances surrounding it will reverberate for a long time. Have an ear out for how it’s being discussed – by the public, by healthcare professionals, by other stakeholders within the industry.
Your nurses are talking about the situation and your organization needs to hear what they’re saying so you can understand the concerns. You know your organization the best, so be present in whatever way makes the most sense for your culture. But be there – whatever that means for you – to hear from your nurses.
Bring everyone around the table. Clinical leadership, operations, legal, HR. Have conversations about how the organization’s mission, vision, values – as well as its commitment to supporting caregivers in a culture of safety – should be applied in this moment. You’re likely to already be having some of these conversations. We encourage you to ensure that everyone is represented and that the discussions are rooted in your mission to serve and to care.
Begin looking at how your organization can support and protect your nurses from an operational standpoint. Work with your team to identify areas where things can be tightened up to limit the chance an error will occur, or where an error is even an option. Nurses are under so much pressure, any place where that pressure can be reduced and safety improved is worth a look.
When appropriate, let your nurses know what you’re doing and how you’re working to support them. Be clear and honest about your organization’s position and the thoughts of leaders within the organization.
If you find yourself trying to say something but unsure of what it is, that probably means there’s more to learn. Go back to the start and listen some more.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think

The Quick Think: Engage Your Readers With This One Simple Trick

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

A good Monday morning to you: Today’s Quick Think is 773 words, a 3-minute read.

1 Big Thing: Axios Wants Us to Read Everything in Bullet Points

A four-year-old media company has risen rapidly to provide excellent reporting in an ultra-consistent, bullet-based format that is arguably changing the way we look at our inbox.

Katie Robertson, writing an Axios-style article in The New York Times, says, “The company’s executives think its short-format writing will build back trust in the media among busy audiences and can teach corporate America to quit its long-winded jargon.”

Why it matters: because in true absurdist fashion it gives us an excuse to pile on and, like the Times, pay our own homage to the newsletter phenomenon sweeping our inboxes. Seriously, we just checked our subscriptions and came up with Axios AM, Axios PM, Axios Vitals, Axios Sports and Axios Nashville. Not to mention competitors Morning Brew and 1440 Digest.

Why it really matters: Because the Axios style of communication works, and we see it every day with clients. Lament short attention spans all you want, but tight prose and well-written bullets are extraordinarily effective at getting the point across.

What’s happening: The rise of sound-bite newsletters is one of two things, or more likely a bit of both.

It’s the latest signal in the ongoing evolution of how America consumes media – short and sweet, but with rock-solid reporting behind the tiny word counts and templated format to capture our ever more fragmented attention.
It’s a market response to the interest people have in consuming a lot of information. Axios is communicating in a way that their audience tells them they want, but, impressively, with both high volume and a commitment to quality on every level from national to local.

Between the lines: During the pandemic, we observed – and may have occasionally participated in – the overwriting of a lot of content.

Provider organizations were trying hard to get large volumes of rapidly evolving, complex information out their communities.
Confusion and skepticism led many to use a lot of words. It’s very difficult to explain in soundbites how pandemics progress, or how a virus functions, or why we need the vast majority of the population to get vaccinated.
“During the pandemic we may have overcorrected from the Twitter approach and now we’re seeing a swing back to the middle,” mused our CEO David Jarrard.

Reality check: The Axios model provides lessons for healthcare marcom, as well.

When navigating any kind of change, offer consistent, concise information through channels that your audience is already connected with.
That means building FAQ and toolkits your team can adapt with the details of any given situation, and then delivering those messages through email, posters, direct voicemail, townhalls, etc.
The ultimate goal is to give just enough detail to get the point across and drive a desired action. Then, if people want more or you need to backstop with additional data or context, you can point them to supporting long-form material – in Axios’ case, “Go Deeper.”

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, , Quick Think

The Quick Think: Command Stations on Tax Exemptions

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

3-minute read

The Big Story: Not-for-profit hospitals don’t earn tax exemptions, researchers say

“Not-for-profit and for-profit hospitals report similar levels of unreimbursed Medicaid costs even though not-for-profits receive billions of dollars a year in tax subsidies, new research shows.”

Key graf: “’The nonprofit hospitals have not done enough to deserve their tax subsidy,’ said Ge Bai, an accounting professor at Johns Hopkins University and lead author of the study. ‘Taxpayers subsidize hospitals to help struggling, working-class Americans, but many nonprofits are not doing enough.’”

What it Means for Health Systems

Another brick pulled out of the wall.

Hospital critics have picked up another powerful, compelling dataset in the national campaign to paint hospitals as Big Business more focused on profits than on care. Painful though it may be to hear, the Modern Healthcare article is a strong piece about the situation some hospitals across America find themselves in. Even our own research shows that just 41 percent of people strongly feel their hospital is a good community partner. In addition, these situations signal the expectations among the public and state and local regulators about where those community benefit tax-equivalent dollars are spent. In short, they want to see more than just sponsoring the local minor league baseball team.

This conversation isn’t going away. The Big Business narrative will continue to build momentum if hospitals don’t tell their own story, are unable to or, worst of all, have a story that doesn’t line up with the reality.

Two things to bear in mind about these articles:

There’s a careful, data-driven and emotionally charged campaign by critics seeking to pin the blame for our dysfunctional healthcare system squarely on hospitals.
There’s misalignment within hospitals in getting their mission-driven story across the finish line and making sure their words are backed up by their actions. The door to criticism is cracked open when there are disconnects between different departments and different initiatives. And – critically – between the different levels of the organization to identify problems and ensure that every move made is in service to the mission. Hospital critics then shove that door wide open, leading to Congressional hearings and class action lawsuits.

So here’s our advice this week:

Check your story. Now – Put time on your calendar to have a real conversation. Soon.

Non-profit hospital or health system execs – Connect with your marcom, finance and clinical leadership to compare notes about how your organization is talking about the work it’s doing in the community and how that lines up with what it’s actually doing in the community. And is it what the community actually needs? Baseball team sponsorship vs. affordable housing. Your call.
Marcom leaders – Initiate that same conversation with your colleagues and C-suite.
For-profit leaders – Sure, the tax-exempt piece won’t apply, but that doesn’t mean you should miss the chance to review where and how your charity care and other community benefits are delivered. You, too, have a mission and a story…and critics.
Health services company execs – Bring your leadership team around the table to discuss ways that you’re giving back and aligning ops with mission. You may not be under the gun for IRS status, but, like the for-profit crew, it’s still worth taking a look. Private healthcare companies, particularly those backed by private equity, are taking hits as well.
Healthcare attorneys – On your next call with a non-profit hospital or health system client, ask them if they’re checking their story. Encourage them to think beyond compliance and consider the whole picture around charity care and tax-exempt status as a function of their mission.
Strategy or operations consultants – Ask how the project at hand fits into the mission to care for your client’s community. Ask your client to review the numbers and projections and then work with marcom to align those outcomes to the story they need to tell.

The knives are out, the narrative has taken shape and the numbers very often don’t look great. It’s not a time to spin and, frankly, even if you wanted to it’s not going to work anymore. It’s a time to buckle down and get it right, to match the desired outcome with the actual outcome, to match the stated mission and the desire and passion of you and your team and your clinicians and staff with the way care is delivered – both medically and financially.

After those conversations, get ahead. What’s interesting about the tax-exempt line of attack is that there’s no mention of outcomes. The criticism is purely financial. The push from critics as currently constructed is to spend the money, not to spend the money and achieve <X>. So that’s a fantastic opportunity for provider organizations. Align on where the money is going – get clear on charity care and all the rest – and then talk about how you’re not just spending it but also moving the needle towards better outcomes and equity. “Our critics say we don’t spend enough in the right places. We’re not just spending it but investing it in our community, and here are the returns.” That’s a winning, mission-driven message to leapfrog the Big Business naysayers. Just make sure it’s true.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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Ian Petty In Change Management, High Stakes, Quick Think

The Quick Think: The Lorax

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

2-minute read

The Big Story: Staffing overtakes financial challenges as top concern among hospital CEOs, survey finds

The workforce shortage is perhaps the biggest topic of conversation across the industry right now. While some providers and staffing agencies are offering large sign-on bonuses, others are going for retention bonuses and raises. Everyone is trying to staff up, whatever it takes. Many, especially but by no means exclusively rural hospitals, are barely hanging on.

What it Means for Our Healthcare System

Pandemic shortages accelerated the growth of temp and travel nursing, effectively changing the compensation model for RNs. That’s created a feedback loop where the shortage has become both cause and effect. Hospitals can’t maintain the tab for travel nurses – yet many can’t properly staff up without them. The jaw-dropping $40,000 signing bonuses are stopgap and not sustainable.

Dawn Carter, a veteran healthcare strategist and founding member of the Rural Healthcare Initiative, likened the situation to The Lorax, Dr. Seuss’ foray into environmentalism that describes the dangers of overusing a resource to the point that it disappears. We need nurses, and they deserve to be well-compensated. Full stop. It’s incumbent on us to design a system that allows that to happen. A system that sustains the forest.

While many are working feverishly to discern the long-term foundational changes necessary to compensate caregivers what they’re worth while keeping labor costs manageable, the land-grab nature of the current healthcare recruitment push continues. And it just might be catastrophic for smaller providers who can’t keep up.

We’re not parachuting in with 750 words to solve a very complex problem. But we do think Carter’s insight on how provider organizations, particularly rural and independent hospitals, might mitigate the damage now with their existing staff – is imminently shareable. Her suggestions cover both tactical interventions and messaging.

An extra week off. Literally, give your staff an extra week off. Maybe two. More hospitals are taking this approach because that time away may help with burnout and is a relatively low-cost benefit to the employee. Many hospitals are already offering other smart benefits – subsidizing gym memberships, meal delivery services and so on. But if we’re talking about people who are thinking about leaving, giving them extra space to recharge may be a wise step towards keeping them.

Professional development. What else can your employees do? Whatever it is, show them that. From the moment they first consider a healthcare career through their entire time with your organization, make clear the ways a team member can grow in the job or grow into another one. Many hospitals are already helping finance additional technical/educational investments. They should make those opportunities known.

Carter cited a speaker from last week’s South Carolina Hospital Association virtual meeting who suggested hospitals ensure that high school students understand the low-cost path to a high-paying job. Someone paying two years of technical college tuition and coming out of it with an RN can enter the market making $60,000, but there’s the potential for $200,000+ by pursuing a CRNA.

Clarity. Carter noted that much of the money paying for those stopgap measures like travel nurses is stopgap funding (federal stimulus and relief dollars). It’s temporary. This is an important point to make when addressing staff nurses who are justifiably frustrated seeing the compensation packages for their traveling peers while they’re receiving far lower raises/bonuses. Hard conversation, but it’s worth sitting down with staff to really talk about the current dynamics and explain why those levels of compensation aren’t sustainable as the one-time relief funds run out. Yes, you’ll still hear questions about why that one-time money is going to temps and not staff, but it will hopefully provide helpful context.

Connection with leadership. The critical message is that the core problem is a broken system, not uncaring leadership. This is no time to be defensive and complain about trying to operate a hospital in today’s brutal environment, especially with nurses who’ve been stretched beyond reason by the past two years. The point, rather, is to have deep, heartfelt conversations with staff about leadership’s position on the issues and the various imperatives they’re balancing.

To imbue those messages, Carter underscored the enduring value of leader rounding and one-on-ones. Find time to build relationships with staff, listen to their concerns and show genuine humanity. Sometimes that means telling your own story, too. We’ve heard from clients whose leadership spoke during town hall meetings about their toughest moments during the pandemic. Showing that level of vulnerability was powerful and helped dampen some of the tension that had been building.

Note that these conversations shouldn’t be used as distractions from or substitutes for practical interventions. They should be a supplement, a way to both solicit helpful information about what staff need and to demonstrate that you and the organization are working towards a collective solution.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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Ian Petty In High Stakes, , Quick Think

The Quick Think: Without Merit

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

3-minute read / 20-minute podcast

The Big Story: Brian Flores sues NFL, three teams as former Miami Dolphins coach alleges racism in hiring practices

The recently-fired head coach of the Miami Dolphins just rocked the sports world with a class action lawsuit alleging systemic racism, disparate hiring practices and incentivizing losing. The NFL came back with a near-instant response saying that Flores’ accusations were “without merit.” Dolphins owner Stephen Ross has responded with a statement that includes the very legal terminology of “false, malicious and defamatory.” Then on Saturday, the NFL sent around a memo saying the organization was bringing in outside council to review its policies.

Why We’re Writing About It

Why, indeed, is a healthcare communications firm writing about a lawsuit against the NFL?

Because this story encapsulates so much of the work we do, the advice we give and the best practices for how – or how not – to communicate in a crisis. Because sometimes it’s good to look at outside examples to shake us loose and give a fresh perspective on long-standing principles.

Principles such as…

Check your story. Remember all those times we’ve written about how hospitals need to be proactive and tell the story of the good they do for their community? Or, if faced with scrutiny, respond with a compelling story? If so, you’ll also remember the warning that comes along with it: Make sure the story you tell is consistent with what’s actually happening inside your organization. For instance, a hospital can’t brag about helping patients navigate their healthcare finances when they’re suing them for nonpayment.

In the NFL’s case, the organization’s immediate response of calling the accusations “without merit” looks rash since it came within hours of the filing. Was that really enough time to have actually gone through the dozens of pages and confirmed that they were in fact without merit? Put another way, are the NFL and three teams being sued REALLY sure that they’re not behaving as accused?

Take time. Inherent to checking the story is that it takes time to do so. The NFL probably could have afforded to wait just a breath before releasing it’s “without merit” statement. Is it a crisis? Yes. Could they have taken a little longer to review the claims and craft a better message rather than one that looks like it was copied and pasted from some sort of “In Case of Lawsuit Break Glass” document? Also, yes. If you find yourself in a crisis, don’t wait around. But don’t go so fast that you rush past a meaningful response.

On Saturday, the NFL did in fact commit to “reassess and modify” the way it goes about things. But coming days after the initial, definitive statement instead of being the first thing released by the NFL, the memo opened the door for additional skepticism.

Prepare. We’re not talking copy-paste here. But you need to have a crisis plan in place with the basic blocking and tackling components. Think general talking points, FAQ, list of potential spokespeople, overarching underlying message. Armed with that, you can use those critical first moments of a crisis to review and home in on the situation. You’re not going to recycle the same talking points for every situation. But having a plan built around the tools needed and the underlying, mission-based message that you’ll want to convey no matter what is the difference between reflexively saying, “Nothing to see here!” and “We’re committed to serving our community and want to ensure that our actions reflect that. We’ll be investigating <XYZ> thoroughly. In the meantime, here’s what we know right now.” Again, it’s the difference between the NFL’s initial statement and the Saturday memo. Better to start with the latter and not backpedal into it.

Know the limits of your credibility. In addressing a crisis, consider your community’s perception of your organization’s reputation. We all know the NFL doesn’t have the best history when it comes to responding to explosive allegations. Their handling of the concussion scandal (which also included an ugly element of racial bias) and various instances of violence and abuse by players has left the organization without much reservoir of good will. Or benefit of the doubt. That’s another reason the instantaneous “without merit” comment looks hollow. Better, perhaps, to acknowledge previous missteps and use that as a foundation to talk about what comes next.

Know the difference between the people and the organization. This is the White Coats vs Dark Suits element. People love their docs. They love their local hospitals. But they lean skeptical about the big business of healthcare. Likewise, in the NFL, people love their team and particular players on it. But then there’s the perception of the organization, the impression that it often cares more about protecting the brand than doing the right thing, its Big Business operations that burn through trust and credibility. The appreciation the public has for the people doing the work – players/caregivers – doesn’t necessarily radiate out to good feelings for the organization – NFL/hospital. If the organization behaves badly, it won’t have much cover from the individuals.

And so here, we see a highly successful and credible voice who has worked at every level of an organization over the course of two decades. He’s making a powerful, emotional and specific accusation. However it all plays out, the NFL reminds us of the two-fold process facing an organization under scrutiny: First, of course, is actually doing the work and doing the right thing. And then it also means taking the time to communicate in a way that is consistent with the stated mission and values of the organization…or risk leaving room for the implication that those aren’t really the mission and values at all.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Change Management, High Stakes, Quick Think

The Quick Think: Nursing Gigs and Workplace Culture

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

3-minute read

The Big Story: The gig economy is trying to solve health care’s burnout crisis

Nursing on demand? Is it shape of things to come?

Startups are building platforms to plug nurses looking for shifts into organizations with shifts to fill. Sorta like if you needed a ride and there was an app to connect you to a driver. (Someone should look into that.)

Point is, tech platforms can ostensibly help organizations staff up to the levels they need while giving nurses more control over where and when they work.

What It Means for Provider Organizations

Seeing caregivers leave for more flexible roles is one of many things putting a pit in the stomachs of healthcare executives. It’s painful for acute care providers, yet the idea of a nursing gig economy makes a lot of sense when we look at the convergence of two ongoing trends. And the ball is in organizations’ court to respond in a way that attracts, retains and supports those looking for more control.

We know nurses are burned out. Many feel disconnected from their employers. And 40 percent of healthcare workers employed within a health system don’t see that environment as their ideal. Instead, they’d prefer travel nursing, health tech, maybe even those enticing flexible gig jobs.

We also know hospitals are getting flak for being greedy Big Business. A recent New York Times video blames the deficit of hospital caregivers on hospitals’ intentional understaffing to increase their margins. These examples go right to the heart of what our research shows is a perceived gap between hospitals’ missions and their approaches to the business of healthcare. And that gap is part symptom and part source of the unsettled workforce.

When it comes to nurses, the problem is that if you can’t give these thoughtful, mission-oriented individuals an environment where they feel supported, connected or even sure that you’re prioritizing patients over money then they’ll look to leave for higher pay, a more comfortable work environment or both. Who wouldn’t?

This presents a brilliant opportunity for health services and health tech companies. If healthcare workers aren’t sure a big hospital is their ideal, then other types of providers can that professional home. Which means that today the competition between provider organizations is real and, unfortunately, there’s a zero-sum element to the whole thing.

Question is: How can we use this great reshuffling and try to get away from a zero-sum recruiting battle? Can we better support caregivers and help the right people land in the right roles, whether that’s at a huge national system or an innovative specialty clinic?

We think so, and the approach is right up Marcom’s alley:

Build personas. Consider the people you need in those nursing roles and who might want them. Younger nurses may be harder for hospitals to recruit now if they’re not tied to one place and would like to travel and make more money while doing it? Others may relish an exciting stint as a staff nurse in your level one trauma unit. Nurses with families or later in their career may be looking for the stability and consistency. Different personas are looking for different things. Know what those things are.

Learn about preferences. The best way to find out exactly what people are looking for is to ask. Yes, money may be one of the things that comes up, and it’s fair to note the discrepancy between a staff nurse’s hourly pay and that of the travel nurse filling a vacancy in the next room. But it’s not always money. We’ve heard from health systems that, based on their surveys, what employees are looking for is relatively simple. They want to be heard and recognized for the work they do. And they want to know what’s going on with the organization. Yes, financial compensation is sometimes part of it, but not all.

Show what you can offer those targeted personas. Maybe it’s the benefits and career advancement available in a large system. Or the entrepreneurial vibe and relative independence of a young health services company. Highlight how you’re unique and speak directly to those who find those characteristics compelling. Basic marketing.

Solidify your culture. Concurrent with your recruiting efforts, reinforce your good culture so current employees stay and newcomers join – and stay. You can’t fake culture. For hospitals, that means not just paying lip service to something like “having a direct relationship with our nurses.” It’s actually having a direct relationship with nurses and being able to point to exactly how you’re doing it.

A note on sustainability: Building meaningful culture requires talking and listening to employees on a regular basis. It entails aligning your recruiting and HR efforts. Organizations with success in their staffing campaigns have a chief nursing officer working closely with HR and the strategy team. With the reality of limited resources, efficiency will be a watchword in healthcare going forward. Make sure you’re aligning everyone towards the common goal of staffing.

Want more? Listen to partner Kim Fox and senior vice president Tim Stewart discuss culture and communications in our latest podcast.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In High Stakes, M&A, Quick Think

FTC Goes “Modern” On Mergers

Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

2-minute read

The Big Story: FTC, DOJ ask for public input in antitrust ‘overhaul’

In a move entirely consistent with the executive branch’s stated goals on M&A, the feds are ramping up an effort to “bolster merger oversight” and “modernize enforcement.” They’re particularly concerned about vertical integration which, they say, may not lead to the efficiencies often promised. Plus, they’re eyeballing scaling health systems’ smaller acquisitions, as those transactions may “skirt regulatory review.”

What it Means for Your Health System

The FTC isn’t just giving lip service to looking more closely at mergers. They’re also digging deeper during the review process. Regulators are requesting more information from health systems and healthcare companies than usual and they’re soliciting public comment. Both, of course, slow down any given transaction.

That’s sure to raise eyebrows at any health system considering a partnership. And there are many of them talking about it in their board rooms right now. Some put a deal on hold due to the pandemic and are coming back to it. Others weren’t looking to partner until pandemic pressure created the need.

All in all, the ball is rolling downhill for the antitrust crowd. They have their target in sight and they’ll be flooding the comments. It’ll be tough for healthcare organizations to push back, but we at Jarrard Inc. don’t think it’s an impossible task. The goal, for starters, should be to balance the comments in a meaningful way and point out where the critics have the narrative wrong. Here’s what that looks like:

Be ready to engage. Don’t wait for anyone to jump in on your behalf. While there’s certainly value in coordinating with associations, you have a distinct story to tell about your organization and community. Focus there and don’t assume that aggregated advocacy will suffice. And when you do appropriately engage in the public comments process, be proactive, not defensive.

Engage with real stories. The prevailing narrative is that consolidation leads to higher prices, lower quality and reduced access. But what about the real stories about mergers that saved healthcare in communities, saved access and improved patient care? Tell those stories and explain how it will work in your community. Your adversaries are using both academic studies and emotional patient narratives. Numbers backed by real faces on camera are a powerful cocktail. You should do the same.

Be specific. Price, quality and access are the areas that FTC is scrutinizing. Hospitals need to give very specific examples of how their proposed deal would address those concerns. That means avoiding platitudes like “We’re going to transform healthcare,” or “This partnership will ensure care for years to come.” Instead, say, “We are going to ensure high quality care by…” and “We will improve access through…” Similarly, where there may be changes – like L&D services leaving a low-volume rural hospital – explain exactly why it may happen and how you’re going to help expectant mothers. When they speak, your critics give specifics rather than rely on vague allusions. Take the lesson and apply it.

*A note on the cost of care: Everything in society is getting more expensive, and according to our latest consumer survey, the cost of healthcare is one of the public’s top concerns. Price is a line of attack hospital critics bring out at every opportunity. When discussing the effects of a proposed merger, be ready with necessary nuance. Talk about how and why prices won’t go up due to the partnership, why it won’t be the merger that further accelerates the increase. If you are the buyside, be ready to show (or defend) your track record of prior mergers and how cost of care played out. And if increases are going to happen, be upfront about the reasons.

Drive change and educate. Talk frequently about the innovation your organization will continue or pursue thanks to the partnership. Get into the specific things you can do to control costs or improve access. Help the public understand that healthcare overall is working toward better utilization of care. Focus on ways that your organization is investing (or will invest) in getting people the right level of care at the right time. Explain that this doesn’t always mean more services, but rather helping patients avoid overutilizing expensive or unnecessary services. The bonus: This helps people understand how they can make better choices that benefit them.

Start internally. When talking about a merger, ensure your employees and physicians truly understand what it means. Our latest survey found that healthcare workers are somewhat more skeptical of mergers than the public, so it’s critical to allay the fears of those on the inside. Provide crystal-clear messaging about how it will work and how it will and will not affect them. Speak in terms that people can understand and give them opportunities to respond and question. Then do the same publicly.

Always answer the question, “Why is this good for the patient?” Need we say more?

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Ian Petty In Firm News

National Online Healthcare Survey Report – Dark Suits and White Coats: Healthcare’s Acute Divide

High levels of public trust in healthcare workers and hospitals only goes so far in insulating provider organizations from mixed feelings about how hospitals prioritize between money and patients, how they handle access and equity and how they support their staff, according to a new survey produced by healthcare strategic communications firm Jarrard Phillips Cate & Hancock, Inc. and Public Opinion Strategies.

Two years into the pandemic, hospitals retain a high level of trust when it comes to providing critical healthcare information, and a majority of adults have a positive perception of the quality of care available in the US. However, barely half feel strongly that their preferred hospital fulfills its mission or provides equitable care, with even fewer feeling strongly that their hospital is a good community partner.

These findings highlight an opportunity and need for hospitals to build on their strengths to improve public perception and understanding regarding how thoughtful business practices allow them to meet their mission.

“Dark Suits & White Coats: Healthcare’s Acute Divide” is Jarrard Inc.’s fourth national healthcare consumer pulse check since the pandemic began. Fielded in December, the response pool included 800 adults and 200 who work in healthcare.

Key themes that emerged involve the business of care, trust and burnout.

The Business of Care

Though 62 percent of respondents think the quality of care in the US is good and meets their needs, only 50 percent strongly feel that their preferred hospital fulfills its mission. Many respondents are ambivalent or unsure about these issues, which provides an opportunity for hospitals to increase support for their approach to the business of care.

“We know hospitals and other provider organizations are doing incredible work to serve patients while operating in an extremely challenging environment,” said David Jarrard, CEO of Jarrard Inc. “In light of that, hospitals would benefit from an even greater public focus on mission to underscore their commitment to patients over finances. They can’t assume that because people prefer to receive care at a specific hospital or are happy with the quality of care that they feel good about the organization and its business practices.”

Jarrard said such soft support in the survey renders patients – and employees – vulnerable to being swayed by critics and competitors. It puts hospitals at risk of lower loyalty and open to reputational damage.

“Hospitals must go beyond looking at metrics of volume and patient loyalty and develop ways to connect even more deeply with the public in fulfillment of their mission,” he said.

Related Data Points:

Only 41 percent strongly feel that their preferred hospital is a good community partner.
Only 35 percent strongly feel that their preferred hospital handles patient-related financial issues well.
Only 42 percent of consumers and 38 percent of healthcare workers, feel strongly that their preferred hospital focuses more on its patients than on its business.

Trust

Trust in doctors and nurses remains high at around 85 percent, according to the survey. And though consumer trust in hospitals did drop six points in the past year to 76 percent, they join nurses and doctors as the most trusted sources when it comes to critical healthcare information.

“Provider organizations can use that public trust to speak to and combat some of the skepticism about the business of healthcare,” said Jarrard. “That means being open about how they operate, what they’re doing to contribute to their community and how they’re delivering on their mission of care. And when missteps are made, hospitals must own them and make clear, meaningful change that people can see.”

Jarrard said organizations should also engage with nurses and doctors to speak on behalf of their organization. But before doing so, healthcare leaders must ensure that they are truly supporting and engaging team members, who are exhausted after two years of pandemic work and somewhat skeptical of hospitals.

Related Data Points:

Consumers trust hospitals more than health officials (64 percent) and the CDC (60 percent).
Nine in 10 consumers trust their preferred hospital, compared with 74 percent who trust health systems in general.
Trust in hospitals has declined more among Republican voters (31 percent) than Democratic voters (17 percent).

Burnout

The study found more than half of healthcare workers are experiencing significant burnout. Nearly a third feel disconnected from their employer, and more than one in 10 are unlikely to remain in healthcare.

“Hospital leadership across the country has recognized the strain on the workforce and has gone to great lengths to help,” Jarrard observed. “They’re looking at compensation models, technology to streamline operations or free up resources and they’re seeking to improve recruitment and more to mitigate the challenge.”

He added that the healthcare industry may be headed toward a realignment of staff and clinicians, particularly nurses, moving away from acute care.

“In particular, if healthcare workers don’t feel connected to their employer, don’t think their employer values their mental health or have concerns that their hospital prioritizes money over patients – the bond that links them has been significantly weakened,” Jarrard said.

Related Data Points:

52 percent of healthcare workers are experiencing significant burnout
More nurses (55 percent) are experiencing burnout than doctors (43 percent.)
Some 30 percent of healthcare workers feel their employer doesn’t value their mental health.
While 52 percent of survey respondents work in a hospital/clinic within a health system, only 32 percent said that is their ideal work environment. By contrast, only 2 percent of respondents work for travel nursing companies and health tech companies, but 6 percent and 11 percent respectively, said those options would be their ideal.

About Jarrard Inc.

With offices in Nashville, Tenn. and Chicago, Jarrard Phillips Cate & Hancock, Inc. is a U.S. Top 10 strategic communications consulting firm for the nation’s leading healthcare providers experiencing significant change, challenge or opportunity. Founded in 2006, the firm has worked with more than 600 clients in over 45 states and served as a communications advisor on more than $60 billion in announced M&A and partnership transaction communications. The firm specializes in M&A, change management, issue navigation and strategic positioning. Jarrard Inc. is a division of The Chartis Group, one of the nation’s leading healthcare advisory and analytics firms. For more information, visit jarrardinc.com.