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Ian Petty

In High Stakes, Issue Navigation, Quick Think, Strategic Positioning

Blame and Balance

Pie chart displaying "who is primarily responsible for the cost of care?"

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: Health insurers soak in pandemic-fueled Medicaid growth

As Americans lost jobs and suffered major financial hits last year, Medicaid rolls swelled. Insurance companies are reaping the benefits because they now manage roughly 70 percent of Medicaid enrollees.

Our Take

(2-minute read)

It’s a strange time. More than eight in 10 adults think healthcare is too expensive, but who to blame? Everyone’s trying to figure out where to point the finger, and everyone in our industry is jockeying to position themselves as THE patient advocate.

But what do patients think? You know, those people actually receiving the care being offered and funded by our $3 trillion industry.

We decided to ask them through a quick survey of 500 U.S. adults.

Easy stuff first: In a predictable landslide, 85 percent said that healthcare is too expensive.

Next question: Who is primarily responsible for the high cost of care? Almost twice as many respondents (30 percent) blamed insurance companies vs. the next biggest culprit, “the system as a whole” (16 percent). About 13 percent cited hospitals. Women – the primary healthcare decision makers – were more likely to blame insurance companies than were men. On the other hand, men distributed their ire a bit more evenly among the various options, though insurance companies still edged out the dubious win.

It’s an intriguing wrinkle in a moment where we’re hearing of mixed results in payer-provider negotiations – some talks are collaborative; others are gloves-off, with payers squeezing hospitals for lower reimbursements. Meanwhile, insurance companies are enjoying the profits they accuse hospitals of pursuing and growing their revenue through increased management of and enrollees in ACA plans, as noted in The Big Story.

All of these pieces – and there seem to be a lot of them lately – add to the imbalance between insurance companies and those who are actually, well, providing healthcare. (Of course, even that distinction is blurring as insurance companies pursue vertical integration).

So, let’s look at a few facts to help balance the conversation:

  • Rural hospitals across the country are at increasing risk for closure, potentially leaving wider and wider gaps in care.
  • Safety net hospitals are barely hanging on.
  • Payers managing the Medicaid population seem to be doing just fine.
  • The five biggest health insurance companies control 44 percent of the market.
  • Medicare Advantage and Managed Medicaid grew from 26.8 percent of payer revenues in 2007 to 51.6 percent 10 years later, per Axios. That means they’re making more money from managed care even as providers make less relative to private insurance due to lower reimbursement.
  • Seventeen percent of in-network claims in ACA marketplace plans were denied in 2019, and only a fraction of a percent are ever appealed, according to a Kaiser Family Foundation study. That means insurance companies managing those marketplace plans are putting consumers on the hook for the cost of care.
  • MACPAC reported that “There is no definitive conclusion as to whether managed care improves or worsens access to or quality of care for beneficiaries.” More on that story can be found in this article from NPR, also linked in the Axios piece above.

There’s a campaign taking shape against providers in the halls of Washington and the pages of the press.

In a sense, it’s an effort to change the survey results you see above. Will it take hold? Time will tell. For now, though, we see that people are more likely to point the finger at insurance than hospitals. Hospitals have a solid reserve of goodwill earned from their long history and pandemic heroism. That’s a reserve they must not squander.

In High Stakes, Issue Navigation, Quick Think

Data and The Upside Down

Up close view of an open filing cabinet filled with documents

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: CVS Health database leak left 1B user records exposed online

Another week, another huge stack of patient information left on a virtual desk for the unscrupulous to rummage through. FierceHealthcare reported that back in March, CVS – through a third-party vendor – left customer data exposed to the tune of one billion search records. As in, not password protected. That’s right, the database had no form of authentication in place to prevent unauthorized entry. The situation was quickly controlled, but it begs the question to healthcare leaders: “How safe is the data you’re entrusting to vendors?”

Our Take

You’re sitting on a gold mine of information, and companies are coming to you with great opportunities for partnerships or you need someone to help manage it all. You have the chance to advance healthcare AND differentiate the care you provide your patients.

What’s not to love?

Maybe nothing. Hopefully nothing. But maybe a lot. So be careful.

With all the growth and excitement taking place around healthcare’s digital front door, a dose of caution is warranted. Because there’s the other side – the Upside Down, for you Stranger Things fans: While more data creates more value for patients, providers and innovators, in the Upside Down, the value goes to the hackers and scammers.

How do healthcare providers run that risk-benefit analysis? You’re certainly not going to build these digital tools yourself, so, how do you pick the right partner and set appropriate expectations with them and your patients? And how do you explain you’re winding down a project if things don’t work out? Finally, do you play a role in educating patients about health tech and navigating the myriad consumer health tools available to them? (Because really, what is Dr. B doing with all that info it collected?)

Here’s our advice.

  1. Create a governance structure in your organization that provides protection from abuse for all stakeholders – including patients, clinicians and staff. Involve everyone in that process: compliance, legal, IT, communications, marketing, operations and clinical. These guardrails will be invaluable as you evaluate any given project.
  2. Ask why you’re considering adopting a technology. Answer the question, “What are we giving up or putting at risk for the sake of convenience?” Run the risk-benefit analysis and make sure there’s a compelling case for the benefits, no matter how shiny the object is.
  3. Consider whether you can achieve the stated goal. Can you do what the end user wants (most likely either your patients or doctors and nurses)? Is partial success possible and acceptable, or is this an all-or-nothing thing? Of course, you can’t really figure this out unless you…
  4. …Talk to the consumer. Find out the value to them and ask about their risk tolerance.
  5. Be open about your decision. If you do move forward, make very clear to the consumer what you’re doing when they sign up. Don’t give them the typical 17 pages of small print terms of service. This is their health, their life and their privacy at stake. Be clear.
  6. Understand from the get-go where the offramps are, whether you achieve success or it doesn’t work out. Have an exit strategy. And then, communicate that exit strategy upfront to all stakeholders. Don’t wait until the project ends – especially if it ends because it didn’t work. People will ask what you’re doing with their data. Answer those questions before you start, not when you decide to quit.

For more on how to prepare for a data breach, check out this recent post.

Questions about your digital footprint? We can help.

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In High Stakes, Issue Navigation, Quick Think, Strategic Positioning

You Can’t Please Everyone

Orange text that reads "The Quick Think" over a kaleidoscope-patterned background

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: 178 hospital workers suspended for not complying with coronavirus vaccination policy

Houston Methodist took a hard line on employee vaccinations for COVID-19 and is under fire for enforcing that rule. Neither the mandate nor the protest is a surprise – a big talking point all year has been, “Can and should healthcare organizations mandate COVID-19 vaccines?”

Our Take

(3-minute read)

The bad news: No matter what you do, someone isn’t going to be happy about it.

The good news: There’s a certain freedom and clarity in knowing that you can’t please everyone. When grounded in mission, it’s an opportunity to do the best you possibly can and then rest assured.

Advice: Mandates are a tough call for healthcare leaders. Whatever you choose be clear.

Now let’s get down to brass tacks. Most people want healthcare workers to be vaccinated. Our own poll from Spring found that 79 percent of Americans believe healthcare workers should be required to be vaccinated. Out of Houston Methodist’s roughly 26,000 staff members, 99 percent got their shot – just over 600 received an exemption or were allowed to defer and 178 refused. Pretty impressive.

Yet questions are swirling as to whether vaccine mandates are legal. Just check out the lawsuits making their way through the courts. One look at the protests at Houston Methodist and you can quickly discern that not all healthcare workers are keen to comply.

This isn’t an easy call. We spoke with David Pate, MD, JD, former CEO of St. Luke’s Health System and our resident expert on this dicey and consequential topic. From that conversation and what we’re hearing from our client network, we know that many leadership teams are making that call based on the following decision framework:

  1. What legitimate reasons do you have as a healthcare provider for mandating staff vaccination? For staff, patients and community.
  2. What other vaccinations are currently required?
  3. Who does the mandate cover – from physicians to vendors to volunteers?
  4. What exemptions are there?
  5. Will vaccinated employees be identified? How?
  6. What changes to current precautions will be permitted for the fully vaccinated?
  7. Who will be educating your workforce about the process for vaccination and answering questions about its safety and efficacy?
  8. Should you first seek voluntary compliance with incentives?
  9. What are the consequences for refusal to get vaccinated?
  10. Do state laws against vaccine passports apply to healthcare employers?

Once you’ve made a decision on your organization’s position, consider these seven communications practices before uttering a sentence or sending your first “Dear Colleagues” email. Above all, know that tension grows when communication is confusing. Inconsistency breaks trust.

  • Explain clearly and often the reasoning and logic behind your decision.
  • Connect your decision with your mission of care for patients and employees.
  • Provide venues for those who feel negatively impacted to voice concerns. Acknowledge their insight, it’s valuable, even if you are staying the course.
  • Define the terms to avoid: “Why does this apply to me and not to them?” Don’t let nuanced decisions appear to be arbitrary double-standards.
  • Prepare for pushback and special requests. Patients may ask to see clinicians who are vaccinated – or demand proof. Have procedures and messaging in place to respond.
  • Put the decision in context. Discuss what other measures you’re taking. If mandating the vaccine, explain who is exempt and any additional precautions they must take. If you’re not requiring vaccinations, lay out plans to keep patients and staff safe.
  • Give people steps they can take. Encourage actions that will promote public health. Reinforce existing guidelines and best practices, voluntary vaccination. Educate people on the benefits of doing so: getting back to “normal.”

Want this information in an easy-to-use resource? Download the one-page checklist here.

In High Stakes, Issue Navigation, Quick Think, Strategic Positioning

Four-Letter Word or Healthcare Hero?

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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: Seesawing Perceptions on the Payer-Provider Playground

This week Modern Healthcare cast providers as potential bullies, taking advantage of COVID-19 to pressure payers for higher rates and bigger margins. This followed on the heels of a tough review of hospital consolidation in The New York Times while America’s Health Insurance Plans rebranded themselves to just “AHIP” as they become providers, too. We’re noticing a thread here.

Our Take

2020 was a banner year for insurance companies, even with a costly Q4. So payers celebrated by rebranding. As the Good Guys. As the ones “guiding greater health.”

This week saw America’s Health Insurance Plans convert to the simple “AHIP.” Very hip to ditch an apparently unpopular word from the moniker. We note, as Modern Healthcare did, what the Edelman Trust Index says about the trust consumers have for “insurance” companies today.

With their reframe, AHIP smartly took a page right out of the provider playbook by using mission-oriented, self-descriptive language such as “champions of care,” and “advancing mental and physical health.”

This blurring of lines might work. Still, wasn’t it jarring to see the news sitting atop the flagship trade publication for, ahem, providers? A sign of the times…and of an opportunity not to be missed.

Each of our picks for The Big Story painted healthcare providers, in part, as bad guys using their size, clout, public goodwill and financial resources to wield power over smaller hospitals and/or insurance companies to boost profits and plump their margins.

This ink is the latest in an accumulating narrative that pins blame for healthcare’s myriad problems – cost, price, pick your poison – on providers. And then elevates payers as the patient-focused advocates for a healthy society.

But that’s not the whole story, of course.

To be clear: Hospitals and health systems are not blameless victims. There are plenty of head-scratching examples of bad practices by providers and, frankly, providers don’t always do the best job of telling their side of the story even when they do the right thing (ahem again).

But there’s another side of the story to tell. One that explores how major insurance companies are raising premiums while pushing for steady or even lower reimbursement to providers. And one pointing out that provider rates are increasing with single-digit speed, while premiums jump by double digits.

It’s an awkward, sometimes contentious moment for providers. We’re not looking to flip the script, but a conversation that will truly make healthcare better needs more balance. An all-around honest and self-reflective look at our healthcare system and how it’s paid for is needed. Because we can’t improve the system without fully diagnosing the problems – all of them.

It’s a big challenge for those covering our overheated industry.

It’s an opportunity and an obligation for providers, too.

So what’s our advice for providers who find their organizations in the middle of these stories? Or who are having to duke out tense negotiations with payers both behind closed doors and in the court of public opinion? Approach it this way:

Steel yourself. Be aware. The tactics and lines of argument used in mainstream media for national stories will make their way into your next local negotiation. One side of this equation (sad that we’re even positioning our healthcare system as having “sides”) has been building a clear narrative and telegraphing that they’ll use it. No provider should be caught off guard. Tune into news like the stories above for the playbook’s X’s and O’s.

Be honest. Engage in some serious self-reflection on how you’re providing care, supporting your teams and doing what you can to fulfill your mission. Don’t let the perception of unfair coverage distract from any real issues that may need to be addressed.

Keep going. If the insurance industry is jockeying for position as the patient advocate, that means it’s a provider’s space to lose. Let payers roll out their new branding. Hospitals and clinics and medical practices are where people go for care, not insurance offices. Nurses and doctors and techs and LPNs touch patients, not actuaries. That’s the story you need to tell.

Get Engaged. It’s a long story. The insurance industry won’t remake their image overnight and providers won’t balance the conversation overnight either. But providers must begin by speaking with a collective voice about their value and engaging in a real, ongoing conversation about the balance our industry must achieve to serve.

Questions about your managed care strategy? We can help.

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In High Stakes, Issue Navigation, M&A, Quick Think, Strategic Positioning

Don’t Duck. Fight.

Two Lego figures in fencing gear fighting with swords

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 or at the link below.

The Big Story: The Healthcare Divide

The healthcare industry was tossed out of the pandemic frying pan and into the media fire this week when NPR and “FRONTLINE” aired The Healthcare Divide, their joint investigation into the growing inequities in American healthcare exposed by COVID-19. More scrutiny came Wednesday when the Senate Judiciary Committee held a hearing on provider consolidation and antitrust issues. Then on Friday the New York Times ran a story about COVID-19 bills.

Our Take

(3-minute read; 10-minute podcast)

Healthcare providers, it’s time to think less like institutions and more like your detractors.

The halo your organization earned through the pandemic is dimming as the negative spotlight shifts back onto institutions providing care. Everyone’s in on the game. Unions are trying to drive a wedge between provider organizations and healthcare workers. The media is collecting hospital bills from readers. Lawmakers are considering how to wield their antitrust powers. Payers are claiming providers are responsible for the high cost of care. And when consumers truly get on board, winter won’t be coming, it’ll be here.

So why aren’t healthcare organizations consistently better at addressing these arguments? Why do responses often sound weak and platitude-rich – like bland, gray word salad? Like they’re ducking the debate?

Fact is, many still aren’t harnessing the power of communications to tell stories in a human way and are thereby yielding their positions as the owners of patient advocacy. Writ large, the provider side of the industry has traditionally operated from a stance of defense and risk management.

But the pandemic showed us a different way; to tell true-grit stories of how they were making the impossible work.

Let’s hold onto that “what works” and make it permanent.

Because all eyes are on provider behavior. Trotting out outdated studies or spreadsheets won’t cut it. That approach doesn’t hold a candle to the other groups bringing in patients harmed by alleged anti-competitive behavior, telling stories of healthcare workers living on food stamps and being sued by their own employer and painting private equity rollups as dirty, get-rich-quick schemes.

Each of those scenarios has taken place at a national level, but similar conversations are happening in local markets. Want to be prepared for when the spotlight turns to your organization? Consider the following.

  • Define the terms. It’s your story, so own it from the start. Use people. Back it with data. Be straightforward. Words like “integration” may help obscure some of the baggage carried by “merger” or “consolidation.” But people need to understand what you’re talking about. Hospital administrators must be masters at simplifying the complexity of business. Lack of clarity leads to frustration and confusion in the long run.
  • Learn the language. What motivates your hospital isn’t always what motivates the PE firm, payer or union who’s sitting across the table from you as you hammer out a partnership. Don’t talk past them. Understand what they’re trying to accomplish, how they think about the industry and the tools/tactics they like to use. Then address the actual issues they’re bringing to the conversation and articulate how you balance operating a company with providing for a critical need.
  • Be specific. Make it a practice to avoid vagaries. You’re better served calling out datasets and concerns specifically. That way, when it comes time for a rebuttal, you’re addressing a real idea rather than muddying the waters and leaving yourself open to interpretation.
  • Don’t keep using the same narratives. People today are responding to things right in front of them – an unexpected hospital bill, changes in the local labor market, mothballing of services at the community hospital. You need to do the same. Stop running with that same old consolidation study. Align yourself with your doctors, nurses and staff and show specifically what you’re doing businesswise to provide support. If you’re called out for negative effects, respond with responsible transparency and humility, not defensiveness.
  • Call out the bad actors. Yes, there are some in every industry niche who don’t have good motives. Don’t sweep that under the rug, because it’ll just mean you get lumped in with them. Some critics, like the Judiciary Committee, are questioning if the PE model is compatible with providing care. If you’re working to show that it is, you need to share the good stories, but be willing to acknowledge when your peers don’t live up to expectations.

Want more? Check out the 10-minute conversation featuring Jarrard Inc.’s David Jarrard and Isaac Squyres:

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In High Stakes, Issue Navigation, Quick Think, Strategic Positioning

Late Night Jabs

Three red banners that hang in front of the Hollywood Masonic Temple that read "Jimmy Kimmel Live"

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 or at the link below.

The Standout News: Brought to You By People Who Are Smarter Than We Are

Jimmy Kimmel, who’s used his talk show to speak on healthcare and politics numerous times, jumped in again last week with a pro-vaccine montage. It featured a handful of physicians who flashed their credentials (and student debt) and insulted people who haven’t gotten the shot. It was self-righteous, hilarious and very cathartic. But not helpful.

Our Take

(2.5-minute read)

We’re offering the white coats a little free communications advice: Skip Plan A – “A” for Aggression – when trying to change behavior. When we talk about using doctors and nurses to advocate and inform because they’re your most trusted voices…this isn’t what we’re recommending. Put simply: Don’t go all Kimmel on your patients. Leave the biting comedy to the pros.

Look, we get it. The absolutely legitimate frustration your caregivers feel having experienced firsthand the trauma COVID-19 can cause and continuing to hear people railing against the vaccines or still denying the virus is an issue.

Even so, wanna make someone dig in their heels? Insult them. Make fun of them. Piss them off.

Of course, Kimmel’s doing a bit, not offering an actual public health PSA (as far as we know). We haven’t seen any of you take his approach. But don’t let it rub off. Don’t let the frustration you feel about stagnant vaccination numbers cloud your pro-vaccine communications going forward. As much as you’d like to verbally throttle people who aren’t inclined to contribute to herd immunity, just…don’t.

Experts say the next 100 million doses will be harder to give than everything we’ve done up to this point. A recent STAT News article titled Vaccinations are plateauing. Don’t blame it on ‘resistance’ put it this way: “As daily vaccination rates settle and the country’s progress toward herd immunity slows down, let’s not rush to the same misguided conclusion that this is mostly about lack of vaccine confidence.” Labeling those who buy into falsehoods “as hesitant or resisters only hardens their viewpoints.”

So how do we make this easier? Well, the CDC’s lifting of the mask mandate is certainly a significant carrot (vs. stick) that ought to go a long way. Otherwise, here’s some advice from your favorite spin doctors – that’d be us – about how to get people to roll up their sleeves.

Listen to understand. You knew we’d include “listen” here. There’s a lot of research out there about what’s keeping people from getting vaccinated. Digest it. Consider what it means for the specific communities you serve. Go to those communities and ask about their experience with the vaccine – why they got it or why they didn’t. Check with influential leaders like clergy and teachers to get a sense of what their communities are thinking and feeling.

Recognize that data only goes so far. Numbers are good to back the position you’re advocating. Combine those with real-life anecdotes for a one-two punch that brings home understanding. Stories resonate far more than bar charts, which is something people who intentionally mislead know well. So as healthcare providers, tell stories about what the vaccine allows people to do, the peace of mind it brings – and back them up with good data. People aren’t asking, “What are the numbers?” They’re asking, “How will this affect me?” Paint the picture.

Set expectations with your clinicians. Doctors and nurses have a lot on them already, so arm them to inform, educate and advocate. Give them the tools they need to do so – whether it’s talking points, collateral, access to your organization’s channels or coaching on how to engage with people who have a contrarian view. Remind them that what they say about this issue reflects on the organization, even when speaking on their own time and channels. This isn’t to say you should take action against a physician who speaks out in a way you don’t approve of; instead, be proactive in reminding people about their role, their mission and the trust people have in them.

Remember that carrot. The CDC lifting mask mandates for those who have been vaccinated is an incentive for those who haven’t. The promise of returning to normalcy should be more effective than threats and insults for those who are still on the fence. Reinforce messages focused on the benefits of vaccination.

Stick with it. We know this is yet another frustration in a year full of them. Hang in there. We may not be able to convince all, but with persistence and calm patience we can convince many. A positive approach – and even a little good-natured humor – will go a long way toward getting more jabs in arms.

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In Firm News

Jarrard Phillips Cate & Hancock, Inc. Continues Record Growth as Healthcare Providers Move Beyond Pandemic Operations

Firm News

National healthcare communications firm Jarrard Phillips Cate & Hancock, Inc. has added six new hires with expertise spanning crisis management, public health, government relations, corporate communications and digital marketing. The consultancy, which focuses exclusively on healthcare providers, is in greater demand as its clients shift from COVID-19-centric operations toward addressing a new equilibrium emerging from the pandemic, alternative models of care, shifts in Washington and renewed focus on health equity.

Leading the new hires is veteran healthcare communicator Robert Scarola. He joined the firm as a vice president, bringing an extensive background in crisis communications and brand management borne out of time in healthcare communications, metropolitan politics and global public relations. Previously, Scarola served as vice president for communications and public affairs at MedStar Washington Hospital Center. He earlier served as assistant press secretary to Chicago Mayor Richard M. Daley and also managed crisis communications, public relations campaigns and brand awareness work for a regional health system. He is a former managing director at Burson-Marsteller in New York.

Two other senior executives have affiliated with Jarrard Inc.:

  • Katie Ballay joined the firm in an of-counsel role following a 22-year career with Cardinal Health, most recently serving as vice president for communications. Experienced in strategic communications, brand strategy, marketing and executive leadership coaching, Ballay focuses on organizational culture and storytelling to help increase stakeholder engagement and drive growth.
  • Kristen Hinton specializes in strategic communications, government relations and media for healthcare providers. Prior to joining Jarrard Inc. in an of-counsel role, Hinton led communications and government relations at Presbyterian Healthcare Services, New Mexico’s largest integrated healthcare system of hospitals, multi-specialty medical group and health plan. There, she was responsible for all public policy and government relations efforts at both the federal and state levels.

“In working with clients across the country, we’ve seen the need for a shift in communications towards long-term strategy, workforce resiliency, partnerships and care delivery models,” said Jarrard Inc. CEO David Jarrard. These were all top of mind in 2019 and have been brought back into the conversation but through the lens of a world still being reshaped by COVID-19.”

Accomplishing so much difficult but necessary change will require a ‘political campaign’ approach, a mindset that the firm has long brought to healthcare communications.

“The backgrounds that Robert and Kristen bring to our team add additional perspective and real-world experience to this approach,” Jarrard said. “Meanwhile, Katie’s impressive experience blending data-driven strategy with culture and engagement to drive growth, enhances our ability to guide clients through the human elements necessary to produce sustainable change.”

Other hires include:

  • Matt Muenzberg specializes in digital copywriting, focusing largely on enterprise website work, ad campaigns and digital marketing products. With a decade of writing experience, Muenzberg previously worked as a copywriter at The Lacek Group, a specialty agency of Ogilvy, where his clients included prominent consumer brands such as Carnival Cruise Lines, W Hotels and Marriott Bonvoy.
  • Savannah Collier is a new advisor in the firm’s National & Academic Health System Practice. In her prior role with the Tennessee Department of Health, she was involved in community health assessments and state government commissions – work that has given her deep understanding of public health issues and the communications best practices needed to drive significant change in health and health policy.
  • Olivia Steaban is also an advisor in the firm’s National & Academic Health System Practice. Having worked in communications for international development and global health organizations, Steaban specializes in strategic planning. Before Jarrard Inc., she served as a program development specialist at Nashville-based Raise the Roof Academy, where she worked on community-wide advancement programs for rural Uganda.

The sustained growth at Jarrard Inc. brings the firm additional expertise to help hospitals, health systems and health services companies emerge through the pandemic.

Internally, supporting and retaining healthcare workers is top-of-mind for providers, along with adjusting operations and communications to reflect new expectations around remote or hybrid work models. At the same time, providers are focused on consolidating and improving new models of care such as telehealth and hospital at home services that became necessary due to pandemic shutdowns.

“Today offers the unique opportunity to make important changes to further improve healthcare delivery in this country and engage with employees, the public, media and policymakers as our industry applies the lessons from the pandemic,” Jarrard said.

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 500 clients in over 40 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 or follow us @JarrardInc.

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In High Stakes, Quick Think

CVS & Mental Health: Running the Gauntlet of Vice

Orange text that reads "The Quick Think" over a kaleidoscope-patterned background

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 or at the link below.

The Basics:

CVS has joined Walmart by placing mental health professionals in a few of its HealthHUBs across the country, with plans to expand. Meanwhile, other major retailers are beefing up their offerings by adding digital mental health services.

Our Take:

(3-minute read or 9-minute conversation)

Somebody clearly had “transform the industry” on their 2021 to-do list.

Yep, CVS got a lot of ink this week.

First, for expanding its mental health offerings. You can get your Essie nail polish, ibuprofen softgels, four-pack of paper towels and chat with a therapist in one convenient spot. Now that’s called meeting people where they are.

Last week the retailer said it’s expanding the scope of its HealthHUBs to increase access in underserved areas. They’re starting with a dozen test sites in places where many have experienced “high instances of mental health symptoms and distress, leading to increases in emergency visits” thanks to the pandemic.

Very triple aim. Props to CVS for democratizing access. Major step in the de-stigmatization of mental health issues – addressing our mental health should be right up there with our physical health. CVS is taking that step, as are other major retailers like Walmart, Rite Aid and Walgreens – Walmart with in-house therapists and all three with digital services.

Second, CVS announced their new $100 million venture fund to invest in digital start-ups.

Together, these should be big Ws for healthcare consumerism.

For CVS, layering mental health services on top of pharmacy, urgent care, family care and wellness products is supremely logical. And it’s just what you thought might happen when they bonded with Aetna in a loving act of vertical integration. These mental health services will be in-network to Aetna members. If this test pans out and the program expands, CVS will be looking to slot into the care continuum – or redirect it. And those not affiliated with one of the several vertically integrated behemoths could be at a serious volume and reimbursement disadvantage.

Finally, with regard to both the digital innovation fund and embedding therapists in stores, convenience is king. The HealthHUB motto is “Where healthier meets easier.” Enough said.

So, say you’re a traditional provider. How do you react?

We see two options: Partnering up with one of the retailers or taking a page out of their consumerism book. On the first point, the future of healthcare rests on partnerships. Traditional providers will want to be connected with CVS and others making similar moves to tap into the stream of referrals.

Now, let’s unpack the latter option.

  • It’s a given that hospitals aren’t the only game in town anymore. Evaluate the landscape so you know which new players you need to take seriously.
  • Look at your “consumer-friendly” offerings. Are they as helpful as those tools provided by other industries? Are they at least headed in that direction? If not, be damn sure not to over-hype your offerings. Advertising a tool or service that became commonplace in retail a decade ago might elicit a mere “meh.”
  • If you are taking meaningful steps to consumer-friendliness, share how you’re making experiences with your organization easier and more convenient. Explain new initiatives that are in the works so that even if you’re not where people might want you to be, they can see how you’re getting there.
  • Reevaluate your stance on price transparency. We’ve been harping on this for a while. This is a significant issue going forward. Not allowing patients to see prices before receiving care isn’t the same level of consumer experience as that nail polish + therapy vibe you can get at CVS. But it does give people a much clearer look at what they’ll be getting when they come to you.
  • Operationally, think about opportunities to integrate disciplines to foster holistic care. Can you embed or better connect behavioral health with primary care with cardiology with…?

Of course, the onus isn’t just on hospitals. CVS, we have our eyes on you. Here’s what we’ll be watching for:

  • Will you focus on episodic care or do you see this as an access point for a real care continuum? (You say you’re offering referrals along with assessments and counseling. What does that really mean?)
  • How will you help patients navigate what our Jarrard colleague Dan Schlacter termed “the gauntlet of vice?” Walking into a CVS, you’re faced with chocolate, junk food, gossip magazines and, in some places, alcohol. What’s the plan for helping patients work through those potential triggers on their way to the therapist’s office? Triggers that, as a successful retailer, CVS has dialed in through years of applying behavioral analysis.
  • Which door do we use? Between those potential triggers and the desire for privacy, how will you lay out your stores and HealthHUBs to make the pursuit of mental health services not awkward?
  • Will you use paper charts? Just kidding. Maybe. But really, as you expand offerings, how will you manage EMRs? And will there be a firewall between medical records and consumer data? If not, how will you mix that data to the patient’s benefit (hopefully)? 

It’s anybody’s and everybody’s game. Let’s hope the victory goes to the American healthcare consumer.

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In High Stakes, Quick Think

Oscars Night Ad Tugs On Heartstrings, Puts Hospitals Under Pressure

A group of gold-plated, muscular man trophies with a clear focus on one trophy

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 or at the link below.

The Basics:

The CMS rule on price transparency went into effect on January 1 but hasn’t been enforced, yet. A new awareness campaign launched during the Oscars last week with the stated goal of combatting hidden prices in healthcare. The group hasn’t gained much traction but has significant (if obscure) financial backing and celebrity involvement.

https://youtu.be/6LSug_UJsGg

Our Take:

(3-minute read)

A dash of celebrity can really bring an issue into the national spotlight.

Hollywood tried to do just that last week when they broadcast a $2 million, 30-second PSA on healthcare pricing during the Oscars. The goal was to raise visibility about consumers’ rights to see hospital prices before they receive care.

The commercial’s talent? Oscar-winner and activist Susan Sarandon herself along with fellow A-lister Cynthia Erivo. To rally the effort, the Power to the Patients campaign is encouraging people to display wall art and murals invoking the cause and designed by celebrity artist Shepard Fairey. Check out cool examples on their website.

So. Did it work?

TBD.

Nothing’s gone viral yet: As of Saturday, the ad had only generated a meager haul of followers with 869 on YouTube, 813 on Instagram, 320 on Facebook and 166 on Twitter.

But providers, dismiss this at your own peril – especially if you’re one of the many that aren’t compliant with the currently-unenforced price transparency rule.

For those hoping this will just go away, you’ve got a few things going for you.

  1. The problem is complex.
  2. It hasn’t generated much coverage (finding a good link for the top of this note wasn’t easy and we ended up using their own press release).
  3. While we haven’t done any man-on-the street interviews, we’re guessing a raised fist – as depicted in the Power to the Patients iconography – isn’t what most people will associate with easy-to-navigate chargemasters.
  4. The ad and the website merely point to a problem without really explaining it or offering solutions.

But – and it’s a big but – Power to the Patients’ star-studded roster could be just the catalyst to fire up Americans about their power to bring healthcare to the consumer-friendly levels virtually every other industry offers. Already, savvy pundits are talking, including healthcare economist and blogger Jane Sarasohn-Kahn (HealthPopuli) who gave the organization a shoutout this week. And President Biden has indicated that he’s not pulling the plug on price transparency.

Providers certainly are more accustomed to insurance companies, pharma and medical devices being grilled as secretive drivers of cost. That won’t last long if this issue isn’t reconciled.

While we’re not exactly Power to the Patient insiders, we figure they aim to: induce providers to be compliant with price transparency; expose those charging higher rates and pressure CMS to enforce its own rule.

Which brings us to the advice portion – after all, that’s what we do at Jarrard Inc. So here goes:

It’s doesn’t matter if the campaign is clunky. Or that it uses splashy but vague tactics like murals and posters. Or that it hasn’t created a firestorm – yet. What matters is that the mission of healthcare providers is to deliver better, more equitable and accessible care to the communities they serve. We understand the challenges and the reasons given to not comply today. But wherever you are right now…

  • Think about the experience you’re providing to your patients. Decide whether that experience matches up with your mission, including on the rev cycle side of things.
  • Meet with your team to determine how far away you are from posting your prices and what you need operationally to make that happen.
  • Ask your community. Check in with your patients to learn what they want and how they’d like to approach things like scheduling, payment and – of course – cost estimates.
  • Be ready to explain why you’re taking the approach to price transparency that you are. If you’re not complying and haven’t been asked about it, consider Power to the Patients as notice served that you will be. If you are compliant, be ready to talk about how the tools work and be willing to acknowledge any gaps that may exist between checking the regulatory boxes and giving patients a seamless experience.

It’s time to step up your game. Otherwise, it may be your organization’s name in lights.

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In High Stakes, Quick Think, Strategic Positioning

It’s Your Reputation

Five stars in a row with 3 and a half filled with a gold shading

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 or at the link below.

The Basics

Two major providers are making a move to help them and their patients by upping investment in online reputation management. They’re looking for more (and more positive) reviews, plus an easier pathway to respond to negative ones. Provider ratings on sites like Google and Yelp are a significant factor when people look for care.

Our Take

A two-minute read for the high points; a 10-minute video/podcast for more

Doctors, we’re talking about your reputation.

And so are a lot of others. While you used to think of marketing and reputation management as “dirty words,” many of you are catching on to the necessity for doing both.

Online reviews are definitely a big deal for patients seeking a provider. Resistance to addressing them is foolish, especially when you start seeing a wave of negative reviews or inaccurate information – like the ambulance that ended up in an empty field because the online listing for a new facility was wrong.

So, how do physicians – ahem, healthcare marketing departments – take care of their online hygiene and manage their reputations? Well, it takes energy and effort – there’s no silver bullet. Which means that before you go sign up with a software provider, you have to do a little of your own recon:

  1. Find your information. Where does your organization show up online? Google? Yelp? Facebook? Where are people finding your brick-and-mortar addresses?
  2. Review your information. Are your hours and basic contact info correct on all those listing sites?
  3. Collect your information. Create a spreadsheet that will serve as a single source of truth. Seem overwhelming? Start with one segment of your organization, say the clinics or just your physicians. This spreadsheet will be critical to tracking your presence online once you do sign up with a reputation management vendor.
  4. Correct your information. You don’t need us to explain this.
  5. Respond to reviews. Get back to people and express your appreciation for their feedback. Don’t avoid negative comments. Don’t do anything foolish, like ask for personal health information in a public forum. Questions? Check with your legal and compliance team – or call us, for that matter (but not for legal advice).
  6. Solicit reviews. Some platforms, like Yelp, don’t allow you to ask for reviews. So check first. Where you can, make reviews part of the post-visit follow up. Make it easy for people. One more time: Make it easy.

So, should you follow in Sharp’s footsteps and embrace reviews, actively soliciting them to help people find you and to look better when the do? If you’ve got your aforementioned ducks in a row, we say bring ‘em on.

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