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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.

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.