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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.

Navigating the C-Suite: Beyond “Go Back and Write About it”

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This week we were honored to help produce a full panel discussion with four top healthcare marketing and communications leaders discussing team dynamics and navigating the C-suite. It’s a conversation around how marketing leaders and their teams can use their seat at the table to not just be scribes for their hospital or health system but to serve as strategic leaders and advisors.

The team includes:

  • Susan Alcorn, of counsel here at Jarrard who previously spent time as chief communications officer at Rochester Regional Health and Geisinger Health System
  • Beth Toal, vice president of communications and marketing at St. Luke’s Health System in Idaho
  • Michael Knecht, chief marketing and communications officer at RWJ Barnabas Health in New Jersey
  • Gayle Sweitzer, vice president of marketing and corporate communication at the University of Kansas Hospital

This conversation is a prelude to a panel discussion the group will be having on Tuesday, May 17th at the Health Care Marketing and Physician Strategy Summit (HMPS) in Salt Lake City. For more on the event, check out healthcarestrategy.com.

Be sure to listen and subscribe to the High Stakes Podcast.

Photo by Benjamin Child on Unsplash

DigitaLee 5: DigitaLee: Healthcare Cybersecurity, Reputation Management & Digital ROI, pt. 1

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Welcome to DigitaLee, the podcast for healthcare marketers, where we look at the digital news, tools, tips and tricks for effective healthcare communications. This week, David Shifrin and digital healthcare pioneer and now healthcare entrepreneur Lee Aase are looking at healthcare cybersecurity, reputation management – should you keep it in-house or outsource? And the first of a two-part miniseries on digital ROI for healthcare providers. The question is how to measure ROI and how that differs between larger and smaller provider organizations.

Listen and subscribe to the podcast, or read the transcript below.

Episode Links

Read the transcript

David Shifrin: Alright, Lee good to see you again. The story that we’re going to kick this off with is from Healthcare Dive titled ‘On high alert’: Hospitals wary of cyber threats from Russia-Ukraine war.It’s a kind of an odd one because you wouldn’t really necessarily expect there to be sort of a healthcare angle to the cyber warfare that we know is taking place.

And frankly, day to day, we don’t even know where this, where the invasion is going and what’s really happening there. So, there’s so much uncertainty, but we have seen kind of similar stories here and there that, Russia seems to be active and you never know where somebody, whether it’s them or anybody else is going to show up.

And frankly, just a week ago, a buddy of mine who’s a PA and he said, you know, we got a ransomware attack and they’re asking for a bunch of cash and we’re locked down and we’re back to paper. It happens all the time, in peaceful times and in bad times. so what should provider organizations be thinking about when it comes to cybersecurity?

Lee Aase: Yeah. I think it just really highlights that cybersecurity should always be a priority because it doesn’t matter where it came from. The Russia, Ukraine conflict might be a precipitating thing. If the United States is involved on the Ukrainian side and if Russia retaliates or wants to find ways of gumming up the American system then yeah, that could be one precipitating event for why hospitals would be under threat, but there’s lots of other threats. There’s always bad actors that are out there. And I think it just really highlights the importance of good processes, good hygiene, good just taking basic security measures. The key one that I think was highlighted in this article and that I’ve felt is really important as well is two-factor authentication. Because anybody can steal passwords or you can guess a password, but with the two-factor authentication, when you have to have a timely provision of that second code, like within 60 seconds, that’s the kind of thing that’s going to be super helpful in heading this stuff off.

I think the other part is just really good training with staff. Helping them to be alert to phishing scams, for instance. I know back in my days at Mayo Clinic, we would have authorized phishing simulations that would be sent out by our IT security team and, you know, it got to be a game where you’d say, yeah, I think that’s one of those when you had forwarded it.

But occasionally you would forward those suspicious emails and they’d say, yeah, that was a real threat, that was really something. And having people be on the alert for it is really important. And yeah, then just the training, the alerting people that this is something that you have to be aware of and have to be careful.

David Shifrin: So you mentioned, you talked about training, Lee. And one of the, one of the quotes that stood out to me in the article was from a chief technology officer at a cybersecurity company talking about how there’s a huge amount of turnover, which is just not…something that I’m not familiar with, the IT world, but anything there when it comes to personnel?

Lee Aase: Yeah, I think it’s really, I noticed that in the article as well, that when there’s…if you have turnover in your key staff that are responsible for these security initiatives that you do put yourself more at risk. And yeah, I think we’ve seen, whether it’s because of people getting terminated because of non-vaccine compliance or whatever, that there have been various reasons for that. But there was the great resignation that everyone was talking about as well. So I think having some lack of continuity among staff responsible in these areas could also put systems at risk.

David Shifrin: Lee let’s use that to roll into the second section which isn’t exactly a platform, but in thinking about both cybersecurity, but then also reputation and the reputational damage that can occur certainly if a breach happens or any other kind of crisis hits.

And we’re talking about the turnover and just the resources that different organizations have. How do you think about what you keep in house? What you outsource, where you draw the line, how do you manage the limited resources that different organizations have recognizing that this is going to vary if it’s an independent community hospital versus a large national healthcare system.

Lee Aase: Larger health systems do have a lot more resources. They also have a bigger footprint. They also have a lot more angles, a lot more service lines that they’re trying to be ranking highly in and where people are expressing their opinions. So it scales up, the need scales up with the size of the organization as well.

I think for any of them, it depends on their stance toward using one of these platforms or doing it on their own, depends on what other priorities they have, where they need to be devoting their resources and what capacity they have. My general predisposition has been to say that people need to have ownership of their online reputation and that the service line folks or individuals who are concerned about what happens when people Google them that the best thing they can do is…

To have an active social media presence. To have an active digital presence that will tend to be over time ranked highly in Google and will show up effectively. So I guess depending on what resources people are willing to put into this they can either outsource it and try to have things managed that way, or they can take a more active and organic role in managing their reputation.

I am just naturally I guess predisposed to the latter solution and to really authentically engaging in these platforms, but can definitely understand how people say, yeah, I just want to write a check or I want to have somebody else take over that day-to-day responsibility because I have other priorities that I need to deal with.

David Shifrin: For our insight this week, Lee, we’re going to have a two-part miniseries. And in talking to my colleagues here at Jarrard, they sort of flagged that they had some conversations with you about digital ROI. And being the content mercenary that I am, I thought it sounded really useful for our audience.

And so this is going to be pivoting away from reputation and cybersecurity and everything, but the conversation is about digital ROI. And the first question for today is what your take is on measuring ROI and how that differs between teams, marketing folks at local hospitals versus at larger health systems or different corporate entities.

Lee Aase: Yeah. I was saying, you know, at the smaller health systems or the local hospitals, you typically have marketers who need to be much more of a jack of all trades, need to be much more nimble and resourceful, much more like MacGyver in trying to get results.

And that has upsides and has downsides. The one of the absolute downsides is the lack of, general lack of resources. But the second then is the priority that puts on and the premium that puts on that resourcefulness, on that creativity, on experimentation.

When I was a…so this would be back in 2009, I published a document that I call my 35 theses on social media. And there were three of these that kind of relate here. And I think that’s what I was talking with our Jarrard folks about is that, number 17, social media freedom, in an ordinary sense of the word.

And that was true back then, anyway. Now, you definitely have to have some money to be on these platforms typically to be able to get the reach. But then the second one that was related to that is that I, as in I in the ROI equation approaches zero, ROI approaches infinity. If you keep getting the I smaller and smaller, that means you don’t have to show as much in terms of benefit for it too be, “Wow. That really works.” So the fact that in all these platforms that if you’re trying to MacGyver it, and that was the 19th thesis is MacGyver is the model for social media success, that you have to be creative and you can get the proof of concept really pretty easily, or at least you can experiment with things to say, So does this work or not?” without risking a whole lot. And that’s actually some of the benefit of the smaller organizations, are in the way they can be thinking about this as that, you know, when you’re working on behalf of a large, resourced organization or with the super-strong reputation, there’s more risk associated with it.

The risk/reward thing in the equation is a little bit skewed in those cases, because what if it doesn’t work? On the other hand, if you’re in a smaller organization you have a lot more upside potential, and also because these digital tools have fewer resources needed to do something that’s actually pretty solid that is a reasonably high quality, like these digital mics, these add-ons that you can get for your phone and to be able to really reduce the cost of production. It lets you try things and then prove their benefit, which can help you make the case for more resources.

David Shifrin: Great. Okay. So next time then we will talk about how healthcare marketers position digital programming to justify that ROI, which is a clear extension of this, and you’ve already talked about that a bit, but I’m looking forward to that conversation next time.

Comprehensive Re-Evaluation

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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: 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.

Vaught Verdict

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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: 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.

Event Recap: Healthcare Private Equity at HPE Miami 2022

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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: Crafting the next-generation value creation playbook in healthcare private equity

“While the pandemic has disrupted demand for certain healthcare sectors, it has accelerated innovation and provided an opportunity for investment in other areas. In particular, there’s been rapid growth in virtual and home-based care delivery, along with the adoption of technology platforms.”

What We Heard at HPE Miami 2022

(2-minute read)

The opportunities and rapid growth were big topics at HPE Miami 2022, but the conversation didn’t end there. In fact, those were just starting points. The annual event, hosted and produced by global law firm McDermott Will & Emery, attracted more than 700 attendees from corners of the industry spanning investment, banking, legal and supporting services (including at least three strategic communications pros).

If we had to pick one word to summarize the trends we heard, it would probably be “leveling.” Investors remain optimistic and active, yet there was a sense that the industry is taking a bit of a breath. Here’s what that looks like:

Global disruption = wait-and-see.

  • There was concern about possible continued or exacerbated inflation and added pressure on the healthcare workforce, but beyond that the crystal ball stayed on the shelf.
  • Why? With Russia’s horrific invasion of Ukraine casting shadows, attendees were wary of looking too far into the future. “We don’t know” isn’t a particularly compelling take, but it’s a reasonable one in the face of today’s deep human concerns and economic volatility.

Plateauing pace.

  • Across the board, 2021 was an explosive year for healthcare PE investing, with several firms noting that they made a record number of investments in promising new technologies and unheralded opportunities to improve healthcare.
  • Yes, but: The result was a rise in valuations that attendees agreed was unsustainable. A common refrain was that 2022 will be a year of “refocusing” and “rebasing,” with valuations leveling off. One attendee suggested that this year will provide a “Zen” moment for healthcare investing.

Many paths to a deal.

  • While 2022 is expected to breathe, that doesn’t mean there won’t be opportunity. Between new family offices, European firms opening offices in the US, special purpose acquisition companies (SPACs)* and a significant reservoir of capital that firms may now be ready to deploy, there are more sources of funds than ever.
  • Plus: Transactions can go through faster, thanks to an accelerated transaction process brought on by the pandemic that shows no sign of reverting. Some bankers said they closed deals last year having never met the client or the buyer in person at all.
  • *Though still a reasonably popular financing mechanism, we heard rumblings that interest in SPACs is cooling. SEC Chairman Gensler has pushed his agency to come up with new, tighter rules surrounding SPACs, and the investment community is watching closely to see where it all lands.

Patients first.

  • As for what’s considered an attractive investment, attendees are continuing to keep their eye on anything that makes patient engagement better, faster, more convenient and less costly.
  • Think: Care in the home, outpatient settings or virtually, interoperability, value-based care and physician specialty roll-ups – to name a few.

Show, don’t tell.

  • There was a level of open pragmatism as the PE community discussed moving from investments based on the art of what’s possible back to those with defined execution and practicality on their way to creating value and improving delivery of care.
  • Put another way: Investing in what companies with a clear path to delivery vs. liberal promises to deliver.

Propping up people.

  • One attendee uniquely framed it this way: The healthcare services sector is fundamentally talent management.
  • Technology, care delivery models and process efficiency may get the headlines. But at its core, it’s people providing a service – a profound and personal service – to other people. Individuals doing that work are mission-driven, financial compensation isn’t the end-all-be-all, and labor is the number one challenge for healthcare today.
  • Therefore: In 2022 and beyond, health services companies must build meaningful cultures that make employees and clinicians proud to work there.

The last word.

  • The event itself was extraordinarily well-received by attendees. Here’s Jarrard Inc. partner and chief development officer Anne Hancock Toomey:
  • “McDermott did a phenomenal job creating an environment where people got to be together for the first time in two years and did it in a safe and fun way – outside in the fresh air and sunshine. More than 700 attendees from across healthcare investing. There was buoyancy among the crowd. Just so thrilled to be in person again.”

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.

DigitaLee 4: Digitally Enhanced Healthcare, Twitter Alternatives & Execs on Social Media

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Welcome to DigitaLee, the podcast for healthcare marketers, where we look at the digital news, tools, tips and tricks for effective healthcare communications. This week, David Shifrin and digital healthcare pioneer and now healthcare entrepreneur Lee Aase are looking at digital-first healthcare – haven’t we been talking about that for years, now? – whether more obscure social media sites like Parler that tend to attract subsets of wider society are worth healthcare’s time, and how healthcare leaders and execs can balance the personal nature of social media with the value of promoting their organization’s brand.

Listen and subscribe to the podcast, or read the transcript below.

Episode Links

Read the Transcript

David Shifrin: So the headline that we’re going to be talking about this week, the news story is titled, it’s from HIMSS Healthcare IT news, and it says, “Like Banks, Healthcare will become Digital-First in 2022.

And there’s a comma and the rest of the title is “Zoom Healthcare Lead Says.” So Lee, I saw this, and thought there’s a headline I have seen in some form or fashion, probably every four months for as long as I’ve been doing this, which hasn’t been that long, but it’s been more than 2022. And it even starts with digital transformation as the topic du jour in healthcare today.

So we’re all talking about it. And everybody’s talking about the digital front door and care delivery being pursued through digital means and hospital at home and all the rest. Is 2022 really the point at which healthcare goes digital first, or is this the optimistic view of a guy from Zoom who has a vested interest in that being true?

Lee Aase: Stock options and stuff, right?

David Shifrin: And stuff, trying to boost things after things have come back down to earth after the pandemic, the pandemic bounce.

Lee Aase: Well, so I think digital first is overstating it. I think digital first is, yeah, it is that thing that a Zoomer would say. I think it’s, there’s no doubt that with COVID digital has made huge strides. That’s just clear. Back when I was working at Mayo clinic, we had some goals for digital going into 2020, and then it was astonishing how quickly things moved because they had to, necessity being the mother of invention. The offspring were a whole bunch of innovations that really were, it made a difference. I think the way reimbursements have changed or did change at least during COVID to say that you didn’t have to be face-to-face to get reimbursed at a reasonable level.

And so because of that it made the telemedicine, made the virtual care much more attractive, much more viable, just economically viable for organizations. I would like to say digitally enhanced is the way of 2022 and hopefully beyond, because I think it needs to be human first.

So the analogy that was used in this article was about banks. Okay. People care about their bank. People care about their money. Not as much as their health and it’s not as personal to them. Banking is much more transactional. And for example, I just deposited a check with my mobile app and that’s perfect.

And like the whole thing about not… just before we were on today, ATMs used to be the big thing. Wow, you don’t even have to stand in line at the teller. I mean, so that the convenience of that, and that’s what it really has to be all about, ‘Is it for the patient’s convenience?’

Is it for the good of the patient or is it just to drive profitability and make it more efficient for providers? So I think from my perspective, I know in a future episode we’ll talk about the other little venture that I’m working on right now personally, but really with that, we’re wanting to establish that human relationship and then use digital where it makes sense for the patients.

If it makes sense to do a phone call or a video visit, because it would be inconvenient to bring the kids in for…to be seen, then yeah. But we don’t want to say if you want your lab results, you need to log into the portal and here are the instructions as to how to do that. No, you can actually talk to a nurse. We’re glad to talk, or your doctor who’ll talk to you.

So I think digital can be a, can and will be a huge enabler and can create some huge efficient…in fact, a lot of the stuff that we’re doing with this new clinic that I’m helping my good friend start, my physician friend start, a lot of what we’re doing wouldn’t have been possible without digital, just in terms of being able to get this going. Having electronic medical record that is cloud-based and that we like, don’t have to have the huge IT expenses; it’s pretty astonishing what digital can make happen. But if that becomes first, digital first is a buzzword, and that’s what the HIMSS guys and the Zoom guys are gonna go for.

But if we lose sight of the human relationship then, and if it becomes not just, not a means to the end of more satisfied patients then we’ll be missing the mark.

David Shifrin: Let’s take a look at the platform or the platforms of the week and in the notes I sent over, it’s Parler, but as you’ve pointed out before, there’s a bunch of these, and we’ve some folks ask about quote unquote, that Twitter alternative, which we assume to be Parler, but that could just be a catch all for things that aren’t the Instagram, Facebook, Twitter.

Lee Aase: Yep.

David Shifrin: With a lot of these, and we talked about this in the previous episode, these are coming about because people feel like they don’t have a place to talk about issues that matter to them. So they are highly politicized, and Parler in particular, tend to cater to specific political segments.

And that also does feed into, I think, to an extent into more of a mistrust of institutions of healthcare. I don’t know if you want a say an establishment, but that potentially that’s there too. So, you know, as you look at all, all these upstart platforms, because at one point Twitter was an upstart and Facebook was and everything else – RIP MySpace – do you see any indication that these are places that healthcare providers should be getting involved in? Is it flash in the pan? What are you thinking about?

Lee Aase: I would suggest this is a – to use the medical term – it’s as a watchful waiting approach that you would apply here. But also I’d start by listening. you can create an account personally if you’re a healthcare marketer or communicator. Get familiar with what’s happening there.

You don’t have to speak, you can be one of the lurkers and just see what people are saying. And maybe try some experiments if you think it makes sense, but I think not paying attention to them at all as the wrong approach.

But I also think given the tenor that will likely be there in most of these platforms, running out there with a whole bunch of establishment kind of messages you’re probably getting the equivalent of a ratio there.

David Shifrin: Yeah.

Lee Aase: On those platforms too. But I do think it’s like, you know, in politics you have to get 50% plus one. Marketers are all about tenths of a percent of market share at the lower end of things and making a big difference in their bottom line by how well they’re reaching people. And so, unless you want to say that this segment of the population is just, we just shouldn’t, don’t even want to treat their kind, you know, then you should be paying attention.

You should at least be hearing what they’re saying and seeing if there’s a way that you could effectively communicate there. But I wouldn’t, I wouldn’t rush into it and say okay, everybody has to have a Rumble page, a Rumble channel and put all their videos on Rumble too.

But I think not at least listening is you know, making the problem worse.

David Shifrin: All right. Last one. The tip let’s…we’ve talked about social media policies, and let’s talk here more specifically about good ways for leadership as individuals to use social media. How do folks in leadership positions in the executive suite build trust and credibility and come across as real people while also presenting valuable information about the brand or the organization as they need to?

And I mentioned before we started recording that I’d love to continue on this thread at some point about how almost the flip side of that is how brands can leverage the corporate voice versus the individual voice.

But let’s start sort of if you’re a healthcare leader how do you balance that and come across as a real person?

Lee Aase: Yeah well, I mean I think healthcare leaders who are going to be or have personal accounts on social media need to be engaged with them, need to be paying attention to them. There are certainly…any public figure who has a social media account is having other people help manage the account just because there’s such a volume of messages.

David Shifrin: Sure.

Lee Aase: But it needs to come across as authentic and that there needs to be some level of the person himself or herself speaking and engaging. And that if it’s all, if it’s all managed and not an individual being involved at all, it’s not going to be genuine. It’s not going to feel genuine and real.

And I think that’s part of what people are thirsting for, is that there would be that ability to, that this is a real person who personifies the brand who personifies the values of the organization. So I think one way, I mean, a lot of that can be accomplished through video by having just the CEO or other leader talking about things but I would say much more like a livestream and “ask me anything kind of thing” versus a highly produced thing with the drone footage, you know, where they’re, they’re coming

David Shifrin: Swooping into the CEO suite.

Lee Aase: Swooping into a CEO suite. It’s like, I mean, I understand there, are different brands that have the different fields and for some that might be just the, like maybe for Elon Musk.

Well, I mean, just let’s think like Elon Musk, okay. I mean, another good example of someone who you’re pretty sure that that’s authentic to who he is and he’s done okay for himself mostly.

David Shifrin: Yeah, it would be hard to ghost write for Elon Musk, he has his own style. That’s a good example because it does show and he does say some things that you can really “Wow, bro.” But he, as you say, he is incredibly successful and he has built real products and he has advanced his brand.

So it does show that people are interested in the human behind the brand. And in some cases they might be inextricable, but it’s not necessarily a bad thing.

Lee Aase: Yep.

David Shifrin: Okay.

Lee Aase: So that’s what I have to say about that.

David Shifrin: All right. Thanks, Lee.

Arnold and the Art of Capturing Attention

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The Big Story: Arnold Schwarzenegger speaks to Russians in emotional plea against war in Ukraine

A masterclass in communications.

The headline tells you exactly what happened late last week. But it comes nowhere near capturing the why, the how, the pure power of one public figure wading with deep authenticity into geopolitics. But powerful it was. Catching our attention. Holding us rapt. Moving us.

Watch it twice. Once to feel it. And then again to understand how it works.

We’re witnessing an extraordinary moment of powerful communications and communicators.

Russia’s brutal invasion of Ukraine has unleashed a parallel communications battle the likes of which we haven’t seen in this generation and which is beyond the scope of our weekly Quick Think. No surprise if textbooks are written about the situation, featuring, among other things:

  • The eloquent, razor-sharp messages – delivered through words and deeds – of Ukraine President Volodymyr Zelensky.
  • The harnessing of social media for “You Are There” journalism and “Are You Really There?” manipulation.
  • The Orwellian efforts by Russia to change the narrative against a sea of troubles, to block a tide of digital and tragically tangible information that cannot be denied.

But for today, we look at a single example from someone whose career trajectory broadly mirrors that of Zelensky – from kitschy actor to prominent politician. That training alone is worth noting when it comes to communications.

Outlandishly long in our distracted age of no attention spans, Arnold Schwarzenegger’s unexpected video – viewed by more than 30 million watchers within in 24 hours of its release – speaks directly to the people of Russia. We’ve captured several outstanding aspects of his compelling, at times personal message. If you take away just one thing, let it be this: The messenger must match the moment. Nothing brings home profound facts and difficult calls to action more than clear-eyed honesty and personal stories well and sincerely told.

Beyond that, a bit of video analysis…

  • It’s built for maximum reach. Schwarzenegger starts by telegraphing a basic communications principle. He says that he’s posting the video on multiple channels to make it as accessible as possible. It’s also subtitled in both Russian and English.
  • It’s built to target specific audiences. Difficult to pull off in a single piece, Schwarzenegger speaks sequentially to Russian soldiers, Russian citizens and Russian leaders – and then even more directly to Putin. The core message remains consistent as the specifics are adjusted for the audience. And in doing so, he is never manipulative. He tells viewers exactly who he’s speaking to – no games, no obfuscation, full transparency.
  • It’s direct about the goal from the start. Schwarzenegger begins by looking into the camera and giving a personal message to the people of Russia, expresses his life-long connection and affection for them, and then explaining where he’s going with it all. The environment is set to emphasize the directness and empathy: a tight shot of him at a table with a sober, but soft, expression.
  • It’s anchored by stories. After his intro, Schwarzenegger tells a story about his connection with Russia and the conflict that connection caused between him and his father – because of his father’s own painful connection to Russia from World War II. Throughout the remaining minutes, he continues to weave in personal stories.
  • It establishes credibility and rapport. Before detailing how the Russian people have been lied to, Schwarzenegger says, “No one likes to hear something critical of their government. But…as a longtime friend of the Russian people, I hope you will hear what I have to say.” By this point he’s already demonstrated his affinity for those very people. He also points out his consistency. He’s not targeting Russians but is “speaking with the same heartfelt concern” that he did to Americans after January 6, 2021.
  • It points no fingers (except at Putin and the Kremlin). He is surgically careful to separate the people to whom he is speaking from their leaders. He is explicit that they are not to blame. On the contrary, he assures them they have been misled. In effect, he comes alongside them with an arm around the shoulder rather than facing them down.
  • It’s methodical. Schwarzenegger knocks down the major points of current Kremlin propaganda one at a time. The Russian people, he said, have been told the invasion is a rescue operation to de-Nazify Ukraine. “This is not true,” he intones. He states facts and frames them with stories. Not only is Ukraine not being led by Nazis, but the current president is a Jew “whose father’s three brothers were all murdered by the Nazis.”
  • It offers emotional context for facts. For example, he shares the fact that civilian centers have been targeted and backs it up with the emotional stories and images from the deaths of mothers and children in the maternity hospital bombing. Even relatively dry data is given emotional weight. He doesn’t just say that the UN has condemned Russia. He adds that 141 members voted against Russia – with only four voting in favor.
  • It includes clear calls to action. Schwarzenegger asks the various audiences to understand they’re being fed propaganda and to consider that what he says is the reality. He asks people to spread the truth. He asks soldiers to consider the effects of the action they’ve been told to take. More than 11 million Russians have family connections to Ukraine and so, “Every bullet you shoot, you shoot a brother or sister.” He calls on Putin, by name, to end the invasion. But for every viewer, an unspoken challenge is clear: Now that you know, what will you do?
  • It ends with words of support and encouragement. To those Russians who have protested and spoken out he says, “The world has seen your bravery. You are my new heroes.” It’s true, and it helps the medicine go down.

A masterclass indeed.

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.

When Is a Win Not Really a Win?

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The Big (?) Story: Jury sides with Sutter Health in federal antitrust case

“A jury sided with Sutter Health on Friday in the long-running federal lawsuit accusing the health system of anticompetitive business practices that drove up healthcare costs by more than $400 million.”

What it Means for Health Systems

(3-minute read)

The short version of what the Sutter result means: One specific health system won one specific legal battle.

That’s it.

Time for more? Read on.

The California health system’s case is making waves in the healthcare trades and among industry insiders. Understandably so. A large system received a favorable jury verdict regarding alleged anticompetitive practices in an environment where that outcome was far from a foregone conclusion.

But while Sutter can take a breath, the provider side of the industry can’t. Or at least shouldn’t. Because this legal result does nothing to change the big-picture issues that are facing hospitals and health systems. Remember that this case began a decade ago and has focused on insurer contracts and antitrust issues, which have direct implications for the cost of care and patient access. Those topics are as hot today as they were 10 years ago.

A few key points stand out when looking at the decision. Note: We’re not making any statements about the legal issues. For that, we’ll recommend this concise piece from our friends at Bass Berry & Sims.

  • “It’s complicated.” In coverage of the jury’s decision, the words “technical” and “complex” came up repeatedly. It was clearly (and rightfully) a challenge for the experts to break down for the jury. The implication is that the complexity of the case made it difficult to clearly determine that Sutter had done wrong. So the default, when faced with a binary choice, was to side with Sutter. Another Modern Healthcare article that discussed this case and its “cousin” case – which Sutter settled – makes this very point. It’s that subtle philosophical difference between “innocent” and “not guilty.”
  • The narrative continues. What happened in the courtroom isn’t likely to mean much in the court of public opinion. The fortunes of one health system aren’t likely to alter the ongoing barrage by critics who maintain that hospitals are Big Business focused on profit over mission, they engage in willful anticompetitive practices, they harm patients through financial malfeasance.

So, yes, the case may have an effect on contracts in California going forward. But this verdict is a sidenote when it comes to the overall trends in healthcare and public perception thereof.  The critics are simply reloading.

So how should providers react?

  1. Unless you’re Sutter, don’t relax. Talk to your legal team. Appreciate that the federal case was an overreach and perhaps too detailed for the plaintiffs to win. Certainly don’t assume that the FTC, DOJ, insurers or anticompetitive activists will back off.
  2. Evaluate the opposition. A single legal loss in a high-stakes and very large scale, systemic dispute won’t deter those siding with the plaintiffs. If anything, hospital critics now have more information about what works and what doesn’t when it comes to pushing the anticompetitive narrative. They’ll use their notes to build a stronger and, presumably, clearer case for next time. Frankly, we’ve consistently seen that hospital critics do a pretty good job of telling a compelling story. Expect this setback to both encourage them and provide them with new resources to further refine their narrative.
  3. Prepare for more. Continue reviewing both your operations and your communications. As always, get everyone in the room for discussions about how your organization is approaching the myriad financial issues raised by critics. Look for gaps and misalignment between clinical, ops, marketing and comms, government relations, community outreach, legal and payer relations. Then, for the marcom team specifically, double down on telling your organization’s story.
  4. Speaking of payer relations… the Sutter case with several other recent high-profile public provider-payer disputes, show how quickly things can escalate once that tension first appears. Avoid escalation. Have your GR team engaged and building relationships with policymakers. Same thing for your payer relations team. That way, if – when – things get tense, you’re starting with a base of personal relationships and mutual understanding. We’re not naïve enough to suggest that occasional drinks with a payer rep is enough to stave off a contentious negotiation, but a bit of human connection won’t hurt. Additionally, even if you “win” a nasty battle, the critics will have had plenty of chances during the process to put dents in your reputation. Over time, dents can become cracks and, well, that’s not ideal.

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.

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

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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.