November 12, 2019
6 Steps: Responding to questions about financial assistance policies
Headlines about hospitals in hot water over their financial assistance policies abound, and health system executives are wondering if they’re going to be next.
This unwanted media attention is happening against the backdrop of an emerging trend – hospitals and health systems being included with pharmaceutical companies and insurance corporations as drivers of increased healthcare costs. Healthcare providers – once thought to be solely solution oriented – are now being called out by the media, political leaders and even patients.
In an earlier post, we outlined five steps you can take today to prevent your organization from being on the receiving end of negative attention regarding your collections and financial assistance policy (or at least being prepared when it comes).
If you’re reading this thinking “It’s too late, we’re already on the front page,” or your policies are being questioned, we have some thoughts for you, too.
1. Don’t ignore anyone asking questions.
Critical views of your policies can come from a variety sources: traditional media outlets, non-traditional media, political leaders, advocacy groups, patients, academics, etc. Regardless of who is asking questions, sit up and take note. It’s 2019. Anyone with a website or social media following has a platform. Questions from an advocacy group or academic institution can quickly turn into a social media post that turns into front page news. It can happen before you have time to think.
2. If your organization is being scrutinized, create a window of opportunity.
Your feet are being held to the fire in a public manner – or a manner that could quickly become public. Don’t panic. Consider giving yourself room to breathe to create a thoughtful path forward.
If you believe it’s appropriate, announce a review period during which time you will analyze the policies being questioned. During the review, it may make sense to suspend the actions that have come under fire. Many of the health systems featured in recent media articles have announced review periods that varied from 30 days to six months in length. It takes time to review your current policies, engage stakeholders, form new policies and develop a plan for presenting them. Take the time you need to do the job well but know that it won’t get easier or be less work if you put it off.
Another tip: If temperatures are high, bring in a third-party expert to review your policies and offer suggestions for improvement. An independent review may provide you truly helpful contextual information. It will also show you are taking the issue seriously and add credibility to your new policies.
3. During the review period, go through steps 1-4 in our first article on the topic.
- Ask: Scrutinize your financial assistance policy.
- Quantify: Determine the true financial cost benefit of your current policy and potential changes
- Reflect: Connect your practice to your mission.
- Listen: Employees and patients can help shape a new policy.
- Act: Update policy appropriately and speak with confidence.
- Show: As much as is possible, make the process and findings public.
4. Thoughtfully announce new policies (or, go to step 5).
Policies are a statement of values. And, collection and financial assistance policies are statements about how a health system lives it mission by providing care to those less fortunate.
When a new policy is necessary, announcing it is an opportunity to bring your employees together and plant a flag for who your organization is and what you believe in. Done well, the announcement can garner goodwill from employees, patients and the community. Handled poorly, you run the risk of causing greater long-term reputational damage.
As we noted in Part 1, reporting your decisions back first to the employees and patients whom you listened to during fact-finding will build trust and help smooth the way for a successful public announcement. Conversely, leaving the people who 1) helped inform your decisions and 2) are directly affected by them to find out through the local paper will cause frustration and resentment.
All announcements should reflect your organization’s culture and be grounded by your mission. Rather than making a flashy, celebratory announcement about how much your organization does to care for the poor, adopt a more humble tone.
- Don’t make the announcement just about money. The average patient doesn’t know what charity care means and they have no way of understanding how millions of dollars of annual charity care really impact those less fortunate.
- Tell a human story. Show how more patients will now have access to assistance, and make it real through examples.
- Own up to mistakes. No one likes to admit fault. But to really change the narrative and move forward successfully it’s smart to acknowledge what you weren’t doing well and then quickly pivot to the solution, i.e. your new policy.
- Remember all stakeholders. This includes all internal audiences and community members. You listened to your employees and patients to learn how your policy could be improved. Go back to those same audiences and let them know that you took their input seriously and acted responsibly. That builds confidence in the future.
5. Or, defend your practices and policies and tell your story.
After reviewing your policies, you might find that your organization is handling collections appropriately and that you have a good story to tell. If that’s that case, tell your story and tell it with pride. Focus on the care your organization provides the community and how you are helping people access that care.
Don’t wait for your policies to come under more fire before you get in front of the issue. And again, when you are talking about your practices, remember that they impact people. Tell a human story and give actual examples of how you are helping patients.
6. Remember that, in all things, everyone is watching.
These emotional stories are designed to touch every heart and to ignite action. They should. That action may be a change of policies. We’re seeing this today as Senator Grassley’s office sends letters to health systems asking hard questions about their practices. It may be a confident and assertive effort by a health system to tell a story defending practices that reflect the mission and heart of its people. In any case, consider the impact of these stories – and your policies – on your nurses, physicians, staff, board, as well as the media and the community. These aren’t small, local stories. Everyone is watching.
We sincerely hope your organization’s policies never come under fire. But if they do, we hope this information will help you navigate the issue and come out stronger on the other side.