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Editor’s Note

Call it perfect timing. Last week, when the nation’s largest provider in California and Anthem Blue Cross finally inked a deal after months of escalating friction, we’d just dotted the final I and crossed the final T on our Special Report on payer-provider tension. Check it out and then chase it down with our Q&A with noted author, speaker, Congressional witness and consultant Wendell Potter. He spent years leading comms and PR at Humana and Cigna before leaving to advocate for healthcare reform and shine a light on how payers operate.

Jarrard Inc.: We talk a lot about the increased scrutiny on providers, and not just from insurance companies – also from media, advocacy groups, Congress and the White House. What are you seeing?

Wendell Potter: There’s a decline in favorability because of news coverage over the past several weeks, months and even years. Part of it is the result of an ongoing campaign by payers to point the finger of blame away from them. Insurance companies are quite adept at shaping the conversation. They’ve spent a lot of time trying to make the public think that they are largely blameless for any ills in our system.

Jarrard: What is it about providers that makes them a target?

WP: One thing is that they have brick-and-mortar facilities. They’re seen, they’re ever-present and we need them. Insurance companies are not that way. People can assume they have good coverage and pay little attention to the name on their insurance card. So it’s less visibility, less awareness, even on lawmakers’ minds. A decade ago, during the debate on the ACA, insurers were under more scrutiny than they had been in a while or have been since. But a lot of the attention has been shifted in subsequent years to rising healthcare costs. The insurance industry has been quite successful in getting everybody to focus on rising cost of hospital care and pharmaceuticals. It’s playing out in what Congress is paying attention to right now.

Jarrard: Why are health insurance companies so good at creating this public narrative?

WP: They’re able to get everyone to sing out of the same hymnal. It’s interesting because AHIP has a pretty diverse membership – non-profits and for-profits of different sizes. But they’ve been good at forcing message discipline and being perceived as the ones wearing the white hats.

For them it’s an absolutely necessary strategy where it might not have been for others in healthcare. I don’t think others have understood the vital importance of doing what the insurance industry does day in and day out. Essentially, insurance companies are not necessary. We’ve got evidence around the world that health systems can get along quite well without them, so they have to have an ongoing campaign to make people believe they offer a very good value proposition. And they’ve been hugely successful in doing that.

Jarrard: We recently asked the public who they blame for the high cost of healthcare. Insurers came in at 30 percent with providers at around 15 percent. People trust their doctors and are more likely to blame insurers than hospitals, but in our view, providers need to cultivate that trust, not rest on it.

WP: I think that’s absolutely right. If you were to do a comparison of what you’re finding now, versus what it was a decade or two ago, you’d see some changes in attitude. The losers have probably been on the delivery side. Insurance companies have always brought up the rear in terms of public opinion. We want insurance to pay our bills and get out of the way. There is a lot of work that needs to be done on the part of provider organizations to rebuild trust with the American public.

Jarrard: How do providers do that? What can they do to tell better stories?

WP: It goes back to value proposition. There needs to be renewed focus on crafting messages that resonate with the public about what the value proposition really is. It’s always useful to have individual stories and throw in data. But if you just lead with data, people’s eyes glaze over. So it has to be packaged in the right way.

Jarrard: What are two or three types of data that providers need to really build that message?

WP: Something along the lines of population health. Talk about what your system is doing to improve the quality of life in the communities that they serve. You can get into wonky topics like social determinants of health without using that term. It can be important for community leaders at every level to understand what you’re doing, how the work that you’re doing improves quality at the individual level and for people who live in the area that you serve.

Another thing is highlighting good work. When an insurance company is giving money to a group in whatever city, they’ll have a press release. They’re always out showcasing their charitable contributions and what they’re doing. You can’t overstate the importance of things like that.