Bodyguards and cheerleaders: the role of strategic communications
When you think about hospitals and health systems communicating with the public, it’s natural to immediately think about a health emergency. After all, we’re only a few years distant from the COVID-19 pandemic. However, in the life cycle of any health system there will be any number of reasons to communicate with internal and external audiences. Strategic communication teams must be flexible, adaptable, and ready to act as a reputational bodyguard — figuratively speaking — or cheerleader depending on the needs of the day. Most days, it is somewhere between the two and the mission is to help the community understand why they should care about what the health system is doing.
Mergers and acquisitions
Due to a variety of market forces, the healthcare industry has seen an uptick in consolidation activity. PwC has been tracking healthcare mergers and acquisitions since before the pandemic. In an interview with Fierce Healthcare, Nick Donkar, PwC’s Health Services Deals Leader, said:
We had crazy years of volume in ’21, ’22, leading into a certain extent a little bit into ’23, and the resiliency and the step-up function that we experienced and have been experiencing since the post-COVID-related markets has been tremendous. The base tends to be around 1,300 to 1,400 announced transactions a year, which is a huge step function.
Anyone who’s lived through a merger or acquisition will tell you that there’s a great deal of uncertainty that comes with it. Internally, there are questions about which corporate culture and policies will prevail, and there are always concerns about job redundancy. Minimizing workforce disruption depends largely on two key things:
- Leadership needs to be visible, optimistic, and confident.
- Clear information needs to reach internal audiences as quickly and regularly as possible.
Neither of those things is possible without a strong communication plan that outlines what is legally appropriate to share and includes preferred messaging. When there’s an information vacuum, you risk losing good talent due to perceptions that may or may not be true.
For external audiences, a health system merger can be an exciting time. Horizontal mergers may expand capacity and shorten wait times, and vertical integrations can offer access to new service lines. However, mergers can also introduce an element of uncertainty in the market. Patients may worry about changes to their experience, insurance network, access to their doctor’s office, and increased costs. A strong, multi-channel communication strategy is an important part of establishing the new combined brand in the community.
Managed care contract disputes
Whenever medical cost trends are high, as they are now, public pressure to reduce healthcare costs intensifies. Insurance companies like UnitedHealthcare are quick to issue press releases asserting their commitment to lowering costs. Then they look to providers and health systems to absorb the hit. When it’s time to negotiate renewals, providers receive fee schedules with no increases — or decreases — vague contract terms, and excessive administrative burdens. It’s no surprise that these negotiations can devolve into disputes that become public.
While it’s not possible to know how many negotiations between payors and providers take a turn for the worse every year, there is data about how many have been covered in the media:
According to Unlock Consumer CompassTM data, 82% of people think it’s normal for insurance companies and providers to negotiate over rates. The numbers are evenly split when it comes to who should tell consumers about a disagreement. And when it comes to whose side they might take, 43% said they’d side with their preferred hospital and 34% said they’d side with the insurance company. The rest said they weren’t sure.
Strategic communications are a key part of influencing public perception of the reasons behind a contract dispute and what’s at risk if it’s not resolved. A survey by the Robert Wood Johnson Foundation found that more than 80% of responders are in favor of:
- Limiting the amount hospitals and doctors can charge for services
- Eliminating copayments and deductibles from health insurance plans
This illustrates a fundamental problem in healthcare. The American public feels rising healthcare costs in their wallets, but they don’t know who to blame for it. In December 2024 a wave of vitriol crashed over payors in the wake of a senseless murder. But there is plenty of blame levied at healthcare providers in the media as well. Most health systems operate on tight margins due to increases in staffing costs, rising costs of materials, and stagnant contract terms with payors. Yet, payors are quick to position themselves on the side of the average Joe and Jane as they fight healthcare providers for lower costs. And if they happen to post billions of dollars of profits for themselves while they do it — well, they’re hoping no one notices.
Attacks: virtual, physical, and reputational
In February 2024, Change Healthcare was at the center of a cyber-attack that resulted in the largest healthcare data breach in history. UnitedHealth Group, their parent company, estimates that health data of approximately 190 million people was stolen in the attack.
Aside from the business disruption the attack caused, the reputational damage to Change Healthcare and UnitedHealth Group was extreme. Countless articles have been written about the incident, the federal government started an investigation into how the criminals obtained access, and more than 48 lawsuits have been filed.
On the heels of the attack, Change Healthcare needed to communicate quickly with internal audiences to find the source of the breach and assess internal policies and procedures. They also needed to develop call center scripts for the innumerable clients who wanted answers quickly and engage their privacy and legal teams. For a company singularly focused on health data, it’s hard to imagine a more devastating PR situation than a data breach on this scale. Both Change Healthcare and UnitedHealth Group needed to put the strategic communications response in motion with written and verbal messaging delivered by themselves and via media outlets.
In this case, the attack on Change Healthcare was digital and the full impact on their reputation has yet to be measured. In other cases, like the murder of Brian Thompson, the attacks are all too physical. However these attacks manifest, whether they’re over quickly or extend into months, a strong strategic communication team is a must. Their role is expansive and cross-functional:
- Quarterbacking every aspect of the response, internal and external
- Providing guidance and counsel to executives, including media coaching
- Developing messaging is appropriate for all impacted parties
- Knowing when to pursue media and external attention for messages and when to stay quiet
- Working with legal and operational experts to craft a communications strategy that works within legal and regulatory constraints while still achieving communications goals
Much more than PR
Strategic communications as a discipline includes PR, but PR is only a subset of the expertise in a strategic communications team. We consult closely with executive leaders to provide insight and counsel in critical moments, including:
- Research that indicates the right path in each situation
- Persuasive messaging and effective channels for each engagement
- Communication planning, advocacy campaigns, and media relations
- Content development and campaign execution
Every day is different for a strategic communications team: senior leaders change, supply chain issues — like the IV bag shortage in late 2024 — can interrupt services, service lines are added and dropped. The lifecycle of a healthcare organization is full of moments that, depending on how they’re handled, can positively or negatively affect its reputation. Whatever the situation is, the strategic communications team’s underlying goal is always the same. To connect effectively with the target audience and deliver compelling messaging that resonates and supports the business needs of the organization.
