The health insurance industry has endured a tumultuous decade. Since President Barack Obama suggested a health insurance shakeup during his 2008 campaign to President Donald Trump’s determination to repeal the Affordable Care Act in 2017, the industry has hardly had a moment to breathe.
In a regulated environment such as health insurance, communications is already complicated. Tom Noland, SVP of corporate communications at Humana, has spent nearly 20 years with the company mastering communications in this complex sector.
His role runs the gamut of corporate comms. He oversees all internal employee communications, including the organization’s employees-only news and social sites; all external corporate comms, acting as chief spokesman; reputation and brand management; content creation; and CSR initiatives.
Noland has a nimble team of 14 staffers to help communicate about the 50,000-employee organization, which last year had revenue of more than $50 billion and covers upward of 14 million people with its various health plans.
As one of the largest employers in Kentucky, Humana comes under close scrutiny from local media. Recent stories to catch the eye of the Courier-Journal in Louisville include CEO Bruce Broussard’s $19.7 million compensation in 2016 and his and other senior executives’ decisions to sell off stock, at a time when the company was cutting jobs in the wake of its failed merger with fellow health insurer Aetna, and Humana was looking to raise $1 billion in bonds.
Noland reflects on a decade under the microscope.
"We have always been a highly regulated industry, but we were not front and center of the public debate 10 years ago," he explains. "That is the major change in healthcare communications: the unrelenting attention being paid at the highest level of government and public debate to our industry."
Obama first raised the Affordable Care Act issue in 2008. After two years of debate, the bill was passed in 2010 and implemented over the next five years. Before it could settle down, both major candidates in the 2016 presidential election were already proposing changes. Hillary Clinton wanted to expand the bill: Donald Trump wanted to replace it with another healthcare plan.
Immediately following the contentious election and Trump’s inauguration, Noland says Humana was in "wait-and-see mode" for what came next.
But with the introduction of the American Health Care Act, he says, "We are monitoring the discussions in Congress and elsewhere around the possibility of health reform repeal, modification, or replacement."
Humana has not publicly weighed in on the fate of Obamacare, but Noland, who is liaison to the insurance industry trade group America’s Health Insurance Plans (AHIP), says the company was working through that group to make its position known to legislators.
"We’re doing it informally and behind the scenes through our trade organization and our own good relations on both sides of the aisle," Noland explains. "Our positions are represented, but not in public."
Although the company said it was waiting for the government’s next move, Humana announced in February it would pull out of all state healthcare exchanges in 2018, shortly after its proposed merger with Aetna was blocked by the Department of Justice.
As a result, Humana will next January be the first major insurance company to completely leave the federal healthcare exchanges.
Unsurprisingly, the announcement caused uproar among the press. Noland laid out the explanation and talking points for why the company is leaving the exchanges, which is largely due to an unbalanced risk pool — when there are more sick people than healthy people signed up for insurance. Many other insurers have cited the same issue for why they are losing money by participating in the federal exchanges.
"We very carefully included a full explanation of why we made this decision in our release," he notes. "We are using word for word what we crafted from that news release when talking to the media."
As for Humana members affected by the pullout, Noland says there will be "plenty of communications that will go out to [federal exchange] members in good time before the end of 2017."
The comms around the now-scrapped merger with Aetna were also set long ahead of time. The transaction was first announced in July 2015, but Noland and his team planned for every outcome from the beginning.
"We knew the outcome ultimately might be, for regulatory or other reasons, that the transaction couldn’t go forward and Humana would remain independent," Noland explains. "That is what happened. We’ve been planning for 21 months for this eventuality, not because we knew it was a certainty, but because we knew it was a possibility."
While the merger and subsequent DOJ court challenge was going on, Noland’s hands were largely tied about what he could tell the public.
"It makes things even more difficult. There’s nothing more we can say to the media and to our employees," he adds.
Humana is again focusing on its goals as an independent company, which include improving the health of communities it serves 20% by 2020 in "bold goal markets" such as San Antonio, Texas, and Louisville, Kentucky, where it is headquartered.
"The company is refining and enhancing its communications, but not changing its strategy," Noland says.
A changing industry
Healthcare comms, as a result of the ACA, have had to evolve with the rapid changes in the health insurance industry. The shift for communicators can be boiled down significantly, Noland notes.
"The business we’re in has two words: ‘health’ and ‘insurance,’" he explains. "For many years, our focus was on the second word. In the last few years, we are focusing on the first."
This idea, he mentions, is simple to explain, but difficult to implement.
Noland illustrates the concept with a recent campaign about aging and senior citizens. Humana partnered with the University of Southern California’s Annenberg School of Communications and AtlanticLive — the events arm of The Atlantic magazine — to change the portrayal of how senior citizens live.
Humana took on the topic because of its large segment of Medicare plan members, roughly 3 million people. After a study from USC professor Stacy Smith found senior citizens are often not shown in a positive light in pop culture and films, Humana joined in to contribute to its research and help people "age with optimism."
"Our research shows seniors are quite active," Noland continues. "Smith’s research has shown they’re not portrayed in a positive light very often. This doesn’t line up with their perceptions of themselves, and that can have negative consequences for their health."
Humana has held two events with the Annenberg School and AtlanticLive to share the research, where Humana doctors spoke alongside Smith about the research, aging, and seniors.
"There’s an opportunity for Humana to make a real contribution to help seniors age with optimism," Noland explains. "When you age with optimism, it can have a good effect on your health."
Rather than simply encouraging seniors to get checkups or take medications, the campaign focuses more on improving mental and emotional health and how something such as negative stereotypes can affect physical health.
The comms team has a simple mission: "to protect and enhance Humana’s reputation," says Noland.
He wants every piece of content that goes out, whether it’s a tweet or a video interview with an executive, to contribute to that mission.
"Humana’s reputation is a company that is committed to improving the health of the people it serves holistically," he continues, emphasizing holistically. "It’s not just physical health, it’s also mental and emotional. It even has to do with the ideas of spiritual health and belonging. All of that plays into what we consider holistic."
To protect and enhance
Noland explains his work to protect and enhance Humana’s reputation comes down to three things: corporate volunteerism, good media relations, and content creation.
Humana’s emphasis on volunteerism is a reputation boost. Noland acts as the liaison for the Humana Foundation, the philanthropic arm of the organization, and oversees the company’s CSR initiatives.
"Because we have 50,000 employees, we are able to make a big impact through volunteerism in the communities we serve, and that contributes to reputation enhancement," he explains.
Many on his comms team are former reporters just like Noland, who worked at The Atlanta Constitution, which he believes helps them understand what media need when they come to Humana for a story, and helps create good relationships with the journalists who cover Humana.
Noland calls the PR industry’s move to social media and content creation a "tectonic change."
"When I first broke into the business, you had to depend upon other people, primarily the media, to get your news out," he recalls. "You would send out a news release and hope The Wall Street Journal would use it. You don’t have to do that anymore. In the new era of social media, a lot of what you do with reputation is up to you."
One of the reasons Noland has had such a long tenure at the company is because of the impact both he and Humana have had on Louisville.
"We’re a high-profile company locally; we’re the second largest employer in the city, and we are deeply involved with many of the arts and human services charitable organizations in town," he notes.
Noland’s interests and Humana’s corporate interests line up well. He currently serves as chairman of the Louisville Fund for the Arts, and the Humana Foundation is a supporter of the local Actors Theatre of Louisville and puts on an annual festival of American plays with the group.
Humana’s focus on improving the health of the Louisville community also resonates with Noland.
"The arts are my personal interest and have been one of Humana’s corporate interests for many years," he explains. "The idea of being in a company that can have a major impact on its home community is deeply appealing to me."