Managed care hopes Hollywood can help sway a cynical publicIt's not only the pharmaceutical sector taking its share of lumps. In fact, these days, the healthcare industry as a whole is coming under fire. Whether it's high-profile mergers, election-year grandstanding on healthcare legislation, or the perennial controversies attending the approval of new drugs and their cost to consumers, industry issues are always high on the news agenda because they hit home. It is an industry with which every consumer has an intimately personal relationship, and as Americans struggle with the concept of healthcare as a for-profit business, healthcare PR must labor to rein in negative perceptions. Like their pharmaceutical siblings, managed-care companies have had their share of tribulations. "We're lucky that there is still tobacco out there to make us look good," jokes Ken Ferber, staff VP of corporate communications for WellPoint, a managed-care giant that handles a portfolio of programs with an enrollment of nearly 50 million, including California's MediCal and Blue Cross. "Dramatically changing science and the financial nuances of insurance are not concepts easily understood by the general public. There is a disconnect in communication because it is such an incredibly complicated area," says Ferber, adding that it took him a year to fully understand health insurance. Among Wellpoint's staff of 17,000 is a small internal PR team of 10 that handles corporate communications and IR, working with Weber Shandwick Worldwide's Powell Tate on a national level. The organization responds to the misunderstandings about managed care by opening its doors to reporters and making senior staff available to them. "You need to utilize the reporters who are experienced so that they can correctly tell the story," says Ferber. Informed reporters are often the chief communication channel between managed-care groups and local communities. "A change in reputation is going to depend on how a health plan gets involved locally with medical organizations and hospitals," says Eve Dryer, president and founder of healthcare PR agency Signova. Although health plans often offer services on a national level, consumers are chiefly concerned with their own doctors and experiences. "In communicating the role of managed care to the public, we need to focus on it less as a national philosophy and more as a local brand of healthcare," explains Dryer. Outreach to physicians groups, revamped websites that ask more questions, and an increased focus on evidence-based medicine are among the efforts being made to help Americans rethink their views on managed care. Michele Parisi, SVP and director of West Coast global health for MS&L, admits to having entered the sector with the perception that managed care was not entirely well intentioned. She says it wasn't until she began working for managed-care clients that she realized what an "incredible rock and a hard place" they often find themselves between. "Once I was educated about the organizations, I couldn't believe they were doing all that they were. Our job is to help them communicate their challenges in a way that helps the public understand that health plans are designed to benefit them." Much distrust of managed-care organizations can be attributed in large part to the nature of what they strive to do - control internal costs while offering optimum healthcare. The negative sentiment can also be partially chalked up to a perception of powerlessness on the part of consumers. But communications professionals potentially have the power to influence, and in turn, alter negative perceptions of health plans. TV gets mixed reviews A report issued by the Kaiser Family Foundation - As Seen on TV: Health Policy Issues in TV's Medical Dramas - asks the question: What ideas does the US' mass media present to Americans about health policy issues? The authors -Joseph Turow, PhD and Rachel Gans - examine the way in which ER, Strong Medicine, City of Angels, and Gideon's Crossing portray issues facing managed care, and then conclude how these shows affect public perception of the sector (see sidebar). The report finds that 50% of scenes on the dramas involving healthcare policy disputes were presented in an "evenhanded manner," and that "the programs may help stimulate thought and discussion by showing people how health policy issues might play out in 'real' people's lives." However, the study found that "other aspects of the healthcare policy scenes may have worked against public knowledge and action." Turow and Gans point out that doctors are most often shown dominating conversations about health policy issues. "Patients, their friends, and relatives had little input into policy arguments - and a higher proportion of the input they did have was depicted more unfavorably than it was with healthcare professionals," they say. Furthermore, "Series in which doctors are depicted as dominating the arena do not suggest that the healthcare system invites, or even provides opportunities for public involvement in key debates about health policy issues." Kaiser is not the only group that has drawn a connection between the perception of managed-care groups and the way in which they are portrayed on television. Last month, the American Association of Health Plans (AAHP) teamed up with Hollywood talent agency William Morris as part of its long-term effort to improve the image of managed healthcare plans. The AAHP says its health plans, covering 170 million Americans, will save participants over $200 billion in healthcare costs over the next five years. It believes that the bad reputation acquired by some managed-care companies is due in large part to the negative way they are portrayed in movies and TV shows. "We need to get to all the places that healthcare news is coming from," says the AAHP's chief of strategic planning and public affairs, Mark Merritt. "And we can't do that if we neglect Hollywood." The initiative, which Merritt terms "a public affairs effort that joins Washington and Hollywood," was designed to position the group as a resource for writers and producers in the entertainment industry. It would seem that the AAHP, and the communications teams working with them, have a lot of work to do before opinions start changing. "The original announcement that we were teaming with William Morris was announced in the beginning of July," says Mohit Ghose, AAHP spokesman, "and we are still getting calls from people who are surprised by it." Reaching the widest audience Speaking through Hollywood is likely to alter public perceptions of managed care groups over time. But communications pros representing health plans are also faced with the challenge of addressing audiences beyond the big screen. "In order for us to do a good job with our managed-care clients we have to understand physicians, hospitals, the patients, their families, HR departments, and senior executives who often make decisions about these plans," explains Laura Schoen, president of global healthcare for WSW. "In other areas, you can do PR with one voice, but here there are so many complex groups to deal with." Addressing the needs of all groups involved in the industry is key to developing an environment in which the different sectors of healthcare can feed off one another, rather than taking turns playing good guy and bad guy. "What I would like to see is for the pendulum of villainization between pharmaceuticals and managed care to stop swinging," says Dryer. Fast and furious news cycles often create situations in which projects need to be dropped when a piece of impactful information - accurate or not - appears in the media. It is imperative that when one sector of healthcare is under fire, another is there to pick up the slack, as opposed to wiping its brow and being thankful it dodged the bullet that time. With such a large percentage of pharmaceutical company customers paying for products through managed-care plans, they must reach out to their managed-care colleagues. Most pharmaceutical firms have staff members who focus on managed care, such as Janet Caldwell who works in public affairs for managed markets at AstraZeneca. "Managed care was set up to manage overall healthcare," says Caldwell. "It isn't just about providing coverage for the corporations that subscribe to the plans." Equally, managed-care companies stand to benefit from the wealth of consumer insights amassed by pharmaceuticals firms over years of market research. "Successful health plans are all about reaching out to the local community, and the pharma world has put effort into getting to know consumers for years," says Dryer. "It is a logical collaboration."
NOTE: A health policy incident is a storyline within a program episode
that deals with a specific health policy issue one or more times.
MOST FREQUENT ISSUES RAISED IN HEALTH POLICY INTERACTIONS
Patient rights 14
End of life 14
Clinical trials 4
HEALTH POLICY ISSUES IN TV MEDICAL DRAMAS
Number of health policy incidents
Program Coded Incidents per Hour
City of Angels 10 9 .9
ER 22 30 1.36
Gideon's Crossing 20 13 .65
Strong Medicine 22 24 1.09
Total 74 76 1.06
NOTE: A health policy incident is a storyline within a program episode that deals with a specific health policy issue one or more times.
MOST FREQUENT ISSUES RAISED IN HEALTH POLICY INTERACTIONS Issues Frequency Malpractice 37 Patient rights 14 End of life 14 Disparities 6 HMO 5 Clinical trials 4 Biotechnology 4