Former House Speaker Tip O'Neill (D-MA) famously coined the phrase, “all politics is local.” What the legendary Boston politician meant was that, if an elected official is to succeed, he must be sure everything he does connects to the folks back home.
One could make the same observation about healthcare and health policy. Despite what you've heard, everyone shares the same personal and local view of the healthcare delivery system: what will this mean to me? How will it impact my relationship with my doctor? Will it change anything at my local hospital? What is it going to cost me?
Legislators and regulators in Washington and state capitals are working today to implement healthcare reform, The Affordable Care Act. This means developing health insurance exchanges, designing the essential benefits package, and creating Accountable Care Organizations. Presumably, they are considering what all these changes will mean to healthcare delivery at the community level. My guess is that they have not yet begun to consider how to communicate these changes at the local level – a critical part of successfully creating lasting change.
In 2006, CMS began to administer Medicare Part D, the Medicare Drug Benefit. For seniors to access the benefit, each of them would be required to enroll in a plan. This meant that seniors needed to understand which plans were available in each state and region, which plans covered the drugs they were taking and how to sign-up. The process was so complicated it provided fodder for a famous Saturday Night Live parody. Yet, at the end of the initial benefit enrollment period, 85% of seniors had signed-up. Why? Research showed that most seniors found local help through their local Area Agency on Aging, a community health center, or local senior center to enroll them in the program.
Several years ago, we coined the word “communiology” at my company. Communiology means determining how a community operates, what links exist between organizations and institutions, the nature of specific community needs, who wields the greatest influence within the community, what communications networks already exist, what networks or channels need to be created, and what messages will be most effective.
Passing healthcare reform was simple. Making it work will be hard. The Affordable Care Act contemplates massive changes in the healthcare delivery system, changes that will impact all who touch and are treated by that system. This administration – and its successors – would be wise to remember the lessons of Medicare Part D and consider ideas like “communiology” as an essential component of implementing healthcare reform.
Robert L. Chandler is principal of Chandler Chicco Companies and SVP of marketing and communications and head of inVentiv Health Communications Europe.