At a time when American policymakers are looking closely at healthcare costs and questioning the future structure of the Affordable Care Act, their checkbooks remain open to new health/tech ideas that reduce cost, improve institutional efficiency and patient care.
These wild swings between saving and spending are not schizophrenic decision-making. Rather, health decision-makers are shifting from a what-something-costs to a value-based, return-on-investment framework.
This paradigm shift is deeply ingrained across all facets of health policy and communications. Once, product innovation and formulary status were sufficient to make the PR investment a smart move. Now position on the formulary, even payer rebates, and co-pay card awareness, are critical parts of PR plan consideration.
In this evolving U.S. environment, companies will no longer question whether PR is a business imperative; they will question whether the communications output is a positive for their business mission, message, and outcomes.
Health PR/public affairs pros will have a greater voice at the client table if they take time to learn broad economic and environmental forces—and how they influence patient care, medical service, and product innovation access.
Below, three key environmental factors today’s PR pros must understand to provide strong client counsel.
1. Pricing: Perhaps the most obvious economic and policy hot topics are questions about drug pricing and cost of care. The seismic administration changes, president-elect Donald Trump and his selection of Sen. Tom Price for HHS secretary, signal Affordable Care Act transformation and a reopening of the access and cost debate for all sectors of the healthcare chain, perhaps with even greater intensity. (Note most Senate inquiries on drug pricing occurred under a Republican majority.) In fact, the motivation behind attacks on pricing outliers such as KC Pharma, Valeant, Turing and Mylan is deeply rooted in two value-based questions: 1) What is the basis for this price in the first place? and 2) Is the cost worth the patient-care result?
Companies—and their communicators—must be prepared to address the imperative of communication around pricing. The culture of our messages, and our advanced planning, must mirror the emphasis on value to be effective.
2. Shifting Patient Habits: Long before the Affordable Care Act and 2016 presidential election, the American health system was undergoing shifts that influenced disease rates. Recently, the Centers for Disease Control and Prevention(CDC) reported we are slipping backward in life expectancy. Death rates for heart disease—which fell nearly 70% from 1969 to 2015—rose 0.9% last year, a statistically significant increase. This is among many examples showing something amiss within the U.S. health system, often tracing back to gaps in primary care.
Part of the challenge for public health communicators is that preventive care requires Americans to have a primary-care physician relationship. Yet consumers’ relationship with a health insurance plan lasts three to five years; Americans switch primary-care physicians just as often. The emphasis on cost and convenience means that walk-in clinics, telemedicine and other forms of convenient care are on the rise. More and more, doctors lack visibility into patient needs; patients have no connection to doctors.
Consumer knowledge about disease awareness, signs, symptoms and prevention is critical to participation in their healthcare. Suddenly, the historic marketing communication of “see your doctor” or “know the signs and symptoms” fails to carry the same weight; either they must be repeated, or incorporated into a strategy for front-page search-engine optimization (and made a priority investment).
3. Challenges in Continuity of Care: The system also is undergoing a massive transformation around patient data. As soon as patients switch plans and doctors, they must either transport their medical records or recreate their health history. This is inefficient. In most cases, patients become their own health historian, recreating their medical story.
Electronic health records (EHR) are just coming online. Fewer than 10% of hospitals used EHRs in 2008; now, almost 98% use some form of basic EHR system. The Health Insurance Portability and Accountability Act (HIPAA), though, inhibits physicians from sending a patient’s record to a new physician without signed patient consent.
Sharing patient health history across doctors’ offices and institutions is a maze. Protecting patient medical record security is a black hole. Many hospitals fail to see IT patient information management as part of their core mission, instead viewing it as a federal mandate forced upon them. Often, they deploy EHR systems without corresponding security to guard against hackers. Without trusting their data are safe and confidential, patients will be reluctant to participate. Institutions and health insurance plans must convince patients their data are safe as a reputation management priority.
What does this mean for healthcare PR? The value of PR remains constant: non-paid media reaffirming innovation value. Brands are producing groundbreaking innovations to improve the human condition. They must be equally innovative in using PR and policy to reach audiences that help close the sale or deploy investment dollars.
These questions around value of care—from how much a physician can charge to whether an innovative therapy should be readily accessible—already are reaching beyond the realm of health policy, and influencing PR’s role in brands’ business. For PR pros to provide value, they will need to understand how the health system works, its vulnerabilities and how process pitfalls impact program development, implementation, and measurement.
Thinking through how messages influence public opinion has long been the expertise of PR. More than ever, increased knowledge of health systems and economics will lead to greater patient benefits and campaign success.