• Trust Index Report
• Deadly Spin
• Uncovered

The lay of the land 

• Health plans historically integrated horizontally but now are integrating vertically, expanding their power within the healthcare industry.
• Growing payor reach and control creates a power imbalance that allows payors to force providers into minuscule reimbursement rates. This power imbalance works to the detriment of healthcare consumers.

Trust Index results reach rock bottom 

• For the last 12 years, ReviveHealth has published an annual Trust Index report which measures the level of trust between payors and providers based on honesty, reliability, and fairness. The Index represents 40% of the hospitals in America.
• This episode of The No Normal Show examines this year’s results featuring health plan executive turned whistleblower, Wendell Potter.
• We thought that COVID-19 would rally the entire healthcare industry to solve problems together for the common good. Instead, the Index showed the greatest decline in trust in the past 12 years – a 34% decrease year over year.

Uncovering the factors at play 

• Health plans influence policy and the public through massive and expensive lobbying campaigns. This practice shifts blame for exorbitant healthcare costs to providers.
• Health plans unilaterally alter language in provider manuals that fundamentally reduce how much they reimburse providers for care.
• Health plans are accountable to shareholders, which means that their core objective is to turn a profit and lower utilization costs.
• Health plans are increasingly denying claims or requesting retroactive analysis with little explanation while also increasing prior authorization requirements and out-of-pocket costs. This delays treatment and increases costs for providers.

Think of your favorite book. Is it your favorite because the synopsis on the back cover was really good, or is it your favorite because of the storyline and the interplay of characters? We'll admit — we kind of set you up for that one, but hear us out: sometimes (not all the time) to get the full value of content, you just have to experience the entire thing. This is one of those times. 

But, of course, we're not going to leave you hanging if you're not convinced. Here are a few of the questions posed by our audience and answers they received from ReviveHealth's CEO, Brandon Edwards, and EVP, Chris Bevolo.  

• Unpopular opinion: While the dust may be settling, we are undoubtedly still in the No Normal and will be for a long time. For example, new variants in Michigan have caused hospitals to delay surgeries again to deal with an influx of hospitalizations.
• Even as businesses start to reopen, we have to remember that the world has been changed for good.
• We must accept these changes and re-establish our identity in this changed world. Who are you? How is your health system different? Who are you competing with?”

• It would be remiss to ignore the limitations and significant lack of funding health systems faced during the pandemic.
• If adequate resources had been available, we would have hoped health systems would have dispersed care sooner rather than requiring patients to navigate complex medical campuses. 

• Many health systems spend their growth budget on acquisitions rather than looking internally to their marketing teams.  Communicating the value of your team may be challenging, but it is possible. 
• Marketing and advertising are often (and mistakenly) used interchangeably. As marketers, we know that "marketing" is much more than that. Communicate that marketing means setting price strategies, developing messaging for target markets, filling your funnel, and keeping it full. 

As for the rest, you'll just have to listen to the episode for that. (:

• United Airlines "Fly the friendly skies" campaign
• Delta Airlines personalization example

Why brands are like people 

• Brands are kind of like people – some you want to be around, some you don’t. Modern brands build positive connections with their audiences through thoughtful interactions.  
• Healthcare is inherently “human,” which gives healthcare brands an opportunity to build lasting connections with their communities. 

Lead with authenticity 

• Above all else, modern brands must be authentic. Align with your purpose and values and stick with those values in every action. 
• If there’s an opportunity to prove your authenticity, take it. Actions speak louder than words, and today’s distrustful consumer requires consistency of action to build trust. 
• Authenticity requires brands to communicate transparently, and it doesn’t have to be at the cost of creativity. You can have creative and honest conversations with your audience.  

Listening could be your competitive edge 

• You can't have an in-person conversation with everyone, but you can use technology to understand your audience and personalize their experience of your brand. 
• Listening to your audience opens the way for a two-way conversation, building brand relationships more effectively. 

Surprising consumers in creative ways 

• People are familiar with advertising, so we have to meet them in unexpected ways in unexpected places to capture their attention. Powerful creative can significantly impact a brand’s ability to engage its audiences. 

• Who is the COVID-19 vaccine for?
• Why you should be looking closely at Optum's acquisition of Change Healthcare

We've changed ... now what?

• COVID-19 spurred new trends in how health systems deliver care, including the pace of play, focus on alignment, consumer attunement, and inclusive branding.
• Healthcare marketers should continue these trends into the future to maintain footing within our increasingly competitive industry.

4 trends here for the long haul

Pace of play:

• Healthcare marketing teams are now working at a new rate of speed, agility, and decision-making. We should continue to seek opportunities to improve agility.

Focus on alignment:

• Health systems have been focused on alignment between people, processes, and delivery, which has opened a “seat at the table” for marketers.
• In order to keep this seat, marketers must challenge themselves to do fewer things better whenever possible.

Consumer attunement:

• Consumers are first – a truth that’s never been clearer to our industry and the leaders within healthcare organizations.
• Use this time of enlightenment to reintroduce conversations about modernizing the patient experience and connected digital infrastructure to drive personalized marketing.

Inclusive Branding:

• Many organizations treat DEI like a mission trip – help a little and then return home. This behavior makes it hard for communities to trust that health systems have their well-being in mind.
• We must acknowledge that we can’t market ourselves to trust but must make a long-term commitment.

• Setting the stage for Rapid Renewal
• Consumer trends report
• Amazon expands Amazon Care
• Chicago Trump Tower vaccinated early – thanks to hospital COO who lives there
• DispatchHealth raises $135.8 million in series C

Introducing Rapid Renewal

• Rapid Renewal is a phase of the No Normal representing healthcare's recommitment to long-term transformation. 
• COVID-19 accelerated transformation in healthcare with much of the groundwork done by competitors vying for top-of-funnel services and insurers with eyes on health systems' margins.
• Catering to emerging trends such as dispersion, mistrust of experts, and worship of crowds in marketing plans will give hospitals systems a competitive edge.

Dispersion – it's time to focus on "how" instead of "where"

• Dispersion is the re-distribution of efforts and resources to remove unnecessary friction and costs. Applied to healthcare, this means creating a fluid customer experience – independent of location.
• Shifts away from traditional care delivery models such as Amazon Care and DispatchHealth tighten the race for top-of-funnel-services by increasing care convenience.
• To counter these forces, health systems must renew the way patients interact with their brand to offer a better care experience.

In vogue: mistrust of experts

• Between COVID-19 and socio-political unrest, 2020 saw a deep erosion of trust in government health institutions like the CDC or even CMS. 
• Health systems and hospitals now have an opportunity to own the role of "trusted health expert" but should tread cautiously to maintain this newfound trust. 

Goodbye, top-down marketing

• The public's trust no longer belongs to experts but instead to the crowds. To account for this change, healthcare marketers must start talking to people, not at people.
• To garner top-of-funnel engagement, healthcare marketers should look away from top-down marketing and transition to influencer, word-of-mouth, and peer-to-peer referral marketing. 

A wide geographic footprint doesn’t come without its challenges 

• Spanning 29 states, LifePoint Health needed to keep a constant pulse on the state initiatives affecting each of its markets. This required a clear and constant line of communication with the compliance team.  
• The marketing and communications team’s greatest challenge was tracking and responding to changes across markets. For instance, South Carolina was the first of their markets to have a COVID-19 case, and therefore needed different communications than other markets at the time.  
• LifePoint was able to take learnings from each of its markets to iterate and refine marketing efforts.  

Getting standardization and localization to work in harmony 

• Local market leaders and corporate LifePoint Health strategists worked in tandem to produce effective results across state lines. 
• Focus on service line marketing vs. branding depends on the competitive nature of the market. In more isolated markets with less competition, branding is less of a priority, but in highly competitive markets, branding takes the stage. 

Earning that coveted “seat at the table” 

• COVID-19 has highlighted the importance of marketing and communications teams in achieving health system objectives. Now, it’s up to us to demonstrate our strategic worth by supporting organizational initiatives. 
• Maintaining marketing’s position as a strategic partner calls for targeted hiring initiatives, alignment on strategic plans for the market, and executive buy-in. 
• When communicating with executives, make sure you’re speaking to the value points they care about. For instance, CFOs and CEOs will likely care more about the bottom line and ROI, whereas CNOs may care more about clinical quality. 

• If air travel worked like healthcare 

Definitions shape how we see consumerism 

• The way we understand “consumerism” has changed to focus on transaction rather than choice.
• Language shapes our relationships with the world, and healthcare often looks at consumers too narrowly. For instance, “patient” may not be the most personalized way to describe a relationship to a hospital.
• We should look at consumerism more holistically – in a way that accounts for needs beyond just the rational.

The power of digital experiences in shaping your brand 

• Technology adds to the consumer experience, but it is not the experience. Digital exists within the end-to-end journey, fitting seamlessly with non-digital experiences.
• Transitions between digital and in-person encounters must be seamless, or else new pain points will arise.

How Intermountain caters to the consumer experience 

• Intermountain implemented My Health + to allow consumers to check symptoms conveniently, effectively, and affordably. This experience is tied intimately with follow-ups, labs, etc.
• Intermountain improved the patient-nurse relationship by making feedback loops more human-oriented and less task-oriented. Healthcare seems incredibly different from Disney, but the same human factors come into play. For instance, safety is a top priority not just for health systems but also for airlines, Disney, and beyond.

• New Consumer Survey Findings Report
• California vaccine sites see misuse of codes meant to prioritize Black and Latino residents
• Last week’s episode with Amy Comeau at Emory Healthcare
• Vaccine makers Pfizer and Moderna pledge massive boost to U.S. supply after sluggish rollout
• Five Long-Term Consumer Behavior Changes Due to COVID-19
• Retail Health Clinic Engagement Rising; May Be Key to Supercharging COVID-19 Vaccine Rollout

Health systems' future role in vaccine distribution

• Health systems haven't been set up for success in vaccine distribution, often hearing about related government decisions at the same time as the public.
• Your hospital cannot control the unknown, but it can manage expectations. If you cannot offer insights into a future state, then offer context – how vaccine distribution has evolved, why vaccine allocation isn't ideal, which rollout challenges your system is facing.
• Continue your hospital's position as a trusted healthcare authority – even if it means you can't always be the one to execute. For instance, if you lack adequate vaccine supply, you can maintain patient trust by referring the patient to a specific location.
• Israel has been the fastest to roll out vaccines, and they’ve hit a tipping point where supply outpaces demand, forcing the country to double down on vaccine education efforts.  U.S. health systems should prepare to act as educators as we get closer to achieving herd immunity.

Ways to co-exist with retail while staying competitive

• Retailers have entered the COVID-19 vaccine discussion, posing a long-term competitive threat to health systems.
• Lower patient volume for top-of-funnel services like vaccinations reduces the number of opportunities within health systems' more profitable mid-to-bottom-of-funnel services.
• To stay competitive, hospitals should consider ways to stay visible to patients for low-margin procedures like vaccinations. That's why we recommend that health systems do not lay off vaccine efforts.

What to prepare for if you decide to step back from vaccine distribution 

• If your health system chooses to pause, stop, or scale back on vaccine distribution efforts, you should prepare a plan to maintain mid-to-bottom-of-funnel patient volume.
• Scaling back on vaccine distribution could impact your health system's ability to secure supply in the future. Be sure to prepare for this whiplash effect if your system chooses to pause, stop, or reduce vaccine distribution efforts.

• Data Confirms Alarming Trend: Covid-19 Fears Are Causing Americans to Avoid the Doctor’s Office and Delay Routine Care 
• Use and Content of Primary Care Office-Based vs Telemedicine Care Visits During the COVID-19 Pandemic in the US 

Defining your COVID-19 CRM strategy

• Emory healthcare implemented a CRM strategy in 2019 but had no real intention of mass communication with patients until COVID-19 hit. 
• With more resources pointed toward crisis communications, Emory Healthcare now utilizes their CRM for monthly communications with patients from their CEO. 
•  Amy Comeau predicts this increased emphasis on CRM communications will continue long-term as the COVID-19 landscape evolves. 

Why re-evaluating community partnerships is a good idea 

• Relationships with community and senior centers offer health systems opportunities to reach patients beyond their EHR or CRM. 
• Emory Healthcare hosts virtual sessions with community centers. These sessions offer engagement significantly beyond in-person information session benchmarks.

Forming a 2021 marketing and communications strategy

• It's hard to imagine a world where healthcare branding moves beyond COVID-19 messaging and creative. Healthcare communications should reflect this truth for the foreseeable future.  
• Healthcare marketers can prepare messaging strategies by defining responses based on pandemic severity. For instance, if variant infections accelerate, your team should plan for communications encouraging the public to wash their hands, wear a mask, and watch their distance. 
• Health systems are learning how to balance crisis response needs with existing business objectives. With this knowledge, marketers are now leaning back into high-margin revenue streams.

How to make the media your ally, not your enemy

• Take a transparent, partner-first approach to media, leveraging their networks to get standardized information to the public.   
• Baystate Health invites the media to virtual briefings in which the health system answers media questions in the order of the RSVP list. This approach reduces the number of duplicative inquiries, standardizes messaging, and builds trust.  

Managing misplaced blame for vaccination challenges

• Some states are more conservative in their vaccine rollout, which can cause confusion – especially for those who live close to state borders and hear mixed messaging. 
• With close to three vaccines on the market, the public expects a new level of consumer choice that isn't necessarily accessible.  
• Consumers often get conflicting messages from different authorities. When setting your system's response plans, pick a lane and stick with it. For instance, Baystate health has aligned with the state Department of Health and CDC. 

Planning for brand evolution in 2021

• Health systems have earned a lot of public trust during the pandemic, but vaccination variables may threaten this goodwill. Branding after COVID-19 may need to involve reputation repair.  
• Healthcare will have to keep COVID-19 messaging much longer than other industries, but it's not clear for how long. We expect the next big focus to be managing challenges related to delayed preventative care.  
• We can use this period of uncertainty to update and refine our current marketing assets. For instance, health system marketers can focus on improving SEO, physician profiles, and landing pages.