In Pittsburgh we have a front-row seat for what has become a battle of national interest. Health care’s collective eyes are on Pittsburgh as the UPMC-Highmark battle wages on. Many in the Pittsburgh region, though, can’t wait for the saga to end.
The situation has progressed to this: UPMC has said it will not renew its contract with Highmark when it expires in January 2015 now that Highmark is entering the provider market by establishing the Allegheny Health Network to compete with UPMC. 
Both health care provider/payers are battling it out over subscribers and access through, among other tactics, a series of antagonistic television commercials aimed at consumers. Allegheny Health Network asserts it wants to provide the region choice by offering an alternative health system to UPMC, yet it also wants a contract with UPMC so that its health insurance subscribers can use UPMC facilities if they choose. UPMC balks at that, even though UPMC and its insurance arm UPMC Health Plan enjoyed that exact situation: its insurance was accepted at WPAHS.
I’ve been trying to figure out why these two systems are appealing to health care consumers who really have little choice in the matter. As it stands now, without some type of intervention, if you are among the majority of working people in this region who get their health insurance through an employer, you will have access to AHN if your employer chooses to contract with Highmark. You will have access to UPMC facilities if your employer chooses to contract with UPMC Health Plan (or, presumably, any of the other smaller players in the market that will be accepted at both facilities). It is part fantasy to believe that consumers have full choice when it comes to health care, yet health systems market to them as if they’re lives depended on it.
One industry insider with whom I recently met posed the same question I had: where are the region’s employers in all of this? Where do they stand on this? Shouldn’t the insurer/providers be marketing to the ultimate buyers using real cost and quality data, not some ranking that some service line earned from one of the many, many organizations that bestow these honors on hospitals, or, worse, fear-mongering? This person also said, “If I’m an employer, I’m going with Highmark.”
Not so fast, at least according to some.
I talked with another professional “in the know.” If employers are so concerned about controlling health care costs, and AHN is the lower cost, equivalent quality provider, isn’t it a no-brainer for employers, I asked? His answer: do you really think AHN provides the same quality care as UPMC? Do you really think you can get the same level of specialty care – cancer care, for example – at AHN versus UPMC? Do you think Allegheny General or West Penn provides the same quality care as Shadyside or Presby? And do you really think AHN’s seven hospitals geographically stack up to UPMC’s 16 Pennsylvania hospitals?
When it comes to certain specialties, the answer may be no, AHN does not stack up against UPMC. Take pediatrics. UPMC owns Children’s Hospital of Pittsburgh. Of course you should expect better pediatric care at Children’s.
But where data are available, the case for equal or better quality and lower costs at AHN facilities seems strong. The Pennsylvania Health Care Cost Containment Council (PHC4) is an independent state agency, based in Harrisburg, with the responsibility to collect, analyze and make available to the public data about the cost and quality of health care in Pennsylvania. Check out its most recent report on coronary artery bypass surgery and make the comparisons between UPMC and AHN hospitals yourself.
Except for what PHC4 publishes, cost and quality data have long been veiled. Each system will debate the merits and shortcomings of the PHC4 data. Instead of commercials featuring a whiny woman bemoaning that she can’t go to UPMC, why don’t these systems put their data where their mouth is? Start to communicate in a meaningful, authentic, contextual way to demonstrate why the community should choose you. Instead of spending millions on names, logos, billboards and beautifully scored and choreographed television ads, how about a meaningful story? Context cannot be placed on a billboard.
Simply put, story trumps brand. A health care organization’s Story, which is broader and deeper than its “brand,” provides a more robust, authentic and useful framework to engage patients and other stakeholders. It provides context. It is authentic. The institution’s story enables its leaders to showcase the true value of what they do in ways that do not have to be shoehorned into oversimplified brand “hooks,” tag lines or other premises.
In the 21st century digital age of transparency, patients are asking why they should get their care there, beyond the standard marketing claims about the region’s greatest heart care or orthopedics team, or the most advanced women’s health center, or the speediest emergency room. They go online to rate doctors, nurses and hospital systems. Their deep conversations about the value of a health care institution have nothing to do with the tagline or traditional branding tactics such as logos and colors.
So, if the premise that employers wield real power in this game has merit, and data can tell the quality and cost story, why are seemingly smart people spending millions to reach the end user? I suspected it was a misguided strategy that would have consumers (i.e., employees) putting pressure on their employers to go one way or another based on what they saw in advertisements (like pharmaceutical companies do today), as if employers would fold at the unrealistic threat that employees will seek alternative employment in droves in order to see the same doctor they have seen for years.
Maybe, but I’m told that what is more plausible is the notion that these antagonistic, fearful ads are intended to work over the community, paving the way for eventual legislation forcing UPMC to accept Highmark insurance. Who in the community would be opposed? Better yet, what lawmaker would vote against that?
I can see the argument that so much of the community’s money went into tax-exempt UPMC facilities that UPMC CEO Jeffrey Romoff should not be allowed to exclude the community from using them. But Highmark has tried to build a case for choice on quality and cost. So tell us a meaningful story. Forget the logo, colors and fear-mongering. Let’s see what you can do on substance.
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Jason Snyder is a senior vice president for WordWrite Communications.
