Managed Care Cos. Begin To Confront Poor Image

NEW ORLEANS--Managed care executives were staggering under the force of media attacks last week when they convened here for the first annual meeting of the American Association of Health Plans.

Incoming chairman Michael Herbert acknowledged the barrage during his inaugural remarks, by showing a series of editorial cartoons lampooning the industry. One featured St. Peter greeting a health maintenance organization executive who had reached the gates of heaven. "Come in," St. Peter said. "But your stay is limited to three days."

Mr. Herbert, president of Physicians Health Services Inc., Trumbull, Conn., said AAHP members have let vested interests batter managed care through "attacks by anecdote." "We have to do a far better job than we've done to date in telling the world how good we are," Mr. Herbert said.

But public relations advisers said AAHP will have to break through a wall of skepticism to persuade consumers that managed care organizations care at least as much about improving care quality as they do about restricting treatment choices and increasing their profits.

Two large managed care associations, the Group Health Association of America and the American Managed Care and Review Association, merged last fall to form AAHP partly so that they could improve their public relations efforts, AAHP executives said.

AAHP hired Goddard Claussen/1st Tuesday, a Washington public relations firm, to develop an industry positioning campaign. The campaign includes lobbying by managed care plans and plan members, educational efforts aimed at reporters, and paid print and broadcast advertising, AAHP said.

Goddard Claussen has produced three AAHP television commercials and a public service announcement. They began a five-week test run in April in Sacramento, Calif., Albany, N.Y., and Tallahassee, Fla.

The commercials suggested that MCOs promote preventive care and strong partnerships between physicians and patients.

One-third of consumers surveyed in the test markets remembered seeing the commercials at the end of the run, said Guy Molyneux of Peter D. Hart Research Associates, Washington.

But more than half had read, heard or watched negative news stories about managed care before the commercials aired, and the percentage was even higher at the end of the run. "In focus groups, phrases we hear a lot are 'supermarket medicine' and 'factory medicine,'" Mr. Molyneux said.

The commercials produced no measurable change in the consumers' views on managed care, Mr. Molyneux said.

Ben Goddard, president of Goddard Claussen, thinks consumers liked the philosophy expressed in the commercials. "But they're not sure we really mean it," he said. "People said, 'Yeah, show me.'"

AAHP is asking member plans to show consumers they care about patients by adopting the group's Philosophy of Care. The code calls on plans to offer information about plan operations, timely access to care, a choice of highly qualified physicians and decision-making processes that include patients and families as well as physicians.

"This indeed is our code of ethics," said Karen Ignani, AAHP president. "Consumers want to hear this from us. Unless we take this seriously, I think other people will continue to define us."