TeamOverviewPlansbook2016

A Message From The Medicaid Team Leader:Leading the Alabama Medicaid account has been such a unique and valuable experience. I felt like I was learning constantly throughout this project, which was one of the greatest aspects about it. I also cannot imagine better team members to have worked on this account with. Needless to say, this project would not have happened if it weren’t for their talent and dedication. I am also grateful for the guidance and efforts of our adviser, Mr. Creek.

I think I speak for the entire team when I say there were good days, and there certainly were stressful ones throughout the course of this project. However, every challenge we faced gave us an opportunity to learn and I believe that’s the most valuable outcome of any campaign.

Emily ClackAccount Executive

TableofContents

Executive Summary

Problem Statement

Situation Analysis

SWOT Analysis

Communication Plan

Goals

Key Publics

Objectives, Strategies and Tactics

Communication Messages

Research

Timeline

Appendix

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ExecutiveSummary

The Alabama Medicaid Agency approached Capstone Agency in Fall 2015 with a desire for students to develop a name, logo and visual identity for Medicaid’s new, statewide Regional Care Organizations.

In order to assist the Alabama Medicaid Agency in reaching its overall goal of effectively communicating this system change to all target audiences through a visual identity, the Capstone Agency team worked to understand the implications of the new program, as well as the target audiences. Therefore, the team conducted in-depth research before developing name ideas and logo designs. Both primary and secondary sources were consulted in order to ensure a well-rounded understanding of the situation and to develop a visual identity for RCOs that conveys transparency and is recognizable to the key publics.

Gary Creek, Maret Montanari, Elizabeth Broussard, Jenna Heard, Claire Stuart, Emily Clack, Morgan McKinney, Robin Rawls

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TeamOverviewSituationAnalysis

Alabama Medicaid is changing and nearly 700,000 recipients who will be affected are currently unaware of the change and its implications.

The problem...

The Alabama Medicaid Agency is making a structural change that is going to affect how nearly 700,000 current recipients (and nearly 25 percent of the state’s population) receive their healthcare. In October 2016, Alabama Medicaid will implement Regional Care Organizations, which are locally-led, managed care systems intended to provide healthcare services to two-thirds of Medicaid enrollees at an established cost. Currently, the majority of recipients who will be affected are unaware of this change and its implications.

The Alabama Medicaid Agency faces many obstacles within the state in regards to its overall negative reputation in the minds of the general public. With the launch of Regional Care Organizations, it is important for Medicaid to be transparent and informative about the program and what it provides. The Alabama Medicaid Agency charged the Capstone Agency team with the task of creating an effective and approachable brand identity for RCOs in order to generate awareness of the program and communicate its purpose to Medicaid recipients, as well as to health providers, elected officials and the general public.

Through primary research of interviewing industry professionals and field testing, the Capstone Agency team gained valuable insight about the Medicaid system and RCOs, along with branding advice. One major challenge the team members faced was their lack of understanding of Medicaid due to having different socioeconomic backgrounds than most Medicaid recipients. Medicaid’s primary audience tests for low literacy rates and education levels; meanwhile, the team members typically think creatively and innovatively. For this reason, members of the Capstone Agency team used their research to create name and logo ideas with the audience’s viewpoint in mind.

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SWOTAnalysis

Strengths• The ability to capitalize on the general

public’s awareness of Medicaid

• The potential to shift the public’s current perception of Medicaid

• Taxpayers’ and legislature’s pre-existing negative perception of Medicaid due to expenses

• General public’s distrust in government agencies

• The possibility of Medicaid having to eliminate certain services due to lack of funding

Weaknesses

Opportunities• Alabama is under more national radar

than other states have been while implementing similar programs.

• The health industry is changing rapidly, and the creation of RCOs indicates evolution of Medicaid

Threats• The potential for recepients’ negative perception

and rejection of RCOs due to the fact that these people can receive free care by going to the emergency room

• Many Medicaid recipients are unhealthy and unable and/or unwilling to make lifestyle changes that a doctor recommends.

• The potential for negative reactions from hospitals due to the risk of losing patients and money

• Oppostion to the expansion and funding of Medicaid with the majority of the state identifying as Republican

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CommunicationPlan

Communicate to Medicaid recipients about the implementation of RCOs and the improved clinical quality and health outcomes.

Maximize the number of Alabama Medicaid recipients who choose an RCO rather than be assigned one.

Medicaid’s Goals

1)

2)

Objectives, Strategies and TacticsObjective: Generate awareness among all target publics of the implementation and purpose of Regional Care Organizations by July 31, 2016.

Strategy: Develop a visual identity for Regional Care Organizations that is effective, appropriate and recognizable for all target publics.

Tactics:• Create a name to replace ‘Regional Care

Organizations’• Design a logo to accompany the new name • Develop a visual identity guide book that

includes name/logo standards and the logo in all necessary formats

Key Publics:

1)

2)

3)Alabama Medicaid RecipientsAlabama Medicaid recipients are the primary audience, as RCOs will affect these people directly. The implementation of RCOs will change how two-thirds of current recipients get their healthcare, so they need to be aware of the change and its implications in order to understand how it will affect them. They will need to know where to go when they need treatment, and they should also understand they have the option to sign up with the RCO of their choice.

Healthcare ProvidersHealthcare providers are the secondary audience to consider in the branding development, as they will contract with RCOs. Providers must understand the system change because they will need to be able to explain RCOs to their patients. They also need to understand the change in their financial incentives, which will focus on the quality of treatment each patient receives rather than the number of patients treated.

Elected Officials and the General PublicElected officials need to know that the state’s healthcare system is changing and why. Since Medicaid is a government program, much of the state legislature is aware of RCOs. However, elected officials should understand the positive changes that RCOs intend to make so they can potentially support and fund the program and help improve the public’s perception of Medicaid.

The state’s general public must also be aware of the system change, as these are the people who pay for Medicaid’s services through taxes. Much of this audience currently has a negative perception of Medicaid and government programs due to growing costs and the belief that Medicaid is inefficient. Therefore, it is important to communicate to the general public that RCOs are intended to improve healthcare efficiency and control increasing costs.

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The University of Alabama’s Capstone Agency team and the communications director at Alabama Medicaid Agency worked collaboratively to identify key communication messages for each target audience. The Capstone Agency team used these key messages as a guide while developing name and logo ideas for Regional Care Organizations.

Key Messages for Recipients:

• Medicaid is setting up a new way for recipients to get their healthcare.

• Regional Care Organizations are a transformative change to improve Alabama’s healthcare and help recipients lead a healthy life.

• Each RCO is different, so recipients should understand they can choose their RCO based on which is best for them and their family; otherwise, they will be assigned one and will likely have a negative reaction to the change.

• If recipients want to stay with the same doctor, they need to find out with which RCO their doctor has signed up. If not, they will choose a doctor after choosing an RCO.

• Each RCO will offer recipients at least the same benefits they had on Medicaid before. In some cases, the RCO may offer more services or benefits than recipients had before.

CommunicationMessages:

Key Messages for General Public:

• Alabama Medicaid is taking steps to improve efficiency and control costs by changing the way healthcare is provided to Medicaid recipients. With RCOs, Medicaid will become more affordable for taxpayers, as well as more effective and quality-based for patients.

• The program will have new requirements to ensure that Medicaid recipients have access to care, that quality of care and health outcomes are improved, and that RCOs are incentivized to be efficient.

Key Messages for Providers:

• Regional Care Organizations are the result of a state law passed in 2013 and are a transformative change to improve Alabama’s healthcare and help recipients lead a healthy life.

• Regional Care Organizations will prioritize treatment quality over the number of visits through results-based financial rewards.

• Providers must be able to explain RCO changes to patients, and they must know what they need to do in order to keep their current patients.

• Providers should understand the changes they will need to make within their offices/practices (financial, administrative, clinical) once RCOs are implemented.

• Providers should understand how their relationship with Medicaid will change and that they will interact with RCOs instead of with Medicaid as they do now.

Key Messages for Elected Officials:

• Regional Care Organizations are a transformative change to improve Alabama’s healthcare and control costs. The program will not reduce costs, but it will control the rate at which they increase.

• Elected officials need to have a high-level understanding of how the program will impact their constituents.

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Research

The role of research was crucial in the creation of a name, logo and visual identity for Alabama Medicaid’s Regional Care Organizations. Formative research was required to gain an accurate understanding of the Medicaid program, who the program serves, and the importance of creating an easily recognizable visual identity. Additionally, formative research was necessary to understand the internal environment of Alabama Medicaid and the public’s perception of the Medicaid program in the state of Alabama. The Capstone Agency team conducted qualitative research through interviews with several stakeholders and individuals familiar with Alabama Medicaid, RCOs and the impact of implementing these organizations within the state. The team spoke with an academic expert in healthcare at a statewide university on Feb. 2, 2016. This expert has been involved in solving and studying many community health issues throughout her career. On Feb. 22, 2016, the Capstone Agency team met with the communications director for a large regional hospital located in Alabama, who provided the team with valuable insight from the perspective of a healthcare provider. Additionally, the Capstone Agency team sought the legal advice of Michael Spearing, the University of Alabama’s chief legal counsel, throughout the naming and branding process.

Key findings from interviews: • Large hospitals and providers are taking huge

risks with the implementation of RCOs, as they will likely lose money.

• Making significant improvements to the health of recipients who have led an unhealthy lifestyle throughout their entire life is nearly impossible for health providers.

• Medicaid recipients need some type of incentive to go to these RCOs rather than the emergency room, which is more convenient for them.

• The intended large-scale goals of RCOs make this effort different from similar programs in other states like Georgia’s PeachCare or Tennessee’s TennCare. Additionally, Alabama is under more national radar than other states have been while implementing similar programs.

• Alabama’s general public and legislature view Medicaid as an entitlement program, which often has a negative connotation.

• The name and logo must be easily recognizable to Medicaid recipients, who tend to have low literacy rates.

• Trademark law is a major component in the naming and branding process. It is necessary to seek a trademark lawyer or outside firm in order to guarantee that the name or logo has not been used previously and to avoid any type of infringement.

After receiving input from Alabama Medicaid employees and other stakeholders, the Capstone Agency team narrowed down the name concepts to Monarch Health Network and Alabama Access. The team then gathered quantitative data from Medicaid recipients by field testing the two final name concepts and several variations of logos and colors. The field testing took place at a local women’s center and the Tuscaloosa County Health Department on Feb. 22 and Feb. 23, 2016.

Prior to field testing, recipients were given a brief overview of the branding process for RCOs. During field testing, recipients were first asked to choose between two final names: Monarch Health Network and Alabama Access, with no accompanying logo or colors. Based on their response, recipients were then shown two different logos in black and white to determine which logo they liked best. Finally, participants were shown the name and logo of their choice in two different colors and were asked to choose the color combination they liked best. See the next page for our field testing flow chart.

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AlabamaAccessMonarch

FieldTesting1

1 1

2

2 2

Choose a logo:

Choose a name:

Choose color:

The majority of participants chose the name Alabama Access, with variations of logos and colors. Many healthcare providers at the maternity center and health department also provided feedback and suggested Alabama Access would be easily identifiable by all audiences.

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Timeline

December 4, 2015

February 3, 2016

January 20, 2016

January 2016

February 7, 2016

February 17, 2016

January 27, 2016

February 15, 2016

February 5, 2016

Initial conference call with client

Phone interview with Academic Healthcare

Expert

Weekly client phone call

Gathered formativeresearch

Weekly client phone call

Weekly client phone call

Weekly client phone call

Team meeting with Regional Hospital Communications

Director

First round client review in Montgomery

February 24, 2016 March 23, 2016

March 30, 2016

March 9, 2016

February 23, 2016 March 21, 2016

Weekly client phone call

Weekly client phone call

Weekly client phone call

Weekly client phone call

Field testing at Tuscaloosa County Health Department

Found out final name is in use by another

organization

Project put on hold due to lack of

funding

February 22, 2016April 1, 2016

April 6, 2016

February 29, 2016

Field testing at local women’s center

Meeting with Chief University Counsel Michael Spearing

Conference call with Robin and the Medicaid

team to decide final logo

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Appendix

Planning

Project Brief

Weekly Call Agendas

Interview Recaps

Deliverables

Logos

Visual Identity Guide

PowerPoint Template

Press Releases

Campaign Dilemmas

Team Information

Meet the Team

Lessons Learned

Secondary Sources

Thank You

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Planning

Project Brief:

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Weekly Call Agendas:

12.4.15 1.20.16

1.27.16 2.3.16

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2.7.16 2.17.16

2.24.16 3.9.16

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3.23.16 3.30.16

InterviewRecaps

Interview with Academic Healthcare Expert

The Capstone Agency team’s interview on Feb. 3, 2016 with an academic expert in healthcare at a statewide university helped the team understand the contrast between Alabama’s Regional Care Organizations and similar Medicaid programs in other states. For example, RCOs are often compared to Georgia’s PeachCare. However, PeachCare is a healthcare program specifically for uninsured children; Regional Care Organizations will apply to more than just children. This individual also informed the team that RCOs are based on the model of Alabama’s Community Care Network , which is a non-profit organization that she helped develop. Additionally, she explained that the state of Alabama is under more scrutiny than other states have been while implementing similar programs, as they are waiting to see how effectively Alabama will implement and fund RCOs.

This expert explained that large hospitals in the state of Alabama are taking on the majority of the risks that will accompany RCOs because these hospitals will be running the program in each region. She provided the team with names of individuals who work in these hospitals and who would be valuable sources to speak with about these risks.

Finally, this individual provided the team with information regarding the current public perception of Medicaid, which is that Medicaid is an entitlement program and a political issue. She stressed the importance of communicating that Medicaid’s programs are more than just a political issue. Furthermore, in order to improve the public’s perception, it is important that the legislature shifts its view to one that sees Medicaid as an aid to those who need health services, rather than a government handout or political issue.

In terms of name concepts for RCOs, this individual immediately rejected Camellia Care and Sweet Home Health, as she believed they were predictable. While she did not suggest any additional names, she said it would be best to have the name and overall visual identity convey a sense of community.

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Interview with Regional Hospital Communications Director

The Capstone Agency team’s interview on Feb. 15, 2016 with the communications director of a large regional hospital in Alabama provided team members with information regarding the basis of the Medicaid program, who it covers, and the risks healthcare providers face with the implementation of RCOs. This individual explained that Medicaid best serves pregnant women and children but often neglects other individuals who may qualify for Medicaid, such as young men, as well as women who are not pregnant.

Furthermore, he explained that funding for RCOs will be provided to each region by the state government, and the amount is based on the number of covered lives in each region. At the end of each fiscal year, any remaining funds will be kept by each hospital system. In the event that there are no funds remaining, or if these hospitals run out of money, they will be forced to incur the costs needed to serve Medicaid recipients. This factor is why hospitals and healthcare providers face the most risk with the implementation of RCOs. The interviewee also pointed out that this is why only the poorest people within the state’s population qualify for Medicaid and not necessarily the people who truly need it.

This explanation also helped the team to further understand the incentive for providers to improve treatment quality. Regional Care Organizations aim to change providers’ incentive of fee for service to education and prevention. However, as this individual pointed out, reversing a patient’s entire life habits (ex. drinking, smoking, unhealthy eating, etc.) is basically impossible for doctors to do. Therefore, it is inevitable that the patient will continue having health problems and making visits to the doctor. Ultimately, as long as public hospitals exist, a system like RCOs is not likely to prevail because Medicaid recipients need an incentive to visit a specific RCO rather than visiting the closest emergency room, where they are guaranteed health services.

The Capstone Agency team showed this individual name ideas and logo drafts, and he advised the team to be especially careful when choosing logo colors. He pointed out that the color combination of one of the logos was too close to Blue Cross and Blue Shield and also told the team to make sure the colors would appeal to the entire state. For example, he noted that red may be associated with The University of Alabama. As for name ideas, he said he did not feel that the Monarch concept communicated the idea of health.

Camellia Care Concept Draft Logos:

Deliverables 33

Monarch Concept Draft Logos:

Alabama Access Concept Draft Logos:

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Final Logo:

Visual Identity Guide:

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PowerPoint Template:

Press Releases:

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CampaignDilemmas

Trademark Issue

On March 21, 2016, the communications director for the Alabama Medicaid Agency informed the Capstone Agency team that she had come across another statewide government organization, the Alabama Department of Senior Services, using the name “Access Alabama” for one of its programs. When this happened, Medicaid had just made the final decision to use “Alabama Access” as the new name for RCOs, and the next step was the governor’s approval. The ADSS had just announced the name that week, so no amount of research could have prevented the issue.

Robin and the health commissioner, Stephanie Azar, told the Capstone Agency team that the individual in charge of this program had worked hard and faced several challenges in coming up with a name for the program. They felt it would be unethical to interfere by attempting to negotiate. Therefore, Robin and the Capstone Agency team concluded that the best approach to handling the situation was to come up with alternative name ideas.

Robin and her colleagues liked the word ‘access’ and wanted to find a way to still incorporate it in the name without infringing on the rights of the ADSS. This led the Capstone Agency team to thoroughly research all uses of the word ‘access’ in names of health organizations throughout the country. The team utilized the trademark search engine on the Alabama Secretary of State website as well as the one on the United States Patent and Trademark Office website. However, the team members were unsure of all the details of trademark registration and infringement, so they met with The University of Alabama’s chief legal counsel, Michael Spearing, on April 1, 2016.

Spearing informed the team that there is no way to be certain about infringing on another organization’s trademark rights without hiring an outside law firm that specializes in this type of work. Robin agreed with Spearing, so the account executive of the Capstone Agency team was in contact with someone from Balch & Bingham in Birmingham about hiring the firm to do an in-depth search.

Project Put On Hold

On April 6, 2016, the team had a scheduled phone call with Robin and Commissioner Stephanie Azar to discuss a new final name, logo and tagline following the trademark incident. However, the commissioner received word that the following day, the Alabama House of Representatives would override the governor’s budget veto, which would leave Medicaid without the necessary funding to be able to implement RCOs in October. At the end of March, the state legislature approved a budget that would cut Medicaid $85 million short of what the agency asked. The governor vetoed the budget due to the impact it would have on Medicaid, and the legislature then overrode that veto on April 7, 2016.

Commissioner Azar explained to the Capstone Agency team during the April 6 phone call that she and her colleagues had no choice but to put the RCO branding project on hold, as the lack of funding will affect if and when RCOs are implemented. The team finished completing the logo, visual identity guide and all other materials as planned. Robin and Commissioner Azar said they hope to still put the team’s work to use at some point.

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MeetTheTeam

EmilyClack MaretMontanari ClaireStuartAccount Executive Asst. Account Executive Creative Director

JennaHeard ElizabethBroussard MorganMcKinneyResearch Director Media Relations Director Asst. Media Relations Director

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LessonsLearned

Listen to the client. Research, research, research. In many cases, the client understands things like the situation at hand and the key publics better than you do. Of course, this is not always the case, but for Medicaid, it was. Our client contact, Robin, provided our team with so much information about the people who made up the target audience––their lifestyle, education levels, how they tend to think, and how we could best appeal to them. When we field tested our logo concepts, everything that Robin told us proved to be true. This audience takes things very literally, and they also do not have high literacy rates; their name/logo choices reflected these aspects.

Not only will it deepen your understanding of the situation and help you develop the best solution, but it will also save you time (and the risk of being sued) in the end–especially in a branding campaign. While our team researched effectively during the first two months of the project, we faced a dilemma in March: another organization was using the name we created. Although this was not due to a lack of research on our part, we searched registered trademarks even more thoroughly than before when thinking of alternative names. Knowing now that we had the option to hire a trademark lawyer, we would have done that at the very beginning of the project.

Google Alerts are your friend. Put everything on the table.This is especially helpful when your client is constantly under the radar of the media and the public. It helps you to stay in-the-know on what’s going on with your client, and it shows the client you care. With Alabama Medicaid, the media was constantly covering the House budget and how it would impact Medicaid’s programs. This directly affected RCOs and our work, so it was important for our team to be up-to-date on what was happening.

At the very beginning, try to address potential problems that may require additional payments later on. This way, you can avoid having to amend your contract and budget, which will save both you and your client time.

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Secondary Sources: Alexander, Alan. (2016, March 16). “Alabama House passes budget, but Medicaid challenge remains.” Birmingham Business Journal. Retrieved April 5, 2016. http://www.bizjournals.com/birmingham/ news/2016/03/16/alabama-house-budget-but-medicaid-challenge.html

Alexander, Alan. (2016, January 19). “What the UAB Health System CEO thinks about Alabama Medicaid’s $157M request.” Birmingham Business Journal. Retrieved February 2, 2016. http:// www.bizjournals.com/birmingham/news/2016/01/19/what-the-uab-health-system-ceo-thinks- about.html

Bogard, H., & Fleming, K. (2014, January 3). “Alabama Medicaid: The Move to a Managed Care Program (Part I)”. Birmingham Medical News. Retrieved February 2, 2016. http://www. birminghammedicalnews.com/news.php?viewStory=1941

Cason, Mike. (2016, January 13). “Alabama Medicaid asks for $157 million increase from General Fund.” AL.com. Retrieved February 2, 2016. http://www.al.com/news/index.ssf/2016/01/alabama_ medicaid_asks_for_157.html

Melson, T. (2015, September 14). “Improving Alabama Healthcare Starts with Funding Alabama Medicaid.” Alabama Political Reporter. Retrieved February 2, 2016. http://www.alreporter.com/ improving-alabama-healthcare-starts-with-funding-alabama-medicaid/

Phillips, Ryan. (2016, January 14). “Alabama Medicaid funding request met with opposition.” Birmingham Business Journal. Retrieved February 2, 2016. http://www.bizjournals.com/ birmingham/morning_call/2016/01/alabamamedicaid-funding-request-met-with.html

Thank you from the Medicaid Team!

Advisers: Mr. Gary Creek, Mrs. Teri Henley, APR

www.capstoneagency.org

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