In mid-2003, about a year into his 11-year tenure as CEO of Kaiser Permanente, George Halvorson realized the organization had a problem that was limiting its ability to recruit new members.
Surveys showed the 8 million people then signed up for Kaiser insurance plans liked its team-based approach to care. But to outsiders, bombarded daily by news accounts highlighting the patient backlash against HMOs, belonging to Kaiser, the nation's largest integrated delivery system, meant not having a relationship with a personal physician. And if you really wanted excellent care when faced with a serious illness, you had to go outside KP.
The reality was far different. Then as now, Kaiser, whose model since its founding in the 1940s combined the insurance plan with service providers under one umbrella, ranked among the best performing healthcare systems in the country for both quality and outcomes. But Halvorson couldn't communicate those facts to outsiders since Kaiser suffered from internal problems that still plague many healthcare systems across the U.S.
Each of the system's eight regions had different electronic medical records. Its then 30 hospitals and scores of clinics had 125 different accounting systems. Though it had the highest quality and was lowest cost in most of its markets, Kaiser couldn't pull together the data to tell that story.
External communications suffered from the same fragmentation, which made coming up with a unified strategy for altering perceptions next to impossible, he recalled in a recent telephone conversation from his home office in Sausolito, just north of San Francisco. Each region touted its own brand and had its own advertising campaign.
Each hospital ran its own communications shop and operated independently from headquarters. When a big issue hit the Los Angeles Times shortly after he got the top job, he had to make three calls—to headquarters public relations, to the regional staffer and eventually to local PR—to find out what was going on.
To tackle those problems, he came up with a solution that might seem strange coming from a leader who learned healthcare on the insurance side of the business. Halvorson had begun his career at Blue Cross of Minnesota. He had helped knit together HealthPartners, a mini-Kaiser in that state, which he ran for 18 years before being recruited by KP's board and top medical staff.
“I knew there was great power in having a redemptive ad campaign that encouraged the best behaviors,” he said. “It was really good for the staff morale in seeing ads about the great things being done by the organization. And you want the patient feeling good about receiving great care.”
Halvorson moved quickly to correct the organization's most pressing internal problems. He set it on a path for common records and accounting systems. He streamlined Kaiser's administrative structure, eliminating many regional positions.
But he simultaneously launched a campaign to create an entirely new image for the organization, one that would communicate his vision for healthcare to both internal and external audiences. He tapped Bernard Tyson, then running Kaiser operations outside California, to run it.