When a New Jersey health plan became insolvent after owing millions of dollars in unpaid claims, its members were forced to learn a painful lesson about the need for a safety
net the state lacked -- an insurance guaranty trust fund. If such a fund had been in place last year when HIP of New Jersey liquidated and the state took over, the $120 million in
unpaid claims would have been paid and a healthcare crisis would have been averted. Instead, the health plan's dire financial situation caused physicians to practice without
guaranty of payment and left 200,000 members panicked about the future of their health coverage. This crisis prompted the Medical Society of New Jersey (MSNJ) to launch a
statewide advocacy campaign that promoted the need for a statewide guaranty fund. Eventually MSNJ filed suit against HIP to recover costs for physicians who were previously
employed by HIP. Throughout the crisis, MSNJ relied on the communications counsel of The MWW Group in Washington, D.C., to position the physician organization as a frontline
patient advocate with the media, state agencies and legislators. By the time the curtain closed on the crisis, the campaign helped to land statewide support for rectifying a
problem that would have left physicians uncompensated and set the wheels in motion for protecting patient coverage when a managed care organization goes out of business.
Early on, the media turned to MSNJ as a key resource on how HIP's insolvency wreaked havoc on patient care. MWW worked with physicians to bring the issue alive from a patient
standpoint and a physician perspective. Physicians often spoke on behalf of their patients who were afraid to speak out on the issue for fear of losing their healthcare. They
relayed the sense of abandonment many patients felt after being enrolled in the health plan most of their lives and being forced to quickly find another provider. Physicians also
discussed the precarious position they were placed in to essentially provide free medical care while the state figured out what to do about the health plan
Once MSNJ decided to sue HIP, MWW quickly had to shift gears from an advocacy campaign that relied on physician spokespeople to a courtroom effort that used MSNJ's lawyer as
the primary media contact. Since the litigation stated that the organization filed suit to recover money for physicians, this phase of the campaign presented a difficult challenge
to MSNJ's credibility as a patient advocate. "Our job was to quell the notion that 'greedy physicians' were in this debate strictly for the money," says Bob Sommer, MWW's EVP and
principal. During this period, MSNJ seized the opportunity to demonstrate its patient commitment through aggressive community outreach. After HIP's assets were liquidated, former
HIP patients had only two months to find another provider. MSNJ conducted statewide educational seminars that informed patients about their insurance options, answered their
coverage questions and highlighted how a similar future crisis could be prevented with a guaranty fund.
By keeping a consistent fire lit on threatened patient coverage through messages in the media and timely community outreach, the campaign not only crafted a compelling argument
for supporting a guaranty fund it also helped patients through a managed care crisis. So far:
- the governor unveiled a plan in her January 2000 budget that would reimburse physicians and hospitals using funds from the state's tobacco settlement; and
- the state legislature is close to passing a bill that would require HMOs to pay into a guaranty fund.
Campaign Highlights
Budget: unavailable
Components: media relations targeting general news and courtroom reporters,
statewide community outreach
Target: MSNJ members, consumers, state agencies, legislators
Key team players: Bob Sommer, EVP, Jon Hendl; senior AE; and Mathew Caruso,
assistant AE (The MWW Group)