INTRODUCTION
GAIN ATTENTION: Identify the problem
Attention-Getter: Runny nose. Coughing. Fever. We’re all familiar with the unpleasant symptoms that arise a few times a year to let us know we’re sick. But a common cold is vastly different from that of the flu. The flu, infecting 20% of the U.S. population a year, has been known to kill anywhere from 3,000-49,000 people a year. It’s intimidating, especially to someone like a single mother with a toddler too ill to sleep in the dead of the night. Who are we to tell her to only seek medical care if she’s positive it’s the flu, or else she risks paying for thousands in medical care?
Preview: Emergencies serve a crucial facet of society, they act as a beacon of hope whenever something goes wrong and people need medical care. No one wants to go there, but eventually most end up needing to use it. This is why I’m here to speak to you all about Anthem’s latest Emergency Room Policy.
Relevance: In 2014, there were more than 141 million visits to emergency rooms in the United States. Chances are you, or something within your immediate network, accounted for at least one of those visits. Here at Anthem, we provide the structure for which these people can get their care. It is our job to ensure that their policies are fulfilled and that our people are given care. This new policy impacts our customer base; it is our duty to do what is best for them.
Credibility: I, like all of you, have invested significant time and resources into this company. Our business is my business. We also have data available to compare the implementation of this policy to the results, giving us the opportunity to see if progress has been made.
Position Statement: It is my honest belief that this policy has been a failure. We’ve put our clients in danger and yielded little benefits from its implementation. We need to change this policy to ensure trust in our company and to place our ethics as people above the bottom line.
Transition: First, let us go deeper into this policy and its effects.
BODY
NEED: Explanation of the problem
Statement: This policy, with its intended financial and utilization benefits, has ended up adversely affecting our patients. It has put them in a position where they’re scared to seek medical care for fear of financial repercussions.
Clarification: After implementing this policy in five of the states we cover, there has been widespread backlash. Senator Claire McCaskill from Missouri is quoted as saying that patients are not physicians, illustrating just how much responsibility we’re placing on our customers to care for themselves. The American College of Emergency Physicians has repeated criticized this policy as flawed and detrimental to the patient.
Illustration: This policy has made our customers lose trust in us as an insurance provider. It’s caused our brand image to be associated with the negative, all while yielding little to no actual results. We’ve declined the claims of car accident victims, people with bronchitis, contusions and sprains. It’s irresponsible to the people we serve and morally shameful. Studies have concluded that more than half of emergency room visits are entirely reasonable, with upwards of 45% existing in a grey area where it’s easy to see the concerns of the patient. With examples like this, it’s hard not to see the negative impacts this is having on our company and our consumers.
Transition: This is why we need change, which I will detail now.
SATISFACTION: Give the best solution to the problem
Statement: The most viable solution to this issue is to reform the policy. We started with good intent, but have lost view of our primary directive to provide care for those who seek medical care.
Explanation: This solution would be to edit this policy and to clearly define what exactly we will and will not cover in emergency care. We need to provide our patients with details if we’re going to expect them to make reasonable decisions for the sake of their health. We need to examine their perspectives and al, possible solutions to their problems. From this point forward, it is no longer acceptable to fault people with legitimate fears for going to seek attention at the emergency room.
Reasoning: Most people are reasonable. They have the intelligence to evaluate their situations and make the decisions they feel are best. We need to have some trust in them if we expect them to trust us. For some, a visit to the emergency room is the only care available. As an insurance company specifically designed to help with medical costs, we shouldn’t create reason to fear proper healthcare.
History: In the twenty-first century, the spread of information has been made easy. Following the reevaluation of this policy, spreading the details in an effective matter should be our top priority. Through email and social media posts, we can increase interaction and the spread of proper clarification.
Nod to other side: Now, I know you may be considering the financial implications as well as the impact this will have on our corporate image.
Transition: Let me explain what this will look like if we continue with the current policy.
VISUALIZATION: Implement either of these solutions
Positive: If we update the policy patient will feel better informed when making decision regarding self- care and we will win and retain their trust. Making our company the company of choice.
Negative: If our patients cannot trust us to provide their insurance, they will seek other solutions. This includes the possibility of finding another provider, or by making potentially unhealthy decisions for themselves or their dependents. By choosing to not seek medical attention when unsure if the severity meets the limits for care, they risk worsening their conditions with potentially devastating effects. This could lead to amputations or illnesses that reach the point of death. Choices made early in care can lead to lasting quality of life.
Transition: Now then, let’s discuss how to implement these changes for the benefit of all parties involved.
ACTION: Specific instructions on how audience can help – Give two ways or examples.
Specific: Take some time to research and thoroughly analyze the data available to determine what it is our patients seek medical attention for. Examine the processes they make to reach their conclusions, while truly assessing their situations. Then build a policy with maximum benefit to our company that still meets the threshold of care.
Specific: We also need to demonstrate that we care, that our clients aren’t just financial numbers to us. It is time we reach out, get their opinions, and open the door for conversation to exist to information can be passed effectively and correctly. We must utilize all the technological advancements available to us, whether it be email, social media, phone calls, etc. Our goal is to be transparent and trustworthy.
Transition: I know I’ve discussed a lot in the presentation today, so please allow me to review.
CONCLUSION
:
Review: Today we discussed our current emergency room policy and its implications on our customers. We talked about how we lost scope of care and how we’ve essentially failed our patients and associated our brand with negativity.
Thesis: I thoroughly believe we need to update this policy, and change it for the benefit of our people. These changes need to be done with all aspects of our plan in mind, as well as communicated in ways which are effective and bring maximum attention and transparency to those who look to us for care.
Call to Action: We are Anthem, and we have faltered in our responsibilities. As current leaders, it’s on us to fix this. Together, we can make this right.
REFERENCES:
Provide a minimum of four references in APA/MLA format
“Anthem Alters Controversial ER Coverage Policies.” FierceHealthcare, 16 Feb. 2018, www.fiercehealthcare.com/payer/anthem-er-coverage-policy-changes.
Hiltzik, Michael. “Anthem Expands Its Policy of Punishing Patients for 'Inappropriate' ER Visits.” Los Angeles Times, Los Angeles Times, 24 Jan. 2018, www.latimes.com/business/hiltzik/la-fi-hiltzik-anthem-er-20180124-story.html.
“National Center for Health Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 May 2017, www.cdc.gov/nchs/fastats/emergency-department.htm.
“What Are Your Odds of Getting the Flu?” WebMD, WebMD, www.webmd.com/cold-and-flu/flu-statistics.