Campaign to Stop Medicare Cuts
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Campaign to Stop Medicare Cuts

Emphasizing the need to prevent cuts in Medicare funding, the American Health Care Association (AHCA) launched a multi-faceted campaign focused around a nationwide mobile petition tour spanning 27 weeks in 2002. The AHCA, which represents nearly 12,000 nursing homes...

Paul Holmes

Emphasizing the need to prevent cuts in Medicare funding, the American Health Care Association (AHCA) launched a multi-faceted campaign focused around a nationwide mobile petition tour spanning 27 weeks in 2002. The AHCA, which represents nearly 12,000 nursing homes nationwide, launched the “Driving for Quality Care” National Petition Tour in Texas to urge Congress and the President to pass legislation to help correct flawed budgetary miscalculations so vulnerable senior citizens will continue to receive the quality care they need and deserve.
AHCA’s efforts mobilized thousands of residents, caregivers and family members who contributed more than 150,000 signatures both through RV and congressional recess events and online advocacy via the campaign’s central Web site. Through grassroots activities, coalition building and special events, the campaign brought the issue to the forefront amongst key federal legislators, their constituents and the local media. Culminating in a Capitol Hill rally on the eve of the scheduled cuts, the 120-foot petition was presented to Rep. Tom Allen (D-ME), sponsor of the legislation blocking cuts to the Medicare Skilled Nursing Facility Benefit.
While the nation’s seniors focused on creation of a new Medicare benefit covering prescription drugs, an existing Medicare benefit covering skilled nursing facility (SNF) care for millions of the oldest and most vulnerable elderly faced direct – but invisible – attack. The reason: in an attempt to correct budgetary miscalculations, Congress in 1999 and 2000 provided additional funding for this “Medicare SNF Benefit” that was scheduled to expire on Oct. 1, 2002. Absent a national wake-up call to this looming crisis, billions of dollars in automatic cuts would go into effect, reducing federal nursing-care funding overnight by $1.7 billion – or about $35 per patient, per day.
Research was conducted both proprietarily, to shape message; and strategically, to make the case and create national and localized news. Proprietary survey research showed the most significant messages related funding cuts to their potential impact on overall quality of care generally, and staffing reductions in particular. Then, to demonstrate the cuts’ impact on patient care, AHCA commissioned and released at key intervals, a battery of newsworthy policy studies showing: Medicare’s crucial role in subsidizing Medicaid long-term care: state-by-state impacts of the cuts, in the aggregate and per-patient; linkage between the cuts and reduction of staff and quality of services in nursing homes (UNC School of Public Health); and impact in rural states (of particular importance to key members of the Senate Finance Committee having jurisdiction over Medicare).
The research data proved vital in raising awareness and concern: for instance, having state-specific data allowed us to “localize” the issue for media in various targeted states and media markets, and to package the data in ways that enhanced coverage (e.g., “the ten states hardest hit by the coming cuts…”).
Planning a program of this dimension entailed ongoing coordination on many fronts.
The first step was to map out a route based on congressional targeting: vulnerable incumbents, those holding key committee assignments, legislators heavily involved in health care issues, or those otherwise viewed as potential champions for the cause. Next, communities in those states/congressional districts were chosen, which, because of size and demographic factors, seemed good prospects for extensive local media coverage. Coordination back home: While a rotating staff of two kept the tour going seven days a week, a team of four in Washington planned event details 4-10 days ahead. Local media were pitched using Medicare cut data pertinent to each state.
Because AHCA is a federation of 48 affiliated state nursing-home associations, the team worked closely with the affiliates representing tour-event communities to: identify local spokespeople; provide local skilled nursing providers for press conferences; reach out to key state policymakers for support; pitch established media contacts, and contact state association members to attend press conferences/rallies.
At the outset, proprietary research was used to craft the strongest messages; then designed the protocols for the four studies that would ultimately provide the empirical “proof-points” to support those messages.
The overall objective was to prevent these automatic cuts from occurring by: making them visible, and thus restoring political accountability; conveying their impact in terms of patient care in “your community;” mobilizing hundreds of thousands of newly aware constituents to demand their legislators stop these fundamentally unfair cuts from going through; and publicly committing legislators to a course of action, then holding them to it.
The “Campaign to Stop Medicare Cuts” was designed to reverse the automatic cuts through a four-part strategy:
· Raise national and local awareness – both through a research-driven national media campaign, and a community-by-community mobile tour designed to “touch” the constituencies of each targeted member of Congress;
· Translate that awareness into passionate, personal appeals – via petition signatures, letters, emails and phone calls to their members of Congress, all urging them to “Stop the Medicare Cuts;”
· Commit legislators to action – through participation in events, statements, co-sponsorship of legislation and letters to congressional leadership; and
· Keep the heat on – through increasing editorial coverage and constituent appeals as the November mid-term elections drew nearer.
Because the objectives focused heavily on localized awareness and action, the PR team settled on the concept of a “national tour visiting our community” as the primary driver. An RV, wrapped in custom art work, with a rollout petition attached to its side, served as an ideal mechanism for “taking a cause to the people,” particularly when its intended beneficiaries were among America’s oldest and least mobile citizens.
The RV was viewed as a traveling podium from which members of any age in any community could join thousands of likeminded Americans in calling on Washington to take action on a matter close to their hearts. In 27 weeks: 111 events in 45 states – From March to September 2002, the tour covered some 21,000 miles, holding at least one earned media event and grassroots letter/phone program in the district/state of every targeted legislator.
Once the PR team succeeded in “removing the veil” and describing the impact of the cuts, they were able to build The Coalition to Save Medicare Now, consisting of 19 national organizations. Many coordinated in issuing action alerts, generated letters to Congress and actively participated in the mobile tour and Washington rallies.
Being particularly eager to hold in-state events while the targeted member of Congress was at home, the PR team worked through AHCA’s state-affiliate associations to hold as many as a dozen major events simultaneously over each of the Easter, Memorial Day and Labor Day Congressional recesses.
Mindful of the political power of Internet–savvy American seniors, the campaign went online with Site visitors could track the tour along a mapped route and agenda of event dates, and view quotes from supportive legislators, along with local media coverage. The site also enabled those willing to add their names electronically to the traveling petition, write their legislators or send letters to the editors of local newspapers.
Critical to the campaign’s success was an ability to enable every concerned citizen the campaign encountered to contact their member and senators right away, and capture their identity into a database for future activation. This was done through a combination of:
To maximize facility level contacts (a constituency base of staff, families, residents, community activists, etc.), the PR team coordinated with each event facility administrator to dedicate 5-6 phones for a call blitz to rep./senators’ district offices through a toll free patch-through phone line. Laptop computers were also set up to enable patients, family and staff to e-mail their reps/senators.
Nothing captured the “national/local” dynamic of the cause so much as the chance for each individual to add the weight of their signature to a 120 foot-long petition signed by literally hundreds of thousands of likeminded Americans, some thousands of miles away.
Each of the four policy studies were rolled out at well-attended Washington press conferences. State-specific media kits and locally signed op-eds helped supplement the national coverage with localized placements as well.
The tour officially ended with a rally on Capitol Hill on September 30th – the day before the Medicare cuts were scheduled to go into effect. Hundreds of residents, caregivers and family members gathered at the Senate Park to present the 120-foot petition to Congress.
 The campaign garnered media coverage nationwide including more than 220 general circulation newspaper and wire stories and more than 130 broadcast segments. Newspaper editorials demanding the cuts be stopped appeared from Tulsa to Tampa; successful op-ed placements included the Las Vegas Review Journal, Arkansas Democrat Gazette, Omaha World Herald, Kansas City Star, Des Moines Register, Indianapolis Star, Idaho Statesman and Billings Gazette.
The campaign collected thousands of petition signatures. In addition, our database now includes approximately 150,000 concerned citizens who have expressed their views and can be activated again. The Coalition to Save Medicare Now’s 19 national members remain engaged. Literally dozens of lawmakers and senior state officials or their staffs participated in our events.
As of this writing, legislation blocking cuts to the Medicare Skilled Nursing Facility Benefit has been introduced with broad, bipartisan support in both House and Senate, and awaits final action. H.R. 5411 was introduced as a direct result of the campaign, according to Rep. Tom Allen (D-ME), the bill’s sponsor. Consequently, an additional $400 million was added to the SNF Benefit legislation in the Senate following the campaign’s grand finale event on September 30.
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