Certificate of need or grandeurs of greed?

Blurry hospital hallway

Tips for managing your health system’s brand perception during a CON battle

Whether you are filing a certificate of need, or in the process of opposing a competitor’s filing of a certificate of need, your brand perception is at stake. As a healthcare communicator, your efforts can help influence your health system’s brand perception for many years to come. This is both a daunting position in which to be, but exciting opportunity to show ‘em what you got (again).

If you’re wondering what a certificate of need is, it’s possible you don’t live in one of the 35 states where it’s legally required for healthcare organizations. In short, a certificate of need requires healthcare facilities (usually, hospitals or skilled nursing facilities) to prove there is a need for a facility before breaking ground. The law originated decades ago, fueled by the argument that more healthcare facilities would increase healthcare spending. Opponents of the CON process (including, more recently, the Trump administration) argue that the process can lead to an over-politicization of healthcare. States not requiring CONs often have health systems facing even steeper competition.

Whether the certificate of need is facing extinction is yet to be seen. In the meantime, navigating communication when your health system is in the CON continues to be an unspoken core competency for many healthcare marketers. Here are some tips for protecting your brand and maintaining your sanity when a CON storm blows your way.

  • First, tap into your superpowers. Certificate of need battles are notoriously contentious, ugly and highly emotional. As a healthcare communicator, you’re equipped with a unique filter – one that allows you to assess the situation from every perspective. Use this superpower to be the voice of reason to your executive team. Proactively present plans for addressing communication that influences public perception.
  • Don’t do anything. One of the difficulties I have with dieting is that it requires me to stop doing something. But, when I stop consuming as much or different foods than I’m used to, I see positive results. This is similar to a classic public relations tactic called “strategic inaction.” By not actively engaging in a public battle with a competitor, you’re actually winning. This doesn’t mean you can’t publicly address certificate of need matters. Rather, it means that you reserve highly visible media channels for the messaging that matters most to your consumers (hint: it’s not your certificate of need battle). Be prepared with statements, frequently asked questions and classic communicator tools. But, be sure to reserve the lion share of your message distribution for brand-related messaging.
  • Think through your call to action. Death, taxes and the knowledge that senior leadership may not always listen to a healthcare marketer’s recommendations are the only guarantees in life. In the event that your battle hits mass media in a big way, think through your call to action. What do you want your employees to do? What do you want your patients or other target audiences to do? And, perhaps most importantly, what are the tools you can equip them with to respond to your call to action? For example, if you’d like for your staff to contact their elected officials, provide templates (and, even addressed, stamped envelopes) to help get the job done. In other words, remove as many barriers to action as possible.
  • Always, always, always put the consumer first. Health systems have one shared mission: To improve the health of the communities they serve. A certificate of need battle is not about the healthcare organization that wants to maintain its market share. It’s also not about the health system that wants to enter a new market. Rather, it’s about providing good care at an affordable price. As you prepare your messaging, consider these common consumer perceptions.
    • Will more healthcare options increase the cost of my care?
    • If I have more healthcare choices, isn’t that ultimately better for everyone?

Your patient must be at the center of every message you deliver. The moment you start discussing the impact a new healthcare facility will have on your bottom line or even to your staff, you run a very large risk of tarnishing your brand with grandeurs of greed.


Stephanie Burton, APR is the Director of Healthcare Marketing at Core Health.

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