In a time of divided politics and policy, advocacy stands as a critical tool for communicating ideas, shaping legislation and driving change. Those who embrace the simple but powerful statement of Dr. Salk, the celebrated medical researcher who developed one of the first successful polio vaccines, are often moved to take action to fulfill a duty to future generations. Whether one is advocating for expanded access to healthcare services, Medicare and Medicaid policies or social or tax policy changes, advocacy skills and effective communication can significantly increase impact. Let us explore the importance of advocacy, a few government relations strategies, and some examples of smart communications for advancing healthcare policy objectives.
The Significance of Advocacy. Advocacy is a cornerstone of democracy. It empowers individuals and organizations to engage in the policymaking process, influence decision-makers, and champion causes that matter. At its core, advocacy is about amplifying voices, raising awareness, and mobilizing support to address pressing issues. When advocating for policy change, individuals can contribute to creating a more just, equitable, and inclusive society.
Essential Skills for the Effective Advocate. In my professional work, my colleagues and I represent providers and we advocate for specific outcomes; this can be in connection with a reimbursement issue, defending an audit inquiry or a regulatory matter or seeking to resolve a contract dispute. The rules that apply to effective advocacy in those contexts also apply when one is looking to effectuate policy change.
Communication. Clear and persuasive communication is essential for good advocacy. Whether one is seeking to address health disparities or advocate for adjustment of reimbursement rates, the ability to articulate a message, concisely, and tailor it to specific audiences is key. The most persuasive advocates employ compelling storytelling techniques to evoke empathy and understanding from decision-makers.
Research, Analysis. A deep understanding of the issues for which one is advocating is crucial. Be familiar with the data and evidence and analyze the policy implications to strengthen the credibility of your argument. Many professional organizations will have collected data points from across a wide spectrum for the impacted geographic area or community in which they might seek policy change.
Honing the Message. Making time for strategy discussions and refining the pitch or the legislative “ask” is an important part of strategic planning and goal setting. Be clear about the objectives. If one is motivated to make a legislative request that is funding related, it will be helpful to know the history of prior appropriations. Prioritize the key initiatives for the current fiscal cycle and develop an action plan, ideally with measurable milestones, to enlist the appropriate constituents to support communication efforts and implement strategies.
Networking. Partnerships can amplify advocacy. Are you part of an organization that brings together community leaders and key stakeholders to leverage collective expertise, resources, and influence? If not, do some research, talk to colleagues and formulate the easiest, simplest first steps to form a strategic partnership. Study other organizations who are effective in letter-writing campaigns or who utilize social media advocacy to amplify their message. If you are looking to influence policy on a state or federal level, build a collection of contacts who are connected with elected representatives in Albany or Washington, D.C. and well-positioned to inspire decision-makers to take action.
Government-Relations Strategies. In the last few years, I have participated with an advocacy group that supports 100+ organizations around the country in securing and maintaining federal appropriations to support early education programs and services. Each year, the group organizes for a summit — to compare notes on local efforts in the prior year, share progress reports, celebrate wins, discuss challenges and to organize communications — by both industry leaders and lay (volunteer) advocates — to members of the U.S. House of Representatives and Senate, so that elected representatives stay well informed of the partner-organizations’ top priorities. Some action items for advocacy are detailed below.
Relationship Building and Maintenance. Member organizations should identify local leaders and cultivate relationships with representatives and especially their senior staff, who are often influential sounding boards for members of Congress on policy matters and constituent affairs. Once you have been connected to a staff member, introduce yourself as a resource, offer to share information and constituent feedback and perspective on the subject issues that matter to your member. Develop a regular communication cadence. This might involve writing emails a few times a year, attending town hall meetings, or requesting or scheduling small group meetings to maintain the relationship, provide new information and receive feedback on legislative issues.
Advocacy Organization. Join up with an advocacy organization that has already established relationships with influential representatives in Albany or on Capitol Hill. Participate in information or education programs, support candidates and campaigns and leverage the subject matter expertise and contribute to collective advocacy efforts to support strategy.
Follow-up and Develop the Art of the Closing the Loop Technique. Having a top-notch follow-up process is an important skill for any advocate. After a meeting with an elected representative or decision-makers or their legislative staff, send a personalized thank-you note (email is fine), and also write with periodic updates during the year and to express appreciation following positive legislative developments. If you are playing the “long-game” to ensure that you have a readily-available channel through which to communicate your position on policy matters, maintain semi-regular contact with your representative’s office throughout the year. This way, when a need arises, the communication channel to advocate for a particular priority issue will already be established and open.
Plan a Trip to Albany/Washington. If you are advocating for policy change, consider participating in a "Hill visit" in Washington or an “Advocacy Day” at the State Capitol in Albany. These are usually coordinated by governmental relations staff of industry associations. Traveling to visit a representative is one way to demonstrate your commitment to an issue. Engaging in face-to-face meetings with legislators and their staff to present your case, share personal stories, and advocate for policy solutions provides members of Congress or the State Legislature an in-person interaction to pair or match with the names of constituents, helps to build a two-way relationship and can have lasting impact.
Recent Policy Objectives in Healthcare Advocacy. The American Medical Association has been focused on policies related to healthcare equity and access. In the last year, the AMA has advocated for (1) reversing rate cuts to ensure access to quality care for patients and fair compensation for providers, (2) more robust regulations of artificial intelligence (AI) in healthcare to ensure responsible and ethical use of new technology (this to safeguard patient privacy, mitigate biases in AI algorithms, and promote transparency and accountability in AI-driven healthcare systems) and (3) initiatives aimed at addressing health disparities by eliminating barriers to care and addressing social determinants of health to provide individuals the opportunity to achieve optimal health outcomes. The Health Care Education Project, which includes a number of hospital organizations, has pushed state officials for Medicaid rate increases to keep pace with the rising cost of care. LeadingAge NY has engaged in similar advocacy to reform and rationalize the nursing home Medicaid reimbursement methodology to address staff retention challenges and ensure quality of care for those who need it.
Conclusion. Staying informed, voting and paying taxes are basic civic duties, and active participation is, likewise, a cornerstone of democratic society. By mastering essential communication skill sets, leveraging good government relations strategies, and aligning with organizations to work toward common goals, individuals can amplify their voice by championing causes, influencing policy, and advocating for meaningful societal change. My own advocacy work has been fulfilling: seeing positive change after engaging in advocacy efforts has reinforced my belief in the power of collective action and reaffirmed the importance of civic participation. If you have already been inspired to “be a good ancestor”, keep up the good work! Continue the effort to seek the policy or legislative change you want to see in the communities in which you live or practice. Whether you support education or tax reform or are focused on ensuring future generations of individuals enjoy more equitable and better health outcomes, let your perspective be heard. If you have not yet been active in advocacy, perhaps one of the ideas in this article will spur you take action to improve the lives of others. As Yogi Berra — the late, great Yankees catcher and manager — stated, “When you come to a fork in the road, take it.”
Reprinted with permission from the May/June 2024 issue of The Bulletin from the Monroe County Medical Society and available as a PDF file here.
David M. Tang, Esq. is a Partner at Underberg & Kessler LLP and serves as Chair of the firm’s Health Care and Creditor’s Rights Practice Groups. He advises, is active with and has served on the boards of a number of nonprofits providing healthcare, educational and affordable housing services. David can be reached at dtang@underbergkessler.com or 585-258-2845.