A Sheep in Wolf's Clothing: Form 990 Is an Opportunity, Not a Burden

What do the public relations practitioner and accountant have in common?

In my experience, not much.

Few consultants with accounting firms understand the importance of public relations, let alone storytelling. They're generally numbers people, and there's nothing wrong with that. But we come from different worlds, different mindsets.

So when I recently heard a senior consultant from that industry talk about the value the IRS Form 990 has as a public relations and communications tool for non-profit healthcare systems, I was impressed. I couldn't have made the case better myself when she put communications on equal footing with finance.

The Form 990 is used to report a public charity's finances. Those in the nonprofit healthcare world are very familiar with the revised Form 990 and Schedule H. In 2008, the IRS significantly changed the form to require hospitals to detail how much community benefit they provide, from free and unreimbursed care to programs that meet specific community health needs. Then, when the Patient Protection and Affordable Care Act was passed in Mach 2010, non-profit hospitals were additionally required to conduct a community health needs assessment and demonstrate an implementation strategy that meets those needs.

In putting these requirements in place, the IRS is compelling non-profits to justify their tax exemption and prove the community benefit they provide is proportionate to their tax savings. Last year was the first time health systems had to complete the revised form.

Because the form is available for public scrutiny, it is an excellent medium for communicating a health system's story and the benefit it provides to the community. Knowing it has to pass muster with the feds, the authenticity and accuracy are hard to question. Yet, as cries for transparency grow louder and tax exemption ultimately hangs in the balance, too few hospitals in complying with Form 990 take full advantage of the opportunity to tell their story.

The Form 990 is a microcosm of what healthcare administrators need to do today to differentiate and prove themselves. It has become a serendipitous marketing opportunity, and it has come just in time.

In the 21st century digital age of transparency, hospitals are being asked what they've done for their community lately. Traditional healthcare brand marketing does not answer the question. The "value propositions" and "differentiators" of years gone by have been replaced by a cacophony of claims, counter claims and general market confusion. The techniques and tactics once thought to create distinction now propagate mush.

Yet there is an ageless alternative for healthcare systems to demonstrate community benefit, justifying their tax exemption and enhancing their market position and distinction. That ageless concept is the story. Form 990 opens the door to this opportunity.

Without question, hospitals face a tremendous amount of work in gathering the information necessary to write an effective narrative. The logistics of soliciting the information from each service line and specialty within the system, cataloging it and turning it into a narrative that jibes with the financial information contained in the form is daunting.

In today's economy, many hospital administrators, especially those managing community hospitals, are working with limited resources. They view the new Form 990 as an unfunded mandate and are reluctant to dedicate the resources necessary to tell a compelling story. Unfortunately, the reality is they are passing on the best opportunity they have to distinguish their health system, which, in this case, also happens to be necessary to meet the Form 990 dictate. Once the story is developed, though, the opportunities to retell it in today's new media world are vast.

Many health systems are already heavily invested in marketing communications aimed at promoting their brand throughout their market. Billboards and newspaper ads aimed at prospective patients tout the region's greatest heart care or orthopedics team, or the most advanced women's health center, or the speediest emergency room. Drive to the next region, and you'll get a different hospital, but generally the same message. Levels of creativity vary, but there is no real distinction. Logos, taglines and jingles permeate brochures, web sites and television spots. Unfortunately, none of these worn tactics tell a cohesive story or demonstrate how a specific community benefited from its hospital's services, and none of them carry much, if any, credibility.

Unlike a brand, a healthcare system's story — complete with a beginning, middle and end — can provide a more robust, authentic framework in which to engage stakeholders, from patients to the IRS. A hospital's unique story showcases the true value it provides without shoehorning it into oversimplified brand hooks or premises.

It takes time, effort and dedication to craft a comprehensive story, but the return on that investment is great. Often, organizations that thought they were one thing come to realize their story is quite different than what they imagined. And that, in our experience, almost always is a good thing.

Hospital administrators who resist the "unfunded mandate" Form 990 represents to them do so at their own peril. Non-profit organizations whose tax exemption depends on the community benefits they provide should not be wringing their hands, asking themselves how they can possibly make the investment in authentically telling their story. Instead, they should be asking, "How can we afford not to embrace this opportunity?" Using the Form 990 to develop a compelling story will not only differentiate a health system, it may well secure its future.

Jason Snyder is senior vice president at WordWrite Communications, a public relations and social media firm that has worked with several healthcare systems on their strategic communications. He can be reached at jason.snyder@wordwritepr.com or (412) 246-0340. For more information about storytelling in healthcare, visit www.wordwritepr.com/healthcare_brand.

More Articles on IRS Form 990:

Community Health Needs Assessment: 5 Phases to Compliance
Hospital Tax-Exempt Status: Considerations Regarding Maintaining Exempt Status
Understanding Health Reform's Tax Implications for Non-Profit Hospitals: Will My Hospital Lose Its Tax-Exempt Status?

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