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UnitedHealth Performs CEO Transplant · Communication Breakdown

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Welcome back to Communication Breakdown, a weekly podcast from the Observatory on Corporate
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Reputation.
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Thanks for joining us.
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I'm Steve Dowling in Silicon Valley.
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And I'm Craig Carroll in New York City.
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Each week Steve and I take a look at strategies companies are using to shape headlines and
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sometimes save their skins.
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It's a post game show for PR Pros.
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This week United Health performs a CEO Transplant and the Wall Street Journal calls this post-op
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complications.
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The country's largest and most profitable health insurance company announcing Tuesday morning
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that Chief Executive Andrew Witty had resigned for what the company described only as
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personal reasons. An abrupt departure, but not an especially surprising one given recent
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struggles.
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Last month United Health missed both revenue and earnings expectations for the first time
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in 17 years and revised its guidance downward.
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Seems a spike in demand for care, especially Medicare services, meaning older patients,
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caught the company flat-footed.
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On Tuesday as they announced Witty's departure, they also suspended financial guidance altogether
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for the year.
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It's just the latest shock in a tumultuous 12 months for United Health employees and investors,
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including news of government investigations, a massive cyber attack that disrupted health
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care services, and of course the brazen, broad daylight murder of the company's top insurance
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executive, Brian Thompson, in New York City last December.
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Whitty himself has received death threats and at least one analyst speculated that fear
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for his family safety might be one of the "personal reasons" the company cited in his departure.
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But most observers point to business challenges, especially the April earnings miss.
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United Health's new boss is a familiar face, Board Chair Steve Helmsley, who was CEO once
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before from 2006 till 2017.
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Following the paper announcement on Tuesday, Helmsley held a 20 minute call with analysts
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and investors.
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"To all stakeholders, including employees and shareholders, I'm deeply disappointed in
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and apologize for the performance setbacks we have encountered from both external and internal
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challenges.
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Many of the issues standing in the way of achieving our goals as well as our opportunities are largely
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within our control."
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Apparently outside the company's control- a scoop by the Wall Street Journal, breaking
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one day after Helmsley's return that the Justice Department has been investigating United
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Health Care for possible criminal Medicare fraud.
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The company called the journal's reporting "deeply responsible" and said it hasn't
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been notified by the Department of Justice.
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Steve, executive departures are a fact of life and sometimes they get messy.
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How is United Health doing with this one?
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Well, I think the announcement itself was solid.
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It had all the elements of a good transition announcement and most importantly, it had
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answers to all the questions that Wall Street knew to care about on the day of the transition.
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They made clear who's in charge, Helmsley, who's in known quantity has a good track record.
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So clarity, continuity, confidence, we can make these all words that begin with C like we're
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buying a diamond.
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On those three, they did well.
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And again, that's what analysts and investors want to see.
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That and the return to profitability next year.
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There's two other areas though.
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I would call them candor and context.
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They're closely related.
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But I think it was a mixed bag even on the day of the announcement before we got this news
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of a possible criminal investigation.
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People were looking at that first line of the press release, 'stepping down for personal reasons.'
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And they noted that it's kind of vague.
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It is vague, probably intentionally vague.
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But that left reporters to write some reporters, not a lot, about what you didn't say.
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And that chips away at what you did say.
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So you kind of have to say what happened, not just what's next.
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And the first news cycle is so critical for tone setting.
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That's why companies play stories, they leak stories, they give out exclusives.
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But you really can't do that with a CEO departure, especially not at an abrupt one like this.
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If you leave people wondering, they might wait for another shoe to drop.
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And who knows if this DOJ investigation, the reported investigation, is related or not.
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But it's another shoe, maybe not from the same pair.
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And it's going to complicate Helmsley's return.
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Yeah.
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I love that: clarity, continuity, confidence. Sort of the investor relations trifecta.
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You're buying a diamond cut, clarity and control of that narrative.
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And you're right for that audience, this was a clean handoff.
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But on candor and context, I think you nailed it, right?
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The message is polished, but still hollow in places.
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Personal reasons is just PR shorthand for "please don't ask any more questions."
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And that works until someone does ask more questions.
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And that's exactly what happened.
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You leave out context and reporters start to reverse engineering the story.
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You build the vacuum and then blame the press when they try to fill it.
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The bigger risk here isn't just the DOJ storyline.
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It's that it starts to feel like there's always another shoe.
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(It) doesn't even have to match the first one.
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Just adds to the clutter noise Helmsley now has to cut through.
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You can't say personal reasons and expect professional silence.
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That phrase is just a blank check the media is going to cash.
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One of the things that company did not address this week is we're talking about what they
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said versus what they didn't say.
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But this one is surely going to be on Helmsley's to-do list at some point.
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And that's the reputational crisis that United Health is in.
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And I don't think crisis is too strong a word.
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And now this reported criminal investigation, if it's real, that's not going to help.
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Let's just rewind for a second.
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Of course, everybody remembers that Brian Thompson, who was in charge of United Health's insurance
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division, he was murdered in the broad daylight, as you said, on the streets of New York
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right before their analyst day in December.
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And just as shocking as the assassination, that's what it was, is how the public reacted.
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And the alleged shooter, Luigi Mangione, he instantly took on this kind of cult status,
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which I think is really hard to sort of wrap your head around.
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But it's reflective, I think, of this widespread frustration that Americans have with the
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for-profit health insurance companies.
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But let's look at how United Health dealt with that.
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Andrew Wittyy, who was Thompson's boss, he sent a video message we talked about on the
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podcast at the time.
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He sent this message to employees, which was then leaked to an independent journalist.
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And Whitty spoke in human terms about Thompson and the loss the company was feeling.
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But he also weirdly talked about United Health's role in the healthcare system.
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And he made some remarks that were seen as insensitive.
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"Our role is a critical role.
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And we make sure that care is safe, appropriate, and is delivered when people need it.
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And we guard against the pressures that exist for unsafe care or for unnecessary care to
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be delivered in a way which makes the whole system too complex and ultimately unsustainable."
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So then a few days later, Witty writes an op-ed for the New York Times and it was not well
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received.
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People said he was deflecting responsibility for flaws in the healthcare system.
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He said no one would design a system like the one we have.
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But here's United Health spending millions of dollars every year lobbying on healthcare issues and
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they might profit mightily from the system that he's deriving as a patchwork.
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So Whitty says United Health is on a mission to deliver high quality care and lower costs.
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The whole thing really fell flat.
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So I think there was this moment after Thompson's death where they might have made some progress
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on softening their image.
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And I think that's one of the reasons why Witty wrote the op-ed to begin with because he
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said they were struggling to understand the public's reaction.
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But instead, at least from my point of view, there's really been a change in tone in their
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public statements since December.
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And they're... United Health is much more defensive, much more often.
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If you look at their newsroom website, they've got all these statements their refuting,
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individual stories in the Wall Street Journal or on social media.
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It's almost combative.
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They don't provide a lot of context.
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They come off as angry.
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I really don't see it as being very effective.
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It's this siege mentality.
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It's not a good look.
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And if they had any opportunity to sort of find some goodwill in the wake of Thompson's
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death, it seems like they have squandered it.
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Yeah.
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I think that moment really crystallized Whitty's reputational struggle.
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He tried to dress something that was human, horrifying and symbolic.
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And he didn't quite land it.
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That video message, which could have been a turning point, ended up being remembered for
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what he missed.
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Yeah.
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He spoke about loss, but then he pivoted into the system's language about appropriate care
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and sustainability.
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And it just didn't connect.
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And I think in that moment, people didn't want to hear about policy pressure.
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They wanted to see emotional leadership.
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And when they didn't get it, that's when the reaction hardened, right?
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The company came off as cold, detattached and even defensive.
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And I think that was the reputational break point, not because Whitty did something outrageous,
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but because he failed to meet the moment.
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And in reputational terms, that's just as damaging.
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Yeah.
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It feels like a huge mess because they had this chance to find a new voice.
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And I think it's sort of cynical calculation, but if there was any sympathy from the public
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to be had, if there was any way to humanize the company that people really had a, I think,
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poor impression of, they didn't do it.
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And now, like it feels like a pendulum has swung way to the wrong side because they're
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taking this very, like I said, it seems angry,
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oppositional stance to the press.
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And if you respond to every outrage and you crank up the indignation to 11 every time, people
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are going to start dismissing those reactions.
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You can't go out every time the Journal breaks a story and say they're reporting misinformation.
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That's outrageous and false.
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This one was deeply irresponsible.
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It's not the way you win in the long run.
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And I think more important, they're not creating any forward motion.
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They aren't countering that narrative.
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It is, I think, generally unchallenged.
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And that's why I think they're in the spot they're in and they're going to have to deal
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with it.
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Yeah.
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You know, what you're describing is like a classic siege spiral where the company stops
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speaking to the public and start speaking against everyone else.
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And the problem is, once you adopt that posture, everything sounds like deflection, even
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if some of it's true.
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So the reacting to outrage with outrage, but reputationally, that's a losing game.
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You know, you might win the headline battle for a day, but you're losing the story of war
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over time.
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And more importantly, you're losing the room.
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And you know, you're right, tone fatigue-
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It's real.
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Every response is deeply responsible, outrageous and false or grossly misleading, eventually
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bleeds an into noise and you can't crank the outrage down 11 every time and expect people to
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still hear you.
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Yeah.
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I think that there is, and maybe this is symptomatic of the problems they're going through internally.
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Maybe it's more isolated.
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Who knows how closely it was related to what he's leadership?
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We may never know.
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But they have a moment now with a new CEO who understands the company clearly, brings
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a lot of credibility.
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I thought it was good that on Tuesday, he issued this apology to employees and to shareholders.
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The reputational issue is really with the customers.
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They've got 50 million people there providing health insurance coverage to and millions and
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millions and millions more who are looking at this very profitable company in a very unpopular
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industry.
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And there is, as I said, this narrative that's basically unchallenged that people are being
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denied coverage left and right.
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And I think somehow United Health has got to try a reset, take a more sympathetic approach,
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ideally with more transparency because I think that is a big part of their problem.
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Yeah.
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And here's the bigger issue.
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You know, they're not replacing the narrative.
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There's no forward motion, no counterweight to the noise, just rebuttals and rebuttals
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doesn't build reputation, signals do, strategy does, meeting stakeholder expectations does,
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story does.
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And that's, I think, what Helmsley's got to do fast.
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You don't calm the chaos by yelling back.
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You calm it by changing the tone and anchoring in transparency and action.
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But the thing I'd say is, you know, I want to make clear, this isn't crisis to me, right?
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To me, this is chaos, just another example of chaos.
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Crisis as a beginning, a peak and a resolution, but chaos is a little bit more ambient.
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It's sustained.
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And I think that's what United Health is in right now.
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They're not just dealing with a single breaking point.
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They're caught in a swirl.
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Leadership turnover, the DOJ scrutiny, cyber tax, public outrage, denial rate headlines, and
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the emotional shockwave of a murder.
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And that's not a comms event.
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That's a communications environment.
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And you just can't manage chaos with a crisis playbook.
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You need a new mindset, a new tone, and a new system for making meaning of this.
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Yeah, I think though you need some place to start.
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And that denial rate issue has been one that is really, I think, been both nagging at
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them.
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And every time it comes up, it undermines their efforts to be more credible, more trustworthy
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in general.
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So this is what happened in the wake of Thompson's murder, about two months later.
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end of January, there's this third party study that comes out that says United Health
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denies 32% of claims, which would be twice the industry average.
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And there was, there were a lot of problems with that report.
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It only looked at certain kinds of care for certain groups.
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I think maybe only in a couple of states.
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And of course, United Health, they went ballistic, and it was reported by the mainstream press.
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They called it 'grossly misleading' to extrapolate that narrow figure.
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So United Health says that overall their denial rate is more like 2%.
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But as flawed as that initial report was, they haven't been able to shake that 32% number.
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And if not the number itself, just this idea that the problem is way more widespread than
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what they're claiming.
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It's a situation that confirms people's worst fears.
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And the profitability just gets people even more furious when they hear about people being
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denied care.
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So it kind of reminds me of this episode last year that we've talked about when McDonald's
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was having trouble shaking this story about an $18 big Mac or whatever the price was.
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And it was like one store in Connecticut.
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It went viral.
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But ultimately, they couldn't because people felt that prices were rising, which they
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were, but they were feeling in their pocketbooks, and they saw prices going up, and it just
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sort of snowballed, and it became this conventional wisdom.
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And I think, while much more consequential for a company like United Health, this situation
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similar.
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And what did McDonald's do?
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They eventually broke their own rules
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and they started publishing pricing data, which they had never done before.
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The transparency was the key.
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And I wonder if there is something similar for United Health and other health insurance
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companies to do to give people more confidence in their numbers.
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I don't know if 2% is any more accurate than any other number out there.
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But United Health is having trouble breaking through with that number.
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And they've got to try something to emphasize transparency if they want to be more credible
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on that topic.
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I think part of it is United Health is dealing with almost the reputational equivalent of a
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fixed narrative.
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The 32%, accurate or not, felt true to people
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and it confirmed what they already suspected that profits came before patients.
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And what's the number becomes a symbol?
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The facts are just going to have a hard time catching up.
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So United Health responded with that 2% number, but they didn't bring receipts.
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And without real verifiable data, segment by segment, plan by plan, it just sounds like spin.
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And in an emotionally loaded environment like this, the more confident you sound, the less
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credible you seem.
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I think they don't even sound confident in it.
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I think that more success breaking through with that number, if they weren't just leading
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with how angry they are at the Wall Street Journal or whatever the source is every time
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something comes up.
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I think this is what gets to what I was saying earlier is if you're just angry and you're
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perceived as railing against. You're calling the Wall Street Journal biased.
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That's a pretty strong statement.
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You may feel that your executives may feel that, but it's a big difference between being
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frustrated and going out and making an accusation like that.
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You need to maintain your own credibility if you want that information to be taken seriously.
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And you also need to be presenting it in a much more rational way.
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Absolutely.
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I like your comparison to the $18 Big Mac story.
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I think that's a perfect example because once the public locks in on a number, you don't
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fix it with outrage, you fix it with transparency.
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Show your work.
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Break down the real data or better yet, invite someone else to.
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They're fighting data perception with press statements and that's not a fair fight and
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it's not one they're winning.
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And when the narrative feels true, people don't need it to be accurate.
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They just need it to be believable.
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In moments like this, transparency isn't a strategy.
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It's the cost of staying in the conversation.
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Well, and let's look at it as an opportunity because that's what I see here.
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There is no agreed upon industry metric or way to get to the denial rate that is going
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to be comparable to other companies, to your own history, whatever.
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And here's United Health Care, United Health Group.
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They are the biggest, the most profitable.
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They're the leaders in this industry.
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They have the opportunity to at least try to lay out a metric that other companies could
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get behind or even if other companies won't do it, that can be consistent over time and
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will add credibility to their assertion that they're only at 2% and not at 32%.
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That's the opportunity hiding in all this, right?
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There's no agreed upon industry standard for denial rates, right?
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The data is fragmented, the definitions are all over the place and everybody's been able
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to hide behind that fog.
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But United Health is the biggest and they're the most profitable.
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Whether they like it or not, they're the benchmark and
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that means they're in a position to lead here to set a standard that the rest of the industry
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can follow.
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They could be the first to say, "here's how we define a denial.
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Here's the rate across product lines.
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Here's what's eligible.
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Here's what's not.
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And here's how we'll report it consistently."
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And that's not damage control.
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That's a agenda setting.
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If you're the biggest, you don't just inherit the blame, you inherit the responsibility to
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lead.
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Right now, they could turn a reputational liability into an industry standard, but only if
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they stop defending and start defining.
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They don't need better rebuttals.
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They need a baseline that the whole industry can see and use.
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Yeah.
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It brings me back again to this tone that they're taking on their newsroom and all
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their interactions with the press.
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Yeah.
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I think if they can make an adjustment there, and also, this is a huge opportunity for the
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returning CEO, and I'm sure it is not lost on him.
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He's going to have an opportunity to talk about these issues a lot more than Witty did.
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I actually, I was surprised and I will not be surprised if someone tells me that I've
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missed something, but I didn't see a single public appearance by Witty in the first five,
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six months of this year.
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There were no industry conferences.
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There were no analysts days. And maybe I'm missing something, but they kind of went quite.
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And listen, maybe this was a security concern.
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Again, you mentioned chaos and all the different... we didn't even talk about the scrutiny that
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they've been under from Congress on cyber security.
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So yes, there's been a siege mentality.
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I would call it, you're calling it an environment that's chaotic.
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I think both are true, but thier going to have to break out by talking.
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They're going to have to break out by showing that they are willing to stand up to scrutiny
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and telling their story themselves, which is something that Whitty started doing with
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the fall start, I think, in December, and then I don't think they ever really got back
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to it instead for whatever reason they have swung to this really defensive posture.
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And if that was not their intention, they're really missing the mark, but they're looking
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for a voice and they haven't found it. But they've got to start taking a different approach
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to this and the arrival of a new CEO is as good a moment as any to do that.
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Yeah, Helnsley is not just walking into a leadership role.
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He's stepping into a reputational deficit.
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The ledger isn't neutral.
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It's in the red publicly, emotionally, symbolically, but here's the nuance, because he's returning
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CEO.
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He's not a stranger and that gives him credibility, but
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it also gives him some package.
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The question becomes, is he here to stabilize or is he here to reset?
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And honestly, Steve, for me, this is where the narrative becomes mission critical.
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If this is just a return of the past, he's missed the moment.
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But if he can frame this as a return with renewed purpose, now we're talking about a second
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act, not a sequel.
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The public doesn't need nostalgia.
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They need new meaning.
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They need someone to start with humility, honesty, clear signals of change, even if the
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face is familiar.
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So he's not just returning to the company.
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He's returning into a story that's lost its plot and his first job is he's got to rewrite
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it.
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Yeah, you said stability or reset.
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I think it's both.
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I think that is the way you get the stability is by resetting.
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And I've got to make a clear break, not necessarily with the previous executive, but they
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need to take a new approach to how they're communicating with the outside world.
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And I mean, consumers first, through the press, investors, maybe, I think they did everything
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that the investors could want in this announcement.
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But addressing the business uncertainties, just as Helmsley said in that quote we played
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earlier, if the issues standing in their way are within their control, then they just
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start to demonstrate that they're in control of them
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and making the changes that they need to and communicating about those changes proactively
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in a way that doesn't feel defensive or angry at the press for questioning them or whatever.
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Accept that scrutiny.
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The press set the rules and we have to play by them.
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Do that and use all the information, knowledge, reputation, the credibility that he brings
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as he returns to the CEO role, apply those and show that they're on a new path.
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Yeah, his job is not just returning to the company.
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He's returning to a story that's lost its plot.
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His first job is got to be to rewrite the story.
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When trust is this low, even a familiar face has got to re-earn its legitimacy.
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This isn't about memory, it's about momentum.
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And the narrative reset that we're talking about here, it's not cosmetic.
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It's existential because people don't want a new chapter;
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They want to know it's not the same book.
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Yeah.
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What's the size with them on this DOJ factor?
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The Wall Street Journal reports that there's a criminal investigation underway.
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The company says they haven't been contacted about it.
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They say it's irresponsible to go out and report that, which I don't think is necessarily
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true and I certainly don't think it's something that you call out.
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But again, I sympathize with them because it's a rough situation to be in where someone
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is saying there's an investigation and you cannot comment on what might be under investigation
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for the most important reason is that if there isn't investigation and even if there isn't,
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you might make it worse for yourself.
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But they are in a real spot here. as we've been saying for the past many minutes.
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And I think that they should really look at ways that they can continue or reset their
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communication without being constrained too much out of fear of what they might be getting
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into with the DOJ or what the DOJ might be looking at.
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You've got an army of lawyers, I'm sure, who are going to help them set some guardrails.
25:20
But I just think that going silent is really not an appealing proposition
25:27
Yeah, Steve, I think what we're saying here is it's like six months of sustained narrative
25:33
damage and most of it is self-inflicted.
25:36
This isn't one crisis.
25:42
It's a pattern, defensive tone and consistent messaging, over reliance on legalese and
25:48
It's a pattern, defensive tone and consistent messaging, over reliance on legalese and
25:52
under delivery on empathy.
25:56
You listed all those rebuttal statements, five or six, I think maybe more, accusing the
25:57
media bias, misinformation, being deeply irresponsible.
26:04
That might feel good in a legal war room, but reputationally, I think it just makes you
26:06
look combative and evasive.
26:11
It's like they're fighting every fire with gasoline and a press release.
26:15
When you layer that on a top of like a 50% stock drop, a leadership vacuum and increasing
26:19
regulatory scrutiny, it's not just a business problem, it's a trust problem.
26:22
And I think that's the job that Helmsely is inheriting.
26:26
It's not just stabilizing operations, but it's stabilizing meaning.
26:31
He's got to shift the tone from defensive to accountable and from opaque to transparent.
26:36
Because even at this point, even if the company technically is right on some of their denial
26:39
rate claims, the tone, the posture, and I think the inconsistency in past messaging, it's
26:42
all going to cost them something deeper than credibility.
26:47
It's going to cost them the benefit of the doubt
26:53
Yeah, I think just as we head towards the end of the show here are some final thoughts
26:59
Yeah, I think just as we head towards the end of the show here are some final thoughts
27:01
I think if I were in their situation, I would be looking for places that I can move the
27:03
ball forward on our reputation. Find areas where you can be more transparent. Lose this
27:09
defensive tone, no matter what.
27:10
And try to leverage that leadership position into more agenda setting and see if you can
27:16
chart a path out of this credibility deficit starting with,
27:23
I wouldn't say it's the only thing, but starting with its denial rate issue because they could
27:27
find a way to define that rate or find an acceptable metric that people will, they may not love it,
27:33
but at least they could find something to build on there.
27:37
I think it could be a good step forward.
27:43
It might feel like a concession to the company, but I think that's, you know, if you're under
27:52
this much scrutiny and criticism, you have to find a place to give.
27:55
And the most important, I think, from my point of view is they've got to be thinking about
27:57
their audience with the customer at the front.
28:03
I think that right now they're talking to investors and they're talking to regulators
28:08
and they may be talking to investigators, but their reputation fix is going to be ultimately
28:12
with the consumers and they've got to figure out how to reach them better.
28:17
You can't rebuild trust if you're still arguing over the fine print.
28:22
And right now the story isn't about healthcare,
28:28
it's about character and I think that's what Helmsly has got to fix first.
28:31
You know, leader can't just say, you know, we're back on track.
28:35
He's got to show that the trains changed.
28:38
Yeah.
28:41
And I think that a lot of the metrics, if you will, that are going to affect their reputation
28:44
with the public are maybe different than the metrics that are going to be satisfying
28:46
Wall Street and their other investors.
28:47
We've got a challenge on multiple fronts here.
28:53
Hopefully some constructive thoughts there for the insurance giant.
28:57
That's our show for this week.
29:00
We want to thank Shawn P Neal and the team at AdvoCast as well as the People Forward Network
29:02
for making our podcast possible.
29:06
If you enjoy the show, tell your friends in the comms world, hit us up on LinkedIn or drop
29:08
us a line by email.
29:13
We'd love to hear from you.
29:16
Our address is podcast@ocrnetwork.com
29:21
Communication Breakdown is a production of the Observatory on Corporate Reputation.
29:22
I'm Steve Dowling.
29:23
And I'm Craig Carroll.
29:28
Thanks for listening.
29:32
We'll be back next week.
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