Newsmaker: Don Nathan, CCO, UnitedHealth Group

From a class-action lawsuit to the ongoing healthcare reform debate, the CCO of UnitedHealth Group continues to face business and reputation challenges.

It was a crisis that brought Don Nathan to UnitedHealth Group.

While working as a partner with Robinson Lerer & Montgomery in 2006, Nathan was asked to work with UnitedHealth Group, a client of the firm, after a Wall Street Journal story reported that then-CEO William McGuire had been backdating stock options.

Within a year of the story's publication, McGuire had resigned and Stephen Hemsley had been named president and CEO.

Hemsley turned to Nathan, asking him to consider a post with the $87 billion healthcare company and eventually naming him UnitedHealth's first chief communications officer in May 2007.

"The fact that the post was created reflects the deep commitment to communications and a recognition of the value of engaging in the public dialogue," says Nathan. "There's a real recognition that we need to do that as a company, that it is a significant responsibility."

Since then, Nathan has created a corporate communications function for the Minnetonka, MN-based company. UnitedHealth Group operates six businesses - UnitedHealthcare, AmeriChoice, Ovations, OptumHealth, Ingenix, and Prescription Solutions. Each has its own communications team, but prior to 2007 there was no corporate team, something Nathan says was needed to coordinate communications for the businesses and establish a voice for the parent company. He reports directly to Hemsley.

"In our field, managing the incoming can be a full-time job for a lot of people," he adds. "We want to spend a lot of time telling our story. It takes more bandwidth to do that."

Nathan has also been instrumental in helping the company navigate what may have been its biggest crisis - the battle over healthcare reform proposed by President Obama.

As one of the largest health insurance companies in the country, UnitedHealth Group was part of an industry that took the brunt of the blame for the failures of the healthcare system. Yet, the company has remained committed to telling its story. It executed a proactive strategy that sought to contribute facts and industry insight during the recent legislative process, all part of a plan to set the company apart as a leader in the field.

Nathan started his career in Washington, serving with the National Republican Senatorial Committee before working for then-Rep. Olympia Snowe (R-WA) as a press secretary and speechwriter. In 1991, he moved to New York and joined Robinson Lerer & Montgomery. It was Nathan's first experience in the private sector and also the place where he developed his eye for handling crisis communications with clients such as Texaco.

When The New York Times reported that executives at the oil company were taped uttering racial slurs in the mid-90s, Nathan worked on the fallout. The experience led to more crisis and issues work for the firm's clients, ranging from bankruptcies to litigation to corporate positioning.

"I was always impressed by his ability to see the core issue, the basic challenge, quickly," says Walter Montgomery, CEO of Robinson Lerer & Montgomery.

In-house introduction
The move to UnitedHealth Group, first as a consultant in late 2006 and then in an official capacity in May 2007, was Nathan's first experience as an in-house communicator.

His first hire in building the corporate team was Mary Stutts, now SVP and head of corporate relations for Elan, in August 2007 as a VP of corporate communications. What stood out to her was Nathan's ability to quickly build the trust of C-suite executives.

"They value the function, they value the leader, and he was able to work closely with them," Stutts explains. "Then we were able to build the team."

The corporate communications team now has 15 staffers, with about 60 pros serving in the six businesses. Company stakeholders range from physicians and hospitals to health-plan members to policymakers and investors.

"A lot of our work exists at the intersection of people's money and health," says Nathan. "We continue to try to show people the things we do that are making the health system work better and that can ultimately help their care."

Nathan's communications strategy focuses on UnitedHealth's record in innovation and how its advances in telehealth and Ingenix, its health information, research, and consulting business, have not just diversified the company, but modernized the healthcare delivery system.*

"That gets to us, as communicators, having the discipline to focus on that intersection of what we want people to know and what people are willing to listen to," he says.

UnitedHealth's 78,000 employees represent an important audience. And because many of the jobs there require direct staff-stakeholder interaction, employee communications has been a key focus.

"He's been exactly what UnitedHealth needed," says Montgomery. "It had to take a big step forward in terms of how strategic it was with its communications."

In late 2009, the team created a one-page document of social media principles to address staff use of tools such as Twitter and Facebook.

During the national discourse on healthcare reform, Nathan prioritized simple, to-the-point messaging for staff. "A lot of it was to reinforce that we're having an effect on people's lives and to keep that in mind," he adds.

Tapping into internal tools including intranet, e-mails, meetings, and webinars was vital to ensure employees understood UnitedHealth's role in the healthcare system.

Nathan says reassuring employees about their work would allow the company to better position itself as it sought to communicate with a broader external audience its role as an experienced provider of care and access.

"Don helped frame that what we wanted to do was offer a constructive contribution to the debate focused on solutions rather than engaging in the tug-of-war," says Simon Stevens, EVP at UnitedHealth Group and president of global health for the company.

Stevens, who was instrumental in shaping the UK's healthcare reform under Prime Minister Tony Blair, notes that Nathan's strategy engaged in the underlying issues, rather than the back-and-forth often reported between media, government, and industry.

The team incorporated messaging on reform into daily communications. It also established the Center for Health Reform & Modernization, which produced three white papers that focused on practical ways to address Medicare, Medicaid, and healthcare administration and technology.

Continuing to tell the story
"It was important to continue to tell the story of what we do," says Nathan. "We have no illusions about perceptions of the industry and company. We bring a much greater value than what is widely understood."

After an intense year of debate, the healthcare bill was signed into law in March 2010.

How UnitedHealth Group moves forward is a question for the healthcare industry, including insurers, drug and biotech companies, and hospitals, as a whole. What remains a constant, though, is the need for companies to communicate effectively to implement the groundbreaking legislation.

"Are there ways that we can increase the understanding of our business in meaningful ways?" asks Nathan. "That's a very difficult thing to do for any business."

UnitedHealth Group was the first company to implement the provision that expands coverage for adults aged 26 and under on a parent's plan. It was a step, says Nathan, that gave it a leadership position on the issue.

Even as UnitedHealth's communications has evolved to a true function of the company and its business goals, Nathan realizes the continued need to make its case to the C-suite.

"We were fortunate here to begin with a seat at the table," says Nathan, "but we need to earn the right to stay at the table every day.

"We have debates over what the right kind of communication is, what the right thing to do is," he adds, "but we're not debating whether we should be thinking about it."

Recent activity at UnitedHealth Group

October 2006: CEO William McGuire forced to resign after investigation in the backdating of stock options. The company named Stephen Hemsley president and CEO a month later

January 2009: Settles class-action lawsuit with customers and medical providers over the way it determined payments for out-of-network services. The settlement is $350 million

March 2010: Healthcare reform legislation is passed

April 2010: Extends coverage to graduating college students, four months before the federal provision that requires coverage for adults 26 years old or younger on their parents' health plans is implemented

April 2010: Works with Walgreens and YMCA to launch the Diabetes Prevention and Control Alliance, which aims to prevent diabetes and obesity

Don Nathan:

2007-present   
UnitedHealth Group, SVP and chief communications officer

1991-2007   
Robinson Lerer & Montgomery, partner (1997-2007)

1985-1991   
US Representative Olympia Snowe (R-WA), press secretary and speechwriter

*CORRECTION: A previous version of this story incorrectly reported the name of UnitedHealth Group's Ingenix business unit. We regret the error.

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