The Texas Organization of Rural and Community Hospitals needed to motivate federal lawmakers to address the effects of Medicare Advantage practices on rural hospitals.

The campaign needed to reach members of Congress as well as the Washington staff members responsible for researching policy, advising elected officials, and shaping legislative priorities. The central challenge was turning a complicated healthcare issue into something a busy policymaker could quickly see, understand, and act on.

Groundswell Health developed an arresting visual for The Washington Post: a businessperson’s shoe labeled “Medicare Advantage” crushing a small hospital in a barren rural landscape. Amid the devastation, the hospital’s emergency room light remains on, representing the essential care rural communities stand to lose.

The final concept evolved from an early political-cartoon-style depiction of commercially managed Medicare Advantage insurers body-slamming rural hospitals. The revised approach shifted the focus toward the consequences for patients and communities while challenging preconceived ideas about rural healthcare.

Every detail, from the composition and shadowing to the limited text, was selected to communicate pressure and urgency without sacrificing credibility.

“Grandstanding and invective might be the standard trend for some, but attempts to attract attention through caustic rhetoric are often disposable,” said Lance Lunsford, MBA, FACHE, co-founder and senior partner at Groundswell Health. “Instead, we want to leave a mark, demonstrate strength through tact, and ensure our clients maintain credibility. Perfecting that standard helps create an image that lasts.”

The result transformed a complex policy concern into a clear human and community consequence, speaking directly to the responsibilities facing congressional leaders.