Published On: November 20th, 2025By

When the Texas Organization of Rural and Community Hospitals came to Groundswell Health with a request to produce an ad for The Washington Post, the goal was clear: Motivate lawmakers to take action to support rural hospitals participating in Medicare Advantage. The challenge? Turning a complex healthcare policy issue — the effects of Medicare Advantage on rural hospitals — into something busy lawmakers and their staff could feel, understand, and act on.

Designing The Washington Post Ad

The design concept began with the phrase: “crushing rural hospitals.”

From that idea came a visual story, a businessman’s shoe, labeled Medicare Advantage, stomping on a tiny, isolated hospital in the middle of a barren landscape. The cracked asphalt and empty fields capture the financial pressure on rural hospitals across the country. And amid the stark landscape, one light remains on — the emergency room sign — symbolizing what’s truly at stake: access to life-saving care.

Every visual decision mattered. The shadowing, the color tone, the composition; each element was intended to communicate devastation and urgency with very few words.

@our.groundswell

When policy feels abstract, design makes it real. This ad for The Washington Post turned a complex issue, Medicare Advantage's impact on rural hospitals, into a single powerful image. See how our designer, Dani Mondragon, did it:

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Purpose-Driven Design

Every detail in a design, from a social media graphic to a lengthier whitepaper, should have purpose and intent. Design is more than color and font and making things look nice. Decisions about what to include…and what to exclude…are intentional. And there is a science behind placement of written content. Audience awareness is also paramount. A “shock-and-awe” ad targeting Congress still has to be tactful and respectful because ultimately effectiveness is the goal.

Not every design will appear in a national newspaper. But every design should be produced as if it will be.

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