Public relations as practiced by the Louisiana Department of Health and Hospitals: Public information model or relationship management perspective?

Carol McNicoll Madere


This study used case study methodology to investigate whether the Louisiana Department of Health and Hospitals (DHH), in its operation of the Louisiana Medicaid Program, used the public information model of public relations, as described by Grunig & Hunt (1984), or whether it operated more from a relationship management perspective, as described by Bruning & Ledingham (1999). The study examined how DHH communicates with its key publics, including legislators, Medicaid providers, and Medicaid recipients, to determine whether that communication was affected by Grunig's division model (J. Grunig, 1974), which predicts that individuals of one socioeconomic class will have difficulty co-orienting with individuals of another socioeconomic class. The study also considered the complexities of communicating with an audience as large and diverse as the Medicaid recipient population and whether those complexities could account for a perceived lack of appropriate communication between DHH and its recipient public. Key Medicaid program administrators and a Unisys provider representative were interviewed, and observations were conducted at a Medicaid field office and a Medicaid enrollment center to gather the information for this study. Neither recipients nor providers were interviewed as a result of DHH restrictions on the study. Consequently, the perceptions of the Medicaid Program reported in this study are those of program administrators only. Interviewees were asked ten case study questions, which were designed to answer the four research questions posed. The investigator found that the Louisiana Department of Health and Hospitals, although typical of the type of organization which would use the public information model of public relations, is moving towards a more dialogical model of public relations due to a nexus of contributing factors, including regulatory requirements, client litigation, and organized resistance to its policies in the form of advocacy groups. The investigator also found that the Louisiana Department of Health and Hospitals is employing the relationship management perspective with some of its key publics, but not its recipient public. The investigator found that Grunig's division model tends to intervene in the establishment of a strong relationship between Medicaid program administrators and the recipient public. Other factors, such as the nature of bureaucracy and the availability and power of advocacy groups to speak for recipients, also influence significantly the nature of the public relations model practiced.