When a person’s medical health requires ongoing treatment and monitoring for three or more chronic diseases and they have functional limitations, they are considered a “High Needs, High Costs” patient.
While The CommonWealth Fund strives to develop a policy response to improve health care outcomes with this unique population, it also faces a communications challenge. The people who find themselves in this unenviable patient population are often overlooked as the high costs of their care, more than four times the average health care consumer in the U.S., attract the spotlight.
The CommonWealth Fund approached me to humanize the consequences of structural problems impeding optimal and cost-effective care for patients with chronic health conditions.
Patients with complex and constant medical needs are already in a vulnerable state of mind. On top of that, their struggles with poverty, stigma associated with chronic illness, and the absence of consistent support exacerbate their health issues. I knew that it would be important to meet with these subjects in their homes, where they would feel comfortable and safe. I requested that trusted supporters be present before I arrived and remain during the interviews. I aimed for a relaxed, natural aesthetic, professional but not fussy. And I simply let the camera run as I sat to the side and spoke with them informally about their experiences.
All of my work for The CommonWealth Fund has a gravity to it. I always feel challenged and enriched by their projects.
The CommonWealth Fund flew me to rural Illinois to interview a variety of people who volunteered to share their experiences with unexpectedly and suddenly losing health insurance coverage.
Health insurance uncertainty is mainly the long-term result of a link between employment and health insurance artificially incentivized with decent intentions in the middle of the 20th century. In coming forward to recount their deeply personal stories, the interviewees were testifying to the persistence of a problem that plagues millions of people in the U.S. and remains largely unaddressed. These videos were developed as part of a campaign to resurface and address this stubborn policy problem.
Any time I interview somebody about emotional, personal stories, it’s so important to build trust by speaking softly, maintaining eye contact, and listening, from a place of decency and respect in the first place, and also with the professional aim of ensuring that people feel seen and heard as they muster the courage to share private details of their lives.
I recommended producing the videos in black and white both to match the intimacy of these stories and to emphasize their common purpose with a single, unobtrusive, stylistic theme.
I was honored when The CommonWealth Fund asked me to help produce its centerpiece Centennial video to celebrate this extraordinary milestone.
The principal technical challenge of producing this video: I would be co-interviewing ten members of its Board of Trustees in a two day span using a single room.
It would have been easy to use one position, to default to a step-and- repeat setup, but the prospect of ten talking heads materializing in front of an identical background was unacceptable to me. Before the day of the shoot, I mapped out an exact order of spaces within the room I would use to give each interview a distinct background. During the five minutes between interviews, I made a series of changes so that the interviews traveled across the room, each aiming in different directions, which required constant relighting, too.
Loud construction work on Fifth Avenue was kept out of the recording mix by using a mix of highly directional microphones, recording extensive room tone during quiet breaks, and some creative soundproofing that preserved natural light flowing through the windows while deflecting unwanted sounds so they arrived at my setups with less crackle and pop and were easier to cancel in post-production.
I used simple slider moves to add production value to the interviews and B-Roll, and shot in 2k for HD delivery to ensure a higher quality final output for a deliverable primarily deployed on the internet.
The final cut pulls together voiceovers and photographic references to noteworthy highlights and accomplishments with the Trustees’ interviews, establishing how its excellent record of achievement has primed The CommonWealth Fund to take on the challenges of the next century.