When the Minneapolis ad agency Preston Kelly was named agency of record for Colorado-based Catholic Health Initiatives (CHI), it was a signal that the small shop has become a national player in the health care field. CHI, a 19-state, $14 billion operation, joins a stable of more moderate health care clients that Preston Kelly has slowly been building since it started doing work for free for the YMCA of the Twin Cities. Now the award-winning agency’s clients include HealthPartners, Medtronic and Gundersen Health System, with the Affordable Care Act offering even more opportunities. We sat down with Chuck Kelly and Chris Preston to see how the agency works.

Q: How did Preston Kelly get into the health care sector?

Kelly: We got into wellness and health care at the agency 14 years ago when we started doing pro bono work for the YMCA. We were looking for a way to give back to the community and liked their belief in helping people of lower incomes and ethnic diversity. If we could help add dues-paying members, it would help fund those programs.

Preston: The Y credits 1 million-plus new members to the ads we’ve created. They’ve been a very trusting partner in what we do. We have consistently hit our goals for adding new members. We do good, and they do good.

Kelly: Other clients started to notice our work in health care. About nine years ago we started working with HealthPartners and launched the “A new way to look at health care” campaign. We looked at health care advertising and all you saw was ads with smiling faces — smiling doctors and smiling patients — and in the end you didn’t remember who the ad was for because everyone was smiling. We wanted something different about keeping health care simple.

Preston: We did unexpected media placements like a sign on a Macy’s elevator.

Kelly: Then HealthPartners and Park Nicollet came together and it was time to make a new statement because this was not the same business anymore. So we developed a new campaign that reflected the entire organization, including multiple hospitals and clinics from Stillwater to Andover. That became, “Make good happen.”

Preston: That was a rally cry for both HealthPartners and Park Nicollet as well as a reach out to consumers that health care decisions don’t have to be so hard.

Q: How did the agency thrive in this market?

Kelly: It’s been our main area of growth over the past couple of years. It’s a category of great need of brand building. With the Affordable Care Act coming into play, people have to make choices with a plan they trust. It means there are marketing opportunities as well.

We did research on our own. We wanted to talk about what was on the minds of people about health care today. We got insights into what consumers deal with and fight with, Sometimes they feel they have to play God because there are really tough decisions to make — taking care of children, themselves and aging parents. Health care is more and more a retail business. If Whole Foods and your bank can offer services online, that’s our frame of reference.

Preston: Consumers are saying, “Don’t just tell us you’re doing better, show us practical solutions.” At HealthPartners, same-day care is new as well as online immunization records.

Q: Medtronic also is a client. It is a different kind of health care company. What do you do for them?

Preston: All of their salespeople are on iPads, and they often just have a minute or 30 seconds to show a doctor what is new, what is the next generation. The fact that we take complex things and make them simple was attractive to Medtronic.

We created the “Ask the ICD” [implantable cardioverter defibrillator] website. It was one of their first consumer-directed tools. It allowed consumers who were considering a defibrillator to ask the questions they may not ask their doctor — the sex question, the golf questions, can I get scanned at the airport?

Q: What are the challenges in marketing a health care brand?

Preston: What makes it difficult is that there are so many different points of view. Doctors have a point of view, insurers have a point of view. We try to bring simplicity.

Kelly: The basic insights into consumers and health care that we’ve gained are not just for people who live in the seven-country metro area. People are frustrated across the country. We’re building platforms. We’re using social media, digital, paid and owned media. We’ve done work for Gundersen Health System out of La Crosse, Wis., where the elephant in the corner of the corner of the tent is based in Rochester [the Mayo Clinic]. The issue is how will regional entities continue to offer value and grow. There is still room for organizations in health care that bring value.

Preston: Gundersen had a very caring reputation and had grown with the community. They had the slogan, “Where caring meets excellence.” We added “love and medicine.”