PJ SOLOMON Presents

EP 13: Healthcare's Greatest "Test & Learn": A Talk with Humana CEO Bruce Broussard

January 26, 2021 PJ SOLOMON Season 1 Episode 13
PJ SOLOMON Presents
EP 13: Healthcare's Greatest "Test & Learn": A Talk with Humana CEO Bruce Broussard
Chapters
0:29
Introduction
1:00
Test and Learn
4:44
Omnichannel
8:46
Continue to Innovate
11:29
The Road Ahead
13:47
Net Promoter Score
16:59
Author and Digital Health
19:04
Leadership Today
PJ SOLOMON Presents
EP 13: Healthcare's Greatest "Test & Learn": A Talk with Humana CEO Bruce Broussard
Jan 26, 2021 Season 1 Episode 13
PJ SOLOMON
Transcript Chapter Markers
BRUCE BROUSSARD:

It has been quite amazing to see the agility of the healthcare system. I think in May we would have never thought that we'd had a vaccine by the end of the year, and here we are getting it out into the public.

RYAN STEWART:

One thing that's very clear is that healthcare at Humana and healthcare across our nation has made 10 years of advancements in less than a year. Welcome to PJ SOLOMON's inaugural Healthcare Technology podcast. I'm Ryan Stewart and I lead our Healthcare Technology & Tech-Enabled Services franchise. I'm delighted and honored to be joined today by Humana's Chief Executive Officer Bruce Broussard. It's terrific to be collaborating together again, we've had many discussions like the one we're about to have. And in particular, at the onset of COVID-19 last April, where you referred to the pandemic as healthcare's "greatest test and learn."

BRUCE BROUSSARD:

I didn't realize that test and learn was going to last so long. I have been amazed at the agility of the healthcare system and I, when we were in March of last year in April, the healthcare system really shut down and didn't know how to deal with COVID and, and the spikes and all the other things really caused the healthcare system not to have any capacity at all. And today, you know , we're seeing in markets that have spikes , that the healthcare system can still perform. We see utilization down by 15% or so, but we're seeing now much better treatment coming out of the hospital system. How they contain the COVID patients and manage it has been quite amazing just to see that. The second thing is, we've talked about genetics, we've talked about the genomics aspect of this for years, and this year through the rDNA kind of development of the vaccine has been really a great test of that genomics and just how that's evolved and , and what we're seeing there. And I I've just been at awe at companies like Pfizer. In fact, one of our board members is the CFO of Pfizer, so I've been able to live the day through him and has been quite amazing to see the progression. I think in May, we would have never thought that we'd have a vaccine by the end of the year, and here we are getting i t a nd getting it out into the public. I would also say, as I've thought back, I w ould h ave never thought the markets would respond the way they have. And obviously we're sitting at all time highs i n various different industries. But in addition, what I've I've been observing is how the markets have supported innovative companies coming to market such as Oak Street or Clover, and really highlights the demand for an asset light model t hat i s care delivery oriented and has holistic care and convenience fashion wrapped around v alue-based payment. And I think that has been coming in years in the past. And I think now it's sort of here and is in style, but I think it's going to be with us for a long time to come. And I'm excited about that both because that's a big belief system of ours, holistic care, value-based convenient for the customer, but I think it's going to be a great part of the healthcare system on the evolution of that. The other thing I probably would be remiss if I didn't talk about it, and that's just the digital growth that we've seen and what have we've learned from that, whether you go from , the high level , most obvious tele-health and the involvement of tele- health and the growth of that to really the way that people are, are utilizing the home. I look at exercising in the home just from a wellness point of view. I participated in a few events this summer and then the fall of yoga classes of 250 people participating on the call for seniors. And it was just fascinating to see how engaged they were and taking somebody that would once be lonely today because they didn't have the means or the ability for mobility to be able to now go out and do that. It just our AEP this year, virtual, you know, we didn't have, we couldn't get into the homes. And we announced last week we had a wonderful AEP season and the virtual selling and our relationships with our distribution partners and so on was all virtual. And so I just see this, it used to be virtual was a 20 year old kind of thing. It was for the 20 year olds. And today is for the 80 year olds. I mean, I'm just seeing this vast change and we have some issues with infrastructure and stuff, but I I've seen some just magnificent creativity and innovation around the digital side and how to serve within the healthcare system and specific seniors

RYAN STEWART:

It truly has been astounding to me how quickly, and I'll use a consumer retail concept that is used more on the retail side of healthcare, which is omnichannel. So companies like Oak Street, partners like yours, like Iora, Amir Rubin at One Medical, that back in April a lot of what we were talking about was the convergence of virtual care and RPN and being able to live healthy in the home, but it was this other concept around meeting the patient, meeting that healthcare member where they want to be met, when they want to be met...If it's phone, if it's text, if it's asynchronous chat, if it's email, or if it's face to face. The Ones, the Oaks, the Ioras, they have this dynamic where even a group like Iora today is saying that only about 50% of their encounters are onsite and they're going to stay there. I mean, Rushika's saying that that volume is going to have this nice, healthy balance between 50 50, which is bringing so much more scale to his model and so many more options to the consumer, to the patient. How have you seen that at Humana? And just any thoughts around Humana and the shift towards, omnichannel seemingly overnight.

BRUCE BROUSSARD:

I think you bring up a great point and a little bit about this convenience that I was referring to as, you meet themwhere they are And health c are has traditionally not been that. It used to be institutional. And it used to be you come to the institution and bow your head and wait in line and all the other things. An d t his is a great change for he althcare. I do think the models that have succeeded during this omni channel ha ve h ad a few attributes. One is around va lue b a sed. The second is around being able to be very agile, both on the needs of your members and the en vironments y ou're operating in. We as an organization have always been big believers in te le-health. But this year we saw a significant spike in tele-health in April and May timeframe, and June. And we've seen it come back down a little bit because of, getting back to your point, not everyone wants to be ha ving a n interface on the te le-he alth side. But this combination of being able to go to the office, someone would come into your home, you have to adjust to the cu stomer's n eeds. And that's probably the most important thing because he alth c a re h a s t raditionally had been whatever the he althcare s ystem is s et up to do. That's what the customer has to adapt to. We've tried to find the right engagement level. We find sometimes th e e ngagement level is great for te le-he alth, but other times we find it's much more effective to get them into the office. And a lot of times th ey w ant to get them in the office, at a number of our provider locations, they want to go see the doctor. That might be our population. That's more senior oriented. The younger population we've seen is m uch more virtual and, but they're more episodic in need as opposed to in t he need of chronic management.

RYAN STEWART:

2020 was clearly the year of virtual. We saw the coming together of two market leaders in Teladoc and Livango, a very interesting combination of virtual care and RPN capabilities focused around frail and elderly populations, as well as commercial populations. From a Humana perspective and this whole concept of the whole person, where you're able to understand and meet the needs of the whole person, in the home and having to do it now a bit more virtually and through remote care, how agenda advancing has been the needed adoption that did occur quite quickly around these technologies to be able to get at enabling them, those that want to and should be aging in the home and living healthy i n the home. But also this whole person that goes beyond major medical gets into behavioral and social determinants and beyond...there's a lot there, but maybe just talk a little bit of that in this age of virtual, how quickly you guys adjusted and where we go? Do we snap back to where we were pre COVID or are we able to kind of stay where we are and continue to innovate?

BRUCE BROUSSARD:

I would say we continue to innovate. I think this is given, I know for our organization, both confidence and our ability to make those investments and our leadership has forced our leadership to be much more aggressive in the pace of change. They've always thought its there, but I think our leaders have always tried to balance the here and now versus the longer term, but this has really given them both the confidence and the push to do that. I think we're on a long trajectory. I do want to just continue to emphasize that the personal need and the empathy of a face to face interaction is still going to be there . There is no different than any of us where we find that the virtual side is convenient. It' an ability to be very effective, but at the other side of it, there is this need to build relationships and trust. And I just feel in the healthcare system, you're going to need to do that. That's where we find the home to be a great opportunity for us to continue to expand the use of the home, to be a place where we can deliver that empathy and that personal face-to-face. And at the same time match the convenience for our members. As you well know we made an investment in Heal this year and made an investment in Dispatch and it's really expanding the permission space of how, so we see that the home is being a wonderful place where you can see how people are living. I know when our nurses and doctors go into the home, there's so much you can take in, whether where their prescriptions are and located, what's in their refrigerator ,to how they're livin,g to their personal preferences. You just get a lot when you , when you're in the home the same time, it's convenient at the same time as personal. So it gives you the elements of all. But tele- health can be a great complement to that .

RYAN STEWART:

You guys are way down the path. Many, many years of bringing that vertical integration in , and we've talked in the past about, you know, the importance of , of controlling some of that clinical supply chain, where the referral is staying within something you have a bit more control over. So, you know, owning Kindred with Welsh Carson, the investments in Heal, partnering with Dispatch, longstanding relationships with guys like Signify Health. Where do you see vertical integration go from here, given the assets you have? And if you think about health plans that have not taken the steps that you have taken, what would you feel like the experience would be if you hadn't put a lot of these pieces in place over the last call it five years?

BRUCE BROUSSARD:

Well, we have a long ways to go. So the journey is early and as long. Over the long run, the differentiation, I believe in the industry as a whole, whether you take plans to providers, is to be able to differentiate yourself on the experience and the health outcomes. For us as an organization, we feel the ability to a operations, a business model around value based payment, which obviously Medicare Advantage has been the most mature over the years. And then integrating that with a really, either strong partnerships with, with providers in the marketplace or assets we own to improve the health outcomes. And we believe that we'll never own a hospital, we will never own specialty groups. We really believe, find those parts of healthcare that have the biggest impact on both the experience and the health outcomes. And we believe primary care, home, behavioral and social determinants of health and pharmacy are all part of those impactful areas that have the ability to engage with the member, but do it in a way that also helps with downstream decisions. So ownerships, i t really wrapped around that. We do believe that t here'll be continued vertical integration into the marketplace because we're not the only ones that have come to the conclusion that clinical outcomes integrated together around a v alue-based payment model and clinical capabilities is really important. Now w e're focused on a more of a senior population. So you see our efforts different than someone l ike a United, as they have been much broader in their approach from surgery centers, t o, to physician groups, to even some markets, even some fixed assets that they own. Ours i s much more oriented to the primary care clinics, more oriented to home delivery and home health. And then in addition t o much more oriented to t he more chronic conditions i n the pharmacy area and social determinants of health. So ours are catered to a different integration, but I do want to emphasize we're not going to own every p art of the h ealthcare system. And so our partnerships with other providers in the marketplace is really important,

RYAN STEWART:

Delivering a differentiated consumer experience on the front end and again, another retail KPI that has quickly made its way into healthcare recently is the net promoter score. So delivering consumer delight on the front end with net promoter score and health outcomes on the backend, you feel like you're in a place at Humana and perhaps in the MA product and in that population, to truly start to deliver a personalized experience.?

BRUCE BROUSSARD:

We started this, I want to say six or seven years ago, and that , and as you all know, our comp formula for the last four or five years, a net promoter score has been part of that where 30,000 people get paid off of compensation or have participated in our b onus composition and net promoter score is part of that. We're finding we're maturing to another level. Our maturation now h as really oriented to the journey of our member and really moving to t eam-based structures where it's wrapped around the journey of the customer. And then how do you get upstream and make that delight service happen? S o I'll give you a great example. We have, as you all know, enrollment is part of our services that we offer. And we always looked at our enrollment in the net promoter score mindset as how do we ensure we get timely to the individual, their card, whether it's digital or whether it's the laminated version of it. And that was sort of, Oh , we got it within five days of enrollment, that was sort of the definition of success. Now, what we look at enrollment as is how do we delight the customer the first time they use that card? And it's a different perspective. And so when you think about the journey and you think about the evolution, it's not about how do you delight just that particular service you're providing us now, how do you delight that? And that has kicked off all kinds of wonderful things for, like right now we measure, do we have their prescription information at the time of enrollment, because we know they're going to call in and want to order their prescriptions . And we sit there, yes, it's already pre-approved. Do you want us to the mail order to do it? Or do you want to do it at CVS or whatever, maybe. A totally different conversation . And that, that I think is where you see our evolution going, and I'm excited about it because it uses digital, uses this ability to get upstream, uses this ability to measure the ease of use within the system.

RYAN STEWART:

I'm glad you said that, you know, we worked together on the Accolade relationship. Again, another place where you guys have made an investment. What you're saying there sort of is the emergence of what I'll call the navigators, right ? The advocacy and navigation that you've seen, you know , out of Accolade, you've seen it out of Quantum Health. What is the role of advocacy and navigation at Humana? You sort of just answered it because a lot of what you were talking about was navigation and consumer experience, but that is becoming its own sector. That is very, very well aligned with the goals and objectives of like you just described, you want humanity to be able to deliver.

BRUCE BROUSSARD:

Oh , you can expand that to someone like an Oscar, or you can expand that to Clover, we're big believers that digital health oriented insurance is going to continue to be a growing part of the delivery mechanism. I think for us as an organization, we've tried to balance how do you keep the engine going and growth in the $70 billion business we have going on, that's hard to just sort of turn on a dial because you've got 25 year old systems and you have all these other things that are less agile, but to be able to get to that advocacy that you're talking about. And , and so we started in , we don't talk about it a lot. And this is the first year , a digital health plan, where about four years ago, I went to our team and I said, we're just going to start new. We're just going to, we're going to hire a fresh management team. Some of it will come from our existing management team. Some will come from out, we're going to go find the best technology based on the customer interviews and understanding and focus groups we had. And we started a new plan called Author. Author is in South Carolina. It's got about 15,000 members in it, and it is brand new. And it starts with that advocacy view. It starts with a health coach. It doesn't start from an insurance perspective. It starts from the health perspective. And so very proactive, very oriented to simplifying and merging the benefits in their health conversation together, as opposed to making those two separate conversations and really not just a navigator about the health insurance needs, but a navigator about the health needs of the individual. It was an interesting way for us to get out of our, well , we can't do that because our systems won't allow us to do that. And it's also an easy way for us to learn from this trial and error kind of thing on a small scale, but being able to port that back over to the larger organization,

RYAN STEWART:

You're in your 10th year at Humana, which is amazing to me, it feels like a lot has happened, you know, and you've gone through the, you know, the Aetna cycle. You've gone through a lot of different cycles. You've done the vertical integration. We're now a year into almost a year into the pandemic. I wanted to just sort of finish on the topic of leadership, what the pandemic in particular has meant to you as a leader and your leadership style and to your directs in terms of how leadership has changed over the last year beyond remote working ,

BRUCE BROUSSARD:

I would say first, it has brought a higher level of intentionality. Sitting in one of our offices. And today there's no one in the office. There's, you know , the parking lot's empty. And so it's , you know, there's three people here, me, myself and I. And so my ability to influence 50,000 people isn't going to be coming to me. And so my intention ality of reaching out and talking to our teammates by our intentionality of communicating written wise or through town halls, and those things has become much more important. So it used to be, you roam around the office that was leadership. And I'd be sitting in Louisville on the sixth floor, and I'd go get a cup of coffee and see some people I'd say, well, boy, I'm doing leadership well today, Hey, that wasn't leadership. That was a false sense of security. It was 500 offices out there and then secondarily it wasn't leverageable and the third thing is it wasn't intentional. I just was sort of this casual thing today. I think a leader needs to be intentional. And so just some examples, I got a list of people and I will randomly them and they don't know I'm calling and it won't be, you know , a business transaction. I haven't talked to you in a while. How you doing? And you know, and I will learn so much about them, but naturally it turns to, Oh, let me tell you about my region. Let me tell me about some problems here. It's a wonderful opportunity to learn every week. Now I've written to the management team, a weekly notes for the last six years or so, but I turned that at the beginning of the crisis to all 50,000 people. So every Monday morning at nine o'clock, there's a note that comes out from me to them. And it includes things like about me, what I did over the week again, and include a picture of something. I did a 60 mile bike ride with my daughter this week. I had a picture of me and her there, and then it will bring in something about that's going on in the, in the external environment. I'll bring something that's going on internally into the organization. So this week it was about an inauguration and Vice - President Harris being the first African-American being able to be brought in, connected it to Martin Luther King then went on into some other personal stuff about reflections on what I learned and so on. And it was just a great way to be able to connect to them. And it's a wonderful way to get response back. So I'll get 500 responses, a thousand responses a year, and we have an analytics engine that goes through and count and looks at it and what's the sentiment and everything else, but it's a great way to get feedback, giving you those examples. Cause intentionality has been so important. The second thing is intellectual curiosity. I have found that in this time where it is not written in the book, can't pull out a book and say, how do you deal with a pandemic? Or how do you deal with digital transformation? Or how do you deal with, you know, the things that you're having to manage through in a very quick fashion, this ability to be intellectually curious, asking open-ended questions and understanding from that. And then the third thing is , is be purpose-driven. I've found that when you are driven by just financial outcomes, your ability to make decisions that are, that are broader and impactful are limited because your measurement of success becomes narrowed . And I've found when you have a , uh , obviously you need to make sure that you're have long-term sustainability through financial performance, but you also need to be at heart, have the purpose there. And you know , we talk about many times, it's the heart, it's the mind, and it's the hands. The heart gives you the aspiration. The mind gives you the direction and your hands do the work. And I just find, if you don't have all three of those, your leadership is really limited.

RYAN STEWART:

I can't thank you enough. This has been terrific, really, really powerful and so tied to our personal life. Right? I think we all, I've had these silver lining moments in just such a horrible time of chaos and despair around family time, around that intentionality as a, as a father, as a son. And, you know, as a consumer and a voter it's manifesting itself, you know, across the continuum, but from a leadership perspective, what a great opportunity to shift the game a bit. I don't know if you know this or not, but some of your people have committed you to Cape Cod in the fall. So we will we'll monitor how things are moving along. Obviously we're not going to do anything that is safe and responsible, but always enjoy these conversations,

BRUCE BROUSSARD:

I think, positively and looking forward to, well, thanks for doing this and wonderful seeing you again. Great .

RYAN STEWART:

And you Bruce, best everybody at Humana. Thank you for listening to our Healthcare Technology podcast, our monthly podcast series with the leading visionaries across healthcare . For more information on PJ SOLOMON, please visit us at pjsolomon .com .

Introduction
Test and Learn
Omnichannel
Continue to Innovate
The Road Ahead
Net Promoter Score
Author and Digital Health
Leadership Today