Health plans have long known the importance of digital transformation. But reorienting large, established organizations around new ways of doing things is not easy, and the COVID-19 pandemic cast a brighter light on existing challenges and introduced new ones. In this episode, we speak to Jake Sattelmair, CEO of Wellframe, and Steve Krupa, CEO of HealthEdge, about how leaders can not only effectively navigate a constantly changing landscape but also spur commitment to change, gain buy-in and implement new ways of working without breaking existing systems.
This episode is brought to you by Wellframe.
Health plans have long known the importance of digital transformation. But reorienting large, established organizations around new ways of doing things is not easy, and the COVID-19 pandemic cast a brighter light on existing challenges and introduced new ones. In this episode, we speak to Jake Sattelmair, CEO of Wellframe, and Steve Krupa, CEO of HealthEdge, about how leaders can not only effectively navigate a constantly changing landscape but also spur commitment to change, gain buy-in and implement new ways of working without breaking existing systems.
This episode is brought to you by Wellframe.
Melissa Turner 0:03
Hello and welcome to Touchpoints, a conversation about care, connection and costs in the US health care system. I'm Melissa Turner. In addition to co-hosting Touchpoints. I'm also content director for health care and life sciences at SmartBrief. SmartBrief is a publisher of digital newsletters for professionals and creator of this and other shows in our series of SmartPod podcasts.
Doug Harris 0:24
And I'm Doug Harris. I'm a custom content editor for health care and life sciences at SmartBrief, where I create content for payers, providers and other health care stakeholders. In addition to our work hosting Touchpoints and at SmartBrief, Melissa and I are of course also consumers of health care just like those of you listening. Together, in each Touchpoints episode, we'll explore the issues that make health care hard for all of us.
Melissa Turner 0:45
We'll also discuss how health plans, health care providers, and their partners in the health care ecosystem, can make it easier. Thank you for joining us on the Touchpoints podcast.
Doug Harris 1:08
Wellframe empowers health plans to become trusted advocates for members. Their team believes that health plans are in the best position to lead the charge into the world of digital health management. Let Wellframe be your partner in improving member engagement and outcomes. Learn more at wellframe.com/touchpoints.
Melissa Turner 1:26
Welcome. I'm Melissa Turner, your host for today's episode of Touchpoints. Today we're kicking off Season 2 with a topic that's pretty compelling at any time and in any industry, but especially in health care after two years of crisis. We're discussing leadership, and specifically the challenges of leading innovation. Let's meet our guests. First is Jake Sattlemair, co-founder, executive vice president and general manager at Wellframe. Jake is a Harvard-trained epidemiologist whose work and research lies at the intersection of public health, technology, data analytics and consumer engagement. Welcome, Jake.
Jake Sattlemair 1:58
Great to speak with you, Melissa.
Melissa Turner 1:59
I'm also pleased to welcome Steve Krupa, CEO of HealthEdge, where he leverages his technical expertise honed as a mechanical engineer, programmer, and as a business leader who oversaw over $12 billion in strategic acquisitions and recapitalizations. Among those successes is the landmark acquisition of US Healthcare by Aetna. Today, Steve leads HealthEdge on its mission to drive a digital revolution in health care. HealthEdge completed its acquisition of Wellframe in December of 2021. Glad to have you, Steve.
Steve Krupa 2:27
Thanks for having me. It’s good to be here.
Melissa Turner 2:28
All right. Well, I want to start by hearing a bit from each of you about your own leadership journeys. So, just thinking in a nutshell, how did each of you land at the helm of a health care technology company? And let's go ahead, Steve, and start with you.
Steve Krupa 2:40
I don't think any CEO comes to the job with any sort of traditional path. I mean, some people work their way up through companies. In my case, I was principally a venture capitalist for 20 years and HealthEdge was one of our investments. Back when the founding CEO came to us and said he thought it was time that he step aside for somebody else, I was volunteered to become the interim CEO. And I got familiar with the company and began to notice that they were doing some amazing things. I fell in love with the job and offered to do it full time. And the board accepted my offer to come in. And from there -- that was about six years ago -- I was suddenly a CEO, and no longer a board member and venture capitalists that recommended to CEOs what they do. I actually had to, like, do it. And I guess it's worked out OK because I'm still here. And it's a completely different experience than the one I had before I started running a company. And my guess is Jake will tell you a similar story in a second.
Melissa Turner 3:33
Well, we’ll dig into the details of that story in a moment. But Jake, why don't you tell us a kind of high-level view of your story?
Jake Sattlemair 3:39
Yeah, it was coming from a public health background and doing research on the relationship between lifestyle behavior and chronic disease risk and prevention and management. I was convinced that I wanted to do something that had a more tangible impact in the real world than publishing papers and spent a bunch of time trying to figure out what that might be. And ultimately fell in love with the idea that technology could be used to extend and scale resources and interventions that could help people make good decisions about their day-to-day health and kind of navigate the health care system at home and in the community. And if you align that with, sort of, incentives of the health care system, you could potentially do that at a meaningful scale. I kind of fell in love with that idea. And that led to kind of forming an organization of likeminded folks with complementary backgrounds to help solve problems. And ultimately we decided that being a for-profit company and then eventually a venture-backed company would allow us to accelerate our path to scale that public health impact. And so the CEO and the leadership part was sort of a byproduct of an orientation to make an impact and to build an organization to do that.
Melissa Turner 4:41
Well, that's an interesting path, Jake, from academia. Pretty different from what you're doing now. What has surprised and challenged you most about that journey?
Jake Sattlemair 4:48
Maybe a more succinct question would be like what hasn't? I think when I came in, I had minimal experience in the working world or the private sector, so everything was new and everything needed to be learned. And so it was sort of one surprise after another and our orientation going in was like, let's assume we don't know anything. We have to aggressively learn as much as possible, and then figure out how we apply it and adapt and improve and get better. And try to think about things from first principles and develop our own conviction on them, but also learn from people who have been around blocks that we hadn't. So whether that was hiring people, managing people, building a team, raising money, building a product, selling to customers, making those customers successful, all of it was learned through a lot of micro-surprises that kind of led to evolving our conviction on how to do things. And I never would have kind of guessed going in, you know, what that journey would have been like. I don't know if I would have done it, had I known what it would be like going in. But I’m on the other side, so …
Melissa Turner 5:45
Nice. And what about you, Steve? What changed for you as you moved from venture capitalism to leading the company?
Steve Krupa 5:52
Listen, to be a CEO can be wonderful in one moment and discouraging in the next. It's a very significant emotional roller coaster that you’re on. But I think it averages out to wonderful, because so much flows through what you do every day from the company. And so you're sort of in touch with everything, from customers, to employees, to products, to problems, to successes, you know, and so forth. So it's super interesting every day and exciting. And if you let it get to you, it can be very stressful at times. But the one thing that is much different running an operating business than running an investment business is the diversity of the people that you work with. And the understanding that without great people believing in you, believing in the business, believing in its mission, you can really accomplish very little. But when you get them to believe in you and the mission and the vision for the business, you will accomplish things that you never thought you could. So it really ends up being very much a people equation when it's all said and done. And that's very different than in some ways from investing. Investing tends to be about people, but it also has a lot of other things that are different than running an operating business that grows from, in our case, you know, 200 people to 1,500 people. So obviously, we'll get a lot more done with 1,500, hopefully, than when we had 200. And when people believe in that really cool things started happening.
Melissa Turner 7:11
Well I know we want to talk about innovation today. But I have to just follow up on something you mentioned. You talked about stress, Steve, and in this climate after two years of pandemic stress, burnout is off the charts in many industries. How do you manage it?
Jake Sattlemair 7:25
From my perspective, the pandemic and working from home has been a major part. But you add to that, like, what you think over the last couple years, like a lot of significant sort of reckoning from a social and racial justice perspective. You add to that political turmoil, global conflict, climate crisis, signals of economic volatility. There's a lot happening in the world that provides a context for frustration or angst or not feeling out of control. And it's inevitable that for everybody, we carry that around with us. And that's always the case. But I think that the last few years have really kind of brought a number of things to the forefront at once. And so, part of it is just acknowledging that that's happening and giving voice to the fact that like that's something that everybody's dealing with and then recognizing that even when we're virtual that people are people and they don't come to work with a clean slate. They come to work with everything else that's happening in their lives, and people have families, they have friends, they have social contacts. They have personal challenges, and trying to give some credence to that and connect with people in a human way so that they know that you care about them. And then also one of the things that I think for us has been helpful, especially as it relates to the pandemic, where it's like, look, if, if this is something that we can do, you know, given we're in the digital health space, and we're helping to support and engage high-risk people, it's like, if this is something we can do to take one step forward to make things a little bit better, then that's something that we can control a little bit, right? And that's something we can focus on and feel some agency around. It's constant learning. And I'd say, like, it's no claim to have cracked the nut on how to address all these things by any stretch. But it's certainly been rife with new learnings and challenges as a leader to figure it out.
Melissa Turner 9:03
Yeah, I want to piggyback on that question and ask you to talk about how the pandemic has influenced your leadership. It could be your priorities, how you've communicated things. Like you were talking, Jake, about recognizing and giving voice to the fact that people are whole humans when they come to work, with all of these other things going on. How would you say the pandemic has changed your leadership?
Steve Krupa 9:21
Yeah, I think it's turned it on its head in that you have to be much more of a frequent communicator, and you have to outreach around all the issues that that Jake talks about, I send out a weekly message to the company, we have more frequent sort of townhalls so that we can get together and talk. We find we want to hear the pulse of our employees more frequently. Because oftentimes, you could feel the pulse when everybody was together, right? And you go down to the engineering groups and you can feel what they're trying to build and where they are and what their priorities are. And you've got to make sure that you're outreaching to them. And you've got to try to make it as personal as you can, because so much of the personal touch has drifted over a two-year span. And that includes like the question, like, “Do you have a best friend at work?” right? So a large percentage of our workforce was hired in the last two years, and they were hired virtually. And I go to meetings, now in-person meetings, and I realize that I've never seen some of these people before or spent time with them personally, which is unique. So the whole idea of being able to outreach and staying in touch and letting people understand that, you know, we're part of the same journey together, as we get through this, so that they feel supported by the business and the leadership has never been as important as it's been, I think, in the last two years.
Melissa Turner 10:39
Anything you would add to that, Jake?
Jake Sattlemair 10:41
I think Steve covered a lot of ground there. And having recently joined the HealthEdge family, I think that we certainly feel that kind of commitment and all the investments that Steve referenced in terms of like that kind of virtual engagement. The other part of this is that we work in organizations that partner closely with large organizations, largely health plans, to drive change in, you know, whether we were on a sales meeting or a customer meeting, like historically, those have largely been in person. And we're flying around the country meeting with our counterparts and aligning on how we help them succeed. And then that stopped, right? And that still isn't happening. And so the other part of it was, like, adapting to how you engage with our customer partners to make them successful in a virtual world. And similar to the employee experience, you know, a lot of the meaningful interactions are the kind of conversations that happen outside of the meeting and happened before the meeting. And you don't have as many of those, so there's also been adapting to how you, you know, how you grow the business and how you partner with customers, how you make them successful virtually. And I've generally been surprised and impressed with how resilient everybody's been, and how creative people have been to make that happen. But you know, as Steve alluded to earlier, it does come with a bit of a cost, right? Where like you, you lose a little bit of that human touch and that opportunity for creativity and spontaneity. So, looking for ways to foster that virtually is challenging, but I think something that all the teams have been working on.
Doug Harris 12:09
Wellframe empowers health plans to become trusted advocates for members. They believe health plans have the knowledge and resources to support more people across more touchpoints in their health care journey. Wellframe’s solutions for digital care management and digital customer service empower members and health plan staff to achieve their best in the most wonderfully human way possible. Make sure your members feel confident, cared for and supported by their health plan. Don't miss this moment. See how a digital health management strategy would benefit your plan at wellframe.com/touchpoints.
Melissa Turner 12:39
I want to talk about the work you do with other organizations. Now maybe we'll pick up some of these threads again. So, you both work with other leaders to bring about transformation in their organizations. Can you just talk a little bit about how you approach that? And maybe Jake, we’ll start with you.
Jake Sattlemair 12:53
As part of HealthEdge’s, you know, broader ambition to help plans to kind of digitally modernize, we focused on digitally modernizing member services and kind of digitally enhancing the relationship between health plan staff and members. And that requires pretty significant changes to how those health plan employees reach out to members and interact with members and support members and engage members and kind of the workflows that they pursue to do that. And we realized early on that we couldn’t just be a vendor that licenses technology. We had to be a partner that drives tech-enabled change management and tech-enabled kind of transformation to services. And change is hard anytime. But in organizations that are very structured and risk-averse, and protocolized, it's even more so. You know, I think it does start with having really strong alignment with the leaders of that customer around what the goals are, and why you're pursuing them, and how you're going to pursue them together. And then it requires a multifaceted effort across every level of the organization to help kind of educate and inspire people to why they should change, and then give them the tools to change and then continuously reinforce that, and hopefully get people to a point of intrinsic motivation, where they actually see the benefit to them for doing something differently. And that takes time, and it takes a lot of effort. And that's not always universally successful. And it's successful to different degrees with different people. And it's a big part of what we've tried to get good at as an organization. And then what can we do as a partner? What can we do through our technology to reduce friction and kind of make that the default path as much as possible, and for as many of our customers and their employees as possible? So it's a big part of what we do. And it really does in many respects come down to the conviction of the leaders that we work with, and their kind of appetite to drive change and hold people accountable to that change. But we try to do everything we can to help them along the way.
Melissa Turner 14:43
And do they have to bring that conviction? Or do you sort of help them find it? How does that work?
Jake Sattlemair 14:49
It's our job to make it easy for them to have the conviction because they see the benefit, right? They have to have it at some point, right?
Melissa Turner 14:57
Sure. Sure. Steve, what would you say talking about working with other leaders in transforming their own organization?
Steve Krupa 15:02
I think Jake covered it great, and I think the other side of that is just having empathy with those leaders, because they're not working just on your project. Like they're responsible for a whole bunch of things, and prioritizing those things, and being responsible for creating success. I mean, I don't think I've seen this density of technology change ever, across the board, economically and within businesses and externally outside of business. I mean, it's pretty extraordinary. Every day, they're faced with a business problem that they probably can apply technology to, to resolve it in some way, shape, or form. So, understanding that they have a lot on their plates. And we have to figure out how to make what they're doing with us easy. And that's not always easy to do. But that's what we have. That's what we have.
Melissa Turner 15:47
So I want to talk about thinking about the position that the leaders you work with are in, the challenges of innovating from a leadership position. I think, Jake, you alluded to some of them. Change is hard, inherently. What are some of the challenges beyond the fact that change is difficult? Steve?
Steve Krupa 16:02
Change is difficult. But it's also, there are many subsets to that. But principally, it's like, you're going to decide that you're going to change something. You have to measure how to accomplish that change, because we won't do anything without measuring it. You've got to set reasonable benchmark progress, and you've got to follow up and make sure those benchmarks are being hit. And then you've got to make sure that you've got people on both sides of that change that are committed to it. I think in looking at the things that we try to do to change in organizations, which are perhaps different than our customers, but similar in that we are very much reliant on a group of people being committed to the change that we want to foster. And when you get that going, and then you agree to measure it, and you agree to measure it frequently up to spec and figure out where you're falling short, or hopefully, where you're on target, you can get to the end. And you have to also do that within the framework of a creative process, which is the hardest thing to do. It's very hard to manage a creative process to the extent that that exists within change, and manage deadlines and metrics and specs, because somewhere in the middle, somebody's going to have to build something new, or come up with a new idea. And you've just got to make them. That's where the people come in. Because when people are committed, they'll solve those problems. And when they're not, the project often gets delayed, derailed, or sort of falls into the bucket of, “We've got to restart.” And you know, from my and Jake's positions in what we did, we really have to work with our customers to ensure that doesn't happen, because that puts us in a tough spot, both of us in a tough spot.
Melissa Turner 17:36
So that's an interesting point about managing the creative process. I'm trying to think about what that looks like in practice. I don't know if an example comes to mind that you can kind of flush out?
Steve Krupa 17:45
Yeah. I mean, in any innovation process, I'm assuming, when you're talking about innovation, you're by definition changing something to something better, something as it is to work better. Somewhere along that line, you're going to run into a technical problem that you didn’t expect, and you still have targets, deadlines and metrics to hit. So in that moment in time, that becomes a creative process. And that is most often the cause of delay. And importantly, that's most often the cause for dissatisfaction along the path of completing a project. And really what's needed there is creativity, which involves giving people space to figure something out that they haven't seen before. And there's tricks to that. And when you enable a creative process, and you enable innovation in that way, you actually start to move faster. But when you pressurize it, sometimes you start to move slower. It's almost like that whole thing, almost like the golf swing. Swing easy, and you hit the ball far. Swing hard, and you pull it into the woods. And that's the whole point. And this happens every time in any creative process where people have to take a step back, calm down and figure out how to solve a hard problem. And managing through that is the hardest, for sure.
Melissa Turner 18:52
It requires a lot of trust, I would think.
Steve Krupa 18:56
An enormous amount of trust and faith in the partnership that you’ve built. So we all agree that we've hit a surprise, and now we've got to be transparent about how we're going to reconcile.
Jake Sattlemair 19:05
You know, one of the things that we talk about internally sometimes is, like, it's easy to criticize a health plan, but it’s really hard to run one. You know, as having empathy for our customers, and all the things that they need to do to run their businesses successfully, I think the more we know and understand that, the more effective we can be as partners to help them innovate and help them change. And I think that in this space right now, where there's a lot of investment and a lot of efforts at disruption, we look at what some of the established health plans are doing. And you know, if you take the metaphor of like the tanker versus the speedboat, or something, right, sometimes it's not always who can get to the finish line faster. But it's who can displace the most water along the way or carry the most people, right? And so I think that helping these larger organizations to shift their direction, and then to move toward their destination, and in a new direction, is a different skill. But I think from my perspective, we see it as a huge opportunity to make an impact in health care overall, and in the health of all the people who are getting care. And so being able to figure out how to do that effectively, I think, is a skill in and of itself. And we see a ton of structural advantages that these organizations have relative to their scale, their reach, their access to resources and capital, that if you can tap into it in effective ways, you can leverage and you can kind of amplify to make an impact. And when you do, it's really exciting to see that. And as Steve said, it's hard. It's hard to get it right. And you've got to refine the approach. But when it happens, and you see a repeatable process to make it happen, it's pretty inspiring.
Melissa Turner 20:36
Well, I want to talk a little bit more about that idea of a tanker versus a speedboat. You know, there's certainly a common perception that large, established organizations like the big health plans have difficulty innovating. I want to just sort of talk about whether that's true, and how you innovate in an organization like this. I think we've talked about this a little bit, Jake. Like how do you keep the lights on? How do you keep doing all the things that you need to do while you are building something new, testing it, and then bringing it online.
Jake Sattlemair 21:05
I can start, and Steve, feel free to pile in. I mean, I think a lot of smaller innovative companies have trouble innovating, right? I mean, if you take a look at a lot of the companies that are talked about in the news, and get venture funding and otherwise, they don't work out, right? And so you got more to gain and less to lose. And so for these larger organizations, the way that they innovate is going to be different, and their calculus around how they innovate is different. But I also think they have more options. They can build things, they can partner with organizations like us, they can buy things. The definition of innovation, I think, is a little bit different. But if you think about it as how they continue to improve the quality and the value of the products or services they offer to their stakeholders, I think they're actually innovating all the time. You just may not recognize it in the way that we talk about innovation, or that we like to look at innovation in the news.
Steve Krupa 21:55
They are innovating, and they’re innovating in a super-complex structure of payments and structure of services business. You know, if you were to design a business from scratch, you couldn't design a business this complicated in terms of health insurance and health care delivery. And I see them innovating at high volumes. And a lot of those innovations don't always move the needle for them. I think that they're constantly trying to improve access to or improve quality of care, reduce the cost of care, improve provider-plan relations, improve access to members, the member experience, and they're trying a whole bunch of things in the course of a premium cycle. And the issue is that sometimes it works, and sometimes it doesn't. I definitely see the plans by and large moving forward with new ideas. And those ideas get shared across the whole industry. But I've been doing this for a really long time in terms of health care. And I would say that there's still so many things and so many challenges in the industry that remain despite that effort. I think that's a lot of times what you see from the outside looking in.
Melissa Turner 22:56
I think it would be a shame for us to not ask a question here about member engagement with the two of you here today. Steve, you were talking about the complexity of health insurance, and that is something we hear all the time. That's a tough framework to work within with respect to the places where you work, the member engagement places. Can you go in and kind of clean up some of that complexity, go in and break the old system and replace it with something simpler? Or do you find that you really have to work creatively within the complexity?
Steve Krupa 23:26
Well, you want to create an abstraction layer above the complexity for the benefit of the member, so that it doesn't appear as complicated as it probably is going to be sometimes. And unfortunately, it does appear complex to the member. Again, when we take the member, we just put into a consumer patient context. When you're accessing care, and you're potentially in in an acute episode, or you're chronically ill, or you're having a wonderful health care event, like having a child, you see too much of that complexity as the patient in a moment in time when you're probably not emotionally efficient in handling complexity, right? Because you're like, “Well, what's gonna happen next?” You know, I've got all this, these next best things that I have to do. And so what I think we've got to do as a system is to create an abstraction so the member can navigate their way through that complexity without recognizing it at all times now. And it has to do with assisting them to understand what's expected of them as they go through the process, what they should expect from the system, and informing them of the ongoing financial ramifications of what they're about to go through, just like anybody would want. And that's all part of the beginning, I think, of starting to change the system, because it becomes a better experience for the patient. Then I think the health care system itself can start to function for the benefit of the individual person, as opposed to being focused principally around how to organize care and organize payments.
Melissa Turner 24:51
Well, I want to wrap up by pivoting back to leadership. I love to ask this question of leaders in my own life. What is the best leadership advice you've been given that you'd like to pass on to our listeners? Jake?
Jake Sattlemair 25:03
I think the best advice that I've ever gotten, or maybe the advice I've used the most in this journey, has been in the pursuit of a long-term goal. Don't let your highs be too high or your lows be too low. And given the profile of experiences that Steve referenced before as a leader, I think that's been really helpful to stay focused on the long-term goal and, you know, kind of navigate through the ups and downs of getting there.
Melissa Turner 25:24
Absolutely. Steve?
Steve Krupa 25:26
The best advice I remember, you know, I got it from a guy named Michael Stocker, who was running Empire Blue Cross, and he said, “Focus on the people.” Being a leader is about liking people, and about focusing on what's in it for them. And if it's if there's something in it for them, you get a lot of really good outcomes.
Melissa Turner 25:44
Great message for this conversation and our listeners in the health plan space. Jake Sattlemair is co-founder, executive vice president and general manager at Wellframe. Steve Krupa is CEO of HealthEdge. Thank you both for sharing your ideas and experience. It's been a pleasure speaking with you.
Jake Sattlemair 26:00
Thank you.
Steve Krupa 26:01
Thank you.
Melissa Turner 26:04
Thank you for listening. We hope you enjoyed today's conversation and learned something, too. You can check out SmartBrief’s health care newsletters by going to SmartBrief.com and hitting the blue subscribe button. Be sure to spread the word and subscribe to the Touchpoints podcast. Finally, a huge shoutout to our friends at the Shift.Health Content Network. We'll be back here in a couple of weeks for another episode of Touchpoints.
Doug Harris 26:32
Wellframe empowers health plans to become trusted advocates for members. They believe health plans have the knowledge and resources to support more people across more touchpoints in their health care journey. Wellframe’s solutions for digital care management and digital customer service empower members and health plan staff to achieve their best in the most wonderfully human way possible. Make sure your members feel confident, cared for and supported by their health plan. Don't miss this moment. See how a digital health management strategy would benefit your plan at wellframe.com/touchpoints.