Accelerating health care’s digital transformation

November 23, 2021 SmartBrief Season 1 Episode 6
Accelerating health care’s digital transformation
Show Notes Transcript

Digital transformation is a goal for many health plans, but it doesn't do much for members and health outcomes unless it's built around a core of consumer centricity. Done right, digital transformation is a means to more compassionate, empathetic, personal health care, and it connects the dots across the health care system. In this two-part episode, UnitedHealthcare Chief Consumer Officer Rebecca Madsen and Wellframe CEO Jake Sattelmair explain how health plans can embrace the promise of digital transformation -- and why they must.

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 US health care. I'm your host Melissa Turner. I'm 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. In addition to overseeing production of SmartBrief health care content, I'm of course also a consumer 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, and we'll discuss how health plans, health care providers and their partners in the health care ecosystem can make it easier. Thank you for joining us.

Melissa Turner  0:55  

Touchpoints is sponsored by Wellframe. Wellframe works with health plans to reimagine member relationships. 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 

Melissa Turner  1:15  

Today, our topic is digital transformation. Up first, in our discussion is a conversation with Rebecca Madson chief consumer officer of UnitedHealthcare's employer and individual market business. Rebecca has held a variety of leadership roles at UnitedHealthcare, having a hand in strategy, product development, marketing and operations. Welcome, Rebecca.

Rebecca Madsen  1:35  

Hi, happy to be here today.

Melissa Turner  1:37  

Really glad to have you. I wanted to just kind of start out by talking a bit more about your role, the evolution of consumer experience, it's been really interesting to watch in this industry. And it's something that we've talked about on this podcast a lot. It seems to track pretty closely with digital transformation. I want to start out with what are your goals for the United Healthcare member experience.

Rebecca Madsen  1:58  

So I've been in consumer experiences as a chief consumer officer, and just in healthcare in the consumer engagement and experience space, for over 25 years. And really, what I focus on and my team focuses on is helping people along their journeys to achieve in the best health possible by new empathy, bringing compassion. But the simplest way is that I explain my role is that the goal is to advocate for consumers, regardless of where they are in the journey, that it's not just about call, it's not just about, you know, processing and claim, it's really the confluence across clinical, digital, personalization, inbound, outbound, and making sure that we bring that together with the clinical and service underpinning. And if you think about it more broadly, it's about how people engage with the health care system, how advocate for them, how to make sure that they make smart choices, and maintain their health and wellness. And one way that we do that is through using things such as data, using analytics to understand the consumer and they're experiencing, identifying gaps, and figuring out how to fill those gaps, leveraging tools and technology and digital is a critical piece of that.

Melissa Turner  3:15  

Well, that's a really good segue into my next question, which is sort of zeroing in on digital transformation. So where are kind of all the places where digital transformation informs or can inform that consumer experience?

Rebecca Madsen  3:28  

The way I think about the experience is that it really is omni channel, that you rarely have a person that only interacts one way, that if you have somebody that has chronic illness, they may do a lot of their interaction through digital, but if they have an acute episode, they may pick up the phone and call. In our experience in the commercial population, our employer base population, we have about 70% of the people that we kind of call cough-cold-flu. And they don't go to the doctor that frequently. They usually only go when they're sick. But we don't interact with them as much historically as we do with the complex members, or the acute or chronic members. So for them, it's you know, how can I interact with you 24 hours a day? How can I get you what you need? And for the individual? I want it when I want it. How do I see the claim I just had? How do I look up a doctor? So digital for them is basically convenience of information. And it's accessibility of that information, 24/7. Then you have the percent of the population that has acute or chronic illness all the way up to the top 1 to 2% of the population. And interaction with them digitally is very different. It means, help me with my care, help me manage my medications, help me look at my experience and make it seamless, help me interact with my provider. And so what we see is millions of interactions across the system, real time and we know consumer expectations are evolving people ones are embracing and digital attitude. And they want digital be part of that omni channel interaction, regardless of where they are on their healthcare journey. And to be able to bring that to life, you need the data, you need the information to be able to help guide them in a seamless way, regardless of how they interact with us.

Melissa Turner  5:18  

Well, I want to ask a follow up about one of those groups, you talked about the folks who really are interacting with their health plan or the health care system when they have an acute care need. Cold-cough-flu, I think you said. It's really interesting to think about providing a personalized experience to someone you don't know as well. How do you kind of customize and create a great consumer experience for somebody who is just reaching out when they're having some kind of emergency? And you know, otherwise, they're sort of ... Are they less known to you? Or are they not? 

Rebecca Madsen  5:50  

Well, obviously, the more somebody interacts, the more information you have on their interactions, you have to claim history, or their call history. We have built a very comprehensive and robust dashboard. And what that dashboard does is it brings in every piece of information about the individual, everything from their preferred name. So if you think of the transgender population, what is the preferred name? What was their last call? What was their NPS score? Do they have a prior authorization in the system? What clinical needs do they have? Do they have incentives that they haven't taken advantage of. And so we do actually know the consumer because of the size and the vastness of our organization, we see all these interactions, and then we pull them in so that when I'm interacting with you, regardless of how I interact with you, I know the decisions you're about to make, the decisions you made and the decisions you don't know that you need to make. And then I can help guide you across that entire interaction spectrum. So even though you are not interacting with the system that much, when you do I capture that information, so that I make sure I can serve you differently. The other thing to think about is we're putting people as you know, their interactions really around when they're sick, we have a very wonderful opportunity to interact with people when they're healthy. And we have a full, robust program that's really about digital health. It's well being that does everything from leveraging tools and technology and wearables or motion program for people who you know, get incentives from walking, we have full incentive programs all around wellness. So there's a lot we can do to interact with a human being, even if they're not sick. And the goal, obviously, is to use digital to be able to help interact with them, so that we can give them opportunities to maintain their optimal state of health and wellness and never get to that point when they're acute or chronic

Melissa Turner  7:48  

Well, certainly sounds like a lot of opportunity there. I want to pull back for a moment and just talk generally about the idea of digital transformation. It's a term that gets used a lot in health care. I'm wondering what does it mean to you and United Healthcare? And then what can you tell us about where you and your team are on that journey?

Rebecca Madsen  8:06  

So digital transformation is really what we look at as a company is how do we bring digital and technology based solutions into our organization, and we've been focused on that for years for so I've been at United Healthcare, actually, August 11, 1997, was my start date, over 24 years, and have been talking about digital since I started here. With the advent of technology and advancements in digital and consumer adoption of digital which we saw, obviously, in the last year and a half during the pandemic, there was much more receptivity to digital interaction. We saw telehealth, for example, prior to the pandemic, only 39% of people said they were interested in a telehealth experience. Now it's 93%. So we've seen the tools and technology really advance. And it's not only important for people in digital transformation, that the term you used to think about it, as you know, just interaction channel, it also provides access. It also provides people in remote locations, it provides people who aren't able to leave their house. And it also enables us to do things on you know, if we look at social determinants of health, which is 80% of what happens outside the doctor's office. How do we leverage tools and technology to do predictive modeling to understand who that individual is. So as an organization, we invest over $4 billion, $4 billion. That's a big number each year in data technology and innovation. And we do that because we really see the technology, the tools and digital as being another way to reach our entire population and to provide the access that they need so that we can engage with them, they can engage with the system which results in higher quality, more cost effective care.

Melissa Turner  9:53  

Now we hear a lot about you know, in these kinds of conversations, particularly around telehealth and things, about the digital divide as being kind of a concern for rectifying versus exacerbating social determinants of health. I think what I'm hearing from you is that it's a potential enabler of connection, of care, of access for folks who are otherwise difficult to reach. Are you seeing that play out? And are you? Are you able to reach folks that you maybe couldn't through those means?

Rebecca Madsen  10:20  

Exactly. So I think, you know, like I said, people want to interact really differently, what we seen most acutely is that how people's interactions vary really are driven by where they are in their state of health, right. So somebody has an acute illness, and they need to interact with us more regularly, don't do so through whatever channel they can. And so is that the call, is that the digital when I'm looking at what we're doing around social determinants of health, and we've been investing a tremendous amount in this. It's getting the data, getting the information, so we know who's more likely to have a social determinants of health need, we don't wait for people to always call us, we have an opportunity to reach out. So if you think of digital, that's an opportunity to have an outbound interaction, you're looking at the website, or you're looking at your app, because you want to look up a doctor. But we have an opportunity then to also say to you, hey, we saw that you left an incentive on the table, we saw that you have an opportunity to engage in a clinical program, your medication wasn't filled. So how do you take those micro moments, and pulling all this other information about an individual specific to social determinants of health is another way to provide access. And I think as people became more and more comfortable with using digital as a way to interact with their provider, it gives an opportunity for people that may have other needs. So one last example, before you go to the next question is around mental health. Or we have a very broad tele-mental health network. We know that during the pandemic, for example, 52% of people said that they had they were struggling with their mental health, how does it provide access to that population, there's a lot of stigma around mental health, that people may not want to go into a provider's office, now they have a ready channel 24/7 to be able to have those interactions. So we've seen it be able to transform in terms of access, in terms of information, both inbound and outbound. That's really encouraging and reaching our whole population.

Melissa Turner  12:26  

Yeah, just a related point on the mental health as well, you know, we saw a lot of, because of the acute need that arose during the pandemic, a lot of shortages, a lot of difficulty accessing care locally, presumably that remote access facilitated an easier time setting appointments, when you can expand your pool of potential providers.

Rebecca Madsen  12:45  

Yeah, exactly. And when we saw that people, you know, obviously went to essential care only. And there was, you know, a lot of overrunning of the health care system, and people really focusing on really urgent and acute and essential care, a lot of the, you know, kind of elective care people didn't have the access they needed. And with mental health in particular, it's such a, frankly, I think that there's a crisis in mental health care in this country, and being able to provide people an avenue where they can get the care that they need, when they need it. It's not always 9 to 5 and often isn't. So having people have that comfort, talk to somebody, it's really been just fascinating how much greater engagement we can have and how much better support we can have for people who really need it.

Melissa Turner  13:35  

Absolutely. I want to ask, now, maybe going back to when you started at United Healthcare in 97, you mentioned you were talking about digital transformation then, and now you're investing as a company $4 billion a year. Huge number, as you mentioned, I think one of the most interesting things about digital transformation is all the areas it touches, as you've mentioned, I guess I'm curious about you know, looking back and in those earlier years, who were the stakeholders who were most important? And then how did you and your colleagues kind of get everyone on the same page? And maybe we can sort of think about this for other organizations that are really are on that journey? What leadership advice do you have to share with them?

Rebecca Madsen  14:19  

So when I look at sort of how it's evolved over time, obviously, there's a lot more robust capabilities that are available in digital properties. There's, you know, back it, I don't want to sound like I'm dating myself. But back in 1997, a lot of people didn't even have cell phones, right. And so now just the ability for people that it's common practice of people expected information when they wanted, how they wanted, they expect everything now, there's a much greater sort of cultural receptivity to engaging digitally and engaging technologically. And you mentioned the stakeholders, and I don't think that there is one stakeholder. There's the consumer that we've talked a lot about, there's the employer who wants the data, so they know how to support their employees, and they want it in a self serve manner. They want to be able to manage the health of the population to lower cost. There's the provider who wants to be connected the hospitals. So if you think about, you know, connected medical records, or you think about all the connectivity across the healthcare system, so people can manage their population more effectively, remote medical monitoring, and treatment is a huge advancement that digital has enabled. So think, sort of remote scales, or wireless scales, or how people can engage and understand what their patient is going from a provider perspective, and have these pieces of information are all connected across the healthcare system. So while there are disparate chunks, kind of who the stakeholders are, they all kind of come together around how you serve that consumer holistically from a leadership perspective, in terms of advice, what I would say is there is not one size fits all. And I think people are sort of prone to saying, OK, let's be the digital first company. But we all need to be digital first companies, but what you really have to do is you have to understand the consumer. And what I say is a piece of technology or tool, in the absence of knowing the person who's using it is just a piece of technology or tool, that you have to understand that individual, you have to treat them with compassion and empathy. And then use this as a channel to do that, to not lose that humanity. And that empathy with an individual, when people are in various states of health, it's stressful, and they want somebody who's there to support them emotionally. And so being able to use the tool and the technology is make sure that you understand that the person that's using it, use your data, use your analytics, and really figure out how you connect across the healthcare system and use it to really surround that individual to make smart choices and achieve their best state of health.

Melissa Turner  16:59  

Well, that's great advice. Good segue into the last question I want to ask you, you know, we've talked about some really interesting ideas, I think you've started to paint a picture of a really compassionate use of digital health technology. As we look to the future, if all of these ideas that we're talking about, come to fruition, continue to advance, what do you think the experience of healthcare looks like? 10 years, 20 years down the road?

Rebecca Madsen  17:26  

I get asked this question a lot. And what I would say is that, in particular, in the past 18 months, but over the past several years, what people see is that the way they access their care, the convenience, the access, the lower costs, leveraging things such as digital and technology as a way to connect with their provider and do all the things we talked about during the course of this conversation, I expect that's going to continue. And it's going to accelerate in 2020 to beyond five years, 10 years. If I think of four big trends, and we touched on some of them, I think remote medical monitoring and treatment is going to be huge. Changing behavior is hard. And if we look at the population, a third is overweight, and other third is obese, and how people change their diet, how they exercise, how they get proactive care if they have things such as diabetes, or heart disease, or any type of illness. And really making sure that this remote medical monitoring enables that connection that people didn't have otherwise, it was too much. Go see my doctor and tell my doctor, what's going on. I think the continued use of technology and digital in this area is really something that's going to be accelerating. And it's going to be commonplace in a way that it isn't today in I would say maybe five years, five to seven years. And that gets more broadly on just this sort of second trend that I think is going to continue to accelerate, which is the connectivity of healthcare. So the greater connection with healthcare providers, and really the different parts of the healthcare system coming together to enhance access and to enhance the ability for people to understand that consumer. And, you know, equipping healthcare professionals with enhanced data, with the capabilities with virtual care, all those trends that we saw accelerating over the past 18 months, this idea of connectivity is gonna really, I think, take off. The third area that we talked about is mental health. I think that the mental health crisis is going to grow, it's not going to decrease and how we continue to support individuals with their mental health challenges. And it becomes destigmatized and becomes a part of just the fabric of you know, it's another illness and how we treat that illness. And then lastly, social determinants of health, which we could talk about forever, but they you know, two thirds of spending in the US is on medical issues. Only third is on social services. How do we really expand our investment in social services so that we can really attack that 80% of health that happens outside provider's office and looked at the whole person.

Melissa Turner  20:02  

Well, Rebecca, I think you just mapped another four episodes of Touchpoints for us. I hope we can invite you back some time for us about them.

Rebecca Madsen  20:12  

Absolutely, I'd be happy to and, and for me, you know, I would say my takeaway from all of this is, you know, have compassion, have empathy, when you have somebody having a health care event, it's really challenging for them and their family. We saw it over the past year and a half. But I think what we've really seen as a population is paying attention to your health, whether you're well or whether you're sick, and using all the different things that you have available to you, digital being one, to be able to engage and get the support you need is is critical. So thank you for giving me the time to be able to talk with you.

Melissa Turner  20:44  

Well, great message to close on. Rebecca Madson is chief consumer officer of the employer and individual market business at United Healthcare. Really appreciate you joining us today Rebecca, sharing your thoughts on consumer experience and digital transformation. It's been a pleasure speaking with you.

Rebecca Madsen  21:00  

And you as well, have a great rest of your day.

Melissa Turner  21:04  

Touchpoints is sponsored by Wellframe. Wellframe works with health plans to reimagine member relationships. 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 care management and advocacy 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 

Melissa Turner  21:40  

Continuing our discussion of digital transformation today, I'm joined now by Jake Sattelmair, CEO of Wellframe. Jake is a Harvard trained epidemiologist whose work in research lies at the intersection of public health, technology, data analytics and consumer engagement. He's CEO and co founder of Wellframe. Welcome, Jake,

Jake Sattelmair  22:01  

thanks for having me. Great to chat with you.

Melissa Turner  22:02  

Glad to have you here. We certainly hear a lot about digital transformation in healthcare and it probably goes without saying that it's important. I'm wondering, what is your take on you know, whether it's mission critical? And what's at risk for healthcare organizations that fall behind?

Jake Sattelmair  22:19  

Yeah, it's a it's a big question, I tend to think of an article published by Marc Andreessen in the Wall Street Journal back in 2011, talking about Why Software is Eating the World. And it talks about how digital technology is essentially transforming every sector in every industry. And that cited several industries, including education and health care that were kind of behind the curve, but where it's just inevitable that modern technology would stand to create so much differentiated value in terms of how organizations deliver their products and services to consumers that would force everybody to to adapt in order to survive and thrive. And I don't, I don't think that healthcare is any exception. And if you think about it, you know, broadly, I think every every healthcare organization, and every leader has to be thinking about digital transformation and thinking about the impact of modern technology on the way that it delivers for its stakeholders. And if you look at the area where we're focused specifically, which is around helping health plans to digitally transform their member facing services, I think it's absolutely mission critical. I'd say that it's it's almost existential. And that plans that don't use technology to modernize the way they support their members and the relationships that they have those those members will, over time really struggle to survive and struggle to succeed. And, you know, when we started, this was not a view that was widely embraced, I would say, by a lot of a lot of health plans. And I'd say today, based on temporal trends, changes and consumer behaviors and expectations and corresponding changes among major stakeholders and then further accelerated by by COVID, is a view that we see being on the top three list of many plan leadership and boards. And so I think that the view that this is mission critical is much more broadly held now than it ever has been before.

Melissa Turner  24:14  

And it's interesting that you mentioned education and healthcare, two of the industries, I mean, certainly any, any and every industry was dramatically affected by the pandemic. But in terms of digital transformation, we've certainly seen healthcare had to pivot, education had to pivot. I'm wondering, what is your take on the state of digital transformation today in healthcare, where are we on that journey? And what's your take on the role of the pandemic in that?

Jake Sattelmair  24:42  

Yeah, I mean, I think it's, it's still early days, but the pace of change has accelerated pretty dramatically over the last few years. And so if you think about electronic medical records as an example, right, where you had kind of a long, slow burn of providers switching from paper based records to digital records, and then you think about the whole process on top of wanting to digitize the record, building applications and algorithms, interoperability to actually make the data useful in terms of improving the quality and efficiency and safety of care. And, you know, there's a major government stimulus, right, that helped to accelerate that path. If you think about where we're focused in terms of helping plans to, to digitally modernize their services, I think that that COVID, and the massive increase in utilization of telemedicine was a wake up call, and has really accelerated investments among plans who are in the process of digital transformation more generally, right, a lot of plans are, are modernizing their core infrastructure, things like how they process claims and things like that. But as it relates to the way that plans engage and interact with and support members, you're seeing things like, you know, virtual first plan products, and you're seeing new entrants that are thinking about a modern digital infrastructure as core to their differentiation thesis. And that is, you know, that plus just the significant shift in expectations among consumers or members, I think, has really accelerated the pace. But I do think it's still early. And I think there's, we're kind of in the earliest stages of a lot of experimentation, and in some cases, fragmentation. I think there are a few phases forward that will ultimately be necessary to, to bring this to the kind of experience that I think we're we're ultimately driving for, for consumers or for members in this case. 

Melissa Turner  26:45  

I want to ask a question, kind of following up on your point about electronic health records, you know, it took a long time for many organizations to move to EHRs. And then there was still kind of the question of getting the data out of them and making use of it. Where are we at in terms of plans having the data that they need? Versus there's still stuff out there that they need and can't access?

Jake Sattelmair  27:08  

Yeah, so there are a few different layers of this question. But you know, plans have a lot of data. And I would say that one layer of the answer is, plans being able to access and aggregate and action on the data that they already have. Another layer of it is plans have a lot of data. But historically, it's come with significant latency. So you can do a lot with a claim. But if you can only read an access or action on that claim months after the encounter, then you know, there's a diminishing the value of having that information in terms of being able to use it to make an impact or to intervene. And then the data that plans have is not the whole picture. There's a lot of data on the clinical side that plans are, in many cases making significant efforts to access an aggregate with claims. And then there's the area that we focus on, which is all the data that pertains to people's day to day experience at home. And then the community, which we know explains the majority of variants and health outcomes and risk and cost and isn't captured well in clinical or claims data, but is really important if you're trying to help improve outcomes and manage risk across a population. So if you think about bringing these different data sources together, I think plans are in an advantageous position as being kind of a and being an aggregator to the extent that they are holding risk on individuals establishing a network of providers, incentivize to support engage their members, between visits, there's a long way to go. And there's a few different few different layers to address for a plan that's looking to improve the way they aggregate and use data to make an impact on outcomes for their members.

Melissa Turner  28:57  

Yeah, absolutely. And some of the challenges you touched on sort of pulling the data together and transforming it into something that you can act on and then act on in real time. And then other challenges health plans are facing as well, consumer centricity, convenience. There's been a lot of speculation around whether health plans, large and established organizations, can really bring the innovation to address these challenges. So I'm just kind of curious about your take on this can innovation come from within this industry? Or does it take an Amazon or a Google to bring change?

Jake Sattelmair  29:33  

I don't think there's a simple answer to this question because I think that every category of stakeholders has a role in driving change in driving improvement. So the way I think about it, at least as it relates to health plans, you have you have incumbent plans that have you know, meaningful market share and you know, are established typically have been around for decades, sometimes you know, much more, you've got the kind of tech and retail giants that you reference that are and have continued to make overtures into the healthcare space. And there's been a lot of, you know, discussion about how successful there'll be and how far they'll go and what role or what impact they'll have on incumbents. And then you have what I'd call kind of early stage disruptors that are either trying to form their own plan or at risk provider, and take market from incumbents, or launch their own services, or interventions that may compete with or complement services that have been offered by the incumbents. And then you have enablers, and I'd put Wellframe in that category, that are providing digital infrastructure to help the incumbents to modernize their own services in a way that will be beneficial for their members and help them deliver more value and be more competitive in the market. And I think there's a role for every category. And I think they're all necessary to drive toward a higher value healthcare system, in some cases, they will complement each other and collaborate with each other, and in some cases will compete. And I think that the, those dynamics will continue to evolve over time. But what I think this is doing, is it's forcing plans to think about what their core competencies are, and where they have strategic advantages and where they don't, and what they need to own as a core competency over time to be successful, and where they can partner or delegate, or outsource or otherwise. And we see leadership among our customers and our prospects, mulling over these questions as we go and responding to new information. And so as an example, you know, a lot of new information came from COVID. And new information comes from the significant investment dollars coming into this digital health space. And, you know, the pace of innovation among new entrants. It's a very dynamic landscape right now. And I think it's important for health plans to really stay on top of what's happening and continue to refine their strategy around where they want to go and where they want to invest and where they want to partner.

Melissa Turner  32:06  

Yeah, well, thinking about some of those health plans you're working with, you talked about Wellframe as an enabler and mentioned the leadership you're seeing in the plans you work with. I think one of the kind of interesting challenges to watch from outside where I sit is, you know, it just seems kind of overwhelming to think about fundamentally transforming how you work, digital transformation throughout an organization while keeping the lights on. Plans have members who need care, and you know, all the things that they're doing at any one time, how do you recommend leaders bring this kind of change to life while keeping things really seamless for the consumers, providers and everyone else that they work with,

Jake Sattelmair  32:46  

From the outside, I'd say it's very easy to criticize a health plan or health insurance company, and it's very easy to see their flaws. But running a successful health insurance company is actually really hard. And it requires doing a lot of things right and bringing them together. And it requires navigating very important, and multiple different regulatory environments that are themselves always changing. And require plans to adapt their rules and their approach and their strategy accordingly. And so that takes a lot. And it's really important to get that right. And the cost of getting it wrong, could be catastrophic in such a regulated industry. And so for plans to innovate, it really requires that they're ahead of the curve, in terms of their people and their resources and their culture and their way of thinking about things as well as from a financial perspective, you know, having the resources to invest in the future is not a foregone conclusion for businesses that are by nature, low margin, and not every plan, you know, is going to be in that position. But plans need to fight really hard to get and stay in that position to continue to stay ahead, especially in this day and age. And then on top of that there are different approaches, I'd say for plans to innovate. And we've seen different things work. And we've seen different things not work. I think for some plans, it's very top down, where there's a leadership mandate to do something new. And that's pushed across different teams. I think for other plans, it's more bottom up where they, you know, equip and empower leaders of different departments and different service lines to figure out how to innovate in their domain. And then let that kind of bubble up as they experiment and they see what works and, and what's not. And they're not mutually exclusive. But there are trade offs to either approach, right? I think in the former, you can get alignment, but you need buy in, and in the latter you typically have buy in but you run the risk of different leaders running in directions that may ultimately be orthogonal to each other. And then we've seen another approach where plans will say, look, this is just too hard to build the car while we're while we're driving it and we're going to set up a whole different team, and that's going to be our innovation investment, we're going to let them run unencumbered by, you know, a lot of the burdens that you reference. And we're going to see what they come up with, with a completely different way of thinking and being able to start from scratch. And then we're going to see what of that we can adopt, or we can bring into the core. And so I think it really depends on, you know, the specific plan in terms of the strategy that they take. But those are some of the approaches that we've seen. And at the end of the day, I think it really, in many ways comes down to the people and culture. And do you have leaders that can see around the few corners into the future, and identify what's going to be needed to be successful, and take bets, which requires having political capital to spend, and being able to take risks and being in an environment where that's supported. And then we're also willing to not just kind of talk about what they want in the future, but move their teams and departments forward to embrace that, which requires change and requires accountability. And requires bringing people along, knowing that not everyone's going to come along. And that can be really difficult, especially when you have 50 regulatory things to make sure you don't mess up on as you go. And so it's tough. But I think that every plan leader that we talk to today knows that it's essential, and are making investments not only in their technology, but in their processes and their people and their culture, to position themselves to do this well. 

Melissa Turner  36:32  

yeah, I think you kind of did a really nice job of illustrating why yes, it's easy to criticize, but this work is is incredibly challenging. And it takes a lot to reorient an organization around these ideas. You alluded to the fact that there is not going to be a one-size-fits all approach here. Is there any kind of roadmap that is somewhat universal? In terms of thinking about digital transformation? Where do you start? Where do you go next?

Jake Sattelmair  37:01  

Yeah, I think that there are some principles that are important that will kind of be guideposts for each organization's roadmap. One of them and this is, you know, we emphasize this again and again with our customers is you need to start with the end of mind, right? And so you need to say, What am I solving for? And what are my objectives? And what do I want to be when I'm done with this, right? And what does success look like at the end of this investment for us where we're focused, we think about member experience, we think about plan product value when we think about market competitiveness of our customers. And we work with them to prioritize investments that we think will optimize success and value in these areas. And so you know, really being clear on what your goals are, and that that's not just on a metric or an outcome, but it's in the context of market dynamics and competitive pressures and consumer expectations, and making sure that you're prioritizing the right things to win in the dynamic market. And then to get the roadmap, right, I think it's everything from embracing the right ideology to having conviction, and empowerment among leadership, to having a plan to transform the way you do things, and to bring people in teams through change management to get there, to having the right technology to enable modernization of these different approaches. And then I really thinking carefully about, is this something that we can do ourselves? Or is this something where we need some outside support? And what's the nature of that outside support? Is it strategic consulting? Is that a technology partner? Is it something we're going to outsource, as it you know, is it something that we're going to collaborate closely with an earlier stage organization? How does that look, and you know, those decisions are really important, because it was one thing to embark on this mission, and to kind of free up resources, but you ultimately need to live with the outcome. And if you, you know, put all this time and energy, and it's not just capital, it's time and opportunity cost and, and people's kind of emotional energy as well. And if you don't land with something that's appreciably better then you not only don't get the result, but you diminish your ability to make these bids going forward, and you make your organization less competitive over time. So you know, being really thoughtful up front about the goals and the strategy. And the resource plan to get there is is really important. And that could lead to all sorts of different roadmaps. But I think those are some of the some of the principles that we tend to talk about with our customers.

Melissa Turner  39:37  

Yeah, we've talked a lot about this from the perspective of the health plan. So kind of, on that same point but flipping to the consumer perspective. You talked about starting with the end goal. I'm just curious as you think about the future of health care, the future of the consumer experience of health care. What does success look like to you five or 10 however many years in the future you want to go. But like, what are we all moving toward? Or what are you moving towards?

Jake Sattelmair  40:03  

So if you think about digital transformation and consumer experience in healthcare, this can manifest in so many different areas, right. But again, I think some of the principles that are really important and ones that that guide us and I think are important more generally, you know, one is you need to think about the role that digital can play on improving convenience and access for people, as they look to get resources that help them on their care journey. The other is the role that it can play in improving transparency and autonomy and positioning people to make more informed decisions. I think there's also a major role in breaking down some of the silos from a data perspective, that just lead to a lot of frustration, as people interact with multiple different stakeholders within the healthcare system. And you can envision digital playing a critical role in making it feel more like a system and making it feel more like an organization that is centered around the needs of the individual, as opposed to the individual needing to heroically navigate multiple different organizations within the quote unquote, system. And so kind of making care organizations more responsive to the needs of consumers. And as part of that, it's positioning healthcare organizations to be more proactive in establishing relationships with members or patients and sustaining those relationships over time. So that you can not only pick up on people's needs as they arise, but you can get better at predicting what those needs might be, and surfacing resources that will address those needs, you know, more and more proactively on the backend of this, you would hope that this leads to a more efficient system, and pulls cost out of the system. But I would argue that will be dictated really by how things are paid for because digital transformation can drive multiple different financial outcomes, depending on the incentives. And I think, you know, having the right incentive to use digital to improve efficiency. And to pull costs out of the system or to reduce the increase of cost in the system is going to be critical. So you know, I think I think at the end of the day, you want care that's higher quality, and more convenient, and more accessible to more people, and ultimately is more effective at meeting their needs, and helping them to get better outcomes as they define them. And, you know, you see efforts to achieve this happening in all corners of the healthcare system. And I think over time, you'll see, you know, whereas the initial investment in digital transformation has, in some cases, increased fragmentation. You'll see consolidation over time that will bring together and organize these kinds of digitally enabled resources in ways that become more and more obvious and more convenient to people. But you know, I think that we're at the beginning of a, of a decently long road there. And that's exciting to be to be part of it. And we look forward to hopefully helping to advance those efforts over the coming years and decades.

Melissa Turner  43:10  

Well really appreciate you sharing your perspective on all this today. Jake Sattelmair is CEO and co-founder of Wellframe. Thank you so much for sharing your thoughts, Jake. It's been a pleasure speaking with you.

Jake Sattelmair  43:21  

Thank you Melissa. Appreciate it.

Melissa Turner  43:26  

Thank you for listening. I hope you enjoyed today's conversation and learned something too. You can check out SmartBrief's healthcare newsletters by going to and hitting the blue subscribe button, Be sure to spread the word and subscribe to the Touchpoints podcast. Finally, a huge shout out to our friends at the Shift.Health content network.

Melissa Turner  43:51  

Touchpoints is sponsored by Wellframe. Wellframe works with health plans to reimagine member relationships. Their digital health management platform empowers members and health plans to achieve their best. Let Wellframe be your strategic partner in providing innovative solutions that improve the member experience. Learn more at