1 00:00:00,160 --> 00:00:02,899 Evernorth brings the power of wonder and relentless 2 00:00:02,960 --> 00:00:05,919 innovation to create world class pharmacy care and 3 00:00:05,919 --> 00:00:09,199 benefit solutions. Our connected health services make the 4 00:00:09,199 --> 00:00:12,080 treatment, prediction, and prevention of health care's most 5 00:00:12,080 --> 00:00:13,059 complex conditions 6 00:00:13,605 --> 00:00:16,344 easier and more accessible as we drive organizations 7 00:00:16,725 --> 00:00:19,524 and people forward. Ever North Home Based Care 8 00:00:19,524 --> 00:00:22,004 provides value based care that helps patients with 9 00:00:22,004 --> 00:00:23,384 multiple chronic conditions 10 00:00:23,844 --> 00:00:26,085 and social determinant of health barriers get the 11 00:00:26,085 --> 00:00:28,884 care they need and the personalized experience they 12 00:00:28,884 --> 00:00:31,660 deserve. We serve patients who struggle to navigate 13 00:00:31,660 --> 00:00:34,060 the health care system by bringing high quality 14 00:00:34,060 --> 00:00:34,560 primary 15 00:00:34,939 --> 00:00:37,739 and preventative care services to the home. By 16 00:00:37,739 --> 00:00:40,700 providing clinical care and support services that provide 17 00:00:40,700 --> 00:00:44,105 whole person care, we improve health equity, access, 18 00:00:44,105 --> 00:00:46,605 and outcomes for the populations we serve. 19 00:00:47,785 --> 00:00:50,105 This is Gracelyn Keller with the Becker's Healthcare 20 00:00:50,105 --> 00:00:53,245 podcast, and we are live at the 2024 21 00:00:53,865 --> 00:00:55,005 payer issues roundtable. 22 00:00:55,630 --> 00:00:57,789 I'm joined by Dennis Hillen, who is the 23 00:00:57,789 --> 00:01:00,909 senior vice president at Oscar Health. Dennis, thanks 24 00:01:00,909 --> 00:01:02,350 for being here. Would love to have you 25 00:01:02,350 --> 00:01:04,750 start off by briefly introducing yourself and telling 26 00:01:04,750 --> 00:01:05,950 us a little bit more about your current 27 00:01:05,950 --> 00:01:08,204 role. Yeah. Happy to. Thanks for having me. 28 00:01:08,365 --> 00:01:10,685 So I'm Dennis Hillen. I'm senior vice president 29 00:01:10,685 --> 00:01:13,484 for our insurance strategy and and product development 30 00:01:13,484 --> 00:01:14,465 at Oscar Health. 31 00:01:14,924 --> 00:01:16,525 I've been in the industry now for about 32 00:01:16,525 --> 00:01:18,685 17 years with Oscar about four and a 33 00:01:18,685 --> 00:01:21,105 half years. Before that, I was with Humana, 34 00:01:21,564 --> 00:01:24,329 for about 12 years, focused on innovation and 35 00:01:24,329 --> 00:01:24,829 transformation, 36 00:01:25,450 --> 00:01:27,310 really after some frustrating experiences 37 00:01:27,609 --> 00:01:30,090 being a health care consumer, for a small 38 00:01:30,250 --> 00:01:32,489 actually, medium sized business at the time, and 39 00:01:32,489 --> 00:01:34,090 then a consumer of the product that I 40 00:01:34,090 --> 00:01:35,930 decided on behalf of the plan or on 41 00:01:35,930 --> 00:01:37,069 behalf of the organization 42 00:01:37,784 --> 00:01:39,545 And, wanted to get in and try to 43 00:01:39,545 --> 00:01:40,984 figure out how to make it easier and 44 00:01:40,984 --> 00:01:43,465 have been dedicated my career since, and happy 45 00:01:43,465 --> 00:01:44,905 to be here today to talk about how 46 00:01:44,905 --> 00:01:47,084 we are making that happen at Oscar Health. 47 00:01:47,384 --> 00:01:49,644 Wonderful. Well, thank you for taking the time. 48 00:01:50,159 --> 00:01:51,459 And let's start our conversation 49 00:01:51,760 --> 00:01:54,819 with growth goals. So from improving member experience 50 00:01:55,120 --> 00:01:57,859 and expanding value based care to controlling costs, 51 00:01:58,159 --> 00:02:00,959 payer executives have ambitious growth goals for the 52 00:02:00,959 --> 00:02:03,439 rest of 2024 and looking into the year 53 00:02:03,439 --> 00:02:03,939 ahead. 54 00:02:04,295 --> 00:02:06,054 So in your role, what is your top 55 00:02:06,054 --> 00:02:07,894 priority and how are you planning to get 56 00:02:07,894 --> 00:02:08,394 there? 57 00:02:09,655 --> 00:02:10,875 So we're pioneering 58 00:02:11,574 --> 00:02:13,435 a national health care marketplace 59 00:02:13,735 --> 00:02:15,974 for the individual consumer. So we see this 60 00:02:15,974 --> 00:02:17,580 as a growing market. If you look at 61 00:02:17,659 --> 00:02:19,419 the size of the ACA today, it's now 62 00:02:19,419 --> 00:02:20,159 over 22,000,000 63 00:02:20,460 --> 00:02:22,780 lives. We see it growing to be an 64 00:02:22,780 --> 00:02:23,840 even much bigger, 65 00:02:24,300 --> 00:02:26,300 component of the way people get care and 66 00:02:26,300 --> 00:02:28,780 ultimately the the health insurance market. This is 67 00:02:28,780 --> 00:02:30,300 gonna happen not only through growth in the 68 00:02:30,300 --> 00:02:30,800 ACA, 69 00:02:31,099 --> 00:02:32,384 but also in the way, 70 00:02:32,944 --> 00:02:36,004 employers buy their health plans for their employees 71 00:02:36,224 --> 00:02:37,685 using something called ICRA, 72 00:02:38,144 --> 00:02:41,664 which is a health care acronym for individual 73 00:02:41,664 --> 00:02:44,224 coverage health reimbursement arrangement. So it's certainly a 74 00:02:44,224 --> 00:02:46,370 mouthful, but the premise behind it is is 75 00:02:46,370 --> 00:02:48,930 actually something aligned with what employers are looking 76 00:02:48,930 --> 00:02:50,849 to do, and that's to drive choice and 77 00:02:50,849 --> 00:02:52,770 reduce cost. So we see that as the 78 00:02:52,770 --> 00:02:54,770 way forward. And what we wanna do is 79 00:02:54,770 --> 00:02:57,189 then make sure that the health care marketplace 80 00:02:57,409 --> 00:02:59,189 operates more like the free market. 81 00:02:59,569 --> 00:02:59,835 It's 82 00:03:00,395 --> 00:03:01,534 one of the largest 83 00:03:02,075 --> 00:03:04,655 industries and and experiences in the country 84 00:03:04,955 --> 00:03:06,715 that is sort of divorced from the way 85 00:03:06,715 --> 00:03:08,635 people normally think about the decisions they make 86 00:03:08,635 --> 00:03:10,555 and the cost that they incur as a 87 00:03:10,555 --> 00:03:13,290 result. And so we're looking at the ACA 88 00:03:13,290 --> 00:03:15,370 and the individual marketplace as an opportunity to 89 00:03:15,370 --> 00:03:16,430 bring these things together. 90 00:03:18,250 --> 00:03:20,730 And let's talk about population health for a 91 00:03:20,730 --> 00:03:23,530 little bit. So how is your organization ensuring 92 00:03:23,530 --> 00:03:26,490 equitable access to care across a diverse member 93 00:03:26,490 --> 00:03:26,990 populations, 94 00:03:27,450 --> 00:03:29,955 and what strategies have worked well for you 95 00:03:29,955 --> 00:03:31,794 here? Or, on the other hand, what has 96 00:03:31,794 --> 00:03:33,014 been the most challenging? 97 00:03:33,955 --> 00:03:35,635 So it's been said often that health care 98 00:03:35,635 --> 00:03:37,314 is very local, and we believe that not 99 00:03:37,314 --> 00:03:39,555 only to be geographically local, but also local 100 00:03:39,555 --> 00:03:40,375 in the context 101 00:03:40,754 --> 00:03:43,155 of people and the communities that they identify 102 00:03:43,155 --> 00:03:44,969 with. So whether it be who they surround 103 00:03:44,969 --> 00:03:46,889 themselves, their family and friends, people that they 104 00:03:46,889 --> 00:03:48,830 feel that are like them, or the experiences 105 00:03:49,050 --> 00:03:49,689 that they, 106 00:03:50,009 --> 00:03:52,030 encounter in life that define who they are, 107 00:03:52,090 --> 00:03:54,090 we think that the healthcare experience should reflect 108 00:03:54,090 --> 00:03:55,849 that as well. So when you look at 109 00:03:55,849 --> 00:03:57,965 our low cost, tech first products, we have 110 00:03:57,965 --> 00:04:00,525 the ability to then bring these preferences and 111 00:04:00,525 --> 00:04:01,504 bring these experiences 112 00:04:01,805 --> 00:04:03,564 into the way they engage with our product 113 00:04:03,564 --> 00:04:05,724 and, ultimately, with the health care system. So 114 00:04:05,724 --> 00:04:06,625 if it's linguistic, 115 00:04:06,925 --> 00:04:10,125 cultural, regional, demographic preferences, these are things that 116 00:04:10,125 --> 00:04:11,025 can be understood, 117 00:04:11,469 --> 00:04:12,989 hopefully, all the way from the way people 118 00:04:12,989 --> 00:04:14,909 choose plans and make that choice I was 119 00:04:14,909 --> 00:04:17,389 mentioning earlier within the way they experience it 120 00:04:17,389 --> 00:04:19,230 at every touch point along the way. One 121 00:04:19,230 --> 00:04:20,750 of the things we've done is really been 122 00:04:20,750 --> 00:04:22,610 focusing on the Spanish speaking population. 123 00:04:22,990 --> 00:04:25,490 So we introduced something, a product called, 124 00:04:25,790 --> 00:04:26,290 Buenasalud, 125 00:04:27,074 --> 00:04:29,954 which is a Spanish first solution for, Hispanic 126 00:04:29,954 --> 00:04:32,115 and Latino members that we are launching for 127 00:04:32,115 --> 00:04:34,615 the first time in 2025 during open enrollment. 128 00:04:34,995 --> 00:04:36,834 So the idea behind this is that all 129 00:04:36,834 --> 00:04:38,595 the way from the way the plan shows 130 00:04:38,595 --> 00:04:39,574 up in the marketplace 131 00:04:40,259 --> 00:04:42,120 through the broker they interact with, 132 00:04:42,420 --> 00:04:44,120 through the documents they receive, 133 00:04:44,500 --> 00:04:46,759 through the providers we help them find, 134 00:04:47,139 --> 00:04:49,699 their experience will be Spanish first and will 135 00:04:49,699 --> 00:04:51,860 understand, you know, the culture that they'll that 136 00:04:51,860 --> 00:04:53,699 they are coming from as much as possible 137 00:04:53,699 --> 00:04:54,919 based off of the information, 138 00:04:55,264 --> 00:04:57,264 not only that they choose to share, but 139 00:04:57,264 --> 00:04:58,625 even the way that they choose to buy 140 00:04:58,625 --> 00:04:59,285 the product. 141 00:04:59,904 --> 00:05:01,985 So if you look at the results as 142 00:05:02,064 --> 00:05:04,544 that that come from this focus, you'll find 143 00:05:04,544 --> 00:05:07,264 a couple things. One, this is based on 144 00:05:07,264 --> 00:05:08,964 what we call Ola Oscar. 145 00:05:09,480 --> 00:05:10,839 If you go to our website, it's high 146 00:05:10,839 --> 00:05:12,360 oscar.com. So it's a little bit of a 147 00:05:12,360 --> 00:05:13,560 play on that. You can also go to 148 00:05:13,560 --> 00:05:15,319 HOLA OSCAR dot com. It'll take you to 149 00:05:15,319 --> 00:05:16,300 a Spanish version 150 00:05:16,600 --> 00:05:18,680 of our main website. But what we intend 151 00:05:18,680 --> 00:05:20,199 to do with that is to show that 152 00:05:20,199 --> 00:05:22,220 there are ways we are being Spanish first. 153 00:05:22,514 --> 00:05:24,194 And if you look at our NPS, which 154 00:05:24,194 --> 00:05:26,035 is something we're very proud of, across the 155 00:05:26,035 --> 00:05:27,334 board, it's around a 66. 156 00:05:28,354 --> 00:05:30,274 So, you know, an NPS stands for net 157 00:05:30,274 --> 00:05:32,754 promoter score. So it's basically the difference between 158 00:05:32,754 --> 00:05:34,514 the people who promote your product versus the 159 00:05:34,514 --> 00:05:36,035 people who would not promote your product or 160 00:05:36,035 --> 00:05:36,694 the detractors. 161 00:05:37,480 --> 00:05:39,419 And we see a significant impact 162 00:05:39,959 --> 00:05:42,040 as a result of the Spanish focus where 163 00:05:42,040 --> 00:05:43,100 NPS is 87. 164 00:05:43,800 --> 00:05:45,800 So if you look at that and translate 165 00:05:45,800 --> 00:05:48,379 that to then how we can engage people 166 00:05:48,439 --> 00:05:49,740 in their health care journey, 167 00:05:50,199 --> 00:05:51,479 the idea that we can meet them where 168 00:05:51,479 --> 00:05:53,154 they are is gonna drive a few things. 169 00:05:53,154 --> 00:05:54,915 1, it's gonna drive engagement, but it's gonna 170 00:05:54,915 --> 00:05:57,634 drive retention, and it's also gonna help drive 171 00:05:57,634 --> 00:05:58,935 a relationship between 172 00:05:59,475 --> 00:06:01,634 our members and the providers that we hope 173 00:06:01,634 --> 00:06:03,254 to build a relationship with them. 174 00:06:04,529 --> 00:06:07,089 And let's talk about leadership for a second 175 00:06:07,089 --> 00:06:09,569 here. So keeping pace in today's dynamic health 176 00:06:09,569 --> 00:06:12,209 care landscape is challenging. So I'd love to 177 00:06:12,209 --> 00:06:13,970 hear a piece of advice you'd share with 178 00:06:13,970 --> 00:06:16,529 peer leaders wanting to grow their businesses while 179 00:06:16,529 --> 00:06:18,069 keeping members top of mind. 180 00:06:18,610 --> 00:06:19,110 Yeah. 181 00:06:20,074 --> 00:06:22,555 My best advice would be to remember you 182 00:06:22,555 --> 00:06:23,694 are a health care consumer. 183 00:06:23,995 --> 00:06:25,995 And it's amazing as as a health care 184 00:06:25,995 --> 00:06:26,495 executive, 185 00:06:27,035 --> 00:06:27,775 how often 186 00:06:28,235 --> 00:06:29,535 the context of 187 00:06:29,835 --> 00:06:32,395 the choices that you are present presented with 188 00:06:32,395 --> 00:06:34,895 or the lack of choices you're presented with 189 00:06:35,279 --> 00:06:37,920 often get abstracted when you are thinking about 190 00:06:37,920 --> 00:06:39,699 your health plan as an executive. 191 00:06:40,080 --> 00:06:42,420 And so what I would encourage is that 192 00:06:42,720 --> 00:06:43,220 when 193 00:06:43,520 --> 00:06:44,500 picking the plan, 194 00:06:45,120 --> 00:06:47,535 in whatever experience that you have, think about 195 00:06:47,535 --> 00:06:49,454 that in the in the broad context that 196 00:06:49,535 --> 00:06:51,535 where you sit in both seats. It's it's 197 00:06:51,535 --> 00:06:53,455 amazing how many people, you know, they know 198 00:06:53,535 --> 00:06:54,975 once people find out I'm a health plan 199 00:06:54,975 --> 00:06:55,475 executive, 200 00:06:55,935 --> 00:06:57,954 these can be very smart, seasoned 201 00:06:58,334 --> 00:06:59,475 other health care executives. 202 00:06:59,854 --> 00:07:01,470 They reach out for help. How can I 203 00:07:01,470 --> 00:07:03,629 get a provider? Who's a good provider? How 204 00:07:03,629 --> 00:07:05,729 much does this cost? What is the deductible? 205 00:07:05,949 --> 00:07:08,349 Like, not necessarily, like, in the strict definition, 206 00:07:08,349 --> 00:07:10,669 but what does that mean relative to my 207 00:07:10,669 --> 00:07:11,169 situation? 208 00:07:11,629 --> 00:07:13,009 And so my encouragement 209 00:07:13,310 --> 00:07:15,410 would be to make sure that, 210 00:07:16,345 --> 00:07:18,185 think about it. Think about yourself as a 211 00:07:18,185 --> 00:07:20,665 consumer when you're making leadership decisions, when you're 212 00:07:20,665 --> 00:07:22,444 thinking about your executive role, 213 00:07:22,904 --> 00:07:25,305 and then also talk to other people within 214 00:07:25,305 --> 00:07:28,125 your network, within your organization and broader, 215 00:07:28,449 --> 00:07:30,370 your family, your friends, and then just your 216 00:07:30,370 --> 00:07:33,330 extended professional network about their experience. Learn about 217 00:07:33,330 --> 00:07:35,410 it. You're gonna learn. It's very frustrating. It's 218 00:07:35,410 --> 00:07:38,290 very challenging. People want help. It is our 219 00:07:38,290 --> 00:07:40,370 obligation as health care leaders to figure out 220 00:07:40,370 --> 00:07:42,050 how to remove those barriers and how to 221 00:07:42,050 --> 00:07:43,110 make it much simpler. 222 00:07:43,745 --> 00:07:45,985 So bring all that data back into them, 223 00:07:45,985 --> 00:07:47,824 the day to day life of being an 224 00:07:47,824 --> 00:07:49,904 executive in decisions and choices that we're faced 225 00:07:49,904 --> 00:07:50,404 with. 226 00:07:50,944 --> 00:07:53,105 Absolutely. Well, Dennis, thanks for being here today 227 00:07:53,105 --> 00:07:54,785 and joining me on the Beckert's Health Care 228 00:07:54,785 --> 00:07:57,365 podcast. Again, we are live at the 2024 229 00:07:57,665 --> 00:07:58,805 payer issues roundtable.