Welcome everyone to the Becker's Healthcare podcast series.
I'm Mariah Muhammad, writer and moderator with Becker's
Healthcare. And I'm thrilled to have with me
today Steve Tringale, president of Mass General Brigham
health plan. Steve, welcome to the podcast. We're
very excited to have you join us today.
To To get us started, would you mind
please introducing yourself and telling us a bit
about your background?
First, thank you for having me, today.
I'm Steve Tringale. I'm president of the Mass
General Brigham Health Plan.
We're a health plan of approximately
400,000
members
across commercial Medicare Advantage
and Medicaid,
product lines.
We also will be entering,
the dual eligible product line, so we have
a full product portfolio.
And we are focused
really on
building a model which
takes advantage
of our integrated health care system
in using
the incredible resources at Mass General Brigham
to provide our members with
a better experience,
a better clinical outcome, and quite frankly,
a better product
than other health insurers
and and really take advantage of that combination
of world class care
and comprehensive coverage that we can provide.
Yeah. Yeah. Wonderful. Thank you so much for
giving us that background. So
health care in hospitals and health plans, health
care overall is really, changing rapidly right now
as I'm sure you're, well aware. What are
some of the biggest issues you're following in
health care this year so far?
Well, it is, in fact,
both the fragility and the volatility of of
both the delivery systems and insurers at the
same time
is something I have not seen
very often in my career.
So when we look at that level of
volatility
in the marketplace,
when we look at,
the level of accelerated
change that you usually get
in the first year of a new administration
and a new congress,
and you put all of those things together,
keeping
our plan
focused
on our North Stars,
which are essentially
providing that member
focus so that they're having a better experience
and a better outcome
and
taking advantage
of our integrated delivery system.
We try and stay focused on that, but
at the same time,
be flexible and agile
to be able to pivot to respond to
both expected and unexpected challenges and opportunities
that are gonna be created by what is
a rapidly changing and a rapidly consolidating industry
on
Yeah. Yeah. Absolutely.
And,
you know, saying this type of change being
something you haven't seen much in your in
your career, is this something that's kinda making
you nervous? And if not, is there anything
that you are most excited about,
whether in tech, whether,
something that is changing overall or anything else
that's making you nervous?
So
I don't know that I'd use the word
nervous as much as
focused.
There are a number of areas that require,
an extraordinary
level of focus right now.
Access is a huge issue and access from
a financial basis,
which means making sure that the products can
stay affordable,
and access
from a physical basis, which means
dealing with the primary
care shortage, which is affecting
both delivery systems and health plans across The
United States, and we're no exception to that.
So coming up with build to purpose,
solutions on the primary care side
and using
AI,
not just
at the the health plan level in terms
of
managing our claims,
volumes and managing,
denials and prior approvals,
using AI
to improve the member experience,
to enhance the ability
to
help the member navigate and move to a
very complex
delivery system
to be at the right place, to get
the right care at the right time,
to make sure that we're providing the member
with the highest level of
digitally enhanced
responses to some of
the clinical challenges, whether it be
in the area of of
high end imaging,
or whether it be in using
AI to help our analytics to focus on
what are the right mix of services
to provide to a member so that when
we look at issues like the lifestyle challenges
between diabetes and obesity,
that
we're not solely focused on
do, we approve
the provision
of a GLP one, but what are the
right
mix of services
that we should wrap around the provision of
that GLP one
that's going to help that member
succeed over the long term
to have
better health outcomes and not just have
some weight loss, to change the way they
look at some of their lifestyle decisions,
to change the way that they
approach some of their day to day activities,
whether it be,
food based, whether it be exercise based, etcetera.
In having,
using AI to build analytics to help us
on those issues
as much as some of
the core insurance issues, which have quite frankly
gotten some negative press
in in terms of how other companies are
using it. We wanna use AI
to improve the member experience and to improve
the member outcome.
Yeah. Yeah. Absolutely. Thank you so much for
sharing that. And access overall is definitely something
I've heard other techs talk about in different
ways as well.
And,
going with this kind of theme of change
and implementing different things,
in your opinion, what would the most effective
health care leaders need in order to be
successful in the next two to three years,
do you think?
A couple of things.
I think the biggest challenge, quite frankly, in
the short term is leadership.
There is so much going on
that you need to keep your teams
focused
on the business of the business
and at the same time,
flexible and agile
to, as I said, to take
advantage of opportunities,
not just to respond to some of the
specific challenges out there.
In terms of the focus on the business,
you know, we're really proud that over the
last two years, we've won
recognition
as from JD Power
as the most trusted
plan
in the commercial marketplace in Massachusetts,
a market which has some very strong competitors,
and we've won that two years in a
row.
That's an example of staying focused.
At the same time, an example of staying
flexible and agile.
You've all written an enormous amount about some
of the challenges that this
health system all over the country faced
when,
Stewart Healthcare went into bankruptcy.
Our team,
stepped up and immediately
looked at
every member that we had, every individual member
that was in a steward facility to make
sure that we could maintain continuity of care
and a care regimen for patients who are
in active cancer treatment, active cardiac treatment, etcetera.
And they did that while we were running
the the rest of, you know, the plan
activities on a day to day basis.
That's the kind of response that I think
you're gonna need from good health plans
to continue to operate in a system
which is almost guaranteed to have
a lot more bumps in the road, a
lot more change,
a lot more consolidation over the next two
to three years. What we're seeing go on
right now is not a one year
interlude.
There is a a a significant sea change
going on in delivery system right now.
So whether it's,
digital innovation,
it's whether working with our delivery system
to improve integrated models of care, which differentiate
us
in the market,
whether it's the blocking and tackling of
customer service across very different product lines, whether
it be commercial,
Medicaid,
geriatrics with Medicare Advantage.
We need to
to continue to improve
what I think has been
rather good performance, quite frankly.
So,
you know, the focus on continual improvement in
a period of rapid change
is a challenge from a leadership perspective.
So the last piece of that is I
need to challenge my leadership team,
to be great two way communicators.
The leadership teams have a pretty good window
on what's going on
at the policy level, at the state level,
at the federal level, at the national level.
But we need to be teaching,
explaining,
and be transparent about both the market dynamics
and the political dynamics
that are driving some of that change.
And at the same time, we need to
be sitting down with our workforce
and be active listeners
and make sure we understand how this is
impacting them in the way they have to
undertake their duties on a day to day
basis.
While this is a huge challenge for leadership,
sometimes I think we forget
how daunting some of this change can be
for the overall workforce.
So I think in many ways, the biggest
challenge
for senior executives, for senior leaders,
for myself,
is to be,
as I said, sort of that great two
way communicator
because
people will respond to challenges if they understand
why they need to do it. It's a
lot harder to respond to those challenges,
and it's a lot more it's a lot
more stressful to respond to those challenges
if you really don't understand the underlying dynamics
about what's going on.
Yes. Yes. Absolutely. Thank you so much for
those final thoughts. This has definitely been an
informative discussion. And, again, I wanna thank you
so much for coming on Becker's HealthCare,
especially for the first time, and I look
forward to connecting with you again soon.
Sure. Thank you very much.