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Welcome everyone to the Becker's Healthcare podcast series.

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I'm Mariah Muhammad, writer and moderator with Becker's

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Healthcare. And I'm thrilled to have with me

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today Stacy Edgar, cofounder and CEO at Venture.

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Stacy, welcome back to the podcast. We're very

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excited to have you join us again today.

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To start our conversation, I wanted to touch

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on finances a bit as it seems like

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it's the main topic for hospital systems

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and insurances today.

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So balancing affordability

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and quality is a constant challenge for health

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plans, as I'm sure you know. How is

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your organization

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innovating to manage the cost of care while

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also maintaining

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or improving member outcomes?

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Yeah. Well, first of all, thanks so much

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for having me. And, by way of background,

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for those,

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who maybe don't know me, I'm Stacy. I'm

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the CEO of Mentor.

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We are building personalized health insurance.

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And how we're doing that is leveraging the

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ICWA regulation.

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That stands for individual coverage health reimbursement arrangement,

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which is about a five year old, tax

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term that allows employers of any size to

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provide cash

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instead of a group health plan.

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And how it works is each employer

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sets a budget.

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That budget is pretax for the company.

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Each employee gets a budget, and they get

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to decide

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which insurance plan is best for them. They

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have to buy insurance to claim the money,

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but they also

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they don't have to use all the money

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on health insurance, so they could decide to,

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allocate part of that funds into a health

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wallet. And to bring that back to your

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question,

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what it does for both the employer and

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employee,

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and also frankly for health plans as well,

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is give this huge amount of flexibility.

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And it also unbundles

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this group model

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where you have this one size fits all

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approach. Maybe,

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you know, what you see with employers is

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maybe there's one person or two people who

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really need,

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especially if they're in the c suite, really

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need access to this one thing, but then

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the whole company

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needs to has to pay for it in

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term form of premiums. In this case, when

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you unbundle it, you get each employee the

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choice to choose, hey. What's important to me?

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And define how they allocate funds.

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It just creates more efficiency in market, but

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also

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allowing each person to, you know, really prioritize

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how money is spent

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based on the priorities in their life, whether

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it is, you know, managing diabetes or planning

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for a new family or, you know, maybe

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there there's nothing going on in their life

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that they're concerned about today. Maybe they can

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focus on wellness and prevention and direct that

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money there.

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So that's how we're doing that today.

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Wonderful. Thank you so much for giving us

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that background. I'm sure it will be useful,

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within our conversation

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today.

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And then kind of to move on, in

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an ever evolving,

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regulatory

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landscape,

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what best practices or tools does your organization

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rely on to keep the quality of care

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at the forefront?

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That's a great question.

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So the North Star for our organization

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is always thinking about the individual and the

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family and making sure that they get what

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they need at the right at the best

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price point. And so if you prioritize that

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I know it sounds very simple, but if

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as long as you're prioritizing the member and

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really thinking about their journey,

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then, you know, a lot of things flow

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from that. And that's actually where, you know,

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our model is actually quite innovative in that

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you put the spending power in the hands

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of the family.

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And so that's how we're doing it today,

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and that's where we're excited that regulatory

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change, especially recent regulatory changes made that happen.

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Yeah. Yeah. Definitely. And addressing health,

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equity has become a critical focus for many

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health plans. As, again, I'm sure you know,

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it's a big topic whenever I I really

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talk to a health plan,

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executive. Can you share an overview of a

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key initiative here that you're involved in or

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particularly,

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excited about?

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One thing that we're especially excited about is

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thinking about different,

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very niche user journeys. So, what I what

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I mean by that actually, this one's not

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that niche, but it's very, very overlooked.

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Helping moms, new moms,

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financially plan their health care journey. So we

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all know

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pregnancy delivery in America

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costs, an astronomical number, like 18,000,

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and that's actually that's when things go well.

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It could be much more than that if,

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you know, you have a complex

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pregnancy.

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And what we do is we look at,

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you know, here if you if you got

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this budget from your employer,

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what's how do we maximize it to basically

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lower the cost of care

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for a new mom or, you know, a

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second time mom or third time mom, but

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really think about,

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lowering the access to care burdens, that maybe,

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like, you know, the cost drivers that are

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keeping people away from getting the prenatal or

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postnatal care they they need and also, you

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know, just making it more,

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you know, having a family more accessible

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to more Americans as well.

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Yeah. Yeah. Definitely. Well, helping new moms is

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an amazing initiative, and I actually haven't talked

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to someone else who's talked about this. So

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that's amazing.

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And kinda going in with that, member satisfaction

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is essential to thrive in today's competitive health

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care market.

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I'm sure the mothers are very satisfied with

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this focus.

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But what experience or engagement strategies have proven,

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effective

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for your organization so far? How are you

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measuring the,

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the success?

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So we measure the success of, in terms

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of member satisfaction

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in multiple ways.

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Monthly

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customer satisfaction scores,

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you know, also satisfaction scores

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at each point

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of engagement

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with our customers. And we're proud to say

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we've actually had a 98%

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customer retention,

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in every year that we've operated as a

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business.

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And key to that is actually,

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that level of personalization.

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So one thing that's really scary is, you

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you know, when you give,

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when you at the employer level, when you,

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walk company through this model, it's a lot

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of change. And so we actually have very

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hands on account managers who are who we

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see as partners

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to our clients, and we're there to be

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right in the thick of things and really

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take things off of their plate and work

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in partnership with them. And then on the

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employee side, when you give somebody a budget

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and you say, alright.

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You know, this is now up to you.

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That can be overwhelming in health care. So

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they really do need

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a guide, and part of that guidance is,

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you know, delivering the form of technology. But

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we always believe that you should always have

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somebody you could talk to about, you know,

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your really personal needs and really make it

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about you. And I think that,

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you know, instead of maybe, you know, having

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a general like, we talked about moms earlier

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in this podcast. Instead of talking generally about

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moms,

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we're able to say, hey. This is your

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pregnancy,

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like, your child, and really personalize that plan

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for each person. And that's what really makes

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a difference and also what I think has

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led to that satisfaction score as well.

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Yeah. Yeah. Definitely. Well, the net,

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promoter score is a powerful indicator

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of member loyalty and satisfaction.

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How are you using NPS to drive meaningful

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improvements across your health plan?

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Yeah. So we we look at,

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basically,

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we look at

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any friction points, and that drives our product

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road map. And, you know, and then we

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keep measuring it until that friction point has

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gone away.

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And looking at,

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how do we boost that NPS score and

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really just keep keeping customer at the North

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Star. And the biggest gift any customer gives

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you is is constructive feedback.

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So really making sure that we take that

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seriously and then act upon it with haste.

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Yeah. Yeah. Definitely. Well, we've talked about how,

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how it's imperative to reduce cost, improve quality,

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and advance health equity.

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But,

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obviously, these are not small task,

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and it takes a bit of time. How

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do you approach aligning these priorities in your

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organization's

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strategic vision?

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Great question. So

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I would say to that,

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the customer is always the North Star. So

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coming back to that comment we made earlier,

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it's really about the individual. It's about the

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family. It's about the employer. And this also

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you know, we also think about the larger

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ecosystem in which we play and whether we're

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talking about payers,

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in terms of insurance carriers or,

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you know, health systems and providers

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and really just making sure that we're creating

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you know there's a lot of actors. And

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because of that, there's a lot of noise.

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And so, you know, we assign a North

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Star, which

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is around the individual and the family.

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But

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we also believe that creating as many win

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wins as possible across the ecosystem, you know,

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helps us do our job better. And so

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we

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And

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so

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what we spend a lot of time on

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is

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making sure we're understanding how our partners work

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and also what their incentives are.

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And so, you know you know, it's often

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easy to say, hey. I demand this of

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you, or why don't you do this better?

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But making it two way of saying, you

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know, we could probably be better too. And

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how do we make this a win win

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for us as for all?

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And,

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so but also just making sure that, you

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know, you have to pick a focus point

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and you can't,

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boil the ocean. So, you know, of all

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those actors, we've, you know, definitely decided, okay.

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This one is the priority actor and everything

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else is in service of that that person,

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and that also clarifies decision making as well.

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Yeah. Yeah. Thank you so much for explaining

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that. I'm sure other people will definitely take

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that, into consideration.

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And, Stacy, before I let you go, looking

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ahead, what do you see as the biggest

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opportunity for payers

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to really lead the, change and transform,

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transforming care delivery and driving better outcomes for

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all stakeholders?

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Really, how can leaders take a step in

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this direction now?

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Yeah.

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I think keeping track of the most important

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thing right now is keeping track of everything

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that's happening,

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which I you know, that's whether it's AI

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or regulation, there's a lot. And, actually, what

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I think we're about to see and for

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anybody listening to this podcast or this episode,

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I would encourage you to take a look

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at ICRA, get to know it. It is

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a new way to pay for health care

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entirely, and there's new regulation even as of

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this week being considered in the house of

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representatives.

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And

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the,

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on top of that, the technology change that

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is happening alongside it,

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the future I see is that we're gonna

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see increasing personalization

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where you know? And I think the consumer

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is gonna demand it as well.

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And we're kinda going back to you know,

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instead of being able to talk about categories

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in general terms, like whether it's, you know,

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we're talking about conditions or we're talking about,

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populations or we're talking about geographies,

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that people will wanna see, you know, this

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is the plan for me

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and really be able to custom fit that.

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And I think that's the next chapter of

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health and health care and health insurance.

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The law is here. The technology is here.

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It's just a matter of time at this

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point.

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And,

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keeping up to date with all the things

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that are changing, I think, is really, really

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crucial at this moment in time.

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Absolutely. I completely agree, there. And thank you

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so much for those final thoughts. It's definitely

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been a very informative discussion. So, again, I

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wanna thank you so much for coming back

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on Beckley's Health Care. I look forward to

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connecting with you again soon.

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Likewise. Thank you so much.