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 Stacy Edgar, cofounder and CEO at Venture.
Stacy, welcome back to the podcast. We're very
excited to have you join us again today.
To start our conversation, I wanted to touch
on finances a bit as it seems like
it's the main topic for hospital systems
and insurances today.
So balancing affordability
and quality is a constant challenge for health
plans, as I'm sure you know. How is
your organization
innovating to manage the cost of care while
also maintaining
or improving member outcomes?
Yeah. Well, first of all, thanks so much
for having me. And, by way of background,
for those,
who maybe don't know me, I'm Stacy. I'm
the CEO of Mentor.
We are building personalized health insurance.
And how we're doing that is leveraging the
ICWA regulation.
That stands for individual coverage health reimbursement arrangement,
which is about a five year old, tax
term that allows employers of any size to
provide cash
instead of a group health plan.
And how it works is each employer
sets a budget.
That budget is pretax for the company.
Each employee gets a budget, and they get
to decide
which insurance plan is best for them. They
have to buy insurance to claim the money,
but they also
they don't have to use all the money
on health insurance, so they could decide to,
allocate part of that funds into a health
wallet. And to bring that back to your
question,
what it does for both the employer and
employee,
and also frankly for health plans as well,
is give this huge amount of flexibility.
And it also unbundles
this group model
where you have this one size fits all
approach. Maybe,
you know, what you see with employers is
maybe there's one person or two people who
really need,
especially if they're in the c suite, really
need access to this one thing, but then
the whole company
needs to has to pay for it in
term form of premiums. In this case, when
you unbundle it, you get each employee the
choice to choose, hey. What's important to me?
And define how they allocate funds.
It just creates more efficiency in market, but
also
allowing each person to, you know, really prioritize
how money is spent
based on the priorities in their life, whether
it is, you know, managing diabetes or planning
for a new family or, you know, maybe
there there's nothing going on in their life
that they're concerned about today. Maybe they can
focus on wellness and prevention and direct that
money there.
So that's how we're doing that today.
Wonderful. Thank you so much for giving us
that background. I'm sure it will be useful,
within our conversation
today.
And then kind of to move on, in
an ever evolving,
regulatory
landscape,
what best practices or tools does your organization
rely on to keep the quality of care
at the forefront?
That's a great question.
So the North Star for our organization
is always thinking about the individual and the
family and making sure that they get what
they need at the right at the best
price point. And so if you prioritize that
I know it sounds very simple, but if
as long as you're prioritizing the member and
really thinking about their journey,
then, you know, a lot of things flow
from that. And that's actually where, you know,
our model is actually quite innovative in that
you put the spending power in the hands
of the family.
And so that's how we're doing it today,
and that's where we're excited that regulatory
change, especially recent regulatory changes made that happen.
Yeah. Yeah. Definitely. And addressing health,
equity has become a critical focus for many
health plans. As, again, I'm sure you know,
it's a big topic whenever I I really
talk to a health plan,
executive. Can you share an overview of a
key initiative here that you're involved in or
particularly,
excited about?
One thing that we're especially excited about is
thinking about different,
very niche user journeys. So, what I what
I mean by that actually, this one's not
that niche, but it's very, very overlooked.
Helping moms, new moms,
financially plan their health care journey. So we
all know
pregnancy delivery in America
costs, an astronomical number, like 18,000,
and that's actually that's when things go well.
It could be much more than that if,
you know, you have a complex
pregnancy.
And what we do is we look at,
you know, here if you if you got
this budget from your employer,
what's how do we maximize it to basically
lower the cost of care
for a new mom or, you know, a
second time mom or third time mom, but
really think about,
lowering the access to care burdens, that maybe,
like, you know, the cost drivers that are
keeping people away from getting the prenatal or
postnatal care they they need and also, you
know, just making it more,
you know, having a family more accessible
to more Americans as well.
Yeah. Yeah. Definitely. Well, helping new moms is
an amazing initiative, and I actually haven't talked
to someone else who's talked about this. So
that's amazing.
And kinda going in with that, member satisfaction
is essential to thrive in today's competitive health
care market.
I'm sure the mothers are very satisfied with
this focus.
But what experience or engagement strategies have proven,
effective
for your organization so far? How are you
measuring the,
the success?
So we measure the success of, in terms
of member satisfaction
in multiple ways.
Monthly
customer satisfaction scores,
you know, also satisfaction scores
at each point
of engagement
with our customers. And we're proud to say
we've actually had a 98%
customer retention,
in every year that we've operated as a
business.
And key to that is actually,
that level of personalization.
So one thing that's really scary is, you
you know, when you give,
when you at the employer level, when you,
walk company through this model, it's a lot
of change. And so we actually have very
hands on account managers who are who we
see as partners
to our clients, and we're there to be
right in the thick of things and really
take things off of their plate and work
in partnership with them. And then on the
employee side, when you give somebody a budget
and you say, alright.
You know, this is now up to you.
That can be overwhelming in health care. So
they really do need
a guide, and part of that guidance is,
you know, delivering the form of technology. But
we always believe that you should always have
somebody you could talk to about, you know,
your really personal needs and really make it
about you. And I think that,
you know, instead of maybe, you know, having
a general like, we talked about moms earlier
in this podcast. Instead of talking generally about
moms,
we're able to say, hey. This is your
pregnancy,
like, your child, and really personalize that plan
for each person. And that's what really makes
a difference and also what I think has
led to that satisfaction score as well.
Yeah. Yeah. Definitely. Well, the net,
promoter score is a powerful indicator
of member loyalty and satisfaction.
How are you using NPS to drive meaningful
improvements across your health plan?
Yeah. So we we look at,
basically,
we look at
any friction points, and that drives our product
road map. And, you know, and then we
keep measuring it until that friction point has
gone away.
And looking at,
how do we boost that NPS score and
really just keep keeping customer at the North
Star. And the biggest gift any customer gives
you is is constructive feedback.
So really making sure that we take that
seriously and then act upon it with haste.
Yeah. Yeah. Definitely. Well, we've talked about how,
how it's imperative to reduce cost, improve quality,
and advance health equity.
But,
obviously, these are not small task,
and it takes a bit of time. How
do you approach aligning these priorities in your
organization's
strategic vision?
Great question. So
I would say to that,
the customer is always the North Star. So
coming back to that comment we made earlier,
it's really about the individual. It's about the
family. It's about the employer. And this also
you know, we also think about the larger
ecosystem in which we play and whether we're
talking about payers,
in terms of insurance carriers or,
you know, health systems and providers
and really just making sure that we're creating
you know there's a lot of actors. And
because of that, there's a lot of noise.
And so, you know, we assign a North
Star, which
is around the individual and the family.
But
we also believe that creating as many win
wins as possible across the ecosystem, you know,
helps us do our job better. And so
we
And
so
what we spend a lot of time on
is
making sure we're understanding how our partners work
and also what their incentives are.
And so, you know you know, it's often
easy to say, hey. I demand this of
you, or why don't you do this better?
But making it two way of saying, you
know, we could probably be better too. And
how do we make this a win win
for us as for all?
And,
so but also just making sure that, you
know, you have to pick a focus point
and you can't,
boil the ocean. So, you know, of all
those actors, we've, you know, definitely decided, okay.
This one is the priority actor and everything
else is in service of that that person,
and that also clarifies decision making as well.
Yeah. Yeah. Thank you so much for explaining
that. I'm sure other people will definitely take
that, into consideration.
And, Stacy, before I let you go, looking
ahead, what do you see as the biggest
opportunity for payers
to really lead the, change and transform,
transforming care delivery and driving better outcomes for
all stakeholders?
Really, how can leaders take a step in
this direction now?
Yeah.
I think keeping track of the most important
thing right now is keeping track of everything
that's happening,
which I you know, that's whether it's AI
or regulation, there's a lot. And, actually, what
I think we're about to see and for
anybody listening to this podcast or this episode,
I would encourage you to take a look
at ICRA, get to know it. It is
a new way to pay for health care
entirely, and there's new regulation even as of
this week being considered in the house of
representatives.
And
the,
on top of that, the technology change that
is happening alongside it,
the future I see is that we're gonna
see increasing personalization
where you know? And I think the consumer
is gonna demand it as well.
And we're kinda going back to you know,
instead of being able to talk about categories
in general terms, like whether it's, you know,
we're talking about conditions or we're talking about,
populations or we're talking about geographies,
that people will wanna see, you know, this
is the plan for me
and really be able to custom fit that.
And I think that's the next chapter of
health and health care and health insurance.
The law is here. The technology is here.
It's just a matter of time at this
point.
And,
keeping up to date with all the things
that are changing, I think, is really, really
crucial at this moment in time.
Absolutely. I completely agree, there. And thank you
so much for those final thoughts. It's definitely
been a very informative discussion. So, again, I
wanna thank you so much for coming back
on Beckley's Health Care. I look forward to
connecting with you again soon.
Likewise. Thank you so much.