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Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast.
Thrilled today to be joined by a very
special guest. Dan Keeter is the CEO of
UnitedHealthcare's
employer and individual insurance business. As an 80,000,000,000
division of UnitedHealthcare,
it is the nation's largest company that offers
health coverage to employers and consumers
nationwide.
Dan, thank you so much for taking the
time to sit down with me on the
podcast today.
Hi, Jacob. Great to be with you, and
thanks for the invitation.
Absolutely. And before we dive into everything we
wanna talk with you about, Dan, can you
tell us a little bit more about yourself,
your background in health care, and what it
is that you're doing today at UnitedHealthcare?
Yeah. Sure can.
As you said, I'm the CEO of our
employer and individual business. So that's the commercial
business within UnitedHealthcare
and UnitedHealth Group.
I joined the company first back in 02/2001,
and since then, I've served in a series
of roles across the organization,
largely concentrated
in the commercial market, however,
and
enjoy this role. Grateful to have it. Grateful
to interact with all the employers, distribution channel,
consumers,
and other constituents that we have in the
health care segment.
I oversee a diverse portfolio of commercial health
plans, ranging from traditional fully employed insured plans
across the country,
Self insured plans at a full scope of
ancillary
individual and voluntary offerings.
Fantastic. Well, like I said, Dan, we really
appreciate you taking the time to be with
us today. I wanna get us started by
talking about something brand new from UnitedHealthcare
just announced, and that is the UHC
store.
So take us through what this is and
how you see this kind of offering changing
the way that employers and your members
interact with their health benefits?
Yeah. Sure. I appreciate that question. United UHC
store, the UnitedHealthcare
store, as we talk about it,
it was just launched. It's a new direct
to consumer and a digital shopping experience.
It's an important part of our continued efforts,
and another step forward in giving consumers
more choice.
The goal here is to help consumers
improve
the customization of their benefit plan and do
so in a very consumer
friendly experience
with tech enabled solutions.
The store is now available to 6,000,000 members,
and we expect it'll be available to 18,000,000
members,
as soon as the end of the year.
It's available through our app and through myuhc.com
as well, of course.
And it helps consumers customize
the experience
for their specific needs, customize
the offerings available to them. So let me
give you a couple of examples of that.
Offerings inside the store include
popular weight loss programs,
orthopedic management
apps,
women's health solutions, and and more. So,
folks can choose an offering
ranging from a everyday health offering,
like those in women's health and and mental
health.
I think people are quite familiar with some
of the leading apps out there. We make
those available to consumers.
Think of Maven as a perfect example in
the women's health space.
Family wellness resources
for family planning,
for caregivers,
pregnancy, postpartum needs, things like that.
And then obviously weight management, something that's talked
a great deal about,
in health care today and has
a lot of consumer interest. So we have
offerings out there for weight management, coaching, nutrition
fitness,
things like that.
And then for other more complicated
and consumer specific
situations,
we offer solutions and enable their easy enrollment
in programs
for diabetes
or other gastrointestinal
issues, musculoskeletal,
kind of orthopedic considerations,
that folks may have. So through the UHC
store and enrollment in that way, it allows
people to save money,
customize,
the solutions
that are best for them and their family.
They can save, you know, 15% or more
in some of these. And by doing so
through the UHC
store, it allows us and,
our consumer member advocates
to be aware of these enrollments and help
better coordinate
more comprehensively
and and in a more customized fashion, the
care for the consumers. So it's one more
example of how I think we're
listening to the market, listening to our members,
our employers, and the distribution channel
to bring more customization
to consumers and allow them to make choices,
that best fit their needs. And as you
can tell by my example of Maven and
and others, if I were to go through
the list, they would
be solutions that people have heard of. They're
we're trying to bring together the best that
the health care marketplace has to offer consumers
and integrate that into their,
benefits program.
Absolutely. Well, I really appreciate you sharing all
the details there for us, Dan, about the
new UHC store.
And and it's so interesting to hear you
talk about the all that because
consumerism is really something we've heard a lot
about from UnitedHealthcare leaders
over these last few years in terms of
where the company is leaning in with innovations
like Surest
and a revamped provider search experience recently. So
I'm wondering if you could tell us a
little bit about that in terms of lessons
you've learned from,
Surest's
rapid growth and and how that's influencing how
you're designing other commercial products.
Yeah. Sure. I really appreciate you raising
Surest. It is something I like to talk
about a lot. I'm a Surest member myself,
and it works great for
for my family and me.
And it is absolutely an innovative model, an
example of where we've listened to the market
and are delivering to consumers
what they most want.
The innovative model certainly delivers cost savings to
consumers and employers. The 10 to 15% range
for employers and up to 50%
for consumers. So we've learned a great deal
about that while we really deliver to consumers
and employers what they most want.
They most want affordability and simplicity.
That's what we hear from them, and simplicity,
of course, includes transparency.
Surest, it delivers
all of that in a very consumer friendly,
intuitive digital shopping experience.
That's really unlike other things out there in
in health care.
You know,
historically, the health care industry
has been
accused, maybe rightfully so, of lagging other industries
in our adoption
of online
solutions in contrast to retail or digital banking
or things like that. And Surest is really
a big leap forward for us. Our initial
leap forward and things like UHC store continuing
to push that forward. So what have we
learned through this?
We've learned that indeed consumers do want more
choice. They do want more transparency.
They want more of a retail experience in
health care
that mirrors what they experience with their online
shopping, whether that be retail oriented or
shopping for plane tickets, concert tickets, etcetera, things
like that. Folks want transparency.
They want choices,
and they wanna know the the cost and
and quality and convenience impacts of those choices.
And
so Surest has delivered that along with the
economic savings that I described, and it's really
helped us
fine tune the UHC store
to
carry forward some of those same,
tendencies, those same capabilities and be responsive to
what consumers want. So,
these are our first two forays in this
area. Most notable built on the back of
dramatic improvements as you highlighted on our digital
app over the past few years. But you
can continue to expect more from us in
this regard as well.
Absolutely. Well, that's some amazing numbers you cited
there in terms of some of the major
cost savings you're seeing from Surest in terms
of, employers and and what members are seeing.
That's fantastic.
Dan, you you mentioned where the health care
industry may have fallen behind other industries,
in the past in terms of,
consumerism. And one area where we've heard across
the industry where,
the health care industry is trying to make
up some ground here is through the use
of artificial intelligence. And recently, we heard from
UnitedHealth Group that the company now has more
than 1,000
AI use cases in production across the enterprise.
So within the commercial business that you oversee,
where are you seeing some of the biggest
impacts of of AI and machine learning on
the member experience and on cost management?
Yeah. Sure can. So I appreciate
that, and you're exactly right. I think industry
wide,
all of health care is really moving in
the direction of AI and embracing it in
so many ways. That's absolutely true inside our
company and no doubt that the responsible use
of AI, I think, holds tremendous promise to
simplify and help us further create value in
in what we all know is a is
a more complex American health care system than
any of us wishes. So we're using AI
in some of the areas that you identified.
Let me give you a couple of examples.
So when it comes to health benefits and
the experience,
using AI there a good bit, working with
partners like Optum, but also others
to develop applications
to provide
for more seamless,
quicker,
faster to answer interactions with our advocates, whether
that be,
when a member calls in or uses an
AI chatbot. We now have tens of millions
of AI enabled searches,
to help customers,
consumers,
and to surely help them with things like
find a doctor, inquire about a claim,
determine where they are on their deduct deductible
accumulation should they have one. But then at
the same time, also
helping our agents on the inside be more
responsive, get faster to answers as I indicated
as AI is pulling forward to our advocates,
that are on the phone with a member
or interacting with them, perhaps in another digital
form, pulling forward recommended answers, anticipating,
what the next question and answer is going
to be. So it is really speeding up
the process.
Some other specific areas,
smart choice
provider search capability,
we call it. It leverages
AI and delivers a more personalized
experience for a member. You know, four key
standards,
come to mind to help a provide help
a member find the provider that they want.
Interested in in
sorting on quality or searching by benefits
or looking for other convenience factors,
like schedule,
opportunities
or proximity to their home or work,
and then allowing consumers to search for other
items of of personal preference and personal choice.
Perhaps the the language skills and capabilities of
the provider, gender,
things of that nature. So and also then
really using AI to help
provide,
assistance to consumers with a members like you
type of orientation. So things that we know
about a member that they share with us.
What are the choices that other members like
them may have made
about using our app, about seeking
a provider,
and things like that. So as
AI gets more data within our systems at
its disposal,
it will continue to improve with these predictive
capabilities. It will continue to deliver a richer
experience for our members that I think they
will find to be more seamless,
quicker to answer,
really much more like the retail experience that
we keep talking about.
Absolutely. It makes a lot of sense. And
it really at the core of things, it
sounds like you're looking to provide quicker information,
better answers about care and benefits to your
members and to your customers.
Dan, I wanna,
switch gears here for a second and talk
a little more macro context about what's affecting
the industry right now, especially as we head
into next year. We're hearing from employers,
all over the country and from,
groups that analyze what employers are saying at
large about, the health care cost increases that
they're estimating, that they're bracing for as we
go into next year. We're seeing anywhere from
6% to 10%,
cost increases
in 2026
driven by factors like catastrophic claims,
specialty drugs, coverage of chronic conditions.
So what are you hearing,
most consistently
from your jumbo and large employer clients right
now,
about how they're preparing for this?
Yeah. Boy, it's something that we listen really
closely to,
take very seriously. And at the same time,
we're obviously always analyzing our own data,
listening to what our
competitors,
in the marketplace are saying about their visibility
to trend,
and just working always to get a comprehensive
view of that and share it with our
employer customers, prospects alike, and obviously the distribution
channel. And as I said earlier,
customers and consumers are most interested in affordability
and then simplicity
right behind that. So
employers are absolutely concerned about rising cost, and
you quoted six to 10%. And I think
in places, we're gonna see it above that.
I've heard recent commentary,
from some other leaders in the industry, counterparts
of mine, if you will,
in various places where they're expecting rates to
be well above that in some pockets of
the country. And and I think that's right.
There's always geographic variation. There's
certain employer circumstances, obviously,
that dictate, if you will, where a specific
rate increase for an employer is gonna fall,
certain benefits, etcetera, the utilization patterns of the
group and so forth. But,
it it costs are elevated. They have been
elevated for a couple of years, and it
sure looks like they're gonna continue to be
elevated with even some acceleration
of that elevation into 2026.
So
when prices for health care products and services
increase year over year,
there's no doubt that it impacts employers. It
impacts,
us as insurers. It impacts the government in
their programs like Medicare. And so there's a
lot of factors that have an impact on
this. You,
quoted some of those. We're absolutely
seeing costs in that in that area of
specialty drugs and pharmacy in general. So all
sorts of pharmaceuticals, but with a focus on
specialty drugs and that's coming in a number
of ways. It's just coming through
cost increases from pharma and it's also coming
through increased adoption of some of the more
expensive drugs that are replacing
less expensive drugs.
Certainly continuing to see chronic conditions as you
indicated
in continued
elevated utilization of behavioral health. We really saw
that in start in COVID. It's continued
since then.
That's an example of where spending more on
behavioral health for the people that need it
is appropriate and it's something that we work
hard every day to enable. So
costs are up. Yes.
Through some things that
we really need to be careful about and
sensitive to and I would put the pharmaceuticals
in that category and there are other things
where costs are up because people need to
care and I put behavioral health in that
category. So we seek to manage across all
of those areas
containing cost, as much as we can in
negotiations
with with pharmaceutical manufacturers and others,
ensuring that we're balanced in payments to providers
and continuing to lead to broad access to
our members, but at the same time,
fare increases from an employer's perspective,
as well.
And then making the increased needs for care
like behavioral health, doing so in the most
efficient way, working really hard and using technology
to help us align the needs of a
consumer
with the capabilities
of a provider.
And you can think about the needs of
of different folks in behavioral health situations, and
and not everyone needs a psychiatrist.
Many of them need a counselor, a specialized
counselor.
Some can,
have all of their needs met through digital
interaction.
And so working really hard to align best
resource with needs of the patient
is helping us manage those costs as well.
So,
we've got a broad effort that approaches all
of these things in a number of ways.
And at the same time,
I'm also sensitive and aware of what Surest
is doing. We talked about that, and we
talked about how how Surest drives savings. It
does so by also
helping manage this appropriateness
of resource to the needs of the patient.
Couple of examples in that area.
We have, you know, 14% lower e r
utilization
on Surest, but then three times
higher virtual visit
utilization.
So that's just
one example in one product of how we
seek to align the needs of the consumer
with the resources available.
That's an example of something that helps us
mitigate costs. Those savings come through insurance. They
gave you the behavioral health example.
There's
many others of examples like that as well
that we're using to help get after this
elevated trend in inappropriate ways.
So many detailed insights for me there, Dan,
about what is ultimately driving up health care
costs, especially as we look into next year.
And you touched on pharmaceuticals, and and that
is really one area where we are constantly
hearing from insurers right now about what is
driving up premiums
for their members in part.
So so let me follow-up on that with
you about GLP ones specifically.
It it's, of course, it's top of mind
for employers given their high costs, the adherence
challenges we we hear about.
So how are how is UnitedHealthcare
considering the balance for that employer demand for
access to these medications
with the need for long term sustainability
with plan design and and the cost trends
that we're seeing?
Yeah. Boy, you're absolutely right to touch on
that topic and absolutely on point as far
as one of the things most talked about
with employers.
We get questions about GLP ones from employers,
all the time. I would suggest that it's
nearly every every employer has questions about GLP
one, and and we really work hard to,
help understand the needs of each employer and
customize solutions
for them.
It's
demand for GLP ones from consumers
at the current price point is absolutely
outpacing
the employer's ability to cover those costs. So
that's why employers are interested in various solutions.
So,
it's not a single solution, just
GLP one coverage or not,
is
is it's more complex than that. It's not
as simple as looking at it from an
employer perspective
of covering it or not. And the the
reasons behind that is it's a, you know,
upwards of a thousand dollars per patient per
month is the cost.
Perhaps there are some situations that can bring
that cost down,
and the high demand and the in some
employers, a relatively high percentage of employees
that would be eligible for suitable for for
such,
treatment,
really makes that unaffordable. So that's why we
work together with employers to put together more
comprehensive
weight loss solutions when they do seek to
cover GLP ones.
Help them think about the criteria by which
they want to cover those GLP ones.
And we've seen a good amount of innovation.
We've seen a good amount of innovation
emerge in that area with weight loss programs
taking a whole person approach.
So those include
pharmaceuticals, obviously, the GOP won many times, but
also clinical and behavioral support,
can be more effective.
You know, that's why we've developed a total
weight support program,
built to help encourage members to approach weight
loss, you know, more holistically,
more than just taking,
the medication itself. So
that's how we work through it with employers.
It's a difficult decision for them to cover
it. And you've seen in in,
your publications and others
how some insurers have moved to broad coverage
and then step back. You've heard of employers
who have stepped to broad coverage
and then step back.
So this is continuing to evolve. You know,
I'm encouraged
by what I read and hear from my
colleagues in the pharmacy space about the emergence
of
of more GLP ones,
perhaps moving to pill form, perhaps,
more manufacturers
of the injectable GLP ones
coming to the economy in the years ahead.
So I'm optimistic
that the cost of GLP ones will continue
to come down. I really do think that
is necessary. I think employers have told us
that. I think we and other insurers have
told the marketplace
that as well, that for widespread adoption to
be affordable,
we're gonna need more treatment options. We're gonna
need more
manufacturers, more delivery mechanisms getting to the pill
form,
perhaps. And and in the meantime,
however,
I think it's the solutions are more comprehensive,
whole person approach as I mentioned,
continued working with the manufacturers,
and then,
really information,
shared decision making, if you will, with employers
through distribution
channel and and employers with their employees as
well
to
try and find,
the most appropriate
offering
that still delivers affordability
for consumer,
and the employer. So,
much more to be talked about, and the
full full book on GLP one has many,
many chapters let to be written. But,
it's an issue for employers, and I think
it's gonna be one,
for years to come. That said, I am
optimistic that several years from now, we end
up with
the ability to offer
broader adoption
at affordable prices.
Absolutely. So clearly a very pressing and evolving
issue. It'll be fascinating to see how UnitedHealthcare
continues to tackle this and offer new solutions
to the markets.
Dan, as you said, there's so much more
we could talk about, but I know you're
a busy man. So I wanna thank you
for taking the time to chat with us
about all the latest happening under your leadership
at UnitedHealthcare
and for sharing your thoughts with us about
what's going on in the wider industry. We
truly appreciate it. Thank you, Jacob. I appreciate
the opportunity.
And to our listeners, if you'd like to
listen to more podcasts from Becker's Healthcare, you
can visit beckershospitalreview.com.