This is where health insurance leadership comes together.
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payer and health plan executives and more than
100 speakers to Chicago April.
This year's event includes keynote conversations with the
industry's top leaders and former president George W.
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here in Chicago.
Hello, everyone. This is Jacob Emerson with the
Becker's Pay Your Issues podcast. Thrilled today to
be joined by SCAN Group president and CEO,
doctor Sachin Jain. Doctor Jain, thanks so much
for taking the time to chat with me
on the podcast once again. Thanks so much
for having me, Jacob. It's always an honor
and a pleasure. Absolutely. Likewise. And, we've got
a lot we wanna, talk with you about
today, Sachin,
about a piece you wrote for Forbes.
But, obviously, as you know, there there's been
a lot happening
across the health care industry this year already
in the first few weeks of the year.
A lot of federal policy debate and proposals,
in Washington.
Got the CEOs of the largest insurers testifying
before Congress last week over rising premiums.
And then you wrote in your piece that,
of course, that all of this is happening
as trust in the industry overall remains fragile,
given the events of the last couple of
years. So
against that backdrop,
you published an op ed in Forbes this
month outlining 10 health care leadership resolutions for
the year ahead.
You you noted it's it's not a trend
forecast. It's not a strategy framework. It's a
candid call for
accountability.
And you're arguing that health care's core challenge
is not innovation fatigue or talent talent shortages,
but a growing deficit of leadership resolve.
So so, correct me if I if I
frame that incorrectly at all, Sachin. But but
how I wanna discuss I think you framed
it I think you framed it better than,
I framed it, Jacob. So thank you. Yeah.
I appreciate it. Hear that. I mean, tell
us, why'd you wanna write this piece? Why'd
you wanna start up this year writing this
in in such a public manner? Well, on
a on a personal note, I'm a big
New Year's resolutions guy, so I like to
spend the last couple of weeks of the
year thinking about the next year. And
as I was doing that for myself on
a personal level, I started to think about
my resolutions from a professional perspective.
And
I started to think about the behaviors that
I wanted to see more in myself and
then also behaviors
that I think we need to see, you
know, more broadly. And,
you know, number one is something I believe
in, you know, to my core, which is
that we all need to say the hard
things and do the hard things more.
I think health care is an industry that
is just bereft with happy talk,
and we need to kinda move beyond the
happy talk in part because
I think the happy talk actually gets in
the way
of actually addressing
the real problems, the real elephants in the
room. If we're constantly kinda talking about what's
working,
we're not talking about what's not working.
And, you know, to connect it back to
the trust point that you made earlier,
we may not be talking about it as
health care leaders,
but all of our patients
and health care workers are all talking about
it everywhere.
And so the trust gap builds when there's
one talk track that's happening at a leadership
level, and then there's another talk track that's
happening at the patient
and clinician level.
And when those two things are, you know,
increasingly misaligned,
it actually
widens the trust gap because it's it gives
people the feeling
that, you know, some people are living on
Mars while other people are living on Venus.
And
we all need to be on planet Earth.
And I think part of that begins with
actually
just naming the problem so that we can
actually start to fix the problem.
Sure. And I and I hear you loud
and clear. I would, share
in being,
and getting sick of of the happy talk
from leaders within the industry. I certainly hear
hear it,
daily. Nick, if you're only now getting sick
of it, I mean, you just you listen
to it all the time. So I'm just,
you know, you listen to it more than
I do. But let me ask you because
I think where this is coming from is
it's, from, you know, you wrote this isn't
coming from lack of intelligence. It's it's not
coming from people who don't know what they're
doing. But at least from, you know, when
I'm having interviews with very senior executives in
this industry,
they are scared to say what they really
feel either because, you know, they they have
their PR department that has written them very
strict things to communicate.
They don't wanna get into legal trouble. They
don't wanna, you know, get into trouble with
their board. Whatever it is, executives are often
very afraid to step in it, and they
don't wanna go in in the way that,
you know, is, I think, framed as the
correct way of communicating
whatever we're talking about in the given moment.
So
how do you how do you counter something
like that? Something that, I think innately is
a fear, from a lot of leadership in
the industry. Well, I'm glad you mentioned the
PR people because I think we have a
broken PR playbook for health care.
And I liken it a lot to the
Ivy League presidents that were
in congress
testifying
and not answering questions that were asked very
directly directly.
And you see that that playbook
of obfuscation,
of
being excessively careful in the face of hard
questions,
plays exactly the way that it played, you
know, when the those Ivy League presidents were
actually testifying
before congress, which is actually plays very badly.
If you're asked direct questions and you don't
answer them directly, and if you're not speaking
truth
in situations where you're
asked to speak truth,
it leaves a certain taste in your mouth.
And I think that,
you know, the instructions that we're getting from
PR people
are outdated. Now we have a great PR
department, small and mighty at SCAN.
But, you know, the truth is is that
we are,
you know, getting out of the world of
talking points and getting into the world of
just speaking the truth plainly and simply and
honestly.
I think, you know, you know, we had
this big national campaign last year with which
was health insurance is broken,
was our our tagline.
You know, SCAN sees it and, is doing
something to fix it.
That's a very different message than you hear
from almost all of our competitors,
both on the payer side and the provider
side, where most folks are touting their US
News and World Report rankings.
They're touting their,
you know, VISIANT ratings. Whatever it is, the
truth is is that
if you actually
look at what's really happening to patients and
clinicians, health care is getting worse and not
better.
And if you actually say that out loud,
it gives you the best chance possible to
actually fix it.
But I think we're robbing ourselves of that
when we hide behind
the p the simple PR talk. And, again,
I'll just say that old playbooks are really,
really outdated. Saying nothing is not a strategy.
And so I would I think that one
of the biggest opportunities we have as an
industry to move forward the quality of leadership
and the impact of leadership
is to actually
commit to speaking more plainly and more truthfully
and more honestly
about what's really going on.
Absolutely. And I and I definitely would give
kudos to SCAN for a very unique Medicare
Advantage campaign last year, such and definitely one
of the more candid moments we've seen in
the industry over the last few years in
terms of just openly talking about the frustrations
that members all across the country, not not
SCAN,
have with their health plans.
But I also wonder, you know, there's a
lot of leaders that don't necessarily see themselves
as wanting to be or needing to be
mouthpieces
for,
industry wide change. They just wanna focus on,
quiet
operational discipline within their their specific organizations.
Do you think that there's a risk here
of them getting drowned out by people who
are louder,
even if those people are less,
substantive in what they're saying? Yeah. Again, I'm
gonna sound like a broken record, but I
think it's an outdated playbook.
I think, you know, one of the reasons
we haven't had more policy change is that
we are quietly going about our business, not
really asking the hard questions and saying the
hard things and and leading the kind of
policy advocacy that we need. And what I'll
say is if you're not part of driving
change, change will happen to you.
That happens over and over again. History proves
that, you know, change will happen to those
who don't actually
participate in creating it themselves.
And so I think we, as leaders, have
an opportunity and almost an obligation
to take our knowledge of what's not working
and actually work proactively
to address it,
whether it's through operations, but also through advocacy,
through policy, through public proclamations. I I think
when you don't speak in 2026,
you're seen as, frankly, complicit in the status
quo. And I don't think that that's unfair.
I think if you are not part of
the voices
advocating for change, you are indeed part of
the broken status quo. And that is not
a position that I think history will look
favorably upon,
in the in the future. So I think
we all have to,
you know, really think hard about how we
show up and what we really stand for
and move beyond the platitudes. And one of
the my least favorite industry platitudes is the
no margin, no mission platitude because it avoids
the kind of reflection that's actually
necessary about what the actual mission is. And
I don't think the mission is to just
keep your organization alive no matter what. I
think the mission is to heal people, to
serve the community, to improve population health. That's
the work that we really need to do.
Yeah. No. It's a it's a good call
out. I I like that you're calling out
your least favorite platitude such, and I I
think maybe mine I would add is, meeting
the member where they are. I hear that
consistently,
probably on a weekly basis. And at least
from my perspective, that seems like something that
should have been What about what about right?
Right care, right time, right place. That's another
one I'm sure you hear a lot on
this, podcast, Jacob. Yeah. Definitely. And, hey, it's
it's it's also something I wanted to ask
about in in terms of just what we
hear so much of right now, but it's
it's almost saying everything and yet nothing, and
it's it's the AI conversation
section. And I and I say that because
it's almost like every press release,
every product raw, every initiative, every project has
to have some kind of AI powered, AI
driven
explainer on on attached to the front of
it. And, you know, I know this technology
is is has been transformative for the industry
right now, but I wanted to connect it
back to what something you said in your
piece. Well, actually actually, Jacob, I've pushed. I
don't think it has been transformative. Right? That's
the point is that, you know, you know,
are you or I getting in to see
our primary care doctors any sooner? Yeah. Are
you or I, you know, actually
getting the kind of care that we need
when we need it because of it, you
know, something that some health system is enabled
by AI? I don't think so. Sure. And
so until the benefit really accrues to the
end customer,
I you know, which is the patient,
I don't think we can actually say that
AI has led to any real change. And
I think a lot of what's happening right
now is we're we're getting a lot of,
quote, unquote, back office innovation, which is really
about revenue cycle management and coding,
and we're not necessarily getting patient facing innovation.
I I had this, you know, my my
team a couple weeks ago was presenting to
us the chatbot
that feed a chatbot feature, which is, you
know, kind of table stakes that, you know,
every company has. And I just kept thinking
to myself, has anyone ever met a chatbot
that they actually like?
And I couldn't couldn't think of anyone who's
there like, oh, man. I use the United
Airlines chatbot, and it was really awesome.
I really prefer that to actually interacting with
a person. Now certainly, like, if I had
a simple request, like, you know, you know,
send me my membership card or something like
that,
Those those types of, you know, features are
are helpful and reduce friction.
But what most people's health care problems aren't
as simple as needing a membership card or
needing a, you know, a a a, you
know, a referral to a specialist. I think
it gets much more complicated than that.
It you know? And and that's the work,
you know, that we need to do is
make those complicated things better and simpler.
So until AI is actually influencing
the the complicated things and truly making the
system work better,
You know, I think we're we haven't the
game hasn't even started yet.
No. And I I appreciate the pushback. I
certainly am guilty of falling for the rhetoric,
I think, just as much as anybody. And
I I I think the question there, Sachin,
is how should the leaders listening in, who
can also be just as guilty of this,
how can they distinguish themselves between genuine transformation,
whether that be at the company or industry
wide, and some of the organizational
noise that you described in your piece? I
would say skepticism is in and toxic positivity
is out.
And I think, you you know, the way
we can actually you you know, another another
truism that my friend, Aman Bandari,
who is,
you know,
the head of AI and and data science
at Vertex Pharmaceuticals
is, you know, show me a startup that's
actually moved the needle on care delivery.
And it you know, the truth is there's
a few. But for the most part,
most of what, you know, the startup ecosystem,
the venture ecosystem is doing is adding a
lot of noise. Now they're getting a lot
of attention right now.
But the truth is is that, you know,
there's a lot of noise,
and the noise
the noise to actual impact ratio is off
the charts right now. And I'd like to
see us really push the impact
numbers up and reduce the noise. And, you
know, maybe part of part of, you know,
what a Beckers can do is is start
to be a more skeptical voice. And I
think health care journalism could play an important
role in this too.
It's yeah. It's I really appreciate that call
out as well. I would agree.
We definitely have a responsibility to be more
skeptical in all of the communications that are
coming our way and what the authorities on
these topics are telling us. So, yeah, I
would agree with you. A simple a simple
fix here. I mean, again, I don't think
Becker's does this that much, but I think
a lot
of venues just get really focused on the
fundraising.
Mhmm. Right? It's like, oh, Joe's startup has,
you know, raised a series b that has
x, y, and z investors, and it's, you
know, $30,000,000 round.
And, you know, we're not actually talking about,
hey. Joe startup,
move the needle
on the care of diabetics in x health
system. Right? That's the kind of conversation that
we need to be having more of, and
that's the kind of stuff that we should
be elevating more, not, you know, whether someone
was clever enough to, you know, raise money
from a syndicate of investors. Yeah. Absolutely. And
I think, unfortunately, that's also a symptom of
our media
media ecosystem,
going towards what are the audiences clicking on.
And I know that's an entire other conversation,
so I won't, you know, go down that
path session. Sure. Sure. Yeah. I'm sorry I
took us there. Sorry. No no worries at
all. But I I wanted to ask about
a few of your resolutions.
One is elevating frontline workers, the people who
are actually doing the work of health care
in these organizations,
rooting out toxic positivity, ending performative initiatives.
I think all of these things really require,
these leaders at these companies to seed some
of their power or or at least confront
entrenched interests, within their own organizations, which, as
you know, across the industry, these companies can
be massive.
So what makes you confident that
executives
will actually do this, can actually do this
kind of thing, rather than simply agreeing with
you having the good intentions,
but then moving on same as usual?
Well, I think we need to change. I
think everyone knows we need to change. I
think most people in the middle ranks of
most health care organizations
are miserable.
And I'll tell you why they're miserable. They're
miserable because there's the happy talk that's coming
from the top, and then there's the frontline
reality that they're trying to manage and buffer.
And they are struggling with the cognitive dissonance
of the words they hear from their bosses
and the cries that they hear from the
front lines
and,
you know, the impact that they may not
be having on patients.
And so I think, you know, most people
live with a certain
amount of cognitive dissonance and moral discomfort.
And I think, you know, part of what
I wanted to do with these resolutions is
give them a language, give these folks a
language,
and maybe even point to me or point
to this article and say, look at what
this guy's saying. How does this apply to
our organization?
It's not easy for someone to say these
things out loud themselves. They are the things
that they grumble about when they're talking to
their friends and their families.
But, you know, if it's an article form,
maybe it's the kind of thing that can
circulate
and start a productive conversation
about how these behaviors are happening in one's
organizations and how they can move beyond them.
So you're laying the groundwork for other leaders,
to
to use themselves, Sachin. I wonder, you know,
jumping off of what we what we talked
about, and what we saw last week in
congress with some of the CEOs of the
largest insurers,
and and what was said or or what
was not said, I think.
Do you see examples of what you're talking
about today already happening in the industry? Is
there something you would point to that gives
you hope that the industry is on the
right path,
or or am I framing that correctly? How
would you describe where we're at in this
process? You know, I give the folks at
AHIP,
a a a lot of credit for some
of the work that came out of the
post Brian Thompson murder. Right? The reform
that they put in place, I think, was
was meaningful, and it was potentially transformative. Certainly
steps in the right direction and something that
we at Scan
have participated in as well.
That said, I don't think we're going far
enough because I think
what the dominant culture is is to
treat answering phones,
and and contracting networks like we're saving lives.
And
I have a message to everyone in the
pair industry who,
you know, believes that we're saving lives we're
not. I think the people on the front
lines of care delivery
are. Our work is to enable those people.
But in many cases, we're putting barriers up
to people actually accessing care, and we have
to make things
as easy as possible. We have to treat
people like they're human beings,
and we have to rehumanize our industry. I
think that that term, rehumanization,
is something that
really needs to start to resonate and percolate
in boardrooms and management teams
because,
unfortunately, a lot of what people have experienced
is actually dehumanization,
not not humanization.
Wonderful. I I think that's a really good
place to leave things, doctor Jain. So I
wanna thank you for taking the time to
chat with me on the podcast, and as
always for for being candid with us and
with our listeners,
in what you said can often be,
an industry and and periods where it's difficult
to to hear those kinds of perspectives. So
thank you for doing so. I really appreciate
it. Always a pleasure, Jacob. Thank you so
much, and, really appreciate the time. Yeah. Likewise.
And and to our listeners, if you'd like
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