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Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast. Thrilled today to be
joined by Craig Kurzweil, who is the chief
data and analytics officer for UnitedHealthcare's
commercial business. Craig, thanks so much for taking
the time to be with me on the
podcast this morning. Thanks for having me. Absolutely.
And before we dive into everything we wanna
talk with you about, Craig, can you first
tell us a little bit more about yourself
and what it is that you do at
UnitedHealthcare?
Sure. That sounds good.
So, I lead our data and analytics,
and reporting for all of our employer customers.
I've been with the company for about twenty
just just over twenty one years now,
and I spent that entire time
focused on how do we translate
massive amounts of data
into something interesting and hopefully actionable
for our employer clients through different iterations. So,
I'm a data nerd at our at my
heart and love to kinda dive in to
see what's happening and how we can use
that data to drive better results.
Fantastic. Well, in that vein, Craig, UnitedHealthcare,
as you know, releases findings every year through
a white paper that you do with the
health action council
where you analyze member data for wider health
care trends.
So it's the ninth year of this of
this paper, that you that you've published. And
I wonder if our audience might not be
familiar, can you give them a sense of
what exactly this report is, what data it
draws from, and and how it's evolved over,
nearly a decade now?
Sure. I it's been a very fun journey,
with the Health Action Council. It's a very
unique collaboration partnership where for an analytic person,
especially,
because within the health action council, we have,
over 225,000
members within,
health action council that we can leverage on
a de identified basis to do these kinds
of broad
view studies of what's happening across the population.
As you mentioned, this is our ninth year,
and so we've spent a lot of time
really trying to focus in on parts of
the health care system maybe that haven't
been focused on enough or maybe not at
all, and kind of really hone in on
those and give employers a unique perspective. So,
for example, we've spent a lot of time
in the pre COVID days, diving into generations
and community health and social determinants of health,
virtual care.
And post COVID, we really been focused on
kinda where do we go from here and
what are some of the new, barriers to
care and to cost.
And for and we'll talk about to the
this study, but really focusing on how the
community has a lot to do with what
happens across these populations. So it's really been
a unique partnership, and that kind of membership
allows you to do some really creative things.
And and, honestly, the Health Action Council kinda
thinking differently and allowing us the space to
come up with studies that are different from
the mainstream is, is is been wonderful,
from an analytic person's point of view. So
lots of really, really interesting ways to kinda
see what's happening across the system.
Absolutely. That makes a lot of sense. And
I I read through the report myself. There's
a lot in it, a lot of different
areas of focus for employers. So I wonder
if we starting off broadly, just talking about
some of the results. Anything this year that
surprised you?
Sure. I think there's a a few things
that kinda jump out to me, and I've
lived in data for, like, twenty one years.
And it's hard to surprise me these days.
But there's a few things that I think
are
changing and maybe different than what people might
anticipate. So as we start to dive into
the data,
and we're really focused in, in this study
trying to look to see,
how do generational
and gender influences,
impact
what we see around cost utilization and affordability.
And and of of the findings for this
year, there's kinda three main areas.
One being, you know, we typically assume that
the younger population
is,
low cost, kind of invincible. Right?
Not really haven't really developed a lot of
chronic disease yet in their their younger population.
But we're starting to see that change a
bit. And we're starting to see some of
those younger folks. They're still definitely lower cost
and lower chronic disease than their older generational
counterparts, of course. But we're starting to see
them rise at a higher rate than we've
seen in the past. So they're kinda catching
up, so to speak to some of those
older populations.
And if you think about employers, typically,
the focus
forever has been how do we manage the
risk in the older population because that's where
more of the cost is driven by. This
might change, some of those strategies or maybe
rethink where we dedicate some of the strategies.
And as part of that rise in the
younger population,
a big piece of that is that catastrophic
health events, are becoming way more frequent.
So we're seeing a rapid influx in the
number of catastrophic claimants are now twice as
common as they were five years ago. And
we're seeing that not only just for the
younger generation, but for all generations, you know,
rise of the number of people
reaching, a 100,000.
And it's but it's no longer focused on
just the older sicker population.
It's focused everywhere. And kind of the third
point that I'd focus in on and, obviously,
a hot topic always is metabolic conditions.
So we're starting to see them rise, more
sharply.
We're seeing we're starting to see metabolic symptoms
rise
quicker in some of the younger populations as
well and and within men.
In particular, we see that,
those men that are struggling with metabolic conditions,
so think diabetes, obesity, hypertension,
much greater health risks, much higher costs,
and, specifically,
men with those metabolic issues,
have much higher risk of some of the
catastrophic events such as heart attack, stroke, and
surgeries where we see a seven times greater
risk within that population. So,
the three main areas that I just would
focus in on is the rise of the
cost in the youth population,
catastrophic claimants start to become much more frequent,
and then the rise of metabolic conditions across
all populations, especially in men.
And, Craig, let's dive into that a little
bit more in terms of the the rise
in care costs for the younger population because
that seems like a huge
concern for employers.
Now a population that maybe in the past
was not a huge cost driver compared to
other generations.
And in the reports,
specifically, it's Gen z's year over year,
care spending. It jumped 18%,
nearly double the rate of, the the rise
in care costs for baby boomers. And it's
driven, like you mentioned,
a rise in catastrophic claims, forty one percent
increase that you noted in the report.
So what is this increase in in chronic
disease, in catastrophic care among younger workers? What
does that signal on the ground for their
employers?
Yeah. Two things, and they go hand in
hand. So first, we are seeing
that,
in younger the younger folks are starting to
develop
chronic conditions or health risks
at younger ages. So we're seeing obesity, hypertension,
behavioral health,
starting to pop up earlier,
in their natural progression.
That
development of chronic conditions
then leads to the opportunity. Some of those
folks are gonna be well managed and making
good choices, but we're gonna see within that
younger generation. They're maybe not equipped or ready,
to really navigate the health care system in
a good way, leading to those chronic diseases
turning into catastrophic events. So we see, again,
like, like, like you said, a forty one
percent increase in catastrophic events among younger adults,
driven by the rise of chronic disease as
well as that population
not being as engaged or educated on how
to use the health care system appropriately
to prevent those types of things from happening.
This is interesting.
The other part you mentioned earlier in terms
of some of the the differences you're noticing
between men and women and how they access
care or engage with the system,
overall,
the data showing that men have consistently lower
PCP engagement than women starting at age 18,
and that gap doesn't close until their sixties,
which is,
I mean, just wow.
So I wonder what is the data telling
you in terms of why men's health has
been so difficult to move the needle on
overall,
And what do you think it would actually
take for employers, for the health plan,
to change these patterns earlier in in their
lives?
Yeah. This is this is definitely a tough
one. This has been kind of an age
old sort of question. How do you engage,
especially the younger male population?
In general, what you see in the data,
is
men make decent health care choices
when something has happened.
So when you are diagnosed with a condition,
when you're diagnosed with diabetes or heart disease
or so or so on, you see that
men will make pretty good health care choices
in that space.
It's the before that we're worried about. It's
the prevention piece. It's seeing your doctor on
a regular basis. It's getting preventive screenings done.
That's where men prior to age 60
really have
wide gaps compared to their female, counterparts.
So it's really about how do you,
engage incense,
nudge those men to start to see that,
prevention matters, and you can stop these kind
you can stop or at least mitigate some
of those events from happening if you do
something before
the bad news kind of comes in from
a health care perspective. And really, really hard,
really, really challenging, but it really comes down
to, as you see in the study, engagement
with your PCP.
Can you
make it easy, make it simple,
make it accessible
for those men to be able to engage
their PCP? Because once that happens, we start
to see analytically
that a lot of those other gaps,
start to change,
pretty quickly.
Sure. No. That makes a lot of sense
in terms of strategy. Men are being reactive,
not proactive
to to their health. And I wonder more
broadly, Greg, how
how close do you think employers' health plans
are to being I being able to identify,
some of those high cost members,
like a man early on in their life,
early enough to intervene meaningfully.
And and, ultimately, what is the biggest barrier
to that right now? Is it is it
not having
enough or or the right data? Is it
the clinical programs themselves? Is it
getting that over that hump of, getting them
to be proactive and engage earlier?
What do you think it is that's, the
biggest barrier there?
I think and and, obviously, I'm biased, but
I think the data has gotten pretty good.
We have, the ability at a population level
within the employers that we work with to
to really
be able to understand
where the drivers are,
where the decisions are inappropriate.
So, for example, rather than kind of peanut
butter spreading solutions across an entire population,
we can hone in that it's not a
PCP engagement issue, and their entire population really
is focused on, for example, the young male
population
or a specific market or a specific,
age group and so on. So analytically,
at a population health perspective, that's gotten really
good. And I think most employers
can precisely see where the where the problems
are, where the focus areas should be. And
even at an individual level, I think analytics
have gotten much better as well as we
start to identify
who's at risk, who's headed down a a
negative path, and as quickly as we can
be able to outreach into that population.
And that's where a lot of the, clinical
programs that exist today are really focused. So,
analytically, we can find these folks as quickly
as possible. We can start to predict the
path that they're headed down and start to
engage them further upstream.
Years and years ago, it used to be
that your analytics were dated, and you would
find out that a member was headed down
a bad path after that event already occurred.
And then clinical program outreach would typically happen
after that event occurred as well. But analytics
have gotten better. Data has become more real
time. And now we can start to identify
these folks,
upstream,
guiding them into programs. So there are there
are programs that can help guide people into
leveraging primary care physicians. There's digital condition management
programs. There's lots of different metabolic health coaching
and monitoring events. For example, with the UnitedHealthcare,
we have level two for die for diabetes
that can help kinda manage those those diabetics.
So there are lots of opportunities out there.
And I think, analytically and clinically, we're now
at a point where we can outreach to
these people sooner and quicker upstream to make
a bigger difference in what the future is
going to hold. But at the end of
the day, it's all about engagement. We can
find those people early. We can have the
best programs in the world that would make
the biggest difference for that population.
But if you're unable to get them to
an engage and to sign up and to
participate,
none of that's worth it. And that's where
a lot of the focus is right now.
How do we focus on the consumer,
make that engagement simple, easy,
make that the easy choice for them versus
the hard choice,
because we know how the health care system
is incredibly complicated.
People get confused pretty easily because there's a
lot of different variables out there, and they
don't know where to go, where to get
the best care, what should I do next.
But our ability to meet the consumer where
they are, whether that be through digital means,
whether it be through telephonic advocacy means,
finding different ways to kind of make sure
it's simple and easy for them to see
the way that engagement can lead to a
better life, you know, for these members.
Absolutely. And you're not just leaving employers in
the dark here with these findings. The report
is actually making seven specific recommendations
for employers,
in terms of how to achieve what we're
talking about, Craig, and and it's everything from
segmenting populations by generation and gender to building
a men's health strategy that starts at age
40. So you said data analytics gotten a
lot better over the years.
Are you seeing health plans and employers actually
act on this kind of data, and and
where do you think is there where does
that gap still exist between the insights you're
providing and then the execution on the ground?
I think there's more action being taken by
employers today than ever. And there's a a
few different variables kinda driving that, but, obviously,
affordability is an issue, and employers
are doing whatever they possibly can with their
partners to help bring
affordability back into a better space. As well
as, many employers
are are seeing are are being being are
able to see on a more rapid basis
that engagement in health
does more than just
impact,
affordability in health care. If we can guide
people towards better health and better engagement,
they're able to see that those employees are
going to be better employees. They're gonna be
more productive. They're gonna be more present. So
it's all encompassing. It's a big issue for
these employers. And I think now like I
said, now they're more than ever. They're starting
to take action upon it. And by that
action, I think it's it's really important to
think about targeted approaches along these efforts. It's
hard to get the the less than 40
year old male population
to start to engage, even the forty to
fifty year old male population to engage. But
if you can be focused, if you can
be targeted,
just like other marketing firms that have done
for for decades now, If you can become
that focused, you're gonna start to understand
what is the best way to get this
unique part of my population to engage. I
might not be able to get everybody, but
if I focus in the biggest outliers,
I can create a strategy whether that be
through communication,
through digital campaigns, and so on, or even
boots on the ground to get that population
to engage in the various programs that a
lot of these employers are offering.
Employers have historically offered lots of different solutions
and opportunities for members,
but have struggled to get people to engage
in those programs. So, again, it's all about
the consumer, consumer analytics, marketing based analytics, finding
ways to make it simple and easy and
targeted for these members to engage.
Well, Craig, before we go,
where where can our listeners
find this report if they'd like to read
it themselves? And is there anything else that
we're missing today that you wanna share with
them?
Sure. The report is is public and available,
so it's you can find it in the
health action council website. You'll see it posted
out there. And I, again, I would just
focus on the fact that and, again, I'm
very biased, but start with the data.
See what's happening in your population.
Cut and slice your data. Don't just look
at things in aggregate. Look at the subpopulations
that are driving your need.
Check to see if the results that we're
seeing in the study apply to you, may
or may not. We we are seeing this
broadly, but make sure this is applied within
your population. And then focus on consumer driven
targeted,
solutions
that can help in the specific areas that
are driving affordability and health challenges within your
population.
Fantastic. Well, Craig, thank you very much for
taking the time to chat with us here
on the podcast and for breaking down these
latest findings for our listeners. We really appreciate
it. Thanks for having me. And to our
listeners, if you'd like to listen to more
podcasts from Becker's Healthcare, you can visit beckershospitalreview.com.