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This is where health insurance leadership comes together.

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Becker's fourth annual spring payer issues roundtable brings

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together over 400

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payer and health plan executives and more than

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100 speakers to Chicago April.

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This year's event includes keynote conversations with the

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industry's top leaders and former president George w

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Bush. For the full agenda and event details,

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visit beckershospitalreview.com

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and click on the events tab in the

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upper right. We're looking forward to hosting you

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here in Chicago.

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Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm

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Scott King. Thrilled today to be joined by

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a very special guest, Tai Wang, cofounder and

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chief executive officer

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over at Engel Health. Tai, how are you

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doing? Thanks so much for joining.

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Doing well. Thanks so much for having me

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on again, Scott. Yeah. Of course. And, you

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know, we're really looking forward to having you

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speak at our spring payer issues roundtable as

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well, and we have a lot of kind

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of big topics to get to here in

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in health care and with health plans. But

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before we address those ties, I wonder if

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you could just please share a little bit

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about your, career background and your journey in

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health care.

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Yeah. I'd be happy to.

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I'm Ty Wang, cofounder, CEO of Engle Health.

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Before starting Engle Health, my,

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cofounder and I were both at Palantir leading,

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major teams and and deployments over there and

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and working

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across government and and commercial

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customers, including,

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health care customers. So,

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that's where we learned a lot of,

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a lot of, I would say, kind of

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the operational,

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pieces of of how this whole ecosystem

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works together and and how we ended up

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building

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today, Angle Health is the first AI native

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vertically integrated health plan, and we're one of

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the fastest growing health care companies in the

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country.

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Our products themselves are fully customizable major medical

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health plans, all ACA compliant for,

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small and medium sized businesses. And,

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essentially, we're delivering

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these Fortune 100 level health care benefits to

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your local businesses. So Angle Health enables brokers

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and their small employer clients to build these

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custom health plans just like a major employer

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with thousands or tens of thousands of employees

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and a large sophisticated benefits team might do

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it. And and we're really

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we've been able to bring that all the

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way down market to your local businesses,

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because of the infrastructure that we've built.

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Thanks so much for sharing that that info

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on your background,

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Ty, and and how, you know, kinda Engel

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Health came to be and what it does.

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And, you know, it it's certainly a time

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where,

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obviously, providers

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and payers are, like, are both facing a

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lot of regulations.

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Right? And and we know how how difficult

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that can be. How how are you seeing

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a relationship between,

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you know,

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providers

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and health plans change,

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you know, on both sides

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as they face cost pressure as, you know,

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specifically in workforce shortages?

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Yeah. I I would say I would say

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one of the biggest shifts that we're seeing

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today is that the relationship

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between providers and health plans is,

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becoming less

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a bit less transactional and and and kinda

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more operational.

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So with like you mentioned, with with,

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all the changing regulation

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with the economy, it's it's impacting providers and

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hospitals just as much

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as health plans, and the two sides are

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really inextricably

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linked. When costs go up on one side,

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they go up on the other side. And,

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as a result, we're we're seeing we're seeing

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more openness, I would say, to shared problem

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solving. So things like reducing administrative burden, simplifying

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workflows like prior authorizations,

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improving,

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integrations and data handoffs, and and being more

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aligned on on the,

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care pathways that actually work. And

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I think,

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for us, as a modern,

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platform for health care benefits, we

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we specifically seek out those partners,

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and and partners that are willing to,

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redesign

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the what more traditional workflows rather than just,

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renegotiating

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fees. And I think we're we're seeing a

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lot more openness and a lot of collaboration

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there across the,

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payer and provider sides.

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Yeah. Yeah. I I've talked to a lot

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of a lot of people speaking at at

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the spring pair of shoes roundtable recently,

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from the health plan side, and and they

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definitely agree

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with you, Ty. It's it's that they're just

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seem like, you know, everyone's got so many

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issues to deal with. Everyone just kinda coming

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to the table Mhmm. With some ideas and

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and to work collaboratively. So, yeah, definitely agree

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with it, you know, seeming to not be

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so transactional anymore. So I appreciate your insight

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there.

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And, you know, I'm also curious, where do

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you see the biggest gap today between

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payer strategy and operational execution?

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Yeah. That's a good question. The I think

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one thing that many plans talk about

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are,

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around value based care, digital enablement,

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things like the member or patient experience.

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But the the challenge that and and I

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would say this is this is the gap

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is that

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many payers and and,

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legacy health plans are still operating on on

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legacy systems, on fragmented systems, manual processes that

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really make executing on some of these things

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at scale very difficult. So there the the

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strategy is really assume,

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and require

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things like having clean data, having real time

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insights, having very much aligned incentives.

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Whereas the

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operational

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side,

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and and to actually execute on that,

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there's still really the operational side is really

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still stuck doing things like reconciling eligibility files

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or

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chasing faxes.

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So I I I think until major health

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plans truly modernize their core infrastructure, so there's

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systems for claims and benefits and provider data

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and care management,

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it'll be extremely hard to execute on those

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strategies. And and that's why we're really building

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and why we started Angle Health by building

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technology infrastructure from the ground up. So although

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Angle Health today is a product company delivering

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these affordable and personalized health health plans to

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thousands of small businesses across the country,

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we really believe that our our core asset

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is the technology platform that that powers it,

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and I think we're seeing a lot more

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focus and and and urgency as well from

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from major players and from the market and,

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also,

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trying to modernize themselves.

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What's the one investment or initiative you believe

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will most reshape

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how health plans operate over the next two

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to three years?

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The the easy answer there is, is is

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AI, I think. But I I I'm happy

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to take it kind of a little bit

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deeper than that. I think I think it's

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it's outcome linked payment infrastructure.

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So,

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as as more reimbursement,

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incentives are tied to outcomes rather than

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pure utilization.

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And I I think this is a major

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push especially with pro the the programs like

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ACCESS.

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Health plans need to be able to really

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track performance across their vendors and providers and

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health systems and and and really in in

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any care setting.

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And it's it's it's much more than, like,

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contracts themselves. It's really investment in the systems

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that that enable them to operationalize things like,

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measurable,

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standardized,

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and and very transparent,

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outcome data.

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If you could change one regulatory or industry

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practice tomorrow, yeah, so, like, very soon to

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improve, affordability

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and access, what would it be and why?

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If I were to change one regulatory or

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industry practice tomorrow,

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I think the I think what could make

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one of the most immediate impacts is,

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I I'd bring a lot more transparency

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into

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employer

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health care costs and broker compensation

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structures, particularly by the major insurance companies. So

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particularly

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by large,

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where where these large incumbents use

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certain incentives to steer behavior.

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We, I mean, we see it all the

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time today in the market where in most

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cases,

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broker compensation is designed in ways that

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favor

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or or or lock,

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brokers and employers into certain carriers,

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or incentivize things like higher premiums

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regardless of whether that's that's best for the

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employers or the members. And we see that

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across, I think, across all all,

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lines of business within the health plan space

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where we're only in the commercial space, but

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it's it's true in,

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Medicare. It's true in in in the government

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program space. So,

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I I think,

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most brokers want to do the right thing,

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but because of the

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kind of very opaque incentive structures that exist

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as well as the gatekeeping of health care

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cost data, which is extremely impactful when you

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talk about small and medium sized businesses and

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and the lack of access that they have

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there.

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That can make it very difficult for for

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brokers to

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be that strategic partner,

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with with fully aligned incentives. So and it's

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it's one thing that we that we focus

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on a lot today. So we're we're I

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would say we're really paving that road at

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Angle Health with, what we we call the

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Angle Health scorecard where we're maybe the only

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health plan today that provides

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an

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unprecedented level of transparency into the actual health

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care costs for employers with every single quote

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that we that we issue.

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And the last question I have for you,

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Ty, what issue is putting the most pressure

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on health plan margins right now,

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and how will you respond differently in 2026?

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Yeah.

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I I think the probably one of the

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biggest ones, very, very timely as well,

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this week is the,

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the Medicare

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rates,

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that's that CMS is,

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is setting.

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It's not it for us, since we're not

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a Medicare plan, it's it's less impactful for

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us, but but it it's the it's still

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it's the medical cost trend. I think that's,

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that has and will probably always be the

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single biggest cost pressure, and and it's it's

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being driven by things like specialty care, by

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things like pharmacy, and and, ultimately,

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unmanaged medical conditions.

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Most I would say in terms of kind

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of how we're responding, I think most plans

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leverage or historically have leveraged these very blunt

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tools to do reactive cost containment.

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How we view it at Angle Health and

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what we're really focused on is is,

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what I would say is is proactive care

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orchestration.

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So,

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being able to identify risk earlier,

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being able to engage and steer members to

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the right settings, and and and being able

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to intervene before

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major costs,

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spike,

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without creating with,

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while also delivering a a kind of first

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class member experience.

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So the way that we're doing that is

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through tighter integration,

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between the actual benefit plans themselves to the

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clinical

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programs and the provider partners that we that

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we work with there

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and then a focus on on workflows that

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really improve

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the engagement workflows that really improve the experience

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for the member and and also drive operational

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efficiencies,

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for,

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for the employer, for the provider, for for

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the health plan. And our our belief is

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that

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margins improve

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if you can make the system work in

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a better kind of more coordinated way

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in the long term,

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not when you increase friction, which may

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improve margins in the short term, but is

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is is a very shortsighted way of of

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of thinking about it. So we really focus

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on on

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on that kind of long term view and

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and rebuilding,

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what we call these kind of core care

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pathways,

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so that,

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we can fully align

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each of the stakeholders

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while also,

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streamlining that experience for our members.

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I think that sounds great. And, Ty, thanks

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so much for joining us on the podcast.

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It was a great conversation. Looking forward to

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having you speak with us in April. Amazing.

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Thanks so much, Scott. This is fun, and

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I'm excited to, see everyone again in April.