This is where health insurance leadership comes together.
Becker's fourth annual spring payer issues roundtable brings
together over 400
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
Bush. For the full agenda and event details,
visit beckershospitalreview.com
and click on the events tab in the
upper right. We're looking forward to hosting you
here in Chicago.
Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm
Scott King. Thrilled today to be joined by
a very special guest, Tai Wang, cofounder and
chief executive officer
over at Engel Health. Tai, how are you
doing? Thanks so much for joining.
Doing well. Thanks so much for having me
on again, Scott. Yeah. Of course. And, you
know, we're really looking forward to having you
speak at our spring payer issues roundtable as
well, and we have a lot of kind
of big topics to get to here in
in health care and with health plans. But
before we address those ties, I wonder if
you could just please share a little bit
about your, career background and your journey in
health care.
Yeah. I'd be happy to.
I'm Ty Wang, cofounder, CEO of Engle Health.
Before starting Engle Health, my,
cofounder and I were both at Palantir leading,
major teams and and deployments over there and
and working
across government and and commercial
customers, including,
health care customers. So,
that's where we learned a lot of,
a lot of, I would say, kind of
the operational,
pieces of of how this whole ecosystem
works together and and how we ended up
building
today, Angle Health is the first AI native
vertically integrated health plan, and we're one of
the fastest growing health care companies in the
country.
Our products themselves are fully customizable major medical
health plans, all ACA compliant for,
small and medium sized businesses. And,
essentially, we're delivering
these Fortune 100 level health care benefits to
your local businesses. So Angle Health enables brokers
and their small employer clients to build these
custom health plans just like a major employer
with thousands or tens of thousands of employees
and a large sophisticated benefits team might do
it. And and we're really
we've been able to bring that all the
way down market to your local businesses,
because of the infrastructure that we've built.
Thanks so much for sharing that that info
on your background,
Ty, and and how, you know, kinda Engel
Health came to be and what it does.
And, you know, it it's certainly a time
where,
obviously, providers
and payers are, like, are both facing a
lot of regulations.
Right? And and we know how how difficult
that can be. How how are you seeing
a relationship between,
you know,
providers
and health plans change,
you know, on both sides
as they face cost pressure as, you know,
specifically in workforce shortages?
Yeah. I I would say I would say
one of the biggest shifts that we're seeing
today is that the relationship
between providers and health plans is,
becoming less
a bit less transactional and and and kinda
more operational.
So with like you mentioned, with with,
all the changing regulation
with the economy, it's it's impacting providers and
hospitals just as much
as health plans, and the two sides are
really inextricably
linked. When costs go up on one side,
they go up on the other side. And,
as a result, we're we're seeing we're seeing
more openness, I would say, to shared problem
solving. So things like reducing administrative burden, simplifying
workflows like prior authorizations,
improving,
integrations and data handoffs, and and being more
aligned on on the,
care pathways that actually work. And
I think,
for us, as a modern,
platform for health care benefits, we
we specifically seek out those partners,
and and partners that are willing to,
redesign
the what more traditional workflows rather than just,
renegotiating
fees. And I think we're we're seeing a
lot more openness and a lot of collaboration
there across the,
payer and provider sides.
Yeah. Yeah. I I've talked to a lot
of a lot of people speaking at at
the spring pair of shoes roundtable recently,
from the health plan side, and and they
definitely agree
with you, Ty. It's it's that they're just
seem like, you know, everyone's got so many
issues to deal with. Everyone just kinda coming
to the table Mhmm. With some ideas and
and to work collaboratively. So, yeah, definitely agree
with it, you know, seeming to not be
so transactional anymore. So I appreciate your insight
there.
And, you know, I'm also curious, where do
you see the biggest gap today between
payer strategy and operational execution?
Yeah. That's a good question. The I think
one thing that many plans talk about
are,
around value based care, digital enablement,
things like the member or patient experience.
But the the challenge that and and I
would say this is this is the gap
is that
many payers and and,
legacy health plans are still operating on on
legacy systems, on fragmented systems, manual processes that
really make executing on some of these things
at scale very difficult. So there the the
strategy is really assume,
and require
things like having clean data, having real time
insights, having very much aligned incentives.
Whereas the
operational
side,
and and to actually execute on that,
there's still really the operational side is really
still stuck doing things like reconciling eligibility files
or
chasing faxes.
So I I I think until major health
plans truly modernize their core infrastructure, so there's
systems for claims and benefits and provider data
and care management,
it'll be extremely hard to execute on those
strategies. And and that's why we're really building
and why we started Angle Health by building
technology infrastructure from the ground up. So although
Angle Health today is a product company delivering
these affordable and personalized health health plans to
thousands of small businesses across the country,
we really believe that our our core asset
is the technology platform that that powers it,
and I think we're seeing a lot more
focus and and and urgency as well from
from major players and from the market and,
also,
trying to modernize themselves.
What's the one investment or initiative you believe
will most reshape
how health plans operate over the next two
to three years?
The the easy answer there is, is is
AI, I think. But I I I'm happy
to take it kind of a little bit
deeper than that. I think I think it's
it's outcome linked payment infrastructure.
So,
as as more reimbursement,
incentives are tied to outcomes rather than
pure utilization.
And I I think this is a major
push especially with pro the the programs like
ACCESS.
Health plans need to be able to really
track performance across their vendors and providers and
health systems and and and really in in
any care setting.
And it's it's it's much more than, like,
contracts themselves. It's really investment in the systems
that that enable them to operationalize things like,
measurable,
standardized,
and and very transparent,
outcome data.
If you could change one regulatory or industry
practice tomorrow, yeah, so, like, very soon to
improve, affordability
and access, what would it be and why?
If I were to change one regulatory or
industry practice tomorrow,
I think the I think what could make
one of the most immediate impacts is,
I I'd bring a lot more transparency
into
employer
health care costs and broker compensation
structures, particularly by the major insurance companies. So
particularly
by large,
where where these large incumbents use
certain incentives to steer behavior.
We, I mean, we see it all the
time today in the market where in most
cases,
broker compensation is designed in ways that
favor
or or or lock,
brokers and employers into certain carriers,
or incentivize things like higher premiums
regardless of whether that's that's best for the
employers or the members. And we see that
across, I think, across all all,
lines of business within the health plan space
where we're only in the commercial space, but
it's it's true in,
Medicare. It's true in in in the government
program space. So,
I I think,
most brokers want to do the right thing,
but because of the
kind of very opaque incentive structures that exist
as well as the gatekeeping of health care
cost data, which is extremely impactful when you
talk about small and medium sized businesses and
and the lack of access that they have
there.
That can make it very difficult for for
brokers to
be that strategic partner,
with with fully aligned incentives. So and it's
it's one thing that we that we focus
on a lot today. So we're we're I
would say we're really paving that road at
Angle Health with, what we we call the
Angle Health scorecard where we're maybe the only
health plan today that provides
an
unprecedented level of transparency into the actual health
care costs for employers with every single quote
that we that we issue.
And the last question I have for you,
Ty, what issue is putting the most pressure
on health plan margins right now,
and how will you respond differently in 2026?
Yeah.
I I think the probably one of the
biggest ones, very, very timely as well,
this week is the,
the Medicare
rates,
that's that CMS is,
is setting.
It's not it for us, since we're not
a Medicare plan, it's it's less impactful for
us, but but it it's the it's still
it's the medical cost trend. I think that's,
that has and will probably always be the
single biggest cost pressure, and and it's it's
being driven by things like specialty care, by
things like pharmacy, and and, ultimately,
unmanaged medical conditions.
Most I would say in terms of kind
of how we're responding, I think most plans
leverage or historically have leveraged these very blunt
tools to do reactive cost containment.
How we view it at Angle Health and
what we're really focused on is is,
what I would say is is proactive care
orchestration.
So,
being able to identify risk earlier,
being able to engage and steer members to
the right settings, and and and being able
to intervene before
major costs,
spike,
without creating with,
while also delivering a a kind of first
class member experience.
So the way that we're doing that is
through tighter integration,
between the actual benefit plans themselves to the
clinical
programs and the provider partners that we that
we work with there
and then a focus on on workflows that
really improve
the engagement workflows that really improve the experience
for the member and and also drive operational
efficiencies,
for,
for the employer, for the provider, for for
the health plan. And our our belief is
that
margins improve
if you can make the system work in
a better kind of more coordinated way
in the long term,
not when you increase friction, which may
improve margins in the short term, but is
is is a very shortsighted way of of
of thinking about it. So we really focus
on on
on that kind of long term view and
and rebuilding,
what we call these kind of core care
pathways,
so that,
we can fully align
each of the stakeholders
while also,
streamlining that experience for our members.
I think that sounds great. And, Ty, thanks
so much for joining us on the podcast.
It was a great conversation. Looking forward to
having you speak with us in April. Amazing.
Thanks so much, Scott. This is fun, and
I'm excited to, see everyone again in April.