1 00:00:00,200 --> 00:00:02,490 This is Laura Dedo with the Becker's Healthcare Podcast. 2 00:00:03,070 --> 00:00:06,650 I'm thrilled today to be joined by Tom Gro, c e o of Banner, Aetna. Tom, 3 00:00:06,650 --> 00:00:08,250 it's a pleasure to have you on the podcast today. 4 00:00:09,310 --> 00:00:11,090 Oh, thanks for having me on. Appreciate it. 5 00:00:12,270 --> 00:00:15,490 Now, I'm excited for our conversation today because I know you, um, 6 00:00:15,490 --> 00:00:19,570 sit at a very important aspect of, of healthcare right now, um, 7 00:00:19,570 --> 00:00:21,010 between Banner and Aetna, 8 00:00:21,110 --> 00:00:25,410 and really seeing a lot of what big trends are driving healthcare and, uh, 9 00:00:26,050 --> 00:00:28,570 resources today. But before we dive into our larger discussion, 10 00:00:28,650 --> 00:00:30,730 I would love for you to tell us a little bit more about yourself, 11 00:00:30,730 --> 00:00:34,290 your background, and how you, um, came to be the CEO of Banner Aetna. 12 00:00:35,640 --> 00:00:37,330 Okay, great. Yeah, I, um, 13 00:00:38,130 --> 00:00:42,330 actually started with Aetna Novec in 1987. So after I graduated, 14 00:00:42,950 --> 00:00:46,970 um, from Notre Dame, I was living in Connecticut and looking for a job, 15 00:00:47,150 --> 00:00:49,650 and at that time it was insurance or insurance. 16 00:00:49,870 --> 00:00:53,490 So that's pretty much how I ended up landing with Aetna. Um, 17 00:00:53,490 --> 00:00:56,490 went through their group school. Um, early in my career, I, 18 00:00:56,610 --> 00:01:00,610 I did sales for small group, middle market national accounts. Um, 19 00:01:01,110 --> 00:01:04,810 ran a national account department for a number of years, and, um, 20 00:01:04,980 --> 00:01:09,170 eventually moved on to the Maryland DC Virginia area, um, 21 00:01:09,220 --> 00:01:12,650 where I was a general manager for middle market business, um, 22 00:01:12,950 --> 00:01:15,770 and then eventually became the market president, uh, for Maryland, 23 00:01:16,230 --> 00:01:20,610 DC and Virginia. Um, at which time I helped, um, um, 24 00:01:21,160 --> 00:01:24,250 develop our first a Aetna first joint venture, um, 25 00:01:24,250 --> 00:01:28,530 called Innovation Health with the Nova Health System in Northern Virginia. Um, 26 00:01:28,650 --> 00:01:33,570 I ended up moving out to Arizona about eight years ago. Um, and, uh, 27 00:01:33,710 --> 00:01:38,010 at that time I, I worked on, um, um, developing the, 28 00:01:38,010 --> 00:01:41,250 the Banner Aetna Joint Venture. Um, I, as part of the development team there, 29 00:01:41,710 --> 00:01:46,210 and I've been running Banner Aetna since we formed, um, back in 2017. 30 00:01:47,770 --> 00:01:49,590 Got it. That's amazing to hear. And, 31 00:01:49,590 --> 00:01:53,230 and just so fascinating how you were able to build your career and grow and 32 00:01:53,230 --> 00:01:56,830 develop, um, within the Aetna organization. So, uh, 33 00:01:57,430 --> 00:02:00,950 I know we're in a little bit different of a time now than we were back in 2017, 34 00:02:01,210 --> 00:02:03,150 but what are you most excited about right now, 35 00:02:03,150 --> 00:02:07,790 and especially looking at where healthcare is headed in, in some of the big, um, 36 00:02:07,930 --> 00:02:10,350 things upcoming over in the next year or two? 37 00:02:11,960 --> 00:02:16,560 I think one of the most exciting programs that we've launched recently was a 38 00:02:16,960 --> 00:02:21,320 diabetes reversal program through a company called Verta. And, um, 39 00:02:21,710 --> 00:02:26,160 that program has, um, seen some significant success since we launched. 40 00:02:26,620 --> 00:02:31,320 Um, we just got back our first six month, um, results, uh, 41 00:02:31,420 --> 00:02:34,040 on, on the program. And, uh, 42 00:02:34,040 --> 00:02:38,440 the results have been incredibly impressive. Uh, the, uh, 43 00:02:38,440 --> 00:02:42,600 participants in in the program have dropped their A1C by 44 00:02:42,620 --> 00:02:47,200 1.4%. Um, they've lost 8% of their weight, 45 00:02:47,940 --> 00:02:48,773 and, um, 46 00:02:49,860 --> 00:02:53,920 we have reduced their diabetic medications by 47 00:02:54,010 --> 00:02:58,560 50% with 40% of them getting off insulin 48 00:02:58,680 --> 00:03:00,520 entirely. So, um, 49 00:03:00,550 --> 00:03:05,240 just really incredible results as a result of this program. And, uh, 50 00:03:05,320 --> 00:03:08,920 I think even, even more exciting is the, um, 51 00:03:09,060 --> 00:03:13,960 the fantastic testimonials we've gotten back from the participants. Um, 52 00:03:14,230 --> 00:03:18,960 this program has really helped to change a number of their lives, um, 53 00:03:18,980 --> 00:03:23,480 so that they're much more active, much more happy and, um, en enjoying life. 54 00:03:23,580 --> 00:03:24,960 And so that's been, you know, 55 00:03:24,990 --> 00:03:29,480 very gratifying from a CEO perspective to implement a program that's had such a 56 00:03:29,760 --> 00:03:31,080 positive impact on some of our members. 57 00:03:32,350 --> 00:03:35,020 Absolutely. Wow, that's fascinating. So, you know, 58 00:03:35,020 --> 00:03:38,060 when you think about this program and how you tackled it, um, 59 00:03:38,170 --> 00:03:40,500 what was most meaningful to get these types of results? 60 00:03:40,620 --> 00:03:44,100 I can imagine many of the, um, individuals who participated, 61 00:03:44,100 --> 00:03:47,180 certainly had tried other things in the past or, or, you know, 62 00:03:47,180 --> 00:03:50,500 were unsuccessful at making changes that they needed in order to be healthier. 63 00:03:50,640 --> 00:03:53,900 So, you know, what, could you tell us a little bit more about the program and, 64 00:03:53,920 --> 00:03:57,380 and why it was so, um, incredibly effective for many of the members? 65 00:03:58,270 --> 00:04:02,720 Yeah, I think that the, the key to the program is continuous monitoring and, uh, 66 00:04:02,720 --> 00:04:05,520 support of a coach. And so, um, 67 00:04:05,710 --> 00:04:09,920 each member is aligned with a coach that works with them and communicates with 68 00:04:09,920 --> 00:04:13,120 them frequently, even on a daily basis, to, um, 69 00:04:13,120 --> 00:04:15,760 make sure they're staying on track with the program and, 70 00:04:15,900 --> 00:04:20,560 and have the best opportunity for success. And that's helped to re to, 71 00:04:21,380 --> 00:04:26,320 um, keep the members really engaged and on track to producing those impressive 72 00:04:26,320 --> 00:04:27,153 results. 73 00:04:28,430 --> 00:04:32,170 Got it. That's great to hear. And, and definitely I can imagine very, um, 74 00:04:32,170 --> 00:04:33,450 helpful as you said, 75 00:04:33,450 --> 00:04:37,290 to have those coaches and in communication easy access to each other. Now, 76 00:04:37,790 --> 00:04:41,290 you know, I I, it's amazing to see how well this program has done, 77 00:04:41,290 --> 00:04:45,210 but I can imagine still as c e o you are spending your time on multiple 78 00:04:45,210 --> 00:04:48,250 different things and aspects of the organization that need attention. 79 00:04:48,470 --> 00:04:51,650 So what are some of the issues that you're really focused in on today? 80 00:04:53,190 --> 00:04:55,760 Yeah, I think the, the two key areas, um, 81 00:04:55,760 --> 00:05:00,240 that we're looking at and focused in on are, are the member experience and then, 82 00:05:00,660 --> 00:05:05,040 um, engagement slash navigation for the members. And so, you know, 83 00:05:05,040 --> 00:05:05,920 the member experience, 84 00:05:05,940 --> 00:05:09,640 and it's really important to try to help streamline the healthcare process for 85 00:05:09,640 --> 00:05:14,120 our members. And, um, recently we launched a frictionless billing program, 86 00:05:14,210 --> 00:05:18,800 which brought together the e O B and the bill into one statement to help 87 00:05:19,080 --> 00:05:22,800 simplify it for our members, which is, you know, been really an exciting, um, 88 00:05:23,080 --> 00:05:24,240 endeavor that we've worked on with, 89 00:05:24,470 --> 00:05:28,360 with banner internet and to bring that to the market for our members. Um, 90 00:05:28,540 --> 00:05:32,640 but right now I think, uh, our key focus on the member experience, um, 91 00:05:32,640 --> 00:05:34,920 like a lot of people is on pre-authorization. 92 00:05:35,470 --> 00:05:38,120 What is it we can do to help automate the process, 93 00:05:38,430 --> 00:05:42,160 make it easier for the doctors, easier for the members, um, 94 00:05:42,660 --> 00:05:45,640 and to improve that process. So that's, that is definitely a, 95 00:05:45,720 --> 00:05:48,960 a big focal point for us is trying to figure out, you know, 96 00:05:48,960 --> 00:05:53,320 much more automated solution, um, on, on that realm. Um, the, 97 00:05:53,340 --> 00:05:56,760 the other area is really on engagement. Um, I, you know, from, 98 00:05:57,430 --> 00:06:00,800 it's really the holy grail in this business, how, how do we, um, 99 00:06:01,390 --> 00:06:06,040 educate our members on what programs are available to them and, um, have them, 100 00:06:06,540 --> 00:06:10,040 um, engaged in their healthcare and, and following, um, 101 00:06:10,350 --> 00:06:14,480 even just taking their prescriptions and, and such. And so, um, 102 00:06:14,480 --> 00:06:19,120 we're testing a bunch of different point solutions in that area to 103 00:06:19,140 --> 00:06:22,360 figure out, you know, how do we better educate our members, 104 00:06:22,590 --> 00:06:26,480 keep them engaged in their healthcare, um, so that, that's a big focal point. 105 00:06:26,940 --> 00:06:30,080 Um, and another one is really about navigation. Um, 106 00:06:30,080 --> 00:06:32,200 especially in behavioral health area, um, 107 00:06:32,200 --> 00:06:36,480 there's just a lot of challenges on access to the care. Um, 108 00:06:36,580 --> 00:06:38,200 we haven't introduced a number, 109 00:06:38,700 --> 00:06:43,440 in fact about 15 different virtual behavioral health programs for our members. 110 00:06:44,340 --> 00:06:44,900 Um, 111 00:06:44,900 --> 00:06:49,240 and what we're focused on now is trying to help them understand which programs 112 00:06:49,250 --> 00:06:54,040 might be best, you know, for their individual, uh, mental health needs. And so, 113 00:06:54,660 --> 00:06:54,940 um, 114 00:06:54,940 --> 00:06:58,440 that's an area that we're spending a lot of time on figuring out which solution 115 00:06:58,440 --> 00:07:02,160 might be best to help help our members navigate to the best behavioral 116 00:07:02,160 --> 00:07:02,993 healthcare. 117 00:07:03,740 --> 00:07:05,920 That's great to hear. And I, I know that, uh, 118 00:07:05,920 --> 00:07:09,720 behavioral health and mental health services and programs are certainly top of 119 00:07:09,720 --> 00:07:14,320 mind for many different organizations, whether on the healthcare side or the, 120 00:07:14,420 --> 00:07:16,880 um, health plan side as well, because, you know, 121 00:07:16,990 --> 00:07:21,040 that type of service is just in such high demand, it can be so impactful for, 122 00:07:21,340 --> 00:07:25,440 uh, an individual's overall health. And so it's great to hear that, you know, 123 00:07:25,440 --> 00:07:29,080 you've been able to roll out some different things and indefinitely, um, 124 00:07:29,080 --> 00:07:32,040 navigating, you know, in that way. Uh, 125 00:07:32,390 --> 00:07:35,440 when you look at where you're at at Banner Aetna and being able to make 126 00:07:35,440 --> 00:07:37,920 adjustments and then roll out these types of new programs, 127 00:07:37,920 --> 00:07:40,800 whether it's a diabetes management program or, um, you know, 128 00:07:40,800 --> 00:07:42,720 some of these behavioral health services as well, 129 00:07:43,110 --> 00:07:47,040 what does it take to have a team that is innovative and able to, um, 130 00:07:47,040 --> 00:07:51,240 develop new things and, and meet the needs of their members, um, you know, 131 00:07:51,240 --> 00:07:52,680 really on a consistent basis, 132 00:07:53,020 --> 00:07:56,160 how do you kind of breed that culture within the larger organization? 133 00:07:57,740 --> 00:08:02,150 Yeah, our, our, our founding mission is to try to fix healthcare. And so, 134 00:08:02,530 --> 00:08:06,270 you know, we have a management team that is very committed to that concept. And, 135 00:08:06,410 --> 00:08:06,650 um, 136 00:08:06,650 --> 00:08:11,470 so we're constantly surveying the marketplace and trying to do, 137 00:08:11,890 --> 00:08:16,630 um, um, see what new solutions are out there that could benefit our members. 138 00:08:17,250 --> 00:08:17,470 Um, 139 00:08:17,470 --> 00:08:21,710 but we're also looking at our own members' experience and seeing where they're 140 00:08:21,710 --> 00:08:25,190 having challenges. And you know, when we identify those, we, 141 00:08:25,210 --> 00:08:28,870 we try to figure out how to not only resolve that one specific issue, 142 00:08:28,870 --> 00:08:32,750 but how do we stop it from happening to our members, um, uh, 143 00:08:32,900 --> 00:08:34,390 overall on an ongoing basis. 144 00:08:34,610 --> 00:08:39,470 And so we're constantly looking at ways just to make the process work better 145 00:08:39,570 --> 00:08:40,910 for our members. Um, 146 00:08:41,010 --> 00:08:44,830 so that's sort of ingrained in how we operate our company. 147 00:08:46,470 --> 00:08:50,210 Got it. That this such an important mantra and I really love that, um, 148 00:08:50,210 --> 00:08:52,930 making sure you're able to fix healthcare. Now, 149 00:08:53,030 --> 00:08:54,570 before we wrap up our conversation, 150 00:08:54,890 --> 00:08:59,280 I would love to look ahead just a little bit. What do you think will be most, 151 00:08:59,590 --> 00:09:00,720 what do you think, excuse me, 152 00:09:00,720 --> 00:09:03,880 most effective healthcare leaders will need in order to be successful over the 153 00:09:03,880 --> 00:09:04,720 next two to three years? 154 00:09:04,840 --> 00:09:08,000 I know the healthcare field is evolving and changing very rapidly. 155 00:09:08,170 --> 00:09:11,000 Technology is changing, what patients are demanding is changing. 156 00:09:11,220 --> 00:09:13,880 So when you think about the next couple of years, 157 00:09:14,150 --> 00:09:17,720 what do will you as a leader and your leadership team need, um, 158 00:09:17,740 --> 00:09:20,680 to really be successful a as the changes unfold? 159 00:09:22,890 --> 00:09:25,900 Yeah, I think, you know, when, when you look at, um, 160 00:09:27,050 --> 00:09:31,950 the landscape now, um, this is a multi multi-trillion dollar business and, 161 00:09:31,970 --> 00:09:36,350 um, there's a tremendous number of startups and other companies, um, 162 00:09:36,350 --> 00:09:40,510 getting involved in the healthcare business and, you know, as a leader, it's, 163 00:09:40,610 --> 00:09:40,960 um, 164 00:09:40,960 --> 00:09:45,230 gonna be coming on us to try to sift through all of the different offerings out 165 00:09:45,230 --> 00:09:48,470 there and figure out which ones are, you know, 166 00:09:48,500 --> 00:09:53,070 most impactful and have staying power, you know, for the long term. 167 00:09:53,290 --> 00:09:56,910 And, um, it's, it's almost a full-time job just trying to, 168 00:09:57,090 --> 00:09:59,310 to understand what's, what's, 169 00:09:59,310 --> 00:10:02,430 what's developing in the market and which companies, you know, 170 00:10:02,430 --> 00:10:07,190 have the greatest promise. So, you know, certainly, um, that's an area that, 171 00:10:07,250 --> 00:10:12,190 um, you know, we're very focused in on and trying to, um, manage that process, 172 00:10:12,200 --> 00:10:16,190 which is not easy cuz there are so many solutions out there. Um, and I think, 173 00:10:16,290 --> 00:10:18,710 you know, long term, you know, every, 174 00:10:18,890 --> 00:10:23,510 all healthcare leaders really need to look at affordability. Um, you know, we, 175 00:10:23,510 --> 00:10:27,430 there's a lot of challenges today. Um, a lot of pressures, um, 176 00:10:27,490 --> 00:10:31,070 on healthcare costs, um, even from staffing and, 177 00:10:31,170 --> 00:10:35,750 and inflation for the providers to, um, high, um, 178 00:10:36,320 --> 00:10:40,230 especially drug costs and, and other things that are driving up costs. And, 179 00:10:40,490 --> 00:10:40,830 you know, 180 00:10:40,830 --> 00:10:44,910 eventually we're gonna reach a tipping point if we don't continue to work 181 00:10:45,270 --> 00:10:48,870 together across all those areas to figure out, um, 182 00:10:48,870 --> 00:10:53,830 better ways to deliver more affordable healthcare to our members. So I think, 183 00:10:54,250 --> 00:10:57,710 you know, collaborating with pharmaceuticals, 184 00:10:57,710 --> 00:11:02,190 collaborating with the providers is gonna be very important. Um, 185 00:11:02,410 --> 00:11:06,630 so we can make sure that we can maintain a, 186 00:11:07,110 --> 00:11:11,670 a affordable healthcare solution, you know, to the people in the United States. 187 00:11:13,850 --> 00:11:17,340 Yeah, absolutely. I think that's such a great point and definitely, um, 188 00:11:17,410 --> 00:11:21,660 looking at the, as you said, the pressures, um, right now, you know, I, 189 00:11:21,700 --> 00:11:26,300 I love that idea that trying to connect with providers 190 00:11:26,580 --> 00:11:31,020 and, and really make, um, healthcare more accessible and easier, um, really, 191 00:11:31,120 --> 00:11:34,180 you know, is the way to go in the future. And, and so, you know, I, 192 00:11:34,220 --> 00:11:37,140 I love that idea of partnering with them and I know you're kind of at this, um, 193 00:11:37,160 --> 00:11:41,060 access point between healthcare providers with Banner and then Aetna on the 194 00:11:41,060 --> 00:11:42,980 health plan side. And so, you know, it, 195 00:11:42,980 --> 00:11:45,980 it is just really fascinating to hear what you have to say and, 196 00:11:45,980 --> 00:11:49,380 and you talk about, you know, where that relationship is headed, um, 197 00:11:49,380 --> 00:11:52,540 to truly act upon the things that will be best for patients. 198 00:11:53,480 --> 00:11:58,070 Absolutely. You know, and I think the developing area right now in healthcare, 199 00:11:58,070 --> 00:12:02,630 there's a lot of investments going in on the primary care physician front and 200 00:12:02,730 --> 00:12:07,630 uh, and there's a lot of huge bets that that is going to be, you know, 201 00:12:07,630 --> 00:12:09,830 the avenue to help control costs over time. 202 00:12:09,970 --> 00:12:12,990 So we'll see how that all progresses as we go forward now. 203 00:12:13,720 --> 00:12:15,550 Absolutely. It is fascinating, 204 00:12:15,550 --> 00:12:18,750 especially too with some of the non-traditional healthcare, um, 205 00:12:19,470 --> 00:12:23,550 entrant coming into the space and really acquiring primary care platforms and, 206 00:12:23,850 --> 00:12:27,390 um, primary care groups in general to bring physicians into their network. Um, 207 00:12:27,390 --> 00:12:31,230 it's just been really interesting to see how all of that is evolving and in 208 00:12:31,230 --> 00:12:33,350 developing and changing some of the, um, 209 00:12:33,350 --> 00:12:35,030 healthcare landscape in certain markets. 210 00:12:35,590 --> 00:12:36,423 Definitely. 211 00:12:36,770 --> 00:12:39,260 Well, Tom, thank you so much for joining us on the podcast today. 212 00:12:39,260 --> 00:12:41,460 This has been a really fun and informative discussion. 213 00:12:41,660 --> 00:12:43,220 I look forward to with you again soon. 214 00:12:44,840 --> 00:12:46,390 Great. Thanks for having me. I appreciate.