This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Tom Gro, c e o of Banner, Aetna. Tom,
it's a pleasure to have you on the podcast today.
Oh, thanks for having me on. Appreciate it.
Now, I'm excited for our conversation today because I know you, um,
sit at a very important aspect of, of healthcare right now, um,
between Banner and Aetna,
and really seeing a lot of what big trends are driving healthcare and, uh,
resources today. But before we dive into our larger discussion,
I would love for you to tell us a little bit more about yourself,
your background, and how you, um, came to be the CEO of Banner Aetna.
Okay, great. Yeah, I, um,
actually started with Aetna Novec in 1987. So after I graduated,
um, from Notre Dame, I was living in Connecticut and looking for a job,
and at that time it was insurance or insurance.
So that's pretty much how I ended up landing with Aetna. Um,
went through their group school. Um, early in my career, I,
I did sales for small group, middle market national accounts. Um,
ran a national account department for a number of years, and, um,
eventually moved on to the Maryland DC Virginia area, um,
where I was a general manager for middle market business, um,
and then eventually became the market president, uh, for Maryland,
DC and Virginia. Um, at which time I helped, um, um,
develop our first a Aetna first joint venture, um,
called Innovation Health with the Nova Health System in Northern Virginia. Um,
I ended up moving out to Arizona about eight years ago. Um, and, uh,
at that time I, I worked on, um, um, developing the,
the Banner Aetna Joint Venture. Um, I, as part of the development team there,
and I've been running Banner Aetna since we formed, um, back in 2017.
Got it. That's amazing to hear. And,
and just so fascinating how you were able to build your career and grow and
develop, um, within the Aetna organization. So, uh,
I know we're in a little bit different of a time now than we were back in 2017,
but what are you most excited about right now,
and especially looking at where healthcare is headed in, in some of the big, um,
things upcoming over in the next year or two?
I think one of the most exciting programs that we've launched recently was a
diabetes reversal program through a company called Verta. And, um,
that program has, um, seen some significant success since we launched.
Um, we just got back our first six month, um, results, uh,
on, on the program. And, uh,
the results have been incredibly impressive. Uh, the, uh,
participants in in the program have dropped their A1C by
1.4%. Um, they've lost 8% of their weight,
and, um,
we have reduced their diabetic medications by
50% with 40% of them getting off insulin
entirely. So, um,
just really incredible results as a result of this program. And, uh,
I think even, even more exciting is the, um,
the fantastic testimonials we've gotten back from the participants. Um,
this program has really helped to change a number of their lives, um,
so that they're much more active, much more happy and, um, en enjoying life.
And so that's been, you know,
very gratifying from a CEO perspective to implement a program that's had such a
positive impact on some of our members.
Absolutely. Wow, that's fascinating. So, you know,
when you think about this program and how you tackled it, um,
what was most meaningful to get these types of results?
I can imagine many of the, um, individuals who participated,
certainly had tried other things in the past or, or, you know,
were unsuccessful at making changes that they needed in order to be healthier.
So, you know, what, could you tell us a little bit more about the program and,
and why it was so, um, incredibly effective for many of the members?
Yeah, I think that the, the key to the program is continuous monitoring and, uh,
support of a coach. And so, um,
each member is aligned with a coach that works with them and communicates with
them frequently, even on a daily basis, to, um,
make sure they're staying on track with the program and,
and have the best opportunity for success. And that's helped to re to,
um, keep the members really engaged and on track to producing those impressive
results.
Got it. That's great to hear. And, and definitely I can imagine very, um,
helpful as you said,
to have those coaches and in communication easy access to each other. Now,
you know, I I, it's amazing to see how well this program has done,
but I can imagine still as c e o you are spending your time on multiple
different things and aspects of the organization that need attention.
So what are some of the issues that you're really focused in on today?
Yeah, I think the, the two key areas, um,
that we're looking at and focused in on are, are the member experience and then,
um, engagement slash navigation for the members. And so, you know,
the member experience,
and it's really important to try to help streamline the healthcare process for
our members. And, um, recently we launched a frictionless billing program,
which brought together the e O B and the bill into one statement to help
simplify it for our members, which is, you know, been really an exciting, um,
endeavor that we've worked on with,
with banner internet and to bring that to the market for our members. Um,
but right now I think, uh, our key focus on the member experience, um,
like a lot of people is on pre-authorization.
What is it we can do to help automate the process,
make it easier for the doctors, easier for the members, um,
and to improve that process. So that's, that is definitely a,
a big focal point for us is trying to figure out, you know,
much more automated solution, um, on, on that realm. Um, the,
the other area is really on engagement. Um, I, you know, from,
it's really the holy grail in this business, how, how do we, um,
educate our members on what programs are available to them and, um, have them,
um, engaged in their healthcare and, and following, um,
even just taking their prescriptions and, and such. And so, um,
we're testing a bunch of different point solutions in that area to
figure out, you know, how do we better educate our members,
keep them engaged in their healthcare, um, so that, that's a big focal point.
Um, and another one is really about navigation. Um,
especially in behavioral health area, um,
there's just a lot of challenges on access to the care. Um,
we haven't introduced a number,
in fact about 15 different virtual behavioral health programs for our members.
Um,
and what we're focused on now is trying to help them understand which programs
might be best, you know, for their individual, uh, mental health needs. And so,
um,
that's an area that we're spending a lot of time on figuring out which solution
might be best to help help our members navigate to the best behavioral
healthcare.
That's great to hear. And I, I know that, uh,
behavioral health and mental health services and programs are certainly top of
mind for many different organizations, whether on the healthcare side or the,
um, health plan side as well, because, you know,
that type of service is just in such high demand, it can be so impactful for,
uh, an individual's overall health. And so it's great to hear that, you know,
you've been able to roll out some different things and indefinitely, um,
navigating, you know, in that way. Uh,
when you look at where you're at at Banner Aetna and being able to make
adjustments and then roll out these types of new programs,
whether it's a diabetes management program or, um, you know,
some of these behavioral health services as well,
what does it take to have a team that is innovative and able to, um,
develop new things and, and meet the needs of their members, um, you know,
really on a consistent basis,
how do you kind of breed that culture within the larger organization?
Yeah, our, our, our founding mission is to try to fix healthcare. And so,
you know, we have a management team that is very committed to that concept. And,
um,
so we're constantly surveying the marketplace and trying to do,
um, um, see what new solutions are out there that could benefit our members.
Um,
but we're also looking at our own members' experience and seeing where they're
having challenges. And you know, when we identify those, we,
we try to figure out how to not only resolve that one specific issue,
but how do we stop it from happening to our members, um, uh,
overall on an ongoing basis.
And so we're constantly looking at ways just to make the process work better
for our members. Um,
so that's sort of ingrained in how we operate our company.
Got it. That this such an important mantra and I really love that, um,
making sure you're able to fix healthcare. Now,
before we wrap up our conversation,
I would love to look ahead just a little bit. What do you think will be most,
what do you think, excuse me,
most effective healthcare leaders will need in order to be successful over the
next two to three years?
I know the healthcare field is evolving and changing very rapidly.
Technology is changing, what patients are demanding is changing.
So when you think about the next couple of years,
what do will you as a leader and your leadership team need, um,
to really be successful a as the changes unfold?
Yeah, I think, you know, when, when you look at, um,
the landscape now, um, this is a multi multi-trillion dollar business and,
um, there's a tremendous number of startups and other companies, um,
getting involved in the healthcare business and, you know, as a leader, it's,
um,
gonna be coming on us to try to sift through all of the different offerings out
there and figure out which ones are, you know,
most impactful and have staying power, you know, for the long term.
And, um, it's, it's almost a full-time job just trying to,
to understand what's, what's,
what's developing in the market and which companies, you know,
have the greatest promise. So, you know, certainly, um, that's an area that,
um, you know, we're very focused in on and trying to, um, manage that process,
which is not easy cuz there are so many solutions out there. Um, and I think,
you know, long term, you know, every,
all healthcare leaders really need to look at affordability. Um, you know, we,
there's a lot of challenges today. Um, a lot of pressures, um,
on healthcare costs, um, even from staffing and,
and inflation for the providers to, um, high, um,
especially drug costs and, and other things that are driving up costs. And,
you know,
eventually we're gonna reach a tipping point if we don't continue to work
together across all those areas to figure out, um,
better ways to deliver more affordable healthcare to our members. So I think,
you know, collaborating with pharmaceuticals,
collaborating with the providers is gonna be very important. Um,
so we can make sure that we can maintain a,
a affordable healthcare solution, you know, to the people in the United States.
Yeah, absolutely. I think that's such a great point and definitely, um,
looking at the, as you said, the pressures, um, right now, you know, I,
I love that idea that trying to connect with providers
and, and really make, um, healthcare more accessible and easier, um, really,
you know, is the way to go in the future. And, and so, you know, I,
I love that idea of partnering with them and I know you're kind of at this, um,
access point between healthcare providers with Banner and then Aetna on the
health plan side. And so, you know, it,
it is just really fascinating to hear what you have to say and,
and you talk about, you know, where that relationship is headed, um,
to truly act upon the things that will be best for patients.
Absolutely. You know, and I think the developing area right now in healthcare,
there's a lot of investments going in on the primary care physician front and
uh, and there's a lot of huge bets that that is going to be, you know,
the avenue to help control costs over time.
So we'll see how that all progresses as we go forward now.
Absolutely. It is fascinating,
especially too with some of the non-traditional healthcare, um,
entrant coming into the space and really acquiring primary care platforms and,
um, primary care groups in general to bring physicians into their network. Um,
it's just been really interesting to see how all of that is evolving and in
developing and changing some of the, um,
healthcare landscape in certain markets.
Definitely.
Well, Tom, thank you so much for joining us on the podcast today.
This has been a really fun and informative discussion.
I look forward to with you again soon.
Great. Thanks for having me. I appreciate.