The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
Behind the Insurance Curtain: Improving the Consumer Experience (and the merits of Amish Doughnuts) with Nick Moriello
Nick Moriello, the savvy President of Highmark Blue Cross Blue Shield of Delaware joins the BP2 Health team for an episode that intertwines the serious business of health insurance with Nick’s love of sweet treats. Together, we navigate the labyrinth of consumer experiences in healthcare, scrutinize the vital roles of brokers and employers, and devour the complexities of health insurance with the same gusto we bring to the homemade treats that kick-off the episode. Nick's expertise, honed over years of leadership and entrepreneurial ventures, peppers our discussion as we explore ways to make financial growth and community health initiatives more relatable and effective.
Prepare to uncover the secrets of human-centered design in healthcare, where we confront the reality that the consumer in the industry is multifaceted and includes the broker, employer, member, patient and provider—and each one affects their interaction with health insurance and healthcare differently. We dissect the nuances of fully insured versus self-funded employer plans, and how these choices affect everything from a person's pocketbook to their peace of mind. With Nick leading the charge, we examine how the personal touch in healthcare can lead to better engagement, outcomes, and ultimately, more affordable care for everyone involved.
Concluding our lively talk, we step away from the spreadsheets and strategy sessions for a whimsical debate about the cultural phenomenon of Amish donuts. This lighthearted finale illustrates our belief that the healthcare industry isn't just about policies and plans—it's about the people (and the pleasures) that make life sweet. Join us and Nick Moriello for a podcast episode that promises to resonate with your intellect as much as it does with your sweet tooth, cementing our commitment effecting real change in the healthcare industry with every insight shared and donut compared.
Welcome to the Reverse Mullet Healthcare Podcast from BP2 Health. Today we were talking with Nick Moriello, president of Highmark Blue Cross Blue Shield of Delaware, about the need to improve the healthcare experience for the consumer amongst a complicated web of different consumers in healthcare. But first, who are we and why are we here, and why did we name our show the Reverse Mullet Healthcare Podcast?
Speaker 2:So we could get these mugs with the mullet podcast. It's because we want to be relevant, informative and creative, but we also want to be entertaining and have fun. Business in the front Sorry, party in the front. Business in the back it's a reverse mullet.
Speaker 1:Yes, you're confused by the Super Bowl commercial this year with the actual mullets, Exactly no party in the front business in the back. We are your hosts.
Speaker 2:Justin Politti.
Speaker 3:Ellen Brown.
Speaker 2:And Dave Pavlik. We are passionate, innovative and collaborative, and we are committed to solving our industry's most important issues together with our clients. We have a combined 90 years experience.
Speaker 3:And I think if we added Nick into that we would make it over the century mark. There you go Pretty close. It makes us sound really old. Most likely, yeah, that does make sense.
Speaker 2:In each episode we're going to dig into a hot healthcare topic and dig into each other.
Speaker 3:Just be gentle on me.
Speaker 1:We've already no noogies.
Speaker 3:No, no noogies. Thank God we haven't done the noogie yet.
Speaker 1:I know I'm kind of scared. I was going to do noogies after the last episode because you were giving me so much flack.
Speaker 3:Yeah, well, it was like your client crush, it's like his bestie.
Speaker 1:Yeah.
Speaker 3:So it was very exciting, like we all have our favorites sometimes, you know, and that was, it was very special for Justin no.
Speaker 4:Nick's my favorite.
Speaker 3:No, Nick's one of my favorites, so I'm super excited.
Speaker 2:All right, it's been a Delaware day, it is Well. That's why we flew up here, yeah.
Speaker 3:It's kind of why we're here yeah.
Speaker 1:Now I'm putting two and two together.
Speaker 3:Are you? Yes, it took you a while. It took you until the third episode.
Speaker 1:You know what I'm feeling today is like one of those lights that takes a little while to brighten up.
Speaker 3:Today we get to talk with Nick, president of Highmark Blue Cross, blue Shield of Delaware, where he has left quite an impressive legacy. During his tenure he has steered Highmark through both a financial and cultural transformation that has led to exceeding financial goals every year for all major segments, while achieving an all-time high of health plan membership. So I spent 10 years on the health plan space of health plan membership which. So I spent 10 years on the health plan space. It was actually so. I was down the road when Care First acquired Blue Cross, blue Shield of Delaware. That has since obviously changed a lot, but in that timeframe and I can tell you for anybody that doesn't know the health plan side to achieve that type of financial success, cultural success and growth simultaneously is pretty impressive and heard of on the health plan space. So wait, cue up the, give me the sound effect.
Speaker 4:There we go, there you go, nick, there you go.
Speaker 3:So sorry, so, anyways, at the same time, Highmark has been recognized as a top place to work in the US the past two years, receiving perfect scores on the Human Rights Campaign's Corporate Equality Index for four consecutive years lifetime health plan CEO. Prior to Highmark, you were the founder and successful entrepreneur who twice built and sold businesses to strategic buyers and investors. Both of those businesses were health insurance agencies, which is on the distribution side of health insurance, which gave you a very unique lens into healthcare. Not to be overlooked is also your commitment to relationships, which is why we've stayed in touch and it's why, I think, part of the connection that we all had when we first met. This also includes collaborations across the healthcare provider and payer divide, as well as not-for-profit board work in a variety of roles and your leadership of blueprints for the community, a fund that has deployed $10 million in 2022 alone for improving health care access, economic stability for families and individuals, mental health, environmental health and the upskilling of the health-related workforce.
Speaker 2:Very impressive. Yes, I have to ask a quick question. I'm sorry to. I don't want to derail, but I worked at Blue. Cross Blue Shield of the National Capital Area. When CareFirst bought that plan, how did I not know they bought Delaware. When did that happen?
Speaker 3:Right after, so it was like a buying frenzy.
Speaker 2:Okay.
Speaker 3:Yeah, well, I mean, I was there when.
Speaker 2:I guess I wasn't paying attention.
Speaker 3:No, but I was there during that too. See, we actually worked for the same entity and didn't even realize it. Dave, it was a precursor.
Speaker 1:So, nick, it's great to have you here. We are lucky enough to meet a lot of people, but when we had to interview you a couple of years ago as part of a client engagement, you really stood out to us as someone who really values relationships, so we're real excited to have you here today, thank you. Thanks for having me.
Speaker 3:So, first, because now we get to have a party in the front.
Speaker 4:I love that yeah.
Speaker 3:So can you share with us and with our listeners of something unexpected about yourself?
Speaker 4:Yeah, it would be unexpected for folks who don't know me. For folks who do know me, it's no surprise at all that I am a connoisseur of sweets. In fact, I'm I'm eyeballing these things sitting on the table here we're ready for you.
Speaker 3:She made these. I baked oh my goodness no, there's so much here, so can I start with mine?
Speaker 2:you go first. Okay so, because they're homemade. Okay so for listeners, she's a big bag is on the table now yes, there is a large bag.
Speaker 3:You have to understand that I love to bake. So when you said sweets, you had me, because I love the challenge of baking.
Speaker 2:I just see more and more stuff coming out of this bag there's so much so Ellen is removing brownies and cookies, so the first is my family. This doesn't translate well to a podcast.
Speaker 3:No, but my family has sort of some endearing terms for these brownies, but they are very special brownies. That's the first treat for you.
Speaker 4:Thank you and then Keep sliding them over.
Speaker 2:Yes, and my son helped me with these. By the way, what's the endearing term? The crack brownies.
Speaker 3:Yes, but I just I wasn't sure if we wanted to say that on the podcast. Well, it's not real crack, I know, but like I don't know. Okay, so we call them crack brownies, but but actually the the connotation as to why I didn't use that week. They are truly called crack brownies because you let them crack on the top and that's how you know that they're done, but they're still gooey on the inside. So that's that's it. Uh, then, this is this was new, but I'm very happy is these are all brown butter chocolate chip cookies. So you actually brown the butter that you use in the chocolate chip and these are Nutella stuffed.
Speaker 4:Oh my goodness, there's so many options here these are non-stuffed and these are fudge.
Speaker 2:Look at the size of those things Wow.
Speaker 3:Let me tell you when you stuff something with fudge or you stuff like it's got to be a big cookie.
Speaker 4:So yeah, there you go. Why not? If you're gonna have a cookie, make it. This is awesome, yes, and then oh, it does, that's there's more.
Speaker 1:Oh yeah, but wait, there's more so I went over to redding terminal this morning.
Speaker 4:first thing I recognize the bag.
Speaker 3:For a sweets connoisseur, Right so.
Speaker 1:Ellen, I'm going to have you open this one, because I got her some gifts, so I'm a sweets connoisseur too, oh great.
Speaker 3:Wait, we're going to open these. Well, we might as well Look and see what's in there so this is a box, but this is for Nick because you're a donut guy.
Speaker 4:Yeah, those are.
Speaker 1:Byler's yes.
Speaker 2:He knows what they are. Just looking at the box Absolutely.
Speaker 4:They are the best donuts Bar none.
Speaker 3:Really yes, what?
Speaker 4:makes them the best donut One. I believe they use potato dough at some point. I could be wrong about that. Maybe I've made that up in my head, but it makes me feel like they're different. And then, on top of that, the quantity of filling inside and the quality of the filling inside is second to none.
Speaker 1:Well, I hope you enjoy the choices that I made. One of them is peanut butter and jelly. I don't know if there's allergies or anything.
Speaker 3:So I just opened my box, which is from Termini Brothers, the gold medal pastry since 1921. And there is a carrot cake, a velvet. So I guess I should do this for those that are watching. Don't drop them, I won't drop them.
Speaker 4:Wow, carrot cake, red velvet cake and some sort of chocolate, chocolate mousse.
Speaker 3:Nice.
Speaker 1:Like a chocolate mousse. Welcome to the Betty Crocker podcast. I don't know what these are, but the woman at the counter sold me on them. She said they're the best one. They make the best ones. I don't know Again. I'm not sure what exactly they are. I was on a buying frenzy. I was like Willy Wonka this morning.
Speaker 3:Well, this is awesome and I have to say I think we have to arrange some sort of there's another thing in more cookies. What cookies do you have in there? Oh, this is the Fourth Street.
Speaker 4:Cookie Company. I'm familiar with those too.
Speaker 3:Are you?
Speaker 4:Yes, okay.
Speaker 1:Ready Terminal is a fantastic place, I got peanut butter and I also got chocolate chips and I got one's blueberry cake.
Speaker 3:Oh, and like a raisin.
Speaker 2:Yeah.
Speaker 3:Interesting.
Speaker 2:Yes, and we do not condone eating all of this sugar and we are.
Speaker 3:We do not condone eating all of this sugar, and, yes, we don't. We are a healthcare podcast. This is so exciting. It's a baking podcast today yeah, so anyway, alright, so I do. I did say that, guys, I think we might have to figure out some sort of like follow up where we do it remote and you like tell us which ones you liked the best.
Speaker 2:We want you on camera you will get a full written report.
Speaker 3:I'm so excited Be on camera with every bite See that was the fun banter. Notice that when I sent you the script I didn't have any of that, because I didn't want you to know that we were going to bring you treats.
Speaker 4:No, this is awesome.
Speaker 3:I'm speechless staring at all these things, I'll be thinking about this, the entire podcast. So then we're like distracting you, so what?
Speaker 2:else other than sweets. Any other outside of the office sort of interests I'll share a current passion.
Speaker 4:I have a little one at home, and my wife and I and our daughter. I have a little one at home, and my wife and I and our daughter we love searching for fossilized shark's teeth on beaches. So I didn't really know this was a thing before, maybe a year ago or so, and now we're completely obsessed with staring down, walking on the beaches looking for them. Now that you see them, you see them everywhere.
Speaker 3:Really.
Speaker 2:Yeah, do you have one of those teeth detectors Like a metal detector?
Speaker 4:No, I wish there was a teeth detector I keep thinking about. They should make like special glasses that take the glare off of everything else and you can zero right in on the shark's teeth on the beach.
Speaker 2:Sounds like a business opportunity. Sounds like a shark tank You've been to Venice in Florida with shark tooth beach.
Speaker 1:it's actually a thing. So, anyway, it's just south of us.
Speaker 3:Well, that's what I was going to ask you is if there are known places of particular density of fossilized shark's teeth.
Speaker 4:Our first discoveries came along in the southernmost beaches of North Carolina, so that's where we had good luck so far and discovered this whole passion around searching for these things. Along with seashells too. Just various size shells all in one piece, things that we weren't as used to seeing in the northern beaches of the East Coast here.
Speaker 2:Right, because they're always broken and you just find little shards.
Speaker 3:He actually said the word. Like Swedish, dishcloth the seashells by the shore.
Speaker 2:Oh, say it three times really fast. No, we had to do that with.
Speaker 3:we talked about a Swedish dishcloth and we couldn't say it correctly and it became sort of a joke. So it was funny that we used that parallel, it's easier to say shammy.
Speaker 2:All right, I'm going to be the ruiner of fun. If you want to hit the button.
Speaker 3:I know, but I have to make one last comment, which is that a classmate of mine growing up is huge into fossilized shark's teeth.
Speaker 4:Yeah.
Speaker 3:And she's always in riverbeds in central Florida like searching for these.
Speaker 4:It's amazing stuff. The best find to date was finding a megalodon tooth and it's like I didn't wow like just millions of years old.
Speaker 3:You just found it unbelievable. Yeah, wow, that's cool stuff, that's super cool, so okay, so now the want.
Speaker 1:Want, oh yeah yeah, unfortunately we're done with the fun wait see justin was given a gift at this we had no idea that they had sound effects because the studio we record at in tampa.
Speaker 3:We have no fun sound effects. So whenever eric the technician and and he showed us these sound effects, it's like we brought our own now, just in case yeah, oh, you know somebody gets the boring button sometimes.
Speaker 4:All right, dan, it's fun, since it's here.
Speaker 3:You can reach those. See, you can actually have a lot of fun. We can go toe-to-toe yeah there's lots of fun.
Speaker 2:So I'm going to kick off our episode a little differently today. As you know, nick, we always ask our guests what their buy the world a Coke, or when pigs fly idea would be for fixing the healthcare system. So can you share yours?
Speaker 4:Yeah, I mean such a complicated question. You know, in my view, and maybe many of us out there, our system is broken, it's complex, it's difficult to navigate, it's expensive. The outcomes could be better, so it leaves a lot to be desired, you know. Just thinking about cost as an example, there's so much waste and duplicity that happens in the system that we can do better. We can find ways to take out. I call it the low-hanging fruit that's in there of taking some of the waste out. And then really, if we found a magical solution, it would be trying to care for the 80% of a person's well-being that happens outside of the traditional health care delivery system, all the social determinants of health that we learn more and more about every day.
Speaker 3:So that's a perfect segue into our discussion today about how we can affect real change with all caps in health care, which is this podcast is our passion project around that, because I think as thought leaders, we don't talk about it enough. We kind of get in our lanes and we don't have an opportunity to sit around a table like this and have a conversation. So when we asked you that question around real change and the importance of it, you said let's talk about improving the experience for the end user. You teed that up and this is something that every industry strives for, right. Like if you talk to anybody in industry any industry they would say we want to improve the experience for the consumer.
Speaker 3:But when you talk about a broken system, you know anytime people ask me well, why don't you just fix healthcare? I always actually talk about the consumer and the fact that it's a multifaceted consumer. There is not one consumer. It's not like when you go in the grocery store and you buy broccoli and you're the person that walks in the grocery store and buys the broccoli and leaves. Right, there's this whole complexity, there's this litany of consumers. So tell us your thoughts on that concept, the complexity there.
Speaker 4:Yeah, even the terminology. We refer to the person differently based on where you sit within the continuum of our industry, and so you hear words like client, customer, member, patient, consumer. It's all different words that can be describing the same person at the end of the day, and there's so little that puts that person at the center of every decision that happens, and so it's another one of those areas where we have a lot of work to do.
Speaker 1:Sounds simple, but it's real complicated.
Speaker 3:So it sounds like we need a framework. Yep there we go I love a framework. These guys are like oh boy, it's like me and the wearables. So I'm actually excited to be able to talk about this, because I feel like this is the first time and this is what our 14th episode. Now, this will be our 14th episode, cool, but we've not talked about 15th 15th sorry, 15th episode. Wow, this sounds like a hefty number.
Speaker 1:Yeah, it keeps going up, yeah it just keeps going up.
Speaker 3:But anyways, we haven't talked about the complexity of this and the term the person you know we need when we talk about healthcare. I guess the first thing I want to make sure we all agree on is that the term person should be at the center of it all, regardless of from what angle? Like, do we all agree with that, if I use the word, because if I throw a framework out, we have to all agree on the idea that the person is at the center. You guys are nodding your heads.
Speaker 1:Yes, yes, all right For your heads. Yes, yes, okay, all right For the viewers.
Speaker 3:Yes, yes for the viewers. Okay, so let's take the framework further. So first we have the consumer or customer right. Then we have which can be defined as a member, which is the person who is getting health insurance right that's you as the consumer into purchasing health insurance. And then you have the patient, which is actually getting the health care. And so when you buy your insurance let's start with the first aspect of that, which is when you buy your insurance or you shop for your health care you're the consumer or the customer right.
Speaker 1:Well, yeah, this is part of the complication, right? We're really looking at four separate groups here. You have the individual buying the health insurance directly, the individual selecting the health insurance from the list provided by their employer, the employer choosing the health insurance for their employees, and then the broker consultant shopping for the health insurance from the list provided to their employer. The employer choosing the health insurance for their employees, and then the broker consultant shopping for the health insurance plans. You've got a whole host of different people in there.
Speaker 3:And that's just for the consumer or customer buying the health insurance. We haven't even gotten into when you're actually trying to use the health insurance or when you're trying to be the patient on the health care side.
Speaker 4:Right, and that's just capturing what some in our industry would call the commercial segment, right, and so it's not talking about the folks whose coverage or benefits are through Medicare at the federal level or Medicaid at the state level or through the government in another fashion, whether it be military or TRICARE or something like that. But yeah, there's a lot of different ways that benefits are delivered and that could impact how we're defining that person in terms of their consumer, customer, member, etc.
Speaker 2:I don't know. It sounds pretty simple to me, not, not, not, I'm kidding.
Speaker 4:I'm kidding so.
Speaker 2:Nick, any thoughts on how we can simplify or improve the experience of shopping for?
Speaker 4:healthcare. Yeah, you know, human-centered design is a practice that's been around forever and I think we need to deploy more of it in our space, right, and so it's putting that human being at the center of what we do. And if you're thinking about that person as a patient, for example, then it's putting them at the center of what that experience looks like as a patient when they're seeking care. If it's when they're purchasing insurance as that individual, then it's what does that purchasing experience look like? How can we simplify the terms and ensure that we have the right level of health literacy in what we're delivering? So there's a lot of different ways, but I think at the core of all of it is, if we deploy human-centered design principles, it will behoove us to create a better experience, or enable us to create a better experience.
Speaker 1:So how about for the employer or consultant broker? Can you kind of go over that experience?
Speaker 4:Sure, as still someone who identifies as a broker from a long past history. You were mentioning your collective years of service this year is 31 for me in the industry but the overwhelming majority of that, before this tenure at Highmark, was in that distribution space, in the broker space, and so you know that person needs to be included in the process of the design as well, because they're guiding.
Speaker 4:Oftentimes a broker or consultant is guiding an employer with the purchasing decisions of what plans to put in the list for their workforce, impacting their workforce and their dependents, and so we need to think about how do we make it simpler and easier to make those choices?
Speaker 3:Yeah. So it's interesting because we had a guest a few episodes ago, mike Barrett. A few episodes ago, mike Barrett and his thought about real change in healthcare was he believes that we will be very shortly seeing kind of the elimination of employers carrying that burden of selecting health plans. He believes that the tax benefits that have driven that are not proving to be really worth what that creates right, the complication it creates for employers, the cost, et cetera, and so he believes that employers are going to largely kind of step out of that role. And what you were talking about before, when we talk about individuals selecting healthcare, like on the exchange or Medicare or Medicaid where there is no broker involved, I don't necessarily agree, but it was an interesting conversation to have that. You know. His point was that's going to create a consumer, a direct-to-consumer 2.0, you know, because it takes, it changes the consumer experience from a perspective.
Speaker 4:Well, you know, it's one of the things when you think about the complexities and how to solve such a large percentage of our population in the US are covered under employer-based plans and so the different changes that some ponder that look to kind of completely change that. It's such a big change to talk about. I am personally I'm a fan of incremental changes and achievable changes. And that's such a big one to alter the way that care is delivered for. You know, on any given day, roughly 60% of the population, so that's a difficult one.
Speaker 3:Well, no, we called it the cataclysmic change.
Speaker 1:I don't think people are educated enough to be able to be informed enough on the decisions that they're. They don't understand to your point the health literacy aspect. If you turn something over, that's so complicated that there just isn't something there, unless the broker becomes part of that equation somehow. And how are we funding that?
Speaker 3:It's like saying that real estate agents are just going to fly away. Well, look at MA.
Speaker 2:I mean seniors have-.
Speaker 3:Medicare Advantage yeah.
Speaker 2:Medicare Advantage.
Speaker 1:They have a heck of a time trying to figure out the hundreds of offers they're getting in the mail, but you have counselors that are available to be, able to help assist in that, but that doesn't exist necessarily in the commercial space, which is why we talk about the consumer experience.
Speaker 3:Right so, all right. So back to my. We could talk the entire time I think about that piece alone. But let's so back to my framework. Let's now move on to the consumer or the person as the member as the health insurance member.
Speaker 2:Sounds like we need a definition here.
Speaker 3:Oh boy, we're always doing definitions, there's no.
Speaker 2:Funkin' Wagnall. Ellen's always looking up definitions. This one, as simple as it sounds, was actually not that easy to find, but in the medical dictionary of the free dictionary by Farlicks.
Speaker 3:Yes, that's a thing.
Speaker 2:I know who knew the definition A person covered under a health plan, either the enrollee or eligible dependent.
Speaker 3:Which was very apropos. So my point is that you could find member. A lot of different definitions of the word member, but the only one that defined member in the health care industry was that.
Speaker 1:So yeah, yeah, but what does that really mean practically, you know, like what does that membership give you? It's like a paid subscription of sorts. It comes with healthcare services, such as administrative services, those types of things. Nick, did I miss anything?
Speaker 4:Even in the subset, within the insurance world for a member then we think about is the member on a fully insured program?
Speaker 2:in which case?
Speaker 4:then the insurer is taking on the risk of the medical bills in exchange for a premium. Or is that member on an employer sponsored plan that's self funded, where the employer is actually covering the bills and the administrator of the plan is covering things like processing and billing and setting up a network of medical providers?
Speaker 3:So what do you think the key ways are that we can improve the interactions here, because this is definitely an area of frustration for a lot of consumers. Like we have people that listen to the podcast that are not in the healthcare industry, but they and this is why, whenever Dave says MA, I always say Medicare. Advantage.
Speaker 4:Yeah, fair enough, you need an acronym.
Speaker 3:Yeah, I do, I do, we do, but I mean, it's important to us that somebody who doesn't know the industry but wants to learn more about it, that this is a place where they can kind of learn that and consume it a bit. And I think it's important because people to me, if you ask somebody, you know why they think healthcare is broken. They're, you know, immediately go to health insurance. You know I hate working with health insurance, or you know they're going to vent about that, and then the other thing they're going to say is my doctor doesn't listen to me. You know, those are kind of the two pieces. So, when you think about it as the insurance consumer, what are some of the key things that you're focused on, that you think or even not focused on, but you think are opportunities for improvement, of how to make it better.
Speaker 4:Yeah, I think first we think about access, and where are there needed access points to care? So if I'm thinking about it wearing a health plan or insurer hat, I'm thinking about is our network robust enough that folks can access care when they need it and do they know where to go to get it? And you know how can we help facilitate that and have maybe some would refer to it as care navigation to find the right care at the right time, you know, at the right place in a highly efficient manner that has the best outcomes. And so I think about access being a core, and there's so many, you know, in the health care industry there's, just like many industries, there's so many workforce shortfalls right now and access is an issue. And if you go to some parts of the country, even not that many miles away from different parts of the country, the access is dramatically different, and so how can we improve that?
Speaker 4:And so a lot of the initiatives. You were kind enough when talking about some of my background. You mentioned blueprints for the community and workforce being one of those things, and upskilling workforce or attracting new workforce. We've tried to do that in Delaware around some of the areas of greatest need and I commend our health systems in the state with residency programs that they've developed to try and bring in a new workforce specifically around family medicine and surgical care different things that were needed quite a bit.
Speaker 3:In fact our guest before this was a product of the Delaware residency system. He was a medical resident at Christiana and Nemours and in internal medicine. So to your point you know he was a somewhat of a product of that. Any other areas as the insurer, when you have your hat on truly as the insurer that you're, you all are doing, or you see in the industry that really display improving the experience for the consumer.
Speaker 4:Yeah, and so it's not always about tech, but where tech can help too. So virtual access to care particularly relevant during the pandemic when folks were sheltering in place. But even beyond that, care like behavioral health and seeing the percentage of adherence to visits that happen virtually, that remove some of the stigma that would have been around in-person visits for those things or scheduling time out of the day to do it. Virtual specialty care, like MSK I'll throw an acronym buzzer at myself there musculoskeletal right, so things of that nature. Where can we enhance those? So I know health plans like ours. We think about that all the time and what products we can deliver as part of the insurance package. That improves the experience. And again, thinking about that person at the core, what do they need? Is it improved access? Is it facilitated access? You know those kinds of things.
Speaker 2:All right. So to go back to the framework, so we've covered consumer, customer and member, so let's jump into patient.
Speaker 1:I think this one's a little tricky because it's defined as a person receiving or registered to receive medical treatment. But there are so many ways to receive medical treatment and it's disjointed. And yet in the beginning of our conversation, Nick, when you talked about improved outcomes, this is the epicenter of that objective.
Speaker 4:Yeah, you know it's so difficult and you think about a patient who might be going through an acute situation in particular. Those are stressful in and of themselves, without factoring in how do I get to my care, where do I go for care? Who do I go to see for care? Does the place that I'm seeing for care coordinate with my family physician? And is that incorporating behavioral health into it and all these different components? It's very tricky and it's tricky for us to solve as an industry. You mentioned some of your audience being outside of our industry. It can be daunting when you're thinking about these things as a patient, and that's if you're thinking about it with a whole support system around you. If you're thinking about it exclusively alone while also dealing with a health issue, it can just be overwhelming.
Speaker 3:Yeah, it's funny. Now that this is our 15th episode, you do start to see some.
Speaker 1:Sorry, no don't mess with me, you just keep adding, you're going to really mess with me.
Speaker 3:I'm like, oh yeah, 16th mess with me. I'm like, oh yeah, six to eight. But this care coordination is a theme now that is becoming more consistent in our discussions as we have different guests from different aspects of the industry to talk, and just now we talked about the importance of the coordination of care and including all of these different ancillary services, like MSK, like you said, the musculoskeletal behavioral health, that we call those ancillaries and as an industry we've sort of thrown them off to the side. They're like bolt-ons, but the truth of the matter is, to us as patients, they're just part of our health care, that's right.
Speaker 3:And we need to acknowledge that from the person's perspective, which is why we're talking about how to improve the experience. We have to put our person hat on and say I'm the patient. So clearly we've created this seemingly insurmountable complex system. Do you think there's a secret sauce to this? That's sort of a common thread. Do you think there's a secret?
Speaker 4:sauce to this? That's sort of a common thread, I do, you know? I think, going back to the keeping the person at the center of everything, I think it's all about relationships, and I have this core belief that if we can improve experiences, we will improve engagement, and if you can improve engagement, you can improve outcomes. And with improved outcomes comes more cost predictability and, ultimately, affordability. And so it's really keeping the experience at the core and the relationship of all those pieces that we've been talking about are really inclusive of relationships, of people, and that's the secret sauce is how can we improve those relationships?
Speaker 3:Well meaningful relationships are truly at the epicenter of it all for me. I mean, when Justin and I first had the pleasure of meeting you a few years ago, we appreciated the genuine nature of our conversation with you. Um, it was. It was a, a very. You know, an interview of a, of an executive, to get background information, isn't exactly a uh, necessarily a warm and fuzzy type of experience set up. But you know, we broke bread together and we got to talk to you, and here we are four years later with you on the podcast, because it was in fact a genuine interaction. So I couldn't agree with you more about relationships.
Speaker 2:Yeah, and that really hits home for us because it's at the core of who we are, the three of us, and it's at the core of our BP2 mission as well. There's actually a line on our website that reads because actionable solutions are the direct results of respect. You'll come to know we believe in relationships too.
Speaker 1:So it is interesting I'll go off script for a second second. But when we meet somebody like you, right, we think to ourselves how do we strike while the iron's hot so we're able to achieve you know what we're, what normally you wouldn't be able to achieve with other people. If you understand what I'm saying that way. Um, it seems like an apropos moment to do the buy the world a coke idea are you gonna sing I?
Speaker 2:think she makes us sing every time. I know you have such good radio voices and then you can sing. I cannot sing. Makes us sing every time I know you have such good radio voices and then you can sing.
Speaker 3:I cannot sing, so I like to hear you sing.
Speaker 2:Dave, dave I'd like to teach the world to sing perfect time.
Speaker 1:Perfect, come on, harmonize with me. No, I can't.
Speaker 2:I like to buy the world of coke. Yeah, keep it company and keep it company yeah, we waxed poetic there for a while.
Speaker 4:I can't sing. My dad had all the musical talent in our family not me, but my grandfather worked for Coke for the longest time.
Speaker 3:Are you?
Speaker 4:serious. I didn't share in our background there.
Speaker 2:Are we going to get sued for doing this song? No, no, no.
Speaker 4:Big Coca-Cola fans are our family Coke might come after us?
Speaker 2:No, I think no. Big Coca-Cola fans are our family. Coca might come after us.
Speaker 3:No, I think they would appreciate what we're trying to accomplish.
Speaker 2:So what is your buy the world?
Speaker 1:a Coke moment.
Speaker 4:Yeah, it's definitely this relationship. So you know, I've had a very fortunate career and it's been an interesting ride for me personally. You mentioned some of the entrepreneurial past and then this current ride at a health plan and the privilege of the position I get to hold right now. But it's all been about relationships and some of the biggest successes came from really what maybe started as adversarial relationships in our industry. And I look at an example where a health plan with a lot of market share and a health system with a lot of market share were kind of butting heads with each other and from the outside, looking in and thinking of myself as an advocate for clients or customers and all those different words we talked about, I was watching those negotiations happen and it looked like an arm wrestling match where somebody's going to feel like they won and somebody's going to feel like they lost and ultimately the person that was mutually being served by those organizations always lost. And so I said couldn't we do something differently? And it would be awesome if we did as a worst case scenario.
Speaker 4:So the buy the world a Coke moment is let's try. Let's try and do something different and as a worst case, we'll learn a whole lot, but as a best case, we might be able to create a replicable model that others can learn from around the country. Because if we go back to the person at the center of everything, I believe that our mission and visions aligned it's to help that person. A system might call the person a patient, a health plan might call the person a member, but it's the same person. System might call the person a patient, a health plan might call the person a member, but it's the same person and that we're trying to help. And so if we can get to a better experience for that person, it's mutually beneficial. And now the tricky part is trying to figure out how to align all the economics around that in a system that's very disjointed today.
Speaker 3:Well and that's well, that's value-based care. I just have to put a plug in there for the old value-based care piece because that, to me, is the glue that binds everybody together.
Speaker 3:Financially, it obviously then a different level of partnership occurs to really join forces to align around improving outcomes. You know, we talked on the episode before this. Dr Elliott mentioned managed care and he was talking about it from like the 90s, the early 2000s, when managed care was, you know, health maintenance organizations and it got the bad rap of care, basically care avoidance, withholding care, right. But now I feel like we are in an era where value-based care really is about improving outcomes, improving the experience for the patient and, to your point, it's also the only way that we can focus on the 80% outside of the healthcare system.
Speaker 4:That's right.
Speaker 3:You know to really obviously we can't be enjoying sweets like we like.
Speaker 2:I just put out in front of us.
Speaker 4:If we want to avoid lifestyle disease. Well, to the dismay of my Coca-Cola family, I'm water only. So, I try to offset examples like today. There'll be some binge today.
Speaker 3:We talk about food as medicine, food as health, all the time, yeah, and then here I am bringing you all that, but you have to have it's all in moderation, and you know.
Speaker 2:So anyways, Our last question, and it very possibly ties into your buy the World of Coke moment is what legacy would you like to be a part of in health care?
Speaker 4:Yeah, you know, I mentioned before that I have a daughter and it's a burning desire in me, kind of like the simplistic leave the world a better place in some way. I want to leave it better for her generation and generations to come and just to have any kind of her generation and generations to come and just to have any kind of part in that would be awesome, even if the part is learnings of what not to do. I want to. You know, if I had a legacy, it would be a willingness to try and to try things differently. You know, coming into this job, in this role, was a leap, even though folks outside our industry would say, oh, it was all insurance, you were at the insurance broker society, now you're at a health. It's very different.
Speaker 4:But it was a leap to say maybe I can do something here and be part of something bigger than myself, and that that's the, that's the passion, and so the legacy is just to try to make the experiences better. And, ellen, you mentioned value-based care and we talked about all the people customer, client, member, patient. What we didn't mention is the person delivering the care, who's part of that equation too. We need to make the experience better for that person and that's something our industry can do a lot better of. When talking about that waste earlier in the system and the distrust and the duplicity that happens, we could spend more than one full podcast talking about prior authorization, I'm sure and all that I actually had that written down and then I was like, oh, I don't want to put him on the spot about that.
Speaker 3:Yeah, no, it's it's okay oh, that would be boring, yeah, but people, people would understand, yeah, yeah.
Speaker 4:But it's that that would that would be. My desire is just to leave something better than I found it.
Speaker 3:Well, you've, you've described what I always call my unicorn client.
Speaker 3:So I I always say I as I kind of come into this last, probably, decade of my career, I really am excited for us to work on that type of work that is really taking a risk, that's stepping outside of.
Speaker 3:So it's that balance of incremental and cataclysmic and to say you know what?
Speaker 3:This is the lane I've always been in, this is the way we've always done it, but it's not working.
Speaker 3:And instead of everyone standing around waiting for Apple or Amazon to come in and disrupt it and turn it upside down, there are so many smart, thoughtful people in this industry that if we just started that conversation and connected with each other, like even today, was really nice, because typically we're in a place where, like this was great because the three guests that we had today, by us coming here, you all are in the same geography with each other, and it was really. I thought it was really cool to connect each of you personally with each other, because we view all of you as the types of thought leaders that can do something different. We view all of you as the types of thought leaders that can do something different, and so it's exciting for me to see coming to fruition that, yes, we are talking about it and bringing a voice to it, but then seeing it happen in real time and it's the unicorn to Justin's like oh, here we go with the soapbox, so anyways so thank you, it's the Megalodon tooth.
Speaker 4:It is the Megalodon tooth Once in a while. It is. It's the Megalodon tooth.
Speaker 3:It is the Megalodon tooth. Once in a while it is, it is.
Speaker 2:Thank you so much for your time, Nick. We appreciate you coming out.
Speaker 4:Yeah, thank you guys for having me and the sweets.
Speaker 3:I can't wait to give you the full report. Yeah, see, we'll have to figure out how to be creative about it. I do want. I am curious.
Speaker 1:They leave that like.
Speaker 2:I have kind of a weird textural diversion. You sound like me and pizza, but these ones have what did you say? Potato dough.
Speaker 4:Aversion. Again, if anybody's watching the podcast that knows these donuts, I'll probably get criticized.
Speaker 2:They're not potato dough.
Speaker 1:But in my head I think they are. Is it called?
Speaker 2:Byler's, byler's, byler's, byler's Donuts Amish.
Speaker 3:And just for the record I have to say that there is apparently a large Amish community where Justin lives in Florida, in Sarasota.
Speaker 1:Sarasota.
Speaker 3:And his original plan and you may get a gift in the mail. His original plan was to get your favorite filled Amish donuts and bring them to you from Florida so that you can compare and contrast, it's a place called Yoder's. There's several.
Speaker 2:But what happened?
Speaker 4:You couldn't pull it off.
Speaker 2:Because he forgot you failed.
Speaker 3:So, I'm just going to say it's either another podcast episode or a gift in the mail.
Speaker 4:That's a good way to entice me back you can come down to Sarasota and look for Megalodon teeth.
Speaker 1:Yes in Venice and go to the beach, fantastic so thanks again, Nick.
Speaker 3:I really appreciate this.
Speaker 2:Thank you.
Speaker 3:I'm Ellen Brown.
Speaker 2:I'm Dave Pavlik, I'm Justin Politti. We are the partners. Justin, come on.
Speaker 1:Tag you're in. We are the partners at BP2 Health. Your best chance for real change.
Speaker 2:As you can tell, we could talk all day about health care. Drop us a line through our website, bp2healthcom. And the Reverse. Mullet podcast was produced today by Mainline Studios in Westchester Pennsylvania.
Speaker 3:And they've been fantastic as a guest studio today.
Speaker 2:Give Jerry a shout out.
Speaker 3:Give.
Speaker 2:Eric Keith.
Speaker 1:Give.
Speaker 2:Eric, you two and the names. I can't remember the names. It's Eric, I know. Call Eric, I was joking, all right.
Speaker 1:All right.
Speaker 3:Thanks.