Unlocking a Healthier Workforce | Roundtable Transcript

Virtual Roundtable Transcript: Unlocking a Healthier Workforce & Driving Organizational Success

Explore breakthrough insights on reducing healthcare cost and improving employee affordability, access and outcomes.

You can access the full event on demand here.

Meet the Panelists:

Welcome, Attendee Survey & Introductions

Ashok Subramanian: We thank all of you for joining, and we thank you in advance for what we hope to be a candid thought, provoking dialogue across a number of pioneers in healthcare benefits, business primary care. And we’re really looking forward to a rich, authentic dialogue, not just about solutions or sales pitches, but frankly, to really step back and reflect on how the healthcare system is working today, where there are opportunities for improvement, and frankly, where there are signs of hope, signs of optimism that we can actually move forward for a more equitable, a more affordable, a higher access, and ultimately a more sustainable solution for all of us who grapple with these issues on a day to day basis.

Give it another ten seconds for anyone who had some technical challenges. Going once. Going twice. Alright. So, who are we? And why are we here? As Admiral Stockdale might have said at the 1992 vice Presidential Debate. So a pretty good mix of geography, we’ve got to work a little bit harder in the South. So, 40% in the northeast, another 40% in in the Midwest. Dan, I think we call that God’s country, right? For a reason. 11% Milt, your old stopping ground in the West. Nice mix of roles as it relates to benefit advisors, benefit decision makers, business owners, leaders.

Dan Cahalane: Yeah, I would say, you know, I’m going to speak from a manufacturing perspective when I say middle-market, and there’s a lot of different industries right outside of manufacturing. But when it comes to manufacturing in the United States middle-market over the last decade we have seen the raises that we’re able to maybe put into the market, there’s been years it’s been 0%, a good year is 2%. And oh, wow! You’re doing great at 3%. Oftentimes the healthcare cost increases when you’re self-funded, or really any funding, have offset those increases. So for the last decade I have been talking to our on the shop floor — I’m a very visible leader and we talk openly — I have to hit it directly like, look, I get it. Your 2% raise was just wiped out by healthcare every year. And I say so the last decade you’re not getting ahead. And yet those cell phone bills don’t go down right. And we get more electronic toys to play with that cost money. I get it, and we as a company haven’t figured out the secret sauce because we cannot always unilaterally just raise prices right? So that’s been going on. And I would say for most manufacturers in middle-market, they’d all be nodding their head, saying, yep, yep, that’s exactly what’s been going on. So, we’ve been communicating for over a decade on that problem right there.

Ashok Subramanian: My main concern is the prevalence of high-cost claimants and being able to have control or influence over how those claims are managed. How choices are made in the in the care paradigm, if you will. Being able to understand if the expense is necessary as it always shows up being other than that. I mean, our population is, probably compared to Dan’s, a little bit younger, probably a little bit lower risk health score wise, just, you know, stereotyping. Sorry Dan.

So, let’s jump in. I think we would love to have a dialogue around the problems, and the more we hear from all of you, and the less we hear from me, probably the better for everybody. So, Dan, I’d love to start with you, kind of representing that middle-market employer. How would you describe the challenge that employers face in providing healthcare coverage to their employees?

Ann Greiner: Well, thanks so much for the invitation to be here. My name is Ann Greiner, and I’m the President and CEO of an organization called the Primary Care Collaborative. And we were started by a group of employers, big employers, and some physician groups because the employers couldn’t offer the kind of primary care they wanted to offer, or they couldn’t buy it, I should say, and the physicians felt like they couldn’t provide it. And so, they came together around a new model of care called the Patient Centered Medical Home, which I think you are likely aware of. And we’re working now to try to get better financing for PCMH and other advanced models of primary care. We believe that we need to invest more in primary care through new kinds of payment models to really realize the value of primary care. So pleased to be here. Thank you.

Brandon Batiste: Good afternoon, everyone, Brandon Bastiste here. I am a Vice President with Morgan Health. Morgan Health is a business unit with JP Morgan Chase, and our mission is focused on improving the affordability, quality, and equity of healthcare and employer sponsored insurance. My role within Morgan Health is to focus on everything cardio metabolic, chronic disease management, obesity, GOP Ones and in partnership with benefits colleagues so good to meet you all.

Milt Ezzard: Thank you Ashok for having me. Hello, everybody. I’m Milt Ezzard. I lead global benefits for a game development company called Activision Blizzard, based in Southern California. I am based in South Florida myself. I’ve been with the organization about 11 years roughly, 8,000 US employees now. Our joy has been to reimagine how we could offer benefits for employees over the past decade and building an ecosystem of tools and resources that support employees that are extremely a diverse set understandably yet doing it in a way that proves to be as efficient as possible given our current environment for healthcare.

Ashok Subramanian: Milt, you’re too humble to say this for yourself, but you’ve been recognized on Glass Door and many, many other forums as being amongst the most progressive benefit leaders in the country. So again, thank you for your support in the cause.

Ann Greiner: Well, thanks for the question. We’re actually a 70-member organization that is very diverse. Yes, we do have primary care clinicians and behavioral health clinicians. But we also have consumer organizations, health plans, employer groups, tech companies. But the common denominator is a recognition that we need to strengthen the foundation of our system. Because, I think, as Brandon pointed out, we’ve got a lot more entrants into the market, a lot more variety in the ways that people access care. But I don’t think most people would agree that we have a system that is more coherent. In fact, I think they might say it’s more chaotic, and more transactional, less apt for you to have that longitudinal relationship with someone who knows you over time, which the research suggests actually is how you get the best kind of care.

Ann Greiner: One other observation, you know, over the over the last ten to fifteen years, is that we’ve also had an expansion in coverage with the Affordable Care Act. But unfortunately, we haven’t had a reduction in costs, and I know that that weighs heavily on all of us – employers, public payers, state governments, the Federal Government, and we haven’t solved for that issue yet. I would say that actually strengthening the foundation which is primary care can help us solve for that issue.

Brandon Batiste: I think it’s quite simple. I think it’s engagement, you know. I think that’s what good looks like, you know, when you think about it, there’s still a big issue with care being deferred right? And for a period of time, COVID-19 was the primary reason for people deferring care. And now it’s cost and so, as Ann mentioned, it’s understanding those expenditures, and coming up with the action plan.

But you know, there’s lots of data to show that primary care has not really returned to the rates pre-COVID. We understand that behavioral diagnoses are up across the board regardless of condition. We’re seeing mortality rates increase, particularly with the younger population. Cancer diagnoses are also increasing, particularly for later stage diseases. And so again, lots of negative comments there. But the value is that there is tremendous opportunity for us to improve, and I think we start by creating access right getting people connected to providers. And I think good really looks like one engagement, but also the connection to the ecosystem right to really be able to address all the specific needs of individual populations of people.

Ashok Subramanian: Now, Milt. Again. You also represent an employer, a purchaser. Maybe not the exact same challenges that Dan has in manufacturing. I think many of us may be familiar with one of your most popular titles, Call of Duty. Which probably has slightly better margins than what might come out of the manufacturing world. But you have your own challenges that you’ve had to work through over the last decade, and you’ve done so well maintaining a well-below-market healthcare trend. So where do you see the problems from your perspective?

Milt Ezzard: That’s a really tough question.

Ashok Subramanian: That’s why I gave it to you.

Milt Ezzard: I don’t know if I’m going to be able to answer it. Obviously, we’re aware of pharmacy costs and the impact that that drugs are having, especially with good old GLP Ones that are beating down our door right now with regard to being a potential cost driver in the pharmacy space. But all that, said our, our pharmacy trend is actually moderated in the last year or two, for whatever reason, even though we do have a high number of specialty drugs in play among our population.

Ann Greiner: Absolutely. We hear from clinicians and primary care doctors and PAs and NPs that their patients are asking questions about whether something is covered under their high deductible health plan, or do I have to work my way through the deductible before it can be covered? They’re stressed out about that. And once they get a diagnosis, they don’t come back for treatment because they can’t afford it, or they can’t afford the drug that you’re telling them that they need. And it causes this moral injury for the primary care clinician. All of a sudden what they want to do for their patient, they can’t do because of this financial barrier, and I think this is contributing to burnout amongst primary care clinicians and other doctors.

Ashok Subramanian: Now, if you would ask me, how did we get down this journey of improvement year over year? Tweak. I will tell you again it’s back to the team, the progressive thinking of Tom England on our team. But, interestingly enough, and I know a lot of brokers are on this call, a broker brought this to us. A broker knew that we were a progressive, open-minded company, and they knew that if they didn’t bring us solutions for taking care of our employees and managing costs, we would be looking for something else. We’d always be looking. And so, this kind of journey was driven by a broker, and good, solid broker leadership. And I will tell you for any of you that are brokers on the call, I would make millions of dollars if I could count the number of emails that I get from all insurance people around the world wanting to set up a meeting to talk to us about how they can help us. And we’d say no to them for the most part, because when you sit in these meetings it’s oftentimes the same story repeated over and over. And very few are bringing revolutionary new ideas. And that’s the culture of who we are. We’re new idea people. So, when those folks brought this to us and helped us with the education, it wasn’t us just being smart on our own, and helping us navigate that, that’s what came together.