Latest / Becker’s Payer Issues Podcast / Stacy Edgar, Co-Founder and CEO at Venteur

Transcript

Stacy Edgar, Co-Founder and CEO at Venteur · Becker’s Payer Issues Podcast

• 0:00
  Welcome everyone to the Becker's Healthcare podcast series.
• 0:02
  I'm Mariah Muhammad, writer and moderator with Becker's
• 0:05
  Healthcare. And I'm thrilled to have with me
• 0:07
  today Stacy Edgar, cofounder and CEO at Venture.
• 0:10
  Stacy, welcome back to the podcast. We're very
• 0:12
  excited to have you join us again today.
• 0:15
  To start our conversation, I wanted to touch
• 0:17
  on finances a bit as it seems like
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  it's the main topic for hospital systems
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  and insurances today.
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  So balancing affordability
• 0:26
  and quality is a constant challenge for health
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  plans, as I'm sure you know. How is
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  your organization
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  innovating to manage the cost of care while
• 0:34
  also maintaining
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  or improving member outcomes?
• 0:39
  Yeah. Well, first of all, thanks so much
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  for having me. And, by way of background,
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  for those,
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  who maybe don't know me, I'm Stacy. I'm
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  the CEO of Mentor.
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  We are building personalized health insurance.
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  And how we're doing that is leveraging the
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  ICWA regulation.
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  That stands for individual coverage health reimbursement arrangement,
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  which is about a five year old, tax
• 1:01
  term that allows employers of any size to
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  provide cash
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  instead of a group health plan.
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  And how it works is each employer
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  sets a budget.
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  That budget is pretax for the company.
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  Each employee gets a budget, and they get
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  to decide
• 1:18
  which insurance plan is best for them. They
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  have to buy insurance to claim the money,
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  but they also
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  they don't have to use all the money
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  on health insurance, so they could decide to,
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  allocate part of that funds into a health
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  wallet. And to bring that back to your
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  question,
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  what it does for both the employer and
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  employee,
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  and also frankly for health plans as well,
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  is give this huge amount of flexibility.
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  And it also unbundles
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  this group model
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  where you have this one size fits all
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  approach. Maybe,
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  you know, what you see with employers is
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  maybe there's one person or two people who
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  really need,
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  especially if they're in the c suite, really
• 1:55
  need access to this one thing, but then
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  the whole company
• 2:00
  needs to has to pay for it in
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  term form of premiums. In this case, when
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  you unbundle it, you get each employee the
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  choice to choose, hey. What's important to me?
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  And define how they allocate funds.
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  It just creates more efficiency in market, but
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  also
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  allowing each person to, you know, really prioritize
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  how money is spent
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  based on the priorities in their life, whether
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  it is, you know, managing diabetes or planning
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  for a new family or, you know, maybe
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  there there's nothing going on in their life
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  that they're concerned about today. Maybe they can
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  focus on wellness and prevention and direct that
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  money there.
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  So that's how we're doing that today.
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  Wonderful. Thank you so much for giving us
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  that background. I'm sure it will be useful,
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  within our conversation
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  today.
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  And then kind of to move on, in
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  an ever evolving,
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  regulatory
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  landscape,
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  what best practices or tools does your organization
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  rely on to keep the quality of care
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  at the forefront?
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  That's a great question.
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  So the North Star for our organization
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  is always thinking about the individual and the
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  family and making sure that they get what
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  they need at the right at the best
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  price point. And so if you prioritize that
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  I know it sounds very simple, but if
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  as long as you're prioritizing the member and
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  really thinking about their journey,
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  then, you know, a lot of things flow
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  from that. And that's actually where, you know,
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  our model is actually quite innovative in that
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  you put the spending power in the hands
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  of the family.
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  And so that's how we're doing it today,
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  and that's where we're excited that regulatory
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  change, especially recent regulatory changes made that happen.
• 3:40
  Yeah. Yeah. Definitely. And addressing health,
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  equity has become a critical focus for many
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  health plans. As, again, I'm sure you know,
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  it's a big topic whenever I I really
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  talk to a health plan,
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  executive. Can you share an overview of a
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  key initiative here that you're involved in or
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  particularly,
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  excited about?
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  One thing that we're especially excited about is
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  thinking about different,
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  very niche user journeys. So, what I what
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  I mean by that actually, this one's not
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  that niche, but it's very, very overlooked.
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  Helping moms, new moms,
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  financially plan their health care journey. So we
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  all know
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  pregnancy delivery in America
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  costs, an astronomical number, like 18,000,
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  and that's actually that's when things go well.
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  It could be much more than that if,
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  you know, you have a complex
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  pregnancy.
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  And what we do is we look at,
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  you know, here if you if you got
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  this budget from your employer,
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  what's how do we maximize it to basically
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  lower the cost of care
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  for a new mom or, you know, a
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  second time mom or third time mom, but
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  really think about,
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  lowering the access to care burdens, that maybe,
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  like, you know, the cost drivers that are
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  keeping people away from getting the prenatal or
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  postnatal care they they need and also, you
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  know, just making it more,
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  you know, having a family more accessible
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  to more Americans as well.
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  Yeah. Yeah. Definitely. Well, helping new moms is
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  an amazing initiative, and I actually haven't talked
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  to someone else who's talked about this. So
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  that's amazing.
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  And kinda going in with that, member satisfaction
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  is essential to thrive in today's competitive health
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  care market.
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  I'm sure the mothers are very satisfied with
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  this focus.
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  But what experience or engagement strategies have proven,
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  effective
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  for your organization so far? How are you
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  measuring the,
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  the success?
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  So we measure the success of, in terms
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  of member satisfaction
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  in multiple ways.
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  Monthly
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  customer satisfaction scores,
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  you know, also satisfaction scores
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  at each point
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  of engagement
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  with our customers. And we're proud to say
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  we've actually had a 98%
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  customer retention,
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  in every year that we've operated as a
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  business.
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  And key to that is actually,
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  that level of personalization.
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  So one thing that's really scary is, you
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  you know, when you give,
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  when you at the employer level, when you,
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  walk company through this model, it's a lot
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  of change. And so we actually have very
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  hands on account managers who are who we
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  see as partners
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  to our clients, and we're there to be
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  right in the thick of things and really
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  take things off of their plate and work
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  in partnership with them. And then on the
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  employee side, when you give somebody a budget
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  and you say, alright.
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  You know, this is now up to you.
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  That can be overwhelming in health care. So
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  they really do need
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  a guide, and part of that guidance is,
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  you know, delivering the form of technology. But
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  we always believe that you should always have
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  somebody you could talk to about, you know,
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  your really personal needs and really make it
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  about you. And I think that,
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  you know, instead of maybe, you know, having
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  a general like, we talked about moms earlier
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  in this podcast. Instead of talking generally about
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  moms,
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  we're able to say, hey. This is your
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  pregnancy,
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  like, your child, and really personalize that plan
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  for each person. And that's what really makes
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  a difference and also what I think has
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  led to that satisfaction score as well.
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  Yeah. Yeah. Definitely. Well, the net,
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  promoter score is a powerful indicator
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  of member loyalty and satisfaction.
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  How are you using NPS to drive meaningful
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  improvements across your health plan?
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  Yeah. So we we look at,
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  basically,
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  we look at
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  any friction points, and that drives our product
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  road map. And, you know, and then we
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  keep measuring it until that friction point has
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  gone away.
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  And looking at,
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  how do we boost that NPS score and
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  really just keep keeping customer at the North
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  Star. And the biggest gift any customer gives
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  you is is constructive feedback.
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  So really making sure that we take that
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  seriously and then act upon it with haste.
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  Yeah. Yeah. Definitely. Well, we've talked about how,
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  how it's imperative to reduce cost, improve quality,
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  and advance health equity.
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  But,
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  obviously, these are not small task,
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  and it takes a bit of time. How
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  do you approach aligning these priorities in your
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  organization's
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  strategic vision?
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  Great question. So
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  I would say to that,
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  the customer is always the North Star. So
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  coming back to that comment we made earlier,
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  it's really about the individual. It's about the
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  family. It's about the employer. And this also
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  you know, we also think about the larger
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  ecosystem in which we play and whether we're
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  talking about payers,
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  in terms of insurance carriers or,
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  you know, health systems and providers
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  and really just making sure that we're creating
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  you know there's a lot of actors. And
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  because of that, there's a lot of noise.
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  And so, you know, we assign a North
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  Star, which
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  is around the individual and the family.
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  But
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  we also believe that creating as many win
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  wins as possible across the ecosystem, you know,
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  helps us do our job better. And so
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  we
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  And
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  so
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  what we spend a lot of time on
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  is
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  making sure we're understanding how our partners work
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  and also what their incentives are.
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  And so, you know you know, it's often
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  easy to say, hey. I demand this of
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  you, or why don't you do this better?
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  But making it two way of saying, you
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  know, we could probably be better too. And
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  how do we make this a win win
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  for us as for all?
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  And,
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  so but also just making sure that, you
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  know, you have to pick a focus point
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  and you can't,
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  boil the ocean. So, you know, of all
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  those actors, we've, you know, definitely decided, okay.
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  This one is the priority actor and everything
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  else is in service of that that person,
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  and that also clarifies decision making as well.
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  Yeah. Yeah. Thank you so much for explaining
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  that. I'm sure other people will definitely take
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  that, into consideration.
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  And, Stacy, before I let you go, looking
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  ahead, what do you see as the biggest
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  opportunity for payers
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  to really lead the, change and transform,
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  transforming care delivery and driving better outcomes for
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  all stakeholders?
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  Really, how can leaders take a step in
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  this direction now?
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  Yeah.
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  I think keeping track of the most important
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  thing right now is keeping track of everything
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  that's happening,
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  which I you know, that's whether it's AI
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  or regulation, there's a lot. And, actually, what
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  I think we're about to see and for
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  anybody listening to this podcast or this episode,
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  I would encourage you to take a look
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  at ICRA, get to know it. It is
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  a new way to pay for health care
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  entirely, and there's new regulation even as of
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  this week being considered in the house of
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  representatives.
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  And
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  the,
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  on top of that, the technology change that
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  is happening alongside it,
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  the future I see is that we're gonna
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  see increasing personalization
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  where you know? And I think the consumer
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  is gonna demand it as well.
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  And we're kinda going back to you know,
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  instead of being able to talk about categories
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  in general terms, like whether it's, you know,
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  we're talking about conditions or we're talking about,
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  populations or we're talking about geographies,
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  that people will wanna see, you know, this
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  is the plan for me
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  and really be able to custom fit that.
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  And I think that's the next chapter of
• 11:35
  health and health care and health insurance.
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  The law is here. The technology is here.
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  It's just a matter of time at this
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  point.
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  And,
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  keeping up to date with all the things
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  that are changing, I think, is really, really
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  crucial at this moment in time.
• 11:52
  Absolutely. I completely agree, there. And thank you
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  so much for those final thoughts. It's definitely
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  been a very informative discussion. So, again, I
• 11:58
  wanna thank you so much for coming back
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  on Beckley's Health Care. I look forward to
• 12:02
  connecting with you again soon.
• 12:04
  Likewise. Thank you so much.