Latest / Becker’s Healthcare Podcast / Inside UnitedHealth Group’s AI and Technology Strategy with Jakob Emerson

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Inside UnitedHealth Group’s AI and Technology Strategy with Jakob Emerson · Becker’s Healthcare Podcast

• 0:02
  - GLP ones, Medicare Advantage Headwinds, a Medicaid landscape
• 0:06
  - that looks different
• 0:07
  - every quarter.
• 0:09
  - Their leadership right now means making durable decisions
• 0:11
  - in an environment that keeps moving, and the
• 0:13
  - organizations pulling ahead are the ones that stopped
• 0:16
  - waiting for stability
• 0:18
  - before acting.
• 0:19
  - Becker's fifth annual fall payer issues roundtable convenes
• 0:22
  - more than 500
• 0:24
  - executive level attendees
• 0:25
  - and 70 plus speakers November second and third
• 0:28
  - at the Swiss Hotel Chicago.
• 0:30
  - Two days of senior level dialogue on affordability,
• 0:33
  - benefit design, value based care, and the strategies
• 0:36
  - shaping how care gets financed
• 0:39
  - and delivered, featuring a celebrity keynote from pro
• 0:43
  - football hall of famer, Emmitt Smith. Agenda and
• 0:46
  - registration at beckerspayer.com.
• 0:48
  - Click events in the upper right.
• 0:50
  - This is Scott Becker with the Beckers Health
• 0:53
  - Care Podcast.
• 0:54
  - And I'm thrilled today to be joined by
• 0:56
  - brilliant journalist and leader, Jacob Emerson.
• 0:59
  - Jacob covers the payer side and does it
• 1:02
  - better than anybody in the country.
• 1:04
  - Jacob,
• 1:05
  - usually, you take us through a couple issues,
• 1:07
  - stories that you're following, That's when we just
• 1:09
  - set this up for our audience.
• 1:11
  - What are you watching currently in in the
• 1:13
  - payer arena, the payer sector? What's top of
• 1:16
  - mind currently?
• 1:17
  - Yeah. For sure. Well, good to talk to
• 1:18
  - you, Scott. It's been a while.
• 1:21
  - I thought today we could take things in
• 1:23
  - a slightly different direction in terms of something
• 1:26
  - that I actually went to in person last
• 1:28
  - week,
• 1:29
  - recording this at the end of June.
• 1:31
  - And
• 1:32
  - it it led to a lot of, I
• 1:33
  - would say, different stories or different
• 1:36
  - insights,
• 1:37
  - that I can kinda detail for you. But
• 1:39
  - I but I think it's important here because
• 1:41
  - it's about UnitedHealthcare,
• 1:43
  - UnitedHealth Group, of course, the largest insurer in
• 1:46
  - the country. So often the ones, you know,
• 1:48
  - kind of a bellwether for where the industry
• 1:50
  - is going,
• 1:51
  - and really definitely the one I would say
• 1:53
  - innovating within the industry often.
• 1:55
  - And last week, I was, I was grateful
• 1:58
  - I got to go to their corporate headquarters,
• 2:01
  - just outside of Minneapolis and meet with,
• 2:05
  - the the vast majority of their senior executives,
• 2:08
  - all the way up to the the the
• 2:09
  - CEO of UnitedHealthcare
• 2:11
  - and the CEO of Optum and then a
• 2:13
  - lot of their division CEOs
• 2:15
  - completely on the record and,
• 2:17
  - no topics barred in terms of what we
• 2:19
  - were allowed to ask them. And then a
• 2:21
  - full eight hour showcase,
• 2:23
  - all over the company and its multiple campuses,
• 2:26
  - giving myself and a few other,
• 2:28
  - reporters a full tour on what the company
• 2:31
  - is working on right now and kind of
• 2:32
  - where it sees itself going as a business
• 2:35
  - moving forward.
• 2:37
  - Fascinating. And and talk to us a little
• 2:38
  - bit about some of what you learned
• 2:41
  - and and and heard when when there.
• 2:44
  - Yeah. Definitely. And I think, you know,
• 2:46
  - the context even was really fascinating for me
• 2:49
  - because I think anybody
• 2:52
  - operating within this industry knows that
• 2:54
  - in the past, especially, even maybe three three
• 2:57
  - years ago or so,
• 2:58
  - United could keep itself a little bit more
• 3:01
  - closed off.
• 3:02
  - And I and I don't think they were
• 3:03
  - unique in that fact. I think that's just
• 3:05
  - given the nature of
• 3:07
  - insurance in this country,
• 3:09
  - and just certain and maybe even corporate culture
• 3:12
  - sometimes, but,
• 3:14
  - it wasn't as open or or wouldn't have
• 3:16
  - had an event like this, in its in
• 3:18
  - its past.
• 3:20
  - And so it was definitely a rare and
• 3:21
  - unique opportunity to get to to get to
• 3:23
  - do something like this. And then, of course,
• 3:25
  - we're coming off of,
• 3:26
  - the the the murder of the the former
• 3:29
  - CEO at the end of twenty twenty four
• 3:31
  - in New York, and then all the financial,
• 3:34
  - issues that the company had been facing over
• 3:36
  - the last couple years as well
• 3:37
  - related to climbing medical clause costs,
• 3:40
  - the reimbursement changes at the federal level around
• 3:43
  - Medicare Advantage and how that affected Optum and
• 3:45
  - all that good stuff.
• 3:46
  - So I think overall, Scott, my main takeaway
• 3:49
  - after
• 3:50
  - touring a lot of the companies, seeing a
• 3:51
  - lot of the products they're working on and
• 3:53
  - how they're trying to shift as a business,
• 3:55
  - what it what it felt like to me
• 3:57
  - was almost like a day
• 3:58
  - closer,
• 4:00
  - almost if I had been visited a a
• 4:02
  - technology company in Silicon Valley than if I
• 4:05
  - had, visited,
• 4:06
  - you know, what maybe you picture in your
• 4:08
  - head as as an insurance company.
• 4:10
  - And, you know, there was live software demos
• 4:12
  - and
• 4:13
  - lots of,
• 4:14
  - AI tools that they're that they were launching.
• 4:17
  - And I think, you know, across basically every
• 4:19
  - session, the company is presenting itself now more
• 4:22
  - as a technology and data company,
• 4:25
  - and one that can basically build
• 4:27
  - tools for its members, its patients, its customers,
• 4:30
  - but also now start to sell those solutions
• 4:33
  - to the rest of the industry. So sell
• 4:35
  - software
• 4:36
  - via Optum to to hospitals, to agencies, to
• 4:39
  - other providers, to PBMs, to other payers.
• 4:42
  - And and you have to remember as well,
• 4:43
  - they purchased Change Healthcare, the largest claims clearing
• 4:46
  - house, a few years back under Optum. Of
• 4:49
  - course, there was that massive cyber attack that
• 4:51
  - then kind of showed some of the vulnerabilities
• 4:53
  - around doing so, but they have so much
• 4:56
  - data, so much analytics now under their under
• 4:59
  - their footprint,
• 5:00
  - that they are now going in a new
• 5:02
  - direction of becoming, yeah, I'd say, kind of
• 5:05
  - a a tech infrastructure for the industry and
• 5:07
  - and then monetizing that.
• 5:10
  - Thank you. But that's sort of fascinating, you
• 5:12
  - know, example. Talk about your yourself going to
• 5:15
  - visit United for the first time,
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  - and, like, you wouldn't expect to see lots
• 5:20
  - of people in lab coats and doctors walking
• 5:22
  - around. You're sort of a a massive corporate
• 5:25
  - complex.
• 5:26
  - What what's the feel of it? What's what's
• 5:29
  - the culture? What's the feel? What what did
• 5:30
  - you, you know, pick up in being there?
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  - And was it fascinating?
• 5:34
  - Yeah. And, I mean, I think, you know,
• 5:35
  - to be fair to our audience, I I'm
• 5:37
  - sure that I was given,
• 5:40
  - you know, a a a a curated version
• 5:42
  - of what the company is like, but, in
• 5:44
  - in terms of the day to day. But,
• 5:46
  - you know, it's it's out it's located twenty
• 5:49
  - twenty minutes or so outside Minneapolis out in
• 5:51
  - the suburbs. Very sleek corporate campuses. Like I
• 5:54
  - said, very,
• 5:56
  - very nice, very modern, very, tech heavy place.
• 6:01
  - And it felt,
• 6:03
  - I would say a bit more relaxed in
• 6:05
  - terms of just, you you know, your day
• 6:07
  - to day employee. It felt like not, you
• 6:08
  - know, lots of places to
• 6:11
  - lounge, if that if that makes sense.
• 6:13
  - But just like I said, it felt like
• 6:15
  - I was in Silicon Valley versus
• 6:17
  - what you just said of, like, picturing many
• 6:19
  - people walk around in lab coats or just
• 6:21
  - a a boring corporate campus. So from that
• 6:24
  - perspective, it was great. And what did what
• 6:26
  - did the people at United have to say
• 6:28
  - about
• 6:29
  - issues you talked about? Was anything interesting? What
• 6:31
  - specifically sort of touched you or you did
• 6:34
  - resonate with you? Yeah. I you know, I
• 6:37
  - I personally think, Scott, one moment. If we're
• 6:39
  - not talking about the business side of things,
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  - you know, at at one point, you know,
• 6:44
  - we were with these people with for eight
• 6:45
  - hours.
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  - Eventually,
• 6:47
  - everyone started to get, I'd say, a little
• 6:49
  - bit more comfortable with each other than than
• 6:51
  - in the first few hours.
• 6:53
  - And it was kind of a I don't
• 6:55
  - wanna say it was an elephant in the
• 6:56
  - room, but, you know, at some point, they
• 6:58
  - they kind of, I think, had to acknowledge
• 7:00
  - what had just happened, which is their the
• 7:03
  - CEO of the insurance part of the company
• 7:04
  - being
• 7:05
  - shot and killed on the street and and
• 7:08
  - and then all of what happened afterwards in
• 7:10
  - terms of the social media outpouring. And,
• 7:14
  - I think even
• 7:16
  - within the industry, you know, some of the
• 7:18
  - the rhetoric, the hostility that the company faced.
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  - And,
• 7:23
  - the COO,
• 7:25
  - of UnitedHealthcare,
• 7:26
  - Mike Baker,
• 7:27
  - he he said to me verbatim,
• 7:30
  - or not to me, but to the to
• 7:31
  - the room of reporters,
• 7:32
  - you know, that after that all happened that,
• 7:35
  - and I quote, he said, you pause to
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  - soul search a little bit and you ask
• 7:38
  - yourself,
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  - am I missing something here? Are we really
• 7:41
  - part of the problem and not part of
• 7:43
  - the answer to the issues that exist within
• 7:45
  - the American health care system? And he said,
• 7:47
  - but I, you know, basically arguing in response
• 7:49
  - to what he had just said, saying, but
• 7:51
  - what I love about this era for our
• 7:52
  - company is that we're in a line of
• 7:54
  - work today where there is a real there
• 7:55
  - are very real needs that exist within the
• 7:57
  - system,
• 7:59
  - and those match the scale and the capabilities
• 8:01
  - of an enterprise like this that nobody else
• 8:03
  - can.
• 8:04
  - And I think he's got a very real
• 8:05
  - point there that they they do have the
• 8:07
  - data, the infrastructure,
• 8:09
  - the the executive teams,
• 8:11
  - just the the sheer capability
• 8:13
  - of,
• 8:14
  - of making change within an industry. Whether you
• 8:16
  - agree with that change or not, whether you
• 8:17
  - think it's positive or not,
• 8:20
  - that that is a company that can definitely
• 8:21
  - drive change within a pretty a pretty large
• 8:23
  - ship.
• 8:25
  - So from that perspective,
• 8:27
  - very fascinating to hear these executives speak, like
• 8:29
  - I said, on the record. I would argue
• 8:31
  - maybe for the first time in terms of
• 8:32
  - the candidness
• 8:33
  - about such a, you know, horrific event that
• 8:36
  - occurred.
• 8:38
  - Thank you. No. And I think it's helpful
• 8:40
  - that they see themselves as as part of
• 8:42
  - the solution,
• 8:43
  - not the problem, of course. But but what
• 8:45
  - a challenging,
• 8:46
  - you know, effort it is to provide
• 8:49
  - services, health care to 350,000,000
• 8:51
  - people in our country at scale
• 8:54
  - and,
• 8:55
  - you know, you know, and and and do
• 8:57
  - so in an effective way. And
• 8:59
  - they're trying to figure it out. Lots of
• 9:01
  - other trying to figure it out. Doesn't seem
• 9:03
  - like we figured it out yet. But for
• 9:04
  - 350,000,000
• 9:05
  - people, we do a pretty good job
• 9:08
  - compared to the other largest comp countries in
• 9:09
  - the world, but it is really challenging in
• 9:11
  - terms of cost, quality, and access right now.
• 9:13
  - I mean, absolutely. And I think that's you
• 9:15
  - know, critics are gonna say, okay. That's this
• 9:17
  - all is great, and you're investing a lot
• 9:19
  - in AI, and you're doing all this, this,
• 9:20
  - and that, all these new solutions.
• 9:23
  - Well, let's all let's look at the cost
• 9:24
  - trend of health care in this country, and
• 9:27
  - from a multitude of different directions. Do these
• 9:29
  - things actually help address that?
• 9:32
  - I think, you know, we'll see. Yeah. I
• 9:34
  - think and I'm definitely oversimplifying a lot of
• 9:36
  - it, but I think,
• 9:38
  - you know, they're they're definitely they're they're investing
• 9:40
  - a lot of money in AI right now.
• 9:42
  - I think $3,000,000,000,
• 9:44
  - total between this year and next year combined.
• 9:47
  - And a lot of that is is definitely
• 9:49
  - for internal use for their members. So things
• 9:52
  - like they're they've developed a an AI assistant.
• 9:55
  - They called it their version of Siri under
• 9:57
  - Apple,
• 9:58
  - to basically,
• 9:59
  - it's gonna start launching or has launched,
• 10:02
  - for for insurance members where basically
• 10:05
  - AI bots can now start to do, you
• 10:07
  - know, schedule medical appointments for you and can
• 10:09
  - call your doctor and other providers.
• 10:11
  - So utilizing AI to actually, you know, do
• 10:13
  - some of the administrative work for members.
• 10:17
  - Overall though, they said they have a thousand
• 10:19
  - AI use cases currently in production in terms
• 10:21
  - of AI, and a lot of that is
• 10:23
  - being funneled through Optum, specifically Optum Insight, which
• 10:25
  - is kinda like the tech arm of the
• 10:27
  - company. And they're like I mentioned, they're monetizing
• 10:29
  - that. They're rolling out new software solutions,
• 10:32
  - claims coding tools,
• 10:35
  - surgery, rooms, scheduling for hospitals,
• 10:38
  - just anything that can basically be automated,
• 10:43
  - more routine,
• 10:45
  - and and and sold again as a software
• 10:47
  - product is is happening.
• 10:49
  - And I think that was what my other
• 10:51
  - really large take is, wow, this company
• 10:53
  - is really becoming
• 10:55
  - a a a software company, a technology company,
• 10:58
  - as much as it is traditionally, of course,
• 11:00
  - insurance,
• 11:01
  - and maybe, you know, medical care itself through
• 11:03
  - Optum Health,
• 11:05
  - this is it felt like to me almost
• 11:07
  - like the apple of of health care that
• 11:09
  - I was attending.
• 11:11
  - So fascinating, isn't it? And and and, you
• 11:14
  - know, you get such a,
• 11:16
  - the press could be so negative on all
• 11:18
  - of it. The reality is they're trying to
• 11:19
  - figure it out, like, so many other people
• 11:21
  - are trying to figure it out. And and
• 11:23
  - I love the reference to the apple of
• 11:25
  - health care. Certainly, they would like that reference.
• 11:27
  - And and the reality is they're trying to
• 11:29
  - figure it out like so many others are
• 11:30
  - trying to figure it out. And, you know,
• 11:33
  - and it it doesn't seem like, you know,
• 11:35
  - I'll I'll I'll take it. It doesn't seem
• 11:36
  - like DC on the Republican or Democratic side
• 11:38
  - is doing a lot to help figure it
• 11:40
  - out, but there are a lot of people
• 11:42
  - trying to figure it out and trying to
• 11:43
  - make a positive difference, and I love that
• 11:45
  - perspective.
• 11:46
  - Yeah. I think one other thing I'd share,
• 11:48
  - Scott, in terms of the business side of
• 11:49
  - things,
• 11:50
  - at UnitedHealthcare, which really I thought was a
• 11:53
  - fascinating,
• 11:54
  - story right in front of me, was something
• 11:57
  - called Cove, c o v e, and it
• 11:59
  - stands for consumer operations, vitals, and experience, which
• 12:02
  - I know not a great name in in
• 12:04
  - the long,
• 12:05
  - but Cove. And it's a it's a command
• 12:06
  - it's a real time data intelligence command center.
• 12:09
  - And we walk into this large room, and
• 12:12
  - I see over 30 large flat screens all
• 12:15
  - up against each other on a wall and
• 12:17
  - about 25 employees,
• 12:19
  - in rows of desks behind them. And, basically,
• 12:22
  - this is a this is a live data
• 12:24
  - command center where they they're tracking everything that's
• 12:27
  - going on with their members all over the
• 12:29
  - country
• 12:30
  - in terms of, you know, 50,000,000 members. It's
• 12:33
  - a it's a lot of people. And so
• 12:35
  - just as an example, this isn't a real
• 12:36
  - example they gave, but let's say you've got,
• 12:40
  - 16,000
• 12:41
  - people in Alabama who cannot access some Medicare
• 12:44
  - portal.
• 12:45
  - And now at the Minneapolis headquarters
• 12:49
  - in this command center, it pings a screen
• 12:51
  - on a on a heat map of the
• 12:52
  - country, and the engineers sitting right there in
• 12:54
  - that room can then see, in Alabama, we've
• 12:56
  - got a problem with these Medicare members. Let's
• 12:59
  - then now we can we know, and we
• 13:00
  - can deploy
• 13:01
  - the company's resources
• 13:03
  - directly to that problem and get it fixed
• 13:05
  - quick versus, you know, just kind of I
• 13:07
  - don't know what exactly was happening before, but,
• 13:10
  - basically, you know, they they're they're tracking all
• 13:12
  - these digital interactions all over the country. And
• 13:15
  - so 50,000,000 members, they said they're gonna field
• 13:17
  - 78,000,000 calls this year, 200,000,000
• 13:20
  - digital interactions that they're overseeing, and they're looking
• 13:23
  - at clicks, survey comments, call transcripts,
• 13:26
  - Medicare complaints, claims data,
• 13:29
  - just really anything and anything in terms of
• 13:32
  - how their their members and their customers interact
• 13:35
  - with them digitally. And then if there is
• 13:36
  - any kind of problem, it pings right there
• 13:38
  - up on the wall, and the entire company
• 13:40
  - can basically,
• 13:42
  - address it right then and there. And I
• 13:44
  - thought that was
• 13:45
  - fascinating
• 13:46
  - because I personally I can't, you know, I
• 13:48
  - don't know for sure. I've never heard of
• 13:49
  - anything like that existing anywhere else in the
• 13:51
  - industry at the moment.
• 13:53
  - That's literally remarkable. Literally remarkable. So so fascinating.
• 13:56
  - So you learned a lot. You came back
• 13:58
  - with a new, appreciation for all that they're
• 14:01
  - trying to do, whether they're perfect or imperfect.
• 14:04
  - I think that's a really good way to
• 14:06
  - maybe summarize all of this, Scott, is and
• 14:08
  - maybe just health care in general. Certainly, as
• 14:10
  - a reporter, what you you learn is there's,
• 14:13
  - of course,
• 14:14
  - a business motive and a a profit motive
• 14:17
  - to a lot of this, but there are
• 14:19
  - very real people behind a lot of these
• 14:21
  - all of this. There's a lot of nuance
• 14:23
  - to all of the topics that we're talking
• 14:25
  - about, and it's very easy, I think, to,
• 14:29
  - make these companies caricatures,
• 14:31
  - when they're you know, you've never been there.
• 14:32
  - They're sitting up there in Minnesota, and you
• 14:34
  - just, you know, conjure up an image in
• 14:36
  - your head. But then you, you know, you
• 14:38
  - see it in real life, and you realize
• 14:39
  - there's, you know, the devil's in the details.
• 14:41
  - And,
• 14:43
  - you can't you can't
• 14:44
  - characterize these companies in any one way. You
• 14:47
  - know, that it's a company that employs over
• 14:48
  - 400,000 people. And like I mentioned, just a
• 14:51
  - very brief,
• 14:52
  - what we just mentioned with all this new
• 14:54
  - tech and stuff,
• 14:55
  - There's a lot of passion. These a lot
• 14:57
  - of these executives very clearly do care on
• 14:59
  - a human level,
• 15:01
  - but another thing I've learned within health care
• 15:03
  - is a lot it's a lot of humans
• 15:04
  - operating within very complicated,
• 15:06
  - very difficult to move systems. So not giving
• 15:09
  - a pass for any, you know, real negativity
• 15:11
  - that is out there around the company. I'm
• 15:13
  - not. Definitely taking an objective stance on this,
• 15:16
  - but I do think just nuance always has
• 15:18
  - to be considered in these conversations. But but
• 15:20
  - but but your point that there's 400,000
• 15:23
  - people,
• 15:24
  - regardless of all kinds of things, there's a
• 15:27
  - lot of people trying to do a lot
• 15:28
  - of good things. There's not 400,000 people saying,
• 15:30
  - oh my god. My job today is to
• 15:32
  - deny care. I want people to get care.
• 15:33
  - That's just not their that's just not their
• 15:35
  - their mantra, and not only they wake up.
• 15:37
  - Most people
• 15:38
  - in most health systems and most payers are
• 15:40
  - are are probably trying to do the right
• 15:42
  - thing and improve things,
• 15:43
  - whether we all agree with how they do
• 15:45
  - it or not. So I I I love
• 15:46
  - the perspective, and I and I love the
• 15:48
  - visit. Jacob, I wanna thank you as always
• 15:50
  - for sharing your thoughts on the Veterans Health
• 15:52
  - Care podcast. They're as good as they come.
• 15:54
  - And I quite frankly love the open mindedness,
• 15:57
  - the learning, the the constant curiosity. It's what
• 15:59
  - makes you a great reporter and great, great
• 16:01
  - journalist. I appreciate the kind words, Scott. Thank
• 16:03
  - you.