Latest / Becker’s Healthcare Digital Health + Health IT / Casey Hossa, Chief Information Officer & Security Officer at Health New England

Transcript

Casey Hossa, Chief Information Officer & Security Officer at Health New England · Becker’s Healthcare Digital Health + Health IT

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healthcare podcast.
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I'm thrilled today to be joined by Casey
1:37
Hossa, chief information officer and security officer at
1:39
Health New England. Casey, it's a pleasure to
1:41
have you on the podcast today.
1:43
Laura, it's a pleasure to be here. Thanks
1:45
for the opportunity.
1:46
Well, absolutely. And I'm excited to have you
1:48
on the line today because I know there's
1:50
so much happening in changing in the digital
1:52
transformation
1:54
in the health care space and particularly
1:56
around security as well. Just being a big
1:58
focus this year, we've seen some really big,
2:01
breaches and challenges in the cybersecurity space. And
2:04
so I'm looking forward to learning a little
2:06
bit more about your perspective on how you're
2:08
thinking about,
2:10
you know, what you're doing today and and
2:11
growing in the future. But before we dive
2:13
into my discussion, can you tell me a
2:15
little bit more about yourself and, your background?
2:18
No. I'm happy to.
2:20
You know, I I,
2:22
I spent the last couple of decades in
2:23
health care, but, probably early in my health
2:26
in my career,
2:28
I spent a lot of time in almost
2:30
every industry outside of health care.
2:32
Right? And so a lot of it's been
2:34
focused on, you know, organizations like Deloitte and
2:37
Ernst, where we brought innovative solutions forward.
2:39
And so the past couple of decades, I've
2:41
really spent quite a bit of time across
2:44
a couple of different organizations in the healthcare
2:46
vertical.
2:47
I spent some time at, actually, here in
2:50
Chicago, one of the largest privately held loose
2:52
plans, HCSC.
2:54
And then I had the opportunity to be
2:56
a CIO,
2:57
for a provider system, a 9 hospital provider
3:00
system in Washington State,
3:02
then pivoted and took an opportunity to really
3:05
drive something different in the world of Medicaid,
3:07
specifically with duals and
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behavioral health. And I was the CIO in
3:12
that space.
3:13
And I joined,
3:15
Health New England
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just about 3 years ago.
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And what's interesting with Health New England is
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we're a provider owned payer
3:23
in Western Massachusetts. So it's a great opportunity
3:25
to think about how do you bring together
3:27
sort of
3:29
the relationship,
3:30
being a provider owned organization and and get
3:33
address some of the friction points and opportunities
3:35
to to really have a strong relationship with
3:39
the providers in this space, and specifically our,
3:42
you know, our parent company,
3:44
and have an impact for our members.
3:47
And so quite a bit of work across
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a number of dimensions in this space.
3:52
Well, it's great to hear. You know? And,
3:53
certainly, I can imagine each different experience has
3:56
given you different tools and,
3:59
abilities to, you know, jump in and, as
4:01
you said, be primed for some of the
4:03
challenges and opportunities in the health care space
4:05
today. And I know, like you were mentioning,
4:08
that relationship between the providers and the, health
4:11
care organizations as well as the payers, it
4:13
seems like across the board is becoming more
4:15
and more essential to have that,
4:17
you know, kind of strong relationship
4:20
between them as health care continues to evolve.
4:22
So that's really fascinating to see.
4:25
From your vantage point, what are some of
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the opportunities and headwinds that you have your
4:29
eye on right now?
4:30
You know, I I think all of us
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are looking at some of the same areas,
4:35
but
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specifically in our region,
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right, we've got some unique opportunities and challenges.
4:41
And so I think Massachusetts
4:43
in particular really is a microcosm
4:46
of national trends,
4:48
because we're often very progressive in terms of
4:50
our policies,
4:52
and just early adoption of healthcare innovations.
4:55
And, I think the areas that we're focused
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on in terms of potential opportunities are similar
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to many of the other payers, I would
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assume.
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And a lot of this has been sort
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of the onset recently of AI, right? And
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I think there are some publications out there
5:11
that begin to talk about what AI can
5:14
potentially do in the payer space with some
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significant savings on the administrative cost side,
5:20
savings on the medical cost side,
5:22
as well as improvement in revenue. And so
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we're certainly like many other organizations thinking about
5:28
how do we get that established, what are
5:29
the opportunities and how do we begin to
5:32
understand how to apply those technologies to really
5:35
those broader problems that are out there?
5:37
You mentioned it, digital transformation,
5:40
right?
5:41
And I think for us, we live in
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a region that's pretty tech savvy, and oftentimes
5:46
are early adopters.
5:47
They were early adopters of EHRs. So it
5:49
really provides a nice fertile ground for us
5:52
for additional innovation.
5:54
And so how do we we're looking at
5:56
how we continue to enhance customer experiences
5:59
and drive things that are focused on data
6:02
integration, so that we can take advantage of
6:04
the broader healthcare ecosystem
6:06
and provide a much more personalized experience.
6:10
The other areas that we're focused on are
6:12
things that are
6:14
you know, again, I had been out in
6:15
the market for a while, but I think
6:17
we're getting to a place where the maturity
6:19
and the tools have really helped us begin
6:20
to emphasize
6:22
things like, you know, value based care with
6:24
quality and cost effectiveness, right?
6:27
And, you know, developing much more,
6:30
I'll call it, robust risk adjustment models,
6:33
care management programs.
6:36
Again, looking at the region, you know, we've
6:39
got aging population, right? And so it creates
6:41
significant opportunities for Medicare Advantage Plans. And so
6:45
we're looking at how do we begin to
6:46
differentiate ourselves like others,
6:48
better understanding our members, offering up tailored products,
6:52
tailored benefits.
6:53
I think the other areas that are, again,
6:56
focused
6:57
on opportunities are telehealth and telemedicine. And I
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think everybody is looking at and we are
7:03
as well at how can we kind of
7:04
expand on the promises that have been out
7:06
there, especially for rural areas,
7:09
things like clinically integrated
7:12
information exchanges, right? Again,
7:15
how do we take advantage of that and
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bring that forward?
7:18
And then I would say,
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like everyone, we're always exploring risk bearing arrangements,
7:23
right? Care coordination,
7:25
enhanced population health outcomes,
7:27
and all those, I think, really are just
7:29
good opportunities.
7:31
I think in the conversation, you talked a
7:33
little bit about headwinds,
7:36
right, as part of the question.
7:38
I would say,
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you know, the health care industry is just
7:41
heavily regulated.
7:43
Right? And so
7:44
Massachusetts
7:45
often leads the way in terms of implementing
7:47
new policies.
7:48
And so, you know, like all organizations, we're
7:51
very much focused on compliance and regulatory, how
7:54
do we develop the expertise to navigate the
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complex environments.
7:58
And I think as a CIO, what that
7:59
means is oftentimes we've got to be pretty
8:02
agile in responding to updates to IT systems.
8:06
You know, talent and retention
8:07
is a big part of what we were
8:10
focused on. There's always, you know, an opportunity
8:13
to take advantage
8:14
of talents and data analytics,
8:16
cybersecurity,
8:17
digital health.
8:19
You know, there's we I mentioned digital
8:22
transformation, but consumer expectations are
8:25
there's an easy button out there. Right? There's
8:27
a there's a rise in health care,
8:30
and health consumer expectations
8:33
around personal access, right, transparent services,
8:37
making sure that everything's offered in advance, right,
8:40
being insight, identifying the next steps,
8:43
you know, and the associated digital platforms
8:46
and messaging that comes along with that.
8:48
Because I think all of us, you know,
8:50
and I think retail has been ahead of
8:52
the game in a lot of ways,
8:54
just reset the customers and consumer expectations for
8:58
personalized care, convenient access,
9:00
right, transparency
9:01
and cost,
9:03
and making sure that and you've you mentioned
9:04
it at the start of this. Right? How
9:06
does all this maintain how do we maintain
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sort of a security
9:10
and compliance associated with this critical space?
9:13
And and I think
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there's a number of dimensions associated with that.
9:18
One of them actually is in the world
9:19
of AI, there's a lot more automation across
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the tool sets in the security space that
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allow us to
9:25
put more quickly understand patterns and
9:29
opportunities
9:30
to almost automatically
9:32
turn things off and turn off risk areas
9:34
and isolate, challenge areas where you might have
9:38
some unusual patterns that occur.
9:41
And so I think all of these really
9:43
provide a set of headwinds and opportunities, right,
9:47
hand in hand.
9:48
And so ourselves along with others are continuing
9:51
to look at and invest appropriately
9:54
to help us you know, in terms of
9:56
long term success and and, again, delivering value
9:59
to our members and and,
10:01
the community.
10:03
That's fascinating to hear, you know, and really
10:05
a lot of the things you mentioned, all
10:07
coming together, whether it's looking at some of
10:09
the areas where, you know, you can,
10:12
optimize the value based care, the quality, the
10:14
cost effectiveness,
10:16
and then integrating
10:17
systems, the digital transformation to be able to
10:19
better coordinate care and,
10:22
facilitate the flow of information.
10:24
And then to thinking about that consumerism aspect
10:27
and how patients and their,
10:30
you know, demand for care and the experience
10:32
that they want from their health care journey.
10:34
It's just it's been really fascinating to see
10:36
how all of those things,
10:38
are changing the way health plans and health
10:40
systems are operating and and, you know, thinking
10:43
about what they need in order to be
10:45
successful in the future.
10:47
You hit all the right buttons.
10:49
No question about it. And it's not not
10:51
an easy task to pursue. Right? There's a
10:53
lot of coordination, a lot of complexity to
10:55
all of it.
10:57
And, you know,
10:58
there's a there's a element of this associated
11:01
with personal privacy.
11:03
We're talking about we're not talking about, hey,
11:05
Casey is getting this pair of shoes on
11:07
Saturday that he ordered
11:09
on Amazon. We're talking about individual health care
11:13
and things that are very personal. And sometimes
11:16
disease management and chronic
11:18
disease management that gets
11:20
pretty complex.
11:21
And there's a lot of interactions across
11:24
caretakers and
11:26
the health payer, etcetera. So
11:28
a lot of complexities. If it was easy,
11:30
I think it would have been done already,
11:32
right. People would have figured it out and
11:34
there'd been an easy button.
11:37
Yeah. Absolutely.
11:38
You know, I I think a lot of
11:40
executives and leaders in the health care space
11:42
wish that easy button,
11:44
existed in front of them. But, you know,
11:47
I I know it's a lot more complicated
11:49
than that as you mentioned. Otherwise, you know,
11:50
we would be in a different place, today.
11:52
But how are you thinking about growth and
11:55
adding value overall in the future? What does
11:57
that look like for you, especially on the
11:59
technology and security side?
12:02
Yeah. For us, it's a continued focus on,
12:05
digital transformation
12:07
innovation.
12:08
Right?
12:08
You know, there's there's a lot of cloud
12:10
based platforms. There's a lot of automation with
12:13
AI that we're taking a look at and
12:14
thinking about.
12:15
And again, how do we deliver those through
12:18
mobile apps, telehealth services,
12:21
omnichannel capabilities.
12:22
I spent quite a bit of time early
12:24
in my career with in a number of
12:26
other industries.
12:27
And so these concepts have been around for
12:30
decades.
12:31
They just need to be implemented differently in
12:34
each of the industries.
12:36
Data analytics and AI,
12:38
in fact, I just finished
12:40
some individual coursework at the University of Chicago
12:42
because there's so much to be harnessed
12:46
with AI and some of the models, AIMO
12:49
and some of the data models that are
12:50
out there and the insights that you're able
12:52
to get. And so much of it is
12:54
really focused on making sure that you've got
12:56
good clean data
12:58
that you can make good decisions on. And
13:00
that's always been a constant struggle,
13:03
you know, for decades. And it's been in
13:05
almost any industry and health care even more
13:08
so just because of the privacy
13:10
associated with so much of that information
13:13
and the compliance and regulations that we need
13:16
to apply.
13:17
All of us are focused, I think, on
13:19
cybersecurity and data privacy. It just has to
13:21
be, right. It's we've got to protect our
13:25
sensitive member data. We've got to ensure regulatory
13:27
compliance.
13:29
It's a top priority for all of us.
13:31
And there's a lot of sensitivity to it,
13:33
not only in the industry, but across the
13:35
leadership. And that's been
13:37
really positive. I think the one positive maybe
13:40
out of it is
13:41
everybody's focused on it, everybody recognizes the importance
13:45
of it. And I think it just puts
13:47
us in a much better place to put
13:49
you know, 0 trust security frameworks,
13:52
encryption safeguards across all platforms.
13:56
I think,
13:57
you know, I talked a bit about AI
13:59
and data.
14:01
And this particular industry is so rich in
14:01
information, right? And
14:02
different
14:04
organizations,
14:05
providers, payers, and the platforms, I think can
14:06
really
14:18
differentiate and create a level of growth and
14:20
value for organizations.
14:22
And we've talked about the other pieces, right,
14:24
member experience with technology, cloud computing platforms that
14:27
allow us to move some things forward.
14:30
We
14:30
those things are just not buzzwords, they're reality.
14:34
We've been able to see that. I've seen
14:36
this in many organizations as well as ours
14:39
today.
14:40
We're able to move things much quicker
14:43
and deliver solutions much more effectively
14:46
and reduce the cycle times
14:48
associated with some of these platforms and the
14:51
experiences and the learnings that have been had
14:53
over the course of time.
14:55
And so we've been able to do a
14:57
lot, I think, in a short window for
14:59
a small organization taking advantage of these,
15:02
you know, oftentimes off the shelf capabilities.
15:06
And then I would say maybe some of
15:07
the other things that are out there maybe
15:09
further out,
15:10
Laura, are things like,
15:13
I've I've been in technology for decades, so
15:15
I'm always a big fan of what you
15:16
can do.
15:18
But, you know, blockchain, again, because it enhances
15:21
security.
15:21
There's transparency.
15:23
There's an efficiency of transactions. And so, you
15:24
know, I'm hoping that, as we look a
15:24
little
15:25
I'm hoping that, as we look a little
15:28
further out, those are sort of the technologies
15:31
that we can begin to take advantage of.
15:33
And then the other piece that's out there
15:35
is there's been a pretty significant pivot over
15:38
the course of time here where a lot
15:40
of organizations,
15:42
especially tech companies, startups,
15:44
and in the Massachusetts
15:45
region, right, we just got so many of
15:47
those because it's a pretty tech rich area.
15:51
There's a lot of collaborations, not only across
15:53
peers, but with some of these, organizations
15:55
and
16:01
solutions that address
16:03
health coaching and chronic disease management. So
16:07
a pretty long winded answer to
16:10
sort of
16:12
the opportunities for for growth because I think
16:14
there's quite a few of them in this
16:16
particular space.
16:18
Well, that's exciting to hear. And, certainly, you
16:20
know,
16:21
having that ability as we've talked a little
16:23
bit about,
16:24
just the automation, the technology, the artificial intelligence,
16:27
then blockchain too, making come back into the
16:30
conversation in health care in a meaningful way,
16:33
is just fascinating. And I I can imagine
16:36
from your perspective looking on the technology side
16:38
and seeing all the challenges that we've talked
16:40
about in in ways that,
16:42
the technology can streamline that is really helpful.
16:46
But on the flip side, I I know
16:47
just thinking about the economics of health care
16:50
today, every dollar is precious. So, you know,
16:52
when you're looking at these growth opportunities and
16:55
technology and consuming,
16:58
optimize,
16:58
from the capabilities that you have, what is
17:01
one risk or investment that's still worth making
17:03
this year even if you even have a
17:05
tight budget?
17:07
In in my opinion, I think it's really
17:09
the,
17:11
risky but rewarding investment of continuing to expand
17:15
into value based care. Right?
17:17
It's just it's a high stakes investment, right,
17:20
for for for payers as you begin to
17:23
dive deeper into
17:25
VBC models, right,
17:27
because it's complex and it's a risky endeavor,
17:30
but the potential awards I think are substantial,
17:33
right.
17:34
The opportunity to improve
17:37
top health outcomes,
17:39
taking on more risk, greater incentive, the opportunity
17:43
to focus on preventative care, chronic disease management,
17:46
the integration of Cures and its corresponding solutions,
17:51
the stronger
17:52
provider
17:53
partnerships that can lead to better care and
17:55
delivery and overall,
17:57
hopefully, reduced cost. Right? And we've talked about
18:01
this, right, that the relevant communication
18:04
services
18:06
and anticipating member needs. So sort of that
18:09
personalized member experience, right?
18:11
That I think is important.
18:13
And I
18:15
believe that we've made so many strides forward
18:19
in data analytics,
18:21
right, that give us the opportunity to begin
18:24
to, especially with the interoperability and exchange of
18:28
some very important information,
18:30
the opportunity to do the analytics around it
18:33
and really begin to be better prepared
18:36
and understand the risk and understand the complexity
18:39
and respond appropriately and take actions. And a
18:42
lot of that takes
18:44
a level of trust that's developed,
18:47
across organizations,
18:49
to be able to do that effectively.
18:52
And so the tools and the information and
18:54
the insights that are coming out, if you
18:56
can begin to build that trust relationship and
18:59
leverage those tools, I think
19:01
it is the one investment that,
19:04
feels, I think, benefits.
19:06
And,
19:07
honestly, at the bottom line, right, improves the
19:09
patient's health and outcomes and and
19:12
a significant impact to quality. So I think
19:14
it's the one area that so many technologies,
19:17
we talked about
19:19
digital transformation
19:20
and AI and data and interoperability, but they
19:23
sort of all converge
19:25
to be able to
19:26
make this kind of an impact.
19:28
So, I I think it's the the one
19:31
space that's worth the worth investment
19:34
for for organizations.
19:37
That makes a lot of sense. And, you
19:39
know, it's just fascinating to see how,
19:41
the value based care,
19:44
has evolved, especially in the last 5 to
19:46
6 years or so. I know in the
19:48
past, there's been energy around it and then,
19:50
you know,
19:51
not as much movement, and actually implementing it
19:54
on the provider side for many organizations than,
19:57
you know, still having to be in the
19:59
fee for service world to some degree and
20:01
not moving
20:02
as quickly as they probably could into value
20:05
based care. And so, you know, when you
20:07
look at,
20:08
what's happening today, is there anything that, you
20:10
know, you're doing differently or that you're seeing
20:13
a different,
20:14
type of,
20:15
approach to, I guess, in order to really
20:18
make sure that, you know, these types of
20:20
investments and, the move towards value based care
20:23
in more risk based models is something that,
20:26
you know, is gonna stick and be meaningful
20:28
for organizations in years to come.
20:31
Yeah. I mean, I think it's the,
20:33
it's the advantages that some of the technologies
20:35
and some of the data and some of
20:36
the insights,
20:38
are are bringing,
20:39
And and some of the AI components as
20:41
well. Right? I mean, we all behave differently.
20:44
We all respond differently. And and the the
20:47
the patient engagement and and their active engagement
20:50
in the process is so critical.
20:52
And so I think that's sort of
20:55
the the pivot. Right?
20:56
The the opportunity to to gain more insight,
20:59
to be able to to to set the
21:00
right incentives, right, to be able to make
21:02
the right connections.
21:04
And then I I think the other element,
21:05
and I mentioned this a bit about,
21:07
the data outside of it. Right? We're also
21:10
so focused on
21:12
integrating information and, oftentimes, clinical information. But in
21:16
addition to that,
21:17
there's been quite a bit of focus on
21:19
social determinants of health, right, and addressing social
21:23
needs,
21:24
the things you would expect, housing, food and
21:26
security, transportation,
21:29
but also, you know, collaboration with
21:32
local organizations and
21:34
and, trying to track the effectiveness of some
21:37
of these initiatives that sort
21:40
of adds
21:41
to, I think, the overall success,
21:43
that you can create in this space.
21:45
But a lot of it is just evolving
21:47
to a place that's much better. And I
21:48
actually think there's
21:50
a space
21:52
having spent some time in the provider world,
21:54
there's,
21:55
and so there's this Utopian precision medicine opportunity.
21:59
But I think there's also
22:01
an opportunity on the payer side
22:03
to get to
22:05
a much more view of
22:09
a position plan almost, right?
22:11
And one that
22:13
fits
22:14
the individual that fits the need.
22:16
And so I think
22:18
there's an opportunity
22:20
as a in the marketplace, right,
22:22
that begin to think about how do we
22:24
do that and what does that take
22:26
us in the long term.
22:29
That makes a lot of sense. And I
22:31
I feel like, as you mentioned, just the
22:34
type of, technology and insights and ability to
22:38
really make strong decisions based on that information
22:41
and data,
22:43
it does make a difference. Now, Casey, before
22:45
I wrap up here, I'm wondering,
22:47
what are some of the opportunities you're most
22:49
excited about for the future? How are you
22:51
looking at growth and,
22:52
really, moving forward over the next couple of
22:55
years?
22:56
You know, for us,
22:58
it's really the the digital transformation
23:01
opportunity. Right? It's understanding how we can begin
23:04
to take advantage of,
23:06
I'll just say, AI.
23:09
And a lot of this is gonna be
23:10
a bit of,
23:12
I don't know, maybe trial and and and
23:14
testing and,
23:16
figuring out where it makes the most sense
23:18
and what we can begin to do with
23:20
it.
23:21
But I would say,
23:23
when you take a look at it, there's
23:25
there's opportunities
23:26
across
23:27
care management,
23:29
care coordination,
23:30
improving our,
23:33
I'll call it, our overall medical cost. There's
23:36
opportunities
23:37
in reducing some of the administrative,
23:40
and friction that's associated with
23:43
some of the existing processes that are oftentimes
23:46
very manual
23:48
and paper based to some degree and maybe
23:50
not paper, but
23:52
faxes that are still used in the industry,
23:54
etcetera.
23:56
And then I mentioned a bit about tailored
23:59
or maybe more precision plans, right? But I
24:02
think
24:03
in optimizing how you
24:06
create you know your member and you know
24:08
the communities and you know the market.
24:11
How do you begin to
24:13
improve and bring that information together and deliver
24:16
a much more
24:18
insightful set of products and plans
24:21
and do the right outreach
24:24
with the right connection and digital experience
24:27
to maintain
24:28
the number retention and and to build on
24:30
that relationship and to really create a trusting
24:31
relationship. Because I think in this particular space,
24:33
there's,
24:34
so much that so much good that that
24:37
is being done and that can continue to
24:39
be done.
24:44
And being able to highlight that
24:46
and to share that and to build that
24:49
relationship versus
24:50
a transactional
24:51
relationship, right?
24:53
I get an EOB or I get a
24:54
bill from a provider and
24:57
how do you take it forward, right? How
24:58
do you begin to look at what detail
25:01
is done in terms of understanding where you
25:04
left off and what you might be looking
25:05
for next?
25:07
And so
25:08
I think those are just areas for growth
25:11
as we go forward.
25:13
And I'm pretty excited about the opportunity to
25:15
bring these things and these technologies together and
25:18
see how we can impact
25:20
them in a positive way, our member base
25:22
and and the quality of the quality of
25:24
health and and the outcomes associated with it.
25:27
That's amazing to hear it. Casey, thank you
25:29
so much for joining us on the podcast
25:30
today. This has been such a fun and
25:32
informative conversation, and I look forward to connecting
25:34
with you again soon.
25:36
Laura, it's been it's really been a pleasure.
25:38
I always love talking about this.
25:40
It's it's been a space that I've been
25:42
focused on for
25:44
way longer than I wanna admit.
25:47
And, it's just such a space that, you
25:49
know, all of us experience
25:53
and need, right,
25:54
at different levels at different points in our
25:56
life. But,
25:57
it's so important. And,
26:00
I'm looking forward to seeing what we're going
26:01
to be able to do in the future
26:02
and really appreciate the opportunity to come on
26:04
here today and
26:06
share a little bit of my thoughts with
26:08
you in the audience.