Latest / Becker’s Payer Issues Podcast / Inside UnitedHealthcare’s Latest Employer Health Insights

Transcript

Inside UnitedHealthcare’s Latest Employer Health Insights · Becker’s Payer Issues Podcast

• 0:02
  This is where health insurance leadership comes together.
• 0:05
  Becker's fourth annual spring payer issues roundtable brings
• 0:08
  together over 400
• 0:10
  payer and health plan executives and more than
• 0:12
  100 speakers to Chicago April.
• 0:16
  This year's event includes keynote conversations with the
• 0:19
  industry's top leaders and former president George w
• 0:23
  Bush. For the full agenda and event details,
• 0:25
  visit beckershospitalreview.com
• 0:27
  and click on the events tab in the
• 0:29
  upper right. We're looking forward to hosting you
• 0:31
  here in Chicago.
• 0:33
  Hello, everyone. This is Jacob Emerson with the
• 0:36
  Becker's Payer Issues podcast. Thrilled today to be
• 0:39
  joined by Craig Kurzweil, who is the chief
• 0:41
  data and analytics officer for UnitedHealthcare's
• 0:44
  commercial business. Craig, thanks so much for taking
• 0:46
  the time to be with me on the
• 0:47
  podcast this morning. Thanks for having me. Absolutely.
• 0:50
  And before we dive into everything we wanna
• 0:52
  talk with you about, Craig, can you first
• 0:53
  tell us a little bit more about yourself
• 0:56
  and what it is that you do at
• 0:57
  UnitedHealthcare?
• 0:59
  Sure. That sounds good.
• 1:01
  So, I lead our data and analytics,
• 1:04
  and reporting for all of our employer customers.
• 1:07
  I've been with the company for about twenty
• 1:09
  just just over twenty one years now,
• 1:11
  and I spent that entire time
• 1:13
  focused on how do we translate
• 1:16
  massive amounts of data
• 1:18
  into something interesting and hopefully actionable
• 1:21
  for our employer clients through different iterations. So,
• 1:25
  I'm a data nerd at our at my
• 1:26
  heart and love to kinda dive in to
• 1:28
  see what's happening and how we can use
• 1:29
  that data to drive better results.
• 1:32
  Fantastic. Well, in that vein, Craig, UnitedHealthcare,
• 1:34
  as you know, releases findings every year through
• 1:37
  a white paper that you do with the
• 1:39
  health action council
• 1:40
  where you analyze member data for wider health
• 1:43
  care trends.
• 1:45
  So it's the ninth year of this of
• 1:47
  this paper, that you that you've published. And
• 1:50
  I wonder if our audience might not be
• 1:51
  familiar, can you give them a sense of
• 1:53
  what exactly this report is, what data it
• 1:56
  draws from, and and how it's evolved over,
• 1:59
  nearly a decade now?
• 2:01
  Sure. I it's been a very fun journey,
• 2:03
  with the Health Action Council. It's a very
• 2:05
  unique collaboration partnership where for an analytic person,
• 2:08
  especially,
• 2:09
  because within the health action council, we have,
• 2:12
  over 225,000
• 2:14
  members within,
• 2:15
  health action council that we can leverage on
• 2:18
  a de identified basis to do these kinds
• 2:20
  of broad
• 2:21
  view studies of what's happening across the population.
• 2:24
  As you mentioned, this is our ninth year,
• 2:26
  and so we've spent a lot of time
• 2:28
  really trying to focus in on parts of
• 2:30
  the health care system maybe that haven't
• 2:32
  been focused on enough or maybe not at
• 2:34
  all, and kind of really hone in on
• 2:36
  those and give employers a unique perspective. So,
• 2:39
  for example, we've spent a lot of time
• 2:41
  in the pre COVID days, diving into generations
• 2:44
  and community health and social determinants of health,
• 2:46
  virtual care.
• 2:48
  And post COVID, we really been focused on
• 2:50
  kinda where do we go from here and
• 2:51
  what are some of the new, barriers to
• 2:54
  care and to cost.
• 2:55
  And for and we'll talk about to the
• 2:57
  this study, but really focusing on how the
• 2:59
  community has a lot to do with what
• 3:01
  happens across these populations. So it's really been
• 3:03
  a unique partnership, and that kind of membership
• 3:06
  allows you to do some really creative things.
• 3:07
  And and, honestly, the Health Action Council kinda
• 3:09
  thinking differently and allowing us the space to
• 3:12
  come up with studies that are different from
• 3:13
  the mainstream is, is is been wonderful,
• 3:16
  from an analytic person's point of view. So
• 3:19
  lots of really, really interesting ways to kinda
• 3:21
  see what's happening across the system.
• 3:23
  Absolutely. That makes a lot of sense. And
• 3:25
  I I read through the report myself. There's
• 3:27
  a lot in it, a lot of different
• 3:28
  areas of focus for employers. So I wonder
• 3:31
  if we starting off broadly, just talking about
• 3:33
  some of the results. Anything this year that
• 3:35
  surprised you?
• 3:37
  Sure. I think there's a a few things
• 3:38
  that kinda jump out to me, and I've
• 3:40
  lived in data for, like, twenty one years.
• 3:42
  And it's hard to surprise me these days.
• 3:43
  But there's a few things that I think
• 3:45
  are
• 3:45
  changing and maybe different than what people might
• 3:48
  anticipate. So as we start to dive into
• 3:50
  the data,
• 3:51
  and we're really focused in, in this study
• 3:54
  trying to look to see,
• 3:56
  how do generational
• 3:57
  and gender influences,
• 3:59
  impact
• 4:00
  what we see around cost utilization and affordability.
• 4:03
  And and of of the findings for this
• 4:06
  year, there's kinda three main areas.
• 4:08
  One being, you know, we typically assume that
• 4:11
  the younger population
• 4:13
  is,
• 4:13
  low cost, kind of invincible. Right?
• 4:16
  Not really haven't really developed a lot of
• 4:19
  chronic disease yet in their their younger population.
• 4:22
  But we're starting to see that change a
• 4:24
  bit. And we're starting to see some of
• 4:25
  those younger folks. They're still definitely lower cost
• 4:28
  and lower chronic disease than their older generational
• 4:31
  counterparts, of course. But we're starting to see
• 4:34
  them rise at a higher rate than we've
• 4:36
  seen in the past. So they're kinda catching
• 4:37
  up, so to speak to some of those
• 4:39
  older populations.
• 4:41
  And if you think about employers, typically,
• 4:44
  the focus
• 4:45
  forever has been how do we manage the
• 4:47
  risk in the older population because that's where
• 4:49
  more of the cost is driven by. This
• 4:51
  might change, some of those strategies or maybe
• 4:53
  rethink where we dedicate some of the strategies.
• 4:56
  And as part of that rise in the
• 4:58
  younger population,
• 4:59
  a big piece of that is that catastrophic
• 5:02
  health events, are becoming way more frequent.
• 5:05
  So we're seeing a rapid influx in the
• 5:07
  number of catastrophic claimants are now twice as
• 5:10
  common as they were five years ago. And
• 5:12
  we're seeing that not only just for the
• 5:13
  younger generation, but for all generations, you know,
• 5:15
  rise of the number of people
• 5:17
  reaching, a 100,000.
• 5:21
  And it's but it's no longer focused on
• 5:23
  just the older sicker population.
• 5:25
  It's focused everywhere. And kind of the third
• 5:28
  point that I'd focus in on and, obviously,
• 5:30
  a hot topic always is metabolic conditions.
• 5:33
  So we're starting to see them rise, more
• 5:35
  sharply.
• 5:36
  We're seeing we're starting to see metabolic symptoms
• 5:39
  rise
• 5:40
  quicker in some of the younger populations as
• 5:42
  well and and within men.
• 5:45
  In particular, we see that,
• 5:47
  those men that are struggling with metabolic conditions,
• 5:49
  so think diabetes, obesity, hypertension,
• 5:53
  much greater health risks, much higher costs,
• 5:56
  and, specifically,
• 5:57
  men with those metabolic issues,
• 5:59
  have much higher risk of some of the
• 6:01
  catastrophic events such as heart attack, stroke, and
• 6:04
  surgeries where we see a seven times greater
• 6:07
  risk within that population. So,
• 6:09
  the three main areas that I just would
• 6:11
  focus in on is the rise of the
• 6:12
  cost in the youth population,
• 6:14
  catastrophic claimants start to become much more frequent,
• 6:16
  and then the rise of metabolic conditions across
• 6:19
  all populations, especially in men.
• 6:21
  And, Craig, let's dive into that a little
• 6:23
  bit more in terms of the the rise
• 6:24
  in care costs for the younger population because
• 6:26
  that seems like a huge
• 6:28
  concern for employers.
• 6:30
  Now a population that maybe in the past
• 6:32
  was not a huge cost driver compared to
• 6:34
  other generations.
• 6:35
  And in the reports,
• 6:37
  specifically, it's Gen z's year over year,
• 6:40
  care spending. It jumped 18%,
• 6:43
  nearly double the rate of, the the rise
• 6:45
  in care costs for baby boomers. And it's
• 6:48
  driven, like you mentioned,
• 6:50
  a rise in catastrophic claims, forty one percent
• 6:53
  increase that you noted in the report.
• 6:55
  So what is this increase in in chronic
• 6:58
  disease, in catastrophic care among younger workers? What
• 7:01
  does that signal on the ground for their
• 7:04
  employers?
• 7:05
  Yeah. Two things, and they go hand in
• 7:07
  hand. So first, we are seeing
• 7:10
  that,
• 7:11
  in younger the younger folks are starting to
• 7:13
  develop
• 7:14
  chronic conditions or health risks
• 7:17
  at younger ages. So we're seeing obesity, hypertension,
• 7:20
  behavioral health,
• 7:22
  starting to pop up earlier,
• 7:24
  in their natural progression.
• 7:26
  That
• 7:27
  development of chronic conditions
• 7:30
  then leads to the opportunity. Some of those
• 7:32
  folks are gonna be well managed and making
• 7:34
  good choices, but we're gonna see within that
• 7:36
  younger generation. They're maybe not equipped or ready,
• 7:39
  to really navigate the health care system in
• 7:41
  a good way, leading to those chronic diseases
• 7:44
  turning into catastrophic events. So we see, again,
• 7:48
  like, like, like you said, a forty one
• 7:49
  percent increase in catastrophic events among younger adults,
• 7:53
  driven by the rise of chronic disease as
• 7:55
  well as that population
• 7:57
  not being as engaged or educated on how
• 8:00
  to use the health care system appropriately
• 8:03
  to prevent those types of things from happening.
• 8:07
  This is interesting.
• 8:08
  The other part you mentioned earlier in terms
• 8:10
  of some of the the differences you're noticing
• 8:12
  between men and women and how they access
• 8:15
  care or engage with the system,
• 8:17
  overall,
• 8:18
  the data showing that men have consistently lower
• 8:21
  PCP engagement than women starting at age 18,
• 8:24
  and that gap doesn't close until their sixties,
• 8:28
  which is,
• 8:29
  I mean, just wow.
• 8:31
  So I wonder what is the data telling
• 8:33
  you in terms of why men's health has
• 8:35
  been so difficult to move the needle on
• 8:37
  overall,
• 8:38
  And what do you think it would actually
• 8:39
  take for employers, for the health plan,
• 8:43
  to change these patterns earlier in in their
• 8:45
  lives?
• 8:47
  Yeah. This is this is definitely a tough
• 8:48
  one. This has been kind of an age
• 8:50
  old sort of question. How do you engage,
• 8:52
  especially the younger male population?
• 8:55
  In general, what you see in the data,
• 8:57
  is
• 8:58
  men make decent health care choices
• 9:02
  when something has happened.
• 9:04
  So when you are diagnosed with a condition,
• 9:06
  when you're diagnosed with diabetes or heart disease
• 9:08
  or so or so on, you see that
• 9:11
  men will make pretty good health care choices
• 9:13
  in that space.
• 9:15
  It's the before that we're worried about. It's
• 9:17
  the prevention piece. It's seeing your doctor on
• 9:19
  a regular basis. It's getting preventive screenings done.
• 9:22
  That's where men prior to age 60
• 9:25
  really have
• 9:26
  wide gaps compared to their female, counterparts.
• 9:30
  So it's really about how do you,
• 9:33
  engage incense,
• 9:35
  nudge those men to start to see that,
• 9:38
  prevention matters, and you can stop these kind
• 9:40
  you can stop or at least mitigate some
• 9:42
  of those events from happening if you do
• 9:44
  something before
• 9:46
  the bad news kind of comes in from
• 9:48
  a health care perspective. And really, really hard,
• 9:50
  really, really challenging, but it really comes down
• 9:51
  to, as you see in the study, engagement
• 9:54
  with your PCP.
• 9:55
  Can you
• 9:56
  make it easy, make it simple,
• 9:58
  make it accessible
• 10:00
  for those men to be able to engage
• 10:02
  their PCP? Because once that happens, we start
• 10:04
  to see analytically
• 10:05
  that a lot of those other gaps,
• 10:08
  start to change,
• 10:09
  pretty quickly.
• 10:11
  Sure. No. That makes a lot of sense
• 10:12
  in terms of strategy. Men are being reactive,
• 10:15
  not proactive
• 10:16
  to to their health. And I wonder more
• 10:18
  broadly, Greg, how
• 10:20
  how close do you think employers' health plans
• 10:23
  are to being I being able to identify,
• 10:26
  some of those high cost members,
• 10:28
  like a man early on in their life,
• 10:32
  early enough to intervene meaningfully.
• 10:34
  And and, ultimately, what is the biggest barrier
• 10:37
  to that right now? Is it is it
• 10:38
  not having
• 10:39
  enough or or the right data? Is it
• 10:42
  the clinical programs themselves? Is it
• 10:44
  getting that over that hump of, getting them
• 10:46
  to be proactive and engage earlier?
• 10:49
  What do you think it is that's, the
• 10:51
  biggest barrier there?
• 10:53
  I think and and, obviously, I'm biased, but
• 10:55
  I think the data has gotten pretty good.
• 10:57
  We have, the ability at a population level
• 11:01
  within the employers that we work with to
• 11:03
  to really
• 11:04
  be able to understand
• 11:05
  where the drivers are,
• 11:07
  where the decisions are inappropriate.
• 11:09
  So, for example, rather than kind of peanut
• 11:11
  butter spreading solutions across an entire population,
• 11:15
  we can hone in that it's not a
• 11:17
  PCP engagement issue, and their entire population really
• 11:20
  is focused on, for example, the young male
• 11:21
  population
• 11:22
  or a specific market or a specific,
• 11:25
  age group and so on. So analytically,
• 11:28
  at a population health perspective, that's gotten really
• 11:31
  good. And I think most employers
• 11:33
  can precisely see where the where the problems
• 11:35
  are, where the focus areas should be. And
• 11:37
  even at an individual level, I think analytics
• 11:39
  have gotten much better as well as we
• 11:41
  start to identify
• 11:43
  who's at risk, who's headed down a a
• 11:45
  negative path, and as quickly as we can
• 11:48
  be able to outreach into that population.
• 11:50
  And that's where a lot of the, clinical
• 11:52
  programs that exist today are really focused. So,
• 11:54
  analytically, we can find these folks as quickly
• 11:56
  as possible. We can start to predict the
• 11:58
  path that they're headed down and start to
• 12:00
  engage them further upstream.
• 12:03
  Years and years ago, it used to be
• 12:05
  that your analytics were dated, and you would
• 12:07
  find out that a member was headed down
• 12:09
  a bad path after that event already occurred.
• 12:12
  And then clinical program outreach would typically happen
• 12:14
  after that event occurred as well. But analytics
• 12:17
  have gotten better. Data has become more real
• 12:19
  time. And now we can start to identify
• 12:21
  these folks,
• 12:22
  upstream,
• 12:23
  guiding them into programs. So there are there
• 12:25
  are programs that can help guide people into
• 12:28
  leveraging primary care physicians. There's digital condition management
• 12:32
  programs. There's lots of different metabolic health coaching
• 12:34
  and monitoring events. For example, with the UnitedHealthcare,
• 12:37
  we have level two for die for diabetes
• 12:39
  that can help kinda manage those those diabetics.
• 12:42
  So there are lots of opportunities out there.
• 12:44
  And I think, analytically and clinically, we're now
• 12:46
  at a point where we can outreach to
• 12:47
  these people sooner and quicker upstream to make
• 12:49
  a bigger difference in what the future is
• 12:51
  going to hold. But at the end of
• 12:53
  the day, it's all about engagement. We can
• 12:56
  find those people early. We can have the
• 12:58
  best programs in the world that would make
• 12:59
  the biggest difference for that population.
• 13:01
  But if you're unable to get them to
• 13:03
  an engage and to sign up and to
• 13:05
  participate,
• 13:07
  none of that's worth it. And that's where
• 13:08
  a lot of the focus is right now.
• 13:10
  How do we focus on the consumer,
• 13:12
  make that engagement simple, easy,
• 13:15
  make that the easy choice for them versus
• 13:17
  the hard choice,
• 13:18
  because we know how the health care system
• 13:20
  is incredibly complicated.
• 13:22
  People get confused pretty easily because there's a
• 13:24
  lot of different variables out there, and they
• 13:26
  don't know where to go, where to get
• 13:28
  the best care, what should I do next.
• 13:31
  But our ability to meet the consumer where
• 13:33
  they are, whether that be through digital means,
• 13:36
  whether it be through telephonic advocacy means,
• 13:39
  finding different ways to kind of make sure
• 13:41
  it's simple and easy for them to see
• 13:44
  the way that engagement can lead to a
• 13:46
  better life, you know, for these members.
• 13:49
  Absolutely. And you're not just leaving employers in
• 13:51
  the dark here with these findings. The report
• 13:54
  is actually making seven specific recommendations
• 13:57
  for employers,
• 13:59
  in terms of how to achieve what we're
• 14:00
  talking about, Craig, and and it's everything from
• 14:03
  segmenting populations by generation and gender to building
• 14:07
  a men's health strategy that starts at age
• 14:09
  40. So you said data analytics gotten a
• 14:12
  lot better over the years.
• 14:15
  Are you seeing health plans and employers actually
• 14:17
  act on this kind of data, and and
• 14:20
  where do you think is there where does
• 14:22
  that gap still exist between the insights you're
• 14:24
  providing and then the execution on the ground?
• 14:28
  I think there's more action being taken by
• 14:30
  employers today than ever. And there's a a
• 14:32
  few different variables kinda driving that, but, obviously,
• 14:35
  affordability is an issue, and employers
• 14:37
  are doing whatever they possibly can with their
• 14:40
  partners to help bring
• 14:42
  affordability back into a better space. As well
• 14:44
  as, many employers
• 14:46
  are are seeing are are being being are
• 14:48
  able to see on a more rapid basis
• 14:51
  that engagement in health
• 14:53
  does more than just
• 14:55
  impact,
• 14:57
  affordability in health care. If we can guide
• 14:59
  people towards better health and better engagement,
• 15:02
  they're able to see that those employees are
• 15:05
  going to be better employees. They're gonna be
• 15:07
  more productive. They're gonna be more present. So
• 15:09
  it's all encompassing. It's a big issue for
• 15:11
  these employers. And I think now like I
• 15:13
  said, now they're more than ever. They're starting
• 15:14
  to take action upon it. And by that
• 15:16
  action, I think it's it's really important to
• 15:18
  think about targeted approaches along these efforts. It's
• 15:22
  hard to get the the less than 40
• 15:24
  year old male population
• 15:25
  to start to engage, even the forty to
• 15:27
  fifty year old male population to engage. But
• 15:29
  if you can be focused, if you can
• 15:30
  be targeted,
• 15:32
  just like other marketing firms that have done
• 15:34
  for for decades now, If you can become
• 15:36
  that focused, you're gonna start to understand
• 15:39
  what is the best way to get this
• 15:41
  unique part of my population to engage. I
• 15:43
  might not be able to get everybody, but
• 15:45
  if I focus in the biggest outliers,
• 15:48
  I can create a strategy whether that be
• 15:50
  through communication,
• 15:51
  through digital campaigns, and so on, or even
• 15:54
  boots on the ground to get that population
• 15:56
  to engage in the various programs that a
• 15:59
  lot of these employers are offering.
• 16:01
  Employers have historically offered lots of different solutions
• 16:05
  and opportunities for members,
• 16:07
  but have struggled to get people to engage
• 16:09
  in those programs. So, again, it's all about
• 16:12
  the consumer, consumer analytics, marketing based analytics, finding
• 16:16
  ways to make it simple and easy and
• 16:18
  targeted for these members to engage.
• 16:21
  Well, Craig, before we go,
• 16:23
  where where can our listeners
• 16:25
  find this report if they'd like to read
• 16:27
  it themselves? And is there anything else that
• 16:29
  we're missing today that you wanna share with
• 16:31
  them?
• 16:32
  Sure. The report is is public and available,
• 16:34
  so it's you can find it in the
• 16:36
  health action council website. You'll see it posted
• 16:38
  out there. And I, again, I would just
• 16:40
  focus on the fact that and, again, I'm
• 16:42
  very biased, but start with the data.
• 16:45
  See what's happening in your population.
• 16:47
  Cut and slice your data. Don't just look
• 16:48
  at things in aggregate. Look at the subpopulations
• 16:50
  that are driving your need.
• 16:52
  Check to see if the results that we're
• 16:54
  seeing in the study apply to you, may
• 16:56
  or may not. We we are seeing this
• 16:58
  broadly, but make sure this is applied within
• 17:00
  your population. And then focus on consumer driven
• 17:03
  targeted,
• 17:05
  solutions
• 17:06
  that can help in the specific areas that
• 17:08
  are driving affordability and health challenges within your
• 17:11
  population.
• 17:12
  Fantastic. Well, Craig, thank you very much for
• 17:15
  taking the time to chat with us here
• 17:17
  on the podcast and for breaking down these
• 17:19
  latest findings for our listeners. We really appreciate
• 17:21
  it. Thanks for having me. And to our
• 17:24
  listeners, if you'd like to listen to more
• 17:26
  podcasts from Becker's Healthcare, you can visit beckershospitalreview.com.