Latest / Becker’s Payer Issues Podcast / Building an AI Native Health Plan for Small Employers with Ty Wang, CEO of Angle Health

Transcript

Building an AI Native Health Plan for Small Employers with Ty Wang, CEO of Angle Health · 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
• 0:13
  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. Welcome to Becker's Healthcare Podcast. I'm
• 0:36
  Scott King. Thrilled today to be joined by
• 0:38
  a very special guest, Tai Wang, cofounder and
• 0:41
  chief executive officer
• 0:43
  over at Engel Health. Tai, how are you
• 0:45
  doing? Thanks so much for joining.
• 0:46
  Doing well. Thanks so much for having me
• 0:48
  on again, Scott. Yeah. Of course. And, you
• 0:50
  know, we're really looking forward to having you
• 0:51
  speak at our spring payer issues roundtable as
• 0:53
  well, and we have a lot of kind
• 0:55
  of big topics to get to here in
• 0:57
  in health care and with health plans. But
• 0:59
  before we address those ties, I wonder if
• 1:01
  you could just please share a little bit
• 1:02
  about your, career background and your journey in
• 1:04
  health care.
• 1:05
  Yeah. I'd be happy to.
• 1:07
  I'm Ty Wang, cofounder, CEO of Engle Health.
• 1:10
  Before starting Engle Health, my,
• 1:13
  cofounder and I were both at Palantir leading,
• 1:16
  major teams and and deployments over there and
• 1:19
  and working
• 1:20
  across government and and commercial
• 1:22
  customers, including,
• 1:24
  health care customers. So,
• 1:25
  that's where we learned a lot of,
• 1:27
  a lot of, I would say, kind of
• 1:29
  the operational,
• 1:31
  pieces of of how this whole ecosystem
• 1:34
  works together and and how we ended up
• 1:37
  building
• 1:39
  today, Angle Health is the first AI native
• 1:42
  vertically integrated health plan, and we're one of
• 1:44
  the fastest growing health care companies in the
• 1:46
  country.
• 1:48
  Our products themselves are fully customizable major medical
• 1:52
  health plans, all ACA compliant for,
• 1:55
  small and medium sized businesses. And,
• 1:57
  essentially, we're delivering
• 1:59
  these Fortune 100 level health care benefits to
• 2:02
  your local businesses. So Angle Health enables brokers
• 2:05
  and their small employer clients to build these
• 2:08
  custom health plans just like a major employer
• 2:11
  with thousands or tens of thousands of employees
• 2:14
  and a large sophisticated benefits team might do
• 2:16
  it. And and we're really
• 2:18
  we've been able to bring that all the
• 2:20
  way down market to your local businesses,
• 2:23
  because of the infrastructure that we've built.
• 2:26
  Thanks so much for sharing that that info
• 2:27
  on your background,
• 2:29
  Ty, and and how, you know, kinda Engel
• 2:31
  Health came to be and what it does.
• 2:33
  And, you know, it it's certainly a time
• 2:35
  where,
• 2:36
  obviously, providers
• 2:38
  and payers are, like, are both facing a
• 2:39
  lot of regulations.
• 2:41
  Right? And and we know how how difficult
• 2:43
  that can be. How how are you seeing
• 2:45
  a relationship between,
• 2:46
  you know,
• 2:47
  providers
• 2:49
  and health plans change,
• 2:50
  you know, on both sides
• 2:52
  as they face cost pressure as, you know,
• 2:54
  specifically in workforce shortages?
• 2:57
  Yeah. I I would say I would say
• 2:59
  one of the biggest shifts that we're seeing
• 3:01
  today is that the relationship
• 3:03
  between providers and health plans is,
• 3:07
  becoming less
• 3:09
  a bit less transactional and and and kinda
• 3:12
  more operational.
• 3:14
  So with like you mentioned, with with,
• 3:16
  all the changing regulation
• 3:18
  with the economy, it's it's impacting providers and
• 3:21
  hospitals just as much
• 3:23
  as health plans, and the two sides are
• 3:26
  really inextricably
• 3:27
  linked. When costs go up on one side,
• 3:30
  they go up on the other side. And,
• 3:32
  as a result, we're we're seeing we're seeing
• 3:35
  more openness, I would say, to shared problem
• 3:37
  solving. So things like reducing administrative burden, simplifying
• 3:41
  workflows like prior authorizations,
• 3:43
  improving,
• 3:45
  integrations and data handoffs, and and being more
• 3:48
  aligned on on the,
• 3:50
  care pathways that actually work. And
• 3:53
  I think,
• 3:55
  for us, as a modern,
• 3:57
  platform for health care benefits, we
• 3:59
  we specifically seek out those partners,
• 4:02
  and and partners that are willing to,
• 4:06
  redesign
• 4:07
  the what more traditional workflows rather than just,
• 4:11
  renegotiating
• 4:12
  fees. And I think we're we're seeing a
• 4:14
  lot more openness and a lot of collaboration
• 4:16
  there across the,
• 4:18
  payer and provider sides.
• 4:21
  Yeah. Yeah. I I've talked to a lot
• 4:22
  of a lot of people speaking at at
• 4:24
  the spring pair of shoes roundtable recently,
• 4:26
  from the health plan side, and and they
• 4:28
  definitely agree
• 4:31
  with you, Ty. It's it's that they're just
• 4:31
  seem like, you know, everyone's got so many
• 4:33
  issues to deal with. Everyone just kinda coming
• 4:34
  to the table Mhmm. With some ideas and
• 4:36
  and to work collaboratively. So, yeah, definitely agree
• 4:38
  with it, you know, seeming to not be
• 4:40
  so transactional anymore. So I appreciate your insight
• 4:43
  there.
• 4:44
  And, you know, I'm also curious, where do
• 4:45
  you see the biggest gap today between
• 4:48
  payer strategy and operational execution?
• 4:51
  Yeah. That's a good question. The I think
• 4:53
  one thing that many plans talk about
• 4:56
  are,
• 4:58
  around value based care, digital enablement,
• 5:01
  things like the member or patient experience.
• 5:04
  But the the challenge that and and I
• 5:07
  would say this is this is the gap
• 5:09
  is that
• 5:10
  many payers and and,
• 5:12
  legacy health plans are still operating on on
• 5:16
  legacy systems, on fragmented systems, manual processes that
• 5:20
  really make executing on some of these things
• 5:23
  at scale very difficult. So there the the
• 5:26
  strategy is really assume,
• 5:28
  and require
• 5:29
  things like having clean data, having real time
• 5:32
  insights, having very much aligned incentives.
• 5:35
  Whereas the
• 5:37
  operational
• 5:38
  side,
• 5:39
  and and to actually execute on that,
• 5:42
  there's still really the operational side is really
• 5:44
  still stuck doing things like reconciling eligibility files
• 5:47
  or
• 5:48
  chasing faxes.
• 5:50
  So I I I think until major health
• 5:53
  plans truly modernize their core infrastructure, so there's
• 5:55
  systems for claims and benefits and provider data
• 5:58
  and care management,
• 6:00
  it'll be extremely hard to execute on those
• 6:02
  strategies. And and that's why we're really building
• 6:05
  and why we started Angle Health by building
• 6:07
  technology infrastructure from the ground up. So although
• 6:10
  Angle Health today is a product company delivering
• 6:13
  these affordable and personalized health health plans to
• 6:16
  thousands of small businesses across the country,
• 6:19
  we really believe that our our core asset
• 6:21
  is the technology platform that that powers it,
• 6:23
  and I think we're seeing a lot more
• 6:26
  focus and and and urgency as well from
• 6:29
  from major players and from the market and,
• 6:32
  also,
• 6:33
  trying to modernize themselves.
• 6:36
  What's the one investment or initiative you believe
• 6:39
  will most reshape
• 6:40
  how health plans operate over the next two
• 6:42
  to three years?
• 6:44
  The the easy answer there is, is is
• 6:47
  AI, I think. But I I I'm happy
• 6:49
  to take it kind of a little bit
• 6:50
  deeper than that. I think I think it's
• 6:52
  it's outcome linked payment infrastructure.
• 6:55
  So,
• 6:57
  as as more reimbursement,
• 7:00
  incentives are tied to outcomes rather than
• 7:04
  pure utilization.
• 7:05
  And I I think this is a major
• 7:06
  push especially with pro the the programs like
• 7:09
  ACCESS.
• 7:11
  Health plans need to be able to really
• 7:13
  track performance across their vendors and providers and
• 7:17
  health systems and and and really in in
• 7:20
  any care setting.
• 7:21
  And it's it's it's much more than, like,
• 7:23
  contracts themselves. It's really investment in the systems
• 7:26
  that that enable them to operationalize things like,
• 7:30
  measurable,
• 7:30
  standardized,
• 7:31
  and and very transparent,
• 7:34
  outcome data.
• 7:35
  If you could change one regulatory or industry
• 7:38
  practice tomorrow, yeah, so, like, very soon to
• 7:41
  improve, affordability
• 7:43
  and access, what would it be and why?
• 7:47
  If I were to change one regulatory or
• 7:49
  industry practice tomorrow,
• 7:52
  I think the I think what could make
• 7:53
  one of the most immediate impacts is,
• 7:57
  I I'd bring a lot more transparency
• 7:59
  into
• 8:00
  employer
• 8:01
  health care costs and broker compensation
• 8:03
  structures, particularly by the major insurance companies. So
• 8:07
  particularly
• 8:08
  by large,
• 8:10
  where where these large incumbents use
• 8:12
  certain incentives to steer behavior.
• 8:14
  We, I mean, we see it all the
• 8:16
  time today in the market where in most
• 8:18
  cases,
• 8:19
  broker compensation is designed in ways that
• 8:23
  favor
• 8:23
  or or or lock,
• 8:26
  brokers and employers into certain carriers,
• 8:29
  or incentivize things like higher premiums
• 8:31
  regardless of whether that's that's best for the
• 8:34
  employers or the members. And we see that
• 8:36
  across, I think, across all all,
• 8:39
  lines of business within the health plan space
• 8:42
  where we're only in the commercial space, but
• 8:43
  it's it's true in,
• 8:45
  Medicare. It's true in in in the government
• 8:48
  program space. So,
• 8:50
  I I think,
• 8:52
  most brokers want to do the right thing,
• 8:54
  but because of the
• 8:56
  kind of very opaque incentive structures that exist
• 8:59
  as well as the gatekeeping of health care
• 9:01
  cost data, which is extremely impactful when you
• 9:04
  talk about small and medium sized businesses and
• 9:06
  and the lack of access that they have
• 9:08
  there.
• 9:09
  That can make it very difficult for for
• 9:11
  brokers to
• 9:12
  be that strategic partner,
• 9:14
  with with fully aligned incentives. So and it's
• 9:17
  it's one thing that we that we focus
• 9:19
  on a lot today. So we're we're I
• 9:21
  would say we're really paving that road at
• 9:22
  Angle Health with, what we we call the
• 9:25
  Angle Health scorecard where we're maybe the only
• 9:28
  health plan today that provides
• 9:30
  an
• 9:31
  unprecedented level of transparency into the actual health
• 9:34
  care costs for employers with every single quote
• 9:36
  that we that we issue.
• 9:38
  And the last question I have for you,
• 9:39
  Ty, what issue is putting the most pressure
• 9:42
  on health plan margins right now,
• 9:44
  and how will you respond differently in 2026?
• 9:48
  Yeah.
• 9:49
  I I think the probably one of the
• 9:51
  biggest ones, very, very timely as well,
• 9:55
  this week is the,
• 9:58
  the Medicare
• 10:00
  rates,
• 10:00
  that's that CMS is,
• 10:03
  is setting.
• 10:04
  It's not it for us, since we're not
• 10:06
  a Medicare plan, it's it's less impactful for
• 10:09
  us, but but it it's the it's still
• 10:11
  it's the medical cost trend. I think that's,
• 10:15
  that has and will probably always be the
• 10:18
  single biggest cost pressure, and and it's it's
• 10:21
  being driven by things like specialty care, by
• 10:24
  things like pharmacy, and and, ultimately,
• 10:27
  unmanaged medical conditions.
• 10:30
  Most I would say in terms of kind
• 10:32
  of how we're responding, I think most plans
• 10:34
  leverage or historically have leveraged these very blunt
• 10:37
  tools to do reactive cost containment.
• 10:40
  How we view it at Angle Health and
• 10:42
  what we're really focused on is is,
• 10:45
  what I would say is is proactive care
• 10:48
  orchestration.
• 10:48
  So,
• 10:50
  being able to identify risk earlier,
• 10:52
  being able to engage and steer members to
• 10:55
  the right settings, and and and being able
• 10:57
  to intervene before
• 10:58
  major costs,
• 11:01
  spike,
• 11:02
  without creating with,
• 11:05
  while also delivering a a kind of first
• 11:08
  class member experience.
• 11:10
  So the way that we're doing that is
• 11:11
  through tighter integration,
• 11:14
  between the actual benefit plans themselves to the
• 11:16
  clinical
• 11:17
  programs and the provider partners that we that
• 11:21
  we work with there
• 11:22
  and then a focus on on workflows that
• 11:25
  really improve
• 11:26
  the engagement workflows that really improve the experience
• 11:28
  for the member and and also drive operational
• 11:31
  efficiencies,
• 11:33
  for,
• 11:34
  for the employer, for the provider, for for
• 11:37
  the health plan. And our our belief is
• 11:40
  that
• 11:41
  margins improve
• 11:43
  if you can make the system work in
• 11:46
  a better kind of more coordinated way
• 11:48
  in the long term,
• 11:50
  not when you increase friction, which may
• 11:53
  improve margins in the short term, but is
• 11:56
  is is a very shortsighted way of of
• 11:59
  of thinking about it. So we really focus
• 12:02
  on on
• 12:03
  on that kind of long term view and
• 12:05
  and rebuilding,
• 12:07
  what we call these kind of core care
• 12:09
  pathways,
• 12:11
  so that,
• 12:12
  we can fully align
• 12:14
  each of the stakeholders
• 12:16
  while also,
• 12:18
  streamlining that experience for our members.
• 12:21
  I think that sounds great. And, Ty, thanks
• 12:22
  so much for joining us on the podcast.
• 12:24
  It was a great conversation. Looking forward to
• 12:26
  having you speak with us in April. Amazing.
• 12:28
  Thanks so much, Scott. This is fun, and
• 12:30
  I'm excited to, see everyone again in April.