Latest / Becker’s Payer Issues Podcast / Driving Affordability and Simplicity in Payer Strategy with Christina Ott

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Driving Affordability and Simplicity in Payer Strategy with Christina Ott · Becker’s Payer Issues Podcast

• 0:02
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  Good morning, everybody. This is Gracelyn Keller with
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  the Becker's Healthcare Podcast, and we are recording
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  live at the pair issues roundtable.
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  I'm currently joined by Christina Ott, who is
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  the chief strategy officer at Quartz. So, Christina,
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  thank you so much for being here.
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  Let's have you start off by introducing yourself
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  and sharing a little bit more about your
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  role and organization.
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  Sure. Nice to meet you. Good morning, everyone.
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  Again, Christina Ott, chief strategy officer at Quartz.
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  We are a multiple provider sponsored health plan
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  located in the Midwest in Madison, Wisconsin.
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  And so very excited to be here today
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  and
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  work with many colleagues across industry to learn
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  more about all the innovations that are disrupting
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  our industry.
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  Wonderful. Well, thanks for taking the time. And
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  let's start our conversation
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  with, from your perspective, what is the most
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  pressing operational challenge facing payers right now, and
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  how are you addressing it? Sure. Great question.
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  Right now, one of the biggest challenges
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  really simply is affordability.
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  As you know, medical costs keep rising,
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  regulations are getting more complex, and at the
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  same time, our members expect experiences that feel
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  seamless
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  and better than they can get from any
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  other payer. And so that makes that tricky
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  from an operational perspective.
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  So old levers that, payers have used, like
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  utilization
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  management,
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  prior authorization,
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  cost shifting,
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  are getting more and more difficult.
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  So we're really focused on changing the role
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  of the payer itself.
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  Instead of just processing claims, we're looking at
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  the opportunity to engage our members earlier,
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  supporting them with primary care, and guiding members
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  to the right care at the right time.
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  When you reduce confusion and friction in health
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  care, you often reduce the cost as well.
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  So that's where we're focusing as the real
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  lever right now.
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  Wonderful.
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  And there's a constant tension between keeping costs
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  down and actually delivering a good member experience,
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  especially as it comes to care coordination.
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  So how is your organization balancing cost containment
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  with improving member experience and quality outcomes, and
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  where are you seeing the greatest opportunity for
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  impact there?
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  Yeah, that's a great question. We spent a
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  lot of time at our organization
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  asking ourselves that.
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  And where, where do our members get stuck?
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  That's really the focus that we've been
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  spending time on. We also wanna know when
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  customers talk about us, how do they say
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  Quirks makes it easy for them?
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  And so that's one of the biggest outcomes
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  that we're trying to create the greatest impact
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  for.
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  And it's really helping someone get through the
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  navigation of health care, really understanding when they
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  should be proactive in their health care instead
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  of waiting
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  until they're in an emergent situation where certainly
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  we will still support them, but really helping
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  them navigate across the way. When our members
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  feel supported and know what to do next,
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  then we have the greatest outcomes to prove
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  our total cost of care, but their total
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  well-being and health.
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  And digital engagement and transformation continues to accelerate
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  across healthcare. So what technologies
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  and AI are you
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  right now and where are you seeing meaningful
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  ROI as well as better engagement with members?
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  Yeah. That's a great question.
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  We've become much more disciplined about that. I
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  think there was a race around
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  digitizing
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  and investing in shiny tools, and we're really
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  trying to, again,
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  reduce the friction for our customers, but align
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  our systems intentionally.
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  And so that will lower the total cost
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  instead of having many systems
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  doing various point
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  solutions that still don't create that seamless experience,
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  we've been focusing there. As it relates to
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  AI,
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  we're probably a little bit earlier in the
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  journey, but we're really focusing on automating
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  workflows that are manual
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  and take a lot of resources, which does
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  drive costs
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  to optimize
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  the overall,
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  output of our organization.
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  And finally, where do you see the greatest
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  opportunity for AI to reduce friction in member
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  communications and administrative workflows while maintaining that personalization?
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  That's also a great question. And as a
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  provider sponsored health plan, I think we have
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  a great opportunity.
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  We have so many communications
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  from various systems going out every single day.
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  So there's two things that I try to
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  focus on for simplicity's sake. One is let's
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  get a streamlined view of all the touch
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  points in the communications and the journey. And
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  I think, you know, certainly digitization and personalization
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  can help with that. And then also, how
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  do we automate things from an AI perspective
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  where it matters
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  and really think about the human interaction where
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  it matters.
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  Absolutely. Well, Christina, thank you so much for
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  joining me today on the Becker's Healthcare podcast.
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  Again, we are at the fourth annual spring
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  payer issues roundtable. Thanks so much. Thank you.