Latest / Becker’s Healthcare Podcast / Leading Priority Health Through Growth, Trust, and Transformation

Transcript

Leading Priority Health Through Growth, Trust, and Transformation · Becker’s Healthcare 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 payer and health plan executives
• 0:12
  and more than 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.
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  Hello, everyone. This is Jacob Emerson with the
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  Becker's Payer Issues podcast. Thrilled today to be
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  joined by Nick Gates, who is the president
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  of Priority Health. Nick, thanks so much for
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  taking the time to be with me on
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  the podcast today. Well, first of all, thank
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  you for having me, Jacob, and thank you
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  for those who are listening today.
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  As you mentioned, I'm Nick Gates, president of
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  Priority Health. Just gonna be a a little
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  bit of a background on Priority Health. We
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  serve 1,400,000
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  members. We're across four states in the Midwest.
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  So that includes Michigan, Indiana,
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  Ohio, and Wisconsin.
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  We are the third largest provider sponsored health
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  plan in the nation and the integrated health
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  plan of Coral Health. And Coral Health happens
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  to be the largest Michigan based health system.
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  So just to give you a little bit
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  of background of my career, I started in
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  public accounting at Ernst and Young in Detroit.
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  And I really always look at this as
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  a great opportunity me for me personally to
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  learn about different businesses, industries,
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  and really gives me an opportunity to lead,
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  teams early in my career. So there's my
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  plug for public accounting for those, who are
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  interested in a in a great career to
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  start out with. But while it was a
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  great start, I really wanted to find something
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  that I was more connected
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  with, connected to a community. And there happened
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  to be an opportunity to join Priority Health,
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  which I was really excited about excited about
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  joining a healthcare organization, but I will admit
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  I knew very little about the industry
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  other than my experiences as a member and
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  a patient. So what I learned pretty quickly
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  is how complex this industry is.
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  And I say is because it still is,
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  it's not a past tense, it is still
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  very complex.
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  But I was very inspired with how passionate
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  our teams were about the members, about the
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  community.
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  There was a lot of conversation around affordability
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  experience,
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  doing what is right for the member. Really,
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  that was the culture and those values,
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  that I looked at and I I observed
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  they were established
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  and they were really lived by the leadership
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  team.
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  My experience as a priority health way, I
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  started through the finance side. I helped, guide
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  big moves, various acquisitions,
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  help to expand our footprint in Michigan and
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  throughout the Midwest.
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  I've also had a front row seat to
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  some of the major shifts in our industry,
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  going all the way back to the Medicare
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  modernization,
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  our launch of Medicare Advantage,
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  of course, the introduction
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  of the Affordable Care Act, and then more
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  recently, the COVID era,
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  with all the various regulations and,
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  even working through the wind down
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  of of, the Medicaid redetermination.
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  So a lot of challenges that we've been
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  through. And what I'd say is those experiences
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  have taught me how to balance discipline
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  with innovation,
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  really balancing the two of those. And today,
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  what I'm excited about is I get to
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  bring that perspective
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  to leading a plan that's focused on affordability,
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  quality,
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  and a better experience for our members.
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  Absolutely. Well, I appreciate you getting this started,
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  Nick, by talking a little bit about your
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  career before Priority Health and then how you've
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  evolved within the company over these last two
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  decades,
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  that you've been with Priority.
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  So you you had served as interim president
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  since May.
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  You were named permanent president,
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  late in 2025.
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  So
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  you mentioned you're the third largest provider sponsored
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  health plan in the country. It's a lot
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  of responsibility,
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  as you know. It's a very complicated business,
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  as you mentioned. So talk to us about
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  what ultimately inspired you both personally and and
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  professionally
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  to take on this this new position.
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  Yeah.
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  So and and I touched on a little
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  bit from a personal standpoint,
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  inspiration really that it it ties to our
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  mission,
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  improve health, instill humanity, and inspire hope.
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  That's been consistent in terms of our focus
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  on the member, our focus on the communities
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  since I've been here. So really, I've I've
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  embraced the organization is why I've been here
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  this long.
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  More than twenty years, as you mentioned. And
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  during that time, I've had a chance to
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  watch our teams show up for our members
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  with empathy,
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  rigor, and a relentless focus on affordability and
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  excellence.
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  And so really what inspired me to take
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  on this role was the opportunity to build
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  on this culture
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  and really make a meaningful impact and meaningful
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  difference during a time, what I would call
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  of significant transformation.
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  I've been part of this transformation, and so
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  I felt it was something that could really
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  provide stability
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  if I had the opportunity to step in
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  and continue to lead this team.
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  I look at Priority Health as some as
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  an organization's incredibly
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  strong. We're value driven.
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  Like many organizations too, we're going through that
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  very significant change,
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  new technology,
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  all the regulatory landscape that we're dealing with.
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  So again, I felt like I could step
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  in and provide that stability and clarity, and
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  really keep the momentum moving forward. Professionally,
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  I saw this as a chance to further
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  lean into shaping the strategic direction of our
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  organization. And so as I mentioned previously, I've
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  been part of several acquisitions,
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  but I've also been part of financial transformations.
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  I've been part of system system wide initiatives.
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  But in this role, I can help ensure
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  that our strategy, our culture,
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  ensure our execution stays aligned with what matters
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  the most and that's serving our members
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  and strengthening the communities that we live and
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  work in. I also see as an opportunity
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  to be an advocate. So being,
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  in the state of Michigan, we're now expanding
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  others. We wanna be
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  represented and heard at the state and federal
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  level.
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  We wanna have the industry partnerships.
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  We wanna make sure that our decisions impact
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  affordability,
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  access, and equity.
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  And so it's something that I was really
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  passionate about and looking forward to leading.
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  What I'd say in terms of the common
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  thread between personal professional, it really is trust.
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  It's trust in our team. It's trust in
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  our mission and then the strategy we're executing
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  together. So I'm really excited to be able
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  to step in as the next leader of
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  the health plan.
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  Absolutely. And and, you know, Nick, I think
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  what's interesting,
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  even from my perspective, talking to leaders like
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  yourself all over the country,
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  at the helm of these insurance companies,
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  everyone comes from a lot of different backgrounds
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  often. And whether it's,
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  directly outside the insurance industry when they step
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  into the top role.
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  There's physicians leading insurance companies all over the
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  country. There's leaders like yourself that have been
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  been within and grown within the company for
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  a long time.
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  So I wonder,
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  given what we see across the industry,
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  what inspires your leadership style? What do your
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  employees,
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  what do they know to expect from you,
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  in their day to day?
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  And given all the change that you mentioned,
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  a a lot of change going on in
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  this industry right now,
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  what attributes do you think today's leaders need
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  to be successful in this industry? So two
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  pronged question there. What inspires your leadership style,
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  and and what do today's leaders need to
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  be successful
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  within this industry? Sure. It's a great question.
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  And I'll start with I think I think
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  good leaders remain authentic,
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  but continue to learn. We are all different,
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  but we can learn from our experiences.
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  And I I prefer and really appreciate learning
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  from great leaders over the years. We I've
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  observed some incredible attributes,
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  credible leaders over my my lifetime, and so
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  I think that's a a place where we
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  can learn. I'm not gonna bore you on
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  the accounting side. I'm not gonna bore you
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  on that background, but, I'm gonna give you
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  a little bit more of a story to
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  to to give you a little bit of
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  a flavor of of my my leadership style.
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  So for
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  me, my leadership style was shaped long before
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  I ever held a leadership role,
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  and that really gets into my inspiration. I'm
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  gonna touch on my grandfather.
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  My grandfather was a farmer. He was a
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  farmer in rural Mid Michigan. If you're familiar
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  with the area, it's primarily corn and soybeans.
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  And beyond his work on the farm, he
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  was deeply committed to his community.
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  He was the chair of the board of
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  the local bank. He was a big supporter
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  of a local senior center, and he spent
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  his time serving his church, and he could
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  keep an eye out for his neighbors as
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  well. And what I the story I like
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  to tell is a very difficult time, and
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  one of a family friend's,
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  life was he was laid off from a
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  local factory and really struggling to make ends
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  meet.
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  And and I watched my grandfather hire him.
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  He hired him to work alongside him on
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  the farm. And it was not because he
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  needed the extra labor, but he he he
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  was part of the community and this was
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  a member that needed his help.
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  So I gave this individual steady work until
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  he was able to get back on his
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  feet. And from my perspective, that had a
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  lasting impression on me.
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  For him leadership, it wasn't about position or
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  authority. It was really about lifting those other
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  others up. And he jumped in when somebody
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  needed help, and it really was an opportunity
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  to create a pathway,
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  for this individual. And
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  And so I always look at, he looked
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  out for people, he treated them fairly and
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  did what was best. And what that did
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  is it built a community of trust. And
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  I'll use that word trust,
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  throughout because I think it's really important to
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  have trust.
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  And as I mentioned, they had a lasting
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  impression on me. It really shaped how I
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  think about leadership today.
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  I think it's about supporting your team members
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  with a purpose
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  and this really, again, I'm gonna use the
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  word again, trust. It builds trust. And when
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  you have that trust, it opens a door
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  to collaboration,
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  accountability,
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  and speaking up in a fast paced environment.
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  That's my biggest concern that people are fearful.
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  Psychological safety, they're concerned to speak up. We
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  need to be able to speak up, listen,
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  learn,
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  say, yes. Let's move that way. No. Let's
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  not move that way, but we need to
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  be comfortable speaking up and talking. And that
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  goes from
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  right on the front line all the way
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  up to the to the CEO and president
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  of the company.
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  What it also does, it helps build, trusting
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  relationships with our customers. So you have the
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  trust in your team members
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  that will resonate and ultimately build trust in
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  our customers.
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  As far as your second part,
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  as for what leaders need today, I look
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  at building again, building a great culture,
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  really important,
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  and that gets to the trust factor that
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  I was discussing.
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  We also need to make sure we're adaptable,
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  have the ability to may remain grounded, and
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  a clear mission.
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  Health care and coverage, as many of you
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  in this who are listening know, moves very
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  fast. So if you can build trust, stay
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  flexible, keep people at the center, I think
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  as a leader, you'll find those decisions come
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  much more naturally.
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  Wow. Well, I really appreciate you sharing that
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  story with us, Nick, in terms of why,
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  the purpose of of community and trust is
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  so important to you going all the way
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  back to your grandfather and now trickling down
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  to the millions of members, that your company
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  serves. It's it's really impactful, so I I
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  appreciate that. And I wanna also hook on
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  to the to the second part of what
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  you were saying in terms of just the
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  the rapidly evolving nature of this industry right
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  now being adaptable,
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  as a as a company operating in this
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  space.
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  I wanted to switch gears and talk a
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  little bit about some of the things that
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  went on under your
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  leadership as you went from interim president to
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  to permanent
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  president.
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  You had advanced a company wide digital transformation
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  effort
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  last year, and then you also guided plans
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  to expand priorities regional footprint to four states
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  that came official this year, and you're now
• 11:11
  operating in Wisconsin. So talk to us about
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  how these efforts align with overall goals for
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  the company moving forward.
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  Thanks, Jacob. And I'll I'll clarify and just
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  emphasize that these initiatives, they didn't just start
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  with me. Our leadership team has been working
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  on these for a year. It really, really
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  is part of our long term vision at
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  Priority Health.
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  And I'll I'll look at the digital transformation
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  and regional expansion efforts.
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  They really are a result of years of
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  planning and collaboration. These these efforts,
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  what we they really will help move us
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  forward. They take a lot of planning and
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  collaboration. So for me as the interim and
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  now, stepping into the president, it's really to
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  keep this momentum going.
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  I wanna make sure we're preparing our teams
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  for change and we really have to stay
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  aligned with those strategic priorities.
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  So when I think about both of the
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  efforts, they do, they aligns very well with
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  our overall goals and it really comes back
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  to something very basic.
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  And it's making priority health a simpler,
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  more unified organization that can move quickly. I
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  talked about that agility,
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  allows us to make smart decisions,
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  address affordability, which is something we've been talking
• 12:13
  about since they had started here and years
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  before that, and and we'll continue on in
• 12:17
  the coming years. And then we need to
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  make sure we're staying centered on the people
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  we serve, really the the mission of why
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  we're here. And that's the kind of foundation
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  I wanna keep building on. When I think
• 12:26
  about the digital side, our move to Epic.
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  So we're moving to Epic and it focuses
• 12:30
  on simplifying how we work.
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  We're creating a better experience for both our
• 12:34
  team members and our customers.
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  We've been updating our systems, modernizing workflows
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  because we need an operating model that helps
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  us move faster, again, back to the agility,
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  and allows us to continue to simplify the
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  member experience
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  and to better connect our members with their
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  provider, and that's something that we're really focused
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  on. And then we need to make sure
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  that at the end, we're improving outcomes
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  and we're able to stay competitive because this
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  this industry is rapidly changing.
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  And then I look at the the, the
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  expansion, and you touched on that as well.
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  So, yeah, it is true. We're expanding our
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  footprint. We're very excited to be part of,
• 13:10
  of four states, and we're integrating plans. We're
• 13:12
  gonna integrate plans like a group health cooperative
• 13:14
  of of Eau Claire
• 13:16
  and physician health plan of Northern Indiana. And
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  what this does, it allows us to bring
• 13:20
  access to our high quality coverage
• 13:22
  to more people.
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  It also positions us to serve more people
• 13:25
  while leveraging shared systems. So when you think
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  about
• 13:28
  scaling this, we're gonna take multiple systems and
• 13:31
  put them onto one platform. So we have
• 13:32
  a really that unified experience.
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  We're also gonna be able to tap talent
• 13:36
  throughout, various states, and then we're gonna have,
• 13:39
  what it's saying, being able to have unified
• 13:41
  capabilities across states.
• 13:43
  And those capabilities,
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  I take the technology
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  expansion that's gonna help us improve experience, and
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  then at the end of the day, affordability
• 13:50
  for our members.
• 13:52
  When I think about moving forward, we will
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  continue to build on this foundation,
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  look to leverage technology,
• 13:58
  make care more personalized,
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  and really look to expand,
• 14:02
  our reach so that more people can benefit
• 14:04
  from what we offer.
• 14:06
  We think we offer a really compelling product,
• 14:08
  and really excited to touch, you know, 1,400,000,
• 14:11
  looking to continue to expand that to to,
• 14:14
  more and more individuals and members,
• 14:16
  throughout now those four states that you referenced.
• 14:19
  And I say none of this happens in
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  isolation. It is a collective effort. We have
• 14:23
  a really strong team here.
• 14:25
  We have wonderful people that we that I've
• 14:27
  been really blessed to work with.
• 14:29
  And I look at we have strong partnerships
• 14:31
  inside and outside the organization. This isn't just
• 14:33
  us. We we have some really strong partners
• 14:35
  as well.
• 14:36
  So really excited about, about the foundation we
• 14:38
  build and excited about the future for Priority
• 14:40
  Health.
• 14:42
  Well, clearly, a lot of growth happening and
• 14:44
  and on the horizon, Nick, for Priority Health.
• 14:47
  So before we go, what else are we
• 14:49
  missing? Any other final thoughts, final bits of
• 14:52
  advice you wanna share with all the other
• 14:54
  health plan leaders listening in?
• 14:57
  Yeah. I guess my final thought and kinda
• 14:59
  tie it all together,
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  but, again, in a fast pacing pace, fast
• 15:04
  changing,
• 15:05
  difficult industry that we we are in, I
• 15:08
  just
• 15:09
  the advice I give is stay grounded.
• 15:11
  Wanna stay grounded in our mission and continue
• 15:13
  to trust our people. And if we can,
• 15:16
  you know, I think it's it it takes
• 15:17
  a leap sometimes, but really building that,
• 15:20
  that trust with our people will pay off
• 15:22
  over time.
• 15:23
  In terms of other health plan leaders, my
• 15:25
  advice is simple and it gets into embracing
• 15:28
  change without losing sight of we'll use the
• 15:30
  term fundamentals.
• 15:31
  Be data driven.
• 15:33
  Kind of going back to the finance background,
• 15:35
  I love data. So be data driven. Let's
• 15:37
  be transparent with each other, be transparent with
• 15:40
  our communities,
• 15:41
  and then making sure we are investing in
• 15:43
  our teams. And so I have to go
• 15:45
  back to our technology.
• 15:46
  That's a big part of that. We're investing
• 15:48
  in our teams. The expansion we're investing in
• 15:50
  our teams. And then I look at never
• 15:52
  understate the power of aligning around our clear
• 15:54
  strategy. So whether again, that's modernizing our technology,
• 15:58
  expanding it into new markets,
• 16:00
  or tightening our focus on outcomes and affordability,
• 16:03
  those are the things that help us stay
• 16:05
  steady in a shifting landscape.
• 16:07
  So to kind of wrap it up at
• 16:09
  the end of the day, we're all here
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  for the same reason.
• 16:12
  Our goal is to make healthcare better for
• 16:14
  the people and communities we serve. And if
• 16:16
  we keep that front and center, you'll create
• 16:18
  real impact. And I said real impact during
• 16:20
  very challenging times.
• 16:22
  So thank you for the opportunity, Jacob. I
• 16:24
  really appreciate
• 16:25
  it. Absolutely. Thank you, Nick, for taking the
• 16:28
  time to chat with us and for sharing
• 16:30
  your insights with our listeners. We really appreciate
• 16:33
  it. And to our listeners, if you'd like
• 16:35
  to listen to more podcasts from Becker's Healthcare,
• 16:37
  you can visit beckershospitalreview.com.