Latest / Becker’s Payer Issues Podcast / Steve Tringale, President of Mass General Brigham Health Plan

Transcript

Steve Tringale, President of Mass General Brigham Health Plan · Becker’s Payer Issues Podcast

• 0:00
  Welcome everyone to the Becker's Healthcare podcast series.
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  I'm Mariah Muhammad, writer and moderator with Becker's
• 0:05
  Healthcare. And I'm thrilled to have with me
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  today Steve Tringale, president of Mass General Brigham
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  health plan. Steve, welcome to the podcast. We're
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  very excited to have you join us today.
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  To To get us started, would you mind
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  please introducing yourself and telling us a bit
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  about your background?
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  First, thank you for having me, today.
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  I'm Steve Tringale. I'm president of the Mass
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  General Brigham Health Plan.
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  We're a health plan of approximately
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  400,000
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  members
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  across commercial Medicare Advantage
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  and Medicaid,
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  product lines.
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  We also will be entering,
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  the dual eligible product line, so we have
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  a full product portfolio.
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  And we are focused
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  really on
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  building a model which
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  takes advantage
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  of our integrated health care system
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  in using
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  the incredible resources at Mass General Brigham
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  to provide our members with
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  a better experience,
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  a better clinical outcome, and quite frankly,
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  a better product
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  than other health insurers
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  and and really take advantage of that combination
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  of world class care
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  and comprehensive coverage that we can provide.
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  Yeah. Yeah. Wonderful. Thank you so much for
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  giving us that background. So
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  health care in hospitals and health plans, health
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  care overall is really, changing rapidly right now
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  as I'm sure you're, well aware. What are
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  some of the biggest issues you're following in
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  health care this year so far?
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  Well, it is, in fact,
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  both the fragility and the volatility of of
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  both the delivery systems and insurers at the
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  same time
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  is something I have not seen
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  very often in my career.
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  So when we look at that level of
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  volatility
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  in the marketplace,
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  when we look at,
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  the level of accelerated
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  change that you usually get
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  in the first year of a new administration
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  and a new congress,
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  and you put all of those things together,
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  keeping
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  our plan
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  focused
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  on our North Stars,
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  which are essentially
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  providing that member
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  focus so that they're having a better experience
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  and a better outcome
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  and
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  taking advantage
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  of our integrated delivery system.
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  We try and stay focused on that, but
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  at the same time,
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  be flexible and agile
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  to be able to pivot to respond to
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  both expected and unexpected challenges and opportunities
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  that are gonna be created by what is
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  a rapidly changing and a rapidly consolidating industry
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  on
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  Yeah. Yeah. Absolutely.
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  And,
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  you know, saying this type of change being
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  something you haven't seen much in your in
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  your career, is this something that's kinda making
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  you nervous? And if not, is there anything
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  that you are most excited about,
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  whether in tech, whether,
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  something that is changing overall or anything else
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  that's making you nervous?
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  So
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  I don't know that I'd use the word
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  nervous as much as
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  focused.
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  There are a number of areas that require,
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  an extraordinary
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  level of focus right now.
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  Access is a huge issue and access from
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  a financial basis,
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  which means making sure that the products can
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  stay affordable,
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  and access
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  from a physical basis, which means
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  dealing with the primary
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  care shortage, which is affecting
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  both delivery systems and health plans across The
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  United States, and we're no exception to that.
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  So coming up with build to purpose,
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  solutions on the primary care side
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  and using
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  AI,
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  not just
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  at the the health plan level in terms
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  of
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  managing our claims,
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  volumes and managing,
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  denials and prior approvals,
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  using AI
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  to improve the member experience,
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  to enhance the ability
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  to
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  help the member navigate and move to a
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  very complex
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  delivery system
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  to be at the right place, to get
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  the right care at the right time,
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  to make sure that we're providing the member
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  with the highest level of
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  digitally enhanced
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  responses to some of
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  the clinical challenges, whether it be
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  in the area of of
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  high end imaging,
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  or whether it be in using
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  AI to help our analytics to focus on
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  what are the right mix of services
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  to provide to a member so that when
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  we look at issues like the lifestyle challenges
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  between diabetes and obesity,
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  that
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  we're not solely focused on
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  do, we approve
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  the provision
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  of a GLP one, but what are the
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  right
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  mix of services
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  that we should wrap around the provision of
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  that GLP one
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  that's going to help that member
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  succeed over the long term
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  to have
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  better health outcomes and not just have
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  some weight loss, to change the way they
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  look at some of their lifestyle decisions,
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  to change the way that they
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  approach some of their day to day activities,
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  whether it be,
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  food based, whether it be exercise based, etcetera.
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  In having,
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  using AI to build analytics to help us
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  on those issues
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  as much as some of
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  the core insurance issues, which have quite frankly
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  gotten some negative press
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  in in terms of how other companies are
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  using it. We wanna use AI
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  to improve the member experience and to improve
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  the member outcome.
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  Yeah. Yeah. Absolutely. Thank you so much for
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  sharing that. And access overall is definitely something
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  I've heard other techs talk about in different
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  ways as well.
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  And,
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  going with this kind of theme of change
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  and implementing different things,
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  in your opinion, what would the most effective
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  health care leaders need in order to be
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  successful in the next two to three years,
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  do you think?
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  A couple of things.
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  I think the biggest challenge, quite frankly, in
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  the short term is leadership.
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  There is so much going on
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  that you need to keep your teams
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  focused
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  on the business of the business
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  and at the same time,
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  flexible and agile
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  to, as I said, to take
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  advantage of opportunities,
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  not just to respond to some of the
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  specific challenges out there.
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  In terms of the focus on the business,
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  you know, we're really proud that over the
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  last two years, we've won
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  recognition
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  as from JD Power
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  as the most trusted
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  plan
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  in the commercial marketplace in Massachusetts,
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  a market which has some very strong competitors,
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  and we've won that two years in a
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  row.
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  That's an example of staying focused.
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  At the same time, an example of staying
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  flexible and agile.
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  You've all written an enormous amount about some
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  of the challenges that this
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  health system all over the country faced
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  when,
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  Stewart Healthcare went into bankruptcy.
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  Our team,
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  stepped up and immediately
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  looked at
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  every member that we had, every individual member
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  that was in a steward facility to make
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  sure that we could maintain continuity of care
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  and a care regimen for patients who are
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  in active cancer treatment, active cardiac treatment, etcetera.
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  And they did that while we were running
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  the the rest of, you know, the plan
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  activities on a day to day basis.
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  That's the kind of response that I think
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  you're gonna need from good health plans
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  to continue to operate in a system
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  which is almost guaranteed to have
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  a lot more bumps in the road, a
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  lot more change,
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  a lot more consolidation over the next two
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  to three years. What we're seeing go on
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  right now is not a one year
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  interlude.
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  There is a a a significant sea change
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  going on in delivery system right now.
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  So whether it's,
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  digital innovation,
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  it's whether working with our delivery system
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  to improve integrated models of care, which differentiate
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  us
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  in the market,
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  whether it's the blocking and tackling of
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  customer service across very different product lines, whether
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  it be commercial,
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  Medicaid,
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  geriatrics with Medicare Advantage.
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  We need to
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  to continue to improve
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  what I think has been
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  rather good performance, quite frankly.
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  So,
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  you know, the focus on continual improvement in
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  a period of rapid change
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  is a challenge from a leadership perspective.
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  So the last piece of that is I
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  need to challenge my leadership team,
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  to be great two way communicators.
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  The leadership teams have a pretty good window
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  on what's going on
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  at the policy level, at the state level,
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  at the federal level, at the national level.
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  But we need to be teaching,
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  explaining,
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  and be transparent about both the market dynamics
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  and the political dynamics
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  that are driving some of that change.
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  And at the same time, we need to
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  be sitting down with our workforce
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  and be active listeners
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  and make sure we understand how this is
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  impacting them in the way they have to
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  undertake their duties on a day to day
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  basis.
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  While this is a huge challenge for leadership,
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  sometimes I think we forget
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  how daunting some of this change can be
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  for the overall workforce.
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  So I think in many ways, the biggest
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  challenge
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  for senior executives, for senior leaders,
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  for myself,
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  is to be,
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  as I said, sort of that great two
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  way communicator
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  because
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  people will respond to challenges if they understand
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  why they need to do it. It's a
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  lot harder to respond to those challenges,
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  and it's a lot more it's a lot
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  more stressful to respond to those challenges
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  if you really don't understand the underlying dynamics
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  about what's going on.
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  Yes. Yes. Absolutely. Thank you so much for
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  those final thoughts. This has definitely been an
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  informative discussion. And, again, I wanna thank you
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  so much for coming on Becker's HealthCare,
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  especially for the first time, and I look
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  forward to connecting with you again soon.
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  Sure. Thank you very much.