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

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Leading Priority Health Through Growth, Trust, and Transformation · 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
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together over 400 payer and health plan executives
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and more than 100 speakers to Chicago April.
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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
0:48
you for having me, Jacob, and thank you
0:50
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.
1:02
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
1:10
plan of Coral Health. And Coral Health happens
1:12
to be the largest Michigan based health system.
1:16
So just to give you a little bit
1:17
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
1:24
a great opportunity me for me personally to
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learn about different businesses, industries,
1:28
and really gives me an opportunity to lead,
1:31
teams early in my career. So there's my
1:32
plug for public accounting for those, who are
1:35
interested in a in a great career to
1:36
start out with. But while it was a
1:38
great start, I really wanted to find something
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that I was more connected
1:42
with, connected to a community. And there happened
1:44
to be an opportunity to join Priority Health,
1:46
which I was really excited about excited about
1:49
joining a healthcare organization, but I will admit
1:51
I knew very little about the industry
1:53
other than my experiences as a member and
1:55
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
2:08
our teams were about the members, about the
2:10
community.
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There was a lot of conversation around affordability
2:14
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
2:24
team.
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My experience as a priority health way, I
2:27
started through the finance side. I helped, guide
2:30
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,
2:40
going all the way back to the Medicare
2:41
modernization,
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our launch of Medicare Advantage,
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of course, the introduction
2:46
of the Affordable Care Act, and then more
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recently, the COVID era,
2:50
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,
3:12
quality,
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and a better experience for our members.
3:15
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
3:29
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,
3:45
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.
3:54
Yeah.
3:55
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.
5:00
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
5:09
lean into shaping the strategic direction of our
5:11
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,
5:25
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
5:33
to be an advocate. So being,
5:35
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
6:12
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
6:19
often. And whether it's,
6:21
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,
6:46
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,
7:09
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
7:16
from great leaders over the years. We I've
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observed some incredible attributes,
7:20
credible leaders over my my lifetime, and so
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I think that's a a place where we
7:24
can learn. I'm not gonna bore you on
7:26
the accounting side. I'm not gonna bore you
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on that background, but, I'm gonna give you
7:30
a little bit more of a story to
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to to give you a little bit of
7:33
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
7:49
with the area, it's primarily corn and soybeans.
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And beyond his work on the farm, he
7:54
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
8:01
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
9:39
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
10:06
in this who are listening know, moves very
10:08
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
10:28
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
10:36
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
10:42
now being adaptable,
10:44
as a as a company operating in this
10:46
space.
10:48
I wanted to switch gears and talk a
10:50
little bit about some of the things that
10:52
went on under your
10:54
leadership as you went from interim president to
10:56
to permanent
10:57
president.
10:58
You had advanced a company wide digital transformation
11:02
effort
11:03
last year, and then you also guided plans
11:05
to expand priorities regional footprint to four states
11:09
that came official this year, and you're now
11:11
operating in Wisconsin. So talk to us about
11:14
how these efforts align with overall goals for
11:17
the company moving forward.
11:20
Thanks, Jacob. And I'll I'll clarify and just
11:22
emphasize that these initiatives, they didn't just start
11:24
with me. Our leadership team has been working
11:26
on these for a year. It really, really
11:27
is part of our long term vision at
11:29
Priority Health.
11:30
And I'll I'll look at the digital transformation
11:32
and regional expansion efforts.
11:34
They really are a result of years of
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planning and collaboration. These these efforts,
11:38
what we they really will help move us
11:40
forward. They take a lot of planning and
11:41
collaboration. So for me as the interim and
11:44
now, stepping into the president, it's really to
11:46
keep this momentum going.
11:48
I wanna make sure we're preparing our teams
11:50
for change and we really have to stay
11:52
aligned with those strategic priorities.
11:54
So when I think about both of the
11:56
efforts, they do, they aligns very well with
11:58
our overall goals and it really comes back
12:00
to something very basic.
12:02
And it's making priority health a simpler,
12:04
more unified organization that can move quickly. I
12:06
talked about that agility,
12:08
allows us to make smart decisions,
12:10
address affordability, which is something we've been talking
12:13
about since they had started here and years
12:15
before that, and and we'll continue on in
12:17
the coming years. And then we need to
12:18
make sure we're staying centered on the people
12:20
we serve, really the the mission of why
12:22
we're here. And that's the kind of foundation
12:24
I wanna keep building on. When I think
12:26
about the digital side, our move to Epic.
12:28
So we're moving to Epic and it focuses
12:30
on simplifying how we work.
12:32
We're creating a better experience for both our
12:34
team members and our customers.
12:37
We've been updating our systems, modernizing workflows
12:40
because we need an operating model that helps
12:42
us move faster, again, back to the agility,
12:44
and allows us to continue to simplify the
12:46
member experience
12:48
and to better connect our members with their
12:50
provider, and that's something that we're really focused
12:52
on. And then we need to make sure
12:53
that at the end, we're improving outcomes
12:55
and we're able to stay competitive because this
12:57
this industry is rapidly changing.
13:01
And then I look at the the, the
13:03
expansion, and you touched on that as well.
13:06
So, yeah, it is true. We're expanding our
13:07
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
13:18
what this does, it allows us to bring
13:20
access to our high quality coverage
13:22
to more people.
13:24
It also positions us to serve more people
13:25
while leveraging shared systems. So when you think
13:27
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.
13:34
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,
13:45
I take the technology
13:46
expansion that's gonna help us improve experience, and
13:49
then at the end of the day, affordability
13:50
for our members.
13:52
When I think about moving forward, we will
13:54
continue to build on this foundation,
13:56
look to leverage technology,
13:58
make care more personalized,
14:00
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
14:20
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,
15:00
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
16:10
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.