Latest / Becker’s Healthcare - Clinical Leadership Podcast / Tom Grote, CEO of Banner | Aetna

Transcript

Tom Grote, CEO of Banner | Aetna · Becker’s Healthcare - Clinical Leadership Podcast

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  This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Tom Gro, c e o of Banner, Aetna. Tom,
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  it's a pleasure to have you on the podcast today.
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  Oh, thanks for having me on. Appreciate it.
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  Now, I'm excited for our conversation today because I know you, um,
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  sit at a very important aspect of, of healthcare right now, um,
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  between Banner and Aetna,
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  and really seeing a lot of what big trends are driving healthcare and, uh,
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  resources today. But before we dive into our larger discussion,
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  I would love for you to tell us a little bit more about yourself,
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  your background, and how you, um, came to be the CEO of Banner Aetna.
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  Okay, great. Yeah, I, um,
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  actually started with Aetna Novec in 1987. So after I graduated,
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  um, from Notre Dame, I was living in Connecticut and looking for a job,
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  and at that time it was insurance or insurance.
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  So that's pretty much how I ended up landing with Aetna. Um,
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  went through their group school. Um, early in my career, I,
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  I did sales for small group, middle market national accounts. Um,
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  ran a national account department for a number of years, and, um,
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  eventually moved on to the Maryland DC Virginia area, um,
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  where I was a general manager for middle market business, um,
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  and then eventually became the market president, uh, for Maryland,
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  DC and Virginia. Um, at which time I helped, um, um,
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  develop our first a Aetna first joint venture, um,
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  called Innovation Health with the Nova Health System in Northern Virginia. Um,
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  I ended up moving out to Arizona about eight years ago. Um, and, uh,
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  at that time I, I worked on, um, um, developing the,
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  the Banner Aetna Joint Venture. Um, I, as part of the development team there,
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  and I've been running Banner Aetna since we formed, um, back in 2017.
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  Got it. That's amazing to hear. And,
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  and just so fascinating how you were able to build your career and grow and
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  develop, um, within the Aetna organization. So, uh,
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  I know we're in a little bit different of a time now than we were back in 2017,
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  but what are you most excited about right now,
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  and especially looking at where healthcare is headed in, in some of the big, um,
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  things upcoming over in the next year or two?
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  I think one of the most exciting programs that we've launched recently was a
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  diabetes reversal program through a company called Verta. And, um,
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  that program has, um, seen some significant success since we launched.
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  Um, we just got back our first six month, um, results, uh,
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  on, on the program. And, uh,
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  the results have been incredibly impressive. Uh, the, uh,
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  participants in in the program have dropped their A1C by
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  1.4%. Um, they've lost 8% of their weight,
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  and, um,
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  we have reduced their diabetic medications by
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  50% with 40% of them getting off insulin
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  entirely. So, um,
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  just really incredible results as a result of this program. And, uh,
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  I think even, even more exciting is the, um,
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  the fantastic testimonials we've gotten back from the participants. Um,
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  this program has really helped to change a number of their lives, um,
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  so that they're much more active, much more happy and, um, en enjoying life.
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  And so that's been, you know,
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  very gratifying from a CEO perspective to implement a program that's had such a
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  positive impact on some of our members.
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  Absolutely. Wow, that's fascinating. So, you know,
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  when you think about this program and how you tackled it, um,
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  what was most meaningful to get these types of results?
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  I can imagine many of the, um, individuals who participated,
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  certainly had tried other things in the past or, or, you know,
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  were unsuccessful at making changes that they needed in order to be healthier.
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  So, you know, what, could you tell us a little bit more about the program and,
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  and why it was so, um, incredibly effective for many of the members?
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  Yeah, I think that the, the key to the program is continuous monitoring and, uh,
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  support of a coach. And so, um,
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  each member is aligned with a coach that works with them and communicates with
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  them frequently, even on a daily basis, to, um,
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  make sure they're staying on track with the program and,
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  and have the best opportunity for success. And that's helped to re to,
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  um, keep the members really engaged and on track to producing those impressive
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  results.
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  Got it. That's great to hear. And, and definitely I can imagine very, um,
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  helpful as you said,
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  to have those coaches and in communication easy access to each other. Now,
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  you know, I I, it's amazing to see how well this program has done,
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  but I can imagine still as c e o you are spending your time on multiple
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  different things and aspects of the organization that need attention.
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  So what are some of the issues that you're really focused in on today?
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  Yeah, I think the, the two key areas, um,
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  that we're looking at and focused in on are, are the member experience and then,
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  um, engagement slash navigation for the members. And so, you know,
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  the member experience,
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  and it's really important to try to help streamline the healthcare process for
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  our members. And, um, recently we launched a frictionless billing program,
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  which brought together the e O B and the bill into one statement to help
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  simplify it for our members, which is, you know, been really an exciting, um,
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  endeavor that we've worked on with,
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  with banner internet and to bring that to the market for our members. Um,
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  but right now I think, uh, our key focus on the member experience, um,
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  like a lot of people is on pre-authorization.
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  What is it we can do to help automate the process,
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  make it easier for the doctors, easier for the members, um,
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  and to improve that process. So that's, that is definitely a,
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  a big focal point for us is trying to figure out, you know,
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  much more automated solution, um, on, on that realm. Um, the,
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  the other area is really on engagement. Um, I, you know, from,
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  it's really the holy grail in this business, how, how do we, um,
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  educate our members on what programs are available to them and, um, have them,
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  um, engaged in their healthcare and, and following, um,
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  even just taking their prescriptions and, and such. And so, um,
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  we're testing a bunch of different point solutions in that area to
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  figure out, you know, how do we better educate our members,
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  keep them engaged in their healthcare, um, so that, that's a big focal point.
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  Um, and another one is really about navigation. Um,
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  especially in behavioral health area, um,
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  there's just a lot of challenges on access to the care. Um,
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  we haven't introduced a number,
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  in fact about 15 different virtual behavioral health programs for our members.
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  Um,
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  and what we're focused on now is trying to help them understand which programs
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  might be best, you know, for their individual, uh, mental health needs. And so,
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  um,
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  that's an area that we're spending a lot of time on figuring out which solution
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  might be best to help help our members navigate to the best behavioral
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  healthcare.
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  That's great to hear. And I, I know that, uh,
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  behavioral health and mental health services and programs are certainly top of
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  mind for many different organizations, whether on the healthcare side or the,
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  um, health plan side as well, because, you know,
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  that type of service is just in such high demand, it can be so impactful for,
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  uh, an individual's overall health. And so it's great to hear that, you know,
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  you've been able to roll out some different things and indefinitely, um,
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  navigating, you know, in that way. Uh,
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  when you look at where you're at at Banner Aetna and being able to make
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  adjustments and then roll out these types of new programs,
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  whether it's a diabetes management program or, um, you know,
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  some of these behavioral health services as well,
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  what does it take to have a team that is innovative and able to, um,
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  develop new things and, and meet the needs of their members, um, you know,
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  really on a consistent basis,
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  how do you kind of breed that culture within the larger organization?
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  Yeah, our, our, our founding mission is to try to fix healthcare. And so,
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  you know, we have a management team that is very committed to that concept. And,
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  um,
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  so we're constantly surveying the marketplace and trying to do,
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  um, um, see what new solutions are out there that could benefit our members.
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  Um,
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  but we're also looking at our own members' experience and seeing where they're
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  having challenges. And you know, when we identify those, we,
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  we try to figure out how to not only resolve that one specific issue,
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  but how do we stop it from happening to our members, um, uh,
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  overall on an ongoing basis.
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  And so we're constantly looking at ways just to make the process work better
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  for our members. Um,
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  so that's sort of ingrained in how we operate our company.
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  Got it. That this such an important mantra and I really love that, um,
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  making sure you're able to fix healthcare. Now,
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  before we wrap up our conversation,
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  I would love to look ahead just a little bit. What do you think will be most,
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  what do you think, excuse me,
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  most effective healthcare leaders will need in order to be successful over the
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  next two to three years?
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  I know the healthcare field is evolving and changing very rapidly.
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  Technology is changing, what patients are demanding is changing.
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  So when you think about the next couple of years,
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  what do will you as a leader and your leadership team need, um,
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  to really be successful a as the changes unfold?
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  Yeah, I think, you know, when, when you look at, um,
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  the landscape now, um, this is a multi multi-trillion dollar business and,
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  um, there's a tremendous number of startups and other companies, um,
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  getting involved in the healthcare business and, you know, as a leader, it's,
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  um,
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  gonna be coming on us to try to sift through all of the different offerings out
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  there and figure out which ones are, you know,
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  most impactful and have staying power, you know, for the long term.
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  And, um, it's, it's almost a full-time job just trying to,
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  to understand what's, what's,
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  what's developing in the market and which companies, you know,
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  have the greatest promise. So, you know, certainly, um, that's an area that,
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  um, you know, we're very focused in on and trying to, um, manage that process,
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  which is not easy cuz there are so many solutions out there. Um, and I think,
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  you know, long term, you know, every,
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  all healthcare leaders really need to look at affordability. Um, you know, we,
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  there's a lot of challenges today. Um, a lot of pressures, um,
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  on healthcare costs, um, even from staffing and,
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  and inflation for the providers to, um, high, um,
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  especially drug costs and, and other things that are driving up costs. And,
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  you know,
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  eventually we're gonna reach a tipping point if we don't continue to work
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  together across all those areas to figure out, um,
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  better ways to deliver more affordable healthcare to our members. So I think,
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  you know, collaborating with pharmaceuticals,
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  collaborating with the providers is gonna be very important. Um,
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  so we can make sure that we can maintain a,
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  a affordable healthcare solution, you know, to the people in the United States.
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  Yeah, absolutely. I think that's such a great point and definitely, um,
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  looking at the, as you said, the pressures, um, right now, you know, I,
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  I love that idea that trying to connect with providers
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  and, and really make, um, healthcare more accessible and easier, um, really,
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  you know, is the way to go in the future. And, and so, you know, I,
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  I love that idea of partnering with them and I know you're kind of at this, um,
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  access point between healthcare providers with Banner and then Aetna on the
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  health plan side. And so, you know, it,
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  it is just really fascinating to hear what you have to say and,
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  and you talk about, you know, where that relationship is headed, um,
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  to truly act upon the things that will be best for patients.
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  Absolutely. You know, and I think the developing area right now in healthcare,
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  there's a lot of investments going in on the primary care physician front and
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  uh, and there's a lot of huge bets that that is going to be, you know,
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  the avenue to help control costs over time.
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  So we'll see how that all progresses as we go forward now.
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  Absolutely. It is fascinating,
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  especially too with some of the non-traditional healthcare, um,
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  entrant coming into the space and really acquiring primary care platforms and,
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  um, primary care groups in general to bring physicians into their network. Um,
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  it's just been really interesting to see how all of that is evolving and in
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  developing and changing some of the, um,
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  healthcare landscape in certain markets.
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  Definitely.
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  Well, Tom, thank you so much for joining us on the podcast today.
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  This has been a really fun and informative discussion.
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  I look forward to with you again soon.
• 12:44
  Great. Thanks for having me. I appreciate.