Latest / Becker’s Payer Issues Podcast / Steve Yurjevich, Chief Executive Officer of Optum Insight’s Payer Market and a member of the American Heart Association Executive Leadership Team

Transcript

Steve Yurjevich, Chief Executive Officer of Optum Insight’s Payer Market and a member of the American Heart Association Executive Leadership Team · Becker’s Payer Issues Podcast

• 0:00
  Hi, everyone. This is Elizabeth Caslow with the
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  Becker's Payer Issues podcast.
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  I'm thrilled today to be joined by Steve
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  Jurkovich,
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  chief executive officer at OptumInsight
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  Payer Market.
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  Steve, thank you so much for joining us
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  today.
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  Thanks for having me.
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  Yeah. So can you just give us a
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  little bit more on your role,
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  and Optum Insights in the payer market, part
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  specifically?
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  Yeah. I sure can. As you said, I
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  currently serve as the CEO of Optum Insights
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  payer business.
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  And in that business, really, the the crux
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  of what we do is partnering with health
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  plans to help them navigate the complex health
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  care delivery system.
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  And we're able to connect payers, providers, and
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  members
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  through data and technology with
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  our mission to make the health system work
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  better for everyone.
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  I've been with OptumInsight for the past sixteen
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  years and in health care for about thirty
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  four.
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  So it looks like you're gonna have a
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  lot of great color to add to our
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  conversation with that experience under your belt. So
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  from your perspective, how would you describe the
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  current health care landscape?
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  And what is the most pressing challenge that
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  payers are dealing with right now?
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  Oh, that's a this is a big question.
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  And I would say costs are the things
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  that are really top of mind right now.
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  Health care costs continue to rise at an
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  alarming rate with
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  U A US health care spending reaching about
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  4,900,000,000,000
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  and growing at about a seven seven and
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  a half percent,
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  rate year over year.
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  Utilization
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  continues to increase,
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  post pandemic, and
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  payers are trying to balance afford affordability
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  with
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  patient experience
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  and regulatory pressures,
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  all while we as consumers of health care
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  are demanding a better and more transparent experience.
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  In fact, I recently talked with a payer
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  CEO
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  who is struggling to balance the reality of
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  the increasing medical cost trends
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  with the need to decrease their operating expense,
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  which, as you might imagine, learned to a
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  great,
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  turned to a great conversation about artificial intelligence
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  and how to use AI, but not just
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  as a cost lever, really as a growth
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  and a cost lever creating a win win,
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  across the market.
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  So I look forward to diving into that
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  a little bit more deeply. How is Optum
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  working on those cost challenges,
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  And where are you seeing real progress? Like,
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  what is working with AI on that front?
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  Yeah. I I would say, first, from an
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  affordability
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  perspective,
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  the industry has finally moved away from pay
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  and chase or post payment recovery,
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  and shifted
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  to more,
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  modernized thinking
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  around prepayment
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  and accuracy.
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  But our work isn't done. It's a nice
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  step forward. But to really make a difference,
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  to really make an impact,
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  we now need to shift to real time
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  interactions,
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  eliminating
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  down,
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  downstream disputes
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  and reducing the administrative
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  administrative
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  friction that exists today.
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  We're seeing our payer partners move from batch
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  processes to real time interactions,
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  and,
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  that's reducing costs across the board.
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  It also results in fewer downstream disputes, less,
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  better relationships between payer and provider. And let's
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  face it,
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  all of those interactions
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  have an impact on the member and the
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  patient.
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  And sometimes it's it's,
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  not easy to remember that, but
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  I think we, as the leadership
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  across
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  health plans, health systems,
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  we need to remember that at the other
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  end of that transaction, there's a member or
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  a patient that's,
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  receiving care. And all of the noise in
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  the process today,
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  could be very distracting for them, and,
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  and it's our job to fix that.
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  The other thing that I see is is
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  payers are moving away from, you know, the
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  days where they have 15 or 20 different
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  affordability or payment integrity partners,
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  shifting to three to five
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  real partners that integrate solutions
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  as opposed to the patchwork framework that we've
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  seen in previous years.
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  And one of the things that's helping to
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  do that is certainly the adoption of AI.
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  So you mentioned the member and patient side
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  of things. How are digital capabilities
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  helping improve the member experience and affordability,
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  for those people?
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  It's a it's a great question. And we
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  talked about shifting from postpaid to prepay
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  and now going from prepay to true avoidance
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  is great for the system.
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  It really is gonna have a meaningful,
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  impact
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  on payers and providers, but also that member.
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  It will it will take them out of
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  the middle. One example is a a health
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  system that we're working with
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  processed over 5,000 visits. And
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  in those five five thousand visits using real
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  time connections to a payer,
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  they reduced the number of errors that occurred.
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  They,
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  received faster reimbursement with fewer disputes,
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  which is terrific, but the real win is
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  that the the,
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  member experience was greatly improved.
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  That has to be our North Star as
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  we think about how to modernize the systems
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  going forward.
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  And looking ahead, say, you know, in the
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  next few years,
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  how does payer provider collaboration
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  shape and inform a more connected health care
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  ecosystem?
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  Yeah. That's the goal, Elizabeth. I mean,
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  I think about health care as,
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  an experience across multiple steps in the patient
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  journey.
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  Pre care, during care, post care, these can't
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  be isolated, and they have to be connected.
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  And if that has to be connected, we
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  also have to think about connecting eligibility,
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  utilization,
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  medical management, authorizations,
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  revenue cycle management, payment integrity,
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  and others to deliver on the promise of
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  a connected transparent healthcare.
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  Bringing these workflows together into the patient journey,
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  decreasing handoffs, driving accuracy,
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  and making a connected experience for all the
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  participants,
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  that's where we're going.
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  In fact, we've we've, recently,
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  launched our OptumReal products in the marketplace that
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  are are facilitating
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  those
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  seamless transparent
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  interactions.
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  And,
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  as I described, the the the benefits are
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  pretty terrific, and the impact to the patient
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  is, is is positive.
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  Well, thank you so much, Steve. And I
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  would just wanna give you the opportunity while
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  I have you here. Is there anything else
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  on your mind that you wanted to share
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  as we wrap up?
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  You know, I think the the last thing
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  that I would share is,
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  as I said, I've been in the business.
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  I've been in the health care industry for
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  a long time, and I'm I'm really encouraged
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  about
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  the way I see payers and providers working
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  together today.
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  It seems to me that the days of,
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  payers and providers sitting across from one another
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  scowling with their arms crossed with a
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  a bucket of claims
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  from each organization
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  that have to be, quote, unquote, reconciled are
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  gone. And,
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  payers and providers are now really working together
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  to solve really, really difficult problems
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  to make the delivery system better and to
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  make it better for us as health care
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  consumers. So,
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  as people listen to this, if, if you
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  wanna learn more, I'd love to talk. Thanks
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  for the opportunity.
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  Yeah. Thank you so much, Steve. It was
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  great touching base.
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  And for our listeners, if you'd like to
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  listen to more podcasts from Becker's Healthcare, you
• 8:06
  can visit beckershospitalreview.com.
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  Thank you.