Latest / Becker’s Payer Issues Podcast / Kevin Knight, Chief Marketing Officer at Sidecar Health

Transcript

Kevin Knight, Chief Marketing Officer at Sidecar Health · Becker’s Payer Issues Podcast

0:00
Hi, everyone. This is Elizabeth Casselow with the
0:02
Becker's Payer Issues podcast.
0:04
I'm thrilled today to be joined by Kevin
0:06
Knight, chief marketing officer at Sidecar Health. Kevin,
0:09
thank you so much for joining us today.
0:11
Thank you, Liz.
0:13
Yeah. So before we jump into the conversation,
0:15
can you tell me a bit more about
0:16
yourself and your career background and transition into
0:19
the health insurance space as well as your
0:21
current role at Sidecar?
0:23
Sure. I spent my career mainly in consumer
0:26
technology. I've worked at companies
0:29
like Google, Microsoft, Facebook, Pinterest, Compass.
0:32
And,
0:33
at one point a few years ago, I
0:36
sort
0:37
of found myself in this moment of introspection
0:39
wondering if maybe I could take the
0:42
really useful skills that I picked up in
0:44
those roles
0:45
and apply them to something that would have
0:48
maybe a little bit more impact, than than,
0:51
you know, cell phones and social media and
0:53
things like that as interesting as that time
0:55
and that era was. And I I really
0:57
found myself gravitating toward health care,
0:59
because
1:01
I worked for companies
1:02
like the ones I mentioned that were all
1:05
really, really audacious. They had massive ambitions, and
1:08
they fully believed that they could change consumer
1:10
behavior and change the way people interacted with
1:13
ideas and content and one another.
1:16
And they're just
1:17
there's there's always been this persistent dearth of,
1:20
I would say, audacious ideas in health care.
1:23
And so I began,
1:25
my own journey in health care, working for
1:27
a point solution called Vida Health, about six
1:30
or seven years ago as, chief marketing officer
1:33
there.
1:34
And what I found is that so many
1:36
of these companies that are really interesting ideas,
1:39
like so many of the point solutions out
1:40
there,
1:41
they really exist because of a failure of
1:44
coverage on the part of carriers.
1:46
And so over time, I found myself gravitating
1:48
more and more toward if I really wanna
1:49
be part of fixing American health care, let's
1:52
go straight into the belly of the beast,
1:53
and let's try and fix health insurance,
1:56
because that is ground zero for so much
1:58
of what is wrong with American healthcare.
2:01
So given all of that, you know, I
2:03
think it's clear that marketing
2:05
for health insurance can be a challenge. So
2:08
what messaging is landing right now,
2:10
for the people that you are serving and
2:12
what's falling flat?
2:16
It's a great question. I I think that
2:18
what what when it comes to consumers,
2:20
patients, members, people, humans, whatever we wanna call
2:24
them,
2:26
it's the jargon.
2:27
It's the lingo, the nonsensical
2:30
rules and red tape and bureaucracy that people
2:33
really get lost in. The fact
2:35
that we call
2:36
explanations of benefits
2:38
something that they really are not. I mean,
2:40
who gets an explanation of benefits and is
2:42
left with any feeling other than confusion? They
2:45
utterly fail to deliver on what they're called.
2:48
And that's true of just about every, piece
2:50
of jargon in health insurance.
2:53
So the longer I've spent in this space,
2:55
the more I've found that
2:57
while we who work in the industry have
2:59
this sense that
3:02
the way things work
3:03
is well entrenched
3:05
and people understand them because it's been this
3:07
way for so long.
3:09
The reality is most most Americans don't understand
3:12
health insurance. They don't understand how to navigate
3:14
health care.
3:15
And the more we can make
3:17
health
3:18
care in America
3:20
work the way everything else we do works,
3:23
the more
3:24
intuitive it becomes.
3:26
And the more we try to solve our
3:28
cost challenges and coverage challenges and access challenges
3:32
with
3:34
new rules and regulations and hoops
3:36
to jump through that are unique to health
3:39
insurance,
3:40
the more we just add
3:42
to the confused state,
3:45
that most Americans already find themselves in.
3:47
So I wanted to talk about that jargon
3:49
point a bit more, for our listeners in
3:52
recent,
3:53
a little while ago. Kevin posted on LinkedIn
3:56
saying the words we use internally show up
3:58
externally. If you call Berger's products internally, you're
4:01
bound to call them that externally at some
4:03
point. How do you simplify and de jargon
4:06
these complex terms that often come up in
4:07
health insurance?
4:09
For example, like ICRA, like, that's that can
4:11
be kind of tricky sometimes for employers and
4:13
employees. So I would love to hear about
4:15
how you go about that.
4:16
Yeah. And, of course, so many of these
4:17
things are really, you know, born out of
4:19
legislation and things like that.
4:21
Boy, what what a reminder that the things
4:23
you write on LinkedIn can be discovered anytime
4:25
and come back to you. So, that was
4:27
a fun trip down memory lane.
4:30
You know, I think it gets back to
4:32
the the core point that I would make
4:34
is that what we have to do is
4:35
we have to make health care work more
4:38
like everything else in people's lives
4:41
and not
4:43
continue to convolute it and complicate it.
4:46
So,
4:47
you know, maybe just give a little bit
4:49
of background because I'll probably
4:51
refer to these concepts over and over again
4:53
during the course of our discussion. But
4:56
when
4:57
the the the sidecar health model,
4:59
just for people's background
5:02
is
5:03
oriented around this concept of let's just get
5:05
people to treat health care dollars like their
5:08
own. If we could get people to spend
5:12
to shop responsibly for health care services, that
5:15
in and of itself would be a massive
5:18
cost control. The same way it is in
5:21
cars
5:22
and,
5:24
groceries and vacations and airline tickets and hotels
5:27
and all these other fairly expensive,
5:29
and fairly high consideration things are that we
5:31
buy.
5:32
But of course, that only works if we
5:34
can make health care accessible, transparent,
5:37
shoppable.
5:38
And so these are concepts that I'll come
5:40
back to, you know, time and again, I'm
5:41
sure during the course of our conversation. But
5:43
because I think they lie at the core
5:46
of the only sustainable, scalable solution we could
5:48
ever arrive at with health insurance. So in
5:51
the case of an ICRA, for example, or
5:53
an HSA,
5:55
both of these are just fancy, you know,
5:57
I'll I'll admit jargony terms
6:00
of basically the same concept.
6:02
HSAs,
6:03
which by the way were the last
6:05
bipartisan health reform we had in this country
6:08
because, the ACA itself was not particularly bipartisan
6:11
at all. But you did actually have people
6:13
crossing the aisle in meaningful numbers to vote
6:16
for or against HSAs back in, 2003.
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But
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HSAs is basically a fancy way of saying,
6:24
we want people to spend health care dollars
6:26
like their own.
6:28
In fact,
6:29
if they do, a good enough job of
6:31
shopping and, you know, or or and also
6:33
have some health luck and don't need expensive
6:35
care, and they have money left over at
6:37
the end of the year, we're gonna let
6:38
them keep it. It's really gonna be their
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own.
6:40
ICRA's are basically saying,
6:42
instead of having a one size fits all
6:44
health solution, health plan for everybody in the
6:46
company,
6:48
Let's let them go buy, care on or
6:50
buy, coverage on the exchange.
6:52
And so in general, I think we just
6:54
need to be talking about these things the
6:56
way they work and not, you know, slapping
6:57
these labels on them. But we do need
6:59
to make sure,
7:00
that getting health care works
7:02
the same way that buying everything else in
7:05
this country does.
7:07
Yeah. So I think it was interesting that
7:08
you brought up HSAs just now, because I
7:10
know there's been a lot of talk,
7:13
at the federal level about giving
7:16
ACA dollars back to consumers. I think it's
7:19
kind of been unclear as to what that
7:20
might look like in practice.
7:23
But what do you think that would look
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like? Would it be an HSA? Like, what
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do you think the next step could be
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if that were to gain momentum?
7:30
Well, you know what's interesting is, HSAs are
7:33
a great idea. Right? Like I said, people
7:35
on both sides of the aisle agreed that
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they were a great idea more than twenty
7:39
years ago,
7:40
but they have not
7:43
taken hold
7:44
as quickly
7:46
as I'm sure most people who advocated for
7:48
them twenty plus years ago would have hoped.
7:51
But I saw some interesting data from, the
7:53
founder and CEO of,
7:56
of a a virtual health care company on
7:58
LinkedIn the other day. This is, Michelle Davey
8:01
from Wheel. And she was talking about the
8:03
fact that they are seeing enormous
8:05
growth in their services, but it's mainly coming
8:08
from people who are just paying out of
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pocket,
8:11
basically through HSAs.
8:13
And one of the points that she made
8:15
here is that there is so much direct
8:18
to consumer health care available today. So you
8:21
think of
8:22
all of the weight loss solutions, all of
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the hair loss solutions, all of the functional
8:27
medicine
8:28
solutions, all of the lab work,
8:31
Amazon.
8:32
There's there's just lots of these providers,
8:35
that are going direct to consumer today
8:39
with transparent pricing.
8:41
And so a lot of people who before
8:43
were not on HSAs are looking at it
8:45
saying, well, I can use HSA dollars for
8:47
that and I know what they're going to
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cost.
8:49
And so it has provided this real
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gust of wind in the sales of HSAs.
8:56
So the thing that's been holding HSAs back
9:00
is the simple fact that
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while
9:03
the theory and the concept is nice that
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people can treat health care dollars like their
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own,
9:09
If they cannot easily access price information, quality
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information,
9:14
the types of data points that people use
9:17
in making decisions for buying anything from shampoo
9:20
to a new car, then how are they
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gonna be able to effectively use an HSA?
9:24
But the more we move towards shoppable health
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care,
9:28
the more HSAs become a really interesting solution.
9:32
And and here, you're seeing that direct to
9:35
consumer
9:36
health providers
9:37
are basically leapfrogging everybody, you know, who's an
9:41
incumbent, like the big health systems and things
9:43
like that. But there is nothing systemically preventing
9:46
us from
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publishing the prices of every service that every
9:50
health care provider offers except
9:53
for
9:54
enormous resistance
9:56
from the incumbents
9:58
who stands to gain everything,
10:01
from the per the the
10:03
the the
10:04
persistence of our broken system.
10:08
What do you think would it take to
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shake that up?
10:13
Competition.
10:15
Competition is what tends to shake everything up.
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If you look at,
10:20
competition and and sometimes technology.
10:22
But if if you look at so many
10:24
of these industries where
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people
10:28
bemoan the cost, but then ultimately have to
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kind of shrug and pay because what other
10:33
option is there?
10:34
Look at long distance phone calls back, you
10:37
know, thirty years ago. I grew up overseas.
10:40
And every Sunday night, we would call my
10:42
grandparents and and and talk to them for
10:44
about twenty minutes. That was a budget item
10:47
in my family growing up. The long distance
10:49
grandma, grandpa phone calls were expensive.
10:52
Now they're free.
10:54
Right? And it is the result of technology
10:57
and also competition.
10:59
If we look at health care, and let's
11:00
talk about coverage,
11:02
specifically here because that's the space I'm focused
11:04
on right now,
11:06
the technology is there. Right? Everyone's got a
11:08
phone on them, a smartphone. They can have
11:10
an app. There's nothing technologically
11:12
preventing people
11:13
from popping up a location assisted app
11:17
and saying, I'm looking for an MRI on
11:18
my knee. What's it gonna cost anywhere around
11:21
me? All that technology is there.
11:24
What has historically not been there is competition.
11:28
And,
11:29
that's what we need. We need more competition.
11:32
We need to have the courage to explore
11:35
new models,
11:37
and
11:38
that will lead to improvement
11:41
in the health care and health insurance industry
11:43
the same way it has with every other
11:45
industry.
11:47
So I know you said HSAs may not
11:49
have gained the traction at the rate that
11:51
people were initially expecting. So realistically,
11:54
what do you think, and this is more
11:56
broad than, you know, an HSA, but what
11:58
do you think employer sponsored insurance
12:00
will look like in, like, three years if
12:03
we give it that timeline?
12:05
If what Sidecar believes in plays out pragmatically?
12:09
Like, what do you think will actually happen
12:10
in three years?
12:12
Yeah.
12:13
So the average
12:16
net margin of a Fortune 500 company is
12:18
eight or 9%.
12:21
If
12:22
health care costs continue to rise for these
12:24
jumbo self insured companies the way that they
12:27
have been the last year or two,
12:30
which is, a steepening of the curve of
12:33
the last twenty years,
12:35
These companies are facing
12:38
a very real
12:40
decision,
12:41
which is basically what you just said. What
12:44
are they going to do? On the one
12:46
hand, they can accept their fate, which is
12:49
they will no longer be in whatever business
12:52
they are in today.
12:54
They will instead be in the business of
12:55
providing health care coverage to people who work
12:58
for the company.
12:59
But they're
13:01
not going to have the resources to be
13:03
able to invest in
13:04
r and d and new hiring and expansion
13:06
and things like that
13:08
because they just with those kinds of margins,
13:10
you just can't fund
13:12
health care coverage in its current incarnation
13:15
without basically sacrificing everything that is strategically important
13:19
to your business. Or on the other hand,
13:21
they can completely upend this and say, you
13:23
know what? What's, what we've been doing for
13:25
the last twenty, thirty, forty years has not
13:27
been working. It has utterly failed to control
13:29
costs, which is, the primary job of employer
13:32
sponsored, health insurance. Of of course well, well,
13:35
I guess the primary job, obviously, is to
13:37
take care of the employees in their time
13:38
of need, but it has to do so
13:39
in a in a cost controlled,
13:41
way. So we have to try something new.
13:44
And what's encouraging here
13:47
is that
13:48
so many employers are willing to do that.
13:51
It's it's it's it almost makes my job
13:53
very easy in the sense that almost anybody
13:55
is up for a conversation on how they
13:56
can materially
13:58
lower their, their health care costs.
14:01
And the reason for that
14:03
is health care costs have finally gotten so
14:06
expensive that people are being forced to explore
14:08
alternatives.
14:09
If you'll indulge me in another,
14:11
federal policy example,
14:14
I think of this as being very parallel
14:16
to what happened in the nineteen eighties. When
14:18
my dad graduated from college and took his
14:20
job, which he had for forty years and
14:22
only recently retired, he had a pension.
14:26
Today,
14:27
almost nobody has a pension. Right? There's nobody
14:29
coming out of college today who's really expecting
14:31
a pension.
14:32
Well, what happened?
14:34
In the eighties, pensions became too expensive. Just
14:36
full stop. It was too expensive.
14:38
And so what we did is we came
14:40
up with all these new sort of, alright,
14:41
well, we've gotta put people in charge of
14:43
their own money. Basically, four zero one ks's
14:45
replaced pensions. And today,
14:47
in fact, if you look at basically a
14:49
twenty, thirty year time frame,
14:52
in about twenty or thirty years,
14:54
it it you went from almost every company
14:57
offering a pension to almost every company offering
14:59
a four zero one k. And today, obviously,
15:01
almost everyone offers a four zero one k.
15:03
And what did four zero one k's do?
15:05
They put people in charge of their own
15:06
money. So I think there's something very much
15:08
to this idea,
15:10
that does come from places on both sides
15:12
of the political spectrum of we've got to
15:13
get consumers engaged in their own health care,
15:16
even maybe putting them in charge of their
15:18
own, money.
15:20
But I appreciate that it's scary to do
15:22
something different, but we have to take courage
15:24
in the fact that,
15:26
it is way scarier to do nothing because
15:29
these costs are completely unsustainable.
15:33
Do you have any final thoughts for industry
15:35
leaders? I know you said it kind of
15:36
can be segmented into the smaller players and
15:39
then the
15:40
more legacy players. So what thoughts do you
15:43
have speaking to that audience?
15:47
Well,
15:48
employers
15:50
are very often the leaders of change in
15:52
this country.
15:55
In fact,
15:57
for a long time, mental health was not
15:59
really
16:00
treated as health.
16:02
In in fact, it's still not covered adequately
16:05
by most health plans.
16:09
But in the days leading up to and
16:11
certainly,
16:12
the darkest days of COVID,
16:14
you saw American businesses rally around their employees
16:19
and say, you know what? Mental health is
16:20
health. And and there was enormous investment
16:23
in people's mental health in a way that
16:24
I think is refreshing, and everybody is is
16:27
is grateful to employers for taking the lead
16:29
on this.
16:30
This is an example too.
16:32
This is a moment of time where there
16:34
will be a separation of the leaders from
16:36
the pack. There will be some employers who
16:38
say
16:40
we have to look at something completely different.
16:43
We have to look at different models that
16:45
can preserve coverage, maybe even offer better coverage,
16:49
as of the case with Sidecar Health, but
16:51
we'll do so with a model
16:53
that can sustainably
16:54
bring costs down. And there will be others
16:57
who will be very afraid to make any
16:59
change.
17:01
But this is that moment of truth. This
17:02
is that opportunity for those who raise their
17:05
hand around pensions and
17:08
migrating, you know, to four one k's and
17:09
things like that or paying for therapy or
17:12
taking care of their employees' mental health. People
17:15
who have that view of leadership
17:18
and see themselves as problem solvers,
17:20
now is their time to show that there
17:22
are other ways. And I'm very encouraged every
17:25
time I talk to a company, whether it's,
17:28
somebody from a 200 person manufacturing plant in
17:32
Georgia
17:33
to,
17:33
some of the biggest companies in the world.
17:36
I see a lot of people who are
17:38
saying, you know what?
17:39
Now is the time to look at something
17:41
different. And so I think, to come back
17:43
to your question from a moment ago, three
17:45
years from now, I think we are absolutely
17:48
going to be astonished at how quickly we
17:50
went from a,
17:53
it's gotta be this traditional legacy network based
17:56
approach to
17:57
you know, there will be at least one
17:59
or two other models that are pretty dominant
18:02
in the space. And the one thing they'll
18:03
have in common
18:05
is that they will
18:07
put employees in a place where they are
18:09
entrusted
18:11
and empowered to treat health care dollars like
18:13
their own and shop for health care.
18:15
Well, Kevin, thank you so much for this
18:17
conversation. I really enjoyed it.
18:19
Likewise. Thank you, Liz.
18:21
And to our listeners, if you'd like to
18:23
listen to more podcasts from Becker's Healthcare, you
18:25
can visit beckershospitalreview.com.
18:27
Thank you.