– I think the biggest
challenge that we see in health care today
is the significant rise in chronic conditions
amongst the population. So, when you look at the
age of the population that there is today, there’s
around 30 million people that have three or more
chronic conditions. And just the simple aging of
the population is taking that, over the next 15 years,
from 30 to 85 or 90. And you have a system in health care that is really ill-equipped
to handle complex patients. And so, when you think about
the way hospitals operate, the way data and analytics is shared, it isn’t really oriented towards addressing that chronic patient at the point in time when
you can actually impact care. And so, the system needs a
pretty significant overhaul to handle this cost,
and it comes at a time when hospital systems are
virtually zero-profit, and so they’re scrambling
for every dollar they have to invest in any technology or other ways to improve their ability to do it, and a government that is
seeing increasing pressure on the Medicare program, where
the aging of the population is going to cause that program to maybe run out of money
in the next 15 years. And, then, the last piece
is that the consumer is now bearing more and more of the cost of their own individual health care. And so, if you were to
go back about 10 years, what you would find is
that health care spend and spend on things like communications was roughly the same for a household. And now, health care is twice as much as the spend on communications, and everyone can think about
how much money they spend on their cell phone and other things, and yet health care is
twice as expensive now. And so, all of those factors together creates a very difficult environment to address this incredible expansion in folks with chronic conditions. And that, I think, is the
largest problem we face today. Well, I think the biggest
opportunity is to figure out how to engage those consumers in ways that they haven’t been engaged
in their health before. I mean, I remember I was
listening to a comedian not that long ago who said, “Well, look, “if I have brain cancer
and the doctor tells me “to go do something, I
go do it immediately. “But if my doctor tells
me I weigh too much “and I should go lose
weight, it’s like eh, “I’ll see you again next year, right.” And so, the consumer is
engaged in their health only at a time when it’s
absolutely imperative for them to be that way, and
usually that is way too late to actually avoid a lot
of the significant spend associated with caring for themselves. And so, I think the biggest
opportunity for us today is that there are ways
now to interact with folks that are a lot less expensive
and a lot less intensive on the interaction, and yet
could offer the opportunity to really keep people healthier and avoid long spend at
the end of their life. And so, one of the things I
think the health care system needs to do is to figure out how am I going to change
the way I treat a patient, both in terms of my actual medicine, as well as just my simple
interactions in light of that. So my simplest example
is, last year I went to get a physical, as everyone
hopefully has been doing, and the first thing they
did is they took my pulse. I said to them, “Look, I
have an iWatch on my arm. “It’s been taking my pulse “every minute of the
day for the last year. “Why don’t you just download
what’s on my iWatch?” And so, the fact that they
are still taking my pulse is a little representative of how little they’ve used the new
tools at their disposal to monitor my health
and to engage with me. And so, I think that’s
where the opportunity exists with the consumer, is to change
the way they think of health from these discrete transactions
that you have with them, and to make it a more of
a perpetual relationship. So Optum has spent a lot of
time and focus on figuring out what is our consumer interactions
now going to look like. So one of the things
you’re seeing with Optum, as you remember I talked about
chronic condition issues, and so Optum has launched into an effort to rethink how we manage
chronic conditions. And one of the most
important elements of that we’ve called consumer engagement. So, if I’m going to manage
somebody who is a cancer patient, how do I engage with that member, not after they’ve begun
chemotherapy and had chemotherapy for six weeks, but the
day they got diagnosed with cancer, and what is
that interaction look like? Is it going to be what
it’s been in the past, which is either an interaction
with a doctor face-to-face or a phone call from a
nurse from a phone bank to manage that person’s care? Or is it going to be a whole
bunch of interactive tools that you can use to
help treat that patient and encourage that patient to
do things around how they eat, what other additional
steps they need to take to treat themselves, what their drugs might be doing to them, what are the ways that your digital interactions
can have with that consumer so that they better understand their care, and they better adhere to
the care they’re getting. So, at the core of what
we’re trying to do, is actually data and analytics. And so, what Optum believes is that one of the fundamental
problems in health care is that the provider at the
point of care isn’t fully aware of what choices to make based
on the full understanding of the patient and a rich data analysis of what other things that they can do. And so, what we’re trying
to do is we’re trying to take information that
we get, because we work with payers who actually see
every interaction you have with the health system, and
we also work with providers who help us by giving us some
of their clinical information, and we’re able to marry the two together and then run a series
of algorithms that say, based on your condition, here is things that should
be done to treat you better. So, as an example, I’ll go back to cancer. So we can look at people who have a very similar
cancer diagnosis as you and all the different ways that doctors in all of the different
places in the country have treated them, and there
are different treatment paths that you can go down,
and we have an ability to figure out which one of
those paths is less expensive, like not just on an episode basis but across the entire
cancer journey they’re on, and also more effective. And so that, but being
able to provide that data to the doctor at the
point of care is the key. And so, that data and analytics,
which leverages things like you’re talking about,
natural language processing and AI and those other tools,
is at the core of that, and the challenge for us is
not just to do the analysis but then to get it to the point of care where the doctor is actually
making that decision. So, Fuqua prepared me in lots of ways. So I think there’s two
really main elements that I got out of being here at Fuqua. One is it’s a very broad
education that you get at Fuqua. And so, I had the opportunity
to take statistics, accounting, macro and
microeconomics, and then a series of other disciplines, finance, et cetera, that really gave me a full view of how companies are
run and are effective. Because some of the issues
we deal with in health care are operational in nature,
and some of them are marketing in nature, and some of
them are finance in nature. And so, though there is a
core, in health care, of topics that we’re working on, it’s
the broad understanding of how all of those things go together. So that, if I’m trying to engage you, and I’ve got a great marketing
program to interact with you, and yet my operational
people can’t do a good job of doing that, or we drop the ball in how we implement a
program, it doesn’t work. And so, that broadness of the
education I think is critical. But the other thing that I
think is really important about Fuqua is it really just helps teach you how to think about business. So, separate it from the
specific course matter that you’re taking, whether
it’s operations or marketing or finance, and it’s just a discipline that I found around how
do I approach problems, and how do I begin to solve problems that are complex and not
specifically laid out for what’s the recipe to fix this problem. And I think Fuqua did an excellent job, and I think it does today
do an excellent job, of helping you understand
how to solve complex problems when you don’t know the
answer ahead of time. Unlike many other industries,
taking care of an individual is fragmented across a number
of providers, the payer or plan sponsor responsible
for them, retail locations that they interact with,
and all of these touchpoints historically have been very uncoordinated. And that has caused part of the problems that we talked about in terms
of increasing cost of care and difficulty in managing
a patient’s condition. And so, what partnerships allows us to do, and I think the industry to
do, is to get those touchpoints to act in a more coordinated fashion across the whole system. And so, as an example, one
of our largest competitors is CVS, who has a pharmacy benefit manager just like Optum does,
but it happens to also be one of our largest trading partners because millions of our members go to CVS every day to
fill their prescriptions. And so, one of the things my team does, and Optum does in general, is think about how do I reach into the CVS environment, which is an important
touchpoint for that consumer around their health, and help impact care. And so, impact care can be
things like they are showing up to fill a prescription,
and it might turn out there is a significantly lower cost drug that they could be on. If the pharmacist knew about that, they could work to switch
that prescription right there. We could look at all of the drugs that person’s taking and look at things like should they be taking these
two drugs at the same time, or are there some significant
adverse interactions? Are they adhering to their drugs? So I know they got the prescription, but did they actually
fill the prescription? And then, of course, they’re in there picking up diabetes medication, but are they on a diabetes
management program with one of our disease
management programs? So all of these things we can do by reaching into the CVS store and addressing those
concerns with the consumer. But, of course, without
a partnership to do that, it makes it very difficult to do. Likewise with a provider or a hospital that that consumer may show up at. And so, we partner with
those organizations, even though they’re competitors of ours, because it improves that
overall cost of care management, and it improves the quality
of what we’re able to do. And so, that’s why this ecosystem, which has been historically
super-fragmented, is now working together with
some of these partnerships.