← Becker’s Healthcare Podcast
Loading summary
Transcript21 lines
- [00:02]
A
This is where health insurance leadership comes together. Becker's 4th Annual Spring Payer Issues Roundtable brings together over 400 payer and health plan executives and more than 100 speakers to Chicago, April 13th and 14th. This year's event includes keynote conversations with the industry's top leaders and former President George W. Bush. For the full agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you here in Chicago. Hello, everyone. This is Jacob Emerson with the Becker's Payer Issues podcast. Thrilled today to be joined by Craig Kurzweil, who's the Chief Data and Analytics Officer for United Healthcare's commercial business. Craig, thanks so much for taking the time to be with me on the podcast this morning.
- [00:49]
B
Thanks for having me.
- [00:50]
A
Absolutely. And before we dive into everything we want to talk with you about, Craig, can you first tell us a little bit more about yourself and what it is that you do at UnitedHealthcare?
- [01:00]
B
Sure, that sounds good. I lead our data and analytics and reporting for all of our employer customers. I've been with the company for about just over 21 years now and I spent that entire time focused on how do we translate massive amounts of data into something interesting and hopefully actionable for our employer clients through different iterations. So I'm a data nerd at my heart and love to kind of dive in to see what's happening and how we can use that data to drive better results.
- [01:32]
A
Fantastic. Well, in that vein, Craig, UnitedHealthcare, as you know, releases findings every year through a white paper that you do with the Health Action Council where you analyze member data for wider healthcare trends. So it's the ninth year of this, of this paper that you, that you've published. And I wonder for our audience that might not be familiar, can you give them a sense of what exactly this report is, what data it draws from and how it's evolved over nearly a decade now?
- [02:01]
B
Sure. It's been a very fun journey with the Health Action Council. It's a very unique collaboration partnership where for an analytic person, especially because within the Health Action Council, we have over 225,000 members within health Action Council that we can leverage on a de identified basis to do these kinds of broad view studies of what's happening across the population. As you mentioned, this is our ninth year and so we've spent a lot of time really trying to focus in on parts of the healthcare system maybe that haven't been focused on enough or maybe not at all and kind of really hone in on those and give employers a unique perspective. So, for example, we've spent a lot of time in the pre Covid days diving into generations in community health and social determinants of health, virtual care and post Covid we really been focused on kind of where do we go from here and what are some of the new barriers to care and to cost. And for example, and we'll talk about this study, but really focusing on how the community has a lot to do with what happens across these populations. So it's really been a unique partnership and that kind of membership allows you to do some really creative things. And honestly, the Health Action Council kind of thinking differently and allowing us the space to come up with studies that are different from the mainstream has been wonderful from an analytic person's point of view. So lots of really, really interesting ways to kind of see what's happening across the system.
- [03:24]
A
Absolutely. That makes a lot of sense. And I read through the report myself, there's a lot in it, a lot of different areas of focus for employers. So I wonder if we starting off broadly, just talking about some of the results. Anything this year that surprised you?
- [03:37]
B
Sure, I think there's a few things that kind of jump out to me and I've lived in data for, like I said, 21 years and it's hard to surprise me these days, but there's a few things that I think are changing and maybe different than what people might anticipate. So as you start to dive into the data, and we're really focused in this study, trying to look to see how do generational and gender influences impact what we see around cost, utilization and affordability. Of the findings for this year, there's three main areas. One being we typically assume that the younger population is low cost. Invincible hasn't really developed a lot of chronic disease yet in the younger population, but we're starting to see that change a bit. And we're starting to see some of those younger folks, they're still definitely lower cost and lower chronic disease than their older generational counterparts, of course, but we're starting to see them rise at a higher rate than we've seen in the past. So they're kind of catching up, so to speak, to some of those older populations. And as you think about employers, typically, the focus forever has been how do we manage the risk in the older population? Because that's where more of the cost is driven by. This might change some of those strategies or maybe rethink where we dedicate some of the strategies and as part of that rise in the younger population, a big piece of that is that catastrophic health events are becoming way more frequent. So we're seeing a rapid influx in the number of catastrophic claimants are now twice as common as they were five years ago. And we're seeing that not only just for the younger generation, but for all generations, seeing a rise of the number of people reaching $100,000 health event. And it's, but it's no longer focused on just the older sicker population. It's focused everywhere. And kind of the third point that I focus in on, and obviously a hot topic always is metabolic conditions. So we're starting to see them rise more sharply. We're seeing, we're starting to see metabolic symptoms rise quicker in some of the younger populations as well. And within men in particular, we see that those men that are struggling with metabolic conditions, so think diabetes, obesity, hypertension, much greater health risks, much higher costs. And specifically men with those metabolic issues have much higher risk of some of the catastrophic events such as heart attack, stroke and surgeries, where we see a seven times greater risk within that population. So the three main areas that I just would focus in on is the rise of the cost in the youth population and catastrophic claimants started to become much more frequent and then the rise of metabolic conditions across all populations, especially in men.
- [06:22]
A
And Craig, let's dive into that a little bit more in terms of the rise in care costs for the younger population because that seems like a huge concern for employers now, a population that maybe in the past was not a huge cost driver compared to other generations. And in the reports Specifically, it's Gen Z's year over year care spending, it jumped 18%, nearly double the rate of the rise in care costs for baby boomers. And that's driven, like you mentioned, a rise in catastrophic claims, 41% increase that you noted in the report. So what is this increase in chronic disease in catastrophic care among younger workers? What does that signal on the ground for their employers?
- [07:06]
B
Yeah, two things and they go hand in hand. So first we are seeing that the younger folks are starting to develop chronic conditions or health risks at younger ages. We're seeing obesity, hypertension, behavioral health starting to pop up earlier in their natural progression. That development of chronic conditions then leads to the opportunity some of those folks are going to be well managed and making good choices. But we're going to see within that younger generation, they're maybe not equipped or ready to really navigate the healthcare system in a good way, leading to those chronic diseases. Turning into catastrophic events. So we see again, like you said, a 41% increase in catastrophic events among younger adults driven by the rise of chronic disease, as well as that population not being as engaged or educated on how to use the healthcare system appropriately to prevent those types of things from happening.
- [08:07]
A
This is interesting. The other part you mentioned earlier in terms of some of the differences you're noticing between men and women and how they access care or engage with the system. Overall, the data showing that men have consistently lower PCP engagement than women starting at age 18 and that gap doesn't close until their 60s, which is, I mean, just wow. So I wonder what is the data telling you in terms of why men's health has been so difficult to move the needle on overall? And what do you think it would actually take for employers for the health plan to change these patterns earlier in their lives?
- [08:47]
B
Yeah, this is definitely a tough one. This has been kind of an age old sort of question. How do you engage, especially the younger male population in general? What you see in the data is men make decent health care choices when something has happened. So when you are diagnosed with a condition, when you're diagnosed with diabetes or heart disease or so on, you see that men will make pretty good healthcare choices in that space. It's the before that we're worried about. It's the prevention piece. It's seeing your doctor on a regular basis, it's getting preventive screenings done. That's where men prior to age 60 really have wide gaps compared to their female counterparts. So it's really about how do you engage incense, nudge those men to start to see that prevention matters. And you can stop these kinds, you can stop or at least mitigate some of those events from happening if you do something before the bad news kind of comes in from a healthcare perspective and really, really hard, really, really challenging. But it really comes down to, as you see in the study, engagement with your pcp. Can you make it easy, make it simple, make it accessible for those men to be able to engage their pcp? Because once that happens, we start to see analytically that a lot of those other gaps start to change pretty quickly.
- [10:12]
A
Sure. No, that makes a lot of sense in terms of strategy. Men are being reactive, not proactive to, to their health. And I wonder more broadly, Craig, how, how close do you think employers health plans are to being being able to identify some of those high cost members like a man, early on in their life, early enough to intervene meaningfully and ultimate, the biggest barrier to that right now is it is it not having enough or the right data? Is it the clinical programs themselves? Is it getting that over that hump of getting them to be proactive and engage earlier? What do you think it is? That's the biggest barrier there, I think.
- [10:54]
B
And obviously I'm biased, but I think the data has gotten pretty good. We have the ability at a population level, within the employers that we work with, to really be able to understand where the drivers are, where the decisions are inappropriate. So, for example, rather than kind of peanut butter spreading solutions across an entire population, we can hone in that it's not a PCP engagement issue in their entire population. It really is focused on, for example, the young male population or a specific market or a specific age group and so on. So analytically, at a population health perspective, that's gotten really good. And I think most employers can precisely see where the problems are, where the focus areas should be. And even at an individual level, I think analytics have gotten much better as well. As we start to identify who's at risk, who's headed down a negative path, and as quickly as we can be able to outreach into that population. And that's where a lot of the clinical programs that exist today are really focused. So analytically we can find these folks as quickly as possible. We can start to predict the path that they're headed down and start to engage them further upstream. Years and years ago, it used to be that your analytics were dated and you would find out that a member was headed down a bad path after that event already occurred. And then clinical program outreach would typically happen after that event occurred as well. But analytics have gotten better, data has become more real time, and now we can start to identify these folks upstream, guiding them into programs. So there are programs that can help guide people into leveraging primary care physicians. There's digital condition management programs. There's lots of different metabolic health coaching and monitoring events. For example, within UnitedHealthcare, we have level 2 for diabetes that can help kind of manage those diabetics. So there's lots of opportunities out there. And I think analytically and clinically, we're now at a point where we can outreach to these people sooner and quicker upstream to make a bigger difference in what the future is going to hold. But at the end of the day, it's all about engagement. We can find those people early, we can have the best programs in the world that would make the biggest difference for that population. But if you're unable to get them to an engage and to sign up and to participate, none of that's worth it. And that's where a lot of the focus is right now. How do we focus on the consumer, make that engagement simple, easy, make that the easy choice for them versus the hard choice. Because we know the health care system is incredibly complicated. People get confused pretty easily because there's a lot of different variables out there and they don't know where to go, where to get the best care, what should I do next? But our ability to meet the consumer where they are, whether that be through digital means, whether it be through telephonic advocacy means, finding different ways to kind of make sure it's simple and easy for them to see the way that engagement can lead to a better life, you know, for these members.
- [13:49]
A
Absolutely. And you're not just leaving employers in the dark here with these findings. The report is actually making seven specific recommendations for employers in terms of how to achieve what we're talking about, Craig. And it's everything from segmenting populations by generation and gender to building a men's health strategy that starts at age 40. So you said data analytics has gotten a lot better over the years. Are you seeing health plans and employers actually act on this kind of data? And where do you think is there? Where does that gap still exist between the insights you're providing and then the execution on the ground?
- [14:28]
B
I think there's more action being taken by employers today than ever. And there's a few different variables kind of driving that. But obviously affordability is an issue and employers are doing whatever they possibly can with their partners to help bring affordability to back into a better space as well. As many employers are able to see on a more rapid basis that engagement in health does more than just impact affordability in healthcare. If we can guide people towards better health and better engagement, they're able to see that those employees are going to be better employees, they're going to be more productive, they're going to be more present. So it's all encompassing. It's a big issue for these employers. And I think, like I said, now more than ever, they're starting to take action upon it. And by that action, I think it's really important to think about targeted approaches along these efforts. It's hard to get the less than 40 year old male population to start to engage, even the 40 to 50 year old male population to engage. But if you can be focused, if you can be targeted, just like other marketing firms that have done for decades now, if you can become that focus, you can start to understand what is the best way to get this unique part of my population to engage. I might not be able to get everybody, but if I focus in the biggest outliers, I can create a strategy, whether that be through communication, through digital campaigns and so on, or even boots on the ground to get that population to engage in the various programs that a lot of these employers are offering. Employers have historically offered lots of different solutions and opportunities for members, but have struggled to get people to engage in those programs. So again, it's all about the consumer, consumer analytics, marketing based analytics, finding ways to make it simple and easy and targeted for these members to engage.
- [16:21]
A
Well, Craig, before we go, where can our listeners find this report if they'd like to read it themselves? And is there anything else that we're missing today that you want to share with them?
- [16:33]
B
Sure, the report is public and available, so you can find it in the Health Action Council website. You'll see it posted out there. And again, I would just focus on the fact that again, I'm very biased. But start with the data. See what's happening in your population. Cut and slice your data. Don't just look at things in aggregate. Look at the subpopulations that are driving your need. Check to see if the results that we're seeing in the study apply to you. May or may not. We are seeing this broadly, but make sure this is applying within your population and then focus on consumer driven targeted solutions that can help in the specific areas that are driving affordability and health challenges within your population.
- [17:13]
A
Fantastic. Well, Craig, thank you very much for taking the time to chat with us here on the podcast and for breaking down these latest findings for our listeners. We really appreciate it.
- [17:22]
B
Thanks for having me.
- [17:24]
A
And to our listeners, if you'd like to listen to more podcasts from Becker's Healthcare, you can visit Beckershospitalreview.com.