The Role of Self-Insured Employers in the Healthcare System

Friends,

This interview is about an organization that is creating a new healthcare category, and whose purpose is to solve the employer healthcare dilemma. But even more fundamental than that, they’re attempting to solve the core struggles that all healthcare consumers are facing.

Glen Tullman is the Executive Chairman and Chief Executive Officer of Transcarent.  Tullman is the former Executive Chairman, Chief Executive Officer, and Founder of Livongo Health  He previously led two other public companies that changed the way health care is delivered – Allscripts and Enterprise Systems. Tullman is also a Founding Partner at 7WireVentures, a socially-minded venture capital fund. He is the author of ‘On Our Terms: Empowering the New Health Consumer’.  Glen was honored in 2019 with a Robert F. Kennedy Human Rights Ripple of Hope Award for his career focused on improving the safety, empathy, and efficiency of our healthcare system. He also serves as a Chancellor to the International Board of the Juvenile Diabetes Research Foundation and as a Board Member and incoming Chairperson of the American Diabetes Association.

In this episode, we’ll learn about:

• The lack of alignment between payers, PBM’s, healthcare systems and employers.  As Glen points out, if employers spend more, payers, PBM’s and healthcare systems make more.
• How the plethora of digital healthcare companies and apps are contributing to further complexity in healthcare delivery.
• Why it makes sense for employers to get rid of copays for preventive care and chronic disease management costs.
• The three things that people want from healthcare and how Transcarent is delivering on those consumer needs.
• The 5 most common issues/questions that healthcare consumers call Transcarent about.

One of the qualities I most admire about Glen is his blunt but eloquent truthfulness. As he puts it – “After 30 years of promises, we have a healthcare system today that is more confusing, more complex and more costly than it’s ever been”. Supporting this statement, he cites the stat that the average self-insured employer must hire 14 different companies to assist in providing healthcare to their employees.

His solution to curtailing the complexity and confusion is to shift from fragmented point solutions to adopting the approach of other industries – which places the consumer in the driver’s seat, provide ease of use, 24/7 access and low cost.

Transcarent isn’t just focused on building a ‘digital front door’ or ‘digital consumer experience’.  It is a wholecloth transformation of the healthcare experience. It is a leader in a new category – part navigator, part health coach, part telehealth provider, part center-of-excellence referral source. Glen is so obsessed with providing a best-in-class consumer experience/journey that his brand promise is personalized, convenient, unbiased, virtual access to coaches, navigators, and doctors – within a few minutes, 24 hours a day, 7 days a week!

What I respect most about Transcarent is not the technical wizardry or their impressive feat of creating a new market category. What I respect most is the unyielding primacy they place on the care of the consumer. For example – despite their ability to deploy chatbots, Glen insists that there be a live person on the other end of the line. He believes that people who seek healthcare want and deserve a live person speaking with them. Transcarent’s approach is “care over costs”, and while this may seem unsustainable, he points out that providing this type of care ends up greatly lowering the overall costs of care.

The key to Transcarent’s approach is the alignment of payment with value based care. Unlike most other healthcare stakeholders, Transcarent does not make its money when healthcare costs and prices increase. Transcarent has completely attached its revenue and business model to cost savings. If your business model is to provide an outstanding consumer experience, deliver markedly improved health outcomes and lower overall total costs – then it makes sense to invest upfront in the way that Transcarent is doing.

I truly wish more healthcare organizations would manifest the vision, integrity and courage to implement the business model that Transcarent has. It would save a lot of money for our country, corporate America, our states and towns, our families and our citizens.  But even more importantly, it would save a lot of lives.

Until Next Time, Be Well.

Zeev Neuwirth, MD