Welcome to StartUp Health NOW! The weekly
web show that celebrates the health
transformers and changemakers
reimagining health.
My name is Unity Stoakes and today we
have a very special guest, Mike Vennera,
who is the Chief Information Officer, of
Independence Blue Cross. It is the duty
of leaders to lead. Of the creative to create,
of the daring to do. The free world expects leadership
of us, its fate in our fate depends upon our leadership.
We are industrious, inventive, restless, with the fires that burn within us.
But I say that nothing is easy and the best things are the hardest.
And our troubles, all our immense difficulties now and in the future can I say be solved
if we have the will, the courage. The future is to those who take it.
Well Mike, it's great to be here with you.
We're at the Accenture HealthTech Challenge
today. Mike, you're the Chief Information
Officer at Independence Blue Cross.
I thought we'd start off just by learning
about you, your role, and what
that means being the CIO at
Independence. Sure. So, I'm really
excited to be here, as well. So, I've been
at Independence for 18 years now, so I've
gotten to see the organization from a
variety of different roles. I currently
serve as the Chief Information Officer,
so I have responsibility for, really,
everything from desktops and PCs,
the heavier equipment, all the way up to
healthcare analytics. Kind of the full
range of technology,
analytics in our organization.
Prior to that I had a grand corporate
strategy for the organization and
actually started up our innovation
efforts within the organization, which,
we kind of looked at as our
outreach effort to the startup community.
You know, both from an investment and
kind of partnership standpoint.
Prior to that, had served in a
variety of different roles in the
technology organization, in some
business areas, over my years there.
What have you noticed, evolved, let's say
over the last three to five years. Has
there been a pretty big shift from
your vantage point? I think there's
definitely been a big shift in
the overall healthcare system.
Whether it was changes driven by the
Affordable Care Act or just, you know,
ongoing kind of increase in
medical trends. There's a lot more focus
on getting costs under control. There's
the whole kind of payor
provider, adversarial relationship is
starting to break down. As
everyone's trying to get their arms
around
cost and bring costs down, you're
seeing a lot more innovation in the 65 00:02:45,170 --> 00:02:48,500 healthcare space. I think the
fact that, it's interesting, I think the
one thing that we sort of bemoan a little
bit in the payor industry is just what a
big portion of GDP healthcare represents.
But, I think that's also attracted a lot
of entrepreneurs to the space, because
there is a lot of money and if you can
just get a fraction of that, that's a
potentially really big pie. And
there's also, it seems like so much
uncertainty today.
You mentioned the ACA. There's a new
administration coming in. What are
your thoughts, just in terms of where the
landscape is today? In terms of innovation
and what some of this
uncertainty means? Potentially, as
opportunity for your organization,
but also for startups? Right. Well, I
mean, I think the uncertainty is,
it is always difficult from a business
standpoint in the short term. Right? You
know, the rules of the game can change a
lot, but I think what that
level of uncertainty means and we
have an administration coming in now
that wants to change a lot of things. We
could have a another change in four
years. So, what it really does is,
reinforcing focusing on the basics.
What I mean by basics are the
underlying fundamentals of how to keep
people well, how do you reduce
medical costs, how to keep
people out of the hospital. Those are the
things that, if you do those well, then
you'll be as successful as
you can be, you know, regardless
of the changing regulatory landscape. So,
I think it actually is a good reason for
everyone to focus on the
fundamentals of the business.
There's opportunity there for
startups as well. So, are you seeing, what
types of innovation are you seeing? Are you
seeing startups and innovators really
come with solutions that address those
challenges the way you're hoping
for? Are you wishing that other
things were
coming across your desk every day
that
maybe change the game a little more?
Yeah. Well, I think what you see,
you see a lot of exciting innovations in
a lot of different spaces. I would say
the biggest challenge that I see are not
a lack of solutions, but you see in
health care a lot of, at least what I
characterize, is very niche solutions. Right, So,
someone's got an app to help manage
diabetes, right?
Someone has a great
medication adherence solution, right?
Someone has a tool that payors can use
to help manage population health.
You got all these things that
touch one piece of a very complex
ecosystem, and one of the things that's
really lacking is a
platform or way to tie all those things
together. Because really, when you're
a payor, right? You've got to
deal with all those problems and
all those problems are part of the
healthcare system. So, one of the things
that excites me and why I think we're
interested in the space. I see the
a payor as potentially playing that
role of the platform of
stitching together the different
solutions, right? So the the diabetes app,
and the medication adherence
solution, and these other
innovations. We can be, sort of, the glue
that helps stitch those all together to
bring a solution to actually
change the market. That's one of the
things that really excites me about this.
I see this as both, I see it as the
opportunity for established
players like health insurers to work
with the startup community. Yeah, that's
where you guys can really take the lead
there.
So, what should startups be
doing? What,
how do they get through the door, so to speak,
for you? What advice and tips
and wisdom? My number one advice
that I always give to any early stage
company that I talk to in
healthcare, is really, to try and
understand health care financing. Because,
that's the most, in my mind, that's the
most complicated thing about healthcare.
Where you get into, sort of, the
medical space there's incredibly
sophisticated science, right? Around
whether it's predicting cancer, or
medical diagnostics. A lot of machine
learning. But, you know, people
that are attacking their associates have
expertise in those areas, right? What I
think a lot of people fall down on is,
entrepreneurs fall down
understanding who's gonna pay for this
at the end of the day. Because, we have
such a complicated healthcare system, at
least in the US, right? Every other
industry, for the most part, is relatively
simple.
I make something, you want it, you pay me
and get the service, or device, or
solution, whatever it is. Healthcare, it's
kind of like, I make something that
will be attractive to you as a
consumer, but you're not gonna pay for it,
you have to get your doctor
to prescribe it, but your doctors not
paying for it, it's your insurers paying
for it and your employer is paying part
of that. It's such a complicated system
that understanding the flow of financing
and, really, asking that question at the
end of the day. Who's going to
want this and who's going to pay for it?
Because, a lot of times in healthcare
those aren't the same answer, right?
I think, that's something that
a lot of people don't pay enough
attention to you in this space. So,
that should be designed right into your
pitching and presentation from the
beginning.
Yeah. Factored into your pitch and
presentation, but also thinking about
putting yourself in the
viewpoint of some of those actors and
sometimes it can be a little bit
counterintuitive, right? To say, you know,
something might be a great solution for
a consumer. Understanding why a
payor may not might want to pay for
that. Something to get your head
around. Sometimes it means
you have to change your focus
significantly.
What are you most
excited about today?
Obviously, we talked about how much
has changed over the last three to five
years.
What's giving you hope of about where
we're going? Yeah. I just think it's the
the passion of people in the
entrepreneurial community, seeing great
new solutions.
The good thing about healthcare is
there's just no end to the problems
to tackle. There's tons of
opportunity, and just seeing people.
I always get excited by people that are
enthusiastic about going out and
solving a problem and having a
creative solution. I don't think
there's any silver
bullets here, but I don't think that's
because, that's not because no one's done
It, it's because healthcare, there is no
silver bullet. It is like a balloon
and you gotta squeeze here, and then pops
up somewhere else, and you've gotta
constantly, whether it's the squeeze the
balloon analogy, or a whack-a-mole
analogy, but just to see the
energy of people going after it is what
excites me.
One of the questions we've been getting
a lot, both from industry players, as
well as as startups. How does the
changing administration impact our
Business? Maybe there's a near-term
and long-term answer. How are you
guys thinking about that in terms of
the context of what needs to
happen in the future? Does it change
anything, in terms of your long-term
strategy?
Well, in some respects it's a
little bit too early to tell. We
think there's some early signals of what
might happen with the new
administration, but it's certainly not
set in stone.
I think, when you think about certain,
then you've got to think about
what your business process is, or what
your company is, if
you're in early-stage company. So, there
are, there have been companies built
and solutions built around things like, you
know, risk adjustment, as an example. In
the Medicare Advantage space, or the
Affordable Care Act space.
Something like that could materially
change. But, underlying a lot of
that are things like analytics around
disease prediction, and disease diagnosis.
Regardless of our healthcare system,
those types of things are going to be
important. So, 290 00:10:27,790 --> 00:10:32,529 in my mind, it's, some of our
short-term direction you might change
and some of our specific
process might change, and if you're a
startup, your niche is
something that's tied to a
specific regulation that's in place now,
that might be trouble, right? But
I think you're addressing
something that's kind of fundamental,
whether it's about
population health, or a specific healthcare
condition, those things aren't going to
change. They are always going to be
valuable. I'd say those
things, I don't see really an impact.
I'd see those just becoming more
important. Are you seeing enough, what we
call, one of the things we focus on at
StartUp Health with our Health
Transformers, our startups and
innovators, is really around the concept
of solving big moonshots. Big leap frog
innovations that are going to
change the game. Are you seeing enough
of that at this stage, in terms of what
you're seeing out in the market?
Yeah. I mean, Is it more incremental? I'm
probably a little bit
more of a contrarian on that point, that
I don't know that I see, healthcare again,
as being that amenable to
huge big shifts. I mean, maybe
within a specific disease state
you could have that, but overall, I
see it as something that is much more
incremental. I guess there are
technologies out there like
gene therapies or down the line
direct gene editing that could really be
totally transformative. But for me, it
seems like it's much more of an
incremental, because even if I'm tackling
this problem over here, right? Let's say
pick a specific disease,
there's lots of other diseases.
There's lots of other parts of
the healthcare ecosystem. It's
hard to have a solution that transforms
all of that. So, I really do view it as
more of an incremental, just by
nature, incremental approach. How do
you view the construct
of external innovation? Just
within your organization, is a lot of the
innovation, sort of, percolating up
internally or is it also coming from
outside?
Obviously, been talking about startups
and those innovators coming in.
How do you think about and leverage
external innovation?
I had mentioned I had started up our
Innovation Program a couple years ago
and we explicitly looked at the
link between external and internal
innovation.
I mean, our viewpoint was, health
care's got to change, it's got a lot of
big problems to tackle. We can do our
part but we certainly can't do
everything. So, we actively looked
to the outside community, and
particularly, the startup community as
ways to get innovations that
we could use for our business, but we
also looked at it, we coupled it with
internal innovation programs to get some
of our associates thinking
about innovation and using innovation
design practices. We actually
look for opportunities to get
both our associates and our
executives together with some of their
early stage companies. We sponsored a, I
think we have four years in a row, a
local health accelerator in
Philadelphia, along with one
of the health systems there.
Part of the rationale for that was
we can help bring some industry
expertise to some of the early
stage companies, and at the same time,
maybe a little bit of the
entrepreneurial spirit would rub
off on our associates. So, they
could take that back to the office. So, we
definitely see that the two things as
linked, but you certainly, I don't think any
organization can do it all within their
own four walls. It's
too complicated. There's too many
different players and it
helps to have external perspective that
you can kind of bring to bear.
Let's talk about the future. What
are your thoughts, what are your big
predictions on, say, over the next
10 years, on where things go, and
maybe, how that impacts the payors of
the world and your organization?
Yeah. Wow, this big question. Yeah. You
know, predictions over the next 10 years.
I would say, kind of focusing on the,
not stay away from any kind of policy,
particularly, because 406 00:14:43,050 --> 00:14:46,260 who knows where those are going to
go. But, really, within the
healthcare space, there's not a
clear end in sight for 410 00:14:52,410 --> 00:14:57,149 healthcare costs. We have a
generally aging population. One
of the downsides, I hate to even call it that,
but one of the, let's just call it, one
of the side effects of some of the
miracle medicines that we've developed,
people live longer and develop
other diseases. Which adds to the
cost over time. So, I think that
will be a problem where you're going to
continue to wrestle with. So longevity,
but healthy longevity. Healthy longevity.
Managing the costs. Right. How to manage
the cost of an aging population.
Particularly, keep that population
healthy. I think that's going
to be an ongoing problem. I
think within the health
tech space, I think you see a
lot of continued
innovation. I think AI has
is a huge opportunity area in
healthcare. You've seen some
of that some of it already. I just think
we're only at the beginning. I
think there's almost endless
opportunities. Is that one of the area's
you're most excited about?
Yeah. I would say that's one of the areas,
at least me personally,
most excited about. I think there's a lot
of opportunity. Whether that's
decision support for clinicians,
potentially down the line
automated diagnosis. I really think
there's a huge opportunity area there.
Those are some of the things,
and then hopefully, we've been
talking about it for so long,
hopefully we'll get to the point of
interoperability between different
systems. Whether it's a provider's
electronic medical record system or
payors claims and
administrative data repository.
We've been talking about that for a long
time. It's been really slow. How's that
actually going to happen? I mean,
everybody talks about interoperability, it seems like
for years. I know the
government spent billions of dollars.
Ended up with five different EHRs, or
however many there are.
What needs to happen to really change
the game there?
Yeah. I mean, I almost think, I don't know,
Like a new entering? Is it just
new technology? Is it some new system? Is
it a platform like you talked about
that ends up bringing a lot of the pieces
together? I think all
those things could play a role and could
help. I'm also an advocate of just
thinking about it. Again, in
innovation they're gonna want to sound
like the incrementalist, but I think
there's value in saying when you try and
say, hey we've got a whole market
that we want to put on an HIE and
have 20, 30 different kind of
healthcare systems all talking together
in real-time. That's a pretty high lift.
That would certainly be
where we want to get to. But there's a
lot of value between
a health system and a payor on
it. Because we have a view of
every doctor that you've seen, even if
it's not within a
health system. Health system has a
lot more in-depth view in their EMR. Even
exchanging that data on a monthly or
weekly basis has a lot of value.So, I
think we have to take a lot
more of those incremental steps, because
we're not even doing that in a lot of
markets. So, I think doing those
will help you bridge to
the true kind of real-time data sharing,
kind of place that we all want
to get to. When you say we is that
industry, startups, government? All of the
above? Consumers, patients? Yeah, I really
think, I really think that one is,
to me, the government on
that particular, just simply needs to
not become an impediment. I really
think that's us
establish actors. Whether
it's provider systems and
insurers working together. I
think there's a role for startups in
that, to help facilitate that data
exchange. I mean, one of the solutions we
saw today provide a little bit of
that middleware potentially around EMR
systems to make that type of data
exchange easier. But, I think at the end
of the day, the biggest barrier is
an insurer and, let's say, a
hospital system viewing their data not
as just assets they've got to
hold onto. And not share with
anyone else, but unleash it and get the value. The
balancing act is to make sure that we're
doing that in a way that helps patients,
but also, sort of, protects the privacy
and doesn't create any
issues from that perspective. That's,
I think, where we need where I kind of
mentioned kind of government to, kind of,
rules around data sharing, of what you
can share and what you can't share. Because, I
think what we want to get to the point
is, we're all, I think, we were
all aligned in the common vision of, kind of,
helping patients get better care.
So, last question
to ask. What do you do to
personally stay healthy? You've been in
the industry a long time. Yeah. Health's
been a big part of your career, but
what do you personally do? My two big
things are trying to eat well. I just try
and watch my diet. Really
limit my intake of red meat. Try to eat
vegetarian at least four or five meals
a week. So, that's probably one big thing
and then, you know, exercise a couple days
a week, so recently started a new
exercise
regime, at least of the last couple
months. Nutrition and exercise. Sounds good.
Yeah. The basics, right? The basics.
Well, thank you so much for your wisdom
and time and and looking forward to
seeing you at the StartUp Health Festival
and participating more with you with
the Accenture Healthtech Challenge.
Thank you.
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