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December 1, 2020

How Transparency, Technology and Data Analytics Are Transforming Employee Benefits [Part 3]

Artemis Health

Artemis Health partnered with BenefitsPro for a webcast panel discussion on how transparency, data analytics, and technology are transforming the employee benefits industry. CEO Grant Gordon participated in the discussion and shared his insights into the future of data analytics in employee benefits. We wanted to share some of the discussion and insights from this webcast panel with you, and we’ll be doing so over the next few weeks in this multi-part blog post series. Read Part 1 here and Part 2 here.

In addition to Grant, the panel included Rion Shearer, Senior Employee Benefits Consultant at USI Insurance Services, and Lester J. Morales, Co-founder and CEO of Next Impact. Let’s dive into their discussion.

Lester Morales:

And there were a couple of key things on the back end that Rion and I talked about again, what he calls proactive and reactive, but what do you do with the data, or rather, how do you monitor that the programs are going well? So Rion, talk to me about two main things. One, you have a very good correlation between the value that you're adding to your clients and how you talk to them about that. But two, how to get clients to make decisions by kind of benchmarking them against other people that look like that.

Rion Shearer:

Yeah. So good question there. So obviously with the data monitoring that going forward helps you determine your effectiveness as an advisor. So a real life example for me, one of my largest clients has a brand new director of HR that came in from another organization that has a relationship with another national broker. And within a few weeks, this director of HR wanted to meet with me and understand the health plan and the decisions that we have made. And so by having the data, monitoring the data and using it to my advantage to show the results we've had for the program, I was able to meet with that director of HR and within an hour, explained to him exactly everything that we had done, showed him the impact of the ideas that we had brought to the table and their spend relative to their competition and to trend.

And pretty immediately, I was able to bring down his defenses, get him on my team and have him sold on me to continue working with that client. So that's key number one, I think we're all as advisors vulnerable to that type of situation where a new CFO comes in, or the CEO has a golfing buddy that is a broker, or the HR manager comes in and she's from another company that wants to get her buddy in there. I think the more data you have, the more value you're driving, the more impact you can show, the more solid your position is with that customer. Because again, you've shown your value, you've identified the impact, and you're making it a lot harder for that new person to come in and flip the business of the competition. That's key. Number one.

The other idea that we have here is, again, utilizing that data again, going forward, as we start thinking about strategies, you start thinking about renewal negotiations and arming yourself for the long-term with that client. So monitoring it, continuing to monitor it, populations change, there's turnover, there are new programs entering the market. Just doing it once and showing the data and sitting back is not going to work long-term to retain that client.

Lester Morales:

Love it. The last thing that I wanted to show, and obviously this is a new broker, and I give a lot of props to people who put their money where their mouth is. So this is a slide that David Contorno shows a lot where, hey, directly correlating your value and aligning your interests with your client can actually make you more money. So, there's nothing that boils my blood more than when I sit with an advisor, show them a way to save 25% on healthcare costs for their client, and the first question I get is, well, how much am I getting paid? I had an old CEO that used to say that the price is only an issue in absence of value. If you're adding value, the fact is this is their second largest P and L expense. And the reality of it, you can get paid more. So if you guys are not out there putting your fees at risk and more importantly, gaining an upside for adding value, I really think that you need to do it.

So, Rion, first of all, I appreciate the insight. I'm going to end with this thought process, and this is just a motivation for change. One, if you think the current model is going to fix this with, Oh, I've heard a couple of people say, man, it's going to be really great that the carriers are buying these PBMs or the PBMs are buying the carriers. If you think for one second, that is actually good for our business, please think again. The amount of shell game that's going to be played between that is even worse than the lack of transparency that's here today. So that's just that.

Think about what's entering the marketplace. And I'm going to leave you with one example. Alexa is now HIPAA compliant. That means that you can pass HIPAA information through Alexa. If you didn't know, Haven (Amazon/Warren Buffet/JP Morgan conglomerate) has already started test piloting their own telemedicine program. They're doing it for their own employees. So mark my words today on the 7th of October, it will be less than a couple years where you're sitting at your coffee table, your dining room table saying, Alexa, I don't feel good. She is going to dial you up or turn on your TB. You're going to be able to access a doc. And because they want to know exactly where you are because it's GPS driven. Two, obviously Amazon knows how to get something to you super fast, whether it's a drone or overnight, and they purchased PillPack. Well three, they're going to steer you to the local convenience store, CVS, whatever it might be. So change is coming, whether we like it or not. And the reality of it is, this needs to be our mission.

This is no longer about just having a job. This is about having a mission. So Rion, thanks so much for being on that mission and adding value to all of your employees and their employers. And Paul, I'm going to shut up now and turn it back to you for the next part of that. Thanks so much for allowing us to chat.

Paul Wilson:

Perfect. Thank you guys so much. And in just a minute we're going to come back to you for some Q and A time, but real quick, first, I would like to throw it over to Grant Gordon from Artemis Health. This is going to just a couple more things. So Grant, over to you.

Grant Gordon:

Thank you very much. And gentlemen, thank you so much for the presentation you've shared. I really enjoyed hearing about the things that you're doing with data. I mean, that's what we're passionate about over here. We really believe that if you want to help fix healthcare in the United States, you need to empower employers and they'll know what to fix, or if anything is working, if you can't measure it, you can't dig into the data. So it always just tickles me to hear this stuff. Really enjoyed it. Just really quickly, I'm going to share some findings and some thoughts that we have with everyone, briefly explain what Artemis does, but I don't want to make this a commercial for Artemis. We do a ton of research talking to employers, talking to them about their data and the things that we hold most recently that are frustrating are just basics.

You know, it's hard to access the right data, just running reports takes too long. A lot of the legacy tools out there are pretty slow and, connecting to varied data sources is hard, and that's hard for a lot of good reasons. But I think with brokers, like the ones we heard today and, and the right technology, a lot of these things are solvable and in Artemis, that's really what we're trying to do.

We like to think about our mission as helping benefits teams climb this mountain of measurement. You know, most of us have seen that all those things under reports, the next thing you want to do after you get those standard reports is, ask some questions and get some ad hoc reporting. Then you want to benchmark yourself and then it's hard to read. So when to visualize it to the visualization, to the dashboard, and then you want to find the insights of the dashboard.

And then ultimately once you do something you want to quantify the impact of what you did. And that's really hard today. You know, if you're using a data warehouse, it's sort of like climbing up this mountain on foot. And what we're trying to do is build like a ski lift to the top of this mountain. We're trying to build the infrastructure so that the kinds of things that you heard today, you can operationalize for your clients and you can prove that value without having to do the work. You kind of dig in there.

Grant Gordon:

So of course, the way we do that, as we pull in a bunch of different data sources for our customers, the minimum is medical claims, pharmacy claims, and eligibility. But for some of our customers, we're pulling in all of their programs, like north of 35-40 programs, to do the kinds of things that we heard today. Just kind of connecting the dots, see what's working, see what's not, get that total picture of the number. And that's all just context to help you understand why I have these predictions that I have. And hopefully they're valuable to you as you think about the market and how to help your clients, and what's coming.

We are doing this day-in-day-out. We deal with billions and billions of records upon thousands and thousands of files. We've got something like 6 million lives on our platform, and we've seen a lot of data, and we've dealt with a lot of data over the years. And I've got three predictions I hope are valuable to you about what's going to happen related to data in this space. The first one is that data-driven advisory is going to become a standard, not an advantage. Today it's an advantage. There's a few brokers, like the ones that we heard from today, who would just do a great job with this, but we're all going to, everyone's going to have to level up their skills here.

The next one is the rise of API. And I'll explain what that means in a little bit more detail, because the terms may not be familiar to you. And the third one is the rise of data mediators to reduce the friction on getting this data. A lot of the presentation we heard today was about, how do you get the data, which is the first challenge to be data-driven.

So in terms of the data-driven advisory, I think more and more, like you heard today, you're probably hearing it through your clients, certainly I hear from the employers that we work with: they're demanding data. And the higher health costs go, the more scrutiny there's going to be on there. And so we see more and more advisors turning to data. We have a lot of partners, some more competitors have partners, but I think today, a lot of the data work to get done is a lot of check the box standard reporting, and it's been good enough, but the advisors that are really winning right now have an advantage because they have really thoughtful insights like the ones we heard today. And they're trying to scale that up for their employers.

And they're also, to the other point, they're proving the impact with data, and that's going to become the new standard. So to each of you, I would say, start boning up on the skills here, figure out how to use the technology, teach yourself about data. You know, generally in data, specifically in this space, if you have a data partner, I'm sure they'd be willing to help you with that. I know we teach our partners things like that, their requests, and we're happy to do it. So, that's one trend I think is happening. Next one is rest APIs right now. Almost 100% of the data that we deal with is coming in through file transfers, where the health plan cuts a CSV file or an Excel file, and they send it to us via FTP.

Grant Gordon:

And then we have to deal with that. There are a lot of challenges there. They could send us the wrong file. They could, like, we've had vendors, send us files for totally different products or clients, which is violation of HIPAA and other things. It's not safe, it's very expensive to scale, so error prone. It's the cause of many errors in the data that you've seen. Whereas APIs are ways for systems to talk to each other directly. So their claims system and our data integration system could hook up, or other products could do this.

Most of the rest of the world has moved on to APIs, but healthcare has not. This is going to happen because it's too expensive on all sides to sustain the cost of giving file data transfers with the increased demand for files. So, especially with so many thousands of point solutions trying to sell products into employers, employers are going to want to see the ROI of those they already do today. Like we can't scan that file base stuff.

So the point solutions are going to open up API. Eventually carriers will open up APIs, there's some legislation about that. And that's going to reduce the friction on getting the data, which is partially what's going to drive innovation. Your clients are going to expect more out of you in terms of differentiated insights, if everybody can get access to the data relatively easily.

And the final one to help those health plans get over sharing that data, you know, a ton of the effort that we have to spend on getting the data is just doing legal work with them, to get the data from them. It can take months sometimes. And, I think what you're going to see is they don't want to deal with that, they're going to be put in a corner and have to share this data, so you're going to see mediators rise up.

I don't know if Artemis is also into this or other companies do this, but they're going to pre-bake novel, legal frameworks and agreements with a lot of these data suppliers and data originators, that let you just quickly add on addendums with folks who need access to that data, who are enforcing data access rights and data legal rights and things like that, to reduce the friction in the space, especially as more API has happened. So all of that is to say, I think the stuff you heard today was great. I think you're going to be expected to think like that more and more in the future and, to the extent that we can, we'd love to help you with that. So that's it for me.