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5 Things We Must Do To Improve the US Healthcare System: With Texas Health Aetna CEO, Cory Scott & Limor Weinstein

My advice is to be disruptive. Be disruptive within the healthcare system and within the communities you serve. We have to push against the status quo. As a part of my interview series with leaders in healthcare, I had the pleasure to interview Cory Scott, CEO, Texas Health Aetna. As chief executive officer of the jointly-owned […]


My advice is to be disruptive. Be disruptive within the healthcare system and within the communities you serve. We have to push against the status quo.


As a part of my interview series with leaders in healthcare, I had the pleasure to interview Cory Scott, CEO, Texas Health Aetna. As chief executive officer of the jointly-owned local health plan, Texas Health Aetna, Scott oversees a unique collaboration between a local health system and national insurance provider that serves 100,000+ members in North Texas. Prior to joining Aetna in 2015, Scott served as Vice President of Sales & Services for Medicare, individual and commercial segments, for Piedmont WellStar Health Plans, an Atlanta-based, provider-owned health plan. He was also the Vice President of Sales & Services in North Carolina, South Carolina and Georgia for more than 11 years with Coventry Health Care. He graduated from Midwestern State University with a Bachelor of Business Administration in management science.


Thank you so much for joining us Cory. Can you tell us a story about what brought you to this specific career path?

My career in healthcare began with PCA Health Plans in Austin, Texas, where I was selling Medicare HMOs to seniors; door to door and table to table. This job allowed me to interact with a variety of people in various community settings. This role, although it may not have been glamorous at times, led me to realize the importance and profound nature of healthcare. A significant portion of my job was helping people save money on healthcare, which in some cases helped free up funds, allowing them to eat more meals during the week, afford their medications and have an overall better quality of life.

As I progressed in my career, I was able to work with hospital health plans where I saw firsthand the true integration between the provider and payer, and how they used data to help support physicians in their day-to-day business. The relationship between physicians and their patients is one of the main reasons I have been in this industry for so many years.

Can you share the most interesting story that happened to you since you began leading your company?

Since taking on this new role with Texas Health Aetna, I have heard some wonderful stories about our virtual doctor application, in which our members can access physicians through texting, phone calls or video chat. Although I cannot get into specifics, this app has made healthcare more convenient and personalized for our members. It is very heartwarming to see how the programs we are implementing here at Texas Health Aetna are positively impacting the lives of our members and community.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I will reference back to when I first started selling Medicare HMOs in Austin, Texas. I did a lot of home visits so clients and I could meet in-person to go over product offerings, answer any questions and help map out next steps. I’ll never forget the day I was greeted by a gentleman in minimal clothing. From that moment on, I made sure to always be prepared for the unexpected, because you never know what is on the other side of the door.

As I continue my career path, I think it is important for everyone in healthcare to remember two things:

1. We service the members of our community that we interact with every single day. We need to look at them as individuals who want to access their healthcare experience differently.

2. It is our job to make sure we have solutions for every one of those individuals. As an industry, we have lost sight of personalized approach to healthcare, and need to recognize that every member’s healthcare journey is unique and should be treated as such.

What do you think makes your company stand out? Can you share a story?

At Texas Health Aetna, we are driven by two core principles and a personal principle. Our two core principles are being disruptive in what we deliver to the community and making sure what we are delivering is simple for our members to understand. There have been plenty of studies that have been done to point to the fact that most of us do not understand our health plans, so we want to be able to address how we can help people through the process.

My personal principle is that the best way to help our members is meeting them where they live, where they work, where they play and where they spend time with their families. In all of these settings, we must allow them access to care when and where it is most convenient to them.

As I mentioned earlier, Texas Health Aetna offers a virtual app that allows our members access to a physician anywhere and anytime that fits their schedule. This app allows us to refer our members to urgent care or the emergency room if needed. It also enables our team to send a specialist from our personalized care team to show up at the member’s bedside during a hospital stay. To summarize, this platform ensures members are getting the care they need in a seamless process.

The recent acquisition of Aetna by CVS Health gives us a whole new breadth of resources we can utilize, such as CVS stores or minute clinics, to better engage with our members right in their communities. We are currently identifying how we can best integrate these new resources within Texas Health Aetna to continue developing the continuum of access to care. Texas Health Aetna aims to meet our members where they are.

What advice would you give to other healthcare leaders to help their team to thrive?

It’s vital to keep your member at the core of everything you do. Every time a decision is made, this question should be asked: “Will this have a positive impact on the member?”

My other piece of advice is to be disruptive. Be disruptive within the healthcare system and within the communities you serve. We have to push against the status quo.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

It’s no secret that many parts of the US healthcare system are broken and need improvement. These are the reasons that stand out to me:

1. Lack of member engagement. When it comes to health and wellness, most of us tend to be reactive. Increased engagement with members and employers will encourage a stronger focus on preventative care, which will ultimately keep members out of the ER, drive down cost and cultivate a healthier lifestyle.

2. The current system is disjointed. If we can continue to find ways to integrate member information and data, we’ll be able to identify an individual in need, and remove any gaps in their care continuum. This will lead to increased quality of care for the member, including healthier outcomes.

3. Absence of provider partnerships. As a health plan, we have to realize that providers play a significant role in the member’s health journey and it’s essential for health plans to create a wholesome collaboration with these professionals and networks. How can we set providers up for success?

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each. 
 
1. We have to encourage members to take control of their healthcare. Identifying primary care physicians, education on preventative care, and virtual care services are a few ways to foster member engagement.

2. We need to push the status quo on care plans and guiding members through a disjointed system. Texas Health Aetna has a personalized care team for our most at risk members, which is a critical resource for this group of individuals. When people are sick or injured, we need to make the road to recovery simple.

3. Equip providers with the tools and resources they need to deliver exceptional care.

4. Continue to expand how individuals can access healthcare and meet them where they are. Our virtual doctor application is a great example of giving people access to care in any setting.

5. We must remember that although it’s complex, we do have the best healthcare system in the world. To combat this, we need to start everyday with the mindset of “how do we make this simple?”

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

For these changes to manifest, it needs to start at the top. Leaders need to make a conscious decision to start steering healthcare in the right direction. On the other end of the spectrum, members need to feel empowered to take a stance on what they really need in terms of healthcare. If the community comes together, we can collectively start taking steps in the right direction. This includes the employer, as they yield a lot of power and can be a major player in shaping the healthcare system’s future.

I also wanted to touch on the importance of having access to care. Technology is going to be a major influence in how people will interact with healthcare in the future. Technology will allow us to change the current dynamic and bring healthcare to people. Not only will this make healthcare more accessible for a larger part of the population, but it will also make it more convenient, streamlined and simpler.

As a mental health professional myself, I’m particularly interested in the interplay between the general healthcare system and the mental health system. Right now we have two parallel tracks mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

Overall, the status quo for the mental health system and general health system are changing and starting to merge together. Some of this is attributed to law and some is from the mental health parity that we have seen over the last few years. This renewed focus and support around mental health has been very beneficial to the community and has allowed providers to continue to improve care in this arena.

The improvement in the cultural stigma around mental health has probably been one of the biggest advocacies for improving care, compared to what it was 10 years ago. This has allowed stronger engagement from employers, resulting in better behavioral healthcare to their employees.

As a community we are integrating behavioral health services and general health all under one umbrella, which allows us to look at an individual holistically. For example, one of Texas Health Aetna’s goals is to add behavioral health services to our virtual platforms and possibly integrate this realm of care into our care management programs. Currently, a part of our personal care team includes social workers, with access to internal and external resources for behavioral health services. We are really trying to round this out so we are touching individuals no matter what their health needs are.

Lastly, let’s not forget that general health is highly influenced by mental and behavioral health. Accordingly to a report from the American Psychological Association, a lack of access to mental health care is a source of stress for 56 percent of Millennials and 47 percent of Gen Xers, while only 27 percent of Boomers and 20 percent of older adults express the same concern. This data displays the increasing importance of integrating these systems to make the needed improvements both in behavioral health and general health.

How would you define an “excellent healthcare provider”?

At Texas Health Aetna, we define an excellent healthcare provider as someone who can continuously disrupt the status quo with the member in mind.

I challenge our team with these questions:

– How do we make things simpler for our members?

– How do we continue to engage our provider network to ultimately deliver an exceptional experience to our members and plan sponsors?

– How do we create a product that allows members to have the coverage they need and live a full life?

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

The quote I have used the most throughout my career is: “Success is simple; do what’s right, the right way, at the right time.”

This concept must be applied to healthcare. The industry is fragmented by nature and has evolved to this complex system over time. This quote is a good reminder for simplicity, which can be achieved through integration within the industry (amongst other factors).

I also received a great quote from Karen Lynch, President of Aetna: “It’s not our fault, but it is our problem.”

This really sums up our role in delivering a differentiated experience for our members. The current experience for members is very disjointed, which is a problem our team at Texas Health Aetna is trying to solve. The local health plan is addressing this problem with solutions like same and next day appointments for our members, virtual access to doctors in our community and a personalized care team that guides our at risk members through their care journey.

Are you working on any exciting new projects now? How do you think that will help people?
 

 Our team at Texas Health Aetna has several exciting projects in the pipeline.

· Collaborating with healthcare providers and family physicians out in the community and trying to help them identify their sickest patients.

· Integrating behavioral health services in virtual platforms through telemedicine, texting or video chat.

· Reaching the behavioral health population in new and innovative ways, such as utilizing our resources at CVS or developing online platforms.

· Simplifying our services as Texas Health Aetna continues to partner with more healthcare providers, and ensuring our members can access information in the most convenient manner.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I read a lot of Jon Gordon books, like “Energy Bus,” which is about culture, teamwork and leadership. Most recently I read “Time, Talent, Energy” by Michael Mankins and Eric Garton. This book speaks about the amount of productivity lost within an organization on things that do not move the organization forward. Although the book is not directly related to healthcare, I do find a lot of correlation. The healthcare industry needs to identify the areas that do not improve the quality of life for our members and work to eliminate them. This is a big undertaking, but is part of our mission to make healthcare simple.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.

I would inspire the integration of all healthcare components — the provider, the payer and the member. There seems to be a lot of distrust within the industry and one another, so implementing a new system with greater transparency is very important. It is our responsibility to be engaged with how we help improve the quality of life for the millions of people who depend on us.

How can our readers follow you on social media?
 
 
LinkedIn: https://www.linkedin.com/in/cory-scott-871a167/

Thanks! This has been very inspiring!


About the Author:

Originally from Israel, Limor Weinstein has been anorexic and bulimic, a “nanny spy” to the rich and famous and a Commander in the Israeli Army. Her personal recovery from an eating disorder led her to commit herself to a life of helping others, and along the way she picked up two Master’s Degrees in Psychology from Columbia University and City College as well as a Post-Graduate Certificate in Eating Disorder Treatment from the Institute for Contemporary Psychotherapy.

Upon settling in New York, Limor quickly became known as the “go to” person for families struggling with mental health issues, in part because her openness about her own mental health challenges paved the way for open exchanges. She understood the difficulties many have in finding the right treatment, as well as the stigma that remains so prevalent towards those who are struggling with mental health issues. She realized that most families are quietly struggling with a problem they’re not comfortable talking about, and that discomfort makes it much less likely that they will get the help they need for their loved ones. She discovered that being open and honest about her own mental health challenges took the fear out of the conversations. Her mission became to research and guide those families to the highest-quality treatment available. Helping others became part of her DNA, as has a commitment to supporting and assisting organizations that perform research and treatment in the mental health arena.

After years of helping families by helping connect them to the right treatment and wellness services, Limor realized that the only way to ensure that they are receiving appropriate, coordinated and evidence-based care would be to stay in control of the entire treatment process. That realization led her to create Bespoke Wellness Partners, which employs over 100 of the best clinicians and wellness providers in New York and provides confidential treatment and wellness services throughout the city. Bespoke has built its reputation on strong relationships, personalized, confidential service and a commitment to ensuring that all clients find the right treatment for their particular issues.

In addition to her role at Bespoke Wellness Partners, Limor is the Co-Chair of the Academy of Eating Disorders. She lives with her husband, three daughters and their dog Rex in Manhattan.

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