Another area of improvement is ensuring the proper use of information and data management, which is an area I’m at the forefront of in my role as an actuary. The healthcare industry has access to an unprecedented amount of data, but the key is analyzing it to develop actionable initiatives. For example, we can use data analytics to identify an individual who might be at risk for a chronic condition, like diabetes, and then work with clinicians to tailor their treatment accordingly. This improves the quality of the patient’s care, lowers their healthcare costs, and ultimately improves their outcomes — hitting on the Triple Aim.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Mr. Kurt J. Wrobel. Kurt is the Chief Financial Officer and Chief Actuary of Geisinger Health Plan, and a Fellow of the Society of Actuaries. Mr. Wrobel joined Geisinger Health Plan in 2014. Prior to joining the Health Plan, he was a consultant for Milliman in Brookfield, Wisconsin. He also served as vice president of large-group pricing and underwriting and as chief underwriting officer for Humana, based in Louisville, Kentucky. He also held positions at United Healthcare/PacifiCare Health Systems, based in California, HealthMarket, Inc. and William M. Mercer Inc. In addition, he has published several actuarial articles on health care reform, risk management, and payment reform initiatives. Mr. Wrobel earned his Bachelor of Arts degree in economics from the University of California, Los Angeles, and has a Master of Science degree in economics from the University of Wisconsin, Madison, and a Masters of business administration degree in health care management from The Wharton School, University of Pennsylvania, in Philadelphia.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Ichose this career path because I wanted to positively affect people’s health by using my technical background in a meaningful and applied way. I thought being a healthcare actuary would be the right avenue to use my quantitative skills to help people — and it’s been a very rewarding career so far.
Can you share the most interesting story that happened to you since you began leading your company?
I’m the CFO and Chief Actuary of a health plan, and it’s been interesting to see how my role has changed in recent years given the radical change taking place in the healthcare industry. Traditionally actuaries, myself included, worked in the background to ensure we have a financially sound and sustainable health insurance system. We’re rarely in the limelight. However, that changed significantly with the passage of the Affordable Care Act. The actuarial profession has been way more prominent than ever before, as we’re on the front line of the changing healthcare landscape.
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?
When I first started as an aspiring actuary, I thought everything in life could be predicted, down to the last decimal point — including being concerned about proper rounding! With age and wisdom, I learned that projections and estimates are much less important than making meaningful operational changes.
What do you think makes your company stand out? Can you share a story?
Geisinger is unique because it provides both insurance and care to individuals, which changes our company mindset about the healthcare delivery system. We try to ensure a seamless experience from the sale of an insurance policy all the way through to providing care for an individual. As an example of this, we decided to stay in the Affordable Care Act exchanges, which was driven by our desire to provide care for the people in our community and less about financial considerations.
What advice would you give to other healthcare leaders to help their team to thrive?
The single most important advice is to understand the individual and what they’re going through as they receive care. When people need healthcare, it’s often a difficult and vulnerable experience, which is why it’s extremely important to take time to understand what the patient is going through. It’s easy to think of individuals as a number on a piece of paper, but we need to understand and approach their care experience as individuals.
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?
I actually disagree with this study. Of course, there is always room for improvement, but it’s difficult to boil down the healthcare delivery system to just a few points since it’s so complex. Consider the following:
- Health outcomes are very dependent on individual lifestyle choices, like diet and exercise. These choices vary by country, and the healthcare outcomes highlight these differences.
- Healthcare outcomes are collected and measured in different ways, which creates inaccurate comparisons across the healthcare system. An example of this is infant mortality data, which different countries around the world report on in different ways.
- We have high end of life expenses in this country, but that’s a choice we made to invest in that care. It doesn’t mean our delivery system is inadequate, just that we made a choice to expend those resources.
- And finally, keep in mind that the US still attracts people from other countries who want to use our healthcare delivery system.
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.
- The US healthcare delivery system should strive to consistently provide cost effective, high quality care that allows individuals to have a favorable experience. Achieving this Tripe Aim is the most important change to make.
- A big challenge facing our healthcare system is the cost of care. To address this, we need to change the culture of every provider organization to ensure that cost-efficiency combined with quality care is paramount.
- The industry should embrace value-based care, which incentivizes organizations that achieve the Triple Aim I mentioned above (improved costs, quality of care, patient outcomes). The current fee-for-service system encourages organizations to provide a high volume of care as opposed to cost effective, quality care.
- Another area of improvement is ensuring the proper use of information and data management, which is an area I’m at the forefront of in my role as an actuary. The healthcare industry has access to an unprecedented amount of data, but the key is analyzing it to develop actionable initiatives. For example, we can use data analytics to identify an individual who might be at risk for a chronic condition, like diabetes, and then work with clinicians to tailor their treatment accordingly. This improves the quality of the patient’s care, lowers their healthcare costs, and ultimately improves their outcomes — hitting on the Triple Aim.
- Finally, another way to improve the use of data analytics is to use a methodology that compares outcomes, results and costs to other organizations. I recommend always using a benchmark to define opportunities for future improvement. We should be in a constant “test and learn” environment to evaluate new programs and initiatives to understand what is and isn’t helping to achieve our goals, and adjusting accordingly.
Ok, its 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?
- Individuals need to take good care of themselves by eating well and exercising. It’s important to foster that mindset within yourself as well as your family.
- Corporations should support a system that provides cost-effective, high-quality care. Value-based care should be a priority.
- Communities should foster an environment of healthier living. Simple additions like bike paths can help encourage a healthier lifestyle for residents.
- Leaders need to take a broad approach to ensure they’re working towards a culture of well-being, utilizing the right financials to achieve their goals, and analyzing data as effectively as possible. All three criteria are important here.
As a mental health professional myself, im 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?
My suggestion is to study the effectiveness of particular interventions to identify opportunities for improvement that ultimately lead to cost effective, quality care. We can’t make blanket statements here: we need to analyze the data to evaluate results and determine which resources to put towards a project to ensure the highest quality of care.
How would you define an “excellent healthcare provider”?
An “excellent healthcare provider” is one that provides high quality, cost effective care, and creates an excellent experience for each patient. It all goes back to the Triple Aim.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Simplify, simplify, simplify.” Henry David Thoreau
This quote is especially relevant for healthcare professionals, as we’ve made today’s healthcare system more complex than it needs to be. In complexity, we lose the importance of the individual and the importance of actually creating meaningful change. That’s why I try to simplify complex processes in my day to day work.
Are you working on any exciting new projects now? How do you think that will help people?
Geisinger just initiated a project, Geisinger at Home, that focuses on providing care for patients at home as opposed to hospitals. It’s a home run for the healthcare system: it’s preferred by patients and it provides cost effective care too.
This goes back to the way we delivered healthcare decades ago, and it’s a good reminder that sometimes the “old fashioned” way can be more effective.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
One of my favorite healthcare reporters is The New York Times’ Robert Pear, who sadly recently passed away. He had a way of taking an impartial view on very political topics, and provided some of the best reporting I’ve seen on the Affordable Care Act. I also value healthcare research from the Society of Actuaries, which provides data-driven, factual and informative research to help navigate complex healthcare topics.
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.
Think about every policy as it relates to your own mother. Too often we get caught up in numbers on a page, and that’s how we miss personal connections. Every policy change, every patient and every act of care should be evaluated through the lens of what you would want for your own mother.
How can our readers follow you on social media?
Thank you so much for these insights! This was so inspiring!