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The Future of Healthcare: “We need to incorporate the social determinants of health” with Bill Miller, CEO of WellSky

Incorporating social determinants of health: While a patient’s physical health takes immediate precedence, healthcare providers need a deeper understanding of external socioeconomic factors affecting their patients, known as social determinants of health, which include transportation, nutrition, housing, and isolation, among others. For example, availability of public and affordable transportation impacts a patient’s access to healthcare […]

Incorporating social determinants of health: While a patient’s physical health takes immediate precedence, healthcare providers need a deeper understanding of external socioeconomic factors affecting their patients, known as social determinants of health, which include transportation, nutrition, housing, and isolation, among others. For example, availability of public and affordable transportation impacts a patient’s access to healthcare providers and care facilities. Similarly, access to grocery stores that sell healthy food affects a patient’s health. By addressing these social determinants, the healthcare system will be able to improve overall public health and reduce health disparities. Technology should generate actionable insights to anticipate the needs of providers and patients beyond the doctor’s office.


Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Bill Miller, CEO of WellSky. Bill is a recognized leader in the healthcare industry with more than 20 years of experience bringing groundbreaking growth strategies and technological innovation to the healthcare marketplace and a proven track record of launching and leading highly successful healthcare IT companies. Prior to joining WellSky in July 2017, Bill served as the CEO of OptumInsight, a division of Optum, which is the health services platform of UnitedHealth Group. Under Bill’s leadership, OptumInsight experienced unprecedented revenue growth, expanded margins, and claimed a transformative position in the health services market. He led the evolution of Optum into the leader in healthcare analytics and launched several tech-enabled business platforms. Prior to OptumInsight, Bill served as senior vice president of technologies at Cerner Corporation, where he had global responsibility for the company’s managed services, outsourcing, and technology services business units.


Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

I grew up in Nebraska, and like most boys my age, I always wanted to play football for the University of Nebraska. I was one of nine children, so I quickly learned how to be independent, how to be competitive, and that there’s no substitute for hard work. As a kid, I brought those skills to leadership roles in athletics, academics, my church, and my community. Through those experiences, I developed good instincts about people, opportunities, and what it takes to win.

But after a series of knee injuries, my dreams of playing college football were dashed. While those injuries were devastating to me at the time, those experiences were some of my initial exposures to the challenges in the healthcare system. That experience of being a patient stayed with me. Later, when I joined the professional world, I was drawn to building new companies and maintained a deep interest in healthcare. I went on to found three companies in Kansas City — and the third company was in healthcare. Once I started working in healthcare, I never looked back. Supporting care providers felt right for me; it felt like more than just a job. Healthcare challenges are big and solving them changes lives. While technology has an incredibly powerful role in shaping the future of healthcare, I’ve never lost sight of the real reason why I love my work: every day, I get to help the providers using our solutions make care better, safer, and easier for millions of people. This has been true of my time at Cerner, Optum, and now WellSky. I’m incredibly proud to pledge my career to advancing healthcare.

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

In 1980, WellSky started as a company of two people called Mediware. Throughout it’s nearly 40-year history, the company had seen it’s up and downs, from going public once and later becoming private again to welcoming new solutions for human and social services. When I joined the company two years ago, it had a well-established culture. Many of the existing patterns, traditions, and behaviors were good. But there were also some practices that weren’t conducive to growth or continued adaptation to the reality of the recent and future healthcare landscape. I initially thought this company would be slow to change and evolve — and we certainly had our challenging moments. I’m excited to see this company has embraced change and realized new successes in the process. Now I’m seeing that WellSky team members are using this success as fuel and gaining a real sense of confidence in our vision for our company and the future of healthcare. People, companies, and governments all want and need leadership. Vision and strategy are certainly key elements of effective leadership. More importantly still, people need to feel connected to an organization’s mission, truly understand how their work impacts that mission, and feel valued for their contributions. That’s how we approach leadership at WellSky today. And while we’re continuing to shape our company culture, we’re moving forward with a team that’s receptive to change and discovering new ways to succeed.

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?

First of all, there are too many to count. One particular simple, yet important, lesson came from a very innocent mistake early in my career. I woke up early to catch a really early flight, and I decided to get dressed in the dark, so I wouldn’t wake up my wife in the process. I ran to the airport, made my flight, and landed at the destination, ready to deliver a speech to a full auditorium. I thought everything was on track. But before I went on stage, I did a quick mirror check. My jacket, pants, and tie all looked impeccable. But then I looked down at my shoes: I had a black shoe on my right foot and a brown shoe on my left foot.

I learned a few important lessons that day:

1. Don’t get dressed in the dark.

2. How to own my mistakes.

I was mortified that I made such a gaffe. While my mistake was superficial, I made a mountain out of mole hill, and I was concerned that I would forever be known as someone who was too incompetent to dress myself. I had the choice to either try to hide it or own it, and both options had their pros and cons. If I tried to hide the mistake, I risked being found out. If I owned it, I risked exposing my vulnerabilities. It was a tough choice, but ultimately, I decided to own it — especially because the hope of finding replacement shoes at the eleventh hour was pretty scarce. While very embarrassing, it was really another opportunity to learn that being transparent and truly owning my mistakes makes me a better communicator and leader. I’m better able to lead by example and show my colleagues that we all make mistakes and even fail. But we all also have the ability to accept our mistakes and move on from them gracefully, with new knowledge in tow.

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

At WellSky, we’ve focused our sights on one of the most underserved categories of healthcare: post-acute care. In the United States, the aging population continues to grow — 10,000 baby boomers enter Medicare daily — and the preference for home healthcare continues to increase. That’s why we’re working to address the significant gap in the marketplace and delivering care where, when, and how people actually need it.

We understand the complex paths providers and patients face when delivering and receiving high quality care, particularly in post-acute settings. By collaborating closely with care providers across many different sectors, we’ve assembled the talent and technologies needed to create and deliver solutions required for today’s healthcare challenges — such as the rising tide of baby boomers — while also anticipating what providers will need in the ongoing evolution of healthcare delivery. By bringing together stakeholders across the healthcare continuum, WellSky ensures that everyone involved in the delivery of health and community care can share their insights and collaboratively make industry advancements.

In the last year, WellSky experienced a historic, comprehensive corporate rebranding initiative — transforming from Mediware to WellSky. WellSky’s transformation successfully united 30 different brands under one, new shared mission and uncovered new opportunities for achieving interoperability across post-acute care and community care settings. Thanks to the strategic vision and actions of our leadership team, WellSky is well positioned to support more than 10,000 clients with intelligent, innovative solutions that enhance the quality of care for patients in settings across the continuum of care.

Today, WellSky delivers the most comprehensive set of software and services in post-acute and community care settings — including home health, hospice, palliative care, long-term care, rehab, home infusion, specialty pharmacy, home medical equipment, long-term acute care, inpatient behavioral health, memory care, adult day care, community-based organizations, rescue missions, government agencies, and human services organizations.

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

Anticipation is key in today’s ever-evolving healthcare landscape. Leaders must have the ability to see what’s coming around the corner. For healthcare IT leaders, that means watching for new industry trends (like provider consolidation and value-based care), actively preparing for new regulations well ahead of effective dates, and above all, innovating ahead of the curve to ensure healthcare providers have the vital data they need to improve patient outcomes. Today’s healthcare leaders must also be incredibly agile to succeed. The ability to pivot and adapt alongside industry changes will ensure healthcare organizations’ longevity and continued ability to serve patients. Forward-thinking leaders will prepare their organizations to thrive in this challenging industry, while those who are comfortable with the current status quo risk being left behind.

The healthcare industry is making a fundamental and ongoing shift toward value-based reimbursement, with new initiatives that reward providers who can measure and demonstrate improved outcomes for their patients. That’s why today’s healthcare providers need actionable data to better understand and ultimately improve outcomes for their patients. Healthcare technology companies must lead this effort to deliver powerful data to better serve providers. At WellSky, we’re leading this charge with our Applied Insights data science initiative which leverages powerful machine learning and artificial intelligence algorithms to deliver our clients the insights they need to provide better care to the people they serve. With the willingness to embrace, harness, and use data, healthcare leaders can ensure their organizations’ success by using technology that allows them to make a measurable impact in patients’ lives.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the U.S. 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 U.S. is ranked so poorly?

While the overall rankings placed the U.S. healthcare system in last place across the 11 countries evaluated in Newsweek, the study also reflected that the U.S. system ranked №5 in the care process, which included prevention, safe care, coordination, and patient engagement — facets rolled out as part of the Affordable Care Act (ACA). While some of the mandates placed hardships on care providers after the ACA began its rollout in 2009, the shift to value-based care through technological advancement continues to improve the overall quality of care delivered to patients. However, this transition is not without areas of improvement.

  1. Administrative efficiency: According to the study cited by Newsweekcurrently the U.S. spends the most on healthcare (a little over 16%) as a percentage of its GDP, but ranks lowest in performance, as compared to other nations. The majority of this spending can be attributed to administrative costs, including documentation and billing, which require user navigation, demand increased coordination across care settings and facilities, and are also time consuming and labor intensive.
  2. Regulatory compliance: As regulators have pushed for continual and rapid adoption and use of healthcare information technology, such as electronic health records, organizations relying on paper-based systems risk falling behind. Ultimately, healthcare providers must be able handle tasks and meet regulatory standards to succeed in today’s industry and into the future.
  3. Patient outcomes: As increased regulation, provider consolidation, and value-based reimbursement continue to drive rapid change across healthcare, providers are under constant pressure to prioritize delivering high quality care in every care setting. Currently, the high costs of intensive acute care and the lack of actionable data to predict patient outcomes are roadblocks that inhibit providers’ ability to improve the quality of care.

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 U.S. healthcare system? Please share a story or example for each.

  1. Adopting comprehensive technology that improves administrative efficiency: As innovations in healthcare information technology come to fruition, providers are able to overcome many administrative burdens. Using technology solutions like WellSky Home Health software that helps home healthcare clients streamline their operations and workflows, all from one comprehensive, scalable software suite. WellSky Home Health allows users to increase their efficiency, grow profit, improve communication, and better coordinate care for their patients.
  2. Keeping up with regulatory compliance: Complying with regulations is often easier said than done, and it’s an especially challenging task as new regulations are continually introduced and existing mandates evolve rapidly. Healthcare providers need both a deep understanding of regulatory changes and ample preparation to ensure they meet the highest quality standards and are properly delivering patients the care they need. For example, with the upcoming implementation of Patient-Driven Groupings Model (PDGM) by the Centers for Medicare and Medicaid Services (CMS) on January 1, 2020, home health agencies must prepare for dramatic reimbursement changes. To do so, it’s critical that home health agencies develop thorough preparation plans, educate staff, and partner with healthcare technology experts and industry professionals to seamlessly implement this change.
  3. Achieving interoperability: True interoperability has yet to be fully realized across healthcare technology and systems, yet the benefits of connecting disparate platforms has tremendous benefits for providers and patients. Various providers involved in delivering care use systems that can’t “talk” with one another; that is, information can’t be shared across platforms. This lack of interoperability burdens patients with the responsibility of sharing healthcare treatments and protocols, this particularly creates a problem when patients who are not in the best of health must compile all of their healthcare information and convey it to all of their care teams. As a member of the CommonWell Health Alliance, WellSky and fellow health information technology leaders are working together to break down the barriers of data exchange on a national scale. This initiative aims to better connect systems across a wide range of care settings.
  4. Harnessing predictive data technology to improve patient outcomes: Traditional methods for predicting patient outcomes are not enough to achieve the level of care they are determined to provide. By capturing real-time clinical, symptomatic, and psychological data with technology, such as WellSky Hospice Applied Insights, we’re equipping our clients with actionable data to deliver smarter care throughout patients’ care journeys. Hospice Applied Insights technology is part of WellSky’s broader Applied Insights data science initiative, which equips clients with the real-time insights and predictive analytics they need to improve outcomes for people across a range of care settings. Beyond just embracing technology, healthcare providers need to ensure their technology works for them and provides the insights they need to demonstrate measurable success for their business and their patients.
  5. Incorporating social determinants of health: While a patient’s physical health takes immediate precedence, healthcare providers need a deeper understanding of external socioeconomic factors affecting their patients, known as social determinants of health, which include transportation, nutrition, housing, and isolation, among others. For example, availability of public and affordable transportation impacts a patient’s access to healthcare providers and care facilities. Similarly, access to grocery stores that sell healthy food affects a patient’s health. By addressing these social determinants, the healthcare system will be able to improve overall public health and reduce health disparities. Technology should generate actionable insights to anticipate the needs of providers and patients beyond the doctor’s office.

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?

  1. Individuals: It’s important for individual patients to be transparent and communicative with their healthcare providers. When patients view their providers as partners and resources throughout their care journeys, they are more willing to share important personal health information, more likely to engage and communicate with providers, and more likely to have a better care experience.
  2. Corporations and Communities: Company-sponsored health plans are the cornerstone of health coverage for millions of Americans, so it’s critical that human resources and professional leaders educate their workforces about what is provided, the initiatives that aim to improve individual health and wellness, and the worker incentives that can keep them healthy. On a public scale, corporations have the resources to sponsor health initiatives and partner with their communities to improve and maintain healthy living through efforts including events, donations, and compliance.
  3. Leaders: Elected public officials and healthcare industry thought leaders need to better collaborate across the board to promote healthy living. Especially with their visibility and access to resources, they are the ones who can be the voice for the people and communities they support, influence policy, and truly make change happen.

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?

We cannot accept this status quo. We have to increase alignment between general healthcare and behavioral healthcare because they’re intrinsically interconnected. Two separate, parallel care systems won’t cut it, and they won’t deliver the best care possible. Care providers can’t serve the whole person when care is siloed and segmented, and interoperable software that supports the need for better connected care is absolutely vital. At WellSky, we know that our technology must be representative of the people we serve, so we have to ensure that anyone can receive quality care regardless of the type(s) of care they need — whether they need general healthcare, behavioral healthcare, or both. That’s why we recently acquired HCS, a healthcare technology provider that delivers solutions for inpatient behavioral healthcare. We added this new dimension to our company to serve even more people and providers across the continuum of care. This addition helps us better align our technologies and break down barriers to better connected care. We know that segmentation in general healthcare and mental and behavioral health technology systems isn’t serving patients well and that increased collaboration and interconnected, interoperable systems support better patient outcomes. Technology must be built to support people who need both healthcare and mental healthcare simultaneously.

How would you define an “excellent healthcare provider”?

Throughout my career in healthcare, I’ve seen that excellent healthcare providers typically embody six key traits that improve outcomes for their business and their patients. In my experience, the best providers are always working on:

  1. Anticipating what’s next: Especially in today’s environment of value-based reimbursements, successful providers must anticipate what’s coming next and be ready to view challenges as new opportunities. Thinking ahead and recognizing the industry’s value-based trajectory, rather than focusing on just the present, positions providers for continued success, even under the most difficult new regulations.

2. Making data-driven decisions: Providers must put their data to work for them, and make informed decisions based on their findings. Trusting your gut can only get you so far. Great healthcare providers can clearly demonstrate measurable success and growth when they’ve got concrete data to back them up. Frankly, organizations that don’t do this risk being left behind..

3. Leveraging technology to its fullest potential: These days, success is less about simply adopting technology, and more about adopting the right technology. Your healthcare technology should first and foremost make it easier on your business. Further, providers must make sure their technology is easy enough to use and that their staff can save valuable time and help them increase their focus on patient care.

4. Seeking new ways to innovate: Compliance with current regulations is critical, but it’s also the bare minimum. To be an even better healthcare provider, organizations should be always be working toward increasing efficiency and looking for new ways to make a patient’s experience even better.

5. Practicing agility and being receptive to change: If there’s anything constant about healthcare, it’s change. There’s not enough room for providers to be set in their ways. Instead, the best providers expect change and are ready to address it, whenever and however it inevitably arrives.

6. Measuring their success based on positive patient outcomes: In the midst of seemingly endless change and new regulations, the best healthcare providers are able to stay grounded and remember the reason why they embarked on a career in healthcare: to provide excellent care to people in need. The real measure of success for the best healthcare organizations is better outcomes for the people they serve.

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

I’m always inspired by this proverb:

When is the best time to plant a tree? 20 years ago. The second-best time to plant a tree is now.

That proverb describes my approach to leadership. I’m a person of action. Likewise, I want to build a company that shares that outlook. It’s not an invitation to be reckless, but rather, an assurance that we will be proactive and make decisions, even when it’s challenging.

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

Based on our recent acquisitions and our comprehensive rebranding effort last year, it’s clear that we’re working on several large-scale projects at WellSky. There’s a reason why WellSky has aligned health and community care: it’s our mission to transform the future of healthcare as we know it.

According to a recent report from the American Hospital Association, socioeconomic factors — including housing, nutrition, and transportation — are responsible for approximately 40% of a patient’s health. Only 20% of a patient’s health is tied to care access and quality of care. At WellSky, we know that patients need comprehensive, complete care that considers both their health and social factors to achieve better outcomes.

That’s why I’m proud to share a preview of our newest, most revolutionary initiative yet: Engaged Care Management. At WellSky, we’re focused on empowering engaged care, which is the active use of intelligent technology, predictive analytics, and comprehensive services to care for the whole individual. The result of engaged care is better outcomes, lower cost, and sustainable care for every community. To deliver engaged care, providers need technology partners who can leverage both health and social assessment data to create an interoperable, longitudinal record for the whole person. Our Engaged Care Management initiative will solve for this longtime need, and we can’t wait to share more details as we develop it further.

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

My best resources are my relationships with great people across the healthcare industry. I deeply value their friendship and perspectives. I’m grateful for my long-term relationships with key leaders across different segments of healthcare, including payers, providers, biosciences, education, government, military, international, private equity, and large technology firms. These relationships are not only personally fulfilling, but they’re also often the best way to better understand healthcare trends and changes. Many of these people have been strong mentors to me throughout my career, and I’m honored to maintain those relationships to this day.

The HIMSS library of podcasts is also a consistent resource for me. Listening to their podcasts is always an excellent way to more fully understand a wide variety of complex and current industry topics, including healthcare policy, security, and interoperability. I also constantly stay updated on the latest healthcare trends and issues by reading a range of press releases, white papers, Wall Street analyses, and industry analyses from well-respected healthcare consulting companies. My career working at large public companies reinforced my reading habit, and it continues to serve me well.

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 envision a future where interoperability is standard. I want to see this become the norm in healthcare: fully realized, fully interoperable technology that delivers shareable data and actionable insights to care providers across all settings. Right now, technology providers are still working to get systems connected, and no one has achieved full interoperability yet. At WellSky, we’re thinking beyond just connecting systems — we’re actively creating new ways to bring meaningful data to providers that can make a measurable difference in people’s lives now. The future of successful interoperability in healthcare technology is incredibly exciting, and it will no doubt support better care and better outcomes for people across health and social care.

How can our readers follow you on social media?

You can follow me on LinkedIn at linkedin.com/in/bill-j-miller.

You can also follow WellSky on LinkedIn at linkedin.com/company/wellsky, like us on Facebook at facebook.com/wellskyhealth, and follow us on Twitter at twitter.com/wellskyhealth.

Thank you so much for these insights! This was so inspiring!

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