How to Give Consumers Control of Their Health through Digital Health

November 22, 2023 - While innovation resulted in life-saving digital health tools, it has also resulted in waste and complications in the healthcare system.

Unlike in the banking, car ride, or travel industries in which apps and useful technologies have been seamlessly integrated, healthcare consumers wrestle with too many siloed apps and tools. Not only can these tools further complicate care, but they can increase costs and take away decision-making opportunities from consumers.

In this episode of Industry Perspectives, Glen Tullman, chief executive officer of Transcarent, addresses how healthcare leaders better integrate useful technologies to make healthcare more affordable, more accessible, and more capable of empowering consumers in their healthcare choices.

Glen Tullman:

I talk about friends and enemies and frenemies. Sometimes all three are the same company. A company that's a customer, that you're doing development work with, and that is also competing with you or partnering with competitors. That's just our world today. Get used to it.

Kelsey Waddill:

Hello and welcome to Healthcare Strategies, Industry Perspectives. I'm Kelsey Waddill, senior editor of HealthPayerIntelligence and Multimedia Manager of Xtelligent Healthcare Media. We're coming to you from HLTH 2023 as we chat with leaders in healthcare tech from across the industry.

READ MORE: How Digital Health Has Ushered in a New Era of VC Investments

In this episode, our VP of editorial, Kyle Murphy, spoke with Glen Tullman, chief executive officer of Transcarent, about technology's role in solving the US healthcare system's affordability problem and how to make health technology blend into the background so that the focus is on human care. Let's listen in.

Kyle Murphy:

What I know you most for was Allscripts, and now today you're at Transcarent. What's been your perspective on how healthcare has changed over, what, it's been two decades or so that you've been in the industry?

Glen Tullman:

It has been two decades, yeah.

Kyle Murphy:

Is it still more of the same with some technology added to the mix?

Glen Tullman:

Well, I think it is. It's interesting, if you survey people today across America, what they say is healthcare is more confusing, more complex, more costly than ever before, and getting worse, not better. So that's not a very good report card for two decades of work.

READ MORE: Challenges, Opportunities of Digital Health in Health Insurance

And if you go to large self-insured employers who we focus on at Transcarent, what they say is healthcare is more confusing, more costly than ever before, and complex. And mainly costly, because today we're at a crisis point where we cannot afford our healthcare. And this is not just about affordability. What's happening is that we will see in this generation cures for things that we never imagined. The question is how do we afford them?

And we're already seeing with the new diet drugs, they will break the bank in terms of affordability, and yet we know they work. And so the question is: how do we find the dollars? And the only way to find the dollars is to focus on the inefficiencies in the system.

We've all heard 30 percent too many surgeries, 30 percent waste in healthcare, that hasn't been addressed. And that's what we need to do, and we need to be willing to challenge the status quo. But in healthcare today, too many people make money from doing the wrong thing.

Kyle Murphy:

100 percent, 100 percent.

So you named some inefficiencies, obviously a lot of it has to do with billing, insurance-related administrative waste. How do you see technology impacting some of that, maybe automating some of those workflows, for instance? Are there some easy wins in the near term? And then, more long-term, how else can technology assist?

Glen Tullman:

READ MORE: Future of Telehealth, Hybrid Care After the Public Health Emergency

Well, I think there are some easy wins. We've seen some efficiencies, but we have to do some restructuring. And that's going to be tough. Because as I was saying, there's an old quote that said, "If you ask a person to make the right decision and lose their job over it, they'll always choose the wrong decision."

And that's where we are in healthcare. So we have a lot of people who are profiting from the wrong thing. So I think what we can do is move more and more back to individuals, to people, to what we call health consumers, to allow them to make the decisions.

And we see that happening in some places. In other industries, we've eliminated the bank teller. So now money is accessible almost anywhere in the world, at any time, securely, so we were able to do that for something that's pretty important to people, and that's their money.

What else is pretty important is their healthcare. And yet we hear privacy, security, and it's all made up. We have the technology to do it.

So we did that in travel. We eliminated the travel agent, and now we have specialty travel agents, which do an amazing job. But for the average ticket, you and I would rather do it ourselves. We'd rather be more in control.

If you think about Uber, I tell the story of my daughter and we were in Washington and we needed to get somewhere. And so we walked out and I said, "There's a taxi." And she said, "I'll Uber." And I said, "Wait, there's a taxi right there." And she said, "It's easier, it's more secure." She said "I don't have to pay for it," but I think she meant... I was wondering whether it was my credit card or not, but it was hers; but she meant she didn't have to go through that whole process.

What she was really saying is, "I'm in charge, and I like that." And that's what consumers say. So if we give people the information they need... And this is a big part of why we started Transcarent, it's: how do we make health and care more easily accessible to the average person? And that's high quality, affordable care. And the way you do it is you put it on their phone, you give them one place to go for all their health and care, and that's what we're trying to do.

Kyle Murphy:

How do you balance that with obviously different demographics and folks who are used to doing things certain way? You have a younger generation: self-service is everything, no human interaction. And then you've got your Medicare population, which is high touch; they want the human experience. I imagine you have to support all those different modalities or ways of communicating. Is it a challenge to make everyone happy, finding who that average or that common denominator [is]?

Glen Tullman:

Sure. Well, it's an interesting question because when you talk about cross generations, today essentially everybody has a cell phone, mobile phone, and everybody has a smartphone. And I know most grandparents get pictures of their grandchildren. They talk to their grandchildren using FaceTime or another technology. Everybody in the country has been educated on how to use Zoom. So the idea that somehow certain groups of people are not basically technology literate, it's two things. One, there's some truth to that. So do we need phones that... My kids make fun of how large the type is on my cell phone.-

Kyle Murphy:

You need to see the numbers.

Glen Tullman:

They're like, "You could read that across the room."

And so one, that's something. So some of that is about accessibility, but I don't think that's it. There's innovative programs from Medicare and Medicaid where people say it's better to give somebody a phone and deliver services that way.

Because if you think of, for example, telehealth, what telehealth did was make healthcare accessible to everyone in the country no matter where they were. Rural populations, inner city populations, people who couldn't leave home, and particularly during COVID, people who were scared to go to a hospital or healthcare facility. And all of a sudden--everybody had access.

And I think what technology does is it makes healthcare more accessible, higher quality, and lower cost, but we have to use it in the right way. And that's really the challenge. But we've done it in every other industry.

Someone a long time ago, they said, "I can't believe your youngest son has never been inside a bank. What kind of parent are you?"

So I asked him, I said, "Would you like to go inside a bank?" And he said, "What would I do that I couldn't do on my cell phone?" And that's really the question today, which is how do we blend this wonderful technology with giving our in-person physicians, nurses, therapists, the amount of time they need?

Right now they're on a treadmill, "How many visits can I bill?" Instead, let's take care of the average stuff so our highly trained, highly skilled doctors, nurses, therapists, other healthcare professionals can do what they love to do, that is deliver care where you have to touch somebody, and that's never going to go away, but we can make it more efficient.

Kyle Murphy:

I'm curious about the health literacy component. Coming back to, you talked about Medicare and Medicaid, there's a lot payer involvement now in the care management space. Whereas before they were just, "They're the payers," whereas now they seem to be trying to take more of a leading role in trying to educate members and beneficiaries. Are you encouraged by some of the changes that are occurring on the payer side of the spectrum?

Glen Tullman:

Well, what I would say is that we don't have time. Often people say, "I'm a disruptor in the industry," and we don't have time to rebuild the entire industry. So we have to find the innovators out there, whether they be payers, whether they be providers.

And if you read last week about our announcement, we announced the first national independent provider ecosystem, and we took 10 of the largest, most prestigious, most well-known, highest quality provider systems, health systems, out there. And we put them together in creating this national independent ecosystem, which would deliver care more efficiently at a higher quality basis than was done before.

And so it's doable to work with, and not everybody, some people say, "I want to stay with cash pay. I don't want to do any risk share. I don't want to be value-based." There are those folks out there. That's their choice. We're going to work with the folks who want to improve the healthcare system.

Kyle Murphy:

When you look at this kind of show [HLTH 2023] and you see the different types of technologies, what do you look at? Where do you train your focus? Are there certain companies or certain capabilities that you say, "Oh, that would be a good addition to our platform?" Do you see it more as a collaboration rather than competition in this space now?

Glen Tullman:

Well, I think there's two answers to that. One, when we're looking for acquisitions and mergers, we're looking for technologies in most cases, some cases we're looking for customer access, but technologies that actually will allow us to advance what we're doing.

So 98point6, perfect example. And they kind of joke about it, "we were doing AI before AI was exciting," and now everybody says they're doing AI. We happen to have a multi-year lead because of that $100 million investment in that company.

But in other cases, I talk about friends and enemies and frenemies, and sometimes all three at the same time are the same company. So you can have a company that's a customer that you're doing development work with, and that is also competing with you or partnering with competitors. That's just our world today, get used to it. That's what it's going to be.

Kyle Murphy:

Last question is just--obviously there are a lot of technologies, healthcare has no shortage of technologies. You talked about AI, there's a lot of potential in AI, but there's also a lot of just mystery about what it can and cannot do. What's your temperature, what's your appetite for AI and where it actually can prove to be useful, safe, secure, and lead to some quality improvements?

Glen Tullman:

Well, let's talk about two aspects of your question. One is, there's a lot of technologies out on the floor. And when we started Livongo, we partnered with General Catalyst and we know we needed technology, but we also knew that we needed a deep understanding of health care. And in particular, because we started there, the diabetes space.

And there were a lot of companies with that deep understanding of the diabetes space, there are a lot of companies with great technology solutions like right back there on the floor. No one had put them together in a way that worked for the actual people we want to care for.

And so it's not about the technology. Almost any time that you're talking about the technology, you know there's a problem. Because we don't say, "Oh, I used my phone and the chip set in my phone talked to these satellites and which satellites were you using? And..." No, we just say, "It worked." We don't get in our car and say, "Isn't this GPS amazing?" We say, "It just gets me to where I want to go. I don't even care how it works."

That's when technology is used appropriately. And there's a quote above my desk and it says, "Technology perfectly applied is indistinguishable from magic." It just happens and we don't know why. And it's just like at Livongo, we would call people and we'd say, "We're just checking in." And they'd say, "You called at the perfect time."

And the answer was they were flashing red on a screen, we knew what was happening in their body sometimes before they did. And we would call and then we wouldn't say, "Can I help you?" That means they're helpless. No, we would say, "What do you need at this moment?"

Now they're in charge, and they would tell us. So it's rethinking that whole interaction. But to do that at scale, the way we need to do it in healthcare, we need that technology on the floor. We just need people to put it together with a deep understanding of the experience that all of us have with our health and care. And that's what we do at Transcarent, that's why there's so much interest in it.

Kyle Murphy:

That's a beautiful way to end it. So thank you so much for your time. I really appreciate it.

Glen Tullman:

Great. Thanks for talking today.

Kelsey Waddill:

Listeners, thank you for joining us on Healthcare Strategies | Industry Perspectives. When you get a chance, subscribe to our channels on Spotify and Apple and leave us a review to let us know what you think of this new series. More industry perspectives are on the way, so stay tuned!