Aon, Boeing and Livongo share innovation strategies for self-insured employer groups

According to recent research from the Kaiser Family Foundation, roughly half of the U.S. population receives health insurance through their employer. Of that population, three-fourths receive coverage under a self-insured employer plan — meaning those companies are bearing much of the risk associated with the health of employees and their families. Essentially, U.S. employers are healthcare companies.

Even before the COVID-19 pandemic, these employers were seeking ways to improve the health of their employees — a trend which has only accelerated in this pandemic year. Many self-insured employers have taken proactive steps in helping their employees during the pandemic, such as expanding benefits and voluntarily waiving cost-sharing for telehealth services and in-network provider care.

Our newest program series, Insights on Innovation for Self-insured Employers, is designed to help employers further advance their healthcare innovation strategies, and help industry innovators understand how to best collaborate with them. At the first event in the series, MATTER CEO Steven Collens was joined by leaders from Aon, a consulting firm that arms self-insured employers with cost and quality control to better negotiate prices with providers, Boeing, one of the largest self-insured employers in the world and Livongo, a consumer digital health company that provides cost savings to employees with chronic conditions that work for self-insured employers. The panel discussed each organization’s current proactive and reactive strategies amidst COVID-19, shared a look ahead into the innovative solutions they are planning to adopt, accelerate and deploy in 2021 and examined the implications of these steps.

Watch the full event at matter.health/live, and join us for part two of this series, Next-Generation Employee Health Solutions: What Works and What Doesn’t, on January 12.

Panelists:

  • Glen Tullman, founder and former executive chairman of Livongo
  • Jason Parrott, senior manager of global healthcare and well being strategy at Boeing
  • Jim Winkler, senior vice president and global chief innovation officer of health solutions at Aon

Following are our key takeaways from the event. Responses have been edited slightly for length and clarity.

Jim: “When you go back to earlier this year, we had an incredibly tight labor market. Organizations were very, very focused on how their health and wellbeing strategy allowed them to attract, retain and fully engage a compelling workforce. As the pandemic unfolded, organizations went pretty quickly into what I’ll call reactionary crisis mode with a focus on quarantine procedures, temperature testing, deciding when to reopen their offices, access to testing and so on. Our employer clients were consistently looking at the marketplace to see how the array of digital health solutions were going to transform themselves to serve the needs of employers in the midst of this crisis. We saw organizations like near-site primary care clinics — which were convenient options pre-pandemic — turn themselves into PCR testing centers almost overnight. Our employer clients really welcomed those sorts of solutions, and we’re still sort of in that mode now as we prepare for what will likely be a similar pivot around vaccine distribution strategies.

“At the same time, organizations, having now lived through a really challenging economic environment, are starting to think about what solutions within their mix deliver measurable economic and clinical value — and candidly, which ones don’t. For the solutions that do deliver clinical and economic value, it’s time to double down, because organizations have to find ways to save money heading in 2021 and 2022, but they need to do it without using the ‘blunt instrument’, cost-shifting strategies they’ve used in the past.”

“For the solutions that do deliver clinical and economic value, it’s time to double down, because organizations have to find ways to save money in 2021 and 2022, but they need to do it without using the ‘blunt instrument’, cost-shifting strategies they’ve used in the past.” - Jim Winkler, Aon

Jason: “As we look at where we’re at this year with the pandemic, the good news is that pre-pandemic, we had a well-oiled machine with a process to fully vet and understand these various solutions and innovators. That gave us a head start on adopting and accelerating a lot of these novel solutions and made them ubiquitous in many ways to the market.

“Since COVID-19 hit early this year, what we’ve seen, within and across my counterparts at Fortune 50 jumbo employers is an acceleration of solutions that are digital that can meet our people anytime, anywhere in whatever preferred modality they may have. And that’s resonating with our member/patient experience, it’s resonating with our health plan. When we think about the reality of closures of doctor offices and dentist’s offices and access issues, there is a myriad of variables and considerations. That has really paved the way this year to where we’re seeing a much greater utilization across the board on these digital solutions that can deliver a better member/patient experience, and ultimately better outcomes at a more affordable model than perhaps what we’ve done in the past. And I think that will stay the course as we look ahead to the future, but there’s a lot of work that goes into assessing upfront and figuring out how to piece all these solutions together so it’s integrated and harmonized with your existing supply chain.”

Solution areas for self-insured employers

Jason: “There have been four common theme pain points for employers overall that we’ve tried to address.

“Medical is one. When we think about the waste and the cost and quality variability in the U.S. healthcare system, we know we can do better around medical solutions.

“When we think about pharmacy, and the migration towards specialty drugs, how do we reign in the waste and the cost, and sometimes the egregious pricing to create a sustainable, predictable, affordable model for the future?

“Third is data analytics. And when we think about data, how can we optimize everything we do from a data-driven predictive standpoint, as opposed to a reactive standpoint, when we think about building, ideating and refining our strategy?

“Fourth is mental health and emotional wellbeing. There’s so much opportunity there.”

Glen: “Number one, you have to show effectiveness and efficiency. Effectiveness in terms of outcomes and efficiency in terms of doing what you do at a lower cost. What happens with self-insured employers is, first and foremost, there are a number of leaders in the space and everyone else looks at what top companies like Boeing are doing. What are they adopting? How are they using it? And then they work to figure out how they can use and implement it.

“And so we had many potential customers that said, ‘Okay, enough, we get hit by five companies a day. And every one of them says, they’ll save us so much that if we added it all up, it’d be more than we’re spending’. Employee benefits consultants, like Jim, across the industry help, but we think that at Livongo, part of what we understood was that what both members and large self-insured employers were looking for was a simpler way to do business and a platform that enabled that. So at Livongo, we combined all of our capabilities onto one platform. We combined diabetes, hypertension, weight management and mental and behavioral health. When we kept getting requests for more solutions, that’s when we realized we needed to bring in telehealth resources.”

“Part of what we understood was that what both members and large self-insured employers were looking for was a simpler way to do business and a platform that enabled that.” - Glen Tullman, Livongo

Top employer solution types

Jim: “I think we’re heading toward an environment where you’re going to have three types of digital innovators.

“You’re going to have targeted point solutions that solve a very specific need. For those organizations to be successful, they have to have a really crisp proof statement. They’ve got to be worth my time to add another vendor to the mix, meaning they solve a thorny issue, and they do it really, really well.

“On the other end of the spectrum are going to be organizations whose primary value proposition is the ability to aggregate, interconnect and share accumulated data. They may not be great at any one thing. They themselves may not deliver any clinical value, but they’re a great aggregator.

“Lastly there’ll be players in between the platforms that aggregate parts of the ecosystem, but maybe not every part of it. There are elements of the health ecosystem your solution won’t do, so you’ll have to connect with another solution. That’s where these kinds of organizations play out.

“It’s really hard to imagine a startup coming out and jumping right into that second bucket, and being really good at five or six things at the same time. That’s probably a recipe for a startup to collapse under its own weight. So you have to be a really good point solution with a plan to connect to other resources or go build aggregation platforms that make it really seamless, easy to connect into a wide variety of technologies.”

How and where startups can tap into the ecosystem

Jason: “On an annual basis, I’m looking at about 300 different innovators and in any given year, I might be selecting and implementing one percent, so maybe three solutions in total. And when I look at who rises to the top of that one percent, there three key pieces to success — and a lot of startups have only two of them. You have to have content expertise in whatever space you’re going to tackle, you have to have technology expertise, and you actually have to understand the convoluted thing that is the U.S. healthcare system. Particularly, you have to understand who pays for what, and when. And I find that a lot of solutions that would come knocking on our door don’t fully understand the role of the employer.

“One of the recommendations I would make to startups would be to go spend time with groups like the employer health innovation roundtables that Jason is a part of or the business group on health innovations forum. It’s a place where you can go as a startup to tell your story to employers who are interested in hearing your story and are going to give you feedback.

“You have to have content expertise…you have to have technology expertise, and you actually have to understand the convoluted thing that is the U.S. healthcare system. Particularly, you have to understand who pays for what, and when. And I find that a lot of solutions that would come knocking on our door don’t fully understand the role of the employer.” - Jason Parrot, Boeing

Platforming employee wellness

Jason: “The wellness industry has been sort of on the same journey as the overall digital health space. You go back five or 10 years ago, employers had Fitbits and step challenges, then they eventually started to think about things like financial wellbeing and a whole bunch of other stovepipe programs that were not connected, with varying degrees of participation and really murky if any, economic value. A lot of our clients took a step back from that and recognized that these programs helped to address problems that still exist in the population, but maybe weren’t being addressed the right way.

“So how do I turn all of these separate pieces into a wellbeing platform strategy? Where any one individual based on their facts and circumstances might be accessing preventative wellbeing strategies in one area like mental health, while accessing through that same platform, more immediate care management through a product like Livongo. We used to sort of place the healthy people with the wellness programs and the sick people with the care management programs. And in reality, everyone that’s sick needs wellbeing, and everyone that’s well likely has a pathway to some care management need in their future. It’s really about how those pieces come together on a platform. It’s less about medical ROI in the wellbeing arena, and much more about improving engagement and stickiness with your programs through wellbeing. Get people excited to use an app, and if in the course of doing so, they learn that there’s a diabetes care management program or they learn that there’s a digital mental health program available to them. Now I’m actually helping them manage real costly diseases, through the auspices of a well-being platform. So it’s really about putting all the puzzle pieces together.”

Want to hear more perspectives on this topic? Join us for part two of this series, Next-Generation Employee Health Solutions: What Works and What Doesn’t, on January 12.