Episode Transcript
[00:00:00] Speaker A: We have an affordability crisis, and to attack that, we have to have different business models in place, different care delivery models in place, and different experiences in place to navigate towards those care models. So ultimately, building affordable products for health plans and helping them put that in place, that's our role and what we see we need to do. When I look at the technology front, the areas that Genai can help, what I would love to see that help and where we're certainly targeted is how do you make that experience for the member and the provider, help them navigate the benefits, right care, right time, right place, help the provider navigate for the member to do that. Because if we don't, we're never going to attack the affordability challenges that we have.
Welcome to the A and M Significant Healthcare Voices podcast series featuring insights on healthcare trends and hot topics direct from industry leaders.
[00:00:54] Speaker B: Welcome to A and M's Significant Healthcare Voices podcast series. I'm Doris Stein, a managing director at A and M's Healthcare Industry Group, and I'm joined by my colleague and co host, Christina Park. And Lori, we are thrilled to have you joining us today. Lori Logan is president and CEO of Nasco, a leading healthcare technology company that provides digital health solutions for health plans. And Lori has more than 30 years of experience in healthcare. She's held leadership positions at Trizetto, UnitedHealthcare, Cigna, and we are very excited to learn more about your career, Lori, and look forward to diving into some conversation. And everyone, welcome to the podcast. I'm gonna have Christina introduce herself and then Laurie.
[00:01:41] Speaker C: Great, thanks. Doris and Laurie, it's great to see you again. Thank you for joining us. Christina park, managing director in our health group. And given the state of our healthcare ecosystem in the US today, I think this discussion and dialogue in your background and your experience in your career really lends itself well to better understanding, kind of how you. How you see that progressing and really understanding how your career has been influenced throughout the years around product design and different lines of business. So thank you for joining us.
[00:02:11] Speaker A: Yeah, thanks. Great to join you both today. Excited to have this conversation and it's an exciting time in the industry, so look forward to it.
[00:02:20] Speaker B: Great, Lori. So first question, you've had an incredible journey through some of the most influential healthcare companies.
Talk to us about your early roles at Cigna McKesson and how that shaped your journey in healthcare innovation and how that led to where you are today as the CEO of Nasco.
[00:02:39] Speaker A: Yeah, so interesting. And the one company that you didn't mention on there is where I actually started and got my roots. And it was at a behavioral health organization. It was a community mental health center in Concord, New Hampshire. So small town, Concord, New Hampshire, but county seat and doing real healthcare. If you want to talk about getting shaped in health care, it was the days of chasing psychiatrists around to get a CPT code on a written piece of paper to get a bill out the door. But it was also when you had to cover for the receptionist, which meant you had to be trained on the red phone. It's the real life of healthcare and what it takes to provide care to patients in need and then do the administrative pieces around it. So that's really where I got my, my true foundation of it.
From there I went to a health plan. So before it was Cigna, it was actually a health plan called Health Source. Health Source was in 18 states and really interesting too. Some of my best friends in my life. We actually had a 40th year reunion two weeks ago back in New England. It was a really innovative health plan. It was founded by a physician and several Doctors from Concord, New Hampshire and it grew to 18 states, over 4 million lives. And that sold to Cigna. So when I started there and I worked there, great people, a lot of energy.
What I didn't realize is how innovative it was. I thought that's how all health plans rode. We had great claim systems, we had great planning tools, we had great analytics, we had great provider relationships, all the things that you want in a health plan. But I didn't realize until I look back now over 30 years, how truly differentiated they were.
One of the projects that I had there, which was a real game changer for me and my career was we co developed a software solution was first generation medical management solutions. So utilization management, case management, disease management. We even back then, this is 30 years ago, had early, we called it early case ID. Early identification of patients that were in need for case management back at that time. And we partnered with a company out of Cambridge, Massachusetts called hpr. HPR got bought by hboc, which if you remember back in that day was a quick fast follow of McKesson buying them as well. So that really started me in my journey of like, what is product management? How do you build new software solutions? But it was still in that kind of that, that medical economic space of it was everything that we did. How do you get the right care for the right people with the right tools in place and the right models around it. So back in the early 90s, we call that now population health, right? And put it in the hands of providers. You know, from that. So for me, you know, at that time, again going back to my roots on the provider side, one of my absolute favorite memories was training nurses on laptops to go to the hospital to do their rounds and be able to take clinical notes. Right. And do those things so really long but on, on the right path for what we needed as an industry.
And then from there I went to a startup company. So it's called Choice Links. It was a consumer driven health plan before CDHPs were a thing. We were competing with high deductible plans, but all fostered on consumer choice. What do I need for me, my benefit plan? What's the actuarial models behind it? How do you put that consumer choice in place with that? And we basically built a health plan as a startup type of thing in 18 months. So again, all that health plan operations, but with that consumer flair of how do I make it EAS easier, how do I tailor what I need in my insurance for me that piece too. So I end up going back to Cigna a couple times for different things. But all of that really led me on the foundation of innovation and change and trying to continue to get that payer provider collaboration, get the consumer experience in place and really try to get that triad to work through that. So all those early days are still things that I'm fighting for driving for now, making it a, a health care cycle that works for everybody. Patient, consumer care, provider, sponsors of care, all of it has to all work together with that. So it also gave me just that different stakeholder view. So payer provider. I've been back and forth a lot in my career and that's not all too common to have the kind of clinical side experience as well as the administrative side. But it started back in those early days, 30 years ago.
[00:06:44] Speaker C: That's really, that's really interesting. And I know product has been like, I'm hearing what you're saying Lori, about the product and how you've been able to kind of see that in the innovation. How do you see the role of product management as we continue, as the industry continues to evolve? How do you see that role of product management really being, continuing to be innovative and continuing to address some of the market needs in the ecosystem. And how do you see product management sort of changing healthcare or kind of evolving healthcare in the coming years?
[00:07:16] Speaker A: Yeah, so interestingly enough, my first role at HPR back as a product manager is when pragmatic marketing hit the market. I was literally, literally one of the first graduates of it 30 years ago, which is a crazy site. But that's when product management started to form as like a discipline. Right. Now you see it in graduate programs and stuff as well. So it's been around for a long time. It is a business function, it is one of the four P's of marketing.
What it really is doing is saying what are the market challenges, what are the ingredients for a solution to come to play? How do you put those together and how do you package it with the right product market fit and go to market strategy to get those products in motion. Right. So it's very business driven, partners with technology because often it's a technology solution, but some aren't technology. Right. Some products are just services too. So in my mind product management has always been a very business driven focus. I think we've gone through the past couple of decades where it started to be more like high tech focus. And I think that's right for super high tech companies, but certainly not for healthcare. Healthcare has to understand the business of healthcare, the economics of healthcare, the experience needs of healthcare and you've seen kind of trends out of like the software development world of agile. And then products start to come in to all like the internal IT shops. And we have to have a product orientation.
Yes, you have to have business focuses. I think what they're really trying to say is focus on the actual business needs. It's not commercial product, you're not putting it on a price tag on it. Right. If it doesn't have a price tag, it's not an actual product that you sell. So I think we've kind of seen some evolution of what is product management or early days of it, high tech, waves of it. And now getting back to it's about the business and economics is underneath every business that's out there with that. What's interesting at this rate and pace and time in the healthcare industry is I think health plans, especially smaller regional plans, are understanding that their need for product management, product strategy and product innovation has hit all time high.
That it has to be fundamentally rethought on what are the affordable products in healthcare that you have to bring to table. But that wraps around an experience around it so that it's adopted and it's used and drives some of those economics you need. So I think product management lives across many any business discipline.
We've tended to focus it on high tech and it's a high tech thing or it's the founder and somebody need more business to the founder in a company. But it really is what's the business you're in? What's the challenges in that space? How can you bring something to market that solves those challenges? Do you have the right to win and then execute on it? So the challenge of product management is not just to think of the big cool stuff. You got to be able to execute on it and deliver it and bring it to market and you play a big cross matrix role in making that happen.
[00:10:04] Speaker C: I love the perspective of the foundational product strategy, product management, and kind of getting back to those basics of what that good looks like in that space to help you kind of elevate and innovate it.
[00:10:15] Speaker A: Great point.
[00:10:16] Speaker B: Yeah, great point, Lori And I know Nasco is doing some exciting things around product and innovation.
What trends or technologies are you most excited about as your Nasco organization is evolving here?
[00:10:31] Speaker A: Yeah, I'll bring it back to the foundations of what we struggle with as an industry. And first and foremost, it's affordability. We have an affordability crisis and to attack that, we have to have different business models in place, different care delivery models in place, and different experiences in place to navigate towards those care models. So ultimately, building affordable products for health plans and helping them put that in place, that's our role and what we see we need to do. And I think where we are now as an industry and have worked for many, many different health plans, the world does not evolve around the claim like it still exists and it's critically necessary. But all the systems and the things and the widgets and the experiences and the, from enrollment to all the pieces, it doesn't all live in the claim system. You have to have a suite of systems to be able to do that. So I think first recognizing that the front office, back office, middle office, that doesn't exist anymore, the front has quickly gone to the back office and that's the experience. Right. So as an industry, we have to recognize that the business has changed, technology has changed to do that. So experience matters and economics matter. That's really the essence of health care.
I think when I look at the technology front, where I see a lot of process and there's, you know, you could spend a day talking about the areas that genai or gentic AI can help. What I would love to see that help and where we're certainly targeted is how do you make that experience for the member and the provider, help them navigate, help them navigate the benefits right here, right time, right place, help the provider navigate, you know, for the member to do that. Because if we don't we're never going to attack the affordability challenges that we have. That's the essence of value based care.
Right time, right place, right care delivery path. And I think where we can use AI is helping our advocates get out of the agent model and be an advocate for care and help them navigate those pieces. When we do that, we start to get all different types of information. It's not all in the call logs, it's not all in the claim. We need new data in health care to really drive that engagement cycle. So I'd like to see us move from the call center approach to really an engagement and experience approach. And I think that's a big promise for AI to help us in that, to get to that engagement platforms of the future.
[00:12:48] Speaker B: Great point. And being able to utilize that data effectively. Right, Laurie? I mean, that's the thing is some of these organizations we see have so much data that they have, but they don't utilize it effectively.
[00:12:59] Speaker A: So that's has to be sprinkled into every stakeholder in health care. Right. Because health care is complicated. It's going to be complicated, but it takes a lot of data to be data driven to guide that path. And the more that we can create, not just around price transparency and stuff, what are the benefits available? Who do I go see when help me navigate my care? That's where we need to build towards to get that. Then, then good things happen.
[00:13:24] Speaker C: Right.
[00:13:24] Speaker A: Then the economics kind of get into the right place, you know, for that.
[00:13:28] Speaker B: That's right.
Laura, you were a key leader in one of the industry's largest transactions, the $2.7 billion merger between Cognizant and Trizetto. And you were awarded the Trizetto CEO Pinnacle Award for contributions. Tell us a little bit more about that.
[00:13:45] Speaker A: Yeah, Trizetto was an amazing journey, first and foremost. It moved me and my family out to Colorado and we're never leaving. And with the world of remote, we don't have to so.
But Trizetta, probably lesser known of Trizetta, is we had a provider business and I ran the provider business. And the underpinnings of that provider business was from a former colleague of mine back at Cigna days actually. And the premise was if you connect payers and providers and put the rails in place to do that, you'll bring down administrative cost and you'll lay the rails open for care delivery to happen, to exchange different types of information.
So my role at Trizada was running the provider business. And by the time we sold and combined in with Cognizant we had almost 200,000 providers running through our platform.
Our channel distribution was through EMR vendors. So we natively integrated with all the EMR vendors which meant we could present information at the point in time in their workflow to do that. It was a clearinghouse business, right? So we sat in the middle of all the data movement between payers and providers.
And what was different about our model is it was all provider revenue. It wasn't a payer revenue clearinghouse where it was a gateway, it's provider revenue. So it MEANT of those 200,000 providers, those 35,000 practices, we had to sell each one each time and provide a great experience for them to help them earn money, right? To help them get paid to do that. So it's a really different orientation. So when you fast forward to the cognizant acquisition, a couple interesting things happened. For me it was a great experience of seeing really large services oriented organization of services and consulting and largely built a lot of big business around Trizetto's platform, right? And the good platform that it was. What was interesting through that is two things. One, the whole provider business was a, was a bonus prize. Nobody knew that they had it right. But if you think about it from a channel distribution perspective, I had channels into the entire ambulatory provider market to impact change, to do that. So it's a really kind of golden nugget in the conversation that added a different value to it. But what I would say the learning was, it's really different business models. Consulting and services versus product. Product. You have to make really hard decisions on product market fit. You can't serve everybody 100%, but if you can get them 90% of the way, there's. You get commonality, you get aligned thought, you get vision and you get margins right in the business. That's the promise of product organizations and general services and consulting is not that right? You land and expand and you go into different markets. So the governance and decision making between the two of them are kind of different business models. And figuring that out is a really thoughtful process. I think that's still for many companies, still a struggle, but it's a challenging thing. The other actually went through this at McKesson as well when they bought HBOC distribution company, right? Supplies and medical supplies stuff. Bought a software company. It's a really different business model. Software companies, you invest, right? And then you get the hockey stick, right? You invest, invest, invest, bring it all together and then you get those great margins after you've created that repeatable reliable Product and service. So for me, my role was to understand that payer, provider collaboration, the provider channel and business that we had underneath it, the influence that we could do with that. Like I said, it was kind of a bonus prize in the acquisition.
What I learned out of it was an example, classic example of services company buying a product company and the inherent challenge and the, you know, the tension on the business model between the two of them. So being a product person, it was extremely intriguing to me, right, to see like how does that happen and how does the go to market happen differently and where do you make your decisions and how do you fund for different areas of investment to get that return out of it.
[00:17:38] Speaker C: It's incredible to hear how your roles have changed and now you are the president and CEO of nasco. Now we're into the next future, the next years.
Tell us a little bit about what, if you will, if you'll share a little bit about what your vision for your organization's role is in shaping healthcare services and technology in the future. And how do you see kind of this next chapter playing out?
[00:18:03] Speaker A: Yeah, it's a really interesting time for us, interesting time for me. I feel like I'm bringing all the pieces and parts of my career together and can make it make impact, you know, for our customers, for health care and why I'm so passionate about it. So, you know, we moved our ownership model about three years ago. We're now wholly owned subsidiary from Blue Cross Michigan. And that's a pretty big change for us. We were formerly owned by several blue Plans and a consortium owned model and really more as a shared service. Right. To bring together synergies to do common things together at a much more efficient rate. So over the past three years and we knew that needed to change, the company knew it needed to change. We needed NASCA to be a leader and bring in products and solutions to the health plans versus kind of sitting behind and just executing on them. So we've been on a trajectory over the past three years or an evolution of the past three years to really reorient ourselves to the market. What's our product market fit, what's the role that we play, where do we want to sit? What's the things that we do differently and uniquely that we want to make sure that we tether and we keep our own and we focus on. So exciting. We're actually reintroducing ourselves to the market this summer with a refreshed brand. That name is not changing, it is still nasco. It's extremely important that we kept the Nasco name. We have 40 years of history and our history is with national accounts. That's what Sardis, what is that complex benefit across state lines, Taking the complexities of health care really head on with that. So over the past couple years we've been focused on that orientation, reframing ourselves. We're bringing new product to market that helps with alternative payment models. So we have to be able to administer all the healthcare benefits, all the healthcare payments. That's what we do. Right. And if you have that administered in a scalable, transparent way, that's what enables the experience and the servicing that we need to do, you know, in the market. So we're introducing ourselves. Our vision is to everyone deserves a better healthcare experience and we want to enable that. Our mission is to make it possible for health plans to innovate, grow and ultimately provide that better healthcare experiences to those they serve. We're here to empower our plan customers and we want to help them grow. They grow, we grow. And we're an engineering company at heart and we put discipline around things and build technology. And we want our technology and our products and our services be oriented around market problems and the products that our customers need to grow. Affordable products, complex benefits that are needed, understanding the rules of that, administering them at scale and really enabling that experience and engagement around it. So we think we have a really broad portfolio of products and services. We've been deeply ingrained in healthcare with the really gritty stuff of it, so it gives us a different lens. So for us to be able to build a new product, for example, we didn't build it because we just had that one idea. We had something missing in a portfolio. And you don't have to buy the whole portfolio, but our orientation around filling that gap is much different because of the depth and the breadth of experience that we have with that. So we thrive on complexity, but it gets back to it's people first. We're in a human centered business, we're all humans and it gets, we have to make it work for the plans, the plans have to make it work for their members and their providers. It all has to come together and healthcare for that. So we think we're in a really great position to reintroduce ourselves. We've got great products and services, super deep knowledge, super broad knowledge, and we get the different stakeholders in health care winning of it. But economics matter and affordability matters and we can help, help bring those affordable products to market for our plan customers.
[00:21:43] Speaker C: It's such an important mission and It's a great brand.
Nesco is a great brand.
[00:21:49] Speaker B: I love hearing your journey, Laurie, and what you've accomplished.
What advice would you give to aspiring leaders wanting to become CEOs and how do they make a real impact in healthcare?
[00:22:03] Speaker A: Yeah, I think in healthcare you have to understand the macros. It is an economics game. You have to understand the business, right?
Understand the fundamentals of the business. Then you can make it better, right? You can enable it and you can make it better, but you have to understand the macros of it to get that win, win, win that we talked about. Then you got to get gritty, get gritty with it and be bold.
Change the experiences, light them up. But it has to foundation of something. It's not about making just a slick user experience. It's the information that you have to collect and present in a way to do that. So health care is not for the faint of heart. It's for the depth of dealing with the changes that we have in a really complicated industry. So don't give up, but go deep, go wide, understand the economics of it. That's the nature of business. And then be a solution, be a bold solution, provider of that.
[00:22:54] Speaker B: Wonderful, wonderful. Thank you so much, Laurie. This has been such a wonderful conversation. Thank you for sharing your experiences, your insights and taking time with us. For everyone that's joined us, thank you for listening. For more information about A and M and to find more of our podcasts, please visit www.alvarezmarcel.com healthcare. Thanks again everyone and thank you, Lori.
