Andrea Walsh recently spent an hour describing her first year as CEO of HealthPartners, one that seemed to be completely without drama.
She hasn’t led HealthPartners to adopt a new strategy. She hasn’t announced any big mergers.
The CEO changed, Walsh stepping in last year as longtime CEO Mary Brainerd retired. The business plan did not.
In a way, steady-as-she-goes should be expected, of course. Walsh was a 23-year insider before assuming the top job about a year ago. But the best way to think of this is that the challenge ahead of the organization didn’t change. Walsh has gone to work on the same problem, for HealthPartners and the industry, that her predecessor had worked on.
The problem, of course, is some combination of quality and access to good care that need to improve, and costs that need to stop growing. Walsh spent a lot of time over the past year meeting with some of HealthPartners’ 26,000 or so employees as well as patients and health plan “members.” And some consumers were crabby.
Health care costs routinely show up in surveys as a top worry for Americans. Most recent news on cost trends hasn’t been encouraging, as last month it was reported that employer health-plan costs increased here last year at a higher rate than the nation as a whole.
The individual market has settled down from the big jumps in cost of a couple of years ago, but a relatively high-deductible plan for a family of four in Minnesota might cost more than $1,400 a month. Shopping for health insurance seems to be the only form of shopping that isn’t any fun whatsoever.
“When meeting with people across our organization, patients or members, they’re saying “I can’t afford it,’ ” Walsh said.
Chasing multiple goals
HealthPartners is a relatively rare form of organization, set up as a kind of cooperative with the express mission of providing consumers with high-quality health care they can afford.
“Here we are 61 years later, and we clearly haven’t cracked that code,” Walsh said. “But we are on a path, and our values and vision are right. So as I stepped into the CEO role, it’s not a vision that requires a radical departure from the path we’ve been on.”
HealthPartners is unusual in the Minnesota market in being both a big health-plan company, offering insurance of various types to about 1.8 million people in medical or dental plans, and a big health care system of clinics and hospitals that serves about 1.2 million patients.
As an integrated health system it has been chasing multiple goals at the same time — delivering care of higher quality, keeping costs down for the people paying the bills (including patients, of course) and making care available to anyone.
What’s meant by quality also has come to include even how the patient feels about their lives, with Walsh using back pain as her example.
Most people have some back pain at some point during their lives. A health system might deliver a clinical fix that’s perfect, restoring a full range of pain-free motion, yet the members might come through treatment and physical therapy and end up disappointed. They may even wish they hadn’t sought treatment in the first place.
Walsh often brings up the idea of simplifying the experience as another dimension of quality. Was the trip through the system simple and easy to navigate, from an exam room to a specialty center or physical therapy office?
“When I think about where we’re focused, it’s how do we make it simple and affordable,” she said. “It’s not as if you can put that on the annual plan and say, gosh, by next year we will have a health system that’s simple and affordable. But I do know, if we put our minds to it, and we focus, over the course of the next several years we will get there.”
More effective screening for colorectal cancer is another example Walsh offered, because it’s one of those initiatives that engages multiple targets at once. One aspect of the problem this program tried to address is access, as way more people should be screened than are, particularly among some ethnic groups.
It’s a pain to prepare for and then get a traditional screening for cancer, maybe one reason many people don’t do it enough. HealthPartners decided to mail a use-at-home kit to many members, including black men older than 50.
This direct-mail approach for everyone older than 50 who hadn’t been screened received a surprisingly high 25 percent response rate.
A baffling system
Another success Walsh cited points to how frustrating the health care system is for patients. Her story was about a new smartphone application used to make shopping for the lowest cost prescription drugs easier.
She heard from a member who was happy to find out that there were two options in the neighborhood to get a prescription refilled. One cost $800 for the month while the same drug was available a block away for about $50. Even as a health care CEO, Walsh couldn’t really explain how that kind of variation in price is even possible in one local market, but she knows that’s only a particularly irritating example of a problem that might crop up other places in health care. It’s no wonder patients are fed up.
Walsh would be happy to see regulatory or legislative action on pharmaceutical pricing, but one of the challenges all health care executives face is that health care policy never seems settled, at the state or federal level.
It almost doesn’t matter what the regulatory framework will be, she said, as her goal of simpler and less-costly care remains. “Because whether it’s individual people, state or federal agencies or big purchasers,” she added, “no one can afford to pay more.”