Blue Cross executive Cain Hayes makes the case for diversity in health care firms

In April, a report funded by Blue Cross and Blue Shield of Minnesota documented a disproportionate prevalence of preventable disease and death within racial and ethnic minority communities in the state.

It is one reason why Cain Hayes, the chief operating officer at Eagan-based Blue Cross, believes health insurers need to tackle the ongoing problem of racial and ethnic health disparities in the United States.

Hayes came to Blue Cross in April 2017 after working several years at Connecticut-based Aetna. Before the health insurance work, he worked for financial-services firms in Iowa and Ohio. In March, Hayes was recognized by Savoy Magazine in its edition "Most Influential Blacks in Corporate America."

Q: When you think about the health insurance industry, is there a lack of diversity?

A: I believe the industry has some opportunity to really do better from a diversity standpoint. The way I think about diversity is really across multiple spectrums. Certainly, there's racial diversity, there's gender diversity, there's diversity across age demographics. It's critically important that organizations that are in the health care space — whether it's a health payer like Blue Cross Blue Shield, or whether it's a provider like a health system — that we have an employee population that is representative of the communities in which we serve. I have a passion around it because I believe we can better serve our members if we have a good understanding of the unique dynamics of those various diverse groups. One of the surprises for me when I moved to Minnesota a year ago — Minnesota is known as having a pretty healthy community. You see the state of Minnesota at or near the top of many of the "healthiest state" lists. I learned quickly that that doesn't apply to the whole population here. We actually have one of the widest health-equity or health-disparity gaps in the country. Blue Cross has really had a significant focus and effort around helping to close some of those health disparities.

Q: Shortly after taking office, President Donald Trump tweeted a photo of himself with a group of CEOs from the nation's largest health insurance companies — a picture that shows a group of all men who are mostly white. Does this photo represent something about the industry?

A: I remember when this photo went out, and that's kind of a proof point to what I was talking about before. I imagine if he had taken a picture with executives from financial services, whether it be banking or other, it would probably be a pretty similar picture.

A: It needs to be a deliberate and proactive effort, vs. either reactive or assuming it's going to happen through natural processes. To have a focus on diversity, it requires every leader in the organization having accountability for ensuring that they have a diverse team. The natural question is: How do you do that? There needs to be incentives, there needs to be all the requisite mechanisms that would be in place to ensure that you're holding leaders accountable for that diversity. And knowing the numbers. In order to improve diversity, it's important to know where you stand today. And so you kind of identify what the gaps are — that's important — but then putting the plans in place to close those gaps. Ensuring that when you have candidate pools, that you have a diverse candidate pool. My experience is it doesn't happen by accident, it needs to be a deliberate focus. Because again, the companies are going to be better for having diversity because you're going to be able to serve your customer base more effectively.

Q: Beyond diversity matters, what do you see as the challenges for Blue Cross of Minnesota?

A: Our challenges are centered around two things, one — and this is emblematic of challenges around the industry — it's continuing to focus on the affordability of health care. Getting at cost, reducing cost for our members, making health care more affordable. In this country we spend $3.3 trillion on health care and one-third of that is waste in the system. And so, our challenge as an organization is to continue to partner with the health systems to help drive down costs. At the same time, we need to improve quality and outcomes. And so as I think about what's important for me in my role, having responsibility for our health business, it's partnering to find solutions to solve those two challenges.

Q: In the past year or so, Blue Cross has outsourced some work to other insurers in public programs, IT and mental health. As that's happening, do you think the overall head count at Blue Cross will shrink?

A: Not necessarily. As we think about our strategy going forward there are parts of the company, just as in any business, that you're going to grow and expand, and there are other parts of the business where you're going to contract. … We operate the business based on what's needed to meet the needs of our customers.