The Granite List Live

Today, we’re continuing our conversation with Michael Thompson, the president and CEO of the National Alliance of Healthcare Purchaser Coalitions. He discusses the importance of whole-person care with hosts Leigh and Sally. This episode is a continuation of The Big Three, what employers are focusing on now. If you haven't listened to that episode yet, you may want to listen to it first and pick back up here after you’re done.

About our guest:

Michael Thompson is the President and CEO of the National Alliance of Healthcare Purchaser Coalitions (National Alliance). The National Alliance is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health, equity and healthcare value across the country. Collectively, it represents over 45 million Americans, spending over $300 billion annually on healthcare including a broad cross-section of private sector and public sector employers as well as union organizations. Thompson is a nationally recognized thought leader for business health strategies and health system reform.

Prior to joining the National Alliance, Mike was a Principal at PricewaterhouseCoopers (PwC) for 20 years where he worked as an advisor to employers, health plans, providers, and other healthcare stakeholders. Prior to PwC, Mike served as an executive with diverse roles with Prudential Healthcare for over 17 years. Mike is a Fellow of the Society of Actuaries, serving on the Health Practice Council. He is also widely recognized as a leading national advocate for mental health and wellbeing and is a Past President of the New York City chapter of the National Alliance for Mental Illness (NAMI).

Here is the full transcript for this episode:

Speaker 2 (00:06):

Welcome to another episode of The Granite List, live, navigating a sea of benefits, solution is daunting at best and new vendors emerge every week. Hosts, Leigh Dill and Sally Pace bring brokers and employers a solid resource when it comes to uncovering what's new, what's needed and what is happening now to allow for the best plan design possible. By staying on top of trends, brokers and employers can in turn stay on top of spending while improving employee engagement and outcomes. Listening to this episode today, where they welcome Michael Thompson, President and CEO of National Alliance of Healthcare Purchaser Coalitions.

Speaker 2 (00:47):

Today, we're continuing our conversation with Michael Thompson, the President and CEO of the National Alliance of Healthcare Purchaser Coalitions. He discusses the importance of whole-person care with host Lee and Sally. This episode is a continuation of the Big Three, what employers are focusing on now. If you haven't listened to that episode, yet you may want to listen to it first and pick back up here after you're done.

Michael Thompson (01:11):

Another thing you talked about partnerships being they can run their course and if an advisory group has long-standing partnerships, they're missing innovation. So just an aside, we have actually launched a marketplace that is akin to open table Vrbo, Amazon, LinkedIn, for these solutions to come and market themselves in a free platform to brokers and employers, because of that, very reason that they can't, they can't get their word out.

Michael Thompson (01:42):

The amount of innovation in healthcare is just unbelievable. The number of new organizations coming out every year, every month, that are trying to get out there. And because there's so much of it, employers don't take people's calls. So they rely on intermediaries to sort through for them. Who should I talk to? And when those intermediaries are "Tied up," because they have partners, where are we going with this? I mean, how do we create a more free flowing source of information that people can look at and try things. And even some of the apps that create marketplaces are vendors. What we have found is that they have a bias towards vendors that have a lot of clients which, of course, is reasonable because they tend to have people who said they're great, but how do the innovators get their clear shot in there. And so I think it's a real balancing act to continue to be aware. And, again, I don't think we need to promote a reward, but we need to give voice to and consider the innovators as they come out.

Michael Thompson (02:55):

And for those of us who've been in the industry for many years, you can, you can tell, not whether something is going to work or not, but is the story plausible? Does it make sense? Is this new? Is this the same thing without the track record or is this something that my clients or my coalition should want to know about, and what is that that's new? Because sometimes they don't even realize what makes them different.

Michael Thompson (03:23):

So I think what makes it great to be in healthcare is it's complex. It's highly changing, it's never boring. If you get bored in healthcare, you're going to get bored in everything because nobody knows it all. I don't care who they are. I don't care how long they've been at it and the shelf life of your knowledge is not that long. You gotta keep on your game. If you're going to do your job, whether it's for your employer or for your client or for the industry, you've got to continually sharpen that saw.

Leigh Dill (03:51):

We have vendors as well in our audience and lots of new vendors who... Everyone that comes up with a new product thinks it's the next best thing since sliced bread, which is understandable and there's a lot of great solutions out there, but like you said, it's hard to get through the weeds of those that have existed for a long time. So what advice would you give to these newer vendors who really do have a great solution and they've solved for something that is needed, how do they get in front of those large-

Michael Thompson (04:18):

Probably the smartest strategic move you can do as a vendor is get a client. First sale is the hardest sale. And if you can get a client, and obviously the bigger the client, the bigger name of the client. I know when I'm listening to a vendor and they say, "Oh, and so-and-so fortune 500 company is using us." Well, first of all, I have such great respect for the people that work at these companies, that if somebody did their due diligence, which I don't have time to do, and they concluded that they should buy them, then I should at least give them the time of day and listen. And so, your ticket to credibility is selling, is actually getting your first but what do you do when you don't have your first, what do you do when you're not there? Well, then you've got to have a way to get the word out. And part of what we pride ourselves on at the National Alliance is really being open-minded to new players out there because we try to stay ahead of the curve. We want to know where it's going, not where it's bent.

Michael Thompson (05:17):

And one of the things that I'm very aware of is that when they get categorized and spreadsheet and rated, well, if you don't have clients, you don't get rated. And if you get categorized, it's essentially saying, you're like them there's nothing new about it. And so we put more emphasis on what makes you distinctive from what's out there, then where do you fit in the world that's out there? Focusing on more what's new than on, "Am I one of them?" Because if I'm one of them, why should I buy you versus them? They've already got clients, you don't have clients.

Michael Thompson (05:54):

So, what's more important is, well, "Why do you exist? Because we already got them, and focusing on what's different and valuable. And what we try to do is then tie it into these broader themes that we think are happening in the industry that we are promoting in the industry and help people to see how this might fit with strategy, not just as a vendor. People aren't out there buying vendors for the sake of buying vendors. In fact, they prefer to have fewer, but if they see how it connects into strategy then I think that can be valuable to them. And the other thing I would say is we try to do it in, and I'm sure you do the same thing, you try to do it in snapshots. People aren't going to give you an hour. You're lucky to get a half-hour.

Michael Thompson (06:37):

And if you want them just to taste it, you got to be able to tell your story in an elevator speech in five minutes, 10 minutes, 30 minutes. And that's what we work on with them, is how to get that, the quick value prop out there so that they become a qualified lead that then you can tell your story in more detail. And then of course, before it's over there, they're going to put you through a due diligence, you're going to have to deliver. But the question is, why should they even take the meeting? Because they just don't have time to take that many meetings.

Sally Pace (07:07):

I Love that. I love that advice. I mean, I swear it sounds like what we all give college students going to interview for their first job, do your homework, you call it strategy. Know the company, know what their values are, know what they're trying to accomplish. And in this instance, I mean, you've got an entire national Alliance of employers that are following your big three strategy. I would love that roadmap. All right, Mike, tell us why you chose to pivot into this particular career path and what has brought you the most fulfillment over the past couple of years in your role?

Michael Thompson (07:43):

Just a little bit on my background, I was 17 years at a health plan. I'm an actuary by background. I was the chief financial officer, I was in charge of marketing, I was in charge of operations, a bunch of different roles, a bunch of different responsibilities at a regional and national level for a health plan. And I left and I became a partner at PwC for 20 years and I was consulting. So I was advising employers but also other stakeholders, so I learned a lot in that process. But in the course of that career, including when I was back at the health plan, I always had a belief system that said, employers play a huge role in influencing the healthcare system, a huge role, much bigger than I ever would have appreciated if I hadn't been there and seen it.

Michael Thompson (08:31):

And they play a role in a micro way, in terms of influencing products and things like that but in a macro way, things like cost-containment and managed care and consumerism and leapfrog, and MCQA. All those things came about because employers made that happen. It didn't come from the industry, it came from employers. And then of course the industry quickly followed. And I've also had a belief that single employers can have an influence, but if employers can get on the same page, they can really move change. They can execute against the industry in a major way, what I call a collective agenda.

Michael Thompson (09:11):

If everybody's saying something different IBMG, GM, everybody's talking at me, I don't hear a word they're saying, but if they're saying the same thing, people stand up and they listen and you can move the system. And it if you're looking in the auto industry, you know that the three big four are at the top of that industry and all the rest of the supply chain pays attention.

Michael Thompson (09:34):

In healthcare, I think employers are part of that supply chain. They're right at the top. They help them move the whole thing. So when you ask me, this is a long way of telling you what attracted me to this. It wasn't for the money because I was making more money before I retired at PwC. But it's a belief that coalitions, employers banding together, working together across the country can help to facilitate a meaningful change in the industry. By working with our coalitions, we're the only organization has this national regional structure across the country. All healthcare has a local layer to it. All health has a local flare to it. It's a very unique value proposition of what we do and we find ourselves leading those changes but then also being able to leverage things that are happening in different parts of the country, and then being able to localize strategies because we have people on the ground across the country.

Michael Thompson (10:34):

And so, what do I love? I love leading change. That's what I love. And we've got some big initiatives underway in a lot of different areas, but one of the bigger initiatives is around mental health and substance use, which is of course a hugely broken system and we are leading an issue around the path forward for mental health and substance use. And again, it's harnessing the purchasing power and the mind share of employers and their representing the best interest of employees and their families across the country. And little by little, you can move it.

Michael Thompson (11:07):

I used to tell people if you want to know where the industry is going, when you're doing a strategic plan for a stakeholder, you're not planning for next year, you're not planning for the next three months. You're not planning for your stock price, you're trying to plan for where is the puck going to be? And I used to tell people, and I continue to tell you, if you want to know where the puck's going to be, look at what the employers are talking about right now. If you want to know where it's going to be in five years, look at what they're talking about right now. Because it may go through fits and starts but before it's over, they're going to have influence and it's going to be there. Helping to influence that future is what turns me on. So, I really enjoy it.

Leigh Dill (11:40):

What are the employers talking about right now? Is it the mental health and substance abuse we’ve been seeing for the past year?

Michael Thompson (11:51):

It's a crisis in access and quality and mental health and substance use and that is an area that has become a top priority. I mean, when I first joined the coal, the National Alliance used to be the National Business Coalition on Health. Frankly, mental health was pretty low in the priorities of the coalitions, today is one of the top across the country. And we know from employers that it's a top three issue for almost every company right now and COVID has only made that more important. But I think the other areas that people are very concerned about is how the industry has evolved with consolidation, the issues around transparency consolidation and that's leading to a lot of the policy issues. I believe if stakeholders in the marketplace abused their privilege of serving communities by overpricing and under controlling their own expenditures, that they need to be regulated.

Michael Thompson (12:44):

I mean, if you act like a monopoly, you got to be regulated like a utility. And it's not every health system or every hospital, but it's prevalent enough that I think we have to start thinking more open-minded that what we call a market isn't much of a market and we need to figure out how to have a more sustainable approach going forward. I do think affordability at its core is critical. And again, as I said before, I don't think it's just affordability for employers. I think it's a crisis for employees and their family. I think people are not getting the care they need when they need it because of what we've done with our plan designs and I think we're going to have to build those plan designs back, but more selectively. And that's where I think our delivery-type strategies are. I think let's guide them to people that are on the team as opposed to the people that are fighting against us and moving that forward.

Michael Thompson (13:41):

And again, I think the whole issue of equity and total person health, that's not going away. It starts with a lens of "It's the right thing to do," which it is. It turns out it's a smart thing to do too, that you get better outcomes if you think more holistically about subsets of your people and support them holistically. I know those are some of the same themes, but that's the way I think.

Leigh Dill (14:06):

Well, and you've got a whole lot of other people thinking that same way which is awesome because, you talked about you're getting away from the siloed approach and getting down to the total person that needs the assistance as opposed to slapping a program on everybody when three-fourths of them may not even need it.

Michael Thompson (14:27):

Well it's always funny. People say, "Well, we treat everybody the same." I say, "We don't treat everybody the same, where there are disproportionate needs you invest disproportionally." You do that today. We're just saying, "Let's put a few more lenses on that and invest disproportionally that way too. Let's not leave people behind and let's not focus on treating everybody the same and focus more on getting to similar outcomes for people across our population."

Leigh Dill (14:55):

I have a big question that you can say in a short answer, Mike, but we've thrown a lot of big words out here; regulation, affordability, transparency, Area fraud, monopoly, and there are so many different vendors out there and it's not really a monopoly yet. You've got your BUCAs that are, but there are so many other players in the marketplace. It sounds like we're trying to go down the right path with those words I just used, how long do you think it's going to take us to get there?

Michael Thompson (15:34):

I don't think there's a there there, I think this will always evolve. I've been at this industry for, I probably am coming up on 40 years, and it's never been a more dynamic period than it is right now. And I'm not sure that in 10 years, it will be still more dynamic. I think the pace of change has been greater, the issues are more complex, we're running out of places to run on the old runways and so we need to build some new runways to figure that out. And when, after we build those runways, we'll be talking about this again in five years in 10 years. But that doesn't mean that we don't have to start building now or that if we stay on these runways, that the whole thing won't break. If people want to support employer-sponsored coverage, we need to work together to solve these issues because I, I honestly think we could break this camel's back if we haven't already. And most of us would like to see it survive, but it can't survive with the trends that have been going on currently.

Michael Thompson (16:35):

I think what we're doing to employees is well beyond what they can afford. What people are doing to us is well beyond what we can afford and our employees can afford, and we need to get incentives aligned so that we're working on the same team towards the same goals, that's the sustainability. Our overall well being is so intertwined with healthcare. It eats into everything else that we could, as a society, afford and do. Sure, of course, healthcare is important and health is important, and everybody wants to get to the right outcomes in healthcare. A dollar wasted in healthcare is a dollar wasted period, and we can do better to build a system that is more responsive to the needs and the values of our society.`.

Leigh Dill (17:21):

I think that's a great ending point for this. Sally. I know you've got one more big question to ask.

Sally Pace (17:30):

And we could use broad strokes with this. This is informational and educational, but Mike, what are you reading right now, either book or publication that is industry related that you think is relevant that the audience might enjoy?

Michael Thompson (17:47):

What I enjoy the most is reading The Economist and that's a little different than... You would think I would be an addict to all these healthcare books, but a lot of times I read the health care books and I said, "I read that, I know that," and I might get a little bit, and it's too much investment for that little extra that I'm getting. I talked to a lot of smart people and I feel like I'm always on my game and I don't necessarily get it through the books, but The Economist, I find, is always interesting.

Michael Thompson (18:15):

And it's so fascinating to see the world view, and look at other industries too. And what's evolving in those industries. And I think it's a mistake to think that we can fix healthcare with this traditional way of looking at healthcare. I think we've got to be open-minded. Look at what happened with Uber, who expected that would happen? Or other industries that have been transformed just with Amazon, with a blink of an eye and suddenly whole industries, when I look at the video industry, God, I remember bringing my kids to blockbuster and they don't even exist anymore.

Michael Thompson (18:50):

I mean, it's just amazing what happens in other industries. Healthcare is slow in that way, but it is really complicated. And I think there's lessons to be learned by looking outside of healthcare. And I personally just find that publication to be so well-written, so timely, so interesting. And I also like hearing the views from other countries looking at us because we're fascinating people here in the United States.

Sally Pace (19:18):

Absolutely that brings us to the end of this episode. Thank you very much for your participation. Thanks everybody for listening. Mike, thank you for walking through this with us. I think your viewpoint is so valuable and valued in our network in particular, because we are dealing mostly with the people who are trying to get in front of your consumer, which is the brokers and the vendors. So, thank you very much for spending some time with us today.

Speaker 2 (19:55):

Thank you for listening to this episode of The Granite List, live. Access our entire library by visiting your favorite podcast venue or subscribing to our site, thegranitelist.live.