4 health insurance leaders share their top goals for the year ahead

Four health insurance executives recently shared their top goals and priorities as they lead their organizations out of the pandemic. Here is what they told Becker's:

Susan Diamond, CFO of Humana: Certainly the number one thing is just navigating the challenges caused by COVID. It's certainly a challenging time, not only for our associates and our members and our partners but also investors. A lot of my time right now is just spent continuing to look for ways to support each of those constituency groups. And obviously that will continue until everything returns to a more normal state. 

As the new CFO within a public company, I'm spending a lot of time getting to know the investors. I am committed to providing transparency for them, and again, in this environment, if you listened to our second-quarter call, that can be challenging — just trying to help them understand the range of complexities we're managing and giving them visibility into our emerging experience. 

I've spent considerable time with our larger investors addressing their questions and in the future, I hope to be able to spend more time with them to learn more about their perspective: what parts of our strategy are most exciting for them, what they'd like to know more about, understanding the concerns they have and what they would like to see from us. And so I'll continue to build those relationships. While we're a large Medicare Advantage payer, we also have a number of other lines of business on the care delivery side, and they don't understand those businesses quite as well just because we tend to have historically not provided as much disclosure on those businesses, which have historically contributed less to our earnings than we expect them to going forward. So we'll continue to work to build some external metrics that we can share to help everyone begin to better understand the range of capabilities to be built and how they can expect those to contribute to our enterprise contribution and shareholder returns going forward. 

And then the last thing I would highlight is I plan to make a larger investment in our enterprise planning function. The industry we operate in is complex, and we continue to invest in more sophisticated analytics, technology and care model capabilities, which are designed to improve health outcomes, manage total cost of care and improve experiences for our members. Those by definition are just more complex investments. We need to make sure that we have a really clear understanding of how the solutions create value for the enterprise and that we're taking full advantage of those advancements in which we're investing. That will require some additional talent and sophistication in our mid- and longer-term planning processes. We're really excited to get started on that to make sure that we have a clear path to delivering sustainable growth and shareholder return.

Eric Palmer, CEO of Evernorth: Evernorth is set up around four different capabilities: to manage our clients' benefits through benefits plus solutions; provide the necessary medications through our pharmacy plus solutions; enable and empower care through our care plus solutions; and have a developing actionable intelligence to help our clients improve their performance all throughout the solutions. 

In terms of priorities specifically, I think it comes down to really a couple of specific categories. The first is continuing to build on the already strong foundation we have in regards to our core pharmacy operations — continuing to strengthen them and continuing to build on that. The second is to expand and really help with the affordability problems that are presented in the specialty pharmacy space. Specialty drug spending continues to grow rapidly.

The Accredo pharmacy that we own is the leading specialty pharmacy and is really positioned well to help our clients manage specialty costs with the number of new therapies coming in and the biosimilars on the horizon. We're positioned to really help our customers and our patients navigate through that landscape, so making sure we're ready for that is a real priority. 

The third would be around developing and executing on the growth plans for the connectivity that we can create across all of our capabilities, such as building and deeply integrating MDLive and building on our care solutions to help ensure that we've got all of the pieces effectively connected across our portfolio. 

Maybe the last one I'd add is just working on continued innovation. We've got a great track record of building solutions, and we've got to work to continue to innovate and bring new solutions to market and bring new insights to our clients to help them get the most from their healthcare dollar.

Matt Eyles, CEO of AHIP: I think our first goal was really around helping to accelerate and improve health equity, especially focusing on vaccine equity. We launched an initiative earlier this year along with the Blue Cross Blue Shield Association and ACAP, another health insurance provider-focused association that joined us later, that was intended to do everything that we could to advance and accelerate equitable vaccine uptake, especially in socially vulnerable communities. We started with the 65-and-over population with the goal of vaccinating 2 million additional 65-and-over individuals. We achieved that goal in less than one hundred days, and we've expanded it to other populations like the Medicaid population. And I think that's really been an important effort and one that continues today. Even though we reached the goal that we stated, we know how important it is to continue to get as many people vaccinated as possible, certainly as we've seen what's happening with the variants.

The second one is really about continuing to expand coverage and focusing on delivery through our member companies and private sector health plans. [We're] extremely supportive of what happened in the American Rescue Plan Act improving the subsidies for the ACA marketplace, and wanting to make sure that people who fall in the Medicaid coverage gap get covered. We know that there's more work to do there, making sure that we continue to keep Medicare Advantage strong for almost 40 percent of seniors that the program now serves. 

I'd say our final area of focus is prescription drugs and prescription drug prices and costs. We know how urgent an issue it is for the country to address. We want to see positive Part D reforms  that make sure seniors are protected from out-of-pocket costs but also don't increase their premiums along the way and make sure that we're doing everything that we can to effectively manage prescription drug prices and costs.

Karen Ignagni, CEO of EmblemHealth: Number one, making sure that we are tuned in to our communities and focused on a very strong community health agenda. That is crucial for us. Second, to make sure that we are playing a role in pushing the envelope with respect to partnerships with providers, whether they be hospitals, physicians, et cetera, in value-based terms so that we can continue the push toward not only value-based care, but care that is better, more friendly to the individual from the standpoint of their language; friendly to an individual with respect to how they want to receive care, whether it's digital or in person; and friendly to an individual in terms of all of the services and support they may need. So tuning into the spectrum of care, from prevention and wellness to care coordination, disease management, and centers of excellence and catastrophic coverage.

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