2 min read August 2023 — Scott Flannery, CEO of UnitedHealthcare Employer and Individual plans of Texas and Oklahoma, spoke to Invest: about the company’s impact on the region, including innovations like its zero-cost model for vital drugs like insulin and Narcan, and the impact of COVID on virtual healthcare. “What it really boils down to is the right level of service at the right time for the right patient,” he said.
What has been the overall contribution or impact of UnitedHealthcare on the North Texas region in the past year?
The impact of UnitedHealthcare in this region boils down to a few things. One is around innovation because we’ve certainly driven innovation over the course of the last year and the last decade. We rolled out a product this year called Surest, for example, that eliminates deductibles and puts a fixed copay on services for consumers. We know consumers don’t like the surprises that come with healthcare. Also, earlier this year, UnitedHealthcare started offering eligible members $0-out-of-pocket for preferred short and long-acting insulins and emergency use drugs like Narcan that are critical in acute, life-saving circumstances. By doing this we are able to remove this financial barrier to care.
The other impactful thing we’ve done – and continue to do – is move to a consumer-first digital-first view, as opposed to the historical, financial, clinical and operational view. This means meeting the customer where they are and providing the services they need when, where and how they need them.
Where do you see the greatest opportunities for the sector?
A lot of it relies on what I call the point of care. Pre-COVID, most of the service was done in a doctor’s office, a facility or a surgery center. From the 1,700% increase in virtual care over the COVID era, we came to find that there are a lot of things that don’t have to be done in a brick-and-mortar facility, such as monitoring someone in an inpatient facility. Studies show that those things can be done at home and it provides higher satisfaction for the patient because they’re sitting in their recliner watching TV in the comfort of their own home and being monitored remotely. There’s even more advancement coming. An example is in mental health. In our region, we have a shortage of mental health providers overall. One way to increase capacity is through telephonic resources in lieu of face-to-face. What it really boils down to is the right level of service at the right time for the right patient. Things can be done over the phone, in a doctor’s office, an urgent care facility or the emergency room. But when it’s time to go to the emergency room, it needs to be there for the right level of acuity..
What are your thoughts on how to make healthcare more cost-effective?
Historically, in terms of how healthcare is consumed, there hasn’t really been a lot of consumer engagement in things like cost transparency and quality metrics. What we’re beginning to see with products like UnitedHealthcare’s Surest is the ability for consumers to become better consumers. If you were going to buy a large screen TV, you would do some research. That hasn’t historically existed in healthcare but now it does and it will continue to evolve. If you’re going to have arthroscopic knee surgery, you want to know who the best doctors in town are. That information is now much more available and has become even more mainstream. Consumer research will really help deliver a lower cost, higher quality service. Maybe it should have happened sooner but we’re getting there now and the data is becoming more readily available. You can literally research and find where you want to have services done. That creates a whole new responsibility for all of us in the healthcare continuum: the providers, the payers, the employers. How do I give my employees that information to make sure that they make the best consumer-directed decisions? Products like Surest will help drive that as well.
Looking at the regulatory environment and legislative issues, what are some things you’re keeping an eye on?
There has been some great legislation in the state of Texas. An organization our size in the state of Texas stays keenly focused on the legislative session and what comes out of it. There’s a lot of focus on network adequacy and network availability for patients, specifically in the rural counties. While some of those may be very well-intended, there might be some unintended consequences and we need to be careful about how we ensure balance. There is a balancing act between what a provider is paid, what a member has paid and what an employer pays for coverage for their folks. You must be careful about creating legislation that knocks those things out of balance. At the end of the day, the employer votes with their feet, so if they don’t feel like they’re getting appropriate value for the appropriate treatment, they walk. We need to continually balance that legislative impact in Texas. The good news is that they go to session once every two years. It’s a frenzy for that amount of time. Overall, I would say most legislation in Texas has been positive for the consumer. Our view is to look at what’s good for the consumer and how we can help facilitate that. That’s how we use any of our corporate intellectual properties when we deal with legislators and organizations in Austin.
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