Steve Nelson is Chief Executive Officer of UnitedHealthcare, a $160 billion division of UnitedHealth Group – No. 6 on the Fortune 500 list. UnitedHealthcare serves one in eight Americans, making it the single largest business dedicated to health and well-being in the United States. In September 2017, he was named to the Office of the Chief Executive for UnitedHealth Group. Read his full bio.
PMWC 2018 Michigan taking place June 6-7, 2018.
Q&A with Steve Nelson
Q: What’s the biggest misconception about UnitedHealthcare?
A: That we don’t care, that we’re just a health insurance company that pays or denies medical claims. In reality, helping people is at the core of what we do every day.
I hope if you asked any of our 135,000 employees about working at UnitedHealthcare, they wouldn’t tell you about processing claims, running analytics or IT infrastructure — unless you really probed them — I hope they would tell you about our mission to help people live healthier lives and to help make the health system work better for everyone. In every one of our thousands of interactions we have with people every day, we remain laser focused on that mission. That means predicting, simplifying, innovating, and – more importantly – caring.
Let me give you one example. In the U.S., two-thirds of our focus is on medical issues and one-third on social and behavioral care. Other countries do the opposite; they know the root of medical issues often start with other factors like behavioral health, food, housing and transportation. Think about how you would manage your health if you didn’t have a home or food to eat. You wouldn’t. The understanding that health is not just about clinical care has sent us on a path to redefine the traditional health insurance model, especially for the most vulnerable populations.
One of the ways we do this is by looking at the whole person and integrating their health, behavioral health and social service access to get a full picture of how to best address their individual needs. We are also investing in things like transportation companies to get members to and from appointments and affordable, stable housing programs (56 housing communities in 14 states), because when we are able to address the social determinants of health, we improve people’s health and quality of life.
That is the opposite of a claims payer who doesn’t care about people and we have only just begun.
Q: What do you see as the biggest challenge in the health care space right now?
A: I know I won’t surprise anybody when I say that America’s health system is facing some profound challenges. It’s fragmented, hard for people to navigate and tens of millions of people remain uninsured. But, it’s also an incredibly exciting time – we’re at a point of major innovation and a shift in thinking that will make health care more consumer-focused, personalized and lower cost while producing better health outcomes for people.
Our main focus is on simplifying the process while also making it more personal. Simplicity begins with streamlining the experience and making it easier for people to understand. Personalization requires a combination of data to create personalized recommendations and interconnection with the community of healthcare professionals who support a person’s health and wellbeing.
Imagine having one point of contact to help guide you through all your various health needs. Well it’s a reality; our Advocate4Me program is where technology and human interaction meet to help people decide the care that is right for them. We’re also creating a personalized experience with Rally, a digital, customized resource that features wellness recommendations to help members make healthier choices and build healthier habits.
Another example of how we will do this in the future is through the creation of an Individual Health Record which combines data from various sources, resulting in a single record for each of the people we serve. Think of your Netflix or Spotify accounts; they know which movies or music you’ll like based on your history. Shouldn’t your doctor know what medications you’re taking, at the correct dosage, regardless of which doctor prescribed them? With Individual Health Record, your personal information will follow you regardless of the provider you see or the doctor’s office you go to – hopefully, making us more like Netflix experience than a Blockbuster.
Q: In the U.S. we spend more on health care than any other country, yet the overall health of Americans doesn’t reflect that. What steps is UHC taking to make health care more affordable?
A: Right now, Americans only receive what’s considered the “recommended care” 55 percent of the time, and 30 percent of health spending is wasted on unnecessary services and excessive administrative costs. That’s not working.
The good news, health care is one of the few industries where you can have a higher quality product AND pay a lower cost for it.
One of the ways we do that is by a focus on value-based care arrangements with providers. These partnerships with providers place a greater emphasis on quality and outcomes, while encouraging payers and providers to work together in new ways. Care providers are becoming strategic partners in working together to advance the Triple Aim of better care, a better experience and lower costs.
We are piloting sophisticated use of data and AI with providers today where we provide detailed information about both outcomes and costs of treatment patterns for specific patients and compare overall performance to peer physicians in that community. Traditionally, a health plan tells a doctor their costs are high because they had a lot of ER visits. Now, we can say, “You have a lot of ER visits because you are not prescribing correctly for these patients.” The result is lower cost and better outcomes.
We’re also empowering people by giving them tools to better understand their cost and quality of care options. The Health4Me mobile app and online resource allows members to comparison shop for health care services based on the actual contracted rates. They can also access personal health plan details including deductible and copay information.
When we shift the emphasis from volume to value, we can make care more affordable.
The Precision Medicine World Conference (PMWC), in its 17th installment, will take place in the Santa Clara Convention Center (Silicon Valley) on January 21-24, 2020. The program will traverse innovative technologies, thriving initiatives, and clinical case studies that enable the translation of precision medicine into direct improvements in health care. Conference attendees will have an opportunity to learn first-hand about the latest developments and advancements in precision medicine and cutting-edge new strategies and solutions that are changing how patients are treated.
See 2019 Agenda highlights:
- Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
- AI & Data Science Showcase
- Clinical & Research Tools Showcase
- Clinical Dx Showcase
- Creating Clinical Value with Liquid Biopsy ctDNA, etc.
- Digital Health/Health and Wellness
- Digital Phenotyping
- Diversity in Precision Medicine
- Drug Development (PPPs)
- Early Days of Life Sequencing
- Emerging Technologies in PM
- Emerging Therapeutic Showcase
- FDA Efforts to Accelerate PM
- Gene Editing
- Genomic Profiling Showcase
- Immunotherapy Sessions & Showcase
- Implementation into Health Care Delivery
- Large Scale Bio-data Resources to Support Drug Development (PPPs)
- Microbial Profiling Showcase
- Microbiome
- Neoantigens
- Next-Gen. Workforce of PM
- Non-Clinical Services Showcase
- Pharmacogenomics
- Point-of Care Dx Platform
- Precision Public Health
- Rare Disease Diagnosis
- Resilience
- Robust Clinical Decision Support Tools
- Wellness and Aging Showcase
See 2019 Agenda highlights:
- Five tracks will showcase sessions on the latest advancements in precision medicine which include, but are not limited to:
- AI & Data Science Showcase
- Clinical & Research Tools Showcase
- Clinical Dx Showcase
- Creating Clinical Value with Liquid Biopsy ctDNA, etc.
- Digital Health/Health and Wellness
- Digital Phenotyping
- Diversity in Precision Medicine
- Drug Development (PPPs)
- Early Days of Life Sequencing
- Emerging Technologies in PM
- Emerging Therapeutic Showcase
- FDA Efforts to Accelerate PM
- Gene Editing / CRISPR
- Genomic Profiling Showcase
- Immunotherapy Sessions & Showcase
- Implementation into Health Care Delivery
- Large Scale Bio-data Resources to Support Drug Development (PPPs)
- Microbial Profiling Showcase
- Microbiome
- Neoantigens
- Next-Gen. Workforce of PM
- Non-Clinical Services Showcase
- Pharmacogenomics
- Point-of Care Dx Platform
- Precision Public Health
- Rare Disease Diagnosis
- Resilience
- Robust Clinical Decision Support Tools
- Wellness and Aging Showcase
- A lineup of 450+ highly regarded speakers featuring pioneering researchers and authorities across the healthcare and biotechnology sectors
- Luminary and Pioneer Awards, honoring individuals who contributed, and continue to contribute, to the field of Precision Medicine
- 2000+ multidisciplinary attendees, from across the entire spectrum of healthcare, representing different types of companies, technologies, and medical centers with leadership roles in precision medicine