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.

Interview with Gabriel Bien-Willner of Palmetto GBA

Q: What does your role entail as the director of the MolDX program at Palmetto GBA?

A: The job directing MolDX is multifaceted; first and foremost the MolDX program is responsible for assessing molecular diagnostic tests on the market and makes coverage and pricing determinations for such tests and technology. This is usually done through local coverage determination policies or technical assessments.

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Interview with Peter Marks of FDA

Q: The CBER’s Regenerative Medicine Advanced Therapy Designation program has been very successful, with about 100 requests for designation in the two years of its existence. Can you please tell us about the program and how it was put together?

A: The Regenerative Medicine Advanced Therapy (RMAT) Designation program came into being as part of the 21st Century Cures Act that was signed into law on December 13, 2016.

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Interview with Calum MacRae of Harvard Medical School

Q: What patient data do we need to better understand the underlying cause of disease and how to prevent it?

A: Medicine at present is highly underdetermined and data poor. To be precise, one must be comprehensive, so medicine (with our consent) will use not only what we currently conceive of as biomedical information, but also data from across our lives.

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Headlines from PMWC 2019 Silicon Valley

A big ‘Thank You’ to all of our presenters and attendees for celebrating 10 years of precision medicine progress with us! PMWC 2019 Silicon Valley was attended by 2000 participants from 35 countries, which included over 400 speakers in 5 parallel tracks!

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Interview with Ken Bloom of Ambry Genetics

Q: Tell us more about your organization/company. What patient population are you serving and which services are you specializing in?

A: Ambry Genetics is a recognized leader in high quality complex genetic testing. We seek to find the genomic cause or contributors to rare diseases, abnormal phenotypes and hereditary disorders.

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Interview with Lee Pierce of Sirius Computer Solutions

Q: What is the state of big data and analytics in healthcare, and how to best use the reams of data available?

A: More than ever, Healthcare organizations are achieving measurable value through use of their data and analytics assets. There is more raw material available than ever to create value. This raw material is the data flowing from internal systems and applications and also from devices and systems external to healthcare organizations.

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Interview with Anita Nelsen of PAREXEL

Q: There are various new, emerging technologies that bring us closer towards a cure for life-threatening disorders such as cancer, HIV, or Huntington’s disease. Prominent examples include the popular gene editing tool CRISPR or new and improved cell and gene therapies. By when can we expect these new technologies being part of routine clinical care?

A: Today’s emerging technologies are making the promise of individualized treatment a reality.

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Interview with Ilan Kirsch of Adaptive Biotechnologies

Q: The Nobel Prize in Medicine was awarded recently to James Allison and Tasuku Honjo for their work on unleashing the body’s immune system to attack cancer, a breakthrough that has led to an entirely new class of drugs and brought lasting remissions to many patients who had run out of options. The Nobel committee hailed their accomplishments as establishing “an entirely new principle for cancer therapy.” What is your first-hand experience the impact that those new drugs had on patients?

A: For decades cancer was viewed as solely a cell-autonomous condition.

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BMS buys Celgene | Lilly buys Loxo Oncology – Does this Signal a Return to Strong Deal-Making Activities in 2019?

Bristol-Myers Squibb’s blockbuster $74B deal to buy Celgene creates an oncology powerhouse amid industrywide excitement about the rapidly evolving science and explosive growth of the sector. The agreement could signal a return to deal-making for the pharmaceutical industry in the $133B global oncology therapeutics market.

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Interview with Gini Deshpande of NuMedii

Q: What need is NuMedii addressing?

A: NuMedii, has been pioneering the use of Big Data, artificial intelligence (AI) and systems biology since 2010 to accelerate the discovery of precision therapies to address high unmet medical needs. Artificial Intelligence approaches are a natural fit to harness Big Data as they provide a framework to ‘train’ computers to recognize patterns and sift through vast amounts of new and existing genomic

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Interview with Minnie Sarwal of UCSF

Q: Genomic medicine is entering more hospitals and bringing with it non-invasive technology that can be used to better target and treat diseases. What are some key milestones that contributed to this trend?

A: Completion of complete sequence data from the human genome project, and the advances in proteomic, microRNA and epigenetic assays added a layer of pathway biology to the understanding of human diseases.

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Interview with Shidong Jia of Predicine

Q: Once sequencing has been validated as a clinical solution via trusted workflows, and coinciding with the technological developments driving costs lower, we can expect accelerated human genome profiling for clinical Dx. How soon, do you think, will we see accelerated growth and what can we expect?

A: We will see accelerated human genome profiling for clinical Dx in 2019 and the coming years as more biomarker-based cancer drugs are gaining approval.

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Interview with Iya Khalil of GNS Healthcare

Q: Artificial intelligence (AI) techniques have sent vast waves across healthcare, even fueling an active discussion of whether AI doctors will eventually replace human physicians in the future. Do you believe that human physicians will be replaced by machines in the foreseeable future? What are your thoughts?

A: I think that there’s a lot of speculation and uncertainty around AI, but I don’t foresee a time when we won’t need physicians.

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Interview with Ilya Michael Rachman of Immix Biopharma Inc.

Q: The Nobel Price in Medicine was awarded recently to James Allison and Tasuku for their work on unleashing the body’s immune system to attack cancer, a breakthrough that has led to an entirely new class of drugs and brought lasting remissions to many patients who had run out of options. The Nobel committee hailed their accomplishments as establishing “an entirely new principle for cancer therapy.” Besides CAR T-cell therapy what do you think next generation immunotherapies will look like to successfully combat cancer?

A: The next generation of immunotherapies will build on the insights discovered by immunologists like James Allison and Tasuku Honjo and extend them to modify the body’s response to tumors.

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Join me to Kick off PMWC Silicon Valley in the Santa Clara Convention Center, Focusing on Every Element of Precision Medicine

My team worked in collaboration with Bill Dalton, Kim Blackwell, Atul Butte / India Hook Barnard, Nancy Davidson and Sharon Terry to create a program that touches every component of precision medicine while bringing together all of its key stakeholders. Leading participating institutions including Stanford Health Care, UCSF, Duke Health, Duke University, John Hopkins University, University of Michigan and more will share their learnings and experiences and their successes and challenges, as they make precision medicine the new standard of care for all.

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Johns Hopkins
University Of Michigan

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
  • 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
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