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Keran has been with UnitedHealthcare for 15 years, in a variety of leadership positions
While most entrepreneurs want to be the one to discover the next Amazon or Twitter, oftentimes major technological shifts are coming from the big companies, the players that have been on the scene for years, if not decades. Those companies have survived because they know how to pivot. They're the ones who either seed new ideas or acquire them and distribute them.
In this column, we talk to those companies and their innovators who are preparing them for what's coming.
Healthcare is one area where advances in technologies like big data, artificial intelligence and machine learning are having a major impact on how the space operates.
Pat Keran is UnitedHealthcare's VP of product and innovation.
During his more than 15 years with UnitedHealth Group, Keran has held a variety of leadership positions involving strategy, data analytics, and program and product development, with a concentration on the use of technology to improve the health system and better serve consumers and employers. Prior to joining UnitedHealth Group, he held leadership roles focused on technology with Target Corp. and NCR Corp.
He holds a Masters Certificate in information technology project management from George Washington University, and a Bachelor of Science degree in General Management from the University of Minnesota – Carlson School of Management. He has been quoted in numerous national and trade media outlets, and is a frequent speaker at industry conference and events, including the Consumer Electronics Show (CES).
VatorNews: Tell me a bit about yourself, your background and your role at UnitedHealthcare.
Pat Keran: From a background standpoint, I’ve been with UnitedHealthcare now for about 15 years in a variety of roles, actually starting out on the technology side where I was a leader within our technology and innovation team, looking at a variety of different ways of how we can better enable healthcare through technology. Then, recently, within the last 10 months, I have transitioned over to our UnitedHealthcare business, leading our virtual care product.
VN: Is there a big difference for you in those two roles?
PK: Quite a bit, actually. From an innovation and technology side, what we’re really looking for here is the enablement through a number of things, like artificial intelligence, devices, data, and a variety of other methods and solutions that are out there, and how we can bring forward these enablers into the healthcare system. So, we're looking at the problems that we can solve through these types of tools.
On the business side, I think it’s the continuation of looking at the technology solutions, but also looking at the broader picture around where we look at virtual care, and the possibilities that we can grow it for our membership, not only through technology but through the business and processes and actually benefits that we can provide, really focusing on virtual care.
VN: How important is virtual care to UnitedHealthcare? What kind of opportunities do you see in this space?
PK: I want to start a little broader than that: virtual care is really important to our members, and how anyone can meet the members within their lifestyle today. We know that, as Americans, we have a variety of different responsibilities and that they’re not always between the 9 am to 5 pm on a daily basis; we have people that work various hours, we have people that have different lifestyles, and when they want to engage them. Virtual care becomes a component, an enabler, in how we can now reach members any time through this type of medium.
Getting down to what it means to UnitedHealthcare, it becomes a strategic direction on how we can better enable the healthcare system but, more importantly, how do we better enable our members now to engage with care within their lifestyle? So, we’re looking at a bunch of broad solutions in how we can now meet the member in their lifestyle through some kind of virtual care, whether it’s through devices, through connecting with doctors, through other means, that becomes important in the way that we can engage. If you’re living in a rural community, or if you’re living in an urban area, it all becomes important in how we engage that member.
VN: How are you seeing care evolve thanks to these services? How has that changed the doctor-patient relationship?
PK: First and foremost, we do not want to break the doctor-patient relationship. That’s very important to maintain on an ongoing basis. If I see Dr. Smith, and have been for the last number of years, I want to continue to see Dr. Smith. So, what virtual care really does is it opens up a broad scope of how we can now engage with that member, maybe a little bit differently, or maybe we can even enhance the experience.
Here’s what I mean: if you look at virtual care today, it really has evolved into more of, “How do we allow members to get virtual urgent care?” If I have a child that might be ill in the middle of the night, instead of having to go into an emergency room, where we know that the expense is great, and maybe the care isn't even going to be needed, versus having a low-cost, high-efficiency, urgent care from virtual standpoint, where I can meet with a doctor via video at 3 in the morning, that ability is there. So, what we can do is we can look at the on-demand care. If my doctor is not available, this becomes an alternative to get the care that I need on a 24/7 basis. That’s how it has evolved today.
Now, where that’s going is, can we now get your primary care doctor and the patient engaged in a virtual relationship as well? If I have a need to see my doctor, but I don't necessarily need that physical face to face, is virtual another means by which we can still provide that relationship to get the care that I need, while still being very convenient for both me as a patient and you as a doctor? Let's keep in mind, we have a number of members that don't have a relationship with a primary care doctor today, so does virtual become a means by which they can now start engaging with a doctor on an ongoing basis?
VN: Do your members need to see that doctor in person first and then have that virtual relationship? Or can that relationship start virtually, where they’ve never met face to face, they never had a physical interaction?
PK: First of all, you have some state laws and regulations that do prohibit some of that initially here, but I think those are becoming fewer and further between.
As far as establishing a relationship, personally, I don’t think it's necessary to have that in-person; they’re still a licensed doctor that I’m meeting with. There are some components that I may need to do, like a physical exam labs or have labs or blood drawn or other things like that, where they can refer me to the local care organizations to get that lab, to get that imagining, to get that physical check. It all goes back, then, to the doctor in a virtual setting, allowing me to continue on with that relationship, so they can look at things like closing gaps. They can look at my long term care and then, of course, refer me to whomever, when I need it. So, they’re still my center point, my hub, when it comes to the doctor-patient relationship.
VN: Obviously I want to ask about some of the things that UnitedHealthcare is doing specifically. How does UnitedHealthcare Motion work? How do you incentivize people to get more exercise?
PK: UnitedHealthcare Motion really is a unique program in how we use incentives on a frequent basis to engage members in their longevity around healthcare. The principle of the program is that, through your employer, you can sign up and what we do is we ask you to get connected to track steps and other measures as well on devices like the Samsung Gear Fit2, Fitbit and, of course, Apple Watch.
We offer, depending on the employer, a potential credit for at least part of these devices. It depends on how each employer wants to set it up, but the basic principle is that, let’s say I’m wearing my Apple Watch, I now have daily goals to meet and get incentives based on the goals that I actually obtain. There are three goals that we set for them member, called our “fit goals”: frequency, intensity and tenacity. Frequency is that I will take 500 steps within seven minutes, six times a day, at least an hour apart. Intensity is that I complete 3,000 steps within 30 minutes. And tenacity is 10,000 steps a day. I can meet anywhere from none to all three and then, based on the ones that make, I get a financial incentive then that goes back into my health savings. If I meet all three goals on a daily basis for an entire year, that can accumulate to over $1,000 worth of incentives.
VN: How many people actually get to that level of incentives?
PK: I can tell you from an overall standpoint that for all the program participants, they’ve had over 272 billion steps and earned over $43 million in rewards. And it’s cash, money that goes right back into your health savings.
VN: What kinds of health benefits do they see? How much healthier do people become as a result of walking those 10,000 steps a day?
PK: I don't have the specific numbers for you, but if you look at it from an overall standpoint, what we is see is a maintenance of a healthy weight, and we see a lot of conditions that are able to be pulled into check. So, things like heart disease, high blood pressure, type 2 diabetes. We’re also seeing some behavioral health benefits by warding off depression as part of this as well. So, from a totality standpoint, it really brings into check the health aspect from a member standpoint.
I’ve heard story after story about how people have lost a lot of weight, and how they feel from an overall health standpoint, but also looking at the longevity of their health, they have seen the benefits, both financially and from a physical standpoint in doing these types of programs. So, even though, time and time again, people are trying to write it off, saying, "wellness doesn't have an ROI behind it," but we’re seeing through this type of program that there are good benefits associated with this from a member standpoint.
VN: In October, UnitedHealthcare updated its app to give more of its members access to telemedicine services, which is another important aspect of virtual care. Why was that important for the company?
PK: Part of that gets into our partnership with Teladoc. We have, through our mobile app and the myUHC.com portal, full integration into what we call a "virtual visit experience,” so virtual urgent care, but the utilization of virtual care is still very low, and I want to be honest about that. However, as we look at understanding why, some of those reasons have to do with the barriers, both from a technical standpoint and financial standpoint, of how we overcome this stigma so that members then can very simply use the virtual visit process.
So, we’ve integrated with Teladoc, making it easier for our members to engage in these digital services. We’ve done some things to bring the visibility of virtual visits, and that virtual care, to the forefront of our digital assets. For example, on both the myUHC.com and the UHC mobile app, virtual visits are one of those features right on the front page. By doing this, what we’re seeing is an increase in utilization from our members in regards to virtual care, and a number of them are using it for the first time because of the ease of use and the understanding that it’s available.
VN: Can you talk more about those barriers you mentioned, especially the financial barriers? I find that very interesting because whenever anybody talks about virtual care they always frame it in terms of being lower cost. So what are those barriers you’ve seen?
PK: With the financial barriers, people may not have a complete understanding of how much a virtual visit costs for them. So, what we really try to do is share with our members, in a number of ways, is that, based on their plan designs by their employer, a virtual visit can be anywhere from a very low cost, maybe a couple of bucks, to maybe up to $49 per visit. It’s making that awareness available and really taking out the mindset that a virtual visit is the same price as going to care in person, which it’s not. We know that urgent care from an in-person standpoint is somewhere around $150 per visit, whereas if I can have this $49 or less it becomes a really big benefit. So, that awareness is number one.
On the technology side, the barrier is making it available to our members right away. More and more of our members have smart devices and computers that have cameras embedded in them where you can get that video care, but we;re also lifting up some of these barriers by now making phone visits another component in how you can engage with a licensed doctor. So, you don’t need that video component, you can do it over the phone.
VN: Ok, so I understand what you meant: it’s not that they can’t afford virtual care, it's that they don’t understand that it’s cheaper and they need that education. How much education goes into this? How much hand holding do you have to do, especially with older members, so they know that virtual care is the same as seeing a doctor in person?
KP: There’s a lot of education that goes into it, and it echoes our multi-pronged approach. What I mean by that is we do a lot through the members’ employers. So, we have a number of transportation companies, as an example, that have done an excellent job in how they communicate to their employees that are on the road that virtual care is something that they can take advantage of and how they can do that and the price associated with it. We see a lot of great marketing and education through our employers that we work with.
We do a number of components of that education too, through a lot of our marketing efforts, whether it’s through digital, through mailers at home, through other acknowledgments, like on social media. There are multiple ways that we’re trying to engage and constantly communicate to our members how this service really can be effective and efficient for them.
VN: We talked about how virtual care changes the relationship between the patient and the doctor, but how does virtual care alter the relationship that UnitedHealthcare has with its members? What kind of responses do you see from patients?
KP: From an overall membership standpoint, even though I mentioned previously that utilization of these virtual services is still very low, that’s an industry-wide problem, that’s not a UnitedHealthcare thing. However, there was a J.D. Power and Associates study that was done in Fall 2019 that looked that the satisfaction of virtual from a member standpoint. It looked at national providers out there like Teladoc and American Well, but also looking at the payers, such as UnitedHealthcare, and one thing that was pointed out in that study was that people that went through that virtual visit had a very high satisfaction rate. So, even though utilization is low, satisfaction is extremely high. In fact, from a digital standpoint, it tends to be one of the highest rated solutions for our members.
It becomes an important piece of how we continue to engage our members: making sure that that we maintain their connection to their primary care doctor, while also leveraging virtual care. Making that connection between those two important pieces is something that we need to continue to move forward with.
VN: What other types of products do you hope to offer in the virtual care space in the future?
PK: Unfortunately, I can’t reveal a lot about what’s coming down the pipe but what you're going to see, and you’re already starting to see this from a market standpoint, is that urgent virtual care is really something that is now foundational. It’s more about where we’re going from there and how we’re growing that. So, you’re going to start seeing areas of growth in the primary care area, you’re going to see growth in the areas of chronic and complex care, of how we can use virtual tool as more of, I wouldn’t call it an interim solution but more of a solution to enhance care with your doctor or specialist today. Then I think you’re also going to see a lot of growth in the specialty areas too. So, for example, we have virtual care that’s available for behavior, and you’re going to see that expand. There’s going to be a good broadening of the virtual care landscape overall in multiple different areas.
VN: What is your big vision for this space? What does success look like for you?
PK: Success for us really is, and I keep mentioning this, that virtual care really is an enabler within the healthcare system for our members today. How can that medium be utilized to meet with your doctor? If it’s within a local care group that I’m a patient of, can virtual be another way or another means by which I can meet with my doctor? If it’s in-person care or virtual care, can I have that continuity of care? How we can really make this a comprehensive program that leverages both in-person and virtual care? The big vision is that virtual becomes another enabler, another way that we can engage members where they want to be met.
VN: Is there anything else that I should know about UnitedHealthcare or your efforts in this space?
PK: First of all, virtual care really is under utilized today by our members and, like I mentioned, this is industry-wide. That’s one of those points that we really have to emphasize: it’s available, it’s easy to do, it’s low cost, so let’s engage more.
The other thing is around the devices, like what we’re doing with Motion. There are other devices in the market could also enhance that virtual capability now in meeting with a doctor. I’ll call out one specifically called Tytocare, which is a multi-solution device where I might be a patient at home, and I want to get virtual care, and this device allows me to take respiratory, heart rate, it has a tongue depressor, it has an autoscope for my ear. All of these things can then be synced up then with that virtual care, now enhancing that session with my doctor. The important piece is that we’re not endorsing Tytocare by any means, but I’m just saying that it’s these types of devices that enhance the virtual experience.
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