Welcome everyone to the Becker's Healthcare podcast series. I'm Mariah Muhammad, writer and moderator with Becker's Healthcare. And I'm thrilled to have with me today Stacy Edgar, cofounder and CEO at Venture. Stacy, welcome back to the podcast. We're very excited to have you join us again today. To start our conversation, I wanted to touch on finances a bit as it seems like it's the main topic for hospital systems and insurances today.
So balancing affordability and quality is a constant challenge for health plans, as I'm sure you know. How is your organization innovating to manage the cost of care while also maintaining or improving member outcomes? Yeah. Well, first of all, thanks so much for having me. And, by way of background, for those, who maybe don't know me, I'm Stacy. I'm the CEO of Mentor. We are building personalized health insurance. And how we're doing that is leveraging the ICWA regulation.
That stands for individual coverage health reimbursement arrangement, which is about a five year old, tax term that allows employers of any size to provide cash instead of a group health plan. And how it works is each employer sets a budget. That budget is pretax for the company. Each employee gets a budget, and they get to decide
which insurance plan is best for them. They have to buy insurance to claim the money, but they also they don't have to use all the money on health insurance, so they could decide to, allocate part of that funds into a health wallet. And to bring that back to your question, what it does for both the employer and employee, and also frankly for health plans as well, is give this huge amount of flexibility. And it also unbundles this group model where you have this one size fits all
approach. Maybe, you know, what you see with employers is maybe there's one person or two people who really need, especially if they're in the c suite, really need access to this one thing, but then the whole company needs to has to pay for it in term form of premiums. In this case, when you unbundle it, you get each employee the choice to choose, hey. What's important to me? And define how they allocate funds.
It just creates more efficiency in market, but also allowing each person to, you know, really prioritize how money is spent based on the priorities in their life, whether it is, you know, managing diabetes or planning for a new family or, you know, maybe there there's nothing going on in their life that they're concerned about today. Maybe they can focus on wellness and prevention and direct that money there. So that's how we're doing that today. Wonderful. Thank you so much for giving us
that background. I'm sure it will be useful, within our conversation today. And then kind of to move on, in an ever evolving, regulatory landscape, what best practices or tools does your organization rely on to keep the quality of care at the forefront? That's a great question. So the North Star for our organization is always thinking about the individual and the family and making sure that they get what they need at the right at the best
price point. And so if you prioritize that I know it sounds very simple, but if as long as you're prioritizing the member and really thinking about their journey, then, you know, a lot of things flow from that. And that's actually where, you know, our model is actually quite innovative in that you put the spending power in the hands of the family. And so that's how we're doing it today, and that's where we're excited that regulatory change, especially recent regulatory changes made that happen.
Yeah. Yeah. Definitely. And addressing health, equity has become a critical focus for many health plans. As, again, I'm sure you know, it's a big topic whenever I I really talk to a health plan, executive. Can you share an overview of a key initiative here that you're involved in or particularly, excited about? One thing that we're especially excited about is thinking about different,
very niche user journeys. So, what I what I mean by that actually, this one's not that niche, but it's very, very overlooked. Helping moms, new moms, financially plan their health care journey. So we all know pregnancy delivery in America costs, an astronomical number, like 18,000, and that's actually that's when things go well. It could be much more than that if, you know, you have a complex pregnancy.
And what we do is we look at, you know, here if you if you got this budget from your employer, what's how do we maximize it to basically lower the cost of care for a new mom or, you know, a second time mom or third time mom, but really think about, lowering the access to care burdens, that maybe, like, you know, the cost drivers that are keeping people away from getting the prenatal or postnatal care they they need and also, you know, just making it more,
you know, having a family more accessible to more Americans as well. Yeah. Yeah. Definitely. Well, helping new moms is an amazing initiative, and I actually haven't talked to someone else who's talked about this. So that's amazing. And kinda going in with that, member satisfaction is essential to thrive in today's competitive health care market. I'm sure the mothers are very satisfied with this focus. But what experience or engagement strategies have proven, effective
for your organization so far? How are you measuring the, the success? So we measure the success of, in terms of member satisfaction in multiple ways. Monthly customer satisfaction scores, you know, also satisfaction scores at each point of engagement with our customers. And we're proud to say we've actually had a 98% customer retention, in every year that we've operated as a business. And key to that is actually, that level of personalization.
So one thing that's really scary is, you you know, when you give, when you at the employer level, when you, walk company through this model, it's a lot of change. And so we actually have very hands on account managers who are who we see as partners to our clients, and we're there to be right in the thick of things and really take things off of their plate and work in partnership with them. And then on the employee side, when you give somebody a budget and you say, alright.
You know, this is now up to you. That can be overwhelming in health care. So they really do need a guide, and part of that guidance is, you know, delivering the form of technology. But we always believe that you should always have somebody you could talk to about, you know, your really personal needs and really make it about you. And I think that, you know, instead of maybe, you know, having a general like, we talked about moms earlier in this podcast. Instead of talking generally about moms,
we're able to say, hey. This is your pregnancy, like, your child, and really personalize that plan for each person. And that's what really makes a difference and also what I think has led to that satisfaction score as well. Yeah. Yeah. Definitely. Well, the net, promoter score is a powerful indicator of member loyalty and satisfaction. How are you using NPS to drive meaningful improvements across your health plan?
Yeah. So we we look at, basically, we look at any friction points, and that drives our product road map. And, you know, and then we keep measuring it until that friction point has gone away. And looking at, how do we boost that NPS score and really just keep keeping customer at the North Star. And the biggest gift any customer gives you is is constructive feedback. So really making sure that we take that seriously and then act upon it with haste.
Yeah. Yeah. Definitely. Well, we've talked about how, how it's imperative to reduce cost, improve quality, and advance health equity. But, obviously, these are not small task, and it takes a bit of time. How do you approach aligning these priorities in your organization's strategic vision? Great question. So I would say to that, the customer is always the North Star. So coming back to that comment we made earlier, it's really about the individual. It's about the
family. It's about the employer. And this also you know, we also think about the larger ecosystem in which we play and whether we're talking about payers, in terms of insurance carriers or, you know, health systems and providers and really just making sure that we're creating you know there's a lot of actors. And because of that, there's a lot of noise. And so, you know, we assign a North Star, which is around the individual and the family.
But we also believe that creating as many win wins as possible across the ecosystem, you know, helps us do our job better. And so we And so what we spend a lot of time on is making sure we're understanding how our partners work and also what their incentives are. And so, you know you know, it's often easy to say, hey. I demand this of you, or why don't you do this better? But making it two way of saying, you
know, we could probably be better too. And how do we make this a win win for us as for all? And, so but also just making sure that, you know, you have to pick a focus point and you can't, boil the ocean. So, you know, of all those actors, we've, you know, definitely decided, okay. This one is the priority actor and everything else is in service of that that person, and that also clarifies decision making as well. Yeah. Yeah. Thank you so much for explaining
that. I'm sure other people will definitely take that, into consideration. And, Stacy, before I let you go, looking ahead, what do you see as the biggest opportunity for payers to really lead the, change and transform, transforming care delivery and driving better outcomes for all stakeholders? Really, how can leaders take a step in this direction now?
Yeah. I think keeping track of the most important thing right now is keeping track of everything that's happening, which I you know, that's whether it's AI or regulation, there's a lot. And, actually, what I think we're about to see and for anybody listening to this podcast or this episode, I would encourage you to take a look at ICRA, get to know it. It is a new way to pay for health care entirely, and there's new regulation even as of this week being considered in the house of representatives.
And the, on top of that, the technology change that is happening alongside it, the future I see is that we're gonna see increasing personalization where you know? And I think the consumer is gonna demand it as well.
And we're kinda going back to you know, instead of being able to talk about categories in general terms, like whether it's, you know, we're talking about conditions or we're talking about, populations or we're talking about geographies, that people will wanna see, you know, this is the plan for me and really be able to custom fit that. And I think that's the next chapter of health and health care and health insurance. The law is here. The technology is here.
It's just a matter of time at this point. And, keeping up to date with all the things that are changing, I think, is really, really crucial at this moment in time. Absolutely. I completely agree, there. And thank you so much for those final thoughts. It's definitely been a very informative discussion. So, again, I wanna thank you so much for coming back on Beckley's Health Care. I look forward to connecting with you again soon. Likewise. Thank you so much.