Innovating Health Plans' Approach to Innovation

Innovation is one of the most over-used buzz terms in our industry today. There is a rabid appetite and glaring need to effect change in the U.S. healthcare system through innovation. That was the driving idea behind Haven—the highly touted venture between J.P. Morgan, Amazon, and Berkshire Hathaway—whose proverbial doors will close next month after 3 years of operation. Haven set lofty goals to innovate American healthcare by bringing giants of the private sector together. And in the end, they found themselves stymied like countless others before who have tried to fix a very complex, cumbersome, and costly health care system.

Do we need a better way of efficiently operating delivery systems? Yes. Do health plans need to do more for access, affordability, and experience? Absolutely. But our fatal industry flaw lies in taking a siloed approach to solving the latter priorities, and then treating these areas as value differentiators, rather than payer-agnostic approaches to bettering the sector. These siloed approaches are unique to each health plan and are ironically perpetuating an industry standard that already struggles with user experience and interoperability. We focus so much of treating the symptoms rather than the disease itself.

I truly believe that when it comes to innovation, the rising tide lifts all boats. When one stakeholder makes important advances, others follow suit. We learn from each other and improve upon one another’s ideas. One lane where innovation is lacking, and demands re-evaluation is in our approach as a payer industry.

This comes from the perspective of a person whose had innovation in a few of my job titles, and in virtually all my job descriptions. I’ve worked for Fortune 5 companies and also some of the Bay Area’s fastest growing start-ups. And the way we achieve transformative change is by embracing and adopting a more communal approach. This will allow greater focus on health equity, obstacles to access, and the gross disparities on the payer side of the sector. If we’re all in this to help our fellow man and woman, then let’s act like it.

Moving away from a piecemeal to a more holistic approach on innovation, in 2021 Sutter Health | Aetna will pivot our innovation division from acting as a think tank and hub to an innovation catalyst and platform. This means we will no longer prioritize a singular need for organically developing the best and brightest ideas, but instead focus our efforts on servicing our platform for the best and brightest to easily partner, pilot, measure, and share the value created. We will share updates throughout the process to help other organizations learn, partner, and grow too! We have developed a team that has standardized our approach to sourcing, contracting, implementation, evaluation & measurement, and publishing our objective results and lessons learned.

Sutter Health | Aetna will pivot our innovation division from acting as a think tank and hub to an innovation catalyst and platform. This means we will no longer prioritize a singular need for organically developing the best and brightest ideas, but instead focus our efforts on servicing our platform for the best and brightest to easily partner, pilot, measure, and share the value created.

I expect this approach will serve our brokers, consultants, plan sponsors, and most importantly, our members in a better and more equitable fashion. Rather than moving the ball down the field, we are bringing the entire game to a whole new level. I do not wish for Sutter Health | Aetna to be known simply as an innovative company, but rather an enabler of evolution; a company that owns the need for industry progression and harnesses the energy of thousands of minds that are all focused on the same thing. That is through more openness and inclusion, greater transparency in place of opaqueness.

Rather than moving the ball down the field, we are bringing the entire game to a whole new level. I do not wish for Sutter Health | Aetna to be known simply as an innovative company, but rather an enabler of evolution; a company that owns the need for industry progression and harnesses the energy of thousands of minds that are all focused on the same thing.

Sutter Health | Aetna’s strategy ensures that our health plan stays on the leading edge of boundary breaking, disruptive approaches to payer operations, care delivery, and user experiences. This approach will also ensure we, as an industry, can learn and evolve together.