Bringing Tranquility to Healthcare: A Conversation with Brian Lobley of Independence Blue Cross
Pulse: Could you please provide a quick overview of your background and current role at Independence Blue Cross?
BL: I have been with Independence for 18 years. Currently, as Executive Vice President, Health Markets, I hold P&L responsibility for all of the Independence businesses across national commercial, consumer, and Medicare. In addition, I have oversight of AmeriHealth – our affiliate in N.J., operations, claims, and customer service. My career has been in 2-3 parts, the early part in operations and IT, and the latter in business strategy and innovation. I have long stayed involved with innovation. Since payers are in the products & services business, I believe they need continual innovation. I have also done a lot of venture investing in my roles with Independence. And I am a founding member and the board chair of Quil.
Pulse: How did the partnership between Independence and Comcast come about?
BL: Comcast has long been Independence's largest self-insured customer and Shawn Leavitt, who runs all employee benefits there, is very forward thinking. He's always ahead of the curve thinking about disruptors in the benefits space. 3-4 years ago Comcast ran a RFP process, looking for ways they could work more closely with their benefits vendors.
Around the same time, Independence launched a program called "Human-Centered Innovation." We realized that all the stakeholders in healthcare need to look at the world using a consumer lens, rather than from other perspectives. With the RFP process, Comcast challenged Independence to put its money where its mouth was. Initially, we pitched a joint investment fund, where both companies would contribute both financial and human capital. Each company brought unique assets to the table. Comcast had Xfinity Home, Interview, Voice Remote AI, and NBCUniversal, covering technology and consumer facing areas. Independence brought know-how around managing risk, coordinating care with hospitals, navigating healthcare from a patient’s view and the associated pain points.
We realized that running an investment fund would require enough human and financial resources that we could instead incubate a company on our own. This process resulted in Quil, a 50/50 JV between Independence and Comcast. Since neither company had incubated companies on our own, we partnered with Oliver Wyman to conduct research on difficulties faced by consumers when navigating the healthcare journey. For example, what is the next step after leaving a CHF (congestive heart failure) planning session?
Pulse: What is Quil?
BL: Quil is a digital health company that will be a platform of services that guide a person through his or her healthcare journey. Orthopedics, where Quil currently focuses, is a good example. Quil personalizes the treatment protocol for each patient, working in partnership with Penn on a new pilot program. The content can be delivered through many mediums — iPhone, iPad, laptop, or TVs — but the key is to get the critical information to patients when they need it.
Quil will have a CEO starting at the end of the first quarter. Currently, the company has 40 developers, mostly in Philadelphia with some in NYC, working alongside the University of Pennsylvania on the minimum viable product and base technology background. We are carefully scaling the company but don’t have to worry about fundraising for Quil because of the backing from Independence and Comcast. The company has its own board of directors, with two seats each from Independence and Comcast. By the end of the year, the hope is to be providing Quil’s care journey support to 2 additional markets outside of Philadelphia and eventually nationally.
Pulse: Quil launched its website and app in the last few months. What do you envision it becoming in the next year and next 3-5 years?
BL: The short-term goal is to build out more conditions, more opportunities, to bend the cost-curve. Orthopedics was a good place to start, because it is a health episode where you can reduce re-admissions and cost throughout the pre-op, operation, and post-op care stages. These stage gates are important and allow data collection and more personalization. This personalized data will be supported first by clinical data, but the hope is to include non-healthcare data as well. Ecosystem partners that can be plugged in, such as a diabetes manager program, will turn Quil into the platform consumers use to navigate their healthcare journey. Long-term, we have a bold ambitious agenda to be a platform that people use to manage their journey. We will be “managing healthy” and engaging consumers regularly. For example, the app would give an alert at 7:35 during Wheel of Fortune to take medication.
Pulse: What makes Quil different from other patient engagement platforms/tools in the market, many of which try to target the patient front door and be the platform to deliver a wide range of services to patients?
BL: A lot of companies start narrow and then go deep. They create a single service, such as content, care management, coaching, or concierge care. The Quil platform will be higher level and operate across all these areas. There are two key differentiating factors for Quil. First, the partnership between Independence and Comcast provides tremendous resources and expertise from the two parent organizations. Second, the ability to tap into existing forms of media and entertainment that consumers already access and use to deliver services. This capability is unique even compared to Apple or Google.
Independence is interested in partnerships, we don’t need to own the space. We are interested in bringing people to the platform. We believe that allowing others to innovate here will help the platform provide a more compelling experience for patients. We like to use “app store plus” as an analogy. You use the app store just to find and download apps. We give that functionality in the content delivery but will also engage you further. Quil will curate the marketplace. Using our earlier example, after you complete your orthopedics care journey, you might receive a suggested nutrition journey. Quil becomes not just a point solution, but an engagement platform.
Pulse: How will Independence & Comcast measure success of the Quil service? Who will benefit from the service?
BL: NPS (net promoter score) is great, but at the end of the day we must lower medical cost. Whoever is taking the cost risk, Quil must be able to show that cost is lowered as a result of adherence to the plan.
Pulse: Some consider physicians the center of healthcare, since they often have strong influence over where and what care patients receive. How should we think about managing the patient journey given this dynamic? How much of patient engagement/ patient journey decisions can be made away from the physician or healthcare provider?
BL: Over the next decade, healthcare will be more consumer-driven, where consumers vote with their wallets. In industries that have been disrupted in the past, it's been ones where consumers have driven and ultimately sustained changes. You have to belief and be emotionally invested in change to succeed.
Pulse: You have mentioned in prior interviews the benefit of working with Comcast/NBCUniversal, given their technological expertise, 75 million person userbase across 23 million households, and consumer engagement expertise. So far, what has worked well and what learnings have you made along the way?
BL: The ability to tap into NBC networks, which are seen by 110 million people, is amazing. They are experts in engaging users with content. Healthcare has a lot of content providers already. Comcast is truly a leading consumer technology company, with Xfinity Home and Xfinity Mobile. The match in culture and values are as important as resources. Despite its national footprint, Comcast is a Fortune 40 company that is community-based. Xfinity also has a local presence with a built-in distribution network of technicians, who can help digitize homes and prepare them for digital health.
Pulse: What do you think of the term intrapreneurship and what advice do you have to people seeking to innovate healthcare from within large organizations? What are the hallmarks of the right culture to support innovation?
BL: I love this question and the term intrapreneurship. The company must have the right culture to endorse and embrace intrapreneurship. If you can’t wait for your shoulder to be tapped, you have to go out and do it. Think to yourself, "I am in function A and I want to learn about function B." There is way to do this organically. You need to be networking with peers across the organization and also those one level above you.
C-suite endorsement of innovation and support top-down are critical pieces of culture, especially in an industry as ripe for disruption as healthcare. The rate of acceleration for technology innovation in the last 10 years is greater than that in the last 30 years and has reached a critical mass that is spilling into other industries.
At Independence, we run innovation challenges and the most successful ideas come from teams that are cross-functional, where 80% of the people on the team don’t have an intimate connection to the issue at hand. For example, a customer service rep can give the member's perspective.