The 37-year-old has a title: executive vice president of Optum. But she wears many hats, including running a division that sells affordable hearing aids that cost from free to $599 for UnitedHealthcare members. Non-plan members can get similar hearing aids for up to 70% less than they’d pay in other outlets.
Will Smith, the co-director of Grand Teton National Park, demonstrates some daring-do to rescue people from mishaps in the mountains of Wyoming. But just like medical directors for health systems, insurance companies, and pharmacy benefits management firms, Smith is in the business of setting policies and protocols.
David Hanekom, MD, and Steven Udvarhelyi, MD, are two former medical directors who became CEOs. Their new job means really understanding the business side of health care, the need for healthy members, and a healthy bottom line. But it also means watching costs and keeping stakeholders —which can include stock holders—happy.
The insurer’s general manager of behavioral and EAP services wants to make mental health care more mainstream. Only 17% of American adults function with optimal mental health. “We talk about it as if it’s them over there, but 83% of us have a need.”
The author’s nephew suffers from a rare form of familial hemophagocytic lymphohistiocytosis. His organs shut down and he’s placed in a medically induced coma. Meanwhile, costs mount to $4.9 million, most of it paid by an employer-sponsored health plan.
For instance, say something a patient needs is not covered by Medicaid or an ACA plan. Blanco helps members find what they need by working with Molina’s Community Connectors (community health workers) who help connect members to local community and not-for-profit organizations.
The 35-year-old medical director of the plan’s office of medical policy and technology assessment has broad interests, but he’s particularly keen on wellness because it “ties into the evidentiary component of my position—evaluating the scientific literature to support evidence-based medicine.” His take: Rely less on active patient participation.
This upbeat doctor-policymaker-entrepreneur sees opportunity where others see a federal policy train wreck these days. For instance, he’s pleased that both political parties seem to endorse a shift from fee-for-service to value-based care. However, continuing uncertainty about the individual market may chill new investment in that area for a while.