UnitedHealthcare CEO Steve Nelson exclusive interview

This is an excerpt from a note from Business Insider Intelligence’s new Digital Health coverage.  Click here to learn how to access to full interview.

The US healthcare industry is in a state of flux, as rising costs, shifting consumer expectations, and a changing reimbursement model threaten a fragmented healthcare system. Insurers are tasked with the balancing act of controlling customer healthcare costs while also encouraging healthcare providers to move to a reimbursement system that emphasizes value over volume.

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Business Insider Intelligence recently spoke with UnitedHealthcare CEO Steve Nelson to understand how UnitedHealthcare — the largest health insurance company in the US — has implemented a digital health strategy to address these challenges. We discussed what’s been successful in UnitedHealthcare’s adoption of digital health, and the obstacles it faced in executing digital health solutions. We also spoke about the disruptive role non-traditional entrants could have in the future digital health landscape — and when digital health will be synonymous with health. Below are some of the highlights of our conversation.

The following has been edited for brevity and clarity.

Business Insider Intelligence: What’s pressured UnitedHealthcare to adopt digital health solutions?

Steve Nelson: It’s no secret that the healthcare system needs some work. In fact, it’s not really a system at all. It’s confusing, it’s difficult to navigate, and it’s too expensive. When you combine that with some of the demographic trends that you see in our country — the population is getting older, we’re experiencing more chronic disease — it gets even more complicated and more expensive. And consumer expectations are changing dramatically as well. So, this creates an opportunity for an organization like ours to lead this digital transformation.

BII: Is there a sense of urgency around adopting digital health?

UnitedHealth CEO Steve NelsonUnitedHealthcare

SN: Yes — it’s hard to articulate how restless and urgent we are. We really are committed to the idea that we have got to drive change. But it’s not just technology and tools that will create change. It’s your mindset.

When you’re restless and you’re urgent, then you’re willing to think about things like a startup or a disruptor would. We’re not stuck to the traditional ways, and so partnering with industries that might be further along in the consumer mindset perhaps can bring in new thinking — we’re bringing talent into our organization from industries outside of healthcare. The CIO of UnitedHealthcare is from Target, our head of operations just came from T-Mobile, and our head of human resources came from Apple. We’re in a great spot where we can attract really talented leaders from other industries — and then combine their thinking and strengths with the incredible capabilities that we have.

BII: Who needs to buy in to facilitate the shift to digital health?

SN: Some of the most important stakeholders in the healthcare system are the people who are the closest to the actual delivery of care. One of the things that’s a real challenge in the healthcare system right now is the need for providers and health systems to move from volume to value. We’re trying to drive that shift in a productive way that’s good for patients by using more evidence-based medicine, eliminating redundancies and unnecessary care, and providing more alternatives to traditional care in acute settings. These improvements in medical care will be driven by the use of more technology — such as AI that informs physicians to alternative courses of treatment that they may not have had access to in the past.

A lot of times people think of us as a payer. But the real payers are state governments, federal governments, and employers. Helping them see the benefits and the value in these new tools can help with this idea of simplifying healthcare and bringing more value. I think really giving these stakeholders the information and the incentives to make the transformation is something that we’ve had some success with.

BII: UnitedHealthcare has been a leader in digital health. Do you expect more organizations to follow a similar route? 

SN: I actually think we’re going to see more players from outside traditional healthcare come into this space, as opposed to more organizations following UnitedHealthcare’s example. I think folks that have a unique skill set and a core capability will also come in, and I think that will add value, and continue to help us improve.

Look at our PreCheck MyScript capability, for example. I think about Netflix and how it recommends films you might like and is customized to your viewing history. Our PreCheck app was built with that same type of experience in mind; it helps physicians find the most effective, low-cost medicine in real time — customized to a patient’s benefit plan and preferred local pharmacy — and it’s all delivered straight to their e-prescribing platform at the very moment the physician is writing out the prescription.

BII: How long until digital health is just health?

SN: Obviously, it’d be difficult to pin down an exact date. But we do see a day in the very near future where digital health is just a normal part of your day. When you wake up in the morning, you’re going to get health inputs. As you go through your day, you’re going to be getting alerts about your kids and your elderly parents. You’re going to have the opportunity to share data with your clinician. And you’re going to have better access to healthcare through other remote vehicles — like telehealth, or other kinds of sources.

You think about some of the technologies that we enjoy today that we couldn’t have imagined seven or eight years ago. And I don’t think it’s going to take us too long until we get to the place where digital health is as normal as doing your banking by phone. I think we’re already broaching the arena of digital health just being health. I don’t think we’re there yet, but I would say it’s not too distant.