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At AHIP’s Consumer Experience & Digital Health Forum (September 12-14 in Nashville, TN), Paul Markovich will keynote a session with Christopher D. Palmieri, President and CEO, Commonwealth Care Alliance® (CCA). Below is a preview Q/A with Paul Markovich.

Over the course of your career, you've demonstrated leadership in many ways within Blue Shield – in collaboration with the broader health ecosystem, and recently even with the state government’s response to COVID. When were you most challenged by your role as a leader?

I do think that the pandemic was the biggest challenge, from my vantage point, because it truly was an existential crisis for our society. We didn’t know just how far this virus could go and what it could do. Having to both try to manage an organization and a company when we weren’t physically together, while also trying to help our state respond to the pandemic, I ended up experiencing stress and emotion that I couldn’t even imagine.

I had to make sure I was emotionally empathetic for people that were going through all kinds of stress – whether that was in my personal or professional world. I really thought the demands of the pandemic were beyond anything I’ve experienced as a leader before.

In September, you’ll speak with Chris Palmieri of Commonwealth Care Alliance in a leadership call to action, putting consumer experience at the center of healthcare. In your view, how can stakeholders improve the healthcare experience for consumers?

The biggest thing that stakeholders can do is figure out how to make health care simplified, digital, and automated. We’ve made the world far too complicated. Everybody has their process, whether it’s in a physician’s office or a hospital, and these processes aren’t very well lined up and they’re not necessarily consumer friendly.

For example, if you go to the hospital as a patient, it’s in different departments. As a patient, you almost always have to get some testing done, maybe some screenings, and then you get picked up and transferred from department to department – which isn’t a great consumer experience. You can overlay that experience in a clinic or when dealing with a health plan.

To me, the biggest thing you can do is figure out how we make things real-time, digital, simplified, and centered around that customer or patient. The more we can do that, the better the system is going to be.

Digital health has made big strides in improving outcomes, engagement, and the consumer experience. As you look ahead, what digital technology most excites you?

The digital technology that most excites me is artificial intelligence, in particular machine learning. The human body is so complex, and the pace of scientific discovery is so extraordinary, that the ability to match up the best possible treatment for any given individual begs for the use of technology to drive insight at a faster rate. Artificial intelligence has great promise in that field.

We’re only going to be able to leverage that promise if we can create a digital foundation. Artificial intelligence is an engine fueled by information. We can leverage data that provides an understanding of a given patient and all of their current circumstances and then we need to overlay all the scientific evidence that might be relevant to that patient’s condition.

But artificial intelligence can’t do that without access to information on both those topics. We do need to get to that digital foundation to achieve the promise of artificial intelligence, but it’s by far the most compelling technology out there.

What are the three most critical issues for the healthcare delivery system to address going forward to more effectively meet consumer needs?

We need to bring health care into the digital age.

We need to tie pay to value.

We need to completely reinvent the pharmacy value chain.

To me, those are at the top of the list because we can’t possibly get to the best treatment for each individual in their circumstances, and really get the administrative costs at the level they need to be, unless we simplify, digitize, and automate the environment that we’re in.

We know that fee-for-service doesn’t work. When the incentives are skewed, you get what you pay for. If you pay for better outcomes and better service, you’re going to get better outcomes and better service. So clearly, paying for value is critically important.

For years, the fastest growing line item for us has been in the pharmaceutical line. It’s just unsustainable in the way that it works today. It’s highly inflationary without a lot of accountability for outcomes.

If we can do those three things, I think we can really get our arms around creating a healthcare system that's worthy of our family and friends and sustainably affordable.

Finally, what is your call to action for other leaders to deliver better healthcare for consumers?

It has to matter to you. We can all talk about what needs to be done, but it’s a matter of leaders stepping up to do it.

The biggest thing for healthcare leaders is to think about the industry as a whole – not just your organization. There are too many things that require the cooperation and the collaboration of multiple players in health care.

For example, in financial services, there are common standards for doing financial data exchanges for international transactions and credit card transactions, which has greatly improved the consumer experience.

If we're going to get this done, if we're going to change the way the healthcare industry works, we need to figure out how to do it together, across organizations. I would ask all leaders to think about how to improve the experience for your customer across the healthcare ecosystem, not just through the lens of your individual organization. What can you do to make the industry better?

Learn more from Mr. Markovich and other leaders at AHIP’s Consumer Experience & Digital Health Forum.

There’s still time to register.