2. Darrell Moon: The Aspirational Healthcare Movement Explained

All right, welcome back to another episode of the Broker's Voice. I'm excited. Today I get to be joined by Daryl Moon, CEO of Orion. Daryl has an awesome story, not only of how he got in the industry, but he what he's doing today inside the health insurance industry with the, with the aspirational healthcare movement which we're going to spend a lot of time talking about today. So, Daryl, welcome aboard. Welcome to the Broker's Voice.

Thanks, Andy. Looking forward to it.

I mentioned it at the beginning there, you have a unique background which makes you, I would say, extremely qualified to do some amazing things in the health insurance industry. But again, you have a unique path to the health insurance industry as well. So feel free to kind of share your story of how you got in this industry that most of us did not get in by design.

So yeah, my goal in life was to be a hospital administrator. Go figure. So I went to college and got a Master of Health Administration and while I was working through college, had the opportunity, it was truly I was in the right place at the right time to open up a brand new hospital as the CFO controller. So I moved into a very prominent position within a hospital while I was still working on my degree. That turned into me running 10 different hospitals, open three brand new hospitals and most of those were for the largest hospital system, Health Hospital Corporation of America. And it was all over the country, so Utah, California, Texas, South Carolina, Illinois. And as I was running hospitals, I became very disillusioned with the idea of.

Who'S the customer? And are we really truly meeting the customer's needs? I was clearly very focused on doctors. That was my customer and that's how my job was pretty much managed. Bonused incentive because doctors admit to hospitals. But if you take a look at really truly, if you look at Edwards Deming philosophy as a continuous quality improvement, who's the customer? How are you going to delight the customer? And when you see variance in the monitors that are measuring whether you're delighting the customer, how do you get those closest to the process to improve the process so you can take out that variance? Well, the very first step is who's the customer? So I'm teaching these principles to become accredited with accommodation from hospital to hospital. And it's like, well, if I step back and I look at the entire industry of healthcare, here I sit at the top of the food chain.

Well, the customer is not the doctor and it's not the insurance company either because they're just a pass through. It's business leaders who every year sign this check for $4 trillion. It's like I could no more be misaligned with my customer than I am. There is nothing about my job that is even aligned with my customer, much less trying to meet my customers needs or delighting my customer. Business leaders buy healthcare, but in my case, the more people that get sick and fall off the cliff and I wind up getting to treat, the more money I get to make. And they don't buy health care to fill up hospitals. That's not why they buy health care. And yet that was my job. So there was this misalignment, this perverse misalignment that drove me nuts. And eventually I left the treatment side of healthcare many years ago to see if I couldn't put fences at the top of the cliff instead of just building hospitals at the bottom of the cliff as people fall off. So that's how I got into this whole idea of healthcare and managing healthcare and putting fences and prevention. And obviously I've been working with the benefit consultants across the country for many years.

So that's how I got into this space.

I'd love for you to give a good definition because I think a lot of consumers.

And brokers alike get this confused that insurance, health insurance and health care are one in the same. And you know, from your time as a hospital administrator, that's not the case. There's a big difference between the health insurance company and the health care consumers receive. If I were to ask you to explain that insurance versus healthcare, how would you explain that?

Well, I like to do it from the customer's perspective. So healthcare is providing healthcare services. Insurance is simply a way to pay for it. But if you really go to business leaders and you ask CEOs and I have the opportunity because I speak to CEOs regularly, to ask them, why do you buy healthcare? You're the customer. What is it you want? Well, it's not that they want a hospital. What they want is to attract and retain top talent. That's their goal. The reason they spend the money is to attract and retain top talent. And they want a healthy, productive workforce because their product is better. Their customers are happier when their employees are more healthy and productive. And they want their employees satisfied and healthy, you know, and liking the services that's validated as good services is quality and they wish it didn't cost so much. That's what they want. That's what we're trying to produce here. And so it's not about what hospital does or what the insurance does. Is how are we working together to truly meet the needs of the customer? That's the perspective we should be looking at.

Yeah, no, it's. It's. I think you nailed it on the head. You know, I do work with advisors and agents, agencies on their brand message, and I have to tell them every single day, guys, your CFO you're trying to attract does not go to work every day trying to fix his health insurance or her health insurance. They're trying to attract good talent. They're trying to keep that good talent. You have got to figure out a way to fit yourself in that story. So I'm so glad you brought that up. So you and I met at a conference, I think it was. We may even have met through a mutual friend, Lee Lewis. You know, now you're in the industry, you're doing some great things as CEO of Orion's around the Wellness and working with wellness coaches and everything you're doing there. But what's really fascinated me was a phone call I received from you early this last summer about a conference, a virtual conference you were hosting Aspirational Healthcare. And before we get into what aspirational healthcare is, let's talk about nuka, the hospital facility up in Alaska that you uncovered, discovered, and you were absolutely blown away by and what's ultimately led you to create the movement Aspirational Healthcare. Talk about that. What. How did you uncover it? How did you come upon it? What did you learn?

So a friend of mine sent me a podcast where the medical director for South Central foundation, who's the one that created the nucas healthcare system, was speaking. And I listened to him and went, oh, my goodness. It blew me away. It's like, I never knew prior to that podcast that there was a healthcare system out there in the world that we could put on a pedestal and say, this is how healthcare should be done. And it truly is. This newcosystem of care that was built 20 years ago is, in fact, the best healthcare system in the world. Superior outcomes at half the price. And they've moved their entire population of almost 100,000 members from. From the low HEDIS scores of 5% now up to the top 75, and in many cases, 90%. That's what healthcare. That's what we should be producing. That's what buyers want, is a healthcare system that improves health and that creates incredible satisfaction. Their patient satisfaction is 97%. Their employee retention is 95%. I mean, it's like if there's an example of what employers want from what they're spending. That's it. And the story behind the NUCA system is one of the most amazing business case studies and stories I've ever heard. So about 20 years ago, back in 1998, the federal government passed a regulation that said, we offer health care to Native Americans through the federal Indian Health Care Services system, but we recognize it's not the best system. So if anyone wants to actually build their own system, we'll let them. And so this group of 190 Native Alaskan tribes said, we can't make it any worse than it already is. It's as bad as it could possibly be. Why don't we see if we can make it better? And so they decided to take over healthcare. And in doing so, they went out to their. They did something that no other healthcare system has ever done. They actually went to their customer and they said, what is it that you want? Wow.

Isn'T that amazing?

It's like, what does the customer want? Right? So what most healthcare systems are, are we're the institution of medicine where all the wisdom lies. You come to us and be the benefactor of our great wisdom. When you fall off the cliff and it's like, that's not what the customer wants. So what they heard after extensively for six months asking their customers what they wanted, the customer said, we don't want a paternalistic healthcare system that tells us what to do. We want a healthcare system that partners with us and journeys with us through life to help us experience life at its fullest, where the focus is on us, the customer, and helping us take ownership in our health. So this leader, Kathryn Gottlieb of the South Central foundation, went to their medical staff that they had inherited and said, we're going to build this. And the medical staff said, we don't know how.

We were trained to be diagnosticians to create treatment plans. We weren't trained to journey and partner with people. So they said, take a hike. They had the tenacity to say, well then take a hike. Which is amazing. That they were like, okay, well we're going to build this, so go someplace else. And over 20 years now, they've created the only healthcare system that's won the Malcolm Baldrige Award twice. They have moved their entire population in terms of health improvement like no other healthcare system in the world. And countries from all over the world traveled to Alaska to say, how can you do healthcare so much better than everybody else? And they put on conferences three or four times a year to say, and I asked them a year ago, so who comes to your conference. Well, Singapore, often considered the best healthcare system in the world. They earned from the nuclear. Sweden, Finland, uk, Canada. Do you ever get anybody coming up from the lower 48? Yeah, not very often. That's a problem. We need to send the message of what you've created right here in the United States out to every business leader in America to say stop putting up with this deficit based healthcare system that you're buying. There's right here an example of the best healthcare system in the world that's an aspirational health care system that costs half as much and gives you a much better product to attract and retain top talent. So we put the conference on this last July and it's all recorded. You can listen to the entire conference, it's free. It's on aspirationalhealthcare.com so this led you.

Then to really creating the aspirational healthcare movement. Right. And you know, I had a chance recently to hear you talk about it. What are kind of the principles inside of it, which blew me away. I was super fascinated. This is the part I really want brokers to hear about because kind of goes if you're going to be that advisor who is doing things outside the box or doing things that is really going to create change for your clients. I think the what I think what you guys are doing inside aspirational healthcare is the future of how we build health plans. So people heard what you just said. They're like awesome, Daryl. They're doing, what are they doing that is actually creating these amazing results? Why don't you, why don't you go into that a little bit?

Sure. So if you look at the architecture of what they built, they said, you know, if we look at our health, it's not so much what the healthcare system does to us, it's what we do to ourselves. And so they said, let's balance the focus of the healthcare system on the needs of the customer. So let's put some focus on making sure we can treat people that have a disease. But let's put a big focus on creating a massively powerful primary care system that influences people to take ownership in their health. And by simply focusing on that prevention and helping people take ownership and journeying with people and partnering with people to help them live healthy. They now have proven after these 20 years, healthcare can cost half as much. It's incredible story of how prevention truly works. So after the conference, a number of very innovative benefit consultants that helped me put the conference, I came in and they said we need to Keep this movement going. And so we said, you know, it's not about which health plan I purchase because I can't go buy Nuka. It's not available to me. It's only available to those 70,000 native Alaskans. But I can learn the principles that they built that were so successful, and I can actually build a health plan for my employees that mirror those principles and. And then let the industry come to me and bring my employees what they want. So instead of putting all our eggs in one basket, which is what we always do, which is, here's a money for a health plan, and I'm going to choose United or Cigna or Edna, and I'm going to let you choose between various deductibles. So there's different payroll deduction amounts, but that's. I'm going to choose that for you. No, say I'm going to put my money, take the same amount of money I'm spending, and I'm going to put it into four defined contribution buckets. I'm going to put some money over here into major medical, and I'm going to let people choose what they want with my money. If they choose something less expensive, they get to keep the difference. If they choose something more expensive, it's a payroll deduction, but it's a shopping cart idea where people can take advantage of all those solutions, even some that are not insured solutions, because maybe that works better for them. Now, the second bucket is for primary care. And we really don't want people using the major medical traditional primary care system. Why? It's a funnel for the health care system. It's about sending people to specialists and about giving people a prescription. But it's not about relationships. It's not about partnering people. Primary care physicians don't have time to do that. So we want people involved in a subscription model of primary care, like direct primary care or virtual primary care, where the primary care providers are incented to keep us healthy and they work with us. And they spend a lot more time building relationships where they're more of a. They're aligned with both the buyer, the employer, as well as the patient to keep people help in the first place. Now, I'm not going to force you into dpc. I'm going to give you money in a bucket for you to pay for that retainer. But if you don't want it, fine. I can't force you into using it. Go ahead and just use your measurement. But you don't get the money. The money I'm putting in this bucket is specifically for you to have a better primary care front door to the health care system that's going to coordinate your care. Third leading cause of death in America, according to Johns Hopkins, is medical errors. Why are there so many medical errors? Because we're requiring the customer patient to be the primary communicator between all these various specialists. So if I've got a DPC or a quarterback that's really invested in my health, they become the primary quarter communicator, which is incredibly better. Now, just because.

I've got a direct primary care physician doesn't mean that that DPC was trained in partnering with me to help me and influencing me to take ownership of my health. And what Nuka had to do is they literally trained these doctors, these teams of doctors and nurses, how to be coaches, made it very clear to them that their prim role was to influence people to make change. Well, we're not going to be able to go out there and train all the doctors again. So the third bucket is money. That's an incentive for people to engage in a relationship with an influencer like a health coach, like a behavioral focused health coach, or a success coach, or a life coach, someone who's going to actually work with them on an ongoing basis to help them experience life at its fullest, not tell them what to do, but help them make the changes that they already want to make so that they can enjoy life better. So I'm not going to tell you you have to work with a coach, but if you will, I'll give you money in your pocket to do that. And then the third bucket is simply a medical savings account that they can have roll over every year and can be used to pay for co pays and deductibles, but it creates consumerism. So that's the four defined contribution bucket strategy.

So, okay, if I heard you right, we've got one bucket's major medical, then we've got this, I called it the subscription based primary care, you know, the primary care where we're actually giving you the right kind of gateway to the healthcare system. You've got the money that's set aside for you to impact or get in touch with an influencer, like a wellness coach, a health coach, a mental coach, whatever that might be. And then you got the medical savings account. But at the end of the day, what you're doing is you're giving that employee the absolute control over who or where they go to spend that money.

Yeah, yeah. And clearly in order to facilitate this, that's A lot of work for an accounting department of a company to try to administer. So there's a TPA that has built the infrastructure to administer this to make it very simple for an employer to simply say, here's how much money I'm going to put into each bucket. Employees can jump on a platform, make a selection, and then the tpa, instead of paying claims, is simply paying based on what that person chose. Whether it's the retainer for the DPC or the premium for the major medical plan, or whether it's the incentive that goes to the actual employee for participating with an influencer, putting money into that medical savings account. The TPA administers this new design.

What are your thoughts? Because I know we talked about this on our previous call. You know, there's that theory of even though consumers say they want to be able to have control of what they do, at the end of the day, do most consumers like the fact their employer just picks their plan for them? Is there any data that backs up that the consumers really love this model because it is giving them the freedom to use those dollars the way they want?

Right. Our experience and our research shows that about 90% of people love the idea of making Choice. There's about 10% that are like, you've always done this for me, just do it for me again. But the key to rolling this out is what Nuka found out. Nuka found out that what people want is a relationship with a small group of people that they can have an intense relationship of trust with, that all healthcare goes for them. So you roll this out by simply saying everyone's going to get a benefit partner who can explain this whole thing, help them understand it, actually answer ongoing all their questions about their benefit. A medical partner, an independent medical partner, that retainer based primary care that can be the gateway to all their healthcare and can quarterback all those services, and that coach partner that's going to be there to help influence them to take ownership of their health. And the key is that there's an intense long term relationship with three people, not 100, not zero, but. But that relationship now is through which all healthcare is accessed. Both staying healthy, understanding my insurance and all the idiosyncrasies of that, as well as all the needs, healthcare wise. That's how you build healthcare, that builds employee satisfaction, that then drives the ability for an employer to attract and retain top talent.

Well, okay, so we need employers who are more motivated and driven to build health plans like this. Right? To attract and retain the top talent, but often to do that need a good broker, they need a good advisor who's going to help them create this type of plan. And you're the community that you're building for aspirational health care is as much for the brokers as it is for those employers who want to make change. So let's talk about the ideal broker who's a great fit for aspirational healthcare. You talked about the three pillars that brokers really have to abide by or follow to be considered a fit for aspirational healthcare. Why don't you talk about those pillars?

Right. So we actually said with these innovative benefit consultants or brokers, let's build a movement and let's have a aspirational healthcare advisors group. And we don't charge brokers to be a part of this group. We simply ask them to abide by three things. One is you work for the client company, not the broken healthcare system. Meaning that your commission, your compensation is through a direct contract with the employer where it's a fee based contract. And then all the incentives or bonuses are based on you helping the employer reach their business objectives for why they offer benefits in the first place. And that's the second requirement, that you help the employer build a strategy where they decide an outline what is it that they want, why are they offering benefits? I want to attract, maintain tough talent. I want a healthy, productive workforce. I want employee satisfaction, I want to drive down costs. Well, then create a strategy where those are the goals. And then monitor to see if you're reaching the goals. And then the broker gets more compensation and earns more money because you help the customer reach the goals and the whole healthcare system now becomes aligned to reach those goals. And the third thing is as advisors that are implementing these, share the results of those monitors with everybody else in the group so that we can make them public and the public can see that. Just like they can see with nuca. When you build healthcare around the customer and you actually monitor to see if the customer is getting what they want, you can produce superior healthcare, amazing outcomes at a significantly lower price.

Okay, cool. So wrapping up. If I'm a broker, advisor, consultant, whatever you want to call these innovative folks that we work with and they want to be a part of this movement, what are the best ways they can get involved? What do they need to do?

You can just email me, actually you can go on that website, aspirationalhealthcare.com learn a ton about this movement, but simply email me and we'll kind of go through just a conversation and see if You're a good fit. And if you want to participate. And again, just abide by those three things.

Well, Darrell, this has been awesome. I want to thank you. I got your email address right here on the video, so if you're listening in or watching, hit Darrell up@darrellryan.com. that's O R R I N T dot com. And Daryl is.

O R R I.

A N T I A N T.

I I. I misspoke. And it's Daryl. Two Rs, two Ls. But, Daryl, I know there's a lot of work that goes into this movement, so I want to thank you. I know you are very. I always get excited for our phone calls because I know when Daryl gets on the phone, he's going to be super passionate about something. And, yeah, I just want to thank you for the efforts and the work you're putting into making this industry better, because we need people like you who are trying to move it forward. If you're an advisor listening in and you want to become part of that aspirational healthcare movement, hit Darrell up. Go check it out, you guys. If I'm right, Darrell, you guys meet a couple times a month.

We do. We give everybody a chance to get on a call and collaborate and share best practices and best experiences and really move this thing along.

Awesome. And if you're an advisor listening in, take this to heart. Listen to what Darrell had to say. If you want to be different, you actually have to execute different. Pontification and execution are two different things. So get ahold of Darrell, become part, and you and your business and your clients will never, ever regret it. So, Daryl, once again, thank you.

Thanks, Andy. Appreciate it.

Another great episode of the Broker's Voice. Until next week. Remember, when clarity and confidence collide, massive action happens. Go make it happen today.

Thanks.