Tracy Saula: Senior Vice President/Chief Product and Experience Officer for Highmark Health Shares Role with the Health Organization and Commitment to All Consumers

At Highmark Health, we believe what makes us unique makes us better. Our differences broaden our perspectives and foster a variety of skills to complement each other, creating a stronger and more vibrant workforce. It's this belief that earned us recognition as the Best Place to Work for the 10th year for individuals with disabilities in a survey by the American Association of People with Disabilities and Disability:IN. We'll continue to celebrate and benefit from the inclusion of all people. To find out more, visit highmarkhealth.org.

Welcome to Disability Matters with your host Joyce Bender. All comments, views, and opinions expressed on the show are solely those of the host, guest, and callers. Now the host of Disability Matters, here's Joyce Bender.

Hi everyone, this is Joyce Bender, Disability Matters on Voice America. I want to wish you all a wonderful day, especially all my listeners. I know I tell you this all the time, but I always think, wow, what would I do if I didn't have all these listeners? I'd just be talking to myself. But you know, you are 22 years. We've been on together for 22 years. And when I go somewhere and they say, oh, I know you. I listen to your radio show. I'm always like, Wow, so overwhelmed. And I mean it, thank you, thank you. I'm going to ask you, please remember, tell your friends about the show, especially people with disabilities. You know, we really work hard to try to get the news out. You all know we have Jennifer Mathis, uh, who is internationally renowned for a mental health, uh, expert, disability rights policy expert, frequently in the New York Times. That's my Mathis on the mic every week. Jennifer's on every week with a little news break, a powerful news break. And don't forget, all you listeners around the world, oh my God, you mean so much to me. 131 countries. 131 countries have listeners. And I highlight the country. So here we go. Bulgaria. Bulgaria has listeners. Thank you, thank you. I mean it. I so appreciate all of you. You remember what I always say, I don't care if you're one, one person can make a difference. But I have to shout out Singapore, number 2 after the United States with the most listeners. Wow, thank you, Singapore. Here we could be like the draft. I could be doing the draft on my radio show. In case you don't know why I said that, we just had the NFL draft in Pittsburgh, and one night, guess what we had? 800,000 people. I don't know where they all stayed, where they all came from, but thank you for supporting the city of Pittsburgh. Joyce Bender: So, you know, I'm a woman that lives with epilepsy and the CEO of Bender Consulting Services and the chair of the Bender Leadership Academy. I'm all about one thing, employment of people with disabilities. And that is why my guest today, one of my most favorite people, I mean it, like when I knew she was gonna be on, I was so happy. Not that I'm not happy with you other guests, but like, She's special to me. So you have her on, it's just so awesome. And here's why. What do I always say? Don't tell me how nice I am. Don't tell me how wonderful I am. Hire someone. Okay? That's where the rubber meets the road. And guess what? Tracy Sala hires people with disabilities. And by the way, not in low-level roles. There was a day, and sadly there is still some days, when I call a company, "Hey, do you have any openings?" "Oh yeah, call center or customer service." There isn't anything wrong with those jobs, but not all people with disabilities should be in those jobs. And Tracy, who is Senior Vice President and Chief Product and Experience Officer, is one of the lead executives at the third largest health insurance company in the United States. Tracy, welcome to the show.

I'm happy to be here, Joyce. You are likewise one of my favorite people.

Well, you are, you are a champion because 70% of people with disabilities are still not counted in the workforce, and yet I'll let Tracy tell you later on about the people she's hired and how they do. But let's start with your journey. So we have listeners around the world, throughout the United States. They always want to know, oh, I really like that person. I want to know more about them. So where did you grow up, go to school, build a family, and then get into the field you're in today? Let's hear, let's hear your story, Tracy.

Sure. So I grew up here east of Pittsburgh in an area called North Versailles. So it's an eastern suburb. I really have never left the eastern suburbs of Pittsburgh. My mother is still there. My father's passed away, but my mom is still there. I'm an only child, so I'm certainly not going to leave her. I have two sons. They are both adults at this point, and they both still live at home with me, but they are both young adults, which I actually love having them with me. I went to school at Duquesne University for accounting., and I graduated, and I became a CPA, and I started working at the public accounting firm KPMG. And it was there— I did all manufacturing work, no healthcare work, but I was there for 3 years, and I met a bunch of people like Karen Hamlin and others who had been at KPMG but left and went to Highmark. And this is right when Highmark was formed. We're talking 1998 at this point. Highmark was formed in 1997. They had it all jumped over to Highmark and they reached out to me and said, hey, why don't you come work with us? It was some financial analyst job in finance. And I jumped over and I've never looked back. This will be in July 5th of this year. I will be here for 28 years. So I've gone from finance to audit and consulting strategy. I went and I did a little stint over at Allegheny Health Network, came back here and through a number of moves ended up in my, my current role. So I've kind of been everywhere, but I've been here a very long Karen Handel, such an awesome person.

So you all know she is second in command over all of Highmark. And I have to tell you a little Karen story. So when she was on, she was talking about her career and being in college. And she said, and that's when I failed calculus, which is hilarious.

I said, you know, Karen, who was the CFO before you moved up to COO?

Oh yeah, yes. So I was out to dinner with Karen and another EVP. Well, Karen's COO, but Carolyn Daronio, who is general counsel at Highmark. I told that story. She said, you're lying, Carol. Karen, that's not true. That can't be true. You're not telling the truth. She said, no, yeah, I really am telling the truth. But she was trying to encourage young people that, you know, you may hit something and think, oh, see, I'm not going to make it. Look at her. That's right. I mean, second in command of Highmark. So, you know, that's why you never give up. Never, ever give up. You keep going. So here you are at Highmark. Did you ever think you'd be doing what you're doing today?

Never in a million years. Never. I mean, I thought maybe I'd stay here a while. I thought I would be in the finance area or in the audit area. I never thought I would have gotten over— I never thought I would have gone to Allegheny Health Network, and I never would have thought that I'd be doing what I'm doing now.

Yeah, you were— when you were at Allegheny Health Network, and so you all know, uh, Allegheny Health Network is owned by Highmark. As a matter of fact, Highmark saved them. Because Allegheny General Hospital, I mean, they were on— they were bankrupt. They were going to be gone. And Highmark saved them. And now 14 hospitals. I mean, look at them now. What did you do there? So I—

it was when— this is when we were in a contract dispute, candidly, with UPMC back, you know, a long time ago, maybe like 10 years ago. And Allegheny Health Network, we were facing a situation where our biggest, their biggest competitor provider system was saying that Highmark Insurance was no longer gonna be accepted by them. And that's where Highmark stepped in to save Allegheny Health Network to make sure that we had choice in our community and that our members would have access. But in the fear of not having access to the largest provider system in our market, we had a bunch of growth to do. There were these investments we needed to make in our women's service line, in our emergency room access. We built the hospital in Wexford, oncology access, access. And I basically went over to help with all of that growth. So I led a lot of that growth in partnership with my then boss, who was the COO of Allegheny. Wow. It was fun.

I didn't even know that.

Yep. I did it for 3 years.

Yeah. You are like Chief Growth Officer.

It was fun.

Yeah, that is really awesome. Well, that's how you got to Highmark.

And do people know— hey Joyce, don't forget to tell people that Allegheny General Hospital, which is the flagship hospital of the Allegheny Health Network, is featured in the TV show The Pit. So if you ever watch the show The Pit, all of the hospital scenes, the park scenes, all the stuff, it's— and it's really cool because there's a big presence here at the hospital. The actors do a lot to give back to the hospital, and it's just a very cool, neat presence that they have here. But that's the hospital that's featured.

Yes, you know what? Just yesterday I was on a call with the American Association of People with Disabilities and Verizon was on and Amazon was on and Wells Fargo, you know, all these. And I said, oh, I'm from the best city in America, Pittsburgh. And by the way, we have The Pit here and it won awards. Noah Wiley.

Yeah, when it first came out, I thought to myself, okay, you have to watch it because it's Allegheny Health Network, like, you just have to do it. But I wasn't anticipating that I was going to like it as much as I did. This is back in the first season, and I started watching it, and I thought, oh my, this is such a great format, it's such a good show. And you're right, it's won all these awards now. It's no longer an obligation to watch it. I genuinely enjoy it.

It's great. Yeah, yeah, it is a great show. And The CEO, Mark Sevko, was the king of the Mardi Gras.

I saw that.

And Mardi Gras is a fundraiser for the Epilepsy Association, which I'm the chair of. And we did a video, and I was in the video where we were pretending Mark had an accident on his motorcycle, and now he was in the hospital, and we had to get him to the Mardi Gras, and all these different Executives were in it and then I walk in. And what happened though, I really, really was like into this. And so there's a bloopers coming out.

Okay.

I think I pretend that I'm going to hit Mark Sevko because he's not ready for the Mardi Gras. But I got to tell you, Mark Sevko, the CEO of AHN, is just the most wonderful person. Uh, so kind. Like, it took me less than 5 minutes to say, and I want to get people with disabilities hired at AH. Okay, let's go.

You know, success there.

Yeah. And that, that's what Tracy is like though. Tracy is all business. Okay, she's like a tornado. I'll tell you that ahead of time. And she, but she's all business, you know. Don't give me any baloney, just the bottom line. And so she was a perfect target for me. Why? Because Karen told me about that. And I am all about bottom line. But of course, when you hire people with disabilities, it's not for charity. Paychecks, not pity. It's a business investment. So Tracy, you have hired several people from Bender Consulting and at a senior level. I wanted you to talk about them and how they've done.

Absolutely. We hired— well, gosh, we probably hired about 5, 5 people over the past couple of years that are all, all here. I will tell you, all of our hires from Bender Consulting have been extremely successful in delivering the value to us, to our members, you know, to our organization. And it's funny, you remember, Joyce, when you you were bringing me the candidates, I would always say to you, you know, I'm going to make sure that all of your candidates get, you know, definitely interviewed, they get into the process. But once they're in the process, they have to earn it. You know, this paycheck's not pity, so they have to earn it. They have to show up. These were product management and analyst type roles that are higher level roles. They've done great. You know, I can give you some examples. I wrote down some examples that I was thinking about last night that I could talk to you about. One is we have one that joined with a ton of product management experience. She was in a clinical product management team, quickly established herself as a leader amongst her peers, you know, someone that was, you know, able to think big, was able to kind of work extremely independently, rallying the team around problems that they had, became a real connector between our team and other teams in the organization. Organization that needed to be connected, kept taking on more scope without asking for anything more. And at the end of the day, we have now promoted her. So now she's in management over that team. So that's an example of someone, you know, we have other ones. I'll tell you one of your candidates.

Excuse me just one minute. I want to make sure you heard that she was promoted. See, this is what I love about Tracy and Highmark. She was promoted. So this isn't a place where you get stuck. We hired our person with a disability, you get stuck. She proved herself and was promoted. Go ahead, Tracy.

Absolutely. Absolutely. I would tell you another thing that your team members that you have brought to us have shown great passion for is their fluency in AI. And it's been a theme that the folks that you have brought to us have been more pioneers in using AI to speed up how they get work done. Some of them are serving as AI champions in our organization. And as an AI champion, you're not only committing to use AI to transform your own work, but you're also encouraging, leading, helping others in doing the same. So that's, you know, an example. One specific example that I can remember was we have this super complex insurance product data set. So if you think about you know, your insurance policy you have that says you're eligible for this at this copay, or you can have this many visits to this kind of service, and it costs you XYZ if you're in-network and out-of-network, and it's super complicated. And one of the individuals who joined our insurance product team, we're trying to do an initiative where we are taking all of this complicated logic and simplify it and say, we can— all of this doesn't need to be very customized and coded into the system. We can create configurability and easier way to build these products, but it, but it involves having to dissect and understand millions and millions of provisions that have built up over years. And one of the folks that we hired from Bender, you know, has been taking a leading effort in using an AI tool to uncover trends, to be able to sort of tangle, untangle all of this logic. So like a really, really big effort that we have going on in the core of our insurance product. That's one of, one of the Bender hires. And another one I can think of, we have an internal— think of it as our internal ChatGPT kind of tool. It's called Sidekick. And another one built this product artifact that we have to use when we're building products, like a document that you have to kind of complete. They built basically an app that enabled them to automate a lot of that product artifact and then trained a whole bunch of people on the tool and is, you know, helping a bunch of people to figure out how to use it. So I mean, those are just a handful of examples, but you know, we never hired your people just because they had disabilities. Like, we— that wasn't even a thing. It was that having a disability got them the interview through your firm, but we hired them because they had the right skill set and they're being successful because they care and they're great employees. So We've had a wonderful experience over the past few years.

And a cabin. Yes, I have to tell the story.

You have to tell the story.

I have to tell this story. So I knew him, this young man, I knew him from years and years ago when he was with WellPoint, even before they went back to being called Anthem. And WellPoint, when they went through that change, had a very large layoff, and he was caught in it. He was in IT there, and he was a project analyst. And then he left and he went with a consulting company. And then after being there X amount of years, they had a layoff. And then he went to another company, and he was there. These were all IT-like consulting companies. So if they lose the contract and you're on it, then you don't have a job. So one day, you know, here I didn't know him. He would keep in touch with me every so often. And one day he said, you know, if you can help me, I'm looking for employment. I said, oh yes, you know, send me your resume. Because I remember that the CIO used to say he was one of the best people there. So, um, he interviews, but what we didn't know is because he hadn't worked for a while, he was doing like menial jobs on the side. And, you know, his disability is something that caused him sometimes when he interviewed, uh, when you're neurodiverse, there can be, you know, people that are The way they are with people with epilepsy, stigma. But anyway, he's just a great person. And so he interviewed in Tracy's area and then Tracy's, they called me and said, hey, we're going to extend Kavett an offer. Oh, we were all so excited. So we called him and at first Human Resources or someone told us we're going to call him around 3 o'clock. So he said, okay, well, I have to go shopping, so I'm going to go early. Well, he went early and guess what? They decided to call him at 1 o'clock. So he's in the parking lot about to go food shopping and he gets this offer. And that's when he calls my office and tells my talent programs specialist, Jill. Jill, I don't have to go back to the food court, the food bank. Oh, and it was like Christmas. It was like we were all crying here in the office. It was sort of like a Hallmark movie. I don't have to go back to the food bank. That is what you did for him. That's what you did.

Well, and that's what he did for himself. Like, and you, Joyce Bender, you know, I wouldn't, I wouldn't have found Kavett if it wasn't for you. And that's the point. Like, I, you know, Kavett would have been in a sea of, you know, maybe 1,000 resumes, or wouldn't even have known that the position that I had was available. What you do, though, is you bridge those connections. So I met Kavett, we met Kavett because of you. And that's the important role that you play, because otherwise, how would he have found us? How would we have found him?

I have to tell you, like, I know you're saying that, but Tracy Sala is a beautiful person outside, inside. She really is. Um, she is— doesn't even know how awesome she is. So I hear everything you're saying, but like You have to be willing to interview the person. You have to be willing to give them a chance. And you have. I agree with everything you're saying because the reason I'm all about business and no pity is if the person gets the job and they're not doing well, absolutely they can't stay. Because if they do, it's going to hurt everything I'm doing. It's going to, you know, oh, I got stuck with that person. You know, that's what's going to happen.

That's what used to happen to women.

When they first start working. If you like, if, you know, if they weren't the top performer, oh, I got stuck with that woman, you know. And so that's— yeah, look at us now though. And that is what would happen. Do you know what I mean, Tracy? People wouldn't want to hire anyone. Yeah. Oh, I understand, which is what you're talking about. So let's talk about Heimark Health. First, what does your division do for the company? How large is it? And when you're looking for someone, what do you look for? Someone's listening to the show now. Let's hear about Highmark, your division, how large it is and what you look for.

Yep. So my division for Highmark— so I work for the insurance part of Highmark. So Highmark Health is our parent company. I work for Highmark, which is the traditional insurance company. And I have kind of two parts to my organization. So my organization in total is 800 people, give or take a few large. About 400 of those are in an area called, um, Health Experience Organization. And this is our nurse case managers, our pharmacists, our behavioral health specialists, our social workers, our wellness coaches. These are the people that engage with Highmark members who have health challenges, who have been in the hospital, and they try to help them, you know, wrap themselves around them to help them get the care that they need. So, you know, when you think about that group, it's a different talent profile than the other part of my team. But the talent profile there are basically those disciplines, you know, nurses that have some kind of case management experience. Social workers, pharmacists, people that want to engage, you know, telephonically or digitally with our members who need support. So that, that's the talent profile that I have in that particular group. And that group works all remotely. So because they're on the phone, they're engaging all the time. There's not necessarily— it doesn't matter where they are to work. They don't necessarily have to be in the office. They work remotely. The other half of my team is the— what I would say, the product and experience side of my team. And if you think about insurance, this is probably the easiest way I could describe it. I tend to think of an insurance card like a gym membership, right? You have a gym membership, and you could have a gym membership— and let's pretend like it's the old days and it's not an app, and you actually have like a card you had to show when you went into the gym— and it could have been a really good gym that had a pool and yoga classes and all this fancy equipment, or it could have been a gym that had barbells, you know, that might have been it. And, you know, if I think about us, what do you get when you get a Highmark Insurance policy? You get that plastic card. And now we're trying to get you to get that card digitally. So you might not even get that. But really, what is the product that you or your employer are buying? It is all of the services that we offer. It's your claims get paid accurately. It's when you have a question, we answer that question appropriately. It's that our digital experience is good. All the, you know, we have a network that meets your needs and you can seek the care that you need and you get it timely and it's paid for. So a lot of what my team is focused on is making sure that that experience that people have with Highmark continues to mature and evolve over time, whether that's the insurance products that we put on the shelf and sell or the services and experiences that exist in support of those insurance products. That's where we spend our time focusing on constantly trying to make those things better for our members. And the kind of candidates that I'm looking for on that side of the house are more product management, strategy analyst. I think there's a lot of business cases for investments that we're going to make. So, we have a lot of analyst-type roles. That's more what I'm looking for. And also, on this side of the house, designers, digital people, you know, that kind of, that kind of talent. So it's kind of a tale of two, two cities. They sit separately and differently.

And when a new product comes out at Highmark, would that be in your area then? Yeah.

Yes, yes. Or a new digital experience or a new solution. You know, if you hear we have a new solution for X, Y, and Z, a health solution, navigation solution, whatever that might be. Yeah.

And what would a digital experience— what would that be?

Um, an example would be My Highmark. So that would be, you know, our, um, our, our app and web experience called My Highmark. That would be an example of one. So, you know, if you think of, uh, you know, PNC Bank, you can do your online banking. You know, a lot of people think they have to call their insurance company to get their problem solved, but we have a pretty robust digital experience where you can self-service a lot of information that you need and access different solutions and programs that are available to you as well. So that's an example.

Yeah.

And that, that has really taken off, to say the least. Now, I know you talk and Karen talk a lot about being patient-centered or patient-centric that I know Karen and David are really focused on that. What does that mean? Like, what are you trying to do?

Yeah, I mean, I think— I mean, candidly, you're trying to help people to live the best life that they can, right? You look at healthcare, and healthcare is so frustrating for people. I mean, we're just— I mean, every one of us that even works here recognizes how frustrating it is. Such a fragmented industry. The incentives for the different players in the industry don't always align with the behaviors that we would want people to take. Like, it's just a very— there's a lot more wrong with it, I think, than there is right. And it's very systemic and it's a very large problem. But I think at the end of the day, what is our goal? Our goal is to help people to live their healthiest and happiest lives that they can live for as long as they can. And, you know, that is what That is a lot of what we're focused on. We're rolling out this week— we do strategies in 5-year increments— and this week we're rolling out our 2030 strategy to all of our 40-plus thousand employees. And, you know, embedded in that strategy has these 4 promises that are, you know, in all of our research that we've done with the people that we serve, that are their, you know, biggest pain points and also our our biggest opportunities. And the 4 promises are: know me, guide me, care about me, and don't fail me, right? And you think about, like, when you call your insurance company or your healthcare provider, you want them to know you. You don't want them to see you as a number. You want them to know you, how you think, how you feel, your health history, how to engage with you in a way that works for you, you know. And our people consistently tell us, I feel like a number. In the healthcare system, and I want to feel like I'm known. Guiding me is, it's so confusing. Can you give me good relevant information to help me make good choices for my health? Care about me is much more around, there are moments in everybody's healthcare journey, whether it's, you think when you were first diagnosed with epilepsy, or when someone has their first child, or somebody has a cancer diagnosis. You're irrevocably changed after those moments, right? Like, how do we show up in those moments to help people to get to the next step? You know, health insurance doesn't traditionally do that. Like, we want to fill that gap and do that. Or let's just say that you have a complex health issue and an authorization, a prior authorization request was denied. Should we wait for you to call us, or should we maybe be proactive and say, how do we reach out to people and go, hey, you had this auth denied, we should, we should talk to you about that? This and help you to your next step. So there's a lot in this strategy about how do we help caregivers become part of the equation. It's very challenging for caregivers to be part of the equation for their children, for their spouses, their parents, whatever. Um, and the don't fail me is, you know, there's, there's a lot of moments in healthcare that can get rocky, but there's some that really matter. I want to understand my benefits. I want to know what something's going to cost. When I have a question, I want it answered sufficiently the first time. Basics, right? Doing that well. So, you know, a lot of our strategy work that's now getting underpinned with what is the actual core work we're going to go do is really around what I just said in those 4, those 4 promises.

Wow. Well, you know, anything that makes it easier. That's right. Because it is, as you said, daunting and scary and You know, when you have something occur like that. So that's wonderful that you're doing that. And it's on the half hour. It is time for Mathis on the Mic. And Jennifer, I was talking about you earlier and how famous you are. Hardly. Well, Jennifer, what new— you know, every time you come on thinking, What news is this going to be? So what news is this today?

There's always something. Um, so, um, this week is actually, uh, the news is a sequel to last week's news. Last week's news was that the Justice Department had issued an interim final rule that changed the deadlines for, um, the, their web accessibility rule, right, for web content and mobile apps, um, that need to be accessible to people with disabilities because they're used by state and local government entities in their programs and activities. And so, um, they had issued that rule in 2024 at DOJ after many, many, many years of both people with disabilities and frankly regulated entities asking for a rule that provided some standards. What do we have to do to ensure accessibility? And so at the 11th hour, right before the rule was going to take effect for larger public entities, DOJ issued this interim final rule without prior notice and comment saying we're going to extend the deadline by another year. So for larger public entities, instead of April 24th, 2026, it would be April 24th, 2027. And for the smaller public entities, it would be a year later. And so that's a lot of time, particularly since many people in the disability community had wanted the rule to take effect much quicker so that they could have access. Because all of the time that we have not had a standard, people have often, too often, been left without access to websites and mobile apps to basic public services, courts, and tax documents, election websites, park, parking, mobile apps, all kinds of things, if they have disabilities that impact their ability to use the web or mobile apps. And so very important, very disruptive that, The Justice Department waited till the 11th hour to then say, oh, never mind, after people had been preparing for 2 years to have that rule go into effect. So what happened now is that HHS, the Department of Health and Human Services, which had a parallel rule for web and mobile access, website content and mobile app access for recipients of HHS funds, they're doing the same thing. So they just issued— but well, they haven't issued anything yet. They have sent something to OMB that is labeled also like DOJ's an interim final rule Uh, it says that it's about the 504, Section 504 rule that they issued also in 2024, shortly after DOJ's web rule. Now, HHS's rule is much, much broader than just about websites and mobile apps. HHS's rule is about many, many different things. It's about all of the application of 504 to their programs, to programs and activities that get HHS money, which is a lot, like most of healthcare. And they— we don't know what exactly is in this interim final rule because we haven't seen it yet. It hasn't been issued yet. We just have a notice that has gone to OMB, a public notice. Saying that they plan to issue this interim final rule. But I think we have a pretty good idea what's in there based on what just happened with DOJ and the fact that HHS had parallel provisions that applied to mostly to the same entities because everybody that was covered by DOJ's rule for the most part is also going to be getting federal money from HHS and is going to be covered by HHS's rule. But also, there's a lot of entities covered by HHS's rule that aren't in DOJ's rule. Doctors' offices, hospitals, all kinds of medical facilities, right, that were required by HHS's rule to have their services and activities that were delivered through websites or through mobile apps be accessible by— theirs was by May 11th. It was slightly later than DOJ's because their rule came out slightly later. So their rule was to go into effect May 11th. So I think, just an educated guess, that we can expect that when that comes out, we'll see, like the DOJ rule, an extension by another year for the larger entities. I think it's the way they divided the line was for recipients of HHS funds that have at least 15 employees, and then the next year was going to be smaller entities that get HHS money. So Here's what I think people can do for right now. We don't have a rule yet, so there's nothing— there should be a public comment period, even though these interim final rules get issued regardless. There's no public comment before they come out, only after, and they don't have to change it necessarily. So what you can do is you can request a meeting with OMB. This is what many people did when the DOJ rule was at OMB. Request a meeting. If you— you can find this on the OMB dashboard, but if you Google RIN, that's the identification number, RIN, and this— here's the number. It's 0945-AA30. That will pull up the dashboard and pull up the entry for this particular thing. There's a place you can click on that says "Request EO meeting." You can ask for a meeting where you say to OMB, "This is important to me. I don't think we should have to wait for another year for accessibility in healthcare services that are delivered digitally. And it has been— it took 14 years to get the original DOJ rule and HHS rule since DOJ had started a rulemaking many, many years before. And this was a long slog and people shouldn't be left behind for more time. So that's what you can do. Again, Google RIN Uh, okay, now listen. 0945-AA30.

One more time.

Okay, RIN 0945-AA30.

Arcana, you've always responded when Jennifer has asked these things, so you got to do it. This impacts all of us, not some of us. You've got to do it. And Jennifer, you can tell us what to do the next time you're on. Okay. Thank you. Thank you. We'll see you. Bye-bye. Take care. Bye. Tracy, we are the only place in the world where we have the news every week. You know, disability-related news. Yes, because we don't have a CNN. So Here we have Mathis on the mic. But as you can see, that's extremely concerning if you're blind, deaf, intellectual disability, speech difficulty. I could go on and on. So I hope, I just hope and pray that something happens here. Speaking of this, I want to make sure I get to ask this one question and then I'll go back if we have time, which we do. During COVID I remember telehealth just getting going. I mean, it wasn't like that everyone was doing it. It was just— I even remember I think it was David saying, "We never dreamt it would take off like this." Could you talk about that? Because I think that was unbelievable.

Sure. And I think what happened during COVID telehealth had existed and all of our people for the most part had access to some version of telehealth, but you just didn't see the usage. People weren't comfortable with it. And I genuinely think it was because it wasn't something, it was something that sat sort of separate from their own doctors, right? Like it was this other thing that sat somewhere else. And what telehealth really did was put their clinicians, their doctors in the lead. They said, "Well, you're not gonna come into the office, but there's a lot that we can do over the phone where I don't actually have to, you know, have my hands on you or you're not getting a diagnostic test at the time." So I think it was really the fact that it was the doctors leading the charge and saying, Trust me, this will work. That really made the difference. I will tell you one place that it has made the difference probably the most to me is where we've had— where we don't have access, right? If you think about in rural areas where there isn't access, or people who are disabled and can't easily get to an appointment without perhaps assistance, it's helped. I'll tell you, mental and intellectual disabilities, you know, if you think about behavioral health services of all shapes and kinds. Massive shortages. It's— people can wait, you know, you can have a person who's depressed or is suicidal and has to wait a month to try and see a doctor. That month matters, right? And it has really just opened up the world of like— we have a behavioral health virtual service that can get people into an appointment in a day. They can get into either talking to a therapist. I think it's a 2 or 3-day wait to get into a psychiatrist who can prescribe medications. That's life-changing. It's absolutely life-changing, the access that that has opened up for all. And it sort of has equalized that for everybody.

Yes. And even if you have lived with epilepsy, a lot of people, no driving, they don't drive. So now, you know, they don't have to wait. And that, that I know how I would feel. So I mean, that is wonderful on so many counts. Elderly people, you know, don't want to go. I would say that actually, have they studied this? Maybe they have already. But I would think that would improve health. You know why? Because people that, let's say I have a mental health disability. I'm ashamed. I don't want anyone to see me because a lot of people, you know, they still have to deal with the stigma that we have. And they maybe don't want to go. Now, telehealth.

We've seen a lot of that, you know, with our behavioral health program, we call it our mental well-being program, when we first launched it, we were really surprised by the high, high, high number of people using it who had never sought behavioral health care in the past. And we do think a lot of that was there was a stigma, right? This felt a little bit more anonymous. You didn't have to actually get the courage up to walk in and sit with somebody face to face live, you know, that sort of thing. But we've seen a ton of— it has broken down the stigma. We talk about it all a little bit more. Openly than probably would have in the past. And I think that's good and healthy. Mm-hmm. That's good.

Yeah. Well, you're nonstop doing things, but you're not just doing things for the patients. You're also using digital innovation to help the clinicians. Now, how are you doing that?

Yeah, I mean, there's a number of things. I mean, I can even speak for our nurses that we have at Highmark, but we're doing these same types of things with the doctors and nurses and clinicians at Allegheny Health Network. When you think about how medicine has changed over the years, and then you're sitting there in the office and your doctor's asking you questions and typing and typing and typing and typing. If anyone's been to a doctor recently, a lot of them don't do that typing anymore because they come and they say to you, hey, I've got this little assistant on my phone. And if you approve, I'm going to have this assistant listen to our call and it'll, you know, type up the notes for me at the end. And then I can be present with you. I just had a doctor's appointment at 11 o'clock today where my primary care physician said, I'm going to use this, this tool. And it really, it does two things for the physician. One is they can be present with you and they're not worried about what am I putting into this, you know, medical record, and they're not typing the whole time. They're, they're present. And the amount of time that doctors have to spend— they call it pajama time. So like, you're done seeing your patients for the day, you've worked a 12-hour day, you're home, and you now have to write all these notes, these clinical notes. And they used to call it, you know, pajama time because, you know, that's what they were doing at night. And, you know, when you talk to the doctors, they will say the amount of pajama time that this has freed up because now AI and digital tools can basically summarize all of those notes, and they're just doing a quick check to make sure that everything was captured accurately. And it's a massive saving. Another thing that I will tell you these tools do, I'm using this with my case managers here at Highmark, is the same kind of ambient listening tool. And it's not just about the charting and writing the notes, but it's also about listening to the conversation and making recommendations. So, you know, you and I could be talking and you could be saying things like, you know, they've been really stressed lately, I haven't been sleeping as well. And I might not say, oh, maybe she's depressed. Maybe I should see, ask her some questions. It will even tee up intelligent recommendations to say like, hey, listen to these words she's saying. Maybe you should ask this question. You know, so it's, it's just, it, there's assisting the clinician in, um, in making their lives easier and allowing them to, you always hear that line, operate top of license, which means you're face-to-face or you're engaging with the person that you're trying to care for their health, you know, getting the rest of the junk out of the way, whether that's notes or whether that's automated prior authorizations that used to be, you know, all these papers faxed back and forth between payers and providers. You know, AI and digital innovation has just made such a dent in the administrative burden of healthcare and allowed clinicians and people that matter the most in the healthcare ecosystem to do what they went to school to do to help the people that they're trying to help. I mean, that was big. And, you know, I don't know if you've ever had, you know, any of the doctors from Allegheny Health Network or Tony Farah or anyone like that. Tony Farah is our chief medical officer at Highmark Health. But, you know, if you start talking to them about where healthcare is going, you know, just imagine a future, and I'm kind of going out there, it's 10 years from now and Each of us, we deeply understand our genetic makeup, like our DNA and, you know, what's unique about me versus you versus someone else. And you could see this world where, okay, I have this certain DNA makeup and I got this cancer diagnosis where, you know, AI can say, like, let's look at all the different people that were treated with the same kind of cancer diagnosis and people whose DNA most closely matches yours and say, that's the treatment. Treatment. That's the treatment that's best for her, right? It starts to take the variability and care out. I mean, some of that is future, but I think, you know, AI is scary in a lot of ways, and digital, you know, use of, um, of AI can feel scary, but I think the opportunities are so massively great that, um, I'm excited to see where the future takes us in medicine.

Yeah, it is scary, but to what you say, well, let's start with the basics. That example you gave about the doctor, better diagnosis. So it doesn't have to be rushed or missed anything. That's right. Uh, say maybe difficulty understanding the person or talking. So, hey, I get that. Uh, but it's that time with the doctor. That's right. And then the doctor not being stressed out because of the pajama time, burnout, and all that sort of stuff.

And it just cuts out the administration. Or even think about an authorization. You know, you, you go see your doctor, your doctor says, I want you to have this scan, I don't like some symptom that you're telling me about. And, you know, years ago it would be, well, let's submit that prior authorization, wait for a couple weeks. The whole time you're anxious, you're nervous. You just want to get the scan and see what's going on. Now, you know, with automation, we can schedule your scan before you even leave the office because all the things that used to happen manually are now happening digitally and they're happening, you know, automatically.

And also, again, looking into the future, but through AI, your DNA could also show, okay, now wait a minute, you have a proclivity toward cancer. That's right. So let's do whatever.

That's right. We just had a— it was a really cool— we have these annually, these innovation competitions for groups of employees that kind of have these cool ideas. And one yesterday was around how do we use a person's DNA to determine if certain medications would work. So they used an example of statins and they said, you know, if you come in and you had a heart attack and now they're trying to give you these medications, and they gave out M&Ms and they gave us pills of M&Ms and they said like, look, 50% of the people we give this to, if you get a green M&M, that means your DNA would say it works for you. Another 40%, um, it's probably not going to do anything. We could give it to you, but it's not going to help you, it's not going to hurt you. And the last 10%, it could really hurt you if we give you this medication. And their point was, imagine if we did a simple blood test to understand which of those three camps you were in, because your DNA can tell us which of those three camps you're in. We're going to make sure that we give you the right medication. We're not going to get it wrong the first time. We're not going to give you something that's toxic for you. You know, and imagine how many steps you take out of the process in trying to get someone from their need to their need being fulfilled with the right thing for them. It was a really cool— like what you said, that reminded me of what I heard yesterday in this.

That is awesome. Yeah. One last thing. I was at this AI discussion at Pitt. And afterwards I said, wouldn't it be something if AI could find the cure for cancer or for Alzheimer's? I mean, it's moving so fast and it's doing so much and it has so much data that, like, no human being could have. You never know. You know, I like to think about the positives. That could happen. And I believe there are positives. Well, Tracy, my last question for you is what would you consider some of your greatest accomplishments?

Oh my. I would say over the last few years, if I try and keep it in the last few years, I think that we at Highmark have and I'd like to think I was a big part of this, have started to take much more of an external focus on the people that we serve as a primary— like, hey, when we are talking about solving a problem, let's not look inward. Let's not look at what's easiest for us. Let's not look at— start with what's the business process that we have to do. Let's start with what are the problems that the people we serve have. And I think some of the hardest changes to make are cultural changes. And I think that wave, which started when David Holmberg came in as president and has continued to this day through his presidency, and we've all had our part in it, of how do we turn our attention to customers and making sure that their problems are our problems, and that's how we start every conversation. It's not an individual thing, but I think that's probably one of the things I'm most proud of. I'd say another one is a lot of the work work that we've done on our digital experiences and how we create more abilities for people to self-serve and get information that they need. That's, that's relatively easy. And I'll say, you know, the last one would be, and I'll just add this because we're on the conversation here, I'm proud of the work that we've done with you, Joyce Bender. I'm proud that we've brought people with disabilities, you know, into our team, and we don't certainly don't think of them as people with disabilities, but You know, we've brought a number of them. We continue to work with you to source additional candidates. It's been a great moment of pride and a great accomplishment for us.

Yeah, it is. Well, I love you, Tracy. And listen, everyone listening to the show, remember Tracy Sala, S-A-U-L-A, hands down one of the best leaders in America that includes you, people with disabilities, at Highmark.com. All right, Tracy, thank you so much. And we end every show, we end every show with a quote. So, oh, and this really fits what we're talking about. Alone, we can do so little, but together, We can do so much, said the great Helen Keller. And in the words of Mary Brooker, when you go out tomorrow, remember, choose joy. Your day will be so much better. Hey, talk to everyone next week.

Voice America would like to thank you for Thank you for tuning in. Please join us next Tuesday at 11 AM Pacific time and 2 PM Eastern time for another installment of Disability Matters right here on the Voice America Variety Channel. We are the leader in live internet talk radio. VoiceAmerica.com.