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Transcript: Medicare L!VE: A Conversation with UnitedHealthcare Medicare CEO Brian Thompson

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ON SCREEN TEXT: MEDI
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MAN: Welcome to UnitedHealthcare's "Medicare Live," with your host Rachel Slavik.

A woman in a gray cardigan sits on a blue-lit stage.

RACHEL: Thank you for joining us. We have many UnitedHealthcare employees in the room as well as many more joining us around the country via live video stream.

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                                     Rachel Slavik
                                     Medicare L!VE Host

RACHEL: We also have agents, select media, and influencers. Welcome, everyone, to the first "Medicare Live" event. UnitedHealthcare Medicare and Retirement is the largest business dedicated to the health care needs of Medicare beneficiaries. It currently serves 12.3 million or 1 in 5 people enrolled in the program. And in advance of Medicare annual enrollment, we want to spend some time today talking about what people can expect from UnitedHealthcare's 2019 plan offerings and also what the company's doing to support seniors and other Medicare beneficiaries around the country.

Rachel sits next to a table with two bottles of water and another chair. Behind her, a large screen shows the "Medicare Live" logo. A backdrop of tall grass lines the stage.

RACHEL: With that, we'd like to welcome Brian Thompson, CEO of UnitedHealthcare's Medicare business. Join me in welcoming Brian, everyone.

Rachel stands up as a well-dressed man enters from the right.

BRIAN: Hi, Rachel.

RACHEL: Hi. Welcome.

The two shake hands. Rachel sits on the left, Brian on the right.

BRIAN: Good morning, everybody.

RACHEL: All right, Brian, clearly an important time with Medicare annual enrollment right around the corner. But before we get into all the details about health plan offerings, we want to talk about what's the state of Medicare and what do you expect in terms of how this program may evolve?

BRIAN: Yeah, well, to give you a sense, Medicare is enormous.

ON SCREEN TEXT: Brian Thompson
                                     CEO, UnitedHealthcare Medicare
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BRIAN: It's--to put some numbers behind it, $700 billion of the federal budget. I think it's between 3 and 4 points of gross domestic product, and it's growing. Over 10,000 folks are aging into the program each and every day. So it's big, and it's getting bigger. And as you're looking at the folks that are aging into the program today, they want choice.

RACHEL: Yeah.

BRIAN: They're sophisticated buyers.

Shots alternate between Rachel and Brian as they talk.

BRIAN: They're looking for value. They're well studied when they're making their choices. And what we're seeing on the marketplace today is a strong interest in Medicare Advantage. And I think that's what we're going to spend a lot of our time discussing today. Today about 62 million seniors in Medicare, about 1/3 of them, are choosing Medicare Advantage. As we look forward over the next five to ten years, we see that number getting closer to or maybe a little north of 50%. So a lot of interest. We're really seeing it pick up steam over the last couple of years, and for good reason. There's a lot of value there. Folks are satisfied with it; oftentimes getting benefits that they otherwise couldn't enjoy for little or no premium. And what I'm perhaps most pleased with is the health outcomes. And our partnership with CMS is recognizing that. Folks that are choosing Medicare Advantage are seeing better health outcomes, and that's great. So it's a good time to be a part of it.

RACHEL: Wow, and I am curious on what influences the decision when you're planning Medicare Advantage plans? And also as you look to your competitors, what are you seeing from them as they're looking to the space to grow?

BRIAN: Well, first and foremost, we listen to those that we serve today. My parents are members, so I certainly listen to them as well, but if you ask my mother, she'll do whatever we tell her to do; if you ask my father, he wants us to leave him alone. So there's a wide range of people that are choosing this product.

RACHEL: Yeah, you really have to tailor your plans.

BRIAN: Yeah, and you have to be flexible. So first and foremost, it starts with listening to those that we're serving today. And as you said, we've got a really strong enrollment base from which to learn. Secondarily, we look to the outlook of the program, generally speaking. And it's--like I said, optimistic to be a part of it, not just because of those that are enrolling in or aging in, but the program itself is being funded in a stronger way than it historically has. It hasn't always been the case. For over a decade, you've heard people like me talk about Medicare Advantage being underfunded. And during that time, we've talked and been very proud of our ability to bring stability in terms of the benefits that those that are buying our products have despite those funding pressures. And as we're approaching 2019, I'm excited, because the funding environment has changed, the satisfaction levels are up, and the program design has allowed for more flexibility as well. We can design programs now and products around specific disease states, what people specifically need. Like I said, my folks both have very different expectations. So bringing choice into the marketplace that meets all the varying needs, I think, is really important. As you said, when you combine sort of this what I'll call optimism around the marketplace with the continued favorable demographics, really the fastest part of American health care, in terms of its growth rate, you're gonna see more competition. And while I would say it's always been a competitive marketplace, I do think that you'll see a stronger competitive dynamic in 2019 maybe than ever. I'm excited by that. I think that's great for seniors in particular. I think you're gonna see more value in the marketplace. So I do expect to see a stronger lean forward. More products on the market, more competition. And again, I think that's just wonderful for those that we're serving, the seniors in America.

RACHEL: All right, well, that's great perspective and a great tipping point to get an understanding very broadly of what we can expect from UnitedHealthcare in 2019.

BRIAN: Yeah, I think if we look forward, you're gonna see more of us, first and foremost. I think we'll be in about 90% of the footprint where seniors are at in America today. And I think that's an expansion of about 2 million people that will have now an offering from UnitedHealthcare where historically they haven't. I'm perhaps most proud of our footprint into Minnesota.

RACHEL: Sure.

BRIAN: Believe it or not, of all the states, this has been our last entry. And I'm excited to be able to put products in this marketplace where so many of us here work and have friends and family. So you'll see more of UnitedHealthcare. I think for those that have UnitedHealthcare today, they're gonna see more in terms of value. 95% of those that we serve today will see either stable or declining premiums. Over 1 million of the members that we serve will actually enjoy a lower premium that they have to pay in 2019 than what they paid in 2018. I think that's fantastic.

RACHEL: My grandma's gonna like that.

BRIAN: Yeah, isn't that great? And when you think about the health care space in general, that's not a conversation that we're a part of very often. You're gonna see stable enhancing benefits at consistent or declining costs. So I think that's fantastic.

RACHEL: I know you just gave a broad overview, but I do want to drill down a little bit on some of the specifics and the examples of benefits and products that people can expect.

BRIAN: Well, it starts with cost and coverage, oftentimes. When a senior's choosing a product, they oftentimes sit with a broker and go through what does it look like for their budget? What are the premiums they're going to pay? What does coinsurance or copayments look like? And one of the things that we've invested in is more simplicity. We're moving away from things like coinsurance.

RACHEL: Yeah.

BRIAN: It's confusing. Percentage of something but nobody knows what the something is. So you'll see us moving towards co-payments. You'll see us moving towards, as I said, flat to in certain instances, declining premiums. We're really pleased with those basics, because they're stronger year over year.

RACHEL: Is that driven by market research?

BRIAN: Well, it's driven by market research, and it's driven by hard investments we've made to make our products more affordable. We know that's what people want. At its most basic, they want coverage at value. So we're really excited that it's going down year over year. But what we're hardest at work at is providing more services, more value. And it starts with things like hearing and dental and vision. These are components that you can't get in other parts of the health care system for Medicare folks. And we've invested meaningfully. One of the things that we've heard over the last couple of years is that folks want a broader network of dentists, and they want more coverage for dental care. So we've done that. Folks want a broader range of hearing devices and audiologists. And we're bringing to market, for the first time, our broadest investment in hearing. It's with a new capability that we brought into the UnitedHealth Group family. It's called Epic Hearing. And we're also making advancements in our vision capability. So those three capabilities, I really love where they're positioned in 2019 relative to 2018. Some of you may have heard of Optum Fitness in the past. We started that last year. And we're expanding it meaningfully in, I think, 12 more states in 2019. We've rebranded it. It's called Renew Active, which aligns really nicely with our other member incentive programs that we have. And it brings not only a broad array of gym memberships, but it brings digital capabilities as well. It brings competencies where folks can enroll and do online fitness at home, some cognitive brain health capabilities that we've brought to market through our partnership with AARP. So really a fresh way at looking at fitness. I think, for me, anyway, the crown jewel of the service offering that we provide is our HouseCalls offering. We've been doing it for a long time now. In fact, in 2018, we will be doing over 1.4 million HouseCalls for members that we serve today. And what it is, is it's very similar to what you would get in an annual wellness visit, but more. You can get your necessary screenings and inoculations. You can spend time, oftentimes over an hour, with one of our nurse practitioners. They can review your medications at home while providing you with the necessary plan of care, and then you can follow up with your primary care physician or a specialist as well.

RACHEL: You know, I've heard from a member that they enjoy that you get more time than if you were just in a doctor's office.

BRIAN: And it provides a nice starting point oftentimes for our members. It gives them that plan of care to say, "Okay, where do I go from here?" Again, and to be able to do that in the comfort of someone's home is another one of those things that we've learned a lot as we spent time with our seniors. Virtual visits, again, being able to consult with a physician over the course of a mobile or a screen opportunity as opposed to traveling is a big part of what we're bringing to market. Transportation's always been a barrier for seniors, as you might expect. And we've made a big advancement in that as well. In fact, we, again, invested in another company. We call it TransMed. And it's a capability, again, brought into the UnitedHealth Group family that has a technology competency that really makes it easier for us to schedule and to integrate those calls for transportation when our members need it. So beyond all that, a lot of technology in the market as well. Wearables--I'm sure you guys have heard of it--activity trackers that help with your fitness. There's a lot of technology that's coming into our benefit. So as I said, this is our biggest year, in terms of investments that we've made for those that we serve, so we're excited by it. And those investments are not only in the form of benefits that you can compare, when perhaps you're looking at plans, but also in terms of new capabilities that we're bringing to marketplace.

RACHEL: Yeah, I'm glad you mentioned wearables. Obviously it's a huge trend right now, especially in fitness and just overall health. So what else is UHC doing in terms of technology and to better serve their members?

BRIAN: Yeah, so maybe on the concept of wearables, beyond benefits, we're really redefining the care model, the care model that we bring to the seniors that we support. For context, I'd say about half of our members have over four different conditions--chronic conditions that they're managing. So it's important that we step into the shoes and support them in a different way. And historically, our ability to engage with our members has oftentimes been limited to either our HouseCalls or an opportunity when they call us--been very telephonic based. What digital is really affording us is a different touch point-- a different way to engage with those that we support and serve. And I'll give you an example. We have over 800,000 diabetics in our plan. So you can understand the importance of having a good program for those who have diabetes. And we've partnered with a company called Dexcom. And what they do is, they bring a continuous glucose monitor. For those of you that understand diabetes, managing your blood sugar's a very big part of the equation. And oftentimes, it's only as good as your ability to do manual blood draws. And oftentimes, folks do those at a certain set time in the day. What a continuous glucose monitor does is tracks your blood sugar 24 hours a day, 7 days a week. So what that provides us is insights that we never had before. Not only is it a more accurate indicator of someone's blood sugar, but we then have real-time insights to when somebody might be having an emergent event or need a clinical intervention. So digital therapeutics is really providing real-time clinical interventions in a way we've never had before. And when you're able to take that and complement it with what we already know about our members, whether that's a claims history, whether that's the drugs they're on, you're really able to instruct a different clinical care path. And it goes beyond that. Digital therapeutics is in a host of different care conditions. Another good example is, you can actually track your vital signs with the same level of accuracy that today--or I should say years ago, you could only get at an in-patient setting, now with the comfort of a disposable bandage that you can wear at home. So it's just unlocking a whole different way for us to engage with the people that we support and serve daily. And I think beyond the digital therapeutics, it's just another--digital is another way for us to interact with those that we serve.

RACHEL: Sure.

BRIAN: Like mobile technologies providing them an opportunity to look up the cost of a service before they engage in it. I already talked about telemedicine. So you'll see digital continue to advance as a part of our offering.

RACHEL: And oftentimes giving that remote access for maybe some of their caregivers as well.

BRIAN: Absolutely; back to that transportation issue. Absolutely. So yeah.

RACHEL: Well, obviously you have a lot teed up for UnitedHealthcare in 2019. I'm sure your competitors do as well. So what differentiates UnitedHealth?

BRIAN: Yeah, so first and foremost, we're oftentimes compared in a spreadsheet-like fashion of "What are your benefits? What are your premiums? What are your copays?" And that's a very important part of the equation. I don't want to diminish it. In fact, I like that comparison, because we've invested meaningfully to make sure that we do well in that comparison when it happens. But I think what I'm most proud of isn't what we sell. It's how we retain those that have already purchased. Not only are we advancing meaningfully in terms of how we're selling and the momentum in the marketplace, but our retention rates, those that have bought our products, are staying with us at a much higher rate than they ever used to with higher levels of satisfaction. And that goes beyond the benefits that they get. That goes to the service that they enjoy. For us, I think our signature advance is around how we support those that we work with. And we're making big investments in that as we speak. I think it'll be one of the more telling things that we've done as a company. It's called Navigate4Me. And what that is, is it's moving away from just a phone number or a call queue for those that need us most. And as I mentioned, over half of our members have chronic conditions that are two, three, or four at one time. And they need a person. They need somebody that's in the health care system with them daily. They need a name that they know, a trusted adviser. That's exactly what Navigate4Me is. We've put it hard to work here for the first time in 2018. It's an adviser that will be with you throughout your health care event. That can be an acute event that perhaps lasts for a couple of days. It could be a chronic condition that goes over the course of a lifetime. It's really dependent on your condition. And we love it. We love what we're seeing. We actually just had some folks in the office last week who had experienced this as members, and they were providing us some feedback to it. And what I love the most about it is they said they didn't expect this from an insurance company. And the sort of relationship provides them that safe haven to ask questions like "Where should I go? Which doctor should I see? How much will this cost me? How do I get there?" These points of transition are where we're needed most and oftentimes where insurance companies in the past have failed those that we support. So I'm really excited when we hear feedback that says it's your adviser, who they know by name. In fact, last week, Glenda, who is one of our service--one of our navigators was in here, and she actually broke down in this feedback 'cause she saw the kind of impact that she's having on those that she supports. And I think what resonated most for her--it certainly did with me--was that she made our member feel safe. And that's what we need to be about. We need to be there when people need us at their most vulnerable. I think Navigate4Me is a perfect example of that. Like I said, we brought it to the marketplace for the first time in 2018, but it's my expectation that it becomes the norm for those that need us most. I think we'll see over 500,000 people benefitting from that service in 2019 and only expanding from there. So I hope it's our experience. I hope that's what people see and remember about UnitedHealthcare.

RACHEL: Right, and it really lays that foundation for trust as well.

BRIAN: Absolutely. Absolutely.

RACHEL: Well, I do have one final question because we do want to get to some pre-submitted questions. So knowing that UnitedHealthcare serves more Medicare beneficiaries than any other companyi, what advice do you have for people as they're moving towards their Medicare coverage decision this fall?

BRIAN: Well, this is an important time; that's why we're here today. October 15th, folks can start to select a product. I would say do your homework. This is an important decision time for seniors. Maybe a good place to start is your mailbox. I'm sure seniors across America are finding it full this time of year, but there's a host of different places where they can get education. I like Medicaremadeclear.com. It's a website where you can learn all about all the different offerings in the marketplace. I also like our plans, aarpMedicareplans.com. I'm hopeful that one of the things that we've been so hard at work at is bringing choice to the marketplace. And that ranges from stand-alone Part D coverage all the way to Medicare supplement coverage and a variety of offerings amongst all of those, including Medicare Advantage. So certainly ask friends and family. Don't stop with just your own research. I think, as I said before, while I'm very excited about what we're putting in the market, I'm most proud of what we've already done in the market, and those that are a testament to our service model and what we can provide. So I think there's credibility. There's stability in the history of what we've brought to the marketplace. But do a lot of homework. It's an important time over the course of the next couple of months, October 15th through December 7th. Take it very seriously. And I'm hopeful and confident that in that search, folks will find a UnitedHealthcare offering that meets their needs.

RACHEL: Great; I'm glad you mentioned Part D, because that does--that's a great segue into one of the questions we had that was pre-submitted. So what can people expect from Medicare supplement and Part D products?

BRIAN: Yeah, so spent a lot of time today on Medicare Advantage, but our offerings go much broader than that. As you said, Rachel, one in five seniors are covered by some product that we put in the marketplace, and we're really excited about the full continuum that we have out there. We're the market share leader in Medicare supplement today. And as you look at Medicare supplement offerings, I think one of the things that you'll want to look for is, stability of premiums. We've been really pleased with how we've been able to keep those very stable in the market for a very long time. And what else is in the offering? You'll see our service model is very different. You'll see wellness capabilities, oftentimes not coupled with a Medicare supplement offering. And on the Part D side, again, you'll see really broad choice from us. I think we have the broadest range of offerings. So as you look at your conditions and your health situation, I bet you will find an offering in there that meets your needs. We're really excited about our partnership with AARP and with Walgreens. A product we put on the marketplace just a couple of years ago has been the fastest moving product in that space. So it's resonating, and we're really pleased with how we have that full portfolio for those that are looking for their right coverage need as they approach the new year.

RACHEL: Okay; as we look to an aging population and their coverage, we have to address that friends and family are oftentimes critical caregivers. So what support do you have for caregivers?

BRIAN: Well, I'm one myself. I'm sure many of you guys here are as well. I think about one out of every five or one out of every four calls that we get is actually from a caregiver. So it's just such an important role. It's a growing role; it's a stressful role.

RACHEL: Sure.

BRIAN: So our Navigate4Me service investment started with not only the senior in mind but the full family and the full host of networks that touch a person when they need help. But beyond that, we've got a capability that's called Solutions for Caregivers. We're excited by it. We've had it in the marketplace for a while now. But we made some nice investments in that competency. It's part of our benefit design in many of our Medicare Advantage products. And what it does is, it really allows that consultation opportunity for caregivers and the senior to sit down, understand their health situation, and truly put a plan of care together over the course of the next year. Help them understand where to go; what's the right next best action? How should they engage? Really providing that step-by-step framework. So we're excited that that in addition to the emotional support that hopefully members will get whenever they call UnitedHealthcare, but certainly the enhanced benefits of Navigate4Me are--are exactly what caregivers are looking for. I know it's what I'm looking for.

RACHEL: I've heard you mention Optum a couple times, and I'm curious on just how Optum works with you to design programs and serve its members.

BRIAN: Sure, yeah, in fact, most of what I said today, Rachel, is brought to the market by Optum. And in fact, I don't really look at Optum as a vendor or a partner. I look at them as a integral part of what we bring to marketplace today. The HouseCalls offering is a good example-- is brought to market by Optum. How we interact with our care providers. As you know, Optum care is a host of network providers in the marketplace today. So most of the insights that we learn about how to be most effective in that partnership comes from Optum. Pharmaceutical coverage and capability. So when you hear UnitedHealthcare, I hope you think Optum as well. It's a strong partnership, and as I said, we wouldn't be a business without their partnership.

RACHEL: Okay. And one final question. What excites you about being able to offer Medicare Advantage plans in your own backyard, in Minnesota for the first time?

BRIAN: Well, I'm excited about that. You know, I joined UnitedHealthcare about 15 years ago. And when I came here, I didn't know a lot about the company UnitedHealth Group, because we didn't have an offering in the marketplace. So 15 years later, I'm so excited that the work we all do each and every day, as I look out here at the crowd, for folks that work here in Minnesota, we're able to bring to those that we care and love about--or care and love so much. So we've been hard at work at making sure that our first step into this marketplace is the right one, and we are certainly excited about what we'll be bringing to so many Minnesotans here in the next couple of months.

RACHEL: All right. Well, thank you, Brian, so much for sharing those insights on what people can expect for the next year. Really appreciate your time.

BRIAN: Thanks, Rachel. Thanks, everybody, for joining me today.

RACHEL: Yeah, thank you, everyone, for joining us for our first "Medicare Live" event. Have a great day.

ON SCREEN TEXT:    Thank you for joining us.
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 i CMS data, 2018.

Statistics can be attributed to UnitedHealthcare internal data unless otherwise specified.