Profiles on Leadership: 5 Questions with Rob Falkenberg, CEO, UnitedHealthcare of California

Rob Falkenberg is passionate about connecting behavioral and physical health with a focus on the mind, body and spirit. The CEO for UnitedHealthcare of California learned the importance of this approach early on, while working alongside a prominent cardiac surgeon, who used this method to care for patients before surgery. Understanding a person’s need for holistic care has greatly impacted and motivated Rob throughout his career.

Rob has been with UnitedHealthcare since 2001, becoming CEO of UnitedHealthcare of Ohio in 2005 and then named CEO of California in 2016. For the last three decades, Rob has devoted his career to the improvement of the health care system, with previous leadership experiences at Sloans Lake Managed Care, WellPoint, MassMutual and Aetna.  

How would you compare California health care with Ohio health care, based on your experiences in both states?

One significant contrast between the two states is that California has an advanced presence of organized care delivery models, which help support evidence-based treatments and promote quality outcomes. Both markets have undergone consolidation of provider systems and acquisitions of independent physicians by hospitals and other organizations. However, in Ohio, consolidation has not led to the same organized care models as California. 

There are many initiatives in California focused on improving value and the care experience for patients. For example, the Integrated Health Association (IHA) is demonstrating how an innovative and cooperative alignment of stakeholders committed to high value integrated care can improve quality and affordability for patients across California. Another example is Canopy Health, a consortium of providers in Northern California committed to improving health outcomes, lowering the cost of care and creating an exceptional patient experience within an integrated delivery model.

It is this kind of focus on stakeholder alignment and collaboration, not just consolidation, which sets California apart from most other markets across the country.

What are some relatively unique challenges for California health care going forward?

The higher cost of living in California creates pressure on the health care system to deliver quality and affordable choices for consumers. We live in an environment of increasing costs for gasoline, housing, food and necessities. For consumers, these spikes in the cost of living leave less of their household budget available for health care expenses. This is why UnitedHealthcare is focused on providing affordable, quality and accessible health care - leveraging data, technology and emerging care models. 

One means to achieve this is through thoughtfully designed innovations centered on improving health outcomes and reducing costs. UnitedHealthcare is committed to investing in value-based care (VBC) models that are designed to align and coordinate care delivery systems, which ultimately produce better care experiences for patients. Value-based care models are predicated by paying for patients’ actual health outcomes rather than the number of tests or procedures they receive. Placing patients at the center of the health care experience improves both the quality and cost of care. Other strategic initiatives include “bundled payments” and Accountable Care Organizations (ACOs), both of which represent new ways to streamline and coordinate services and payments to health care providers for delivering value.

Another challenge for California is that we are facing a provider supply deficit. As doctors age and retire, this creates pressure on the delivery system with a potential shortage of providers. To create better, more affordable choices, we need to foster scalable and competitive career opportunities for independent providers, the majority of whom would like to maintain their independence. The key is to help create environments that support the opportunity for physicians to remain independent while providing access to administrative, technology and data analytics resources under an organized structure – often associated with a larger care delivery entity.

Making health care simpler, more accessible and more affordable for everyone helps all of us live healthier lives.

What person(s) influenced your career in health care the most, and in what way?

Earlier in my career, I had the privilege of working with Dr. Henry Cleveland, a prominent cardiac surgeon and one of the founders of Sloans Lake Managed Care, based in Denver. Dr. Cleveland understood the importance of approaching each of his patients holistically, by assessing the patient’s mind, body and spirit prior to undergoing surgery. This focus of connecting behavioral and physical health has greatly impacted me and motivated me to help create Colorado’s first alternative medicine program with insurance coverage.

Today, I continue to recognize the importance of having a holistic viewpoint of patients’ needs, working to help treat people, behaviorally and physically.

As an industry, it is also important that we breakdown the silos of care delivery. Both providers and payers must connect a patient’s care and their coverage, and treat patients as whole beings.

Personally, I am proud of UnitedHealthcare’s efforts to collaborate with care providers and provider systems to develop performance-based networks. These networks are designed to provide patient-centered care focused on the physician and patient relationship. Unlike some care delivery models where patients may see a different physician each visit, UnitedHealthcare’s performance networks are built around the need for a strong physician-patient relationship – creating a more personal and coordinated care experience.

How would you describe the current climate between the payer and provider communities in California?

I am optimistic about the future opportunities for health care organizations to work more closely in a coordinated, aligned relationship. At UnitedHealthcare, we recognize the demanding environment that care providers face and our commitment is to be a trusted collaborator. I am excited about the work we are doing across the state, as well as the positive momentum we are building as an industry.

In Northern California, UnitedHealthcare is committed to our relationship with Canopy Health. Together, we are working to improve the value and experience delivered to patients. In Southern California, we are investing in new performance networks with providers, provider groups and systems that share our commitment to improving health outcomes, lowering the cost of care and creating an exceptional patient experience. Through collaboration, we are helping remove walls that exist between payers, providers and patients by creating performance networks that seek to deliver the right care, at the right place and the right time.

Are there any recent initiatives or developments at UnitedHealthcare you're excited about and would like to share?

I am energized by UnitedHealthcare’s mission to help people live healthier lives and make the health system work better for everyone. This statement demonstrates the value proposition of who we are as an organization and what we want for our members. My personal goal is for the people we serve to know that we are working together with their care providers to help them live healthier lives. We will know we have achieved our goal of transforming the value of health care in California when our many stakeholders – from providers, to employers, consumers, brokers and regulators – echo our mission and speak as enthusiastically about it as my team does.