Jeff Dobro, Health & Benefits Strategy & Innovation Leader at Mercer Consulting

Getting Employers a Win in Healthcare with Jeff Dobro, Health & Benefits Strategy & Innovation Leader at Mercer Consulting transcript powered by Sonix—easily convert your audio to text with Sonix.

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Saul Marquez:
Welcome back to the podcast. Today, I had the privilege of hosting Dr. Jeffrey Dobro. He’s partner H and B Strategy and Innovation leader at Mercer. Jeff leads the Health and Benefits Strategy and Innovation Services work based in New Jersey. His interests spanned from furthering evidence-based health management initiatives to innovative opportunities for employers to work more closely with health systems and providers to optimizing the effectiveness of their client’s workforce. Prior to joining Mercer, Jeff was the chief medical officer at One Medical designing their innovative model of care, and he was responsible for the company’s B2B strategy. As you all know, that company’s gone public and it’s doing pretty well. Jeff has also served as the CMO at Redbrick Health, where he was responsible for the company’s clinical programs, wellbeing, disease management, medication therapy management. He led design, development and ongoing operations of the clinical and coaching programs, as well as leading outcomes research for a range of population health programs. Previously, he was partner at Willis Towers Watson, where he was responsible for employer-based health management programs, employer provider contracting and onsite near-site clinics. He’s operated a national group of 58 primary care medical practices, was CMO of an early HCO management firm and was an analyst at a hedge fund. He’s a leader in this space and in particular, we’re gonna be covering health care for employers and what employers can be doing to empower themselves to get more out of their health care dollar and the benefits that they provide to their employees. Jeff is a board-certified internist and rheumatoid allergist and an associate professor at the NYU School of Medicine. I’m excited to showcase our interview with him today. And with that, I want to welcome Jeff to the podcast.

Jeff Dobro:
Thank you. So excited to be with you today.

Saul Marquez:
So let’s dive into the amazing work that you’ve done and really kind of getting to the heart of it. What inspires your work in health care?

Jeff Dobro:
I’ve been a tradition and in the health care field for over 25 years. And it feels like now is the time that the health care system is really ready to change. My inspiration really is around transforming the healthcare system to better serve the entire population of the United States and the patients that need care day to day.

Saul Marquez:
Well, I think it’s a great way to do it. And you’ve been part of some really interesting companies. You know, One Medical that just went public and Virgin Pulse. And now Mercer. Your influence as a physician leader in the space is very, very interesting and inspiring as you think about how you and the business over there at Mercer are adding value to the health care ecosystem. What would you say that is?

Jeff Dobro:
Well, we have done so many really interesting, innovative things that Mercer. Right now, I would tell you that the most interesting thing that we’re doing is working on transforming the delivery system. We’re working with employers every day to build better relationships with providers directly with health systems and doctors shifting from a volume and cheaper service focus to a value-based care delivery system. We have a great initiative going on right now that we call employer centric chain of deliverance. Can you imagine from the name of that what we’re really working on? So we work with employers every day to help get them to understand physicians that hospitals and physicians are dealing with, to working with him every day by computer, just 24 second. So we’re working with them every day to better understand the working model physicians that hospitals and physicians are dealing with and working to improve the quality of care as well as value. So we work with employers to understand what advance primary care looks like and how they can access that. We’re working with them to build what we’re calling a quality network open days so that their employees and their families can identify who are the better providers for any particular kind of service that they might want to get and then how to access those particular people. We’re working with some other events where we’re directly contacting with provider systems, whether it’s from centers of excellence or bundled payments or even accountable care organizations.

Saul Marquez:
There’s a lot to be done. And you guys are very focused on that. As you said, love the employer centric care delivery. Last year during the health conference, you guys had a very strong presence there. Owning the employer track, bringing over 300 employers to the table to discuss what matters most as we think about the transformation of our health care system. I think employers have a really strong influence and have a really accurate sense of what’s going on by targeting them. And I think by doing that, you’re also helping providers navigate because there’s a lot of need from the providers side to to help navigate this shift. What would you say about that?

Jeff Dobro:
Yeah, absolutely. You know, employers are in a very interesting position. They are funding a large part of the health care budget in America, but they are also very directly involved in the delivery of care and in improving the quality of care if they choose to be. Since employers are funding all this care, it matters directly to them that their people are healthy so that they show up to work to do the type of work that they were hired to do. And employers are also directly concerned with the cost of care and the efficiency of care since they are funding it and they’re not primarily in the health care business. They’re in the business of running whatever the business they’re in. So the employers have the jury protected as fiduciary duties to care about cost, quality, efficiency and the experience that their employees and their families have as they’re going through the care process. That’s actually one of the key reasons that I chose to work at Mercer. Mercer happens to have an amazing culture, is very creative, very innovative. There’s a lot of out-of-the-box thinking and they do sit at this unique intersection of the delivery system, the health plan, insurance system and the employers that are funding. You have a direct interest in performance of the entire system of health.

Saul Marquez:
That’s really interesting. Cost, quality, efficiency and experience, things that we’re all striving to get better at. And so you chose Mercer and the road ahead is exciting with where you guys sit in the ecosystem. What makes what Mercer does different, unique or even better than what’s available today?

Jeff Dobro:
Well, you know, sitting in this unique position that we have, which is right in the intersection of both the financing and delivery, the following, the insurance. It allows us to bring creative ideas together and bring partners together that might not normally ever work together. We can be as creators as we possibly can, bringing new ideas to all the various constituents in this system of health. So we work directly with employers and actually represent their interests. But we’ve spent quite a bit of time also working with the health plan to help them understand and improve the delivery of their service. As we’ve discussed, we are now working very directly with health systems, with hospitals and with physicians and all the other elements of the system. And we also get to see about the community. Now, we understand that people’s health is vastly influenced by the way that they live their life and their lifestyle. Things that we call social determinants of health. Their interaction with their community. And we have a number of programs and initiatives that we’re going on to directly influence and impact those social determinants of health. We get to think about physical health and emotional health or emotional well-being and behavioral health. So when we go and work with a client, we try to understand exactly what their problems are. We have access to a tremendous amount of data. And like I said, a tremendous amount of innovative, creative thinking. So in our jobs, we only work to help our clients find the best pricing, the best health insurance plan. But by understanding this larger ecosystem, this broad set of issues, we bring new solutions to our clients. We actually also bring new solutions to the health plans and to the providers and even out to the community. Bringing all of that together as we recognize something that I’d like to phrase is a system of health. And that large system encompasses all of the various influences on an individual person that helps them be healthier and be more productive and be happier in their life.

Saul Marquez:
I think it’s awesome. And as we think about this, you know, we’re having this great discussion. Dr. Dobro here and what’s going on at your company? You know, and do you really have all the answers if you’re honest with yourself? The answer to that question is no. And so in this time, it’s critical that we consider companies like Mercer that are being innovative in their thought process about how they can add value to us employers and leaders in health care. If you could hone into, for example, a particular program that’s resonating right now, Dr. Dobro, what would you say that is? And how has an improved outcomes or made business better?

Saul Marquez:
You know, you presented in a great way. So, you know, nobody has all the answers. Look, this is 2020. To believe that the health care system is going to look in 2025 or 2030 will be so different than the way it looks right now. Oe of the most interesting things we’ve seen in being forward-thinking is trying to understand and learn from companies that are building artificial intelligence. We know that the use of data and our ability collectively, all of us, to access a wide range of data to better understand what the health of our population looks like with the risks and potential that each individual person has is just incredible. But we are just on the cusp of using artificial intelligence in health care. In fact, we have an AI that is studying and working with vendors and computer scientists to try to understand how this can better be used in healthcare to deliver the benefits that I just described before around the quality of care and the person’s experience and the cost of other set of issues around use of technologies that would be machine learning. And I was just describing or creating it and working with centers that are creating better apps to drive engagement. That’s one of the big challenges that employers have. They’ve created these great health management and wellbeing programs that are very beneficial to those individuals that use them. But one of the things that we find is they are underutilized. So one of the other really interesting things that we’re doing is working around engagement strategies. Some of the really interesting thinkers out there in the market, like Bob Shelby and B.J. Fogg and others, so forth, on the design.

Saul Marquez:
Well, Jeff, it’s it’s the cash. You know, you’ve highlighted these really kind of four areas, cost, quality, efficiency and experience. And, you know, where do we want to play? You know, there’s so many different solutions looking for a problem out there. It’s critical that we pause and just think about what Jeff is saying. It’s focused on one of these issues and work with the actual problems to develop a solution for it to actually get some traction in the market, working with influencers like Dr. Dobro and Mercer that can help get the solutions to the people that need the most. You’ve been a part of a lot of different organizations doing very transformative things in health care. Dr. DobrO, what what would you say is one of the biggest setbacks you’ve experienced and a key learning from that?

Jeff Dobro:
That’s a great question. You know, the setbacks usually come from change just not coming fast enough. I would say when I was at Redbreast, which is now Virgin Pulse, we had built some pretty amazing behavior design tools, apps, new ways of doing coaching and engaging people. And, you know, the biggest setback there was we couldn’t just build it fast enough. It takes a tremendous amount of resources to build new tools to take new approaches. And you just don’t always have the time and money and resources to build something else exactly the way that I would want it. So while it was a great moment for reference to be acquired by Virgin Pulse, I would have liked to had more time, more money, more resources to build out that set of products and tools exactly the way that we would have wanted to.

Saul Marquez:
Now, that’s an interesting call out. And how would you do it differently, Jeff? I mean, if you say, like, you know, four years before the acquisition, what would you do? Definitely knowing what you do now.

Jeff Dobro:
You know, what was interesting is going through that process, we actually learned all of us together learned about rapid cycle development because much of the learnings from that software industry and then apply them to all sorts of program development processes. We built our coaching processes that way. We built our analytics and the research team to have much more rapid cycle will build beyond just the software itself. In fact, what we’ve done from that experience is build a whole sprint process that is developed at red brick and then brought that it’s immersive to rapidly develop our own new package, your new consulting solutions, so that we can bring new ideas to market much more rapidly than we would ever have before.

Saul Marquez:
That’s really great borrowing from software scrum. I think they call it right. Yes, two other areas. And I think that’s really smart. You know, we often talk about but don’t do the idea of learning from other industries and other practices. And this is a great example, Jeff. Appreciate you sharing that. What can you do with a scrum practice or, you know, a sprint process? It’s a it’s a really cool idea to borrow from these areas and apply them to other specialties within what we do. Well, what are you most excited about today?

Jeff Dobro:
And yes. So actually, what we’re doing right now is is using that sprint process to build out that whole set of initiatives and employer centric care delivery. I don’t know of anyone else that’s taken that broad approach to building the analytic tools and the diagnostics to help employers understand where their opportunities are around working with providers. And this is where most of my energy is going right at this very time. And we have, I think, moved 10 different initiatives that all intersect and build on each other. If we had to try to build one at a time and then tie them all together in one large initiative, it would take us years. Instead, what we do is we have 10 different sprint teams running through what we’re calling a stage healing process of building out a wireframe, not typically a term used in consulting, but we look at things as though we are building little bits of software that are all connected. So we run through a sprint. We have a few different steps that are involved, five different steps generally where we have some microfilming in design. And then we engage with what we call our challenge team to help us understand where we get it right and where things need to be changed, or where maybe these come up with completely untenable ideas and go back and then restructure the product that we’re delivering. And that’s our challenge. When we’re dome, they’ll have us build our business case and bring it into to senior management with a go or no go or potentially go back and even. We think the idea that the entire process is at least six or eight process instead of a year long process. And as we’re doing that, also tying all of the elements together. And we’ve now tested this out with several of our clients, even as we’re going to these early iterations and getting a tremendously positive response from employers who previously had really shied away from even thinking about engaging provider systems.

Saul Marquez:
Well, I think it’s a very unique way of approaching very common problems with new thinking. And so I really it’s exciting to hear about how you guys are doing it, Jess. And the way that you mentioned that at the beginning of the podcast captures so much the employer centric care delivery. And from my perspective, I believe that one of the strongest forces in the transformation of health care is going to come from the employers. So it’s so great that you guys are focusing your efforts there. How would you say, you know, for those that don’t really know or understand? How does Mercer fit into the picture and who can you know, who can reach out to you guys? Like who are your typical collaborators in this type of work?

Jeff Dobro:
That’s really interesting. So what we’re doing now is we start in a local market and we bring the major health systems to the table and we bring the major employers to the table. And we start initially just talking about the quality of care. And we may talk about maternity care or cardiac care or simply care, cancer care, you name it. It’s whatever the key topics are that are of interest to our employers. We call those quality and treatment collaborative. And we’ve been running those in a number of markets across the country for oh, that’s three 1/2 years now. Then what will happen to those is a level of trust is developed. No, trust is always one of the barriers to get to parties that don’t know each other or may even have or perceived that they’ve had an adversarial relationship when in fact they really haven’t. So we start by having these all of these discussions and then the employers really see that know providers might be willing to work with them directly or think about people who care in a different way or maybe do a direct contract. And then we build on those initial conversations, build our business relationships. We may work with third parties. We may work very directly with the providers. In different markets we build out what we call an advanced primary care model, where the employers contract directly with these very unique and very innovative primary care groups to expand access and the ease of service, improving the quality of care, reducing the total cost of care, and working on preventive services and working with what we call high value specialty networks in each of these markets. In each of these communities, like I mentioned before, we will also work on identifying what we might call centers of action that might be centers of excellence available on a national basis or through our analytics, identifying those high performing vital organizations that are right in the community.

Jeff Dobro:
For example, not everybody needs to go to the Cleveland Clinic to get a heart surgery, although that’s one of the highest performing cardiac centers in the country. In many communities, many cities, there are cardiac centers that perform at the same level. So our hope is that he is that it’s one of the interesting solutions that we bring to the table. One of the things we also make it is connect them to accountable care organizations right there in their community. We have a number of employers that are working directly with these CEOs and not only the contracted basis, but they work with them day to day, month to month to identify ways to better engage their employees and families to get preventive services into the employer world to improve. First, we mentioned that the beginning to improve the cost and quality and outcomes and efficiency and experience for everybody. So this is pretty unique. I personally have been working with a provider system in for a very long time. And I have to say that this is the time for those two components of the health system to start to work together. This is one of those very interesting tipping points where we’re fairly sure that the system is going to change. Mercer is very unique in the same way ahead of the market, as far as I can see, in building this kind of employer centric care delivery system.

Saul Marquez:
That is so exciting, Jeff. And, you know, you mentioned the tipping point. I agree with you. It’s happening. And, you know, the employers that see it are going to have to get ahead of it. I mean, when something like health care that, you know, ends up being the largest line item expense aside from labor cost and maybe, you know, materials, it becomes an area where you have to get engaged. You have to roll up your sleeves. And with a partner like Mercer that has relationships with really all the stakeholders. What a great way to do it. And these quality improvement collaboratives are fascinating and be really cool. This in one of those just to hear the discussions that happen in the real world, things that matter to these employers, the, you know, areas that providers get help. What a great way to do it. And I know you guys are going to be back at that health conference again. I’m excited to see you guys there again with the hands on approach to that track, the employer track. So, folks, if you have a chance. This is the tip of the iceberg to engage with Mercer and Dr. Dobro. More to come at that event. But before we conclude here, Dr. Dubrow, I’d love to ask maybe which will firstly, what is your favorite book? Always interesting thought what the thought leaders are reading.

Jeff Dobro:
My favorite book is called Corelli’s Mandolin. And it’s a book actually about Filiberto families living in the mountains in Greece during the time of World War Two. And it’s about the humanity and the frailty and the strength of individual people when they’re under duress and creative and energetic approaches they take to make their lives better and stay alive.

Saul Marquez:
That’s a cool book, Corelli’s Mandolin,

Jeff Dobro:
Corelli’s Mandolin.

Saul Marquez:
A great recommendation striking at the heart of human character and perseverance as something that we need a lot of as we engage in the transformation of health. Tell us a closing thought here. Jaff in the best place for the listeners to continue the conversation with you and Mercer after this podcast as.

Jeff Dobro:
Oh, sure. I just you know, in closing, I would just say, you know, be persistent, be creative. Now is the time to make change. And Mercer cannot do this by themselves. Well, we need everybody to go out there to continue to think about how the health system can be improved and what they individually can do to improve their own health and the way the entire system is working. So I would give everybody the advice and just keep going. We’re going to get there. And I guess, you know, in closing, just help me getting such a thing. My name is Jeffrey Dobros as and dot com. I would encourage employers or anybody who’s a creative idea around improving the system else that these get in touch with me. We’re open to all ideas. And then I think he said so this is the tipping point. So if we’re just looking forward to the next five, 10 years to what we can do to contribute to make this whole thing work better.

Saul Marquez:
Outstanding, Jeff. Well, listeners take action. Don’t just think about doing it. Just gave you his email. And so do you have an idea and you believe that you don’t know everything, that there is a way to do it differently and better, now’s the time. And with that, I just want to give you, Jeff, a big thank you and listeners, appreciate you all tuning in and looking forward to continuing the discussion.

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