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Manav Sevak:
Welcome to the Memora Health Care Delivery podcast. Through conversations with industry leaders and innovators, we uncover ways to simplify how patients and care teams navigate complex care delivery.
Matt Troup:
Hi, everyone. This is Matt from Memora Health, one of the medical directors and co-hosts of the Care Delivery podcast. I’m excited today to be joined by Dr. Marc Watkins. Marc, thank you so much for coming on the podcast today. Would you take a minute to introduce yourself to the listeners?
Marc Watkins:
Matt, yeah, thank you for having us and thank you for having me. My name is Marc Watkins. I’m the Chief Medical Officer of Kroger and Kroger Health. Been in my role for a little bit more than eight years and really pleased to share some of the things that we’re doing in the space around food as medicine and how we’re crafting messages to engage communities living and being the best versions of themselves, which really translates to healthier communities and helping people live healthier lives. Those will be some of the topics we unpack today and look forward to a robust conversation at.
Matt Troup:
Yeah, me too. I would love to start though, with kind of what inspires you. Your background is so interesting to me, even before your time at Kroger Health. Can you give us a little bit of insight into how you got here?
Marc Watkins:
I really believe that it started with my mom being incredibly influential in my life, as many moms are, and I don’t think my mom was, I believe she, she wore a cape. And I could probably imagine that many of us believe the same thing. But my mom was really instrumental in being supportive and really opening my eyes that I could be anything I wanted and really spoke a lot about the profession of medicine. She had an ally along the way, which was my pediatrician, who also confirmed that. At a very young age and encouraged me to be proactive, he supported me throughout my developmental years, obviously, and having a figure to, in the profession to look up to, to aspire to be was very important. And but then as I’ve gotten older, my journey isn’t so unique. I had people that believed in me. And I think when we talk about where we are today with the youth and the youth in America, it really it takes a village. And so it’s hard to say that if folks aren’t encouraged along the way, it’s hard to keep those aspirations and dreams going. So I credit a lot of that to my mom. My background is in occupational medicine, preventive medicine, public health. Prior to coming here, I had, to Kroger, I had a stint with a large physician company called Concentric Health Services, a stint with Humana, a stint with a long stint with the United States Navy as a Navy physician for almost six years on active duty. That was incredible in terms of that amount of camaraderie and bonding with the team and then really being mission-focused. So that’s helped me in my career to really look at the overall strategies that we’re trying to deploy, no pun intended, using my Navy acronym there, but how do we make sure that things are in sync with the overall message and goals of the organization so that we’re able to really deliver them and deliver them at scale and also to really make sure that that it has meaning and it resonates with those that we serve. So as a physician, many of the things that we’re doing at Kroger Health just seem natural and would love to share what that looks like over the course of the next few minutes with you and your audience, Matt.
Matt Troup:
Yeah, I would love and that’s exactly what I would love to touch on next. As you think about the career trajectory, what’s really made the most sense as you’ve landed at Kroger and you’ve stayed there now eight years and as you told me, kind of brick by brick building, something that really feels is rooted in passion and empathy. Yeah. What’s been the drive now to really see that vision through?
Marc Watkins:
It’s really to help people live healthier lives. You know, unfortunately, when we look at the climate of health in the United States, we have some significant headwinds. First, the unit costs are incredibly high for many Americans to afford health care. Health care is incredibly expensive. We’re somewhere spending north of $4.1 to $4.2 trillion annually on health care. We are sick as a nation and and in fact, we look at that six out of ten folks have a chronic disease and four out of ten have more than one chronic disease. So we believe that there are these nutritionally related diseases and ailments that continue to drive chronic disease and obesity being one of them, folks being over ideal body weight. We know that the contributions of nutrition to things like poor health, like cardiovascular disease, heart disease, we also understand the implications of things like high blood pressure and diabetes as it relates to nutrition. So really understanding how do we begin to, I like to call it course correct. We didn’t get here overnight, but how do we course correct and give Americans an opportunity to regain control over their health. So as we have unpackaged a lot of the things that we do around food as medicine, it’s really to provide. This intersection between where food and nutrition aids individuals through interventions that support health. And we at Kroger believe that it’s a dedicated, educated and personalized approach to eating and enjoying foods so that we can live healthier lives and prevent illness before it starts. Now, that’s a mouthful, but it’s really, if you think about it, all foods fit, let’s find the best foods for you. It may be different for me, it may be different for you and your family. But find foods that really make a difference and then use that as a way to begin to put that brick in the mortar and think about this as brick by brick. So it’s not something that you need to go and to your pantry and throw everything out and start anew. It’s really about how do we make incremental changes as we build the foundation to a healthier life.
Matt Troup:
Yeah. I’ve always, as a health care provider myself, struggled with the consistency of this behavior change message that has to happen to get people to make better decisions with regards to their health and specifically food. As you think about your approach in the retail space, especially with the number of people coming through Kroger at any given day in America, what’s been really effective in starting to address that sort of mindset shift for the larger population for you and your teams, what’s, what’s been really effective so far?
Marc Watkins:
Hey, Matt, thank you for that question. I think when we look at our core competency as a 140 plus year old grocer, our foundations have been built on the trust that we’ve earned in the communities that we’ve served. Taking a page out of that book, we want to be able to provide folks with an opportunity to understand what may be healthier for them. So we created a very simple up scoring system which actually scores the food in our stores. So as you as a health care provider, myself and others are struggling with helping to change behavior, how do we say, hey, what’s healthy for me? Just simply take your smartphone, scan an item in our store. It’ll be rated from 1 to 100. Just think about it. The higher it scores, the better it is for you, the lower it scores. And this is really based on the attributes of the food and the nutrition facts that are in the food. So think about them as simply macro ingredients, micro ingredients. And if you remember just a brief science tutorial for the audience, the macro ingredients would be things like proteins, carbohydrates and then fats in food. The, those are all your macro ingredients. Your micro ingredients could be some of your things like elements of the foods. Certainly be your sodium, calcium, magnesium, other types of attributes. And we score those in a very simple way. That red means, hey, let’s have less of that in your basket. If it scores yellow, that’s better for you than red. You can have more of that. And then if it’s green, you can have as much of that as you want in your basket. So the representation is very easy to think about. And as you as a health care professional, as you are having these conversations, you could say, Mrs. Jones, we want your basket when you’re shopping for you and your family to be 50% green, 40% yellow and less than 10% red. And it’s almost like a stoplight, right? You pull up, everyone knows universally red means stop, right? Caution if it’s yellow, and green means go. So making it easy for folks to really make good choices in our store.
Matt Troup:
Oh, my gosh. I love that initiative. How has it been? Do you see your providers, your pharmacists at Kroger Health talking about this openly, getting buy-in from consumers? Are any of the providers reviewing this data for their patient populations? How has that really worked into the care delivery model?
Marc Watkins:
That’s a great question and I think we’re very fortunate. We have a team of registered dietitians that make up our continuum of health care providers at Kroger Health. So they work very closely with our nurse practitioners and our advanced practice providers, whether they be nurse practitioners or physician assistants also are registered nurses. So as those teams come together, they provide that level of interdisciplinary consultation that helps to further drive knowledge and awareness within our organization. But further it helps for them to communicate that message to their patients. And we also do that with system affiliations, payers and others throughout the ecosystem by sharing what we know about food attributes and then with our opt up scoring system. So this is something that we’re just keeping to ourselves. We really believe that we’re going to course correct and change the way America eats. We really need to be able to share this and share this at scale.
Matt Troup:
Yeah, that transparency of data is so critical. And one of the things I love, at Memora we’re trying to do is really create this longitudinal data journey, tracking everything that happens in between the episodic moments of care. How, my gosh, Kroger and the amount of data you must collect on consumers, whether it’s within the grocery system itself or within the clinics or the pharmacy, how are you, what’s your approach to being data-driven in health care and thinking about the delivery of care? Are you where you want to be? What are the opportunities that really exist? When you think of health care at scale for your teams?
Marc Watkins:
I think there’s a couple of things there, Matt. And let’s start first by understanding that data is only good as the data, that good data, right? So bad data creates a lot of noise in the system and it’s hard to really decipher that. What we’ve been doing with our data is through a decades long approach of earning customer loyalty through our analytics, where we get to know more about each individual consumer at our store through our loyalty program. And that’s been an award winning program that we’ve had deployed for several decades. As I mentioned, those insights help us craft something as simple as what items to put on the shelf. But more importantly, it gives us an opportunity to connect with each individual customer at a personal and emotional level so that we can begin to offer things to you, the consumer, that relates to you. So many retailers do something similar to that. What we’ve done and taken that a step further for health care is when we have members and patients permission, we begin to assimilate some of that data into our repositories in order to overlay that with that first party consumer data, but also with health care claims data, pharmacy claims data and other data to get a better picture of what’s happening in those communities that we serve and then surface that information back to payers. The one thing that we’re doing with that and with other with health systems is how do we determine rising risk in a population. So I opened by hearing that there are so many Americans with chronic disease. How do we get ahead of that? How do we recognize that some of the behaviors happening in our store with Mrs. Jones is an example? If she’s buying a 12 pack of sugary beverage every week, is that an indicator in our models that she is at risk for for obesity or being overweight or potentially diabetes or heart disease or high blood pressure? So putting that to the provider group, letting them be aware that that we’re, we’re noticing this. And one of our goals in the future is to be able to have an ability of our organization to share some of this data longitudinally with health systems, with providers. So you yourself would get a food score or an opt up score in the chart for your patient like Mrs. Jones, just like a vital sign, like her blood pressure, her weight or her pulse. In a way that you can have meaningful conversations with her about her nutrition scoring.
Matt Troup:
Yeah. Oh, it’s incredible. I’m also going to shout out my mom. She is a loyal Kroger. She loves her local Kroger. Kroger’s always done a really great job of building that loyalty to their to consumers from a grocery standpoint. What’s been the challenge of kind of redefining Kroger as a health care provider? You go there for your groceries, but now you can also get care, primary care, all of your pharmacy needs. Is it, has it been tough to make that shift in people’s minds or is it starting to come naturally, especially in a post-Covid world?
Marc Watkins:
I think there’s a couple of things. And we, and if I’m lucky enough to get an invite back, we can unpackage this or there’s a lot there, Matt, but I think, one, it’s really based on the foundation of earning trust and we’ve earned your trust with things like your food, your shopping, your retail shopping for food and how do we earn it on the health care side? We started 40 plus years ago with the retail pharmacies, introduced clinics to 15 years ago. So all of this is an evolution of providing convenience to the customer. When we did our first, one of our first voices of the consumer, even back before we got into the clinic business, our CEO and chairman, Ron McMullen, asked the question, what, in terms of health care, what some of the issues and some of the issues even 20 years ago were the same as they are today. One was access to care, two was convenience, the third was pricing transparency. So as we create a seamless health care organization that provides the optimal license that world class care, how do we couple that with convenience, ease of scheduling, and then also really transparent pricing so that we can compete? And what I mean by compete, think about competing with shoppers that are in our stores and those that are new to us that they can have the same amount of trust with our health care organization as they do with our grocery business.
Matt Troup:
Yeah, and it starts to make a lot of sense when you think about these community institutions that have been there for a long amount of time, who already have a lot of trust, and then leveraging that to now provide them with their health care needs and other needs that really promote a healthy lifestyle. Shifting a little bit from the being patient centric now to providers, which you and I know that lifestyle. How do you think about the experience of the the care teams that you now employ from a Kroger Health standpoint and optimizing their experience now as as care providers within the Kroger Health ecosystem?
Marc Watkins:
Great question, and as Chief Medical Officer and I’m incredibly privileged to work with, on the Kroger Health side, a little bit more than 24,000 health care folks, about 9/10,000 of these folks are licensed to some degree and are, and provide care. And so it’s privileged. It’s a huge honor and professional privilege for me, one of the things that that we want to accomplish is, is very simple. We want to have our providers, our clinicians, no matter what license they have internally to practice at the top of their license. We believe that’s the point of difference, that if we create systems, processes, platforms that allow them to practice at the top, they can deliver that high level of care which is rooted in trust, the best evidence care that’s out there and deliver a great, great outcomes for our patients and our members. That’s really what we’re trying to do. And I think that appeals to most clinicians as they’re transitioning from training or from another practice or another health system. They want to be supported to practice at the top of their license and to deliver value to the, to their patients. And I think that’s what our team is trying to create.
Matt Troup:
Yeah. And I also think it’s, that a lot of that passion for knowing that you’re seeing the kind of holistic view of a patient, right, not just treating the bad outcomes, you’re going upstream and trying to be as preventative as possible.
Marc Watkins:
Put a wrap around them. We’re really trying to yeah, yeah. It’s just not an idea of just treat them and street them, right? It’s, we are trying to really create a, not only a framework but what we call it in the academic world around a patient, but really trying to listen to understand. And then how do we provide solutions to those customers and patients that really make it a win for everyone?
Matt Troup:
And kind of as we wrap your initial beginning of this podcast where you talked about the passion that you bring to medicine and the work you’re doing at Kroger, how do we keep that passion alive as we think about the burnout that’s happening in the landscape of health care after Covid, as you, again, think about your own care teams, how do you really, what can we do as health tech company, as providers, as care delivery companies to really ensure that our workforce is as healthy as possible?
Marc Watkins:
And that’s a great question again, Matt, you’re pretty good at this podcast thing. I think, I think you should, we should all remember why we’ve gotten into health care. It’s simple for me. I got into health care because I wanted to help people. I think that’s a good premise to start with. As we think about creating opportunities for folks to practice at the top of their license, understanding all of the things you mentioned coming out of Covid, we talk about burnout. Our job as leaders is to support them, support them in their craft, remove obstacles if we can as leaders, right? And then understand that they are people, too. They’re humans, right? And I am not in my role. I’m in my role because I’m here to support them. And I think we as leaders need to just remember that we are supporting those at the tip of the spear. And I’m using my, again, my Navy analogy that we’re supporting those that are at the, on the front lines. And our job is to really make sure they have the resources to, to get their job done and then understand that most, if not all of the providers and clinicians that we have at Kroger Health are some of the best in the country. And again, being incredibly fortunate to be part of that organization that we need to continue to support them so that they can do their job in which I believe is to help our communities live healthier lives.
Matt Troup:
Marc, I feel inspired. This is.
Marc Watkins:
Thank you.
Matt Troup:
Giving me confidence that as a society here we can start to move the needle a bit in health care and create better access. As we wrap up, I just want to know what excites you the most right now about health care. Where do you think where is, where do you have the most optimism about where we’re headed?
Marc Watkins:
I am really optimistic that we can take a lot of the lessons learned from what’s happened at, through Covid, understanding that there’s been a plethora of of health care professionals that helped us get out of the pandemic, including pharmacists, advanced practice providers, understanding how we can work the health care ecosystem and in order to put the patient back in the center. So I get super excited when I hear our chairman and CEO talk about having the healthiest workforce in America. And I think employers and others can begin to think about healthy workforces, healthy communities. That’s good for business, that’s good for the bottom line. But it’s also good for families, right?
Matt Troup:
Right.
Marc Watkins:
We just can’t afford to be on this course anymore. With so many Americans dealing with chronic disease and then dying from chronic disease, how do we stop that? So I think as we look towards the future, I’m optimistic that we’ll learn to work collaboratively and think about this as that healthy communities are a winning strategy.
Matt Troup:
I can’t thank you enough for your time today. We’re going to have to schedule another one because there’s so much more to dig into here.
Marc Watkins:
Look forward to it, Matt.
Matt Troup:
It’s been such a pleasure. I hope we get to chat again soon.
Marc Watkins:
You take care. Have a great weekend.
Manav Sevak:
Thanks for listening to the Memora Health Care Delivery podcast. For more ideas on simplifying complex care for care teams and patients, visit MemoraHealth.com.
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