Improving Health Equity Takes a Village, and Creative Risks

Brian Urban:

Yes, this is the Healthcare Rethink podcast, I'm your host, Brian Urban, and today we have a good one. We have the US Go-to-Market Leader from Aon joining us, Kevin Fyock. Kevin, thanks for joining our little show.

Kevin Fyock:

Thank you so much for having me, super excited for this, and really nice to meet you, Brian.

Brian Urban:

This is going to be a lot of fun. We've gotten to know each other a little bit back and forth before our recording here. And Kevin, with every episode we have, we'd love to have our audience get familiar with our guests, and there's no better way to do that than to go back before all of your creative innovation work at Aon, maybe even before your time, your fun days at Penn State. What took you into a large impactful corporation like Aon? What took you into the innovation space that you sit in now developing some really cool tech, some really cool data exchange ideas? Take us through the journey.

Kevin Fyock:

So it probably all started at Penn State, which I'm sure you'd be happy to hear. I started my career at a different consulting and brokerage firm, so I started with a different organization, and spent about 13 years doing strategy consulting and benefit consulting with large multinational organizations. And then I wanted to scratch the itch around going into the health tech space, so I spent two years on the commercial side at a small AI driven symptom navigator, which was a ton of fun, really enjoyed my time there, and decided to join Aon about a year and a half ago in the capacity that I work in now. And it's been a ton of fun. Aon is an organization that puts innovation first. And to your point, we're doing some really neat stuff around innovation, around products and solutions we're rolling out. So the journey has been all within healthcare throughout my whole career, but waffling between consulting and brokerage tech, and then now back to consulting and brokerage.

Brian Urban:

That's really helpful to know, just contextually, what you've experienced and done getting to where you are now, the impact that I think a lot of your work will make across the healthcare ecosystem and even beyond that. One thing I thought was interesting about your background is you going to a startup firm, coming from maybe a very large organization before Aon, and I was listening to some other really interesting podcasts today, Steven Bartlett mentioned that he recommends a lot of people in their career at one point or another go into a tech startup, whether it's software-based, AI-based, so they can have their closer connections to the decisions being made, closer to your money's being put in investment. And then if it fails, you're seeing why in real time, and then you can move on. But do you think that was a big component of you in terms of growth and impact within your career?

Kevin Fyock:

Oh, absolutely. I talk with my wife about this all the time, prior to going to that organization and then rejoining consulting coming to Aon, I think it was probably one of the best career moves that I made. So an opportunity to, one, try something different, but then see it from a materially different angle. So it has been phenomenally enjoyable to see, to your point, a totally different side from fundraising to how employers consume tech in a different way than sometimes we see in consulting. And I think it's probably made me a better consultant too. So when I speak with organizations throughout the country, I think I can look at things in probably a little bit of a different lens. So very happy about the path that I took, and just very grateful to have the opportunity to spend a little time that I did in tech.

Brian Urban:

That's really helpful because I think people will take that career stepping stone is something nice, a feather in your hat, a note on your CV, but it's more than that. It's something that can be built into your view when you share a perspective from a consultative standpoint, and then actually have it be applicable, not just an opinion, but actually applied. So I always thought that was an interesting part of your background, so thank you for digging into that.

Kevin Fyock:

Yeah, sure.

Brian Urban:

Kevin, it's safe to say you're definitely a cross between a health techie and a true techie at this point because you've done so many things across industries, but let's talk a little bit about what Aon's next big thing is these days. You touch a lot of different industries and sub-segments within that, reinsurance, cybersecurity, insurance growth strategies, and we're going to talk about a really cool tool that you've developed, you got lot of users on it as well, the Health, Equity, Affordability Tool. But what's some of the cool things with that, or maybe aside from that, that Aon's working on these days?

Kevin Fyock:

So Brian, it's not one thing, I would say it's a variety of focal areas that we really want to touch. And I think at the end of the day, we're keenly focused on what our clients are interested in, what pain points they're trying to solve. So I could rattle off a series of trends, many of which that I'm assuming would resonate with you, from the rise of GLP-1 medications and obesity, having such a significant light shining down it, focus on cancer and looking for solutions that really support a broader cancer journey, wellbeing, mental health, behavioral health. So there's a lot of things that we have the incubation stage of products and solutions that we're looking to develop to address a lot of these concerns that our clients are bringing us.

And then also looking at the linkage between providers and value, network contracting and value. Our clients constantly ask us for creative and innovative ways to actually have people steered towards the highest quality providers. But being at Aon, I think we're so fortunate because we are an organization that has a massive risk presence. So I sit on our healthcare team, but I partner very regularly with our risk folks, and it was through that lens that we developed a solution that we've been scaling pretty successfully in the past couple months, and that's this tool called our Health Risk Navigator. So we recognize that high cost claimants are such a huge concern out in the marketplace, so we developed a machine learned predictive model that looks at claim data, gets smarter the more claim data we have, and we can help organizations better produce risk, reduce volatility, and then use that as a key input to say what's the underlying clinical makeup of our population to steer folks to the right place to access care?

So that's something I'm super excited about, because it's not just addressing a single condition, but tying together both sides of the house at Aon, across health and risk, and then going to market with a solution that helps to address those problems from a high cost claimant perspective.

Brian Urban:

That particular tool, I'm not very well-educated on it, so it's good to hear you explain a little bit more. And it sounds like it's a risk analysis tool that's looking at spend, but it's also maybe looking at productivity of employees at a large employer group, or looking at other economic vasculars that are maybe touching someone related to the clinical makeup that you were describing. So if I'm right? Okay.

Kevin Fyock:

Yeah.

Brian Urban:

Cool.

Kevin Fyock:

Yeah, that's exactly right.

Brian Urban:

And so this is newer the last few months, you said, so you all at Aon rapidly get to this traction and scale point, so very good adoption so far? Good feedback?

Kevin Fyock:

Yeah, there's been a lot of chatter in the marketplace for it. I think there's a huge need. Throughout my career, high cost claimants are an area that have been a pain point for many organizations. And I remember throughout my career, sitting down and going through review meetings and saying, "Oh, here are your top 25 high cost claimants," and then we say, "Oh, well there's not really much you can do about hemophiliacs," for example. And so we went to market saying, "What if we can better predict that risk?" Because our clients are saying, "We want to smooth out volatility, we want to predict risk, we want to be able to target folks to the right programs that makes sense for them." So we're excited about this because I think it has such a positive spiderweb effect to impact other aspects of what our clients are asking for. So again, at our core, we like to focus on risk at Aon, so being able to lean in with a tool like this has been a lot of fun.

Brian Urban:

Interesting, what you shared, as you know, we recently talked to your Chief Medical Officer in North America, Dr. Charlie Smith, he was talking a lot about, and we'll ask you about this in a second here, the different socioeconomic factors that weigh in on what a score of risk would be, and he was taking the term, associating it down to determinants of health, and what societal fissures we have that exist that are difficult to predict, and even more difficult to address, and it takes a village approach. So with that prelude, your HEAT tool, I'm curious of this, the Health, Equity and Affordability Tool, so it combines a lot of the economics and societal challenges at a group individual level. So this has been developed the last couple of years, I think, and you've led a lot of that development. So tell us an update on the HEAT tool here, I believe you refer to it as the HEAT.

Kevin Fyock:

Yeah, we do. So it's our Health, Equity and Affordability Tool, but it's really affectionately known as the HEAT tool, which is great because I think part of the data visualization associated with the tool is a heat map, so I like to say all pun attended with HEAT. But I appreciate you asking about it because this is a tool that we rolled out in early 2023 and it's been really successful. We've run it close to a thousand times for organizations throughout the United States. And similar to your conversation with Dr. Charlie Smith, we recognize that one of the key questions that our clients ask us is around social determinants of health, which is around vulnerability, and how do you address vulnerability using analytics?

So we said, how do we go to our clients, get a limited set of data from organizations we work with, and report out on really four main factors? You've touched on a handful of them, but taking the HEAT name, focusing, one, on affordability, two, on social determinants of health, but we like to use an analytic measure of social determinants of health called the Area Deprivation Index or ADI, which is really a score from one to 100 of how vulnerable is a neighborhood? And then the final two measures are around access to, or I guess shortage to, primary care physicians and mental health providers.

And it's interesting because we recognize that there are all these macroeconomic conditions facing employers, facing our nation today, around inflation challenges, around healthcare costs, challenges around affordability, around equity, and we created this tool trying to further the discussion around specific views that we could help bring to an employer to impact ultimately their bottom line, but the vulnerability of their conversation with their employees. And we'd like to do it with, we risk stratify a population, who of your population is considered low affordable? So who is functionally uninsured because they spend an outsized portion of their income on healthcare? And then of those, who live in an area that are particularly vulnerable? And when you put those two elements together, we can have a really fun conversation with an organization to say, "Maybe we should talk about micro-segmenting your population. Maybe we should lean into this vulnerability and try to find ways to impact pockets of the United States maybe more this year than we were able to in years past."

Brian Urban:

And I love this approach, and we've talked to, on our little show here, a variety of health tech startups, those that are deep in research, in public health, lens of our ecosystem. And it truly does take a big village, there is not one national repository of data at the individual level, there's Social Variance Index, there's Deprivation Index that you mentioned in terms of what you're using for your tool. But it's so difficult because examining the human condition, household by household, community by community, and regions and so on. So what you've seen in terms of your early success with this tool is really exciting because it's showing that the employers, large, small, are bought in finally to, how do we help people outside of our walls to get them, not only met with their basic needs, but help them become more productive in life? And then [inaudible 00:13:23], that carries over into their work performance as well, so that's the big storyline that I really like coming out of your HEAT tool here.

Kevin Fyock:

And you know what's so fun about it, Brian too, is there are things that the employer can control, there are elements of healthcare costs you can control, but then there are things that an employer can't necessarily control. When you think about vulnerability, an employer, most of the time, can't build grocery stores, can't build libraries, can't increase the average income in certain communities. But it's spurred all these really interesting conversations where, in certain geographies, we've had pockets of organizations come to us and say, "Hey, we've all collectively run this tool. Can we get together in a room and talk about is there an opportunity to impact our collective community in a different way?" And that's been a really fun path to go down because I think to solve some of these vulnerability challenges, yes, I love that the employers are leaning into it, but it's going to take a broader social change beyond just company X, Y, Z saying, "Well, I'm going to reduce premiums," or, "I'm going to increase access." To your point, it takes a village.

Brian Urban:

Yeah, anchor systems, federal, state, municipality, all levels in terms of what can be changed, regulatory policies, access and improvement from there on out. But it's great. It's a catalyst. It sounds like this is a catalyst-

Kevin Fyock:

It is.

Brian Urban:

Is what this tool has started. So I guess you probably didn't imagine that it would be part of that type of maybe a miniature movement that you're seeing this tool be a part of. I guess you didn't see that coming, but maybe you did.

Kevin Fyock:

I think we hope for it anytime we roll a new product or solution out, especially a tool like this, which by the way is complimentary, we run it for almost a thousand clients and we don't charge for it because we feel so strongly about furthering the conversation around equity, furthering the conversation around affordability and vulnerability. So I don't think we were fully expecting it to scale the way that it did, but boy, it has led to some really fascinating conversations just in the past nine months.

Brian Urban:

I'd love to hear that, it's health equity being advanced without a hard dollar sign next to it. I think that's the other big takeaway aside from this being as a catalyst for change and being able to have a deeper view on what's happening in a society level, community level. So we could definitely talk all day about this.

Let me transition us to, I got another thought I had coming into our conversation, Kevin. You face a lot of different organizations. Not just employer groups, you face health plans, healthcare institutions, there's life science side of a division of AI as well, all things in between AI, cybersecurity, et cetera. What are you seeing from those corners of the ecosystem that are wanting to advance health equity in terms of technology being used? Not just community health programs or anything like that, that's very fundamental, but in terms of injecting health equity through technology, what are you sensing or seeing from those different entities?

Kevin Fyock:

Yeah, what I'd say, Brian, is everyone plays a pretty important role, albeit a different role. So you think about Aon's role versus a payer versus an employer versus a health system. I think we're all extremely important to the equation of health equity. And I'll use a couple examples. So health plans play an integral role in developing ways to improve access, just like tech solutions on the innovation side also play a very important role there. Providers are an incredibly important part of the stakeholder equation as well. So recognizing that there are different ways that members want to consume healthcare, virtually, in-person, providers rising to the occasion of adopting things like telemedicine and virtual care, meeting people that have that hurdle to get over because there's a cost associated with going to a physician.

So I think there are different levels of involvement that everybody can have. But what I love about where we are in the genesis of equality and healthcare in the United States is most of the stakeholders throughout the ecosystem are having the dialogue, and I think that's the right place to start, is we define what the problem is, it's an access problem, it's an affordability problem, it's an equity problem, and I think we all play different roles in helping to advance that.

Brian Urban:

It's nice to see that this has finally become, not necessarily to the center of the healthcare industry, but it's become one of the predominant agenda items on every single conference, every single forum, thought leadership article, that is on a daily basis. You can't go a day without seeing in healthcare, finance news, HFMA Magazine, Modern Health, New York Times, for goodness's sake. It's everywhere. And there is not one solution. I think it's probably interesting what you might hear from CFOs, or different finance leaders across the healthcare ecosystem, is they want an ROI, like show me the ROI, the evidence, which is so laughable because, and I've said this on different forms, they need to be a part of that journey in creating it. This is beyond a product and a transaction.

What have you seen maybe in your interactions with some of these finance leaders in different healthcare organizations, institutions? Are they more intuitive than generations in the past? Or are they more vulnerable to trying new things, more creative risk-takers? What are you seeing in terms of that audience?

Kevin Fyock:

I think we have seen a material change among the C-suite from finance, to operations, to different CEOs that we meet with on a regular basis. And our HR partners, I think our HR partners have talked for so long around equality, especially from a healthcare perspective, and I think the businesses, from a finance and operations perspective, have recognized that there is a connection to business performance. There are all these stats that I can rattle off around, organizations who lean into diversity, equity, inclusion, accessibility and belonging, have better financial results in organizations who don't.

But I think what's so important, and what I hear more and more, this year more than last year, last year more than the year before, is this isn't about words on the page. Specifically when you talk to finance and you talk to ops and you talk to HR leaders, they're looking for really actionable things. So how do you make an impact from an equity perspective beyond just, let's draw some bubbles on a page and say, "Oh, let's focus on these as our core values," but instead to say, "Yes, these are our core values, but here are the things that we're going to do to advance equity, that we're going to do to advance women's health, that we're going to do to lean into BIPOC populations and the LGBTQ population?" So those conversations have turned into really a business imperative, and I think it's been really fun to have those dialogues with all different facets of the organizations we work with.

Brian Urban:

I like what you said there because they're pinpointing some very specific things, so like believe that intention is to find a starting point in something, and there's been some great people that have said some comments around the health equity strategy. John Gorman was on our show many moons ago, and a successful entrepreneur in terms of identifying a population with data and analytics and starting to connect that into social health interventions. But don't try and tackle everything is what I'm hearing from you, pick something and work that into the values and ethics and that compass strategy and your business strategy, and start to do something. And I agree with you. HR, cultural competency, corporate responsibility, it's always been there, but now it's this new addition, it's evolution of now belonging, and then also addressing health equity. And I think HR partners across the ecosystem are really becoming more and more involved in that work from people [inaudible 00:21:48] internally and then also externally too with clients, et cetera. So that's really helpful to hear that.

Kevin Fyock:

To your point, the do something, I think, is what's key. It's a spectrum. From the level of budget you have, the how you're focusing on your culture from an equity perspective, and what I tell clients is, irrespective of where you sit on the spectrum, that's okay, and it's about defining where you want to go, what is your objective to move down the spectrum or stay where you are? Because that's where you want to focus. And again, that's okay. It's about defining where you want to be as an organization.

Brian Urban:

I love that you said defining because that, I feel like a lot of organizations you probably work with, consult with, they feel lost with where they can tackle, what they can do, their resources, their constraints, things like that. But one thing that this makes me want to go beyond our subject right now into, I think the influence of adopting new healthcare technology innovations. What are you seeing driving the most shoddy object adoption, or trying to jump the next big S-curve of innovation? Is it hardware, AI, other influencers in the industry literally showcasing what they're doing? What's some of the biggest drivers you're seeing out there?

Kevin Fyock:

I love this question because, one, this is just such a fun question to answer, and it's coming off the heels of the HLTH conference in Las Vegas where I had an opportunity to go and just really shined a light on some really amazing innovation that's coming out. So you named a couple across software, hardware, AI, you can't enter any conversation in the healthcare landscape in the past several months without talking about AI. ChatGPT has really shined a light on that in a pretty big way. So I think where we are from a healthcare perspective is there has been an unbelievable proliferation of software products, especially on the employer side, SaaS-based products that look at engaging folks, look at addressing specific chronic conditions, and the list goes on and on and on. Some amazing organizations that have really materially impacted the lives of members and reduced costs for employers, which is great.

I do think though that we're in a super exciting time where there has been so many different software products come to the table, where we're starting to recognize that there's an unbelievable role for hardware to play a role as well. So you think about wearables that people have, I'm wearing one right now. The significant focus on remote patient monitoring, I met with a whole bunch of organizations recently that focus on remote patient monitoring, whether it's blood pressure cuffs or virtual stethoscopes, this is something we've talked about for many, many years, but one of my bets is this is going to be something that continues to be greater and greater focus for employers, and then I think just healthcare more broadly.

I also think, because of the rise of so many different software products and now hardware products, we're probably going to start to see a level of consolidation in M&A in this space as well. You think about massive saturation across certain chronic connection elements, probably going to see some of these organizations potentially come together, which I think could certainly be good for employers. And again, that comment that you made, or the note you made around artificial intelligence, I spent a lot of time talking to organizations throughout the US around the rise of different language models, generative AI, artificial intelligence. In fact, I'm taking a course right now at MIT on AI just because I find the topic so fascinating, and there has been some amazing things coming out. From chatbots, to mimicking a human in an empathetic way, to even things like we developed with our health risk navigator using machine learning to predict claims.

But I think we are right on the precipice of some really exciting stuff. And I say to clients that in the mid-nineties, we didn't know the power of the search engine the way we know it today. And I feel the same way about artificial intelligence where ChatGPT is a household name. We don't fully appreciate yet as a society about the amazing impact this is going to have within healthcare and the small minority of providers who are using it today, that's going to rapidly change over the next five to 10 years, and I for one am super excited to sit, watch, and hopefully be a part of it as well.

Brian Urban:

It is amazing, using ChatGPT for the first time earlier in the year, looking at it, I was thinking, was this the similar experience that those, I guess, organizations at the time had with first sending emails? A miracle online. And searching for something on the internet. Definitely just this huge, huge move to AI and how that will impact, and everything from NLP, to being able to have more intuitive engagement conversations, coordination of benefits, of clinical information, social health information, everything. So it's just going to be amazing. And how it's used will be, I think, to be determined in more universally accepted models. So it's very exciting, I hope you had a good time at HLTH.

Kevin Fyock:

I did.

Brian Urban:

They looked to pull off a really cool, almost Dreamforce vibe, they got some mascots there, but obviously focused on healthcare. So I hope you had a good time there in Vegas, you didn't party too hard, but...

Kevin Fyock:

Oh, no. I was busy. I had quite a few meetings and it was incredibly productive. But that event has grown each and every year, but it was a lot of fun. Your comment about looking back on what it was like sending an email with ChatGPT, I think what is so fascinating to me is the amount of time it's taken for these products to scale. ChatGPT to get to a million users was a matter of two or three days. When you think about Netflix to get to a million users, it was a matter of years. So the scale at which these technologies are coming out and being adopted commercially is amazing. So when you have that situation where things are scaling so quickly, the innovation is just going to follow and be faster and faster and faster and we're going to start to see it touch so many facets of our day-to-day life.

Brian Urban:

Yeah, you're so right on. It's this societal arc, we've said that a lot of our population is very tech-savvy. To a certain degree, that isn't just hitting buttons and using phones and falling process, but intuitively searching for something or using tech in maybe unintended ways, in different ways. So yeah, it's really exciting, I'm glad that that was a fruitful conference for everyone that attended.

Kevin, I want to look down the road a little bit here in terms of your impact and your innovation work at Aon. What do you think the next three, five years will be? What's a big contribution you think that your organization's going to make to the ecosystem?

Kevin Fyock:

Yeah. Well, I think we're going to continue to scale what we have in market. And I think when we opened up our conversation here, I made a note around clients asking us to focus on GLP-1s and cancer and mental health and behavioral health. We're going to continue to lean into those big macro problems. But I think our big focus on Aon is, one, to continue to address those needs using innovation on behalf of our clients. But I think harnessing tech at a more rapid rate than we've done before.

So whether it's language models, whether it's artificial intelligence, I'm on a mission here at Aon to have our name become synonymous with innovation, so it's the first thing that folks think. And so I'm really looking forward to the role we can play, but at the same time, having hopefully a seat towards the front to watch this rapidly evolving ecosystem, where right now we have so many different things that feel very disparate, and watching them come together, especially around the equity piece, Brian. So you have situations where organizations focusing on LGBTQ populations, organizations focusing on women's health, men's health, men's fertility, BIPOC population, look forward to us helping to play a role to bring some of that together, not just from an equality perspective, but more broadly too.

I think we sit in a position where clients are asking us to help them solve big, chunky problems, and we look to organizations, tech companies, vendor partners out in the ecosystem, I think we could play a role in helping to bring some of those together to create products and solutions and solve problems in a harmonious way. Because if there's one thing that I would say that hopefully resonates with the audience here is when we work together, especially in healthcare, we've seen that the results are far better than people working separate from each other.

Brian Urban:

I love that you ended on that, the collaborative note there, and excited to see what Aon can contribute and the catalyst that you all have shown that you act as, to creating change and impact. It's going to be so exciting. Kevin, well, thank you again for being on our little show here. This has been a really fun conversation and I just appreciate your time.

Kevin Fyock:

Yeah, thank you, Brian. This was a lot of fun, so I appreciate you having me.

Brian Urban:

And for more exciting excerpts and insights, please visit us at finthrive.com.