Erin told us about her journey into healthcare and Crossover in Part 1, and how Crossover became the place not only where she could combine her various skills, but also where her interest in making a difference could bear fruit. In this second part of our conversation, Erin describes how the company has evolved, how the marketplace is changing, and the power of Crossover’s culture.
How has your role at Crossover changed since you started?
Account management has changed a lot in the last three years, and I’m really proud of where we’ve been, how much progress we’ve made, and where we’re going. I’m now the Vice President of Account Management for the company. When I joined, I was responsible for the East Coast and then took on responsibility for Central as well. About a year after I joined, I had the opportunity to put forward a plan for what I thought the overall account management team could look like. It had been working well, but couldn’t accommodate the growth we were beginning to see.
What were the key changes you enacted?
We had a structure in place at the time that was geographically-based, which aligned with our medical group. But since I saw the majority of our growth coming from existing clients, I reorganized account management by client, not location, because many of these relationships were national in scope. We also had a one-on-one approach, where each account manager had a list of exclusive clients, but this did not scale well, nor could a manager escalate or delegate an issue.
The structure we put in place instead is called the principal-associate-principal structure, where we have three senior principals who are the strategic partners for our clients. They’re focused on what those clients are trying to accomplish from a healthcare perspective for the next two to three years and making sure we’re earning the right to grow with them. These senior managers then guide their teams of associate principals who oversee the day-to-day execution.
As part of our process, we have created triads so that every physician leader and practice leader is paired with somebody in account management. It’s one of the things that makes us successful, because we are bringing business acumen to the clinical teams, and then we have their clinical expertise that our team can rely on for client interactions. These partnerships are crucial and I don’t think there is any substitute for that balanced approach to strategic client partnerships.
What problems are employers trying to solve? Is it more than just costs?
The truth of the matter is, cost matters. All of our clients are organizations that need to make a profit. We know that if you invest upfront in primary health services over time your healthcare spend will go down. Initially, it was our hypothesis, but now both market experience as well as our own operational experience with clients is proving this out. To us, we see this as black and white.
But cost isn’t the only factor for employers. They are also trying to solve challenging access issues as well as ensuring that their employees get the right care when they need it. They also want to keep their teams healthy and productive, and that was certainly brought home this year. There’s no entity that’s more incented to keep a population healthy than an employer which is why we love thinking about them as an innovative payers. We find employers much more progressive and creative in this space than I think many of the traditional payers. They are working very hard to address issues in not just primary health services, but also mental health, centers of excellence, and other cost drivers. I think what they’re solving for when it comes to healthcare is relatively simple—doing the right thing for their employees and their families, trying to give employees access to higher-quality and lower cost care, and enabling employees to contribute more effectively and productively at work.
How widespread do you think this innovative attitude is among employers? How responsive are they to what Crossover is offering?
When we first started, most of our clients were the Bay Area tech companies. But today, we have employers in every single industry. There’s only so much tinkering with plan design that they can do and if they really want to have an impact, they have to get into care delivery itself. I’m sure there was a point where it was only the boldest, most progressive organizations. But you know, once enough of those organizations had data proof that our model works—and it pays off—others were excited to jump on the bandwagon. I am so incredibly proud of the diverse group of organizations that we are privileged to call our clients.
How do you communicate the Crossover difference to existing and new clients?
Although I’m not in sales, and my team isn’t considered sales, the majority of our growth does come from the relationships we establish with existing clients. But we have to earn this “right to grow” as we describe it on our team. The significant majority of our clients start with Crossover in one unique population, and we talk about what success looks like, what’s important to them, what metrics they’ll be using to determine success. As you start to achieve success as defined by the client in each market, you earn the right, piece by piece, to go to the next population until you are covering all the employers lives across the nation.
When we talk to prospective clients, the simplest way to communicate value is to tell clients’ stories. Talking about a client that did a pilot with us in New York, where utilization and NPS were off the charts, and then pointing to the claims analysis that shows that members who use Crossover as their medical home had a much lower healthcare spend than their counterparts in the community…that’s a powerful peer example and our best sales tool. These prospects can follow the narrative of starting in one location, and constantly expanding until there is a consistent approach across the country. I don’t know, really, of any other organization that has such a clean, clear succession of success stories.
How has the pandemic changed the employer landscape from your perspective?
It’s pretty interesting. Every organization and every vendor is rushing into the virtual space, but we’ve started to get some initial data from clients. The employees of some of our clients will use, say, the telemedicine services, and then they’ll show up in the community for care a couple of days later. That’s not good. Based on the data from one pilot that we’ve started to pull together, even with virtual care, we’re keeping almost 90% of patients within the Crossover universe. I think telemedicine is great for a few things, but what’s the point if you need to go back into the community the day after your visit?
I think our clients have been forced to become experts on things they probably never dreamed they need to be experts on. With our Medical Group leadership, we have been able to provide our clients guidance and perspective, and help them cut through all of the noise. They’re inundated not just by what’s happening out in the world, the news, and the media, but by different vendors, offers, and solutions. In March, we started hosting weekly client council webinars that were COVID-related. Steven Ezeji-Okoye, our Chief Medical Officer, would host them, talking about everything from testing to vaccination strategies to new delivery channels. We’re uniquely positioned to serve as their trusted source of truth, and the great feedback we receive confirms this. And now, we’re getting into larger issues of mental health, and of people having put off managing their chronic diseases and how to turn that around. Our clients want their employees to consume healthcare. It’s not good for anybody when they don’t.
How are your management and leadership approach adjusted during a year of crisis?
My team has always been remote. We have an advantage in that we have always hired for strong independent work capability and a willingness to work in a remote structure—we consistently over communicate. We typically get together a few times a year, but we’re scattered all throughout the country, so I ensure that we allow as much work flexibility as possible. My team is so committed to our mission, they always figure out how to get the job done. We might have a few more kids popping into our zoom meetings when they need help with remote school but otherwise, we’re just doing what needs to be done! One of the keys to remote management is trust and we have developed tremendous trust in and on my team.
When you’re developing talent, how do you communicate the magic and the mission of Crossover?
When I interview people, before I hire them, I tell them that this can be a hard place to work, because we’re at that teenager stage. Not everything is worked out. There isn’t always a manual to read and often times if you are writing it you might be editing it. We’re still growing. We are still learning. And, in a setting like this, you have to really be connected to the mission in order to be successful. If you are obsessed and focused on making healthcare better any of these minor bumps in the road don’t feel like such a big deal. I used to wonder why Nate gave me Sticky Bumps when I first came onboard Crossover, but now I understand that sometimes you need a little help to stay on your surfboard.
Having that connection to the mission has to be genuine though, you can’t really fake it. The simplest way for our team to stay motivated and for our clients to stay excited, is by sharing member stories. It is always the thing that just lifts the team up on a daily basis. We look for them and then we circulate them. In this environment, where people are remote, shooting emails out to just say thank you to this doctor or nurse or provider or, and making sure leadership is aware, really goes a long way. These stories genuinely give us the energy that we need to overcome any of the little daily challenges.
Alot of the magic remains very personal for me. I always feel so honored if Scott and Nate give me the chance to do something that really represents Crossover, and really represents the two of them. Our founds really created something out of nothing. So if they give you a little piece, and trust you’ll be responsible with it, you have to take it seriously. It’s an amazing learning opportunity. None of us have ever created something like this, so in spite of all my experience, a lot of it is learning on the fly.
Can you share how your leadership experience has impacted you as a parent and what you want for your own son?
This question puts a smile on my face. Being a parent is extremely humbling. Every single day, I am amazed by this little person and continuously surprised by how uniquely himself he is. There are certainly parallels between leading a team and being a parent. When I was a newer manager, I thought my job was to solve all of my team’s problems. As I’ve developed and refined my management style over time, I’ve learned that I don’t have all the answers and that is ok. More often than not, my team members instinctively know what they need and I can best serve as a sounding board and advocate. Throughout any given day, I’m constantly evaluating which role I need to play – driver, navigator, or passenger.
As a mother, I want to fix every problem for my son. But, as he grows up, he won’t develop the resilience and confidence that he needs if I don’t give him space to make mistakes and handle hard things. I will not be able to control what my child does when he’s an adult, but I hope that my husband and I can influence and guide him in the right direction. I might be biased but he is a bright, kind, and curious child and I hope he realizes his potential. We want him to find something that he’s passionate about, and find a way to leave his own mark. And that could be big or small. To do something that he cares about, and something impactful, that’s what I want for him.
Many thanks to Peter Heywood (one of our long-standing brand advisors and business consultants) who helped conduct these interviews. You can search for Peter’s other Crossover Leader Series Interviews here.