Joel recently began his journey at Crossover, joining us in the newly-created position of Chief Product Officer. He spent many years within the UnitedHealth Group, in particular with OptumInsight, and brings deep knowledge of health infrastructure, product and design experience with a specific focus on payer and provider environments. In this first interview, we learn about his roots, his career trajectory and above all, his family.
Congratulations on your new role. What are your first impressions?
I started on July 19th and in the first two weeks I’ve had the chance to travel to meet the team in person, which was a great way to onboard. There’s a tremendous energy and collaboration when you have the chance to meet in person that you don’t always get through Zoom. Being in San Clemente also gives you the full picture of our corporate culture and, I’m starting to work on my surfing lingo . . . including learning to say “super stoked” in a business setting, which is something this Minnesota born and bred boy hasn’t had a chance to do before.
Tell us about your back story
I grew up in Faribault, Minnesota, a small town just south of the Twin Cities, and I currently live about 40 minutes from there. I have always called Minnesota home and it has been a great place to raise a family and build my professional career. I did leave the state briefly for college, heading to Luther College in Iowa, a small liberal arts school where I graduated with a double major in management information systems (MIS) and communications, and worked on a minor in computer science. I graduated in the era of the Enron scandal and the 9-11 tragedy, so it was a difficult job market without a lot of corporations hiring.
I had applied for an internship at Accenture the previous summer and eventually joined the firm in September of 2002. I enjoyed my four years there, focusing on supply chain management and advanced inventory planning. Much of my time was focused on software development in support of operational improvement and retail efficiencies.
I had to spend a lot of time on the road, though, not just in the US but internationally, with multiple weeks away from home. I worked on engagements extensively in Australia with Coles Myer, spent time in England with Sainsbury’s, the grocery store chain and worked with the Williams-Sonoma/Pottery Barn business in San Francisco, to name just three. I was flying Monday morning through Friday morning, and as much as I enjoyed the people and found the work exciting, I now was a father with my oldest born in 2006. I realized I needed to get off the road given how important my family is to me. I just knew that I needed to change.
How did you find your way into healthcare?
I was recruited to join a part of UnitedHealth Group called the Innovation Lab in 2006 which had been formed as an internal consultancy at UnitedHealth. UHG was investing heavily with large consulting firms and believed that if they could even carve out half of the investment with these external agencies and build an in-house consultancy, it would not only save money, but they could also begin to build an internal tribal and institutional knowledge asset. I joined that group in the summer of 2006 and spent the next 15 years in a variety of increasingly interesting and challenging roles. I ran large systems analysis on product benefits for UnitedHealthcare for the first two years with the company. In January 2008, I had the opportunity to join Ingenix, the precursor to Optum, and lead all of our payer product implementations. That included everything from credentialing, provider data, fraud, waste, and abuse to payment solutions and claims editing capabilities that we sold as software and service to large health plans. I managed the teams that did the development, testing, and implementation. In 2011 I was asked to help reimagine a way for payers and providers to work together and optimize the provider networks that payers like UnitedHealth have created. My role was to help create a new business unit we called Network Optimization.
We were ahead of our time. For a lot of health plans, network management and development was their secret sauce. Their differentiation is their network, either because they have curated the largest network or the highest performing narrow network. We got some traction, but not as much as we’d hoped, partly because we were too early in the industry’s value-based care evolution.
What’s your view on accountable or value-based care today?
I think we still have not cracked that challenge in 2021. I don’t believe we’ve achieved the tipping point for provider systems to change their dynamics. The infrastructure, like EMRs, is still biased towards a traditional fee for service model and things like provider incentives continue to be based on driving productivity rather than achieving outcomes. There are only a few systems that are taking on significant capitation and focusing on risk based populations, and these tend to be higher performing than others. I think the challenge is that systems that try to retrofit their infrastructure, their processes, and their tools to support both fee for service and value-based care don’t have the level of commitment required to make the hard cut over. They still require a significant amount of volume to be successful. That’s why the role at Crossover was so intriguing to me; finally, a company that was committed to upending fee-for-service and focusing on outcomes. Now I see it as a part of my job to make sure the market understands just how we are doing that.
Capitation was given a bad rap by HMOs decades ago. Why is it the right solution now?
It was. But then the pendulum swung from there all the way over to “I need as much access as possible” with payers trying to manage the costs through benefit design and access restrictions. The pendulum is starting to settle down a little bit more in a realistic middle ground, in that consumers have acknowledged that they have to pay a premium to get access to every major reputable system and doctor in the United States. Subsequently, there are more and more consumers that are willing to purchase more reduced access with better aligned care at a more affordable price. We’re seeing an uptick of aligned groups like Crossover where there’s a willingness to have a narrow network or tiered network product, as long as it’s not just an access denial mechanism, but a more aligned care story that matches the value consumers are willing to pay for.
How did you end up connecting with Crossover?
Following my time with Network Optimization, I had a number of other great opportunities during my time with Optum. I supported their Growth Office as a Solution Architect on Optum’s largest partnerships including with John Muir and Boulder Community Health. Prior to my transition to Crossover, I led Optum’s provider product portfolio including revenue cycle management, clinical, analytics and broader services.
But, after 15 years, I began to realize I was not as energized around figuring out how to make sure patients have an easier time paying their bills. That wasn’t what got me up in the morning. I’ve always been naturally drawn more to the clinical aspects of healthcare and figuring out how to provide a more comprehensive and integrated care experience.
Like many people, the pandemic allowed me to pause a bit and reflect on what I wanted to be doing personally and professionally. I reinvested my time into my family, I coached my daughter’s softball team for the first time and I reached out to a variety of mentors and advocates that I’ve known throughout the years to consider future options.
In that process, I reconnected with Katie Higgins, a former colleague of mine who was now Chief Revenue Officer at Crossover. Katie and I had the opportunity to spend quite a bit of time on some amazing client projects at Optum that required deep strategic thinking and high alignment between stakeholders, and we were at the forefront of a specific engagement. With a profound respect for her vision and integrity, I was picking her brain on what my options could be and she put me in contact with Scott Shreeve, Crossover’s Founder and CEO. I started talking to Crossover in March and while I’m intrigued by what they have done with their primary health model of care and their onsite / nearsite / virtual offerings, what really got me excited is where they were going. I spent time understanding how Crossover saw the accountability of product, and what they needed from the CPO role. Through this, the more I talked to the team, the more excited I became. What originally was just mere curiosity became a strong enthusiasm which, as Scott would say, eventually became “inevitable.”!
Part 2 of our interview with Joel will discuss his role as the new Chief Product Officer, his view of insight enabled care, and where he sees the future of Primary Health.