Don Antonucci is just 43, but already he’s worked in health policy, sales and management in locations across the country. Now, as president of Regence BlueShield in Washington, he is drawing from a broad range of resources within the BlueShield health insurance empire to address the challenges of operating in a rapidly changing health care system.
YOUTH: I was raised in Washingtonville, 50 miles outside New York City. My mother was the secretary at an elementary school and my father was a Ph.D. in organic chemistry who worked for Champion International, the paper company. He coached me in baseball and basketball. I didn’t have natural talent and, in elementary school, I was on the “B” team. But my father encouraged me to practice a lot, and by my senior year I was on the “A” team and I was MVP of my team. That taught me the value of perseverance and hard work.
EDUCATION: I studied political science at the State University
of New York at Cortland, and then did a master’s in public policy analysis at SUNY/Binghamton, graduating in 1994. My first job was at the Health Insurance Plan (HIP) of New York, where I spent five years. It was an HMO and I did research and analytics on things like customer satisfaction. My bosses would always say, “Just do what you’re told.” They just wanted me to collect data. I always pushed back. I wanted to know how they were going to use the results to improve health care.
STRATEGY: So I moved to Mathematica Policy Research, where I got to do health policy studies. Still, the fun policy stuff was done by the mathematicians, so [in 2000] I moved to Horizon Blue Cross Blue Shield of New Jersey, where I did competitive intelligence and product development. I enjoyed being on the strategy side, so I took a job doing market analytics at Anthem Blue Cross Blue Shield in Maine. There, I worked closely with sales. I got to apply research to results.
SALES: People told me I should go into marketing, but I wanted to go into sales management. I like sales because it’s where the rubber meets the road. You get to know what customers are thinking. I like to work by doing things face to face. Even today, I do management by walking around.
MANAGEMENT: In 2010 [at The Regence Group] in Oregon, I joined an organization that needed to grow. [As vice president of sales and later as president,] I was able to tap my experiences to put together a solid management team. I drew on my sales and marketing experience to grow. We significantly grew several segments, including self-funded plans, which climbed from 400,000 to 600,000 clients.
THE SEATTLE CHALLENGE: Our parent company, Cambia [Health Solutions], has 20 companies that include seven different health plans. Since each client is different, our challenge is to take those assets and weave them into solutions that fit their needs. HealthSparq is our transparency tool. It allows people to see the cost of health care (see page 42). That product serves 60 health plans with 60 million people. We also have LifeMap, which offers life insurance, and OmedaRx, which offers pharmaceutical services.
HEALTH EXCHANGE: BridgeSpan [Health] is a new brand we created that offers health insurance through the state health exchanges. We made a strategic decision to move into that market slowly. We wanted to look at [the consumer health exchange] market in depth. It’s a different market. Since the products are standard, off-the-shelf, it’s hard to be distinct. And it’s a different consumer experience. [With the state health exchange,] you put out products and services to attract buyers versus what we are good at, which is wholesale service.
CHANGES IN THE INDUSTRY: Today, most companies pick a carrier [for insurance]. Only 10 percent of health insurance customers are retail. In the future, that will be flipped on its head. By 2020, 50 percent will be retail. More companies will move toward defined contribution in which they give their employees dollars and let them choose what kind of insurance they want. If consumers choose higher deductibles, they will be more careful about how they spend their health dollars. Many companies will become part of private exchanges that will allow employees to pick and choose what services they want.
TRANSPARENCY: The Affordable Care Act has lit a fire and people are finally taking steps to simplify things for the consumer. Transparency is key. The information is available; the question is how you make it easier for consumers to use. The trend is toward high-performance networks [in which health care providers are chosen based on efficiency and quality measures], so that you are not paying for the volume of health care delivered but for value. We need tighter partnerships with providers to manage costs and control utilization. People on health savings accounts will look at what they are spending. It’s also a question of how benefits packages are structured.
CLAIMS DATABASES: States like Maine have claims databases, but how do you get people to use that information to make decisions? If someone needs an MRI and they are told it will cost $900, they can call our customer service to get recommendations. Sometimes you can get the same quality for a lower price. But we want to be able to negotiate discounts [with health care providers] so we are the most competitive.
WASTE: About 30 percent of health care spending is considered waste. One way to cut the waste is to build high-performance networks that enable health care providers to partner with patients more closely. You can design into
benefits incentives to keep people healthy. You might get a deduction off your premium if you lower your cholesterol,
for example. Companies like that [scenario] because increasing wellness is not only good for the employee, but it also reduces absenteeism.