TEDMED Insider Insights from Gravie’s CEO: A Consumer-Centric Healthcare System is Needed

Gravie recently had the opportunity to present at and participate in TEDMED, a healthcare edition of the well-known TED conference. Specifically, we were part of TEDMED’s Hive Startups, a group of healthcare-related young companies that were invited to showcase their ideas and emerging solutions to the audience. Gravie’s CEO, Abir Sen, shares what he took away from the event and what it means for the future of healthcare. 

As I interacted with the other Hive companies at TEDMED and listened to the thought-provoking speakers, several themes began to emerge. As I considered them, I realized these are the themes that will define how we plan, manage, and finance our healthcare in the future.

One important factor contributing to change in health and healthcare is that we’re far more knowledgeable today about human physiology and understand (as much as we can) that every body is remarkably unique, right down to the behavior of our cells. We each have predispositions to disease and the ways our bodies attack it; we all have unique risks determined by our DNA. These aren’t new findings. What is new, though, is that we’re taking this information and changing the way we treat and manage health.

The changes happening in healthcare will inevitably lead to changes in how we handle health insurance. With the capabilities to understand at a very granular level the health of an individual, health insurance will trend toward a more individualized approach. Today nearly half of the people in our country have a health insurance plan through an employer (49%), but instead of covering people with a “one-size-fits-all” group plan, doesn’t it make more sense to create plans specific to each person’s healthcare needs, their predispositions, family history, and other factors? There certainly has been early progress in this trend towards customization. When the ACA was enacted, individual plans became more accessible and affordable – so much so that The Kaiser Family Foundation reports that the individual market grew 46% between 2013 and 2014.

How Might This Look in The Future?

Highly personalized care and the customized insurance to cover it is only a hypothetical today. But all signs point to care that’s based on a patient’s needs and that looks at a horizon further out than we typically do today.

This approach might someday take the form a multi-year health plan – where instead of making benefit choices every year, one takes a longer term plan for their health, much as they would approach their financial plan (imagine the confusion if you had to choose a whole new retirement solution every year!). This approach may also lead to consumers, with the help of advisors, constructing their own customized network of doctors; making sure that their network includes everything that they would need, but excluding things that they don’t. (If you live in Indianapolis, do you really need access to that hospital in California?) More generally, this approach leads to a system optimized for the needs of every single individual consumer, versus being collectively optimized for a large group of individuals (such as all employees in a company).

The benefits to consumers of such a system would be enormous. For one, it would allow consumers to explicitly make trade-offs that all too often are made for them by someone else. For instance, let’s consider the new trend of having insurance plans with really narrow networks. Yes, these plans are cheaper, but what if you want the ability to go to any doctor at any time, and are willing to pay a bit more for the privilege? If your employer chooses a narrow network plan, you are out of luck.

A consumer-centric system allows the consumer to exercise their own will, and make decisions and trade-offs that are right for them. In almost all other facets of life, the American consumer likes to customize what she consumes. We buy cars that have the options that we want, construct music playlists that are exactly to our taste, and build burritos with ingredient combinations that would make a mathematician’s head spin. With something as important as our healthcare, why should we let someone else choose for us?

A consumer-centric system also holds all the suppliers of services accountable. Too often today insurance decisions are made based solely on what the broker has presented to the employer, and too often the broker is biased in favor of plans and insurance companies that make him or her more money (look up “health insurance contingent commissions” for the dirty little secrets about how brokers make money). The consumers’ needs and desires are an afterthought, at best. In a consumer-centric system, every service provider – from the insurer to the doctor to the pharmacy – is focused on the needs of the consumer. If the consumer doesn’t like something, they can vote with their feet and choose a different supplier. They are not shackled by other people’s ulterior motives. They are not limited by sub-optimal decisions made by someone else. They can ultimately be in charge and have the system work for them.

The future of healthcare in America is bright. The potential is enormous, and we are on our way. To reach our full potential, however, we as an industry need to focus solely on the consumer, and stop worrying about the needs of parties that don’t ultimately matter (employers, brokers, politicians, and everyone else).

About Abir Sen

Prior to founding Gravie, Abir was the CEO of Bloom Health where he led the creation of private exchanges – one of the largest trends in healthcare services. Prior to Bloom, Abir was co-founder and president of RedBrick Health. Under his leadership, RedBrick Health launched the industry-leading Health Earnings system, created innovative product and distribution partnerships, and achieved health improvement results that far outstripped any of RedBrick Health’s competitors. Before co-founding RedBrick Health, Abir co-founded Definity Health and was part of the team that invented the Personal Care Account, the predecessor to the Health Savings Account.

Abir has a B.A. in Economics from Lawrence University and an M.B.A. from the Harvard Business School. Other than healthcare, Abir’s interests include aviation, dogs, and U2.