A healthy balance

Amid a challenging industry landscape, Network Health and CEO Coreen Dicus-Johnson walk the line of meeting the needs of both employers and members

Posted on Jun 29, 2018 :: Cover Story
Jessica Thiel
Posted by , Insight on Business Staff Writer

When Coreen Dicus-Johnson saw the dates, she couldn’t make sense of them.  In the early days of taking the helm as CEO of Network Health in 2016, she was looking at a report when years like 1985, 1988 and 1992 began to jump out at her.  “As a new CEO, you want to look under every cover, every hood,” she says. “So, I get this report, and it is every single group, how they’re performing, and it tells me the first date when they became a customer. And I’m like, ‘OK, this can’t be right.’”  She called underwriting to investigate it and confirmed the years shown indicated how long companies had been customers. From there, Dicus-Johnson asked the department to calculate Network’s average retention rate and learned it was 10 years versus two to three years for the company’s competitors.

For Dicus-Johnson, who’s been in her role for about 18 months, the longevity of these relationships reflects the trust companies place in Network and the vital role it plays in the communities it serves.

“It was like a call to action for me in the sense that we’ve been rewarded by the community and employers,” she says. “We have to continue to answer that calling.”

The insurer seeks opportunities to become a partner to employers in decision-making, ultimately helping in recruitment and retention efforts and maintaining health care costs, Dicus-Johnson says.

Managing the needs of those companies and their employees — or Network’s members — can prove to be a balancing act, however. To navigate this, Network works to understand where all the opportunities fit together.

One element is key to helping provide this balance, Dicus-Johnson says: health care literacy.

Dating back to her time as president of Wheaton Franciscan Healthcare, Dicus-Johnson, who holds a law degree as well as a bachelor’s degree in communications and public relations, has been passionate about educating patients. She wants people to understand their plan and options for the services provided.

“When they’re better at navigating it, it directly translates into cost containment,” she says, and that benefits all parties. “It’s empowerment. It helps people understand how to effectively purchase their health care services and to be accountable. Members want that. Employers need that.”

Network operates on a local level, and that’s what differentiates the Menasha-based company, Dicus-Johnson says. Employees live and work in the communities they serve, and because Network is a private company, all the money stays in the state.

Profits are reinvested into the communities Network serves — its coverage area includes much of the eastern half of the state, from Racine to Eagle River. The company is not beholden to outside shareholders, but rather to local communities and Network’s members and patients.

The company’s relatively small size means it can roll out improvements quickly, and this benefits members and employers as well as brokers and Network’s provider-owners, Dicus-Johnson says.

“It also allows us to be more flexible because we are local, we’re smaller,” she says. “We have enough size to do what’s necessary to take care of our members, but we’re small enough to be nimble and flexible in our decision-making and, more importantly, our implementation.”

Traversing tumultuous terrain

That flexibility is an important attribute given the unpredictable and ever-changing health insurance landscape.

Network, which offers individual plans on the health care exchange, noted rising costs and looked at how it could impact those. It’s vital for members to foster relationships with providers quickly, but cost is often a barrier for people.

Recognizing this, Network enacted a policy of no co-pays for the first three visits with a primary care provider. It was a physician-recommended change the company was able to implement quickly.

The company remains committed to staying in the individual marketplace, Dicus-Johnson says, but uncertainty from both the state and federal legislative perspectives continues to loom large. She’s watching two areas of legislative and rule-making discussion that could destabilize the individual and group markets.

There’s been talk on the federal level of extending short-term health plans, so they could last up to a year and be renewed. The inexpensive plans provide limited coverage and attract healthy people, but this carries consequences. Healthy people may then start to leave the individual marketplace if they can get cheap, short-term, renewable coverage, creating adverse selection. This would destabilize the marketplace and drive up costs, Dicus-Johnson says.

Association health plans also are an issue. With these plans, a group of small employers comes together to purchase health insurance.

“I know that everybody looks at it and at first blush says, ‘Well, this is great. People can come together to buy coverage,’” Dicus-Johnson says.

However, similar plans have failed in the past because consumer protections weren’t in place to ensure associations had enough money to pay claims and underwrite the costs appropriately. In the past, it was not uncommon for someone to go to the hospital thinking they had coverage only to learn their plan was insolvent and they didn’t have enough money, Dicus-Johnson says.

Though Dicus-Johnson doesn’t think these plans would be good for the industry, Network still needs to understand what’s going on with them and be nimble enough to support them if necessary.

The company’s Assure product provides one solution to what’s going on in the industry. It’s a level-funded product that helps put smaller employers on an even playing field with larger employers, Dicus-Johnson says.

Made for companies with two to 100 employees, the plan offers the predictable, fixed monthly rates of a fully insured plan, but employers only pay for health care that employees use. The plans also can be underwritten — plans under the Affordable Care Act cannot.

“What we’ve found is, it’s substantially lowering the health care costs of many employers and puts them in a much more cost-effective position,” Dicus-Johnson says. “We can support them, but it also gives them peace of mind that in the event something does happen, it’s not going to tank their business.”

Responding to the marketplace and employer needs is something Network excels at, says Cindy Van Asten, a broker at M3 Insurance.

“It’s important to understand what those individuals, business decision-makers and brokers/consultants are looking for when making their health insurance purchase,” she says. “By hearing the true needs of the network, they are able to identify ways to provide their members with top-quality service and clinical services.”

Integrated care

Network aims to provide holistic care for its members. As a provider-owned company, health care providers are part of a circle of integration at Network, and that informs member and patient care. Physicians at Network work closely and regularly with physicians within health care systems to address issues related to patient care, collaboratively planning and designing products.

The company has embraced clinical integration, a model that calls for coordinating member care across conditions, practitioners, settings and time. Its goal is to promote high-quality care in a safe, efficient, unbiased and patient-focused manner.

Teams of providers work with Network physicians and staff to identify opportunities for improvement. They create a scorecard and accountability and tracking that goes all the way up to the boards, Dicus-Johnson says.

Clinical integration has been shown to help members and practitioners establish and build relationships and raise standards for primary care to include prevention services and care for chronic conditions. In addition, it educates patients about proper channels to follow when health concerns arise after hours.

All this leads to better outcomes, Dicus-Johnson says. Patients and providers report higher levels of satisfaction, and education around appropriateness of care leads to cost savings. In addition, it encourages collaboration and reinforces patient connections to primary care providers.

Network takes a complicated industry and helps its members navigate it, says Penny Ransom, the company’s chief administrative officer. People may reach out for care in pain or crisis, and Network can help alleviate that stress by making sure they get the right care at the right time and place.

Embracing change

Network, which marked 35 years in November, has undergone a major transformation in the past five years. In 2013, Ministry Health Care became the parent company of Network and Ascension Health. In 2014, Milwaukee-based Froedtert purchased 50 percent of Network. Today, Froedtert Health and Ascension each own 50 percent of the company.

It’s a collaboration of two high-quality providers that each offer unique strengths, Dicus-Johnson says. Froedtert brings the clout of a nationally known academic center, and Ascension, the world’s largest Catholic health system, delivers faith-based and mission-centric care.

“We’ve got literally the best of both worlds,” she says. “We’ve got a plethora of clinics and health care sites that are really focused on the best-quality care. Wisconsin is a very fortunate place.”

When Dicus-Johnson became CEO in October 2016, she brought about her own changes. That started with recruiting a new executive team. In her first six months, she hired nine new leaders, seeking out industry veterans who were subject matter experts and knew how to inspire and work with others.

The changes have yielded positive results. Employee engagement scores jumped by seven points in one year. Financials increased as well, boasting a 40 percent improvement on bottom line and beating plan by $1.3 million. The company, which posted $798 million in annual revenue in 2017, has aggressive growth strategies for 2018.

For Ransom, the shift in energy and engagement has been palpable.

“It’s really been an incredible transformation,” she says. “We hear consistently that Network Health is like family.”

The company traditionally had been reactive, Ransom says, and now has become proactive. Rather than waiting to see what others are doing, it’s forging its own path.

Dicus-Johnson says she tries to build a work/family culture. The oldest of 11 children, she grew up in Las Vegas before coming to Marquette University for college and falling in love with Wisconsin, praising its openness and friendliness. Her upbringing informs her leadership style, and she says she tries to nurture relationships with employees while at the same time expecting accountability.

“I would define Coreen as a solutions-based leader,” says Mary Hosmer, a friend of Dicus-Johnson and TEC/Vistage chair for Vistage Worldwide. “Coreen has been on all sides of that continuum of care. She sold that insurance. She was a purchaser in her lifetime. When you couple that with her law degree, it’s incredible.”

Jessica Fischer, Network’s director of strategic planning, says she appreciates the company’s open-door policy and culture of approachability and transparency. Under Dicus-Johnson’s leadership, Fischer has witnessed a renewed emphasis on customer experience for members, brokers, provider-partners and communities served.

Dicus-Johnson leads from the top and connects personally with stakeholders, Fischer says, including embracing face-to-face interactions with members.

“I think for people in the community to have direct access to a CEO is pretty amazing,” she says.

As the company moves into the future, Dicus-Johnson, who lives in Menominee Falls and splits her work time between Brookfield and Menasha, says Network will continue to expand its market share in the Fox Valley as well as looking to establish its presence and visibility more firmly in the southeast part of the state.

Network is working on member engagement strategies that will use technology to provide greater access and improve opportunities for members to experience the company on their time versus during business hours. She also hints at to-be-announced innovative products that will “change the paradigm of what you typically see in products, but supports employers and employees.”

Dicus-Johnson professes a “rising tides lift all boats” philosophy and strives to continue to facilitate growth within the company and to put out products that make people proud to be members.

“I’ve just got to tell you, I’m having a great time,” she says. “It’s kind of like when form follows function. When you create an environment of winning, that’s a lot of what we’re doing.”

 

Network Health

Network Health is a locally-owned, provider-owned company. It prides itself on partnering with the communities it serves. Network serves much of eastern Wisconsin. Its coverage area extends from Oconto and Door counties down to Kenosha County.

By the numbers, it serves:

Commercial: 855 employer groups with more than 54,000 members

Medicare Advantage: 4.5-star plan with more than 64,000 members

Individual and family plan members: 8,862 members

Headquarters: Menasha

Founded: 1982

Employees: 440

Annual revenue: $798 million in 2017

Website: networkhealth.com