Focus on Employee Health and Cost Savings at Northwell Direct

Chelsea Glenn [00:00:00]:

Everyone is super busy. People are at work. They have a hard time prioritizing themselves and their health, right? And so we’re trying to bring way better access. So we’re really just trying to make it way easier to engage with your health by bringing it to you because you’re always at work. We spend all of our time here, right? So why don’t I bring your healthcare access to you and make it a lot easier to understand and navigate? Because healthcare is complex. We’re trying to simplify. Take down walls there. From Healthcare IT Leaders.

Narrator [00:00:29]:

You’re listening to Leader to Leader with John McDaniel sitting in for Ben Hilmes. Our guest today is Chelsea Glenn, chief growth officer for Northwell Direct. In our conversation, Chelsea discusses how Northwell Direct is innovating healthcare delivery by providing direct, cost-effective clinical services and care management to employers and their employees.

John McDaniel [00:00:52]:

Good afternoon. I’d like to welcome Chelsea Glenn to our session on this podcast around innovative new solutions in the industry. Chelsea, welcome to the program. I look forward to learning more about your initiatives at Northwell Direct. I think a lot of our listeners are familiar with Northwell Health, one of the premier health systems in New York in the tri-state area, who may not know a lot about Northwell Direct. So let’s start there. Can you start by giving us an overview of Northwell Direct and tell us how it fits into the larger system of Northwell?

Chelsea Glenn [00:01:25]:

Absolutely. Thank you, John, and really excited to be here as well and getting the opportunity to speak with you. So thank you very much. So, Northwell Direct is the employer partnership vehicle for Northwell Health System. We’re a wholly-owned subsidiary of the health system. We’re part of the overall mission and vision for Northwell Health, of bringing better health to the communities. And we serve specifically the 50% of people who receive their insurance through their employer. And we do that in three ways, all tightly aligned with the health system mission, but unique in our own way, given we are our own company.

Chelsea Glenn [00:02:00]:

The first is we help manage the 85,000 member employee health plan for Northwell Health. So all of our employees, independents, keeping them healthy, making sure they have good insurance coverage, and are well engaged in their health as well. The second thing we do is we help take clinical services from the health system outside the four walls of our hospitals and practices and bring them into an employer setting, make them really accessible for employees and their family members. And that manifests in a lot of different ways because we have so many different types of clinical services. So we do onsite flu shots at employers on site cancer screenings, education, events, concierge, primary care, you name it, we have that kind of clinical service. So we partner in novel ways with employers to really engage their employees on how do you stay healthier, how do you manage your chronic conditions better? All of that good stuff. The third thing we do is what we call a direct to employer contracting model. So we’re actually a network of 32,000 providers across the New York metro, extend into Jersey, with partnerships via RWJ, Barnabas and other providers.

Chelsea Glenn [00:03:03]:

And we actually form the tier, one of a two tiered insurance product, basically for self insured employers. So we aren’t an insurance company ourselves, we’re just that contracted network. But what we’re doing is bringing a direct model, cutting out the middleman, going directly to employers and saying we can provide the access, the better pricing and the care management for your employee populations to make healthcare more affordable, more understandable, and better accessible for your employees and their families.

John McDaniel [00:03:33]:

That’s awesome. You mentioned that Northwell Direct was born out of the desire to serve the employers more effectively in that tri state area that you just alluded to. Can you kind of elaborate on the challenges those employers face with traditional healthcare insurance models and how you’re making a difference?

Chelsea Glenn [00:03:50]:

Absolutely. So cost is a major issue they are getting from their traditional carriers, 15 2025, sometimes 30% year over year increases in the cost of their plans. Whether if they’re fully insured, it’s through those total premiums they’re paying, or if they’re self insured, the actual cost of care is just rising very, very quickly. Northwell has a commitment to do something about that. And our affiliate independent providers that we’ve brought into this model as well, really want to partner with employers on making a difference and impacting that area. And we do that both through a pricing lever. We’re offering a better discount because we’re cutting out and taking out the middleman administrative services. So we’re offering a better price in the market.

Chelsea Glenn [00:04:34]:

But also importantly, cost of care is priceless utilization. So that care management component we do super key. We are there at the bedside of the patient, where the trusted provider entity, your insurance company calls you. You don’t answer, you’re really afraid that they’re going to bill you or something like that. But when your provider calls, you answer and you listen to their clinical advice. And so we really lean into that, take that very, very seriously of making sure people are right time, right care, right place in terms of utilization and managing their chronic conditions as well. So really big on that cost lever. And then the second thing I would highlight is simply, I think employers are having a hard time.

Chelsea Glenn [00:05:10]:

There’s a whole plethora of these point solutions out in the market. Looking at the tech backed, VC backed, we should be the healthiest nation on the planet. But really, it tends to fragment. Right? Like there’s all these different point solutions that are treating only one condition instead of treating you as a whole patient, whole person. And so we’re really trying to come in and say, no, no, I have every service line under the sun. So I’m not just treating you as a depression case. I’m saying, hey, you have sleep apnea. Let me get you over to pulmonology.

Chelsea Glenn [00:05:37]:

You have a bad knee that prevents you from exercising, which prevents you from getting better in your behavioral health condition. Hey, I have a ortho or I have pt. You know, we’re able to really treat you as a whole person and partner with employers to get their people better, not just manage one condition that that person has.

John McDaniel [00:05:53]:

Great. You mentioned earlier the three service areas that you kind of focus on. Northwell Direct. Can you talk about the benefits that you’ve seen through the implementation of this program to both the employers and the employees?

Chelsea Glenn [00:06:08]:

Yeah, absolutely. So I’ll start with the one that’s easiest to understand. It’s those clinical services that we bring out of our four walls and into the employer. That one really obvious value prop. Everyone is super busy. People are at work. They have a hard time prioritizing themselves and their health. Right.

Chelsea Glenn [00:06:24]:

And so we’re trying to bring way better access so we don’t say, hey, on your weekend, you have to go get a flu shot somewhere. We’ll just bring it to you. Come down at lunch, right, we’re right there. Or we’re there doing biometric screening, looking for diabetes or heart disease or challenges with bmI, those kinds of things, and then connecting them immediately into recommended clinical next steps where we’ve done cancer screenings on site for skin cancer, for prostate cancer. So we’re really just trying to make it way easier to engage with your health by bringing it to you because you’re always at work. We spend all of our time here. Right? So why don’t I bring your healthcare access to you and make it a lot easier to understand and navigate? Because healthcare is complex. We’re trying to simplify, take down walls there.

Chelsea Glenn [00:07:08]:

That benefits the employer ultimately, too, because you find a stage one, stage two cancer, way less expensive than treating somebody in stage four, way fewer missed days work, and that employee stays with you right, they’re able to get the treatment they need, they’re able to come back to work versus you wait super long, it may not be the case. It’s way worse outcomes. And so that’s really our mantra there, of making sure that we’re there in front of the employees, engaging them where they’re at versus expecting them to come to us. The second piece around our network, that’s really around that being able to deliver something that’s a higher value, lower cost, because we’re a high quality network, we have coordinated care, and we’re also offering it at a discount to the market. And then the third thing around the care management we talked about already, it’s really around making sure that we’re engaging that whole person, meeting them where they’re at.

John McDaniel [00:07:57]:

I think Northwell Direct was initiated during the pandemic. Now, how did that timing impact the development of the services that you currently offer, and how will those services evolve over time?

Chelsea Glenn [00:08:08]:

It was a massive impact. So we started in 2020, which is a very interesting time to start. We started with an original, hey, we’re going to be this direct to employer vehicle in all of these different ways. And then for two years, we were exclusively Covid-19 related services. So pre vaccine, it was, how do I bring my essential workers on site safely? So we partnered with airlines, we partnered with shipping and delivery type companies, everybody that had essential workers in the New York metro that were like, oh, no, I need these people to come in, but I need them to be safe. I need them to feel safe at work. So we did a lot of partnership on that and then partnership on vaccine rollout. We are one of the first entities as Northwell Health to have mass access to vaccines.

Chelsea Glenn [00:08:48]:

And we did a ton of work of onsite vaccine delivery. So that translated to in 2022, we started getting to expand our service set outside of Covid-19 because we had managed the pandemic. Can’t say it’s gone, but it’s far more managed than before. And so we were able to take that knowledge and experience and partnership that we had with all of those local employers and expand it in a lot of different areas. Behavioral health services, primary care, diabetes. We have all these other programs that we started to be able to introduce now that we’re not just pandemic focused.

John McDaniel [00:09:21]:

Great. I know there’s a number of initiatives in health and wellness that you’ve implemented. What kind of impact does that had on some of the employers you worked at a specific use case like what you’ve done with New York police Department around the behavioral health program, we are.

Chelsea Glenn [00:09:37]:

Always trying to invent new ways of making ourselves more accessible and easier to navigate as a health system. So the NYPD partnership is a great example. It’s a critical population. It’s a population where there’s sometimes a very high stigma of behavioral health related issues because they’re really afraid that they’re going to be put on the desk, that they’re going to get their gun taken away, that they’re not going to get promoted as quickly. And so it’s a real deep concern, but it’s a population that faces extreme stress, extreme trauma, just in the character of their job. And so what we did was partner with the NYPD to create a dedicated, confidential, and secure pathway into behavioral health services for the 36,000 badged officers of the NYPD. And they’re given a special call line. That call line is manned by clinicians, so they immediately speak to a social worker or master’s level therapist who listens, understands what their issue is, and helps create a care plan, and then connects them into longer term treatment and providers.

Chelsea Glenn [00:10:34]:

And so that’s usually into our own service line, given we have good breadth of geographic location, there’s virtual options as well, if the officer would prefer that. And so we are able to do the full access navigation, help them get where they’re going, help them actually get into care, and then coordinate any medical referrals. So back to my point of, like, we aren’t just treating a single condition if they have other health needs, we absolutely serve them and have a navigation support to serve them in that. And that’s above and beyond what we’re contractually doing with NYPD. It’s just we need to make sure that they’re treated as a whole patient because they become a northwell patient. As well as being part of this.

John McDaniel [00:11:09]:

Program, are there other organizations similar to that that you’re in the process of working with to deliver those services?

Chelsea Glenn [00:11:16]:

So we have a similar. It’s not behavioral health. It’s actually on the primary care side with a large financial institution that’s a multi year partnership. We have a primary care clinic that is right next to their big Manhattan office building. And so we do same day primary care. And then we’ve been evolving that product because we found folks also want specialty coordination. So we’ve been adding that in. You’re calling, but actually you need dermatology or Gyn or it’s more urgent, and we need to escalate you into a more urgent care pathway.

Chelsea Glenn [00:11:47]:

So we’ve been working with them on that. That’s been a very successful pilot that we’re continuing to expand, and we have a very large international second opinion service that we provide across specialties and that serves a lot of different areas across the world in providing second opinion services. And so we have just this plethora of different areas in which we are trying to expand and pilot on top of all of those onsite services. We do where we go with flu shots or biometric screening or cancer screenings to employers, which is kind of where we started because that was most akin to Covid. Right? We were on site doing Covid shots. Oh, what else can we do on site? But we really are expanding into other areas of, hey, I have all these clinical folks, how can I plug them into employer needs?

John McDaniel [00:12:31]:

Great. That actually leads into my next question, and that is, how do you leverage the extensive network of infrastructure and expertise that Northwell Health has while still being somewhat of an innovative startup within that health system?

Chelsea Glenn [00:12:47]:

Yeah, it’s a great question. So we absolutely are able to focus on what makes your beer taste better because we leverage all of the back end of the health system. So there are primary partners, as we think about finance, HR, legal, digital, and it that all sits on the health system side. So we’re not replicating cost structure unnecessarily. And then what we’re able to focus on is the health system really does allow us to be an innovation lab. You know, we have an ultimate goal, make care more affordable, more accessible for employers, employees and their family members. We have a board. That’s all the Northwell health executives that sit on our board agreed they are aligned on that vision.

Chelsea Glenn [00:13:28]:

And then all of our initiatives and experimentation were allowed to do. As long as it serves that mission right, it always connects back to, is it something that makes care more affordable, more accessible for employers, employees, families? Then let’s experiment. Let’s be able to act like a startup in those ways.

John McDaniel [00:13:44]:

One of the key issues I hear from executives at large employer organizations is how do I continue to manage my cost and reduce those? How are you able to manage some of the savings that you’re achieving for those employers? And do you have some examples of that?

Chelsea Glenn [00:14:02]:

Yeah, absolutely. So two ways. One, whenever we’re onboarding a new employer in that more insurance side, which is where the network component of the self insured employer stack, we do something called pre sale analytics. So we’ll actually do a claims repricing. We’ll take their historical claims and say, if you were under our contracted rates, what would you have paid instead? And so that repricing analysis is what we then present to the employer and their broker or consultant so that they can see the actual physical savings. We can’t guarantee their utilization patterns will be exactly the same in the coming year, but we can say, hey, if the only thing you change, if you didn’t influence behavior at all, if the only thing you changed was you were under our contracted structure, with our tiered network, you would be able to save this many millions of dollars. And so that’s our starting point. And then once we go live with them, we don’t only kick in those rates, but we kick in the care management, which is all about making sure that employees and their family members, their dependents, know where to go, know when to go, and go in a coordinated way.

Chelsea Glenn [00:15:03]:

So they’re not getting four different mris when they only really needed one, because their care was so fragmented that everywhere, you know, they went to the emergency room, got an MRI, then they went to the orthopedics office, which was independent, and got different MRI. They don’t bounce around like that. Right. They’re part of this coordinated network of providers who have made a commitment to providing care in this way and being an integrated system. And so we really focus on making sure that that care management function, we have health coaches, registered dietitians, nurses, all of this care team is there to support folks on their journey and make sure they’re having the most efficient, and ultimately, that’s the highest quality, but also the lowest cost or best cost savings because they’re not doing all this unnecessary stuff. They’re getting the right care the first time.

John McDaniel [00:15:46]:

One of the challenges I see in the industry is how do you track the status of that employed individual to ensure they’re following your direction, compliance with the care management protocol that you have in place. How are you engaging from that perspective?

Chelsea Glenn [00:16:04]:

Yes, this is where we have a massive advantage as the provider system, because we are the physicians, so we’re the doctor’s offices, we’re the hospital, we’re the ambulatory surgery site, managing, etcetera. So unlike a normal payer, where they have this independent network that they’re trying to influence just the patient because they can’t influence the provider system, we’re the opposite. We’re able to say, hey, patient, you’re coming to us, we’re treating you across this journey, but we are managing, if not owning, the points on that whole journey. And we have all of the EMR data that our clinicians are able to leverage that interconnects. So it’s not just Northwell, but it’s all of the health information exchange data that we’re able to get and apply. So that’s on top of claims, which usually come at a lag, by the way. So it’s not like, oh, you know, four months ago, you had a million dollar claims expenditure and, like, I guess we should intervene on you. No, we’re able to move up way.

Chelsea Glenn [00:16:56]:

Right. They’re the ones locking in our doors. We’re the ones prescribing. We’re the ones creating the course of treatment. And so we’re able to be much more involved in that patient’s experience because they’re a member on one side and they’re a patient on the other, and it’s one Northwell experience. And our affiliates, we talked a little.

John McDaniel [00:17:13]:

Bit about the physical presence of Northwell health. Virtual care is becoming very important in healthcare. How’s Northwell Direct? Incorporating some of the telehealth, telemedicine digital health solutions into your overall offerings.

Chelsea Glenn [00:17:27]:

So we started with really leveraging what Northwell and our affiliate partners like RWJ have in place, and so they have strong and robust virtual health platforms. So that NYPD example I gave you, virtual mental health and therapy is one of the options that’s built on the Northwell platform. One of the things we’re working on now is developing out a more unified navigation experience digitally, because a lot of our pilots in navigation have been telephonic first. We’ve been able to learn, understand what members who are using those services are needing and asking for that primary care example I gave related to concierge primary care ballooning into actually specialty navigation and coordination as well. Really helpful learnings. And we’re actually working with several digital partners right now to convert that into more virtual options. Right. There’s still going to be that telephonic for folks that aren’t so keen on having the virtual only pathway, but making sure that there are smoother digital navigation services into each of our referral destinations, our provider system, as you and you.

John McDaniel [00:18:29]:

Mentioned, certainly you’re obviously working with Northwell Health and RWJ now. As you start to expand beyond that network, what’s your approach to developing new partnerships with other health systems and providers in the tri state? Even broader area?

Chelsea Glenn [00:18:45]:

This is interesting, right? So unlike direct to consumer, which is where hospitals, providers normally play, where, hey, it’s fine. I have my geography. I serve everybody in my geography. Employers are different because, especially now, post pandemic their employee bases are really spread out. And so you have to be able to serve a much broader geography when you target an employer than when you’re targeting an individual consumer. So we’re very cognizant of this as we think about growing our partnerships. We added Garnet Health, for instance, earlier this year, which has expanded us up north. The way that we’re approaching it is finding anchor partners in other major areas where we know that there’s employee bases that are shared employees between New York and those other geographies.

Chelsea Glenn [00:19:25]:

Finding those partners who are really committed to the same model. Right. It is a model about creating greater affordability and access, and they have to want that. We’re not recreating the entire blues network. It’s not a PPO where 98% of all providers in America are part of it. That’s why we have this tier two wrap, which is that preserved provider choice. But that tier one that we’re creating is like minded partners that our anchor systems and these other geographies that are willing to partner with us in this novel way, willing to provide that care management and that oversight as well. And that’s how we’re looking to expand.

John McDaniel [00:20:01]:

This model is relatively unique in the domestic US. How are other systems, or are there other systems around the US that are starting to emulate your business model? And what elements do they need to have in place to be able to replicate successfully the model that you have in place?

Chelsea Glenn [00:20:19]:

So I think there’s a lot of experimentation on direct to employer around the US. There’s some health systems that have laser focused on specific employers. So the Henry Ford GM model is one example. There’s other provider systems that have their own health plans and that’s how they’re targeting it. So Baylor, Scott and White, Providence. Henry Ford actually has hap as well. And then there’s some that are actually turning to their payers to, to partner on this kind of thing because they want to leverage the relationships and infrastructure that their payers already have in place. So you’ll see blues partnering with health systems in novel ways on joint venture products in the insurance space.

Chelsea Glenn [00:20:57]:

So there’s a lot of this kind of experimentation. There’s a whole industry around commercial bundles. So I think it’s honestly, we don’t view that as competitive at all. We’re really pro the concept of can we create novel innovation where we’re all working together toward having a more affordable, more sustainable healthcare financing platform? And I think there’s quite a bit to learn. We do a lot as we think about working across the industry, going to different conferences, providing advice and consulting for health systems, interested in our type of direct to employer model. But we also don’t have all the answers. We absolutely learn from our peer institutions as well and continue to want to work and, and be able to serve more folks under our model.

John McDaniel [00:21:41]:

As this model becomes more deeply rooted in the US, do you see more collaboration with those organizations you just mentioned with around sharing information? Because obviously patients are very transient today.

Chelsea Glenn [00:21:53]:

Yeah, I think it’ll be important because even when a provider system has their own health plan, they have a geographic constraint challenge because they have really strong provider assets within their specific geography. And we face this issue as well. That’s why it’s nothing. We can’t just stay Northwell. Why we’ve created these other anchor partnerships. And so the more we can collaborate with external health systems, the better, because I need to leverage their geographic coverage in a way that Northwell just isn’t positioned and shouldn’t be positioned to do. I’m not looking to create one universal health system across America. So we absolutely need these partnerships in order to serve larger employers.

John McDaniel [00:22:31]:

Great. And just kind of looking ahead, what’s next? I mean, what are the opportunities do you see for growth or expansion of these services that you’ve talked? You’ve talked a little bit about it, but for a broader picture, what do you see as the future holding?

Chelsea Glenn [00:22:46]:

The first thing is geographic expansion. We’re absolutely continuing to look at different partners across our region so that we can make sure that we’re providing enough coverage. You know, people think Northwell, they’re like Long island, okay, now we’ve spread into Manhattan, but we really need to be able to serve, you know, start moving south along Jersey west. This is a very commuter pattern oriented geography as well. And so it really is important to us. And it’s not going to be through, like, acquisition. Right? It is absolutely through partnership and this kind of model where they stay independent, they’re managing their own model, but they’re agreeing to participate in our direct to employer arrangements. So geographic expansion through our anchor partnerships, absolutely important to serve larger employers.

Chelsea Glenn [00:23:32]:

The second is what we talked about around creating digital pathways. So a lot of our pilots have been telephonic. We are formalizing and creating options for more digital navigation. This just better meets consumers where they’re at, right. As we think about the end user of employees and their families, some folks want to engage with us that way. And so making sure that there’s pathways to do that is very important. So I think those are the two main areas. Again, continue to work with the health system to expand services and be able to flex into whatever employers ask for.

Chelsea Glenn [00:24:03]:

But I think that’s more of our bread and butter today, and so we’ll continue to do that. But these are the ways we want to break out and be more novel in our approach in the future.

John McDaniel [00:24:13]:

Chelsea, thank you so much for taking time to spend with us on some of the innovative solutions that Northwell Direct is working on. I think it’s something that will be a significant focus in the future in our industry as we look at new innovative solutions to drive down the cost of healthcare and actually do a better job of managing patients wellness status. So thank you very much for your time.

Chelsea Glenn [00:26:02]:

John, thank you. I really appreciate being able to be part of this and thank you for all your questions. They’re very insightful, thoughtful.

Narrator [00:24:37]:

Thanks for joining us. For Leader to Leader to learn more about how to fuel your own personal leadership journey through the healthcare industry, visit healthcareitleaders.com. don’t forget to subscribe so you don’t miss any insights and we’ll see you on the next episode.