Mission & Margin

Why regional health plans win on trust instead of scale | Hillary Galyean

27 mins

Overview

Healthcare isn't broken in one spot. Hillary Galyean, Chief Growth Officer at St. Luke's Health Plan, believes it's broken in all the spots, and the root cause is trust. After nearly 25 years in health insurance, including a co-op that was one of only two to survive, she backs the integrated model.

Show Notes

Healthcare isn't broken in one spot. Hillary Galyean, Chief Growth Officer at St. Luke's Health Plan, believes it's broken in all the spots, and the root cause is trust. After nearly 25 years in health insurance, including a co-op that was one of only two to survive, she backs the integrated model.

 

Hillary tells Trey why regional plans lose competing with nationals on scale, how lighthouse accounts bring like-minded employer groups with them, and how a virtual care visit led to a PCP connection and a mammogram after more than seven years.

 

Topics discussed:

– Competing on trust instead of scale as a regional plan

– Why integrated models fail when they lean toward delivery

– The structural failures behind ACA co-op collapses

– Cultivating a culture comfortable with payer-provider tension

– Resisting the easy button of annual premium increases

– Staffing virtual care with in-house doctors to close gaps

– Technology platforms and AI as the biggest administrative wins

– Holding retention against broker pressure to shop accounts yearly

 

Listen to more episodes:

Apple: https://podcasts.apple.com/us/podcast/mission-margin/id1896789104

Spotify: https://open.spotify.com/show/033kCfDSdndEFcVRsPJq2J

YouTube: https://www.youtube.com/@Siftwell

Website: https://siftwell.ai