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Keith Loria is a contributing writer to Medical Economics.
Joan Budden has created a culture at Priority Health, the No. 2 health insurer in Michigan, that encourages and rewards innovative thinking.
Priority Health is a $4 billion Michigan-based health plan that is nationally recognized for improving the health and lives of the people it serves-and leading the efforts is Joan Budden, its president and CEO.
“I really see my responsibilities as being threefold. First, it’s dealing with the current real-world healthcare issues and figuring out how to provide affordable care product and services that our members need to get healthy, be healthy, and stay healthy,” she says. “Second, it’s developing strategies for the future to understand what will be needed and anticipating how the industry will continue to evolve to make sure that Priority Health is well-positioned to take on the challenges of tomorrow.”
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And the third, which Budden has done to a tee, is to be a leader and champion of culture and talent within the organization.
“Underlying all of that, my most important responsibility is truly to our members, figuring out how we can provide value to the people and communities we serve,” she says.
Under Budden’s leadership, Priority Health has reported growth across all business lines for the past five years and is now the second largest health insurer in Michigan, impacting nearly one million lives across the state each year. Priority Health was also the only insurer in Michigan to reduce rates on the individual market for 2019.
The road to Priority Health
With over 30 years of healthcare experience, including leading the individual consumer division, project management office and corporate strategy departments for Blue Cross Blue Shield of Michigan, Budden came to the health plan in 2009 looking for a change.
“After many years of experience in a standalone insurance company, I was interested in exploring the complexities and advantages of a fully integrated health system that included a health plan, a medical group, and a hospital,” Budden says. “The opportunity to address complex healthcare issues from multiple perspectives and collaboratively debate the challenges and develop solutions was something that fascinated me.”
Today, she is a fierce advocate for Priority Health members and is committed to ensuring that they have the tools and resources they need to help them play an active role in managing their own health.
Under her leadership, Priority Health has designed affordable health plans that meet the needs of individuals across Michigan, which has resulted in a 35% increase in the number of people being covered.
“Many integrated delivery systems often have the heart of the member through the provider ties, but may lack some of the expertise from an insurance perspective to really soar,” she says. “We’ve always been known for being member focused, but recently we’ve also focused on strengthening our financial discipline and expertise to make sure we had a solid foundation from a business perspective. In addition, we have also made a commitment to really understand our members and their needs across all of our key market segments.”
For instance, she notes the needs of a 67-year-old Medicare member are significantly different from that of a 28-year-old shopping for insurance on the ACA exchange. So, by customizing the approach and focusing on the unique needs of each segment of membership, Priority Health was able to design plans and services that met the specific needs of every member.
Over the years, Budden has spearheaded numerous programs that reflect her commitment to transparency and passion for helping members engage in their healthcare.
“When trying to lift the cloak of secrecy surrounding cost of care, many people have resorted to price-shaming providers,” she says. “We took a very different approach. We recognize that it’s not about passing the buck or blaming others, it’s about giving consumers the information they need to be proactive and make an informed decision about their care.”
Priority Health’s Cost Estimator provides members instant access to cost information for hundreds of health care procedures in a way that’s personalized to their individual health plan-specific to their location, prescription, and benefits-to help them make truly informed decisions about their care.
Hundreds of procedures are available in the tool, and earlier this year, more than 6,000 prescriptions were also added.
“We also enhanced our Cost Estimator with a provider view to allow doctors and other healthcare providers to work together with their patients to find the best value when seeking care,” she says. “Priority Health is the only health plan in Michigan to deliver one comprehensive experience with a transparency tool, offering cost information for healthcare procedures, services, and prescriptions.”
Launched late last year, the Priority Health Wellbeing Hub offers a personalized online health and well-being experience. The Wellbeing Hub is intended to help members get and stay healthy by providing content and tools tailored to their specific health and well-being needs. The Wellbeing Hub uses predictive analytics, or “smart” learnings, to evolve the member’s experience-so it becomes more customized as they engage with the platform.
“I’m also proud of new care model programs like Home-Based Primary Care that allows us to meet members where they are, and provide personalized care-which improves outcomes and reduces costs,” Budden says. “Our program offers the patient a full support system of individuals dedicated to their health care and overall wellbeing.”
This team includes a physician, nurse practitioner, registered nurse case manager and a social worker who work collaboratively to provide routine and preventive care-as well as direct access to care when the patient has a serious health concern or is managing multiple chronic diseases.
A strong leader
Budden likes to think of herself as an inclusive leader and hopes her team agrees with that assessment.
“I’ve always tried to encourage a culture of collaboration and innovation, and I think one of the best ways to do that is to try and provide as many opportunities as possible for every employee to feel like they have a voice,” she says. “Over the past year, I held 17 listening tours across Priority Health’s multiple campuses throughout the state to receive feedback from all employees, personally.”
In the meetings, there are open discussions about what is going well and what needs improvement. She also encouraged employees to share their ideas about how Priority Health might be able to better execute on the company’s vision.
“Feedback was analyzed from every one of the sessions for our executive team to consider-leading to improvements to today’s operations, as well as new opportunities,” Budden says. “My philosophy on innovation has always been ‘think big, start small, adjust fast, grow to scale’ and that’s the approach I’ve tried to instill in my team.”
Life away from work
When not at her job, Budden likes to spend as much time with family and friends as possible. An empty nester at home with her husband Doug, with their children Megan and Mitchell off working on their own education and careers, the couple likes to golf, hike, and enjoys all types of outdoor activity.
“One of the things that I really enjoy is mentoring. I personally benefitted from having a couple of wonderful mentors over the course of my career, so I try and work with young women each year- offering advice and support, hoping to provide them with some guidance to help them along in their careers,” she says. “One of the pieces of advice that I share from my own experience is that sometimes you have to be bold and take a chance.”
That’s what Budden herself did when she made the risky decision to leave a good job at a large insurer, after many years with the same organization, to pursue an opportunity with Priority Health.
“There were certainly challenges along the way, but I’ve never regretted that decision and every day I’m thankful that I had the courage to make that move,” she says. “The future is very bright for Priority Health. We have a great team and a fantastic culture and I genuinely believe that we are helping people improve their health. We’re financially stable and well-positioned for continued growth.”
Keith Loria is an award-winning journalist who has been writing for major newspapers and magazines for close to 20 years.