Interview with Ann Mond Johnson, Chairman at ConnectedHealth

Ann Mond Johnson will join us on stage at the Health 2.0 Spring Fling: Matchpoint Boston on the Health 2.0 2.0 panel where she will discuss he journey and endeavors into multiple companies in the Health 2.0 space, and the lessons learned along the way. This interview is part of Spring Fling: Matchpoint Boston series.

Indu Subaiya: It goes without saying that your background in consumer facing health has been interesting and you have seen a lot of innovation and services for consumers. First with, and even before, founding Subimo and then going to the acquisition WebMd, and now chairing the Board at ConnectedHealth. Tell us a little bit about your journey starting with Subimo. What were you trying to change at the time? Do you think you achieve that?

Ann: Sure, and thank you first of all for giving me the opportunity. It’s always fun to talk about our story because I think in retrospect it’s more powerful than when you’re in the moment, if that makes sense. When you’re in the middle of it, it’s hard to tell that you’re making a difference or you’re making progress and stepping back it’s fun to look back on our success and to see what we did and what we didn’t to and how we did it.

I would say the first thing to remember is that our focus at Subimo was to help consumers make better decisions about their health for themselves and their family. It was interesting because when we started the company in 2000, there wasn’t a whole lot of discussion about things like hospital acquired infection rates, comparative outcomes, variation and outcomes and so forth. But in our previous lives we had work with all this clinical data,  so our focus was to take very complex, involved data sets and make them more accessible for the consumer.

The Health 2.0 Boston event is focused on partnering, so I think it’s worth pointing out that part of our growth at Subimo was that as we made clinical information about hospitals and physicians available to consumers through their health plan and employers. We allowed individual hospitals in each market free access to our data so that they could review and comment as necessary.

This was a transparency that was really unique at that time and was especially welcome because there was a whole lot of discussion emerging in 2000 and 2001 about transparency at a national level, particularly the groups like Leapfrog. By allowing hospitals to have access to this information and engaging them in a dialog, they helped evangelize  the data rather than fight us. We found that although we are providing our tools and information to the payers in the market, we are also ultimately facilitating discussions between payers and providers about the outcome variation and quality. At Subimo, we thought that the consumer won because they had access to much better information.

In terms of whether we accomplished what we set out to do, which was to help people make better decisions, I think that we can all agree that consumers are much more aware of variations and outcomes today than they were 12 years ago. So, I would say that while we all have a long way to go as a society, improving health systems and improving how we pay for services, how we incent providers for services, I would say that Subimo contributed significantly to that offer.

Indu Subaiya: I would completely agree because I think reading about Subimo, it was almost synonymous with the consumer directed healthcare movement and that was the example people pointed to. In some ways, you were I think ahead of your time because now, look at the Health Data initiative that Todd Park is evangelizing, Castlight Health and groups like it, and this was 12 years before.

One of the themes at Boston is going to be partnerships and mergers, and what it’s like for an entrepreneur to go through different life-cycles in a company. What was it like being acquired by WebMD, and how did your role change in that transition?

Ann: We were acquired by WebMD in 2006 and that came about because we saw an opportunity to do much more in healthcare decision support and felt that WebMD provided the best option for continuing the growth of the products that we had initially created. We not only had products that were focused on comparative quality, but also products to help people assess what might be their best insurance options and cost quality trade offs, even on the outpatients setting.

The acquisition was completed at the end of 2006, and at that point I transitioned into a product strategy role within the Health Services division. That is the division within WebMD that provided services to health plan and to large employers. Initially, a majority of our focus was taking the best-of-breed products and figuring out the best and most effective approach to deliver them to health plans and large employers.  I would say that I learned a lot during that experience. I left at the end of 2008 and I feel lucky that I’m able to call many of my former colleagues my friends today.

Indu Subaiya: How big was Subimo at the time that was acquired in terms of employees? Was it a big shift in terms of the size of the company?

Ann: Yeah, it was a big shift. We were a much smaller organization in terms of full-time employees and WebMD, of course, has this phenomenal brand. If you think about trusted brands in health, clearly the public portal WebMD was the most trusted brand in healthcare.

Indu Subaiya: So, you were in that role for two years; can you connect the dots for me from that point to being involved with ConnectedHealth?

Ann: Connected Health was started by two of my colleagues who had been with me at Subimo, Joe Donlan and John Fiacco were both co-founders of Subimo along with myself and Tracy Heilman. They had a vision about continuing to help consumers make better decisions. The industry that they went after was health insurance. So there are a lot of similar themes between what we did at Subimo and what we’re focusing on the ConnectedHealth. John and Joe, to their credit, really started from ground zero getting their licenses as health insurance brokers, and really understanding that health insurance and benefits continue to be confusing for people all over the U.S., including myself, even though, I’m very ingrained in it.

What the team at ConnectedHealth does now is to put insurance in context. It’s not just about health insurance, we are focused on the broader goal. We’re looking at health insurance, life insurance, disability, critical care. Health insurance is one part of helping people protect themselves.

The other thing that we found with insurance, which is not too dissimilar for making decisions about your provider or hospital, is that we believe the market of insurance and making decisions about it is only going to get harder as the market shifts to a retail focus. What we’ve learned in studying consumer behavior and decision making is that too many choices can make making a decision difficult, especially when it’s hard to compare options. If you add to that our inability to accurately assess risks, either for cancer or the risk of our house burning down, we have a hard time really estimating the likelihood of things happening. We can either overestimate it or underestimate it. It turns out that we’re not very good at making complex decisions, so that’s really the focus of ConnectedHealth now, helping people navigate that system and make better decisions for themselves and their family.

Indu Subaiya: How do you think the world will change for consumers with these health insurance exchanges that we are anticipating? It certainly seems like a need for ConnectedHealth will be even greater as we look at the horizon.

Ann: We certainly believe the need is going to become greater and we have certainly seen this. Not just with the health insurance exchanges but with the fact that employers are talking more and more about shifting from a defined benefit to defined contribution, and creating an environment where the consumer has a pocket of money to deal with and is making decisions that best reflect the needs of their family and themselves at that point in time.

Indu Subaiya: Right, and that’s been a spectrum that’s been moving in that direction for a while now.

Ann: Correct. I think that regardless of what happens with the Supreme Court, the reality from our perspective is the retail focus and making things more understandable for consumers is going to expand.

Indu Subaiya: I think we share your point of view on that. One point that’s sort of related to the work of ConnectedHealth is the transition we’ve seen as health insurance plans position themselves in a changing market. I believe it was Mark Bertolini of Aetna who said famously at Health 2.0 that we are no longer a health plan, we are a technology services company with an insurance vehicle attached to. Earlier you spoke about WebMD having a trusted consumer brand, do you think health plans can become trusted brands for consumer audiences as we evolve in this landscape?

Ann: I had a lot of optimism about this. If someone or some organization helps you manage your health, then they should be a trusted brand. However, as you know, it’s clear that many plans and insurance carriers have some work to do in terms of trust. At the same time, we’ve seen some recent efforts such as Aetna repositioning themselves or CIGNA repositioning themselves with their Go You campaign. Even with Blue Cross, Blue Shield of Florida changing their name to Florida Blue. From our vantage point if an insurance company is interested in a long-term relationship with the member and is not expecting to lose them during open enrollment, then a plan must become a trusted brand.

Indu Subaiya: Absolutely. We are seeing some interesting acquisitions where plans are merging with or acquiring smaller innovative startups, and if there are going to be those distribution platforms for consumers, there certainly has to be a repositioning there.

Ann: No question.

Indu Subaiya: Last but not least, as you know we have a lot of entrepreneurs working very hard in the trenches. Since you have led companies at many different stages, what are some of your favorite lessons learned as a leader in the healthcare technology space that you’d want to share?

Ann: The three lessons that I would share is that with experience there comes fewer surprises, what to expect, how to respond and where to find the best resources for the company. Even where to be searching for best resources for the company. That can be technology, it can be people, it can be any number of different things.

Another lesson is the importance of staying focused. All too often it’s tempting to go off in different directions that look sexy or enticing but are not core to either your expertise, your focus or what the market really needs. The lesson of being focused is important.

Finally, the third lesson, which is one that I’ve learned from the very first company I was with, is that people always want to be part of a winning team. There’s a lot of fun and excitement and a ton of energy in working with smart and focused people, and I would have to say that our group has been really lucky in that respect all along.

Indu Subaiya: Those are great words of advice and ones that I am listening to eagerly as I think about how Health 2.0 is growing as a company. Your point about focus is interesting because sometimes you may have an initial bit of success, but then how do you choose and direct the ship?

Ann: Exactly. I’ve read some studies and articles about entrepreneurs going through multiple companies and some have a high risk of not being as successful in their second as they were in their first. Part of the reason for that is that with their first they had an area of expertise that they focused on, and then with the second endeavor they thought that they could be just as successful in anything else.

Indu Subaiya: Absolutely! We wish you luck with the new company and I’m looking forward to seeing you in Boston in a few weeks.

Ann: We look forward to seeing you as well. Thank you!

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