Love and family. Devoted Health, a start-up launching Medicare Advantage plans in 2019, aims to connect those words with healthcare.

In this episode, Dariel Quintana, the Florida market president for Devoted Health, talks about what’s changed with healthcare in his two decades in the industry, what’s remained the same, and why choosing a healthcare plan needs to look more like online car shopping.

Listen in to hear how Florida stacks up with other states’ Medicare Advantage options, tips for people approaching age 65, and find out how Devoted Health is using world-class technology – and love – to change the way we think about healthcare plans.

COMPLETE TRANSCRIPT:

Chris Cate:           Welcome to the Fluent in Floridian podcast featuring the Sunshine State’s brightest leaders talking about the issues most important to the people of Florida and its millions of weekly visitors. I’m your host Chris Cate, and in this episode created by Salter Mitchell PR I talk to Dariel Quintana, the Florida Market President for Devoted Health.

Chris Cate:           Dariel has spent two decades helping Florida seniors navigate Medicare and the Health Insurance Marketplace. Now he’s using that experience to help a startup disrupt the system with world-class technology. I talked to him about the growing use of tech in healthcare and how it’s changing the way Florida seniors gain access to the best care. And you can hear it all right now.

Chris Cate:           Dariel, thanks for being on the show. For our listeners who aren’t familiar with your background, can you start by sharing how you got your start in healthcare and what drew you to work in the health insurance industry?

Dariel Quintana: Yeah, Chris. I actually started in my early 20s as a sales representative. So, actually selling Medicare Advantage plans, which back then were called Medicare Plus Choice plans, across the kitchen table just in client’s homes. Yeah.

Chris Cate:           How much would you say that health insurance industry has changed since you started? Are things better or is it worse.

Dariel Quintana: Yeah, that’s a great question. It’s interesting, a lot has changed and yet a lot remains the same. The biggest change, enrollment periods have changed. How people select doctors have changed. The types of questions that consumers ask have changed. As baby boomers starting aging in and now we’re well into baby boomers aging in, no doubt it’s different consumer. How we can access some healthcare information has certainly changed. When I started as a sales representative and insurance agent, there was no such thing as an electronic application or an electronic provider lookup really that was reliable.

There have been a lot of changes, but interestingly enough there’s a lot that remains the same. We recently conducted a survey of folks on Medicare and tried to understand their needs today before launching the company and I was surprised that there are some of the same concerns that were there 20 years ago. It’s really interesting, but it’s still difficult today to find information on provisions as a healthcare consumer, right? That part really hasn’t changed a whole lot. Concerns around comforts. Concerns around network choice. These concerns were around back then and they are still around today.

Chris Cate:           How does Florida’s health insurance market compare to other states? Particularly considering how many retirees live in Florida and how many people are constantly moving to Florida.

Dariel Quintana: Yes. Do you know we’re very lucky in Florida that we have some pretty advanced Medicare advantage choices for those that are on Medicare and we do have great providers in Florida, but I told you, number one, it’s really not the same story throughout all of Florida. When you look at the plan choices available to somebody in a rural area versus someone in one of our big metropolitan areas, there really aren’t the same plan choices and the physician choices are not the same. There are parts of the state that look like a lot of other parts of the country where you have one or two dominant provider systems or hospital systems or large provider groups that tend to provide most of the care in that area and then you have other areas of the state that really provide a lot of choice for consumers particularly in some of the bigger areas.

But I could tell you overall, I think we’re very fortunate in Florida that we have a longstanding history of well-accepted Medicare Advantage plans and these plans have helped people for quite a number of years. This is not the case everywhere else. You can compare the cost share in some of Medicare Advantage plans in some of our areas in Florida to some of the smaller areas across the country, you’ll find that we generally offer richer benefits here and this all helps the consumer ultimately.

Chris Cate:           What advice do you give to someone who’s just turning 65 and is unsure of how to approach retirement and finding the best plan for them?

Dariel Quintana: I think it starts with network selection. In other words, it’s a really funny thing for somebody who spent their lifetime working at the company insurance side of it to say, but I do think it starts with network selection. I think it starts with asking yourself several questions. One is, is there a particular doctor that’s very, very important to me? Is it time for me to get a second opinion or a new opinion altogether on my care? Is there a particular hospital or healthcare system that is very important to me? Is there a particular pharmacy I use that I really don’t want to change? All of these questions will lead you to finding probably more than one insurance company that can serve your needs.

And then I also think, of course, it’s very important to compare cost. In the world of Medicare Advantage, oftentimes this is really comparing benefits and not necessarily premium because many plans are zero premium plans, but the benefits may differ and certainly do differ from plan to plan. But those are really the big questions they have to look at and of course, pharmacy is extremely important. Making a list of all the prescription drugs that you take now and even the prescription drugs that you believe you may take in the immediate future if you’ve spoken with your doctor about potentially starting a different treatment, it’s important to understand whether or not any coverage you are considering does provide coverage for that specific medication and if so, what is the cost share.

I think that’s probably exactly where I would advise people to start. Doctors, hospitals, prescription drugs, plan benefits, and of course that will likely lead to a number of possibilities because again, here in Florida we have a lot of options. Then at that point I would also lean on people that you trust. I think there’s a lot to be said for speaking with your family, friends, neighbors, and of course an insurance professional that you trust to guide you through the process.

Chris Cate:           What do you find is the most misunderstood thing about the health insurance industry among everyday Floridians that you’re talking to?

Dariel Quintana: There’s a lot that’s misunderstood. First, it’s interesting how the economics of it is misunderstood. I still meet people when I’m out and about, whether it’s a senior center or meeting healthcare consumers, I still meet people that have really no idea as to the cost of healthcare services because quite frankly, it’s not that they don’t care, it’s that it’s not easy information to find. It’s incredible, but you can go to the drug store and pick up your prescription drugs and pay whatever the applicable co-payment may be for your company and not really realize the actual value, the actual cost of that prescription drug.

And the same goes for a lot of services, right? You may step into an emergency room and maybe you understand that you’re responsible for whatever that co-payment is, but not understand the entire cost of that visit. So, closely tied to the economics of it, I do think that another area that’s misunderstood is, what is the right care at the right time? I’m still very surprised by folks that want to access very high-level care for a healthcare concern that quite frankly does not merit it, right?

It’s incredible how oftentimes the healthcare consumer can bypass their primary care doctor and I’ll use an emergency room as an example, there are times when you should absolutely go to an emergency room. I want to be very clear, I am not a physician, I’m not giving any kind of medical advice here, but I can tell you don’t have to bypass your primary care doctor when the healthcare need that you have at that time could be handled by your primary care doctor. It’s still interesting to see that, how the levels of care and what is the right care at the right time is still often misunderstood.

Chris Cate:           Do you think the government’s level of involvement in health insurance is just right, too much, or not enough?

Dariel Quintana: That is a tough question. Healthcare is a very broad term, right? I do think in many areas it’s just right. I do think in other areas there could be more, quite frankly. I do think other areas it’s probably a little too much.

Chris Cate:           Are there any obvious changes in your opinion that the government could make to improve how people get their healthcare?

Dariel Quintana: Making healthcare data broadly available. You asked earlier about what’s changed and this is still just, it’s hard to understand. Consider this, if you were car shopping today you could compare the gas mileage, the curb weight, the wheel base. These are very specific metrics on just about any car out there. You could put two or three of them side by side online and figure out all kinds of things. Sadly, it’s much more difficult than that to find information on healthcare providers. So it’s really interesting how, I see this even in people in my own family and around me that, how they pick a healthcare professional, it’s really interesting, right? Are they close to me? Do they have good parking? Are the hours convenient?

These things are important for sure, but I can even go to deeper questions, right? Can I see that doctor’s CB? Do I know where that doctor trained? Do I know if that doctor actually has experience treating this particular symptom that I have? These are very deep questions that are very, very important and the information is not readily available. So, there’s one thing that I’d love for, and I think it may take just additional work from the government to get there, I’d love to see us very quickly as a country get to a place where all healthcare consumers can easily access all kinds of information on providers.

Chris Cate:           You previously worked for Humana, which is a well-known company, and now you’re at Devoted Health, which is a startup that you’re helping get off the ground. What made you make that jump to the big well-known company to a startup like Devoted Health?

Dariel Quintana: I’ve got to tell you, I’m having the most fun I’ve ever had in my career and that is because the level of involvement and the level of, quite frankly, the passion of all the associates is something that is rather unique to a small company or start up in particular. I have never been around such an enthusiastic group of people that are all here with this mission to help make healthcare better and everybody’s driven to treat every patient, every member, like our own parents, right? And that’s not just a tagline. We’re very literally building the company that many of us are putting our parents on, myself included, who are very excited to join the plan. That’s very different.

It is entirely different when every associate in the company can pick up the phone or walk right in to the office and speak with any senior leader. Every single associate in the company has my cell phone number. Providers that are contracted with us that depend on us and we depend on them, have my cell phone number. We have immediate access to the operations leadership team, which is fantastic and 100% dedicated to our members. We are building our own technology, and this is a very differentiator, building our own technology from the ground up that is purpose built to serve our members. That is very different. I believe you can only do that in a startup environment.

The most exciting part of all that is that when a person has a need, when one of our members has a need, there is no bureaucracy. There are no 10 layers of people and leaders to go through to get the answer. It’s a very, very nimble organization, which is very different, and again, I’m having a blast.

Chris Cate:           Yeah. I saw on your website that Devoted Health has a stated goal to change healthcare, how it’s paid for, delivered, and experienced, which sounds like really ambitious goals. What do you think that Devoted Health can do that other companies haven’t been able to do?

Dariel Quintana: It’s really interesting. If you look at our founders, there’s a very big tie in to technology, which we’re absolutely using as a tool. But I want to be very clear about this, what makes this company very different and what makes us believe that we can deliver on that goal, is the fact that we’re using technology and incredible data analytics to back up the human beings that are doing the work, to empower those folks and to give them the tools that they need.

So, if you think about really world-class technology coming together with people that have deep experience in the industry and quite frankly a deep love for the patients that they serve, that is what makes us different. We use the word love around the office, right? We love our patients. We love our future members. We are very, very serious about taking care of everyone like our family. That is what’ll make us ultimately very different.

Now, in more tangible terms what that means is, if you look at areas such as traditional customer service for example, we call our customer service folks guides because they are there to guide you through the system, right? Like in a lot of places, instead of a team that is measured on how fast they can handle a call or how many times you transfer somebody or whatever the case may be, we don’t care about metrics like how fast you handle a call, we care about things like did you actually take care of that person’s need, were you able to provide the service that they needed or get the right answer right away? Is it the right answer? Let’s start there. Oftentimes that can be frustrating. We look at everything very, very differently.

This guide team, if you think about folks that work in groups and pods that have access to, and part of that team are clinical folks, folks with social services type background, and they have immediate access to very important resources inside the company such as operations leaders, the claims folks, people that work in our clinical team are associate and chief medical officers. Everyone in the company has access to them. So that makes us very, very different. How we treat the patient and our approach to everything as simple as customer service or as complicated as how we work with providers.

Another area that makes us different and very aligned to delivering that stated goal of ours is the fact that our network is actually fairly different from others. We have a large network of hospitals. A large network of, quite frankly precisely the hospitals you’d want to go if you were in trouble. We have a very large network of specialists and we have a hand-selected network of primary care physicians that are really focused on providing care to senior citizens. I’m not saying that that’s all they do necessarily, but our network is absolutely purpose built to take care of Medicare Advantage consumers, people that are on Medicare and would like specialized type care. That does make us very different.

And then also the people. I’ve got to tell you, I go back to ultimately a company’s nothing than a group of people that have come together with a purpose, right? And that is incredibly different. When you look at our co-founders, Todd Park and Ed Park, wow, just incredibly humble, caring individuals that are pouring, like all of us, we’re all pouring 100% of our existence into building this company and making sure that we do the best for our members.

Chris Cate:           How much do you talk to doctors about how to serve patients better and what do they tell you?

Dariel Quintana: Yes, all the time. We are constantly engaged in conversation with our physicians, particularly our primary care physicians, which we believe are the backbone of the system quite frankly. We spend a lot of time talking to them, listening, but also collaborating in a deep way. I’ll share with you that a couple of the larger primary care groups that we’re working with that are very senior focused, we’re collaborating to the extent that we’ve had some of our operations leaders and folks from our engineering team actually sit down with some of the associates that do things like processing claims or processing referrals, authorizations, dealing with the front desk, and actually very intently taking notes and figuring out what is tough about their day and how could we do it different.

This opportunity to build a company from a blank slate, you can only start from zero once and we’re not taking that lightly. So we’re spending a lot of time up front understanding the consumer and understanding our physician partners in an effort to try to make their lives easier and what is very different about us is, we can actually deliver on that. We are actively building our own technology. We have our own technology already and it’s iterating an incredible rate, which is what makes those conversations very valuable.

To me, let’s face it, sitting down with an end-user in a very well-defined operation or very well-defined system, I’m not sure how much you get out of that, but sitting down with an end-user when you are building the thing that they will use, that’s powerful.

Chris Cate:           I appreciate you answering a lot of these questions that I know a lot of our listeners have about health insurance. I want to transition now to the final four questions that I ask every guest, the first being, who is a Florida leader that you admire?

Dariel Quintana: Wow, that’s a tough one. A Florida leader that I admire.

Chris Cate:           It could be from the past or the present.

Dariel Quintana: Yeah, I’m gonna take a different approach to leaders, not thinking in terms of public service per se, but Don Shula, I’m actually gonna throw out there. Here’s a person that brought an entire state and entire communities together around the game and around a group of people that were trying to accomplish and did accomplish a great goal. So here’s a person that I think it’s incredible the way he was able to bring all kinds of people together around this one common goal.

Chris Cate:           Yep. Don Shula of course being the well-known Miami Dolphins head coach. The next question I have on our list is, what is something in Florida that deserves more attention than what it’s getting?

Dariel Quintana: I love the Florida Keys, I spend a lot of time there, and so I’m very sensitive to all that we all do and how it affects our environment, right? It’s very well connected in a sensitive place like the Florida Keys. It has been getting a lot of attention as of late, meaning the effects on our waters, but I think that there’s probably no such thing as too much attention there. I think the environmental concern around our more fragile ecosystems.

Chris Cate:           I totally agree. There’s not enough attention we can give to that, especially in Florida. The next question I have is, what is a favorite place in Florida for you to visit?

Dariel Quintana: Wow, that’s tough. There’s so much that I love in Florida. If I had to pick one, I would stick to the Florida Keys. I just love the environment there. It’s amazing. It’s an hour away from Miami and a world away, right? I love the Florida Keys, but I also think there are a lot of hidden gems in Florida that are overlooked. Here’s one I’ll throw out there. Coral Castle in south Dade. I live in Broward, but I grew up in Dade county and Coral Castle is this amazing little gem, little piece of very awkward Florida history quite frankly, and it’s interesting how many people live here and have never heard of it, so I would say that’s a little gem.

Chris Cate:           Cool. Yeah, I’m not familiar with that place. I’m glad you mentioned it. The last question I have is, what is your favorite Florida sports team?

Dariel Quintana: I would say the Dolphins.

Chris Cate:           Yeah, I’m not surprised you said that. I really appreciate you taking the time to answer our questions and hopefully clear up some of the questions that our listeners have about healthcare and health insurance. Again, thank you for being on the show.

Dariel Quintana: Thank you. Thank you, Chris. I appreciate the opportunity.

Chris Cate:           Thanks for listening to the Fluent in Floridian podcast. This show is executive produced by April Salter with additional support provided by Heidi Otway and the team at Salter Mitchell PR. If you need help telling your Florida story, Salter Mitchell PR has you covered by offering issues management, crisis communication, social media, advocacy, and media relations assistance. You can learn more about Salter Mitchell PR at SalterMitchellPR.com. You can also learn more about the Fluent in Floridian podcast and listen to every episode of the show at FluentinFloridian.com or by searching for the show using your favorite podcast app. Have a great day.