Health Tech: Tim Gronniger On How Signify Health’s Technology Can Make An Important Impact On Our Overall Wellness
Maintain the ability to be flexible. While we do the work on the front end to make sure what we’re building fits with clinical workflows, there is always room for improvement once tools are built. It is important to provide opportunities for clients and customers to give feedback and for us to adjust accordingly.
In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Tim Gronniger.
Tim Gronniger, MPP, MHSA, is the Chief Value-based Solutions Officer at Signify Health. Tim joined Caravan Health in 2017 and was President and Chief Executive Officer when the organization was acquired by Signify Health earlier this year. He is a notable health care industry thought leader, had held senior adviser roles for health care policy at the White House Domestic Policy Council, and is a frequent speaker at national educational conferences and summits. Under his leadership, Caravan Health became the national leader in accountable care with $120M in shared savings returned to clients over the past two years.
Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?
I grew up in the suburbs of Kansas City, and was raised a proud, Kansas Jayhawk in Olathe, Kansas. I grew up with two brothers and then 10 years later, two more siblings joined our family. We always had a full house. It was a fairly standard upbringing for the area at the time. My mother worked what seemed like a million jobs to take care of us. She was, and is, one of the hardest working people I’ve ever known. My father and stepfather remained very close to us.
I was a nerd in high school. I got involved in music and was active in playing trombone in marching bands, jazz bands, and orchestras, and I continued that through college. I also loved science and biochemistry and worked in biochem labs in high school and college. Fortunately, I started early so that I could burn out early — by the time I was a junior I knew that bench life wasn’t for me, but the long hours in the lab led me to National Public Radio, which taught me all about the importance of Medicare and the Congressional Budget Office. Armed with a few nuggets of interest but not much else, I went to grad school to learn how the health care system works and how what we pay for affects what patients receive.
Can you share the most interesting story that happened to you since you began your career?
Passing the Affordable Care Act in the House was an eye-opening experience. I had the opportunity to work closely on some of the components that were viewed as controversial by certain members of Congress. It was interesting to see how certain topics catch fire with certain members and become hot topics. One of those topics was related to abortion and was ultimately resolved by an intervention from the speaker of the House then and Nancy Pelosi now. It was a last minute topic that, as you can imagine, was rather touchy with some conservative members.
But even more surprising was the way some members referred to Medicare as a geographic inequity. There was the assertion by some that Medicare was unfairly overpaying certain parts of the country at the expense of states like Minnesota, Washington, and Wisconsin. There were members passionately arguing their points. They argued about the Physician Fee Schedule and whether it should be increased by three points or four. They argued that physicians in Minnesota were being penalized for being efficient, data be damned. Speaker Pelosi and the House leadership would bounce between meetings on abortion and on Medicare’s geographic payment adjusters at midnight in the Capitol building. It was surreal.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
In all fairness, there are too many people for me to list and do everyone justice, but I’ve mentioned my mother and my parents who set the foundation for my self-belief with their nurturing support. There have been various, incredible professional sponsors and mentors I’ve had along the way who have supported me and helped me realize I can do more to lead organizations and change health policy. These include Jeanne Lambert, who led health care policy for President Obama for much of his tenure; Andy Slavitt, Mandy Cohen, and Patrick Conway at CMS; and ultimately, Lynn Barr, who gave me a chance to leave the government and take charge of marketing and sales at Caravan Health. I’ll always appreciate her willingness to take a chance on me.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I may be in the minority here, but I mostly don’t like inspirational quotes and when I do, I keep them to myself.
You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?
I think the way I was raised and what I learned from my family was that being calm, steady, and persistent seems to work best. I’m not someone who goes into hyperactive panic modes like we often see; avoiding panic is, to me, the first step in formulating a strong response and finding good outcomes. I’ve seen how sometimes my calm responses can agitate others who tend to prefer to be hyperactive in certain situations, but I just go the other way.
One memory, in particular, from the early days of the Affordable Care Act stuck with me. There was a strong contingent of liberal or left-leaning members and an equally strong contingent of centrists, and they were debating health care reform, which quickly became complicated and divisive. I watched as Henry Waxman and his Chief of Staff, Phil Barnett, stayed calm and listened to the two opposing sides argue and debate. Watching the volatility between the two sides, I never imagined they would reach a consensus. Members were insulting each other over the very idea of a health reform bill. I was relatively new and was fairly shocked. But patient persistence from Henry and Phil over months on end — I mean meeting after meeting of being berated, respectfully, by these Members — led them to find a middle ground which led to a path forward. It was an arduous path, but I see how that calm and steady approach led to success.
Ok super. Let’s now shift to the main part of our discussion about the tech tools that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?
Earlier this year, Signify Health acquired Caravan Health, and a primary catalyst for that decision was to collectively solve gaps in patient care outcomes in our nation’s health care delivery system. Our current system is a collection of fragmented patient experiences; through our innovations we are connecting the dots for patients between provider visits and helping facilitate a continuity of care.
One of the problems with our nation’s delivery system is that the proverbial left hand doesn’t know what the right hand is doing. With so many different clinical specialties, patients may see multiple providers and, historically, it has been too easy for providers not to know who else their patients are seeing, nor about the various medications and interventions they receive. This can put the onus or pressure on a patient to remember details of every provider visit and to explain it to every clinician who sees them. To make matters more complicated, patients can easily be confused with medical instructions. Nearly nine out of 10 American adults lack the skills required to effectively manage their health and prevent disease. Low or limited health literacy can prevent patients from understanding how to comply with instructions and, for example, if a patient is discharged, perhaps medicated, and likely distracted or under stress, and maybe has memory issues, it’s not a recipe for health success. Patients need support and for their health care providers and teams to be in sync. We are helping them stay engaged with their individual health care through our Provider Enablement Platform that helps break down barriers and remove silos that can prevent optimal care.
How do you think your technology can address this?
We’re helping make health care more effective and efficient for patient and provider, something that has been missing in health care. Historically, the fragmented system isn’t necessarily known for its efficiencies, yet efficiency is an essential step to help improve patient outcomes. Our Provider Enablement Platform helps activate supportive services and wraparound services, to not only prevent patients from slipping through the cracks but also maintain a continuity of care regardless of the number of clinicians or variety of specialists they see. Our client physician or provider or a Signify-employed provider follows up with patients within days of discharge and helps connect them to clinics for transitional care. This includes proactively addressing social determinants that, for example, can prevent patients from affording prescriptions or accessing their provider’s office.
This platform helps to track the patient experience and reports back to the patient’s main care providers — essentially helping that proverbial left hand know what the right hand is doing. It’s about holistic, patient-centered care and it provides the ability to identify care gaps. We’re also opening new doors to the in-home visit for Medicare patients and for patients who may be better off at home rather than trying to navigate care in hospice or a nursing facility.
Can you tell us the backstory about what inspired you to originally feel passionate about this cause?
I first got the bug when I understood that we, as a nation, had accidentally stumbled into a policy and economic equilibrium where we gave physicians and hospitals incentives to provide excessive, poor quality care. That offended me, because it harms patients, and it makes health care providers — people who chose to dedicate their lives to the caring of others — choose between providing the best care to their patients or taking care of their own families.
How do you think this might change the world?
Fortunately, I’m surrounded by people who feel the same way I do about helping improve our health care system. We know our system has problems and through our Provider Enablement Platform and other technology platforms, we are seeing the differences we’re making. In 2021, our Provider Enablement Platform won a Globee award for ‘Best Healthcare Technology Solution’. That acknowledgement and recognition felt great but hearing from our ACO partners who are using it every day and sharing success stories and positive feedback tells me it’s already working. We may not be changing the world, but we are most certainly changing health care in this country for the better.
Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?
Honestly, I view Signify’s Provider Enablement Platform and Transition to Home platform as solutions to other, much more problematic tech –like EMRs that are optimized for billing, not population health; discharge processes that don’t automatically connect patients back to their primary caregivers or to home-based resources to support them.
Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”? (Please share a story or an example, for each.)
- Understand who will be using the technology. If I were in the business of making chairs, I would talk with the people who would potentially sit in the chair and learn how they plan to use it and what would make it a great chair for them. I would also ask what they would not want or need in a chair. This is what we did with our Provider Enablement Platform. We talked with the health care professionals who would ultimately use the tool. We asked what they wanted and the problems they needed to be able to solve. We also asked what would not be helpful and we designed the technology accordingly to fit both parameters.
- Learn the jobs and roles your potential customers have. In order to create technology for a population health nurse, we talked with population health nurses. We talked with care teams to learn about their care management roles, and we talked with billers and coders for the same reasons. We learned about their jobs and what they dealt with day in and day out. Then we designed a tool that fit within the parameters of their jobs and their workflows, so we were confident that the tool we were creating would be useful and efficient rather than another obstacle that requires multiple logins or more portals.
- Be creative. On apps, it is important to use creative engagement technologies and to be inclusive. For us, that means SMS, phone, and user-friendly tools that help get in touch, and stay in touch, with patients in every possible way.
- Just because you can, doesn’t mean you should. It wouldn’t make sense to design technology for ourselves or because we think something is fun or jazzy. I think we can all speak to new and improved technologies that may indeed be new but aren’t actually improved. Many tools in our space are all sizzle and no steak — care management staff can look at 100 beautiful Tableaux report views, but not have the next best three actions in their face. We try to stay tactical.
- Maintain the ability to be flexible. While we do the work on the front end to make sure what we’re building fits with clinical workflows, there is always room for improvement once tools are built. It is important to provide opportunities for clients and customers to give feedback and for us to adjust accordingly.
If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?
This is more than one thing, but I would tell anyone who’s trying to figure out what they want to do to try on a couple of different hats and see what you like to do. When you know what you enjoy doing, whether it’s talking with people, presenting, writing, data analysis — whatever it is, if you like doing it you will generally be more successful. It’s much easier to be productive doing work that you enjoy.
I highly recommend considering government service if they end up in a career where that is possible. There is no substitute for being exposed to the realities of what politicians have to live with and to understand the way public policy works. I would also tell them to be flexible and to continue to invest in their career.
Networking is valuable and it helps you learn what other people do whether they are in your field or not. It’s okay to be creative with how you approach your career. You never know how one conversation could lead to discovering an opportunity you never would have known about.
Is there a person in the world, or in the US, with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. 🙂
I think I would like to have lunch or even cocktails with Patrick Mahomes. He is the quarterback for the Kansas City Chiefs and is very entertaining to watch. He seems like a fun and engaging guy off the field and my brothers would be jealous.
How can our readers further follow your work online?
You can follow me on Twitter @TimGDC and I’m active on LinkedIn at https://www.linkedin.com/in/timgronniger/.
Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.
Thank you for the opportunity.
Health Tech: Tim Gronniger On How Signify Health’s Technology Can Make An Important Impact On Our… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.