Craig Keohan has been hit by a car, run over by a ski boat, flown on a commercial flight with an electrical fire, evacuated from a burning hotel and survived an attack by an angry goose after accidentally killing its mate with an errant golf tee shot. But while Craig might seem to have nine lives, none of these close calls compares with the professional and industry obstacles he continues to encounter and overcome.
(That was item No. 6, my personal favorite, on Keohan's list of "25 Random Things" about himself that I asked him to send me before we sat down to discuss the future of health insurance and consumer-driven health care.)
The exercise is a great ice breaker. From his list, I discovered Keohan is a licensed pilot, has eaten stale bagels at the White House, loves to weld stuff, started his first revenue-producing business at the age of 14 and will never retire.
Most importantly, though, is that Keohan is encouraged by the possibilities that exists in what many fear is a dying field. While others think inside the box, Keohan visualizes new and exciting changes that will create opportunities like we've never experienced within our industry.
E. Craig Keohan is considered a pioneer in the consumer-driven health care community. He has more than 24 years of professional leadership experience, with a focus on the convergence of the health care and banking disciplines. In 1999, Keohan became a partner in the organization that would eventually be known as First Horizon Msaver Inc., and since then he has guided the company to become one of the nation's leading administrators of bank card based consumer-driven financial products.
Keohan also serves as chairman emeritus of the American Bankers Association HSA Council, and, in 2006, was invited to the White House to attend a health savings account strategy session led by President George W. Bush. Since then, he's been asked to consult with leaders in Congress and the administration regarding consumer-driven health care issues.
As you might expect, Keohan has received numerous accolades for his expertise and made several contributions to the consumer-driven health care industry. In 2007, he was awarded the CDHC CEO Leadership Award by Prepaid Media, and under Keohan's leadership, First Horizon Msaver was named the "Model Healthcare Bank" at Celent's 2009 Banking Innovation and Insight Day.
Move that bus
To hear Keohan tell it, you would think the White House just wrapped an appearance on the hit television show Extreme Home Makeover.
"The Bush administration," he explains, "was very pro CDHC, pro private market, pro personal accountability and responsibility.
They felt that this approach was good for the industry and for the individual. Perhaps that's why the HSA Council was so successful at providing not only education but also lingo and sound bites for the White House to use when talking with the media.
The new administration, in contrast, is "more prone toward government-run programs, which remove the consumer from the decision-making process."
And this, Keohan insists, would be "a step backward in regard to trying to control any type of pricing within the health care system."
This administration, he continues, is truly viewing health care as a right: "In their view, you as an American have a right to all the free health care you can consume irrespective of how you perhaps put yourself in the position to need so much care."
A spirit of cooperation
Not too long ago, someone asked President Obama what has surprised him the most, disappointed him the most and enamored him the most during his first 100 days in office. Keohan answered the same question about his time in the industry.
"When you look at HSAs, they're not really in the mainstream. In fact, they're not even close. Only about 8 million people have a qualified high-deductible health plan, but what has truly enamored me the most is the way competitors are working together to share ideas and information that will help make the product better for the employer and for the end consumer, specifically through the HSA Council. I'm always amazed at the amount of cooperation that exists between industry leaders. That typically doesn't happen in any other industry - you don't see auto executives getting together to share ideas about making better cars," Keohan argues.
His biggest disappointment? The possibility that all of this work could be for naught. There are members of Congress, he says, who won't even listen to or acknowledge the solutions and success stories the HSA Council is bringing to the table.
As Keohan explains, "It is easy to dismiss what you don't understand."
Education and service: a formula that works.
From a professional standpoint, much of Keohan's success can be attributed to his strategy of marketing through agents and brokers.
As he tells it, "What really pushed us over the edge was when we understood that we could not compete with larger financial institutions in regard to big insurance carriers. We weren't a household name, so we flipped our strategy and said 'why don't we go to the point of impact.' "
And that's just what they did. At a time when nobody really focused on the broker as part of the health savings account distribution channel, Msaver reasoned that agents were the ones selling the high-deductible health plans and they should be the ones recommending an administrator. So they set up a unit to educate brokers, reach out to employers, and make sure the accounts are set up correctly. By providing concierge service that brokers weren't getting elsewhere, the company positioned itself to be a hero to the agent.
In Keohan's words, "It was an expensive proposition, but it made sense to us."
Today, of course, many HSA administrators market the same way. But could that soon be changing?
The times they are a-changin'
In her groundbreaking 1969 book "On Death and Dying," Dr. Elisabeth K?bler-Ross describes the five stages of grief: denial, anger, bargaining, depression and acceptance. While most insurance agents still find themselves struggling through the "shock and denial" phase, Keohan appears to have skipped the first four stages and moved directly to "acceptance."
That's not to say he's sitting idly by and watching the industry disappear. On the contrary, he and the HSA Council made a recent trip to Capitol Hill to meet with a number of elected officials about the future of health savings accounts, and they've also sent a letter to the Senate Finance Committee, headed by Sen. Max Baucus, D-Mont., encouraging them to reconsider several proposed modifications to HSAs, including a controversial proposal that would require employers or third-party administrators to substantiate that all HSA distributions are for qualified medical expenses.
Nonetheless, Keohan can see the writing on the wall: "Executives like me will need to be able to adapt to the new industry structure, which is going to be significantly different."
How different remains to be seen. But one thing is certain - major changes are on the way, changes that will require companies to rethink the way they do business. And, depending on what the final health care bill looks like, that might require a shift in the way they distribute their products. In other words, the broker's role could soon change.
It's a tough business
So what would Keohan say to someone just getting into this industry? He's pretty straightforward: "I'd tell them to do a lot of soul searching, this is a tough business."
What about existing agents? Is there anything they can do - either individually or as a group - to alter their fate?
His answer is equally frank: "Agents need to get involved now and align themselves with organizations and professional associations that represent the interest of all parties involved along the benefit food chain. Agents and brokers have an opportunity to join organizations like NAHU [the National Association of Health Underwriters] to let their voice be heard."
Turning lemons into lemonade
It's true Keohan is "concerned about the viability of the business model that exists today for all banks - all financial institutions in general that are in this business."
On the other hand, "with the new administration and the changes that are guaranteed to come, it will create new opportunities that don't exist in our business today."
In a word, he's excited.
"I'm encouraged as an entrepreneur about the new opportunities that will emerge from the changes we'll see in the next 12 months. There will be new technologies that will create new cottage industries and new opportunities."
Clearly, Keohan has entered the "acceptance" stage.
And he seems fascinated by the possibilities. As he points out, we now have the ability to adjudicate a claim within a matter of seconds rather than a matter of days.
"One of the significant burdens within the system is that we're using too much paper and we're not using the technology that exists today to make the system more efficient and more transparent."
He's also interested in the trend toward electronic medical records. Not only can they save lives in emergency situations, collectively they can reveal trends that will help policy makers and medical providers address and treat health problems more effectively.
So what's Craig's utopia in regards to health care reform? It's pretty simple: "To me, utopia is that every American has access to health care but they also have access to the information that helps them manage their care."
