Drew Leatherberry

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Drew Leatherberry, founder and advisor, Avergent, is passionateabout transparency and transformation in health care pricing anddelivery for the long-term sustainability of employer healthplans.

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Paul Wilson: How did you get your start in the benefitsindustry?

I started 11 years ago, coming from the startup technologyworld, where I met a gentleman who had been in this business for20+ years. He provided my previous company with office space, andwe would have lunch and happy hour conversations about health care.When my startup dissolved, I co-founded a health insurance agencywith him and we ran it for about four and a half years, workingwith small and mid-sized companies in Northeast Wisconsin.

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We developed a care advocacy program to help employees makedecisions when they got to that mid-level of care—an MRI, a CT scanor an orthopedic procedure—and try to steer them toward value. Wetried to help people navigate their care pathways.

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Related: Ask the (health care) concierge

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When the ACA hit, it became more difficult to serve some aspectsof the plan. In 2013, I decided to sell the agency and latch onto alarger regional agency in Green Bay. For the next five and a halfyears, I was one of their core producers and ran the businessdevelopment team. Then, about two and half years ago, I startedhaving an ethical dilemma. I got into this business to make adifference for employers, understanding health care costs were ahuge expense for most businesses. But even though we were doingsome innovative things around wellness and we had a near-siteclinic, we weren't making a dent in the year-over-year trend. Ilearned about Health Rosetta, and David Contorno and I were bothintroduced to a mutual prospect at the time. I found out who I wascompeting against and decided I was not going to win that one. Ireached out and congratulated him, and he actually proposed that weco-advise the client, which was completely new to me, but we wereable to make it work. My eyes were really opened up to differentpossibilities.Drew Leatherberry's kids

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The agency I was working for at the time was fairly traditional,and I decided at the end of 2018 that it was time to move on. Ifounded my agency, Avergent, on the idea that employers need todiverge from the status quo. We focus on bringing awareness andcultivating and educating employers about the opportunities thatexist for them to control the cost and provide better quality careand more sustainability from a cost standpoint, as well as a bettermember experience.

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In the last year, I'm happy to say our agency has really takenoff. We've pulled in over a dozen accounts all around Wisconsin andwe have employers who are seeing some dramatic cost savings.

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PW: How has your career path and these experiences helped shapeyour current perspective and priorities as a broker?

Having worked for multiple start-up companies and being anentrepreneur by nature, I've had to make challenging financialdecisions for myself and my family. That has given me a verypersonal view on the cost of health care. Because of that, I have ahigh level of empathy when I'm asking people to do certain thingsor telling them their deductible is going to go up. The datasupports that Americans have been handing their pay increases, andthen some, back to health care for some time. We've seen out ofpocket costs for member plans jump to levels that are reallyunaffordable. I often use the term "functionally uninsured" when Italk to people about their health insurance. It's personal forme.

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PW: How are you adapting to COVID-19? How has it changed theway you do business?

We've actually seen the benefits of having to change ourcommunication frequency. We've been communicating with clients on anearly weekly basis and in some cases, multiple times aweek. Moving to virtual communication has actually createdmuch tighter communication timeframes. In the past, we sometimessaved communicating with clients until we had the opportunity to goin and meet with them. We now see we can actually save the time itwas taking us to travel and set up on-site meetings; now we canhave more frequent communications that are more pointed. That hasbeen a silver lining from all of this; I think it's going to set anew standard for us.

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The other element is with fewer claims flowing through thesystem, it has given us a chance to take a step back and look atinternal processes and consider some of the ways in which we engageour clients. It has provided an opportunity to enhance some of thesolutions we bring to our members.

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PW: How do you see this pandemic changing health care andbenefits? How will it impact the way you plan and work with clientsgoing forward?

We were already moving to create better virtual healthinteractions with providers, and this puts a big exclamation markbehind that move. I've talked to people on all sides of the healthcare world, from providers and carriers to employers and patients,and I think virtual interactions will be not only the norm, butmight actually become the requirement and the standard.

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From a perspective of access to care, there has been veryobvious data that supports the need and importance of ambulatorysurgery centers for elective procedures due to cost and qualitybenefits, but now we see additional benefits from the perspectiveof preventing the spread of disease. I would imagine they will onlycontinue to grow in utilization.

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I also think there will be a tighter lens on fraud. We'realready seeing cases of misaligned incentives around diagnosingpatients with COVID-19. Some appropriate protocols weren't in placeand hopefully, this will illuminate the broader discussion aroundfraud, which is certainly something the health care world needs toaddress.

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PW: What are the best things about being a proponent for changein the industry? What are the biggest challenges?

Brokers are often not at the front end of innovation; they'vetypically been reliant on the insurance carriers to drive change.The positive of being in a community like Health Rosetta is thatadvisors are really stepping into the lane of program design andasking questions that aren't usually asked about plans. From aproactive standpoint, that's a huge positive. I can tell youthere's a number of initiatives that I'm involved with now thatcreate opportunities to make a significant impact on the cost anddelivery of care. That's really exciting, because it allows peopleto see the outcome of their efforts, whereas in the past, thetraditional broker really felt like they were reacting all thetime.Drew Leatherberry at Lambeau

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One of the challenges is there's a lot of skeptics anddetractors, not only from the broker community but from carriersand the health care status quo. When we wake up in the morning,there are 3.6 trillion reasons we're going to meet resistance. Theindustry has a strong lobby. I hadn't realized how much of a habitskepticism had become for me as a broker. It gets easy to findreasons why something won't work, and that's a terrible view. Ifyou have a bunch of people who are supposed to be architects forhealth plans who are disillusioned and skeptical, how are we goingto move forward and create a new normal? There are a lot of peoplewho want to tell you why things won't work, who have financialreasons to fight against transparency, or price equity.

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We wouldn't accept this anywhere else, but we're at the pointwhere not only is it allowed, but those who argue it should bedifferent are considered illogical.

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PW: Are there any particular challenges or opportunities uniqueto your part of the country?

It's always tough to answer this type of question without firstqualifying it by noting that our health care professionals are verygood in this region. But, we are heavily systematized. Independentclinics and physicians are nearly non-existent in this state, andthat makes it very difficult. The corporate powers control theprice and flow of health care, and a lot has to do with health caresystems being aligned with the major carriers.

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We talk about recreating the relationship between the payer andthe provider and disintermediating and trying to remove all thefluff and waste and abuse out of the middle of the supply chain,but it's very difficult to do that here because we have a lot ofentrenched financial interests. Health care systems own themajority of hospitals in the major metropolitan areas; we haveprimary care physicians that are almost entirely owned by healthcare systems. We have a lot of consolidation and health caresystems that own their own insurance plans. It's very difficult foremployers in our region to get through those alignments offinancial incentives.

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PW: This industry has long been seen as stodgy and reluctant tochange. Do you see that changing? If so, how can we keep thatmomentum going?

We all tend to become more realistic over time, but I canhonestly say I've never been more optimistic, because I'm seeing adifferent response from the employer community. Maybe it's thatthey've reached a breaking point financially; maybe it's that theyunderstand they can no longer just react and need to be moreproactive. Or maybe it's that some in the advisor community arestarting to bring actionable ideas to the table that havemeaningful impact.

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You typically think it's the innovative employers that aremoving the needle, but some interesting things have started tohappen in my place in the world. I have clients who are fantasticinnovators and not afraid to try things to move the needle, but acouple of clients have followed suit that I wouldn't classify asinnovators. I feel like we're moving into the early adopter andmaybe even the early majority phase from an employer standpoint,where people are making decisions differently.

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When you think of tipping points, you need to be pushing towardthe point where it becomes more normative for people to adoptstrategies. That's why I'm optimistic; I think we're there. We haveenough momentum in the advisor community to no longer accept thestatus quo and technology is allowing different care deliverymodels and financial incentive models. You have providers who aresaying, "Enough is enough" in terms of being at the back of thedecision tree regarding price and delivery of care. They want towork directly with employers. Things are going to change one way oranother. Our alternatives are for employers to take the wheel orwe're going to move to some form of Medicare for All orgovernment-driven plans. I'm optimistic that employers will takethe steps they need to take.

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PW: What are your favorite things about your job?

What's exciting for me is that it's a frontier-type environment;there's a lot of really great things going on, and if you want tobe part of it, you can. Innovation and the opportunity to shapewhat the future will look like has never been closer for someonewho wants to be part of it as an advisor.

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Of anything we consume, health care is where we are least ableto make a consumer decision. It's an emotional time and it oftenhappens reactively; there's complexity about the price and how it'spaid for, so it's natural that abuses happen. It's exciting to getup in the morning and think, "I can make a real difference that'smeaningful in helping protect people financially."

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PW: Where do you look for inspiration when you need it?

I have four kids, ages 2 to 10. They are a great inspiration andhave been part of my entrepreneurial journey. I'm very open withthem. We talk about what running and owning a business looks likeand "What does Dad do?" I get recharged when they ask questionslike, "What are you doing with your clients?"It's almost a therapeutic effort of distilling somethingthat's very complicated down to a very simple, easy to understandpoint. It helps.

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I also love reading on lots of different topics. It alwaysre-centers me. And I don't know how, but over the past few years, Ibecame a marathon runner. I like to stay active and I try to keepfitness at the forefront.

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I'm also really into mentorship, so I participate with our localchapter of Big Brothers Big Sisters and support that agency withone-on-one mentoring. I also have several business and personalmentors who I meet with regularly—virtually, as of late. I lovethose conversations; there's an old proverb that says, "Ironsharpens iron, and so one man sharpens another." To me, that's whyI engage in mentorship; it's the ability to have someone challengeyou, peer into your life and give you a different perspective.

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PW: Finish this sentence: The key to success in this industrygoing forward is…

Perseverance. In my company's development, we have seven corevalue behaviors. One of them is "embrace skinned knees." Everyoneis going to fall down, but it's about getting back up and learningfrom the experience. Embrace the failure and realize it's the keyto success.

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Paul Wilson

Paul Wilson is the editor-in-chief of BenefitsPRO Magazine and BenefitsPRO.com. He has covered the insurance industry for more than a decade, including stints at Retirement Advisor Magazine and ProducersWeb.