The Value-Based Healthcare Podcast: Bob Dunn

Reveleer welcomes you to episode 3 of The Value-Based Healthcare Podcast. Our guest this episode is Robert (Bob) Dunn, President and CEO of Babel Health.

This series aims to assist health plans become more successful through shared experience and best practices used by their peers in the industry. We interview executives at all levels within Risk Adjustment and Quality Improvement groups to share various perspectives.  

The Value-Based Healthcare Podcast is about sharing inspiring and real-world solutions from the people who are questioning the way business has always been done. We aim to educate across the spectrum of healthcare so that managed care organizations, providers and members alike are more successful in navigating and operating in this complex and ever-changing landscape. Subscribe today to ensure you receive the latest episodes!

Podcast transcription: 

Jay Ackerman, CEO of Reveleer:
Hi, I’m Jay Ackerman, CEO of Reveleer. For those of you new to our podcast and to us, Reveleer is a software and services company committed to providing health plans with innovative technologies to maximize their return from HEDIS and risk adjustment initiatives. A must in the value-based care world we operate in. I'm back with session three of our podcast series entitled ‘Succeeding in a Value-Based Reimbursement World.’ We aim to widen the visibility and voice of people shaping significant functions inside of health plans.

I'm thrilled today to be joined by a business partner of ours, Bob Dunn, CEO of Babel Health. Bob has had a long and successful career in healthcare working in technology, operations and consulting. For the last 11 years he's been in the CEO and COO positions of top vendors in the payer space. Prior to his foray in the healthcare, Bob was a CIO and a national advertising and communications company. He calls Pittsburgh home where he lives with his wife of 42 years. I hope you'll enjoy this podcast, feel free to share with others via social media. And now with that let's hear from Bob.

Bob, how about we begin with a few questions regarding your career progression? You've had quite a career. So can you start by sharing how you entered healthcare?

Bob Dunn, President & CEO of Babel Health:
Yeah, it's an interesting story. Jay, I had actually been a young CIO of the advertising firm that you mentioned in my bio. It was the top position in the organization. It was the top six advertising public relations firm in the country. And then I was really looking for something else to do. So, I ventured out from my own consulting company and really at the time, look for work that I could get to feed my family or to use some of the experience that I had. I was looking for areas that I felt were uncovered a little bit backward in technology. Things were just emerging in the marketplace and healthcare seemed to be right. There wasn't a lot of new technology, there was a lot of things that were just currently being automated. Small groups of vendors to provide a platform system but not a lot of stuff around. So, I saw the opportunity, mostly in the provider space.

I started off doing consulting and then subsequently, as the company grew and anyone who's listening to the call knows that recreating your revenue over and over again in a professional services firm isn’t easy, so I was looking for some transactional revenue and came up with an idea to outsource the technology of small to medium-sized hospitals. I bought a data center that was owned by George Regional Hospital from the hospital, outsourced them and then started the successfully outsource small hospitals. But what I found was in the linkage between the provider and the payer space, that there was a lot of missing elements that exist today, even years and years later.

And then the opportunity to introduce new ideas, new technology, that really could have an impact on the operations of the healthcare organization; whether it be a provider or a payer, were significant. So, one way is we passed the resistance I felt at the time, a lot of the other areas of technology were more mature. So, we got into it, both as an entrepreneur, grow a company and actually saw the opportunities for the continuous improvement.

Jay:
That's quite a story. I'm sure one full of learnings for many other budding entrepreneurs. Can you share how you found your way into Babel? 

Bob:
Yeah, it’s an interesting story. I had been around in the payer space and for some of the larger vendors in the space and several people obviously have either been customers I worked with and partnerships, like we have with HDVI. I had recently had been the chief operating officer of DST, I was thinking of slowing down a little. And one of my previous employees was an early investor of Babel Health, felt that Babel needed some healthcare expertise to kind of complement what I thought was pretty good basic technology they built and asked if I’d be an advisor to their board. The company was headquartered in Arlington, Virginia. I went down and met with the two founders and the chemistry was good. And what I saw there with their fast pace, the data management ETL tool, a lot of opportunity, both to develop transactions and to use that easy to acquire ETL purpose-built and proprietary to really gather data easier than you normally can in a healthcare organization. Which we all know is an eclectic mix of connections and data and a problem that it would be great to find the silver bullet to solve. So, but I met with them, kind of agreed on the spot to be an advisor and a board member.

But when I was driving back from the DC area to Pittsburgh, it’s about a four-hour drive, the two founders called me and asked me if I'd be the CEO of the company as well to kind of build a strategy and figure out where the best places to apply the technology were. As I was driving, I said, ‘Well, if you are willing to move the headquarters to Pittsburgh, then I'll take the job.’

So, that was three years ago and we had a slow start like any other startup. Trying to get traction and trying to get the product built, ramp up with some customer implementations in 2017. And then it 2018 we had a very good year, an expanding year. Went from 2 to 15 customers, signed a large Blue plan, signed a large Medicaid deal to, you know, things are moving forward. But it was an interesting story of how it all began and how it got started. One thing I will mention as we are both in the risk adjustment space is one of the areas of one of my previous roles as the chief development officer at PNG Health, we had 40 plus customers. One thing that was really problematic for us in the BPO outsourcing business was the proliferation of in the amount of people that were in the risk adjustment space. And there was a lot of single shot, rightful shot solutions but nothing really comprehensive. Whether it was within submissions, or coding, or chart retrieval that was connected together. And I saw a real opportunity for that moving forward.

Jay:
Thinking about your phone call and your drive back to Pittsburgh. How long did it take from that call to when you were embedded as CEO? How long did it take for you and the founders to get down and for you to fully insert yourself?

Bob:
You know it was almost immediately and they obviously prepared the little dive into an employment contract. What I did is, for about the first month they paid me as a consultant and advisor. We worked it out for the position. You know took a position based on the experience that I had, knowing that I was going to bank on the future more than on the current where we were. I was more interested in getting rewarded for results and growing the company. So, we came to an arrangement right away. It was a good opportunity for me having commuted and traveled all over the country daily for previous jobs to kind of be in one place and fill out a quality company here in Pittsburgh. So, the whole process took 6 to 8 weeks.

Jay:
Wow that’s fast. That's great. So now that you've been there for a few years, can you share your goals related to the company and maybe how they have evolved?

Bob:
Yeah, I think, from my perspective when I got in and I think I was always thinking about building something that was going to be a little bit larger than where we started. And we started focusing on solving the risk adjustment problem on the submissions side between EDPS and RAPS. Building a system that could gather data for both and reconcile data across both, you know, given the regulations and the slow grandfathering out of RAPS over time.

As we got past that single shot solution, I felt that what was missing is an entire platform that allows the use of our detailed data management tool. And, you know, as we all know, in a health plan, they don't have separate claims systems or usually separate chart retrieval systems for each of their different program lines. They may have different vendors and contracts; they make that very complex. For my concept was to rationalize that and to use that single ETL data management tool to be able to have the health plan accept data from an eclectic range of sources, not have to rely on API, not have to rely on multiple vendors to do it, and more importantly, not have to rely on their internal IT department as part of the process. To meet a lot of these timely and quality type issues.

On the other side from user interface and the rationalization of the workflow, which related, a lot of the small to mid-sized plans, who are operating in multiple programs, don't have a lot of resources or funding to support that. So I tell rationalizing resources with a single look and feel UI that allowed them to distribute workflow depending on what submissions were being submitted at the time, whether it be Medicaid or ACA or the Medicare Advantage for RAPS and EDPS that they’d have a clear, transparent view across all of those applications, whether it was correcting error correction, getting the submissions out on time through a single product, with a single look and feel, almost making the submissions around everything they did almost ubiquitous to the health plan.

Jay:
Hey Bob, thanks for sharing that background on Babel, your entry into the company and income business goals and objectives. So, let's talk a little bit about the industry and the change that's unfolding. What industry trends are you focused on and how do you see them as beneficial to your organization?

Bob:
Yeah, I think one of the interesting things, as you know, particularly working and navigating the government program space, this Damocles sort of compliance and regulation and the ability to change, and the variables and multiple programs. Then you see that evidence, not so much in the Medicare Advantage space, but I think that's a solid program and it's been proven successful but you see it in the ACA with the Obamacare and they change in the administration or the change in politics, that can effect what you're doing. So, you have to be able to create technology and I think this is where a SaaS environment are a lot more flexible to be able to create environments that allow you to respond to those changes in compliancy. But more importantly, I think you have to almost, and I used the word transparency before, put control over compliancy and transparency over the processes in the hands of the health plan.

The other two things that are very, very important and I think as the cost of healthcare go up, as the cost of either providing the services or administering the services go up, any of the opportunities for a health plan to retrieve back or to maximize revenue based on, in our case, the risk adjustment submissions, is a huge win for them. And it's found money and if they do it right and they do it correctly and they do it timely, it allows the health plan to reassure themselves that they're maximizing the revenue for the plan. I think equally important and I think especially important to the mid to small size plans, but we're seeing it, and the one large plan that we just sold, that there's a lot of resources and expenses that go into the day to day care and management of these systems. And it consumes a mindshare out of IT, it consumes multiple resources to be able to do this cross-programmatic work. And with the eclectic mix of different vendors in the mosh pit of internal systems connected to them. It's a very convoluted, expensive process to administer. Interestingly enough, not unlike other healthcare things, they really don't realize that, because it's just the way they've been doing business for a long time.

I think if you can hit and solve those three business issues and prove it out for empirical evidence, you know, we're attempting to do through case studies, that we can guarantee compliance and that's a big thing. If we can show you how to maximize revenues and demonstrate it, and then we can actually show you how you can reduce, repurpose or rationalize your staff across certain processes that allow you to save significant money and time and effort that can be used for other things. Savings. They can be applied to the health plan’s bottom line. I think they are the key issues and they're the business. Obviously, there's probably issues, there's performance and administrative sort of things that you can match. But when you look at it from a healthcare perspective, the ability to save money and to use those opportunity dollars for clinical care or to improve the richness of benefits for a health plan, as opposed to burying them into the administrative side of the business is a good thing.

Jay:
With those industry trends unfolding, what do you see as the greatest barriers or challenges for Babel and being successful in that environment?

Bob:
I think, you know Babel is entering the environment through trying to be the answer. I used the word before, ‘silver bullet’ for the risk adjustment submission side, by consolidating the way that the data is acquired, by validating that data in one place for multiple programs, for being able to make that entire process transparent, provide more control, provide more insight to the plan is the big win, but it's only a part of the picture. And I think relationships that we're trying to nurture and develop with HDVI, with other vendors who offer what I would call ‘food chain services,’ testing the specific risk adjustment area are important.

There are a lot of people; it's just as we've consolidated and made the risk adjustment submission across programs very efficient. I think you can extend that out to a larger universe that includes the HEDIS, the HCC chart retrieval activities, prospective and retrospective, look at the data. Using that data and repurpose it for clinical outcomes, population health-type initiatives, are all there. I think we are just a small part of a larger solution. We want to be the best of breed in that space, but I think as we grow and as we look to expand, I think the market is actually looking for a quality vendor to connect the dots through that entire food chain or the risk adjustment submission process.

Jay:
So just playing off of your last comment there about quality vendor, you know, in this evolving environment where the patient change is more fluid in arenas like ACA, how do you work to establish partnerships with your customers to stay close and to understand what is top of mind, highest priority for the senior executives inside of the payers?

Bob:
Yeah, I think health plans are an interesting animal. And one of the things that in my previous position as the Chief Operating Officer and Chief Development Officer at PNG Health was the fact that we were working with 40 plus health plans and managing their day to day, you know, mostly backroom administrative initiatives.

So, all the things that I mentioned before about the revenue and finance and all that are important. Obviously to the health plan, providing quality care services is important too, but I think one lesson that I learned and I really believe as a strong differentiator, whether it's developing partnerships go forward with health plans for maintaining a high level of customer service is really understanding that when you're dealing with health plans that you really got to be focused on providing a high level of customer service. The same level of customer service that they're provisioning, or their members are demanding in their health plans. That you're treating their members, their providers, just that that they were a part of your organization and they were your actual companies. And I found successful in dealing with large and small plans, is that when you approached your customer service, you approached your relationship with them, empathizing and understanding that that's the really true important thing and you designed your company and your services with that same sort of empathy for the providers and payers, but also that same commitment to a high level of customer service and support, that you'll be very successful in this space.

I think you know the areas used a lot of big vendors who dominated the space. Their calloused for the smaller plans. I think that some of that’s unintentional if it's based on size, but I think the real key is, if you can maintain those relationships and you can maintain that rhythm and pace and that commitment to that day to day customer service with the same core values and objectives that that health plan believes that they're providing to their members or providers, their other constituents, you'll be very, very successful in that space. And takes a little more time, it takes a little bit more effort, take some more employees and some expenditures to get there. But I think if you put the time, the effort and the money into it that you’ll get paid dividends geometrically from the time and money you put in.

Jay:
Yeah that certainly rings true to me, Bob. Let's talk about your life inside of Babel for a minute. What gets you excited in working with your own team?

Bob:
Yeah, I really enjoy a collegial environment, I love a professional environment, I love a peer environment. I like motivating people to achieve goals that they feel are, maybe way beyond their own ability and their own dreams. Many of the people that we've hired at Babel worked with me in the past so they know I’m always in perpetual motion, I'm always thinking, always looking for a creative way to do things. But I'm always communicating and always sharing things with them. So, I think I did that, I get, you know, may seem maybe a little bit trite or whatever, is, you know, seeing the hard work and the effort. Sometimes the courage that’s overcoming the fear in a startup is anybody who has been involved in a startup is aware of. And meeting that fear head on, looking beyond it and working beyond it to achieve results is a great satisfying accomplishment. I've been taking on those tough paths, overcoming the naysayers, overcoming setbacks and moving forward. I think energized. I think I would go comatose if I was in a regular job where I was doing one thing, or there were no issues, or you weren't looking to make whatever you had bigger and better going forward. So that again.

Jay:
Yeah, you and me both. I think that kind of steady-state environment would be the death of me. How do you ensure your organization stays aligned to the goals that you're laying out?

Bob:
Like I mentioned before, I'm a big believer in communication. And I actually, on a weekly basis, and I did this when I had thousands of employees that were reporting to me in larger companies and I do it if I have a couple of employees, but every Monday we have an all-hands meeting for the entire company. Some of the things that are topical for the agenda is really open for them and the employees to talk about their concerns to suggest ideas. And believe me, not so much a Babel, but when you have several thousand people on a call, you get some crazy ideas, but most of them are good and most of them are thoughtful. But I think the ability to maintain that pace of communication, that same communication for me and, I've been accused of over-communicating many times, but I'm a strong believer in it.

Also goes from a Babel perspective, to our investors, to our board, to our customers. So, I think the more you're open and honest, the more you’re direct, the more you're willing to share, not only good and bad news, but reasonably and effectively. And hopefully, if it’s with customers, the bad news with some solutions and ways you're going to fix things is that you'll be okay. And I think when you go silent and you build a culture that is walled in as opposed to a culture that's open to listen, to hear criticism and to really focus the efforts of the company on continuous improvement, you know, then you'll be successful. And at least if you're not, you addressed it head on and everybody in the organization knows they can do their best. The thing that I emphasize and I should say, really simply, is you hear at all the time, but ‘if we win, we all win, and if we lose, we all lose.’ So, whose, everyone in the company, that if someone's in trouble they raise their hand and we circle the wagons and we make sure we get them out of the situation and help them in any way we can. A real simple advice and nothing new and nothing earth-shaking. But I think if you execute on it, you'll be successful.

Jay:
Yeah, I wouldn't underestimate the challenge around executing something as straightforward as that, consistently. In a fast-growing environment with a lot of change, it's easy to say, ‘Hey, we'll cancel this week’s all-hands and we'll do it next week.’ And then next thing you know that pivotal communication vehicle has disappeared. So, kudos to you. Hey Bob, I knew this would be a great conversation from the time we spent working together in the marketplace. So, I want to thank you for carving out the time. You've been a wonderful guest and your insights are quite valuable. As we bring our podcast to a close, I'm hoping you'll indulge me with 5 lightning round questions. So, let's just move quick and if you can share what's top of mind for you, I would really appreciate it. So, what keeps you up at night? 

Bob:
Yeah. Hey, anybody that's been in this situation, my mind is always going. I think it's a sense of letting down the investors, letting down my employees, letting down, you know, our board, our customers and not being able to deliver on what we're delivering. That's from a business perspective. From a personal perspective, and I never thought I'd say this, but what keeps me up at night is the state of where our country is today. Divided. You know I have a couple grandchildren. I look and see, you know, what's happening in the world and the country and it's, you know, it’s disconcerting. The America that allows us to build companies and to be successful and to bring in employees and make them owners of the company and professionals, is, in that spirit, that growth is kind of being drained out. So, that bothers me a little bit on a personal basis. I'd like to see, you know, the country coming together a little bit more and focusing in on a lot of the right things and the good things about America.

Jay:
Yeah, I can certainly empathize with that. So, when you have those sleepless nights, what book might you grab from your nightstand and why are you reading it?

Bob:
Yeah, I mean, there's a lot of different things that I look at but the one book that again, maybe trite is, you know, The Art of War by Sun Tzu. You hear a lot of people quote that book but I think the straightforward advice, the common-sense advice that that provides, in terms of a life and a business strategy is very helpful. And, you know, to say the best way to win things is to avoid issues and problems. So yeah, I just lean on that and I have a couple copies of it actually. One that I used to carry with me all the time and another is sitting comfortably on my nightstand.

Jay:
Nice. So, we are going to go a little deeper on this one. If you could redo one decision in your life, what would it be? 

Bob:
Boy, that’s a big one. It’s a good thing my wife isn’t listening to this podcast, huh?

Jay:
I’ll make sure I send it to her.

Bob:
Yeah, but that's a joke. My wife and I've have been married for a long time. We got married when we were 19 years old, so we had to grow up early. But I never regret that and never regret, you know, any of the time and the energy and things that I put into that. But I'm, you know, maybe crazy; I really feel that if I would have focused in, I would have been involved in a career that, because I'm pretty self-motivated, would have been more, to be a doctor. I think if I wasn't as lazy and I didn't get married as early as I did and raised the family, I think I would have gone back and put in the effort to be able to be involved in doing something that I felt was helping other people directly. But circumstances take you to where you are. I'm not regretful for where I am as well.

Jay:
Well, I appreciate you indulging me in that question and sharing something personal. Pulling back up a bit, what's the favorite app on your mobile device?

Bob:
Yeah, I'm a big list person, right? And my wife jokes with me about having all kinds of controlled things. So, I have two apps. One is ‘Things’ which allows me to focus, both on my personal and work things that I need to do all day. And the second one is ‘Priorities.’ And I like to reinforce the things that need to get done so I don't lose sight of what they are, whether they're in my personal life or in my work life. So, I focus heavily on those. And then third would be the ESPN app after that.

Jay:
Alright, last question. How do you invest in yourself?

Bob:
Jay, it's been funny over the years probably since I was in my late 20s and 30s, I’ve been an entrepreneur and that's consumed my life. And try to, you know, take the time to spend mostly with my family. And when I was younger, I was the sports coach, even though I was running these businesses for all of my kids’ teams. I coached youth football for six or seven years and my boys played for me. I coached basketball. I coached, at one time, my daughter's softball, my two boy’s baseball teams. So, it was a good way for me to relax and spend time with my family. But in myself, you know, probably not as much as I should, because I’m consumed mostly with family and business. I try to exercise and keep myself healthy, and eat right and take a little bit of time to learn every day which is another thing that’s big on my list.

Jay:
So, someone who spends a lot of time coaching, I think you might be underplaying the value that has in your own development. That separation from work and trying to influence young children, you know, in groups of them on a field. Like the lessons there are highly applicable into the work environment. I've enjoyed being a coach to my own two boys as well.

Bob:
Yeah, it’s a lot of fun and I enjoy it. And I think it was interesting how the state of my wife when all three of my kids graduated from high school. They graduated from a big place from here in Pittsburgh and, you know, the kids were going up and receiving their diploma; how many of them had played athletics for me at one point. It was amazing. So yeah, it's very satisfying.

Jay:
Well, that brings our lightning round to a close so thanks for responding to those questions and thanks again for your time and your openness on the podcast. This will bring our ‘Succeeding in a Value-Based Reimbursement World’ podcast to a close. And Bob, thanks again. You've been great. Please follow Reveleer on LinkedIn. You may also follow me, Jay, on Twitter @AckermanJay.