Founding partner of Humana Health Ventures to startups: Don’t approach us simply to get a check

The founding partner of Humana Health Ventures and the person who leads the Kentucky payer’s efforts in digital health innovation has a strong message for startups that want to work with the company: Look at us as a mentor and not as an entity simply writing checks.

‘I spend a lot of time talking about partnership in its truest sense,” declares Busy Burr, the Silicon Valley executive Humana tapped to lead innovation a few years ago. “A lot of times smaller companies — they just want to approach us as people are going  to write checks for them — [as] commercial partners.”

But, look at big companies as a mentor to you, she advises. Burr currently leads innovation and heads the Palo Alto office, but the actual investing is being managed by a different executive at Humana Health Ventures.

Interestingly, Burr, who has an enduring interest in improv finds parallels between that performance art, innovation and Humana’s overall mission. In a phone interview, she expanded upon the connection between the two, described the characteristics of true patient engagement, and which of Humana’s portfolio startups pique her interest. Below is that conversation (edited for length and clarity)

MedCity: How does your experience in improv frame your vision of how innovation at Humana must occur?

Burr: I have been doing improv for a long time and for me improv is an art form, it’s a creative outlet.The story that you are creating with your fellow improvisers is only going to exist once. And as soon as that story is over, it will never exist again. So what’s joyful about improv is in the creativity, in the act of creating something together with other people.

To be successful at improv, there are a number of key things you need to be good at and you have to really practice. It’s being immersive and accepting the immersion into somebody’s space, where they’re coming from, so to be really good at that, you have to tap into empathy.

Then there is what I call exquisite listening — being really, really good at taking the time to listen when someone is giving you an offer. In improv, the way it works is that people give offers to one another and then you accept those offers and the way you accept them is by listening to what someone is doing. So you have to be really present. You cannot be planning what you are gonna say. You have to be present and listen and respond to what was said wholly.

The other piece that is really about improv is selfless generosity, which is to recognize that your job on stage is to make your partner look good. And then the last thing I always talk about when I talk to people about improv is trust. It’s trust in your partners to be there for you. When things are not going well, there are people you can trust that people are going to jump in and keep you from doing a face plant.

But also trust that inside of yourself in this unbelievably vulnerable creative space in front of a crowd you will have what you need when you need it inside of yourself.

So it’s really about empathy, which is a big part of being able to be effective with our members and our provider partners. It means listening and selfless generosity, which means helping everyone else be successful at Humana. And the last thing is really about folks having more creative confidence and being able to be a little less prepared about every conversation. That great stuff will emerge from that and that we will work together as a team.

MedCity: Selfless generosity seems counterintuitive in Silicon Valley with the huge egos and the sky high ambitions. Have you found it hard to use selfless generosity as you work with startups to further innovation at Humana?  

Burr (laughs): It’s a really good observation. Definitely, when I talk this way, it causes people to stop and take notice because it is different.

Healthcare is super complicated. My belief is that there’s not going to be tons of Amazons that are going to emerge from all the companies that are out there. There may be a unicorn or two, but because of the complexity of healthcare, success is going to be reliant on startups having true partnerships with some of the big companies out there because the big companies they have a lot of subject matter expertise. They know how to help navigate the complex regulatory infrastructure. They understand all the different kinds of biz models and they understand how value flows in the system. In a place like Humana, we understand how Medicare Advantage members engage. We know how to engage people with chronic conditions.

But a lot of time the smaller companies – they just want to approach us as people are going to write checks for them – commercial partners. But I think they should approach partnerships as a learning activity. When we talk to companies I always say that we are exploring and we understand what we as Humana are trying to learn from an innovation point of view. And I want that company to be able to articulate what it is they’re trying to learn. And so we can figure out what we are trying to learn together.

So instead of talking about what’s the deal, what’s the PMPM — the cost to payers per member per month — it’s what’s the learning journey we are going to have together.

You have to shift the conversation from dollars and cents and PMPM to let’s go on a learning journey together, let’s make sure that I provide for you what you need to advance your company and let’s make sure you are providing for me what I need to advance my strategy. [That’s where exquisite listening and selfless generosity come into play.]

MedCity: What does true patient engagement really mean from Humana’s perspective?

Burr: The word engagement has been coopted mostly by our friends in the digital sphere, the app sphere, and they measure engagement by how much time users spend on an app. We tend to measure engagement in more of a way of recognizing how self-engaged members are in their own health, how empowered they feel, whether or not they have the tools to self-manage. People want to be engaged in their life. They don’t want to be engaged in their medical care.

So we try to look at Healthy Days, which we do as a measurement of our Bold Goals.

Health is what happens in those 360 days that they are not in the doctor’s office as opposed to the five appointments that they have. So how do you help people in those 360 days when they are not in the doctor’s office and it can be a whole variety of things. Maybe they are going to the SilverSneakers fitness program [that Humana and other health plans offer to seniors.] Maybe they are doing something in their community. Maybe they are doing something that fulfills them in their lives and their conditions are not holding them back.

The kinds of programs, activities, conversations everything that we ar trying to do is trying to build systems and support for people to have better human-to-human conversations whether it’s between a doctor and a member or whether it’s between a member and caregiver. It’s really about trying to enable better human engagement, human relationships, human touch in the system and not just clicking the app button on your iPhone.

MedCity: What are the metrics that you look at internally to see whether a member is truly engaged in their lives and managing their disease?

Burr: It varies program by program. In the end what we are trying to do is to see whether we are bending the trend on their health on their condition. Are they getting healthier? Are they getting better? Is their A1c going down? Are they having fewer condition-related episodes. So we measure on health.

MedCity: When you are discovering startups, what is your focus? Is it purely health IT and digital health type of companies or are their other kinds of companies too?

Burr: We are looking at things that will advance our strategy. We are spending a lot of time in trying to help our members achieve their best health. We look at it in three core ways.

• One is by identifying things that will help a member either manage their chronic condition that they have or literally slow their disease progression.
• We look for things that will help providers deliver better decisions, so tools that will help doctors deliver better care to our members.
• And then we look at those programs that will help our members stay in their homes and be in their communities.

MedCity: Would it be fair to say that most of the startups that you are interested in along these strategic lines are in the health IT space?

Burr: Health IT is kind of a funny word. When we talk to startups we want to make sure that whatever they are delivering are products/programs that are highly scalable and generally that means there’s going to be some sort of technology underneath it. Either it’s digital or data and analytics enabled, AI-enabled or it’s just frankly eliminating friction and barriers in the system by creating more technology where there wasn’t any before.

It’s about looking at removing barriers, ease, taking friction out of the system and generally technology does that but it doesn’t have to be.

MedCity: Since when have you begun to invest in these companies?

Burr: 2015 is when it started.

MedCity: How many startups have you invested in total?

Burr: We don’t spend a lot of time discussing our portfolio because we don’t invest for the sake of building – we are not a financial investor. We don’t have a fund.We invest off of Humana’s balance sheet. We have investments in a number of companies. We don’t look for a number. We find companies that align with some kind of element of our strategy. There are a lot of companies that we partner with that we choose not to invest.

MedCity: What stage would these companies be? Do you do seed rounds, Series A, B?

Burr: It varies. It’s on a case-by-case basis. We are investing in a way that is aligned with Humana’s strategy and so because of that the stage of the company isn’t what’s important. It’s how they align with what strategic objectives we have at any point in time.

There’s a big consumerization trend in healthcare. So we are looking for companies that can really help us move the needle on our members’ health. There are plenty of companies out there that can help providers deliver better care. There are going to be solutions in the pharmacy world that make it easier for members and doctors to get connected around pharmacies.

We are a retail company and we do have relationships directly with members but we also have a Humana at Home business, which is focused on delivering care management services for our members. We have a pharmacy business. We have provider clinics that are owned and those that are joint ventures. So as a business we have a lot of different areas of healthcare that we touch. So we are looking at companies that can have an impact on our strategy.

MedCity: What are the character traits of a successful entrepreneur?

Burr: I think particularly in the space, the startup founders who have a real thirst for learning, for recognizing that they don’t know everything — because nobody in this business understands the whole thing — those CEOS that have a real openness to learning, I think those are ones we obviously look for.

Just like everybody else, we are interested in a CEO who has a really good story and passion for why they are going after the space that they are going after. It’s super hard to do the work of a startup CEO so you want to make sure that someone is in it to win it.

I think we also look very carefully for a CEO who has a lot of emotional intelligence because good CEOs are going to attract and retain talent and it’s not easy to find and retain talent in Silicon Valley. So that model of a sort of swashbuckler, maverick CEO that is the kind of a jerk but wow they are smart and strong isn’t going to last long.

So if you want to have the best and brightest in healthcare, you better be mission-driven, mission-focused, and be emotionally intelligent because you’re not going to be able to attract the best and brightest people if you are looking just to be coin-operated.

MedCity: When it comes to portfolio companies, is there one particular or a couple of companies that you are really excited about in terms of the impact they can have on healthcare?

Burr: I like all of our portfolio companies. I am very interested in and excited about what’s happening at Livongo right now because now they’ve been around a while and they are starting to capture enough data to actually be able to do some really interesting analytics around the diabetes space. This will enable them to start to create really highly personalized recommendations around someone’s medication regimen, analytics that really hadn’t been able to be done before.

That’s very exciting and very interesting to watch.

I think Omada Health is a really interesting company to watch in part right now because there is so much happening in the DPP [Diabetes Prevention Program] space with CMS [Centers for Medicare and Medicaid Services]. And I think what Omada is really working on doing is creating a very differentiated, highly personalized experience.

These are  IDEO guys so they’ve built it as a really amazing customer experience and they’re starting to [like Livongo] capture enough data so that they can create a highly personalized DPP experience for folks.  DPP has been typically kind of turnkey, off-the-shelf, here’s the curriculum you do kind of program, but now Omada is approaching it as a how do you actually create a really individualized curriculum that is appropriate for people and the kinds of struggles they have. I think that is super exciting.

There is a lot of urgency in the work that we do. And I think it’s because of the combination of both the mission of making people healthy and helping people be healthy but also the urgency of this ecosystem right now.There are so many things that can happen. I think we all are feeling the fire.