Leveraging Technology to Simplify the Business of Healthcare with Rajeev Ronanki, the CEO of Lyric

[00:00:00] Hey everybody, welcome back to the Outcomes Rocket. Today I have the privilege of hosting Raj

[00:00:07] Varnanke on the podcast again and his new role as chief executive officer. Raj has over 25 years

[00:00:15] of experience in innovation driven industry and also social change across healthcare and

[00:00:20] technology. As Lyric CEO, his vision is to invigorate Lyric's technology and utilize AI,

[00:00:28] blockchain and machine learning while building best in market strategic partnerships. Before joining

[00:00:34] Lyric, Raj led the transformation at Elevance, formerly Anthem from a traditional insurance company

[00:00:40] to a digital platform as the president of Keralon. So Raj, tell me what inspires your work in

[00:00:46] healthcare? Thanks for having me, so I'm good to see you. So I love the fact that healthcare

[00:00:50] creates such an impact whether it's bringing delightful solutions to consumers, simplifying

[00:00:55] the provider experience, simplifying the myriad transactions that are comprised of healthcare

[00:01:00] that contribute to the nearly trillion dollars to spend that I believe is not value and ultimately

[00:01:05] the patient or the provider experience. You put all that together for the country that has as

[00:01:10] much innovation as we do in healthcare and as many advances that we make in healthcare,

[00:01:16] there's still a lot more to be done whether it's creating more access to care,

[00:01:20] making care more equitable, removing bias from medical care, reducing medical errors,

[00:01:26] improving the quality of care, moving more to align outcomes between providers and insurance companies,

[00:01:33] making consumers more, I guess, make consumers better educated, more informed about the care

[00:01:38] they're receiving. There's an endless series of problems and opportunities in healthcare

[00:01:43] and me personally, I feel that technology can have a dramatic impact on the future of health in our

[00:01:50] country. And I'm excited that at Lyric, I have a platform on which to do that along with hundreds

[00:01:57] of talented colleagues that all share the same purpose, which is ultimately to simplify the

[00:02:01] business of healthcare. That's great. Yeah, and you've always had such an innovative

[00:02:06] approach in the work that you do, Raj. So I've been a fan of what you do. And at Lyric,

[00:02:12] the focus is payment integrity, right? And so serving health plan clients, do you see

[00:02:17] payment integrity, especially through innovation and technology growing to

[00:02:21] touch and impact other stakeholders? And if so, how? Yeah, great question, Sol. So the history

[00:02:28] of the company, the legacy of the company has been in serving health plan clients and that's been

[00:02:32] done for the better part of 30 years now with great distinction. The customers that we do have

[00:02:38] the retention rate is incredibly high. We have to have a single voluntary customer

[00:02:43] and sort of attrition event, if you will. So that speaks to the stickiness of the product and

[00:02:47] at the core of what we deliver in terms of value to our health plan customers.

[00:02:52] But beyond that, I think we also have an opportunity to serve providers by better

[00:02:56] educating them on submitting transactions that are clean and pristine to begin with so that

[00:03:01] we can start to minimize the noise and the friction that exists between providers and

[00:03:08] payers on this transactional flow between the two and allow both of them to ultimately focus

[00:03:14] on what matters, which is creating a delightful experience with consumers, improving their health

[00:03:19] and outcomes for them. And then enabling doctors and clinicians to focus on the things

[00:03:25] that they enjoy, which is ultimately care and care related matters as opposed to

[00:03:30] administrative and transactional overhead that we've created in the system. So

[00:03:35] I see Lyric as down the road being able to serve not only providers, employers, consumers,

[00:03:41] and obviously continuing to serve health plans with distinction.

[00:03:44] That's really great. Thank you for that. And you've done a lot of thought leadership work

[00:03:48] around AI. And in particular last year, you talked at TED AI where you shared your thoughts

[00:03:54] around organizational structure and AI. Can you share a little bit more about that and how

[00:03:59] you see it impacting and perhaps catalyzing healthcare company leaders and laggards?

[00:04:05] Yeah. So the genesis behind that was there is I think a tendency when it comes to AI to start

[00:04:13] building capabilities, to buy a software solution or hire a team in-house and start

[00:04:20] creating new capabilities and new solutions or exploring any one of the platform point

[00:04:25] solutions that are available that seem to crop up by the hour by the day.

[00:04:29] The question is where does this all integrate into and what's the organizational design that

[00:04:36] leverages these capabilities to the utmost and ultimately create better ROI for customers

[00:04:41] in an improved experience for all the stakeholders out here. So what's I think missing from the

[00:04:46] equation is how should companies be organized to take advantage of these capabilities?

[00:04:52] In my TED talk in last October in San Francisco, I

[00:04:56] drawn an analogy between what happened in the original industrial revolution back in

[00:05:00] late 1700s and early 1800s where as that revolution started to move from steam to electricity,

[00:05:08] it gave factories an opportunity to redesign the factory floors on electric motors. So now you

[00:05:14] could take electric motors and put them to where the work is create sort of the notion of a

[00:05:19] modern assembly line and make factory floors more open, more airy, more worker-friendly.

[00:05:27] And whereas if you just try to kind of put in an electric motor and in the place of a steam

[00:05:31] shaft and organize factory floors vertically then you really wouldn't have taken advantage

[00:05:36] of electricity and all the innovation that it brought to the table for factories.

[00:05:40] I think nearly 200 years later I think we're in a similar spot with AI which is

[00:05:45] for the most part companies are organized by departments and those departments probably have

[00:05:51] their roots in paper-based workloads. So we had an underwriting department, we had a customer service

[00:05:57] department, we had a claims department, we had a grievance department and back in the day you

[00:06:01] could imagine people with inter-office mail floating around supplying inputs and outputs to

[00:06:06] those different departments and they all kind of work together that way. With the advent

[00:06:11] of tech in the 80s and 90s I think a lot of that was automated but the departmental structure

[00:06:17] was still retained. And ultimately now with AI you still have the same structures that you saw

[00:06:23] in the 50s and 60s and companies to this day. The question is should they exist in that way

[00:06:29] or could they be reimagined with AI organized around different sort of purposes of an

[00:06:35] enterprise. So if one department's goal is to serve customers with satisfaction and with distinction

[00:06:43] then why not organize the entire supply chain that constitutes that under one structure.

[00:06:49] And if there's another department whose goal is to minimize friction between stakeholders

[00:06:54] and make sure that transactions are settled with no errors and with straight through processing

[00:07:00] then let's think about how to organize that along those lines versus in the way that

[00:07:04] they're currently organized which is based on honestly the 50s and 60s architecture. So in modernizing

[00:07:10] the operating design of the company, the organizational structure of the company

[00:07:14] and then marry the capabilities into it then I think you have a better chance of success

[00:07:18] than I think simply chasing the next new widget or next new capability without

[00:07:24] thinking about the largest structure into which all that kind of comes together.

[00:07:27] I really love your perspective on that Raj and it speaks to peeling back the layers

[00:07:32] don't get tactical, get strategic and start with the organization right and the results could be

[00:07:37] transformational from what you're telling me. Yeah and I think conversely if you're only chasing

[00:07:43] down capabilities and solutions and initiatives I'll think ultimately I think one will feel

[00:07:48] disappointed with the results because it's really not giving you the total impact that

[00:07:53] it could have without changing all of the surrounding structures around it.

[00:07:57] I love that and so all of these things you've had years of experience implementing at various

[00:08:04] organizations none of this comes without lessons learned. So I love if you could share with all

[00:08:10] the innovators listening maybe one of the biggest setbacks you've faced and a key learning that

[00:08:15] came from that. Far too many to counsel and that's a failure as very instructive and that

[00:08:21] keep keep teaching you the things that you have to remember probably more so than the

[00:08:25] successes you've had did not avoid I guess to making them again. So to me it's I'll maybe

[00:08:31] paint an abstract view of all the different lessons over time of the things that that haven't

[00:08:35] worked so one is clearly that like with my engineering background early on in my career

[00:08:40] I had a great degree of focus on building initiatives, building capabilities, building

[00:08:45] solutions without all the surrounding things that need to be accounted for for making something

[00:08:50] successful. So that's organizational upskilling, it's change management, it's understanding the

[00:08:56] motivations of change and the resistors to those change and systematically creating an

[00:09:01] organizational design an organizational change management plan to make sure that

[00:09:05] ultimately the solution and the products create the ROI and the impact that you would

[00:09:09] expect it to have and then working backwards from the outcome sometimes I think we tend

[00:09:14] to start with what's easy and then you get a third of the way and or a half of the way

[00:09:19] on your trajectory to your destination only to realize that the last half, the last third,

[00:09:25] the last mile is incredibly hard and costs a lot more and takes a lot more time to to pull off

[00:09:33] whereas knowing that upfront I think would change the priorities and the sequence in which you

[00:09:39] would go after it and in retrospect for me now what I start with when taking on anything new is

[00:09:45] understanding all that could go wrong, all the dimensions of risk whether it's people or its

[00:09:52] talent or its structure or its capability or its platform business model what have you

[00:09:57] looking at all the variables that have that create the most amount of uncertainty

[00:10:02] and then starting with a plan to reduce uncertainty so as you get closer to the

[00:10:06] finish line then the amount of variances and uncertainties you have is much smaller than

[00:10:11] when you start in whereas typically I think when startups get launched or when new product gets built

[00:10:17] or new business models get invented I think we tend to move the uncertainty to the right

[00:10:22] and then discover surprises later in the game which I've had a fair share of that over time

[00:10:27] my career and based on all of that those are all the things that I'm doing differently.

[00:10:31] That's great Raji, yeah it's a planning for the the inevitable surprises the inevitable things that

[00:10:37] will come up is key and minimizing uncertainty right is the name of the game. Exactly right.

[00:10:44] So you've spoken about the importance to simplify the business of care what does that mean

[00:10:50] and how do organizations and individuals get to that place? Yeah to me I think so the

[00:10:57] healthcare is missing the notion of a platform so if you think of Amazon and the work they've done

[00:11:03] in retail it's probably the most advanced piece of technology that connects consumers to the

[00:11:09] things that they buy and transact on that through a platform that's very easy to use

[00:11:16] with hardly any issues and things that could go wrong with it and if and when they do go

[00:11:20] wrong something does go wrong then there's excellent customer service to come back around and

[00:11:25] fix it so no one ever leaves that experience with or very few people would let's say leave

[00:11:30] that experience with any amount of dissatisfaction but if you look at healthcare that is probably

[00:11:36] the opposite even when I'd say someone has a pretty serious illness they get the best care in the

[00:11:42] world and they come out of it healthy and with equal with the right outcomes even then

[00:11:47] even when you interview all the stakeholders involved in that process there's usually something

[00:11:52] that they're not happy about either the financial transactions that's around that or the process by

[00:11:58] which they got the care or some element of care that could have been better let's say the lag work

[00:12:04] being better coordinated with the clinical work with genetic work all those things tend to be

[00:12:08] in silos so to me the entire system if you were to step back and look at it is a series of silos

[00:12:14] with very little communication and collaboration between the stakeholders

[00:12:18] and as a result incredible amount of waste incredible amount of rework and ultimately the

[00:12:24] consumer experience is very subpar so then if you think about like if we put those two thoughts

[00:12:31] together what does a platform look like in healthcare so that we can have a scaled view

[00:12:36] into which we can introduce innovations that means that you and I as consumers need to have

[00:12:42] a common set of front door capabilities and experiences that we could use to start our healthcare

[00:12:49] journey finding a doctor making an appointment making our information available to whomever needs

[00:12:54] it in a secure and friendly manner and having all of the specialists and the primary care docs

[00:13:01] and every other stakeholder that might be involved in care having a common understanding of one's

[00:13:08] medical profile then comes the supply side of it the providers all need to be connected so that

[00:13:16] the electronic medical records could be integrated in with administrative systems

[00:13:20] and that's who's available at for what price point and what outcomes will be created all

[00:13:24] becomes readily available so that we can think of healthcare as a supply demand problem with

[00:13:30] the care that consumers need with the clinicians providing the care to the consumers that need

[00:13:36] and connecting it digitally so that we can have global instrumentation around it

[00:13:40] once we have that and only a few big companies can do that that have access to providers at scale

[00:13:47] and have access to consumers at scale but there are tech companies like Lyric that can provide

[00:13:52] the enabling capabilities to do that so once you have those that end the bookend of consumers

[00:13:57] and care providers connecting in digitally then we can start to take all these transactions

[00:14:03] of healthcare and reimagine them whether it's prior authorization or claim submissions or risk

[00:14:10] adjustment processes or its heaters and quality measures all of these things which are essentially

[00:14:16] measuring what happens between consumers and the care they need and adjudicating the outcome

[00:14:22] of that what should be risk adjusted what should be paid what's considered out of

[00:14:26] network what's your cost here all those things are just outcomes of an event that's happened

[00:14:31] between a consumer and a care provider and because every one of those things happens in a silo

[00:14:36] we have the system in the country that we do but I think we can reimagine that by systematically

[00:14:42] creating sort of these platforms for connecting care and care providers and then digitizing all

[00:14:47] the things that happen at the intersection of that great examples of that across the country

[00:14:52] including at my former company Elements and the work we're doing now at Lyric and which

[00:14:56] kind of gives me you know reasons to be optimistic about what we can do in the future

[00:15:01] Morage I appreciate the vision for what healthcare could be I guess putting the Lyric and the

[00:15:07] alignment in in healthcare it leaves us with with really kind of something to look forward to

[00:15:13] as consumers and even as providers right seeking to make the experience that much better for

[00:15:18] consumers look excited for you and what the team are building there what closing thought would

[00:15:24] you leave us with and what's the best place for listeners to learn more about you and the work

[00:15:29] that you're up to at Lyric yeah so thank you for having me always a pleasure to connect with you

[00:15:36] I always enjoy our discussions we have the most insightful questions that always gets the

[00:15:40] mind going you can find us at Lyric.ai that's our company website where we usually have the

[00:15:46] latest and greatest information about our products or initiatives or points of view on

[00:15:50] various topics I'm active on on LinkedIn at you know Rajiv Ranaki or on X at Rajiv Ranaki on X

[00:15:58] as well as Lyric has a presence both on Twitter as well as on LinkedIn as Lyric Clarity and Notion

[00:16:04] and we typically if you follow us there we'll keep you abreast of all that's happening in AI with

[00:16:09] our company as well as anything that may be related and again thanks for having me and

[00:16:13] look forward to our continued collaboration likewise Rajiv and and we'll be sure to

[00:16:18] leave all of the links that you mentioned in the show notes for everybody listening to stay

[00:16:22] in touch with you as well as Lyric thank you so much for spending the time with us thank you