Interview with Michael Carson, Health Care CEO, Investor and Advisor

In today’s highly competitive job market, employers are actively seeking innovative solutions that help their benefit packages stand out. Health carriers—who compete for employer business—have an opportunity to attract attention by providing robust decision support tools that increase health care affordability and access.   

Michael Carson—who has over 25 years’ experience in the health care sector, including serving as President and CEO of Harvard Pilgrim Health Care—has long advocated for decision support’s value for employees, employers and, in turn, health carriers. In this interview, Carson shares why decision support is a must-have product for health carriers—one that can help them promote transparency, increase member satisfaction, and attract and retain new employer groups.

What was it about decision support that captured your interest? 

Michal Carson: Two things… I saw an opportunity to address a less than optimal healthcare consumer experience and to create greater value of the health care dollar for consumers and health plans.

As for the health care consumer experience, it’s as simple as this: even as a CEO in the industry, I find it challenging to navigate our complex and fragmented health care system. It’s difficult to interpret and decide what benefit coverage is best for me and my family and to pick the right doctor and place of service that I can trust to give me high quality care at an appropriate cost. All of this is complex and costly, and yet critical for us to have health coverage. Anything that takes my individual needs into consideration and helps me understand my options and the implications of my decisions is great.

MyHealthMath’s platform, Decision Doc, does just that. Decision Doc is empowering, and its deep analytics is uniquely accurate. That’s reassuring and as much as I benefit from support like this, there are millions of others who would benefit even more. This means more greater value for consumers and their health plans.

Why do you think these products have value for health plans? 

MC: Health plans rely heavily on customer satisfaction and affordability to gain and retain employer group clients. Through decision support, health plans have the opportunity to provide a consumer-informed, personalized, and more effective product selection experience. This is especially true with solutions like Decision Doc that are highly personalized.

MyHealthMath also creates a path for the health plan to partner with its employer group customers to develop the best and most cost-efficient coverage options possible. They can support higher health plan member Net Promoter Scores (NPS) and, as a result of informed employee plan selection decisions, can enable health plans and self-insured employer groups to offer more affordable coverage options. 

About Michael Carson

Michael Carson is the CEO of CareAbout and Senior Advisor of Ascend, a health care focused private equity investment firm. Carson previously served as President and CEO of Harvard Pilgrim Health Care, a major Northeast health carrier. Prior to Harvard Pilgrim, Carson’s roles included: Chief Operating Officer for ConcertoHealth, a private equity-backed, value-based care delivery organization; President of Anthem’s Eight Health Plan Eastern Region Medicare business; and the Chief Operating Officer of Amerigroup’s National Medicare Business. With 25 years driving change in the health care space, Carson serves on various health care company advisory and business boards.

How does decision support help health plans differentiate in the marketplace?

MC: The health plan marketplace is very competitive. Health plans large and small are faced with challenges in balancing cost, services, technology and innovation. The industry is also plagued with poor customer experiences and perceptions.

To me, Decision Doc is an affordable and no regrets solution squarely focused on meeting the need of improving customer experiences and ensuring appropriate use of everyone’s healthcare dollar. Health plans which target investments on these types of solutions differentiate themselves in the marketplace.

Looking for more information about decision support and health carriers? Check out this e-book on Five Ways Health Carriers Can Use Decision Support to Create Value.