Episode 36

Paying for Health, Not for Healthcare

with Felicia Norwood

November 18, 2021

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Felicia Norwood
Executive Vice President and President for Anthem, Inc.’s Government Business Division

Felicia F. Norwood serves as Executive Vice President and President for Anthem, Inc.’s Government Business Division. She is responsible for the strategic direction and all operations related to the company’s Medicaid, Medicare and Federal Government Solutions businesses. Norwood has extensive experience in both the healthcare industry and government sector. Prior to joining Anthem, Norwood served as the Director of Illinois’ Department of Healthcare and Family Services. Previously, she held a number of senior leadership positions at Aetna including President, Mid-America Region; CEO, President and Chief Operating Officer of Aetna’s population health management subsidiary ActiveHealth Management Inc.; Head of Medicaid; National Head of Small Group and Individual Market Segments; President, Aetna Government Health Plans, LLC; and Regional Manager, Mid-Atlantic Region.

 

Episode Highlights

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This interview with Felicia Norwood was conducted on November 11, 2021 by Gary Bisbee, Ph.D., MBA.

The full interview appears on The Gary Bisbee Show, and it can be viewed on YouTube or heard on your favorite podcast platform including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

 

Any advice for our younger leaders on how to work your way through a company?

I would say don’t be afraid to ask questions. People ask me how I moved from the law department to the business side. I was curious enough to say, “I know you generally don’t move people, but here’s my pitch. I think it would be a good fit for me.” Being curious and being able to articulate what you’re looking for, from an overall growth perspective in the organization, is important. Stepping outside of that proverbial box that people place you in. After that, it was the ability to deliver results and do good work. I never found myself having to look for the next role. Somebody else noticed and asked me whether I would be interested in doing the next thing.

 

Have you seen a growing trend in adopting virtual care, on both the commercial and government side?

We have tremendously. I recall my days back in state government, where states were reluctant to move into virtual care outside of a few areas. Interestingly enough adoption in Medicaid and Medicare has been strong. When seniors were home without access, and at the peak of the pandemic that was really difficult, the adoption rates went up significantly. As we surveyed our commercial and Medicaid population around patient satisfaction of virtual care, it’s been high as well. I do think that that will be something where we won’t go back significantly in terms of how care gets delivered. I’m very optimistic around virtual care helping in some of the rural areas with physician shortages or psychiatry shortages. Those areas have always demanded a new solution to support access.

 

Do you see value-based care growing in the government services populations?

Absolutely. I will say it’s probably at the top of mind in a lot of the contracting efforts we’re engaged in. We want providers who are going to be looking at our members holistically. And I say value-based care in the context of thinking about not just healthcare, but whole person health: behavioral health, pharmacy, physical health. Some people call it social determinants, we call it those drivers of health.

I think value-based contracts are here to stay. They’re going to grow. The overall issue is trying to make sure that you are aligning the right incentives so that you get to the outcomes. And that’s what it’s all about, improving the outcomes and making sure that you’re able to manage care more effectively when you’re thinking holistically about the member.

 

There are racial and gender barrier in corporate America and governments. How has that influenced your life?

I say to myself: others who came before me paid a price for me to be here. Every single day I work hard to make sure that I never disappoint. I want there to be quite a few Felicia’s that come up through the ranks of Anthem. I do a couple of things. I try to always work hard, deliver results. What people think, I can never be responsible for. I don’t go through the work hoping that people like me. I want people to ultimately be able to say “she did a great job, was respectful, a good collaborator, she’s a good person.”

People have issues around race and gender. You become accustom to people’s issues, but you don’t let them define who you are. While we’ve made so much progress in this country, we still have so much work to do. The things that we have in common are far more than the things that divide us.

 

What do you think is the most important thing to change in healthcare?

It’s too complex. If I could snap my fingers, I’d make it simpler. Our mission is about improving lives and communities, simplifying health care. We’re still not there yet. When I think about the complexities that are associated with just understanding health care. If you’ve even gone on to medicare.gov during this period of time of open enrollment for Medicare, it is not easy. I think we still aren’t where we need to be around simplifying health care, particularly for the people we’re trying to serve. That’s a responsibility of all of us: payers, providers, health plans. That is to me the holy grail, trying to simplify this process, make it easier to understand, and reduce the complexities of navigating this healthcare system at a time when people need it most.

There are a lot of lessons that we've learned through the pandemic that are going to remain with us in terms of being able to deliver care and equal quality.

Transcript

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Gary Bisbee, Jr. 0:48
Today we sat down with Felicia Norwood, Anthem’s Executive Vice President and President of the Government Business Division. Felicia’s healthcare career has spanned public and private sectors, which has informed her approach to solving problems and delivering results. Felicia emphasizes the importance of reaching across the aisle, both in terms of the political process and private sector leadership. Felicia’s passion for public service and her ability to bridge public and private leadership has distinguished her career. Felicia encourages leaders to be curious and articulate if they want to try something new. By delivering consistent results, Felicia never had to look for her next role, someone always found her. We discussed trends in healthcare, such as the increased use of telehealth during the pandemic and the importance of holistic healthcare. Felicia reflects that value-based contracts are here to stay, but it’s important to ensure we are aligning incentives to improve health outcomes. She thinks in terms of paying for health rather than paying for healthcare. She advises leaders to never let anyone else define you. You are in control of the results you deliver and the culture you create.

Gary Bisbee, Jr. 2:07
Well, good morning, Felicia, and welcome.

Felicia Norwood 2:10
Good morning, Gary, how are you?

Gary Bisbee, Jr. 2:12
I’m well, thanks. We were joking a little bit before, it’s happy Thursday for us. But we’re pleased to have you at this microphone. Felicia, as you know, the Gary Bisbee Show is about leadership and the learning and decisions that go into that. You’ve been a great successful leader during your career. So we’re eager to chat with you about your views of leadership and the decisions that you’ve made along the way. First thing we’d like to do if we could is learn a little bit about you. What was life like growing up for you, Felicia?

Felicia Norwood 2:46
Life was good. I grew up in a very small town in Georgia, about three and a half hours south of Atlanta. The name of the town is Camilla. Most people have never heard of it. It has a population probably of maybe close to 5000 if we’re being generous, but I’m the oldest of five girls, had a very close knit family, raised by my mom, and really my grandmother, and I would say probably my extended family with my aunts, because we were all in the same kind of neighborhood and community. You know, growing up was, you know, school. Education was super important to us. And then on Sundays, it was always church. And it was Sunday school, and then church service. And then after church, it was the kind of family dinner that brought everybody together. And that was it growing up. So really, faith, family, and friends, simple in some respects, but a really close knit family and community.

Gary Bisbee, Jr. 3:49
Well, it sounds like small town America in a sense, which is still important to the growth of this country. What did the young Felicia think about leadership?

Felicia Norwood 4:01
You know, that’s interesting, because the young Felicia probably never thought about leadership so much. What I knew is that I was oldest in my family. And for me, I think about it in the context that it was always important to kind of set an example. You know, I had a mom who got up every morning, went to work, worked hard for all of us. And as the oldest in the family, I thought you should basically just set an example for the rest of your sisters. And in some respects, I do think that is what leadership, it was kind of those first, nuggets of leadership, which is to lead by example, which is something to me that’s really still a basic tenet even to this day. But it’s not at the time when I was doing it, I thought about it in that context. But it’s today even, you know, so much, so foundational to how I think that I lead, trying to lead others in a way that displays the, you know, behaviors, that you want them to see. So, kind of leading by example, starting at home, but then extending into, you know, professional life certainly much later on.

Gary Bisbee, Jr. 5:10
Do you think your leadership style emanated from your mother and your grandmother?

Felicia Norwood 5:16
I guess I never thought about it that way. But when I think about the two of them, they’re just super strong women. And it was always, you know, that mantra of, you needed to get things done. And I still believe that today. And I do think over the course of my career, even on tough assignments, I’ve often heard others say, if you need to get something done, give it to Felicia. So it was kind of that get things done[ and accountability that literally emanated from them, that still resonates with me today.

Gary Bisbee, Jr. 5:51
Where did your interest in health care come from, Felicia?

Felicia Norwood 5:56
That almost happened, almost happened by accident, frankly. You know, when I left the University of Wisconsin-Madison after getting my master’s degree, I moved to Springfield, Illinois. And I moved to Springfield, Illinois to take a year long fellowship in state government. And the year long fellowship gave you the ability to work in the governor’s legislative office. You got to work in the the Bureau of the Budget and you also got to work in a state agency. And then after the year long fellowship was over, you got an opportunity to go into some part of state government. And I was fortunate enough to be able to join Governor Jim Thompson’s program and policy staff working under a leader by the name of Paula Wolf, and she is probably one of the most, you know, just I think one of the best strategic thinkers and public policy thinkers in Illinois and probably anywhere. But my assignment happened to be within the health and human services policy areas. So that happened to be the department of the Medicaid agency, the Department of Mental Health, Children and Family Services, all the human service agencies, I used to say kind of the heart of what government is about. So it was almost the accidental assignment. But at the same time, having done, you know, policy around health and human services for three years, it became something that I was incredibly passionate about.

Gary Bisbee, Jr. 7:34
Did your interest in law come out of your time with Illinois government? Or had you been interested in law before then?

Felicia Norwood 7:43
I think I always, I won’t say I always knew I wanted to go to law school. But my interest in law probably started when I was in high school. I was on the debate team. It was probably one of my favorite high school clubs. I liked the give and take, you know, kind of arguing a position, being able to establish, you know, kind of, this is what it should be. So the interest in law came then, but I couldn’t afford to go to law school. So it was always one of those things I wanted to do, was pretty passionate about. And so after working in state government for, you know, three years and spending time saving money, so I could put myself through law school, I applied to law school and did that.

Gary Bisbee, Jr. 8:30
I was just thinking, as you were talking about arguing and negotiating and so on, being the oldest of five children kind of leads itself to that, doesn’t it?

Felicia Norwood 8:41
I had gotten some practice early on. So absolutely.

Gary Bisbee, Jr. 8:45
So when did it come about that you decided to go to Aetna? What were the kind of transition points in your career that led to that decision?

Felicia Norwood 8:55
I went to the law firm after law school. But interestingly enough, I only been at the law firm for a little over a year when another Governor got elected, and that was Jim Edgar. And during the time I had been on program and policy staff, I had met some individuals who were going to be a part of the Edgar administration. And they approached me about coming back to state government and I went to work for Governor Edgar heading up Health and Human Services within the governor’s office. And during that time, I met probably every public sector entity that had any impact on health care: managed care companies, your hospitals, your nursing homes, your community based agencies. If there was a linkage to the state’s Health and Human Services program, I had an interaction with them. So during that time, I actually met most of the healthcare and managed care plans that were looking to do business in the state of Illinois and had interactions with the state government process just through Governmental Affairs and Public Policy. And I met some of the individuals that were a part of the Aetna team at the time. So as the first four years of the Edgar administration ended and he had been reelected, I was trying to make a decision on what I would do next, whether I would go back to the law firm or do something completely different. And the folks at Aetna approached me about coming to join them at Aetna, in the law department as their Midwest region general counsel.

Gary Bisbee, Jr. 10:32
And were there any surprises when you went to Aetna, having spent a lot of time in state government, but anything about working in a private sector company like that, that surprised you?

Felicia Norwood 10:43
You know, it’s interesting, because I think people always see, they think of state government, and they think, boy it’s bureaucracy and a whole bunch of other things. Private sector has its share of bureaucracy, as well. It’s just on a, you know, in a different way. But I do think the thing that was more interesting, there was the ability to move with speed quicker on the private sector side than the deliberations that happened in the public sector, which just take longer. You know, in the public sector side, you’re always having to come to consensus, to be able to reach compromise, particularly across the aisle. I was working for a Republican governor, the legislature was all Democratic, incredibly great skills in terms of understanding how you bring people together to make things happen from a policy perspective. So public sector was certainly slower, and much more deliberative. On the private sector side, you had your share of bureaucracy as well. But you were able to, you know, I think move with quicker speed in terms of decision making in the private sector.

Gary Bisbee, Jr. 11:54
During your time at Aetna, you advanced through the ranks, I guess you could say, but a number of different positions there. Any advice for our younger up and coming leaders on how you kind of work your way through a company like that with progressively more responsible positions?

Felicia Norwood 12:14
I would say, don’t be afraid to ask questions that people don’t think you would normally ask. People ask me all the time, you moved from the law department to the business side and how did you do that? And I said, I was curious enough to say, I know you generally don’t move people from the law department to the business. But here’s my pitch in terms of why I think it would be a good fit for me. And most people don’t have the courage to do that, which is to kind of step outside of your lane, and be able to pitch what you think differentiates you from others that might be there. So it was a non-traditional way of going to the business side, because most of the time on the business side, your P&L leaders had kind of grown up either in the sales organization or the network organization. But what you, you know, happened on the law department side, you had an opportunity to interact with all of those areas in terms of serving as their counsel. So being able to be curious and also being able to help articulate what you’re looking for from an overall growth perspective in the organization is very important. So stepping outside of that proverbial box that people kind of place you in when you’re the lawyer on the team was one of those things I think was important for me to say, I loved what I did in the law department. Now it’s time for me to do something different. And let me tell you about the things that prepared me for that. And then after that happened, Gary, it was just really the ability to just navigate the organization, always delivering good work, you have to deliver results and do good work. And when you do that, I never found myself having to look for the next role. Somebody else noticed and found me and asked me whether I would be interested in doing the next thing. So a certain level of curiosity, certainly the right mindset, the ability to be able to collaborate, you know, the collaborative skills, being able to work across, I always say across the aisle because that’s my mindset coming from the public sector, where I had to do that so often, were always things that served me well when I moved to the private sector.

Gary Bisbee, Jr. 14:29
You think the actual law degree or your kind of framework for thinking about things as a lawyer, did that help you on the business side, Felicia?

Felicia Norwood 14:39
Tremendously. I mean, I tell people that helped me all the time. There’s just the strategic thinking and asking the questions that nobody else has asked. And I do think it’s just that way of approaching issues with a mindset where you’re always trying to make sure you’re getting to the underlying truth. You know, you got to start with understanding what’s the core and heart of the issue in order to get to the answer. And so I find that probably my training, and certainly just the thinking and curiosity from a legal perspective, and the way you approach issues, has served me probably better than any other training I got anywhere.

Gary Bisbee, Jr. 15:20
Yah, I can see that. Well, as a former Aetna executive, what did you think about the Aetna/CVS merger?

Felicia Norwood 15:28
You know, things are changing. First and foremost, I always say I never comment on the strategy of my competitors. But at the end of the day, you know, healthcare is changing, and more and more of health care is about taking care of the whole person. So in some respects, it was probably a natural extension. But you know, I know people in both parts of the, you know, the Aetna side and the CVS side, so we wish them well. But we will look forward to competing against them in the marketplace when it comes to healthcare.

Gary Bisbee, Jr. 15:59
So after your term at Aetna, then you went back to the Illinois state government for a while. What led you back to government, Felicia?

Felicia Norwood 16:08
First and foremost, I think most people can tell I really believe in public service. I really do. And I was one of these individuals who would frequently say to my husband, why aren’t they doing this? Or why aren’t they doing that? So when Governor Rauner called and asked me to head up the Department of Health Care and Family Services, which is the, you know, predominantly the state Medicaid agency, and we do some other things as well. I had been in the administration. I’d never been in the area before you really have to execute and get things done. So that was the new growth opportunity. And equally important, having spent time at Aetna, on the private sector side, and having a real view of how I thought managed care could work for individuals in the public sector. You know, this was a department that was probably one of the largest departments in government, one of the biggest budgets, and an opportunity to shape and transform healthcare and human services for over 3 million people. That was just an incredible opportunity, and probably one of the best opportunities I ever had. So when you have a passion, and it aligns with your profession, you’re pretty fortunate to be able to do that. So that was the attraction to going back into public service, because it was on a different dimension than I had ever done before.

Gary Bisbee, Jr. 17:34
Well, what were your main priorities? 3 million people, a little bit of a supertanker here. How quickly can you turn a supertanker around? But what were your main priorities, Felicia, during that time?

Felicia Norwood 17:47
You know, you are so right, it is a supertanker. And one of the things you have to do is work quickly. But a big focus and priority for me at the time was the integration of physical and behavioral health. So we spent a lot of time focusing on an 1115 waiver from the federal government and were able to, during the time that I was there, bring in over a billion dollars into the state to really help the integration of physical and behavioral health in a state Medicaid program where behavioral health issues drive so much of the costs in a state program. And it was really that focus around thinking about the whole person, and what does whole person health really mean. So we worked very hard with a terrific team on the 1115 waiver. As I said, brought in over a billion dollars into the state for behavioral health, completely redid the the managed care RFP process and narrowed the number of managed care plans to a manageable number that the state could manage effectively, and then worked with the community based agencies that are on the frontline of health care every day: your community based mental health agencies, your federally qualified health centers, so that you could really have a comprehensive way of thinking about not just the cost part of health care, but driving better quality. So just incredibly proud of the work we were able to do in terms of garnering additional federal dollars, reshaping and transforming all of the areas of government that were working in collaboration with the Department of Health Care and Family Services through other agencies, because you had your public health department, your mental health department, think about it, even your Department of Corrections, because individuals that are coming out of the correctional system who then have to come back into care, together with all of the departments of education where children are so impacted about what’s going on from a healthcare perspective. So, to be able to align all of those agencies, and state government, and focus on transformation, and thinking about whole person health and people who cut across a number of different agencies, was really a tremendous opportunity.

Gary Bisbee, Jr. 20:05
Yeah, for sure. Well, in terms of Medicaid managed care, what other initiatives did you take with the managed care side, and particularly how to ensure or create some accountability around quality of services?

Felicia Norwood 20:22
Yeah, you focused on the metrics, in terms of the outcomes that you’re looking for. Certainly, if when you think about the issues that are facing your Medicaid population, being able to address some of the social drivers of health, focusing on the core issues that are impacting the population in terms of maternal outcomes, making sure that the managed care plans are collaborating more closely with providers that are on the front line of delivering care. So you have to bring the hospitals together, your community based agencies together to work with the managed care plans to improve those outcomes. Health plans don’t do it alone. So, really focused on strengthening those partnerships Gary, because too often, everybody’s at odds with each other. And you have to really think about bringing those entities together more closely around collaboration, which is what the waiver helps to do as well. Because at the end of the day, it’s always about putting the people who are going to use the service at the center of what we’re trying to do, and really eliminate some of the administrative inefficiencies that were in the system in order to make that happen.

Gary Bisbee, Jr. 21:37
As a leader, how did you think about private sector, public sector leadership? Are there different strategies, techniques, different mindsets? How do you think about that, Felicia?

Felicia Norwood 21:48
Well, I used to tell people often that if I could navigate Illinois government, you could navigate anything. And you know, it’s an interesting, interesting state. But, you know, I did pride myself on being able to work across the aisle all the time, because that’s the only way you drive things for the people that you’re trying to serve. So that’s the prop, you know, kind of the public sector mindset. But then the same thing really happens when you move to the private sector because, even though I sit here, you know, in our government business, I still have to rely on a number of partners here within Anthem, be able to get things done for the people that we are serving. So you have to rely on your IT team and your digital team to build solutions to support your populations. You’re relying on your network team to help develop the right network strategies and solutions to be able to serve your population. You have all of the, what we call growth partners, that are strong, strong collaborators in terms of delivering results. So on the public sector side is certainly one of those things where you’re trying to bring together more of Democrats and Republicans. On the private sector side, you’re trying to bring together all of the individuals that are going to help you deliver results and outcomes for the individuals that you’re really privileged to serve.

Gary Bisbee, Jr. 23:20
What was the decision point to dive back into the private sector with Anthem?

Felicia Norwood 23:25
I got a phone call from our our president and CEO Gail Boudreaux, and Gail and I knew each other from our time at Aetna, but we hadn’t really worked together. But her reputation was one of a great leader. And when we had the conversation, and she talked to me about what she was looking to do at Anthem and she had joined Anthem in November of the prior year. And she talked about building the team. But what she talked about first and foremost, was creating a culture of high performance. And the culture work was going to be at the center of what she was doing. And frankly, culture is foundational. You have to have the right culture in an organization to deliver results. And I was so impressed with the focus on the culture being the center of what she was looking to do in terms of driving those results and leading to high performance, and had already known about her leadership, that I was sold in a very short period of time. Since the administration, literally, I had been there a little over three and a half years. It was time to really come back to the private sector and, this time, be able to bring all of the learnings from having served and worked with Medicaid and Medicare populations on the public sector side and being able to come over to the private sector side, but more importantly, in government programs. So I tell people I really feel somedays like I’ve hit the jackpot because my passion is really government programs and being able to serve our Medicaid, Medicare, and Federal Government Solutions populations in our private sector organization, Gary, it’s an honor, but it’s an humbling experience, because every single day, you are confronted with the real needs of people that we’re trying to serve.

Gary Bisbee, Jr. 25:28
As president of the government business division, can you describe your responsibilities, Felicia?

Felicia Norwood 25:34
So our government business division, within Anthem, includes three areas. It includes our Medicaid business, and we are in the Medicaid business in about half the states in this country and Puerto Rico. We are the second largest Medicaid managed care company in the country. We have about 10.1 million members in Medicaid. So it’s a huge responsibility and obligation, and I have just one of the most incredible teams. These are individuals who are passionate about serving Medicaid beneficiaries. And then in addition to Medicaid, we have Medicare. And we serve, you know, about 2.8 million Medicare eligible individuals in this business. We’re the fourth largest Medicare Advantage plan in the country. And certainly being able to focus on individuals that are dually eligible for Medicaid and Medicare is an area that is a high growth area and something that we are, I think, uniquely positioned to do just because of our footprint in the Medicaid space. And then we’re certainly honored to be able to serve federal government employees through our federal government solutions business. And in that business, we serve about 1.6 million federal employees as their health plan. And we also manage for CMS two Medicare Administrative contracts in two jurisdictions in the country. So the full range of services, all government related, all, you know, working very closely with government partners that I’ve worked with over the course of my career. So it really is kind of a natural link between the prior experiences that I had on the public sector side and the private sector side.

Gary Bisbee, Jr. 27:34
10 plus million Medicaid recipients, that’s about 10% of Medicaid recipients in the country, isn’t it?

Felicia Norwood 27:42
Yeah. And Medicaid, as you know, Gary has grown a lot since the pandemic. We have the public health emergency that has been in place now and was recently extended as a result of COVID-19. Trying to make sure that individuals continued to have access to care during this time, the Secretary of HHS obviously extended that public health emergency through January of next year. So across the country, state Medicaid programs have grown significantly to make sure that individuals had access to care during this time. And that’s been, I would say, particularly important when you think about the behavioral health needs of this population as well. The behavioral health demand during this pandemic has been significant in Medicare and Medicaid, and actually in the broader population as well. So trying to ensure that individuals continue to have access to care and continuity during this time was incredibly important.

Gary Bisbee, Jr. 28:48
It seems like there was an extra burden on women in terms of behavioral issues during COVID. Did you find that in your populations?

Felicia Norwood 28:59
Of course, you know, at the core of Medicaid and the Medicaid programs are moms and babies. So if you are trying to, you know, care for a family, the stressors that are there during this period of time have been significant. But I will say, Gary, we’ve seen it equally in our government business as well as in our commercial business, particularly, even in the student health business on the commercial side during this time. So the demand for mental health services increased significantly. The good news is that virtual care, really, I would say, took root during this time. And for a long period of time, there had been reticence around using virtual care. Was it as good, you know, as in person? So there are a lot of lessons that we’ve learned and have come through this pandemic, that I think are things that are going to remain with us in terms of being able to deliver you know, care at equal quality, through certain virtual processes as we kind of move post pandemic, from a healthcare perspective, that will be super important when you think about some of the rural communities where access to care has always been an issue, and particularly access to mental health care. So there are some things that have come out of this pandemic from a healthcare perspective that I think will live on and will be good for the system overall in terms of access.

Felicia Norwood 29:48
So, have you seen a growing trend in acceptability to virtual care among your populations, both on the commercial side and the government services side?

Felicia Norwood 30:42
We have tremendously. And you know, I recall my days back in state government, where, you know, states were really reluctant to really move more into virtual care outside of a few areas. But interestingly enough, I will say adoption in Medicaid has been strong, also Medicare. And you think about it, when seniors have been at home, not really able to have access. And at the real peak of the pandemic, that was really difficult. The adoption rates went up significantly. And I do think, as we look and survey our commercial and Medicaid population around whether or not they believe, so the patient satisfaction around virtual care, it’s been high as well. So I do think that will be something where we won’t go back, you know, significantly in terms of how care gets delivered. And as I said, I’m very optimistic around virtual care helping in some of the rural areas where physician shortages, psychiatry shortages, and all of those areas have always demanded a new solution to be able to support access.

Gary Bisbee, Jr. 31:56
What about the providers? Have you found that they’ve embraced virtual care as quickly as the individuals, the consumers?

Felicia Norwood 32:04
I think the receptivity has actually been high, I think we’ve all had to learn how to do things differently through the pandemic. And so I think the adoption has been, I think, higher than I thought it would be. So providers have adjusted, you know, patients have adjusted. And I think government partners will have to make some decisions around those things that will be allowed to continue from a payment perspective as we move post pandemic, to make sure that we continue to provide access. And I think individuals overall, have just become accustomed to wanting to do things more efficiently than they have before. So consumer preference has changed during this time and I do think we have to be more responsive, around kind of meeting our members where they are.

Gary Bisbee, Jr. 32:55
What about, the term is value based care, which has some elements of risk and risk could be carried, let’s say, by the providers. Do you see that growing in the government services populations?

Felicia Norwood 33:09
Absolutely. I will say it’s probably at the top of mind in a lot of the contracting efforts we’re engaged in right now. I mean, we want, you know, providers who are going to be looking at our, you know, our members holistically And I’d say value based care in the context of thinking about not just health care, but health. You know, you’ve got to think about whole person health, you know, behavioral health, you know, pharmacy, physical health, and now all of the, you know, some people call it social determinants. We call it those drivers of health, the kinds of things that, you know, you’re thinking about more critically. You know, food is medicine programs, food insecurity, a big issue that we were all confronting during the pandemic. And as we reached out to our members, hundreds of thousands of members that we were calling to see how they were doing, the things we learned around food insecurity, issues around transportation, you know, things that happened with respect to social isolation, just a range of issues that we were having to address with our members. So value based contracts, I think are here to stay, they’re going to grow. The overall issue is trying to make sure that you are aligning the right incentives so that you get to the outcomes. And that’s what it’s all about is improving the outcomes and making sure that you’re able to manage care more effectively, when you’re thinking holistically about the member.

Gary Bisbee, Jr. 34:41
Yeah, the alignment sometimes in this case, is just availability of resources. So in this whole area of social determinants, have you found governments are willing to expand the way they think about paying for these services to get more into some of the non traditional services relative to the delivery of healthcare, but are so important in terms of the outcomes?

Felicia Norwood 35:06
I will say, Gary, that scenario where CMS has certainly been a leader in the Medicare program. When you think about the ability to have supplemental benefits for our seniors, and you know, we’re in the middle of the annual enrollment period, but food, transportation, home delivered meals, all of those things have been critical. So I would say CMS has certainly led in the Medicare space. The state government side has been slower. However, we are now seeing pockets of state governments where they’ve always said they wanted us to provide these what they call value added benefits. The question has been, well, how do you really pay for it? And more and more of those state partners are looking at, how do you think more broadly about paying for health and not just healthcare, because when you look at the Robert Wood Johnson Foundation study, those drivers of health are more important in terms of overall health than what we see in terms of health care. And so there are now, I would say, some new models with some state governments that are leading in this area. I will say North Carolina is a great example, where Secretary Cohen there has been very focused on drivers of health and paying for health versus just healthcare. And I do think, as other states see, some of the, I call them, pockets of innovation, that you start to see in states, others start to look to see whether or not there are ways that they can do the same thing. So I am optimistic that some of the the innovation that we’re seeing in certain states will start migrating to other states as you see the outcomes and the results, because you really do have to focus on health and not just healthcare.

Gary Bisbee, Jr. 36:59
For sure. Hopefully, one of the benefits of COVID is that a broader group of people will understand that point. It’s not just you, they’re actually in the middle of it. So let’s hope that’s the case. Felicia, let’s turn back to you for a moment in terms of your leadership career. Have mentors played a role? Can you identify, I don’t know, 1, 2, 3, 4 mentors that have been helpful to you as you’ve developed as a leader?

Felicia Norwood 37:28
You know, I get asked that question a lot. And I have to honestly say, it’s not like I’ve ever had a mentor. What I do, I tell people, I consider myself the ultimate sponge. I learn a lot from people that I interact with. And fortunately for me, that’s people that I’ve worked for. But equally important is people I work with every day. So I probably learn as much from people that have reported to me versus people I’ve reported to. So I think I’ve really brought together things that I’ve seen over the course of my time in government, and the ability to lead others to get things done, even when there has been disagreement, you can find things to agree about to move things forward, and brought some of those same lessons into the private sector. You know, I feel fortunate that I’ve had an opportunity to see all kinds of leadership. And I tell the team a lot, sometimes that’s been good, and other times it hasn’t. But I look to individuals across the spectrum that I’ve worked with to get learnings around a number of things. Mostly important: listening and learning from others, because I still do believe it’s a journey. And every single day, I get a chance to interact with people who do things differently and provide great value to the people we serve. And as I said, I learn as much from them as I do other people that are a part of the organizations that are our peers and elsewhere.

Gary Bisbee, Jr. 39:12
You’ve spoken earlier about the importance of culture, and that’s one of the things that attracted you to Anthem. How do you as a leader Institute culture, in your, in this case, the government business division?

Felicia Norwood 39:25
It almost goes back to that early thing of living by example. The one thing I know is that the shadow of a leader is so important. And the tone that comes from me sets the tone for the people that I work with in my organization every day. So I try to be very mindful of how we treat people, how we lead. What do you do when nobody’s watching, because somebody always is watching. And how do you basically set the example of saying, you never ask your team to do anything you aren’t willing to do. So I always say that you never get accused of leaving before the work is done, not rolling up your sleeves to do the work, thinking that anything that needs to be done is ever beneath what you should do, and making sure that at the end of the day, everybody understands it’s all about the people we’re serving. That’s what we come in here to do every day. And every time we work with the state, we earn the right to do business with them. That means we have to deliver. So all of the threads of accountability, the inclusive leadership that I try to, you know, demonstrate with my team, how we think about how we develop the next generation of leaders, how you lead in an environment every single day where the demands can be significant, particularly when you’re in a publicly traded company, but doing things the right way. And when you do well by the people that you’re serving, I know that the financial results always follow.

Gary Bisbee, Jr. 41:05
Felicia, it’s obvious that there are racial and gender barriers in corporate America as well as governments. How do you think about that and how has that influenced your life?

Felicia Norwood 41:16
I think every day, what I say to myself is, others who came before me paid a price for me to be here. And so every single day, I work hard to make sure that I never disappoint because I want there to be quite a few Felicias that come up through the ranks of Anthem. I don’t want anyone to ever say, well yeah, you were the first person on Anthem’s executive leadership team that was African American. I want there to be quite a few after me. So I do a couple of things. I try to always work hard, deliver results. But what I’m always mindful of Gary, I let no one define me. What people think, I can’t ever be responsible for. And I don’t go through the kind of the work hoping that people like me. I want people to ultimately be able to say, she did a great job. She was respectful of people. She was a good collaborator and at the core, she’s a good person. People have issues around race and gender all the time. I’m one of these people, my husband’s white. We’ve had to live in a culture that, you know, where interracial marriages are, certainly, you know, they’ve been around for a while now. But we still get these strange looks when you walk into a restaurant and people say, “how many people?” And we look at each other, like, “two”. So you just become accustomed to, you know, people’s issues and challenges, but you don’t let them define who you are. And I do know that, all the time, it’s almost like an educational process of helping people understand, while we’ve made so much progress in this country, we still have so much work to do. And the things that we have in common are far more than the things that divide us.

Felicia Norwood 41:18
Well said, Felicia. If you could snap your fingers and change one thing about the healthcare system, what would it be? And I asked this in the context, you’ve been on the government side, you’ve been on the private sector side. What’s the one thing that you think would be the most important to change in our healthcare system?

Felicia Norwood 43:39
I still think it’s too complex. If I could snap my fingers, I’d make it simpler, You know, our mission, we talk about improving lives and communities, simplifying health care. That’s the part we’re still not there yet. You know, when I think about the complexities that are associated with just understanding healthcare. If you’ve even gone on to medicare.gov during this period of time of open enrollment for Medicare, it is not easy. I have, you know, family where my task at Thanksgiving will be to walk individuals through, all of my mother sisters, whether they do a Medicare Advantage Plan, or Med SAP, but it’s not easy and even medicare.gov is so complicated. So I do think we still aren’t where we need to be around simplifying healthcare, particularly for the people we’re trying to serve. So that’s still, I think, a responsibility of all of us, you know, payers, providers, health plans, you name it. That is still, to me, that holy grail of trying to continue. Simplify this process, make it easier to understand, and reduce the complexities of navigating this healthcare system at a time when people need it most.

Gary Bisbee, Jr. 45:06
Felicia, this has just been a terrific interview. We appreciate your time and sharing your thoughts with us. I have one final question if I could, and that is, for the number in our audience who are up and coming leaders or earlier stage leaders, what advice would you have for them?

Felicia Norwood 45:24
I think the right mindset, a positive attitude, and a strong curiosity will go a long way. You know, I am one of these people where, every single day, young people stop into my office, they want to be mentored. And I always tell them, just be open and be flexible. Don’t come in thinking that, on day one, you need to already be planning your next move. Deliver on what you’ve been asked to do. And I do believe that when you do that, others will see the good work and give you an opportunity to continue to grow in these organizations.

Gary Bisbee, Jr. 46:03
Felicia, thanks again so much for your time. Terrific interview. We love the way you think about leadership and your actions certainly have shown a lot of success in your career. So thanks again, Felicia.

Felicia Norwood 46:17
Thank you, Gary. It’s been my pleasure.

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