Mavericks of health care #1: Nancy Giacolone

In today’s environment, people are hungry for integrity and appropriateness.  We use buzzwords like “transparency” for the demand for accountability.  This is reflected by a loss of trust brought about by inappropriate, sometimes erroneous, or even fraudulent billing practices paired with crippling pricing for health care.  And when we don’t trust the bill, we demand a breakdown – accountability for why a bill is inappropriately high.

PricewaterhouseCooper’s annual medical cost trend study predicts a rise of 4-10% in 2021.  Renal dialysis accounts for one of the most taxing health care costs on our nation’s economy.  And with the crippling costs of dialysis, some anticipate an extension of the 33-month coordination of benefits period due to the heavy burden on our Medicare system.

One business-owner here in Meridian, Idaho shared with me that health care for his employees was his biggest expense, and with an expected 20% increase in premiums expected next year, he is at a loss for how to provide the benefits he needs for the employees he cares about.  Many of the employers I have talked with who have previously not considered self-funding are now open to learning about this option because the pain of staying in a fully-funded plan that they can’t afford is overwhelming.

Season of the maverick

Most of us came into health care because we have a desire to help.  As a nurse, I feel hurt by the lack of trust in our system.  At the same time, I am excited about our future because of the community here in the self-insured space and the insatiable drive I see in so many of us who are really striving to create meaningful change.  We recognize that the track we are on is not sustainable.  And there are many who I admiringly call “mavericks.”  A maverick in health care is someone who thinks outside the box to create meaningful and positive change for the greater good.  They demonstrate a desire to serve people and systems to promote proper care for others – not at the expense of a profit, but rather, a maverick can promote care and profit simultaneously and appropriately.

Service is at the heart of what drives a maverick and the market will always reward those who serve the greatest good for the greatest number of people.  In other words, an appropriate profit always follows those who put service above profit.   These leaders give me hope for the future of our health care system.

I have talked with many mavericks over the last few months.  In a series of four vignettes, I am happy to share some key insights and a look into the philosophies and paradigms that make someone a maverick of health care.

Common values exemplified by health care mavericks

• Caring and competence
• Innovation partnership
• Appropriateness and stewardship
• Trust and advocacy

Vignette #1 in a four-part series:

Nancy Giacolone:  President/Owner – Olympic Crest Insurance

Maverick Values:  Caring and competence

“Create Value – Create Relationships” 

As a Health Rosetta Benefits Associate Advisor who is widely respected in our industry, Nancy is no stranger to the struggles and challenges facing employers today in affording the robust benefits they need to attract and keep quality workers.  Brokers and advisors are expected to know all the resources that are just the right fit for their groups in the midst of a changing landscape.

Nancy resonates with the values caring and competence and she strives to create significance in her role in health care.  Being well-established in her career, she cites a desire to create meaningful change from the top all the way to the end-user in the industry, and she recognizes that the only way to do that is to respectfully recognize the ‘what’s in it for me’ reality amongst all the players at the healthcare table.

She has a desire to help throughout the health care system.  Specifically, in areas including:

• Shaping how people understand, access and pay for their health care
• Empowering members to ask questions
• Understanding the way employers review their benefit programs
• Analyzing ways providers communicate what costs will be and what the patient’s share will be
• Uncovering ways that insurance companies share their pricing model

She sees caring as a key component of being competent in the industry.  One who cares does the work required to be competent.  We must care about the needs of others in order to create the change we say we want.  She challenges all of us to ‘pull back the curtain’ and to employ respectful curiosity in order to understand the positions of each other and our counterparts at the table – and to challenge what doesn’t make sense.

What advice does she have for those who want to be mavericks and for her counterparts?

• Seek education and professional designations
• Learn to speak the language and get educated (She recommended NAHU as a resource for the developing broker/advisor/consultant)
• Be curious
• Consider and lead with the needs of the other player at the health care table
• Employ vulnerability to ask questions
• Be brave in challenging (respectfully) assumptions that don’t make sense
• Be real and always lead with value – not the sale
• Be impeccable with your word – do what you say you are going to do

Meaningful change that serves the greater good requires all of us –provider, payor, vendor, advisor and consumers – to care enough to be competent and to listen with the intent to understand the issues so that we can truly create the vale that will become the change we need.

Kimberlee Langford, BSN, RN, CCM, CRMT, CPC,  is director of business development at Specialty Care Management.