Make change a little at a time: A Q&A with Robyn Tikia
Evolution is a gradual process, says Risk Strategies' Robyn Tikia.
Robyn Tikia is the director of operations and client services for the Central Region at Risk Strategies, where she provides strategic planning, oversees client relations, and manages the company’s team of resources.
Paul Wilson: How did you get started in the benefits industry?
I grew up in a household where my mom built her career in employee benefits, but I always planned on becoming a neonatal doctor. I went to med school after getting my undergraduate degree, but I realized it wasn’t a good fit for me.
After that experience, I feel like I got a second chance when I discovered the business side of health care. I joined Tikia Consulting group back in 2011, and with that opportunity, I was able to work in the insurance industry with my mom (Rina Tikia), one of the best mentors anyone could ask for.
As we all know, people rarely plan to work in insurance, but once you’re there, you never want to leave.
PW: Did you ever discuss taking over the agency?
I have to preface this by saying that I’m fortunate enough to have the choice to have a work/life balance because of what my mom built and how hard she worked. She came from nothing, so she didn’t have that luxury. We had a lot of conversations about it. I said, “Mom, I love it, but I don’t want to do exactly what you did.” And she understands. So that was when she started looking to sell, and it took about two or three years before we found Risk Strategies and sold to them in late 2017. The main reason we went with them was because they’re like a family, and we have been able to stay autonomous.
PW: What does an average day look like?
I started off mainly with account management, but my role has grown over time. These days, I interact with other Risk Strategies offices across the country; I’m working with our Atlanta office right now to introduce some efficiencies. I also manage our New Orleans office. I recently moved to Houston, so I’ve been working remotely and networking here. It’s a great market. So it’s a mix of managing, helping other offices and working on my own book of business, which is made up entirely of self-funded groups.
PW: Can you talk about your experience in the industry, the idea of mentorship, and a little more about the influence of your mom?
A big part of the reason I love this industry so much is because you’re constantly learning. Acquiring knowledge, constantly keeping up with new trends, thinking outside the box and staying at the forefront of the industry, these are all things that will lead to success, no matter your gender or background. Those are some of the things that my mom has taught me. Rina is relentless, and she’s one of the strongest people I’ve ever known; she’s not afraid of things, which is a big part of being successful. Because you’re going to get knocked down sometimes and sometimes you’ll be defeated, but you can’t let that stop you from moving forward. That’s a key quality in such a competitive and quickly changing industry.
She’s also been a great mentor for me and for the other women in our office. The majority of people who have joined our firm, most of whom are women, have been completely green and new to the industry, but under her direction, they’ve chosen to make it their career.
PW: What are the biggest opportunities and challenges in the industry?
The biggest challenge is probably the uncertainty; we’ve seen a lot of turmoil. Even in 2020, the claims were lower because of COVID, but the unit cost for services actually increased. In addition, there’s the lack of proper reform, you have hospitals buying physician groups and vice versa, insufficient funding by state governments, the impact of the Affordable Care Act.
Some of the main areas of focus for us are pharmacy contracts, rising drug costs and the lack of transparency, which desperately needs to be addressed.
There’s also the issue of reshaping health portfolios and reeducating the C-suite about the ongoing changes. The C-suite is playing a much larger role in the benefits decision process than in the past.
Evolution is a gradual process, but we’re slowly moving many of our clients away from the PPO plans and introducing high-deductibles, multiple plan options, ideas like reference-based pricing, technology and virtual care, concierge services and direct primary care. They’re fast becoming the norm. More and more people want to have that conversation.
PW: So you’re seeing employers becoming more open to new ideas and strategies?
Yes, our clients are becoming more receptive to many of these innovative changes that weren’t prevalent in the past. For example, if we find RBP to be a good fit for an employer, we have that conversation every year. If there’s a big self-funded group, we tell them how it would look. Often, the employer will say, “OK, I’m interested but let’s put it off for another year.” Every year, we keep the conversation going and now more than ever, they’re more open and receptive.
Another example is stem cell treatments that offer a non-invasive alternative to surgery. More employers are offering that as a benefit; it’s in its infancy but growing quickly. Patient data and analytics are starting to become huge and we’ve introduced it to many employers. Even with something like artificial intelligence becoming part of health care, these changes are prompting employers to discover and consider new ways to cut costs, set themselves apart and attract and retain employees.
PW: How do you balance meeting employers and employees where they are with also gently moving them toward where you think they need to be?
I think the best thing to do is not introduce too many things at once. You don’t want to shock the plan participants or the employer, so you gradually introduce changes year by year. Maybe the first year we introduce a HDHP; obviously a big key to their success is employee education.
It’s going to take a couple of years to even see the savings. Then maybe we start to talk about direct primary care. You often want to introduce these cost-saving options on a smaller scale and then gradually introduce more. An ongoing conversation is the best way to make them successful.
PW: How are you adapting to the pandemic? How has it affected your business and your life?
I moved to Houston in July, when COVID was already going strong. So everyone was already used to working remotely.
We had a lot of prospects in the pipeline come to a halt when COVID started. But over the past few months, we’ve written a ton of business, which has been great.
In a way, it’s almost made us more efficient because we don’t have to rely on seeing each other in the office every day; we’ve gotten better at guiding and supporting each other from a distance. At the same time, it’s harder to maintain work-life balance when you’re working remotely; you end up working constantly.
PW: What changes do you think will stick around after the pandemic?
Two of the things I find very interesting are telemedicine and employee assistance programs. We have been offering both for many years, but until COVID, people still weren’t very familiar with either. Before the pandemic, employees would completely forget that they had telemedicine available to them, and they rarely understood it. Now, it’s become the norm and I think that will stay. It’s saving people time and money and doing the same thing for the plans. And obviously employee assistance programs have played a large role in helping employees with the mental and emotional impacts of the pandemic.
PW: And what about within your own company and with future enrollments?
With enrollment this year, it kind of depended on the employer. We have one large client in Florida who wanted us to do in-person meetings, so I went down and stayed there for a week and held meetings from 7 AM to 5 PM every day. There could only be a certain number of people in the room at a time, so it took a while.
Certain groups or demographics want and need education and that hands-on approach. But we also work with a local law firm where we could have easily held the meeting in person, but she said, “COVID or not, we want to move things toward virtual meetings going forward.”
So it has really varied by group, depending on their situation and strategies. I prefer to do them in person; I feel it makes more impact to sit down with employees after the meeting and talk about their needs and what they’re going through so I can help them navigate. I think it will be a hybrid going forward.
PW: How do you stay optimistic and motivated while working within a broken, complicated system?
I think you can tie it back to many of the reasons I wanted to be a physician. There are a lot of elements that people who are unfamiliar with the industry don’t often see. And those aspects are a big part of why I love what I do: compassion for others, the ability to create a difference, the opportunity to help people navigate a complicated system. It’s possible to create change and that’s another reason I love the meetings so much. Seeing people suddenly understand it and say, “Thank you so much! I never knew that.” There’s a lot of great things about our industry. Unfortunately, people don’t always look kindly upon it, but I think it’s a really great place to be if you want to create change.
PW: How are technology and transparency changing the industry?
We’re seeing a lot more in data privacy and protection and also in virtual care. Those are both going to play a large role in the future of our industry. Many employers are introducing on-site clinics that often feature a doctor who is available virtually. And a huge percentage of health care costs are associated with the administrative side of things, so the impact of AI on things like following up on unpaid bills and maintaining records will really help.
Transparency is something I’m very passionate about. A big part of what we do is dissecting pharmacy contracts; we carve out the PBMs in all of our cases. We sit and analyze those contracts with them and it’s definitely a process; it’s not going to happen overnight, but it’s something we all need to continue to work toward. If people focus on it, it will continue to move forward at a faster pace.
There are a ton of data analytics tools out there now, too. The C-suite wants to see the numbers. They’re going to ask, “Exactly where am I saving?” Data analytics is going to remain on the forefront.
PW: How can the industry do a better job of innovating, adapting and bringing in younger and more diverse candidates?
Everyone we’ve hired has been new to the industry. We’ve tried to teach them and be good mentors, and most of them have stayed and learned to love it.
The idea of creating change is key and a lot of that comes from being hands-on with people, whether it’s your employees or your clients and their employees. It’s about that personal touch and taking time to talk to them, teach them and help them understand. You make change a little bit at a time. That’s how it works. Even if it’s just a little bit every day, have those conversations with friends and family about what health care really is and what it means. That’s the way to reach people.
PW: What are the benefits of looking for new talent from outside the industry?
They are a blank slate and don’t have to unlearn bad habits. We look for passionate people who want to learn. That’s all I ask for. If you’re not engaged, you’re not going to be successful. It’s a great career. It usually doesn’t take them long to see the value and decide to stay.
PW: Finish this sentence: The key to success in this industry going forward is…
Motivation, determination and passion. You haven’t done your best if you know you can do better.
Read more from our Face of Change series: