Michelle Wright: Payer executive. Mom, first and foremost. || EP. 158

[00:00:00] We all do what we do for our families, right? Like it's like, well, that's what we do for our

[00:00:03] families. And I think it's a stereotype, but I think women just, you know, will be the tiger mom,

[00:00:09] whether they're three or they're three. Right? Like so, you know, when I get home, I'll have

[00:00:15] to brush his teeth and I'll have to help him in the bathroom still and all those things,

[00:00:18] but he has more peace in his mind. And so if the advocacy work I do outside of my day job

[00:00:26] can help with that, then that's great. You know, and there's it's never too late. Like I

[00:00:31] got my degree during COVID, which was amazing. Like it was a lot of work, but it was,

[00:00:35] you know, working full time while you're doing that. But yes, it was a good thing.

[00:00:39] Well, you're really speaking to obviously a very important part of your why.

[00:00:49] This is Inspiring Women and I'm talking to Michelle Wright and she is a long-time

[00:00:54] executive and she is the founder of Certis Consulting. We're going to talk about your

[00:00:58] long career in the payer space, in the HR space and trends that you're seeing.

[00:01:02] Michelle, thank you for being on Inspiring Women. Thank you so much. It's an honor to be here.

[00:01:07] It's great to talk to you. So just in terms of, you know, you're in Maryland and you've been

[00:01:13] in Maryland for I think your entire career, right? Born and raised. So you've been playing

[00:01:18] the long game, but give us sort of like the bio sketch of sort of like where did you start?

[00:01:22] How did it evolve over the years? Right. So gosh, I have, it's funny, even though I've played the

[00:01:29] long game, I have a lot of different experiences. And so I find that that's kind of the secret to

[00:01:35] the long game. Like if you're going to be with one company for a long time, which I was,

[00:01:39] I was with a payer for 20 plus years, but you have to keep finding, you can be there as

[00:01:45] long as you're finding opportunity, you're still growing. Right. And so I did and I came out of

[00:01:50] school with degrees in, I have degrees in math and computer science and business and

[00:01:57] pharmacy. So I have like multiple degrees in different topics, but it's helped me

[00:02:04] create opportunities for myself and growth. And I've never wanted to be pigeonholed.

[00:02:09] I came up first through finance and I did actuarial work coming out of school. And then

[00:02:16] I moved over into HR at some point, helping companies. And then I really just never wanted

[00:02:25] to be pigeonholed. I was chief human resources officer for a large payer, a state payer,

[00:02:30] but I never wanted to just be HR. I always wanted to, I actually, maybe it's a little bit of

[00:02:37] the syndrome of women not always feeling good enough, but I never wanted to just be the,

[00:02:42] I don't know, not disparaging, but I didn't want to just be the HR girl. Right. Like that is,

[00:02:46] that is the one place where women, right. It is more common. Right. Senior executives that are out

[00:02:52] there and there are some women on the team very often that woman might be the senior HR person.

[00:02:58] And that's the only person in the room. Right. A woman often. And I never wanted to just be

[00:03:04] the HR person. I wanted to, I learned early on from a great mentor that I had, who was a female

[00:03:11] leader, who the importance of understanding the business that goes behind it. And I think that's

[00:03:16] what makes me super effective. So in my time, my last 10 years with the blues, I was the chief

[00:03:22] human resources officer, but I also ran product lines. Oh, as the chief. So again,

[00:03:28] I had that opportunity coming up in a large business that had lots of different opportunities.

[00:03:35] And so I ran wellness and disease management products across government sectors, self-insured,

[00:03:42] fully insured. Oh my gosh. You really have done all the different angles. Direct to consumer.

[00:03:47] And so when you're doing that and you can see the people aspect as well as the business

[00:03:54] aspect, I think it just makes you like super valuable, but I've never wanted to be

[00:03:58] pigeonholed and just slotted. So I had a lot of opportunities. I had a lot of opportunities.

[00:04:03] Well, my goodness, you've done all the different things. And I think also today,

[00:04:06] I mean, the chief human resources person, that's a different level of role. Today,

[00:04:12] human capital is always the most important thing, but in a post pandemic world and building

[00:04:16] an engaged workforce, and then also being able to have all the business understanding in terms

[00:04:21] of understanding all the angles that you do is incredible. So we're talking to a bonafide

[00:04:27] payer expert sort of like knowing all the angles that you do. So I want to talk about

[00:04:32] some of the trends that are out there with payers today, because certainly over the past,

[00:04:37] I don't know, few decades, I'll just say the amount of power that is in the payers hands

[00:04:42] has really shifted. And so first, maybe I just asked you what are the trend lines that we

[00:04:48] should be paying attention to just from a payer perspective that you think about as you advise

[00:04:54] payers and help them work on their strategies? And I'll just say, most of what I do now is not

[00:05:01] advising payers. Oh really? Which is really interesting. But payers are big and they have

[00:05:06] lots of people there that are smart and know like I was when I was there and know what

[00:05:11] they're doing and they have the money to get consultants to talk with that. I'm often

[00:05:17] advising the people that want to work with payers. And you're very much, the lines are blurred

[00:05:24] because so many groups are taking on risk now. And so you have big health systems taking on

[00:05:31] risk. You have providers taking on risk. You have that managed Medicare, Medicaid space. And

[00:05:37] so you have all of these different avenues where people are taking on risk and kind of

[00:05:42] becoming like quasi payers. Right? And so I tend to advise growth companies, the companies that

[00:05:50] are growing pretty fast and a lot of them are either providers or they're people that

[00:05:56] are providing healthcare services like niche services and they want to find out how to get

[00:06:02] in with payers. And so is it how to access payers and then partner with them? Is it

[00:06:06] sort of reimbursement strategies? Or around the strategies for what's the payer perspective

[00:06:18] what you need as part of your pitch. Right? What are the points in your pitch that you want

[00:06:23] to get their attention because payers get, oh my gosh, so many pitches. I mean, weekly requests

[00:06:32] to just see this pitch, that pitch and always from great people and great ideas. But you're

[00:06:37] inundated and there are all these niche things that you as the payer or the large provider

[00:06:42] have to integrate all those services. And you have to think about like, how am I going to

[00:06:47] like, this is great. This diabetes management group or this sickle cell group or this group

[00:06:53] that does behavioral health for substance abuse. But I have to like work across all of that

[00:07:01] like, how am I going to manage all these relationships seamlessly for my client?

[00:07:06] So I want to actually, I want to move to behavioral health and some of the new innovative

[00:07:10] areas of care that are out there. But before we go there, Michelle, so four organizations

[00:07:16] that you advise, what are some of the key things that they don't know that you're

[00:07:20] helping them know to work successfully with a payer? What are you seeing generally?

[00:07:26] I mean, again, first of all, a lot of times when people are, when private equity, which

[00:07:35] is very much in a lot of these conversations, right? And they're trying to get into it.

[00:07:43] They're getting into a provider space or they're getting into something and maybe it isn't

[00:07:47] something they've 100% done before. You're just, you're working on the value proposition

[00:07:52] with them. So I've done it from the boardroom and I've also done it as a consultant. And

[00:07:57] I'm generally, like I said, I'm working on their value proposition and how to maximize

[00:08:02] those relationships. And they may be existing relationships and they may be new relationships

[00:08:07] they're trying to form because there are smaller companies coming up.

[00:08:10] Yep. I know you've spent time in some of the new spaces and we're spending a lot of

[00:08:15] time talking about behavioral health or like new opportunities for care. And sometimes things

[00:08:21] that are slightly adjacent to what might be considered traditional medicine. So maybe

[00:08:27] Michelle, could you just tell us sort of like what you're seeing out there that's interesting

[00:08:32] to you that think that may have the opportunity for a lot of change or opportunity for people

[00:08:38] who really need care in those spaces? Yeah, I think there's probably like three or so things

[00:08:45] that I think are innovative right now. First of all, access is all anybody's talking about

[00:08:50] because we came out of, it was not great before and now we come out of COVID and there's no

[00:08:55] way, and especially for children. Yeah. My gosh. And underserved populations, right? Just like

[00:09:01] maternal health and other things where it's the most affected is underserved populations,

[00:09:06] people of color, all kinds, you know, so it's really, really difficult. So what I'm seeing

[00:09:11] is companies being really creative with ideas around access because we can't just mint

[00:09:17] a bunch of psychologists and social workers and they're like, they're not there. Like

[00:09:22] all the ones that are there have been really, really hard to meet the demand. So I just see

[00:09:27] groups just going so much further than just the traditional telehealth, right? Because that

[00:09:32] was the game during COVID. But even beyond that, you know, different types of programs,

[00:09:38] peer training, parent training, like I could go on, but there's a lot of things going

[00:09:43] at that access, which I think is super, super important. You know, I think what's close to

[00:09:50] my heart because I do have an adult son who's profoundly affected by autism and, you know,

[00:09:58] he's had labels of schizophrenia and catatonia and like just so many things over the years,

[00:10:03] and he is very, very affected, not like anything anyone sees on TV. And when you look

[00:10:11] at the numbers, I was looking at a PBS special a few months ago. I think only like less than 5%

[00:10:18] of the mental health providers in the country will even take on someone with profound and

[00:10:27] really serious diagnoses where it not, you know, look, anxiety, depression, all of those

[00:10:33] things are important, but this is like people who, you know, are using the emergency room

[00:10:38] regularly for their healthcare because they are sitting and waiting for inpatient beds because

[00:10:45] there is no, they're just sitting in emergency rooms for a week at a time waiting because

[00:10:49] there's no place for them to get service. Right. So Michelle, like just, you know,

[00:10:54] beyond being an expert as a mom, you know, with a son who maybe doesn't fit whatever the

[00:11:02] right, you know, numbers are or a therapy program that, you know, is traditional sort of like,

[00:11:09] what do you think about? How do you provide all that expertise for the care delivery system

[00:11:15] and then, but help your son. This is very, very close to home.

[00:11:19] So the third area is that I have advocated for a lot. So there's medication management,

[00:11:25] right? So people often with very severe behavioral mental health needs are on a cocktail that they

[00:11:33] are regularly on five to 10 medications daily. My son, when he was at his worst about five years

[00:11:40] ago, one of the five medications he was on at the time was just a benzo like had a van or Xanax.

[00:11:47] He took it six times a day. That was one medication that he brought at the time.

[00:11:52] Antidepressants, neuroleptics, you know, just anything, anti-psychotics, mood stabilizers,

[00:11:59] seizure medications to, but he doesn't have seizures, but they give them seizure medications.

[00:12:05] So you're on all these medications. They were not working. His symptoms were getting worse and

[00:12:10] worse. And we actually, okay, so this is I work in traditional healthcare, but he actually

[00:12:19] benefited when we had after five years of him being really, really ill and them talking about

[00:12:25] inpatient, talking about electroconvulsive therapy. They were talking about just another

[00:12:34] level of medications. We actually tried medical cannabis on our son. And it's amazing, not

[00:12:42] amazing in that it's not like a cure. There's a cure, right? He's got a lot of issues, but

[00:12:49] we did notice a small difference right away. And I've actually studied that some. So that is

[00:12:56] my pharmacy degree is actually when I got in my fifties going back to school. And I went

[00:13:02] to university Maryland pharmacy school where they had developed a first in the nation master's

[00:13:07] program in medical cannabis pharmacy, because there is a lot of science there. And a lot of

[00:13:14] things that my son suffers from is where there is a lot of scientific evidence. So I studied

[00:13:19] that and I advocate in that area. So I advocate not for adult use or recreational use. That's not

[00:13:27] I'm not saying I'm against it. I'm not saying I'm for it. I'm not even going to go there.

[00:13:31] What I do advocate for is medical access because it is the only thing that has helped my son. I

[00:13:38] make pills for my son, what my husband does. He's the assistant pharmacist. And my son

[00:13:45] is a three-year-old essentially, even though he's in his thirties and he would not smoke

[00:13:50] or vape. And I don't want him to smoke or vape, but we make pills for him. We make capsules

[00:13:55] for him. He takes capsules several times a day and he's pretty much off all of his medications.

[00:14:02] It took two years to wean him off all his medications, but he's off all of those. So

[00:14:06] what I do now is I try to advocate for the safe medical use and forwarding a lot of the

[00:14:15] laws that will support medical use more in our country. Michelle, I really appreciate you

[00:14:20] telling this very, very personal story and just how important not just the work that you do

[00:14:27] on behalf of patients everywhere, but how very personal this is. And how as somebody who with

[00:14:32] all the degrees that you have and all the experience you have, how you've had to study

[00:14:37] more, learn more, find other ways to work within the health system and provide opportunity

[00:14:44] for your son. So again, thank you for sharing that story. I really-

[00:14:48] We all do what we do for our families. That's what we do for our families. And I think it's a

[00:14:54] stereotype, but I think women will be the tiger mom whether they're three or they're three.

[00:15:03] When I get home, I'll have to brush his teeth and I'll have to help him in the bathroom still

[00:15:07] and all those things, but he has more peace in his mind. And so if the advocacy work I do

[00:15:13] outside of my day job can help with that, then that's great. It's never too late. I

[00:15:20] got my degree during COVID, which was amazing. It was a lot of work, but it was

[00:15:25] working full time while you're doing that, but it was a good thing.

[00:15:28] Well, you're really speaking to obviously a very important part of your why in terms of what

[00:15:34] you do. And maybe I could just bring it around to some of the additional work that you do

[00:15:39] because you bring that to helping other women. You bring that to mentoring, you bring that to

[00:15:44] the boardroom. And so maybe as we just think about your leadership journey and close out on

[00:15:50] this inspiring women conversation, I would love to hear from you as you think about leadership

[00:15:57] and what's important to you as you show up every day as a leader, what advice might you

[00:16:04] give to other and specific business inspiring women? So other younger women who are out there

[00:16:10] who are ascending into leadership. What are the things that you might advise to them as they

[00:16:14] think about forging their own careers? I think one is common, and you probably hear it on

[00:16:21] almost every one of your podcasts because I think women do mentor women well. I've had lots

[00:16:27] of mentors, but my female mentors in particular, finding like-minded successful women and just ask.

[00:16:35] I mentor multiple women and I just think it's so important. That's what I love about WBL.

[00:16:42] That's what I love about this organization is because it's just every day. You help each

[00:16:50] other all the time. And if I can't help you, I'm going to find somebody that can help you.

[00:16:54] Do you have a WBL story? I do have a WBL story. So I was in WBL for a long time when I was an

[00:17:01] executive and I didn't really get that involved. And then when I started doing advisory after I

[00:17:07] left PayorWorld, I attended the board programs. So there's two big programs. They do a year and

[00:17:13] one is on board service. And I attended that and out of that, I've attended that multiple times.

[00:17:18] And out of that, I had been on boards before. I've been on boards for 20 years, but I've been on

[00:17:23] boards a long time, but it focused me to get on specific boards and I did. I found my board

[00:17:34] seat through WBL. So I'm on multiple nonprofit boards and finance committees and I have a

[00:17:42] governor's appointment in the state of Maryland for a board, but they helped me find

[00:17:48] a board out of the nonprofit space, which was something that I had been seeking.

[00:17:52] So absolutely. And I get calls. I would say that there's probably,

[00:17:58] and this is you got to find your tribe, right? You have to find that group of women

[00:18:01] around you. And I would say that there are 10 people today that I could name at WBL that I

[00:18:08] could just ping to and say, does anybody know anybody in this space or in this particular company

[00:18:16] or on this board? And I will get like, ping, ping, ping, ping, ping, ping, ping, ping, ping.

[00:18:22] Everybody's saying, yeah, well no, I don't, but I know somebody who can help.

[00:18:27] It's such a great organization for that. The sisterhood of it is so powerful and I love WBL

[00:18:34] for that. So I'm super proud to represent them in this.

[00:18:38] Yes, and be a part of it and help others as you do. Thank you so much, Michelle. This has been

[00:18:45] an amazing inspiring women conversation. I'm inspired having listened to you and I've been

[00:18:50] speaking to Michelle Wright and Michelle, thank you so much.

[00:18:54] Thank you, Lori. Appreciate it.

[00:18:56] This has been an episode of inspiring women with Lori McGrath. Please subscribe, rate,

[00:19:01] and review. We are produced by Kate Cruz at Executive Podcast Solutions.

[00:19:07] More episodes can be found on inspiringwomen.show. I am Lori McGrath and thank you for listening.