On Being ReWired… with Karen Walker Johnson || EP. 156

[00:00:00] In this case, they really have to demonstrate that they're making a demonstrable improvement in outcomes.

[00:00:07] It's tying their successes, if you will, to how much they're paying. And I think that's here to stay.

[00:00:14] And I think that's a really good thing because, as I said, having gone through all the various

[00:00:19] aspects of a payer, one of the ones that really resonated with me is the quality piece. I

[00:00:24] worked in quality improvement. I worked in terms of really being able to demonstrate that what we

[00:00:31] were doing, what we were providing to our members actually made a difference in their health outcomes.

[00:00:37] And so when you think about value-based contracting, it really does tie and align very well to quality

[00:00:44] outcomes. So I think that's here to stay. That's a trend that is being just embraced more.

[00:00:48] I even see it now, not only in with primary care physicians, but you see it in specialty

[00:00:54] areas as well that specialists are also going to be paid that way.

[00:01:03] This is Inspiring Women and we are at the WBL annual summit. And I am here today talking

[00:01:09] with Karen Walker Johnson. And we are going to be spending a little bit of time talking about

[00:01:14] this idea of retirement because Karen says she's retired. There is literally nothing

[00:01:19] that suggests that she is. She is 35 years in healthcare as a senior executive. She's been

[00:01:25] an executive of payers and she has been and is a board director, a chair of a board,

[00:01:31] many different boards. And now additionally is back in the CEO saddle. So Karen, thank you

[00:01:37] for being on Inspiring Women. Thank you so much for having me.

[00:01:40] All right, well, let's um, why don't we start with sort of like a little bit of the biosketch?

[00:01:44] So how does a nurse turn lawyer, turn into payer executive, turn into board director and all the

[00:01:51] things you do back in the CEO seat? So tell us a little bit about that. Well, first of all,

[00:01:56] I wish I could say that it was intentional, but it really was not. I started my career as a nurse,

[00:02:02] a pediatric nurse specifically, and decided pretty early on that I thought I wanted to

[00:02:07] go to law school. And so I completed my program in nursing and went to law school.

[00:02:13] And I think what happens often when you're really young, you think you know what you want to do

[00:02:17] for the rest of your life. And I quickly realized that practicing law wasn't

[00:02:21] what I wanted to do, but I really enjoyed healthcare. And so with my background, I kind

[00:02:27] of fell into managed care and to risk management because I had the nursing and the law degree

[00:02:32] and that's really how I ended up in and working for a managed care company.

[00:02:37] Over the course of my career, what did become intentional for me is I knew that I wanted to

[00:02:43] quote unquote run a health plan. I really enjoyed working for them. I loved all the variations

[00:02:49] and the different aspects of a health plan. And so with that, I took upon myself

[00:02:57] to work in every aspect of a health plan that you can, including sales and marketing

[00:03:02] and underwriting just things that really weren't comfortable for me. But I thought they were

[00:03:07] really important if I was going to have overall responsibility as a general manager.

[00:03:11] And that's sort of what happened. And so I often took lateral moves just so I could get that

[00:03:18] wide breadth of experience and ultimately ended up having the privilege quite honestly of leading

[00:03:25] the health plan. Okay, so Karen, I want to double click on a couple things there. So you are a nurse

[00:03:29] and then you went and you got your law degree and I know that your parents are very important to you.

[00:03:35] So how happy were they with you when you said, okay, forget this degree. I'm now going to go

[00:03:40] do something else. Was that like, was that a welcome move? And like, what was that?

[00:03:44] I will say that probably my dad most specifically because he was someone who, you know,

[00:03:51] retired from a place he had been for 40 years. He was a civil servant and, you know,

[00:03:56] he retired with a pension, et cetera. And every time I made a move to somewhere else,

[00:04:01] he kept saying, how are you going to have a pension? What are you thinking?

[00:04:06] So as much as I think he was definitely inspired, if you will, by the different things that I

[00:04:12] did, it made him a little uncomfortable. What's really interesting though is my father now,

[00:04:16] he's 88 years old and he is my biggest cheerleader. And he often says to me, you know what, honey?

[00:04:24] I'm so glad that you were willing to take risk, that you were willing to do things differently

[00:04:29] because I couldn't be more proud of the impact that you've made because I have been very intentional

[00:04:34] about the type of work I've done though. And that's been primarily with vulnerable

[00:04:38] populations underserved, et cetera. And that was something that was really important to me.

[00:04:42] And so my dad, I think he likes that. Well also, you know, I mean, let's just,

[00:04:48] you know, state it. I mean, staying very specifically that you wanted to run a health

[00:04:53] plan. You wanted the top job at a health plan. There aren't a lot of people, black women leaders,

[00:05:00] like you, who were doing that. So when you stated that out loud, I mean, how do people

[00:05:06] react to that? I mean, that is so unusual. And when you say that you are intentional,

[00:05:10] I mean, that is incredibly intentional. Well, I have to say that I had some really,

[00:05:17] really good mentors. And there's a gentleman that just keeps popping up at tip nine of a white gentleman

[00:05:25] who really took me under his wing and I shared with him. He had that job himself in a health

[00:05:31] plan. And I shared with him that I wanted to one day do that. And he helped me quite a bit.

[00:05:36] He helped me. He gave me really good constructive feedback. He allowed me to participate in many

[00:05:44] leadership development programs and every opportunity that I could join him for meetings,

[00:05:49] etc., he would bring me along. And so that's it a lot to me. It said that he believed in me

[00:05:55] that my desires were not unrealistic and that, you know, people are willing to help you.

[00:06:02] And that has been my experience, honestly. Yeah. And I know it is also your experience in

[00:06:06] terms of giving back to others and bringing up additional generations. So, okay, Karen,

[00:06:12] so let's like talk about payers just like more broadly and you're back leading a payer again

[00:06:18] as a CEO, as a retired person. Okay, that is just like funny to me.

[00:06:24] So but like the payer landscape has changed very, very significantly over the past 20 some odd

[00:06:29] years where they are truly the power players, they are brokering, you know, the care delivery,

[00:06:34] access and everything else. So what are the sort of industry trends that you're paying attention to

[00:06:40] today? And how do you see the landscape shifting? What are you excited about? What are

[00:06:44] you worried about? I'd love your perspective. Probably the thing that comes to my most is

[00:06:49] value based contracting. It's bantered around quite a bit. And first of all,

[00:06:56] I believe that it is here to stay. There are a lot of providers who probably hope that it isn't

[00:07:00] they're used to getting you know, fee for service, they do something and they get paid, right?

[00:07:05] In this case, they really have to demonstrate that they're making a demonstrable improvement

[00:07:11] in outcomes. It's tying their their successes, if you will, to how much they're paid. And

[00:07:18] I think that's here to stay. And I think that's a really good thing. Because as I said,

[00:07:23] having gone through all the various aspects of a payer, one of the ones that really resonated with

[00:07:28] me is the quality piece. I worked in quality improvement. I worked in terms of really being able

[00:07:35] to demonstrate that what we were doing, what we were providing to our members actually made a

[00:07:41] difference in their health outcomes. And so when you think about value based contracting, it really

[00:07:46] does tie in line very well to quality outcomes. So I think that's here to stay. That's a trend

[00:07:52] that is being just embraced more. I even see it now, not only in with primary care physicians,

[00:07:58] but you see it in specialty areas as well, that specialists are also going to be paid that way.

[00:08:03] Yeah. Another trend that I think is really important and you see a lot more now,

[00:08:08] emergence is around health equity. Yep. It is it is that you have all of your federal programs

[00:08:13] now that are requiring that within the contract, the way they're evaluated, etc. How does that

[00:08:20] tie back to health equity? Are people getting access? Are they getting access to the right things?

[00:08:26] And so I think that that again is another really plus, particularly when I think about

[00:08:31] something that I just recently got involved in about a year ago and that was the March of Dimes,

[00:08:36] which is around infant and mom mortality and morbidity. We have some of the worst outcomes

[00:08:42] in this country. And so when you start to think about what are important trends,

[00:08:48] health equity, because if you look at women of color, they're three to four times more likely to

[00:08:53] die. Yeah. Three to four more times their babies to be born premature. And so I think it has really

[00:09:00] captured, if you will, and rightfully so the medical community, but not just the medical

[00:09:06] community, the community in whole around what we do and how we take care of our moms and

[00:09:12] babies. So health equity is something that's very important. And I see it in a lot of different

[00:09:16] areas. And then a final area that I think is emerging and where payers really are stepping

[00:09:22] and leaning in, is what you will hear referred to as a pay fighter. And it's basically when you have

[00:09:29] a provider group, if you will kind of work alongside partner with very closely a payer.

[00:09:36] And that's very powerful when you are the payer as well as the provider. And you're seeing

[00:09:42] more and more that because it gives leverage in contracting. You can take care of larger

[00:09:47] populations. So I think that's another trend. Yeah. And I think these trends are,

[00:09:52] you know, I really appreciate you sort of putting the light on the macro trends because

[00:09:56] along the way it's bumpy. I mean, we've been moving towards value based care and contracting

[00:10:01] for probably 20 years, we've been talking about it, but it seems like it's starting

[00:10:04] to cross that cast on in terms of the number of contracts that are out there.

[00:10:08] Despite all the resistance fee for services, it's a lot easier to perhaps to understand

[00:10:13] as a provider and the health equity. I also appreciate you pointing that one out because

[00:10:18] that one there has been this huge spotlight on it. And for things that have been known,

[00:10:24] but not as well talked about or whatever, but it's going to take some time to work through

[00:10:29] that. So the data collection, working those things into contracts is going to be obviously

[00:10:34] a big step. I want to come back to you and just talk about the, you know, despite being retired,

[00:10:40] ha ha ha, you have spent some time moving into board service. And so that was also an intentional

[00:10:47] move for you. So could you just talk about when you determine that becoming a board chair,

[00:10:55] a board director and, you know, advisor to like Google Ventures, all the things

[00:11:00] that you do, how did you go about preparing for that? How did you go about making that happen for

[00:11:06] yourself? Well, this is one where I wish again, I could say that this was something I had in the

[00:11:14] back of my mind years and years ago. It was not. In fact, what was really the precipitating

[00:11:19] factor for me was what happened with George Floyd. I was always involved in not-for-profit boards.

[00:11:25] That was just something that was really important to me to give back, to be able to

[00:11:30] excuse me, to contribute to my community. But when that happened and there were so many repercussions

[00:11:37] as a result of that, and it was right, as you, what we call the pandemic, we were at home. I was

[00:11:42] working from home and I really started to think about a couple of really important things, one of

[00:11:47] which unfortunately my stepmom had been diagnosed with Alzheimer's. And so I knew my father needed

[00:11:54] help. I had already been thinking about maybe it might be time to think about when I might

[00:11:58] like to stop working and my husband had already retired. And so it was just like this perfect

[00:12:04] storm. George Floyd happened. I kept thinking about the fact that there was a need to have people

[00:12:12] who look like me in the room to do all kinds of things. I was thinking about how I could help

[00:12:18] my dad with my stepmom. And I just said, you know, I think it's time for me to retire.

[00:12:24] And so I said, well, I can't do it immediately. But perhaps within the next couple of years, and I

[00:12:29] said, okay, but what will that look like? Particularly because I like to be stimulated intellectually

[00:12:34] quite honestly. I thought I can't imagine myself just being quote unquote retired doing nothing.

[00:12:39] And so what will I do? And it just seemed to me it was natural that given that I had experience

[00:12:46] in governance, in terms of in the not for profit side as well as the fact that

[00:12:52] you know, I was seeing everything that was a fallout, if you will, of what it occurred with

[00:12:57] George Floyd. I said, I think I want to see how I could be more impactful. And I think I can do

[00:13:03] that by board participation. And so being probably a overachiever, some might describe me as,

[00:13:11] rather than just saying I can join a board, I thought it was really important for me to

[00:13:15] prepare. And so I actually sought out and participated in some very organized, structured

[00:13:22] coursework around board governance. I really wanted to feel good and probably as a little bit of

[00:13:28] that imposter syndrome quite honestly, thinking that perhaps I didn't necessarily have what was

[00:13:33] needed. And so I took and participated in two different programs. And, and so that was

[00:13:40] really important. But the other piece that I learned while I was doing the programs was

[00:13:44] the importance of networking. And I will tell you that I am probably a very, very strong introvert.

[00:13:51] People who know me well say that I work really hard to be extroverted during the day, but I'm

[00:13:55] naturally an introvert. And so networking really scares the machinibis out of me quite honestly.

[00:14:01] The last thing I want to do is walk into a room with people I don't know and introduce myself.

[00:14:05] But I realized that that was important in terms of if I really wanted to serve. And so I started to

[00:14:11] really kind of cultivate my network and I reached out to some mentors that I have to help me as to

[00:14:18] how to do that well, because it wasn't something that was natural. So the combination of, you

[00:14:23] know, taking the courses as well as intentional networking were kind of what led me along that

[00:14:30] path. Well, I tell you what, the thing that is so inspiring about everything that you just

[00:14:35] said is that you take the crisis of George Floyd in terms of the national impact and the choice

[00:14:42] that you made was to step further into leadership. That was your action. And I just think that is

[00:14:50] so incredibly powerful. So the idea that you prepared and you did the hard things in terms

[00:14:56] of being an extrovert, but the important thing is you moved into the next level of leadership

[00:15:02] as a way to deal with that horrific time and occurrence and, you know, putting a spotlight

[00:15:09] on something that is now known by many that was, you know, always, always there. So

[00:15:16] that's just awesome. That is just really, really awesome. You know, we're here at the WBL summit

[00:15:22] and when I talked to powerful women like yourself, one of the things that I often hear

[00:15:29] is that networking is still important and buildings that have like other colleagues,

[00:15:34] lifelong learning, those are the types of things that are important to them. So Karen,

[00:15:40] in terms of WBL, and we're here at this summit, what is important to you about WBL and why are

[00:15:47] you here? Well, I joined WBL about three years ago and it was at the invitation, if you will,

[00:15:56] of Mary Ann Mason, who most everyone knows me, Mary Ann, the ultimate connector. And I met with

[00:16:03] Mary Ann through a mutual frit who introduced us. And when she told me about the organization,

[00:16:09] I didn't quite honestly know that it existed. You know, unfortunately I didn't. And she said,

[00:16:15] you know, you really should consider it and I joined. And the first thing that struck

[00:16:19] me was the warmth, the warmth of the members. But equally as important to me was I had never

[00:16:26] had the opportunity to participate in an organization that was really focused on

[00:16:32] female healthcare executives. I had been a part of programs, but nothing where it was all women

[00:16:38] who were there to support each other, who all had made significant impacts in their own right.

[00:16:43] And so it was, I mean, literally like your show, it was very inspiring. And so as soon as I could,

[00:16:50] and it was kind of during still the pandemic. So I participated virtually. The first time I had

[00:16:55] an opportunity to go to something in person I did. And what brings me here? This is my first

[00:17:01] attendance at a summit. I wasn't able to come last year. I had a conflict, but I was really

[00:17:06] looking forward to it for a number of reasons because I'd been to a couple of other events

[00:17:10] and new again, just kind of the warmth. But I'm so impressed by the caliber of women that are in

[00:17:16] the organization. But all of that aside, it is really about how willing and genuine women are

[00:17:24] about helping each other here. And so I thought, well, now I have to call myself rewired as opposed

[00:17:29] to retire. My family told me I couldn't call myself retired. So as a rewired female executive,

[00:17:36] I think it's really important for me to give back. And one of the things that I've enjoyed is that

[00:17:41] people are so willing to ask you for assistance. And so I think people kind of comb, you know,

[00:17:47] the directory they see, perhaps what you are aligned with or what some of your experiences

[00:17:52] have been and then think about reaching out and there's no hesitation to do that. And I

[00:17:57] am so happy to be able to reciprocate because people have done that for me. Mary Ann did

[00:18:02] that for me, introduced me to people when I came to my first event. Continues to do so.

[00:18:08] And so I was excited about coming to this as a first time attendee. I was signed a navigator,

[00:18:15] which was really awesome. And everyone says I got the star. And Jeanine, excuse me,

[00:18:25] Rivette. And so I am just already yesterday ahead of all, and I'm looking forward to the

[00:18:32] really good sessions too, you know, the people who will be speaking the panels. So everything

[00:18:38] about it is awesome. Well, it's inspiring to meet you and to have you as a fellow member

[00:18:43] and something that I can look to. So Karen, as we close out on inspiring women, I love

[00:18:48] to always ask again, powerful leaders, if you look back at things that worked for you

[00:18:54] along the way, things change, right? Like people don't need to walk in all the same footsteps

[00:19:02] that you laid down. But what advice has stuck with you that you think would be really useful for

[00:19:08] younger women who are looking to be Karen Walker, John Samlin, they grow up?

[00:19:14] Being authentic. One of the things that when I always think back, so Karen, how did you get

[00:19:20] here? You know, I mean, I'm the obvious. I'm an African American woman, right? And

[00:19:28] often, almost all the time, it I was the only person in the room for a lot of things. And

[00:19:34] though it was uncomfortable, I always was Karen. That was really important to me. I thought that

[00:19:41] people just needed to know me and to be my authentic self. So I think that's really

[00:19:45] important. Another thing is to be patient. You know, I think sometimes particularly younger

[00:19:51] people, they've grown up in this world of everything is instantaneous. But you have to have some

[00:19:56] patience to get to where you ultimately want to go. And I definitely had a lot of patience

[00:20:02] when I think back now. And I think that's really important. A final thing I would say is

[00:20:07] it's about being willing to take some risk, you know, not unreasonable risk,

[00:20:13] but to take risk by that. I mean, you know, take a roll on that may not necessarily be something

[00:20:19] that you would have thought you could do. I did a lot of lateral moves in my career,

[00:20:23] just so I could get a different set of experiences and competencies. I think that's

[00:20:28] really important to do as a leader, particularly as a female leader, because you bring so much

[00:20:35] more if you will to the party by having that broad set of experiences. So I think

[00:20:41] being willing to take some risk and to be patient and to be their authentic self.

[00:20:47] Well, that is just fantastic advice. And I really appreciate it. I've been talking to

[00:20:51] Karen Walker Johnson, the rewired Karen Walker Johnson. I'm inspiring women. Thank you so much,

[00:20:57] Karen. Thank you. This has been an episode of Inspiring Women with Laurie McGraw.

[00:21:03] Please subscribe, rate and review. We are produced by Kate Cruz at Executive Podcast

[00:21:09] Solutions. More episodes can be found on inspiringwomen.show. I am Laurie McGraw and

[00:21:15] thank you for listening.