The Evolution of Healthcare Services And Thoughtful Leadership

The Prime View had the opportunity to interview Michael Privat, VP of Digital at Availity, a company that provides a transparent exchange of information among health plans, providers, and technology partners leveraging its largest health information network in the US.

Michael, can you give a summary of your career in the IT industry?

I have been programming for as far as I can remember. As a teenager in France, I used to pack my Amiga computer and a small portable TV into a bag, and we would ride with friends on an overnight train to somewhere like Copenhagen or Frankfurt just to participate in a coding party. When I began to do it professionally, programming turned more into engineering and then into implementing greater visions.

At Availity, I started as a consultant and then became a developer and architect to end up in my current role eventually. I have been at the company for over ten years now. Before joining Availity in 2006, I worked at a large health insurance organization with lots of processes, lots of bureaucracy. Back then, Availity was still very small, and that was a big change for me but definitely a very enjoyable one. Availity had a startup feel. Now, it has grown, but there is still a fair amount of that energy around. It consumes the vast majority of my time in and out of the office. 

Michael Privat

VP of Digital at Availity

What specific services does Availity provide?

The fundamental service that we are providing facilitates the interactions between the healthcare providers and the health plans. Providers deal with many health plans. Health plans deal with many providers. That creates many relationships. A provider may see many patients, and they all have different insurance plans. When they need to go and file a claim, if there were no Availity, there would be many different processes for every provider and every health plan that they have to submit claims to. This is where we come in, and we make that exchange a lot easier. Providers submit their claims to us, and we deal with the connectivity to the health plans and routing responses back. It was the premise of how we started 20 years ago. 

Since then, we have evolved with the healthcare services system in general. We have evolved more towards data accessibility today, making sure that we always show the right data at the right time to the right person, with the important caveat that we enjoy the appropriate permission from the data owner to do so. To me, this is the future of healthcare services, at least in the IT space. New AI capabilities can enable virtual assistance for providers. These data-driven AI capabilities will require solid ways to exchange data through safe, secure, and of course, compliant systems. I think we have a big role to play there.

The Healthcare industry in the US is highly regulated. How does regulation impact your ability to innovate?

We’re very focused on strict compliance with frameworks such as HIPAA. These impose many constraints on how we conduct business, how we manage our infrastructure, and how we deploy our systems. Of course, it is a bit of a challenge when it comes to innovation because they are essentially constraints that require a lot of work to get right.

Regulations often get characterized as innovation inhibitors. It does not have to be the case. They are immovable constraints. But they exist for a reason; they keep everyone safe. We have to find a symbiotic relationship and work not around or against it, but with the constraints. If you understand the spirit and reason for the regulations, you turn them to your advantage in a way that makes your solution that much stronger.

What kind of people do you bring to your teams? 

I want genuinely passionate people, not just overly excited people but people who channel their excitement into productive outcomes and get things done. 

I care a great deal about team players and other soft skills, but you cannot truly be passionate if you do not feel the urge to share, bring everyone up in your world, and make them feel the excitement. In the end, I want people to walk around gesticulating while describing their ideas to solve the next problem. I want to see people who try to pair up with a co-author of a technology book or people who come and ask me for permission to be away for a few days while they go speak at a big conference. 

And so, of course, I have a special relationship with the members of my team. I aim to help them find purpose in a way that advances the team’s ultimate goal. I try to awaken the passion in them. I try to sync up with what gets them interested, and at the same time, that helps push our agenda forward. 

What have you learned about your management style while navigating the transition to your current role?

I think my synthesis of management comes down to two things. Number one is about transmitting passion. Number two is a managing failure. 

I am extremely passionate, in case you have not noticed yet. Sometimes I have to deal with people who have not found their passion yet. Luckily mine is very contagious, so most of the time, it is easy to win hearts and light up a new fire. 

The other dimension of management is dealing with issues. I am talking about failure, or rather the fear of it. To me, it is more important that we converge towards success rather than hope we will hit it right away. It leaves some room for failing and pivoting along the way. When we get there, it is a stable success because it was not a lucky shot. My advice to the team is never to fear failure. It is okay to fail. I completely expect that, and we all do it. Myself included. What is not okay is to not prepare for failure or not try. 

How do you generate demand for your offerings in the competitive market?

At Availity, we are lucky to have very thoughtful business leaders who truly care about improving everyone’s healthcare system. For healthcare providers and the insurance companies but also for the patients. It is just part of our company’s culture, evidenced by our philanthropic efforts to help our community with scholarships and mentoring. We want to improve things.

It is a great catalyst, but it’s not enough. The marriage of a genuine desire to improve the healthcare system’s efficiency with the ability to execute with novel technology is one of the things that sets us apart. I think Availity has been running one of the most efficient clearinghouse processing systems in the country, and this has contributed to a big part of our growth.

Also, we are at the nexus of a gigantic network that connects healthcare providers and health plans. And this is another thing that sets us apart from the rest. If a provider wants efficient connectivity to a health plan so they cannot only submit their claims and get paid but also interact in meaningful ways with them, Availity is the obvious answer. Earlier I said that we want to present the right data to the right person at the right time. It crystallizes what we are trying to achieve with our next big steps in innovation, providing users with a meaningful experience, both enjoyable and productive.

 Who are the other players on the market that compete with Availity?

Many companies compete with us. Some companies are bigger, and some are smaller. And, of course, many little startups are trying to play in this market. It is critically important to understand that exchanging administrative and clinical transactions has mostly become a commodity. It is not a differentiator. Nobody feels strong emotions towards a clearinghouse, good or bad. At Availity, we have been thoughtful enough to build an efficient clearinghouse implementation at the core of our products.

What differentiates us and drives the demand for our offering has been the size of our network. It creates gravity, attracts providers and health plans. It is big enough that it makes sense and is beneficial to our customers. We take advantage of our network’s size, combined with data analytics capabilities, to provide that great experience to our customers that I’m talking about – exactly the right data when that person needs it in their work. 

What changes can you envision in the post-COVID 19 healthcare system?

It is still very early to talk about that kind of stuff. But during the confinement periods, there were substantially fewer claims filed, so there was a very substantial drop in our normal volume. I think when we go back to this data towards the end of the year and look back at the entire year, we’ll find out that it all evens out. I do not think that it is going to create additional demands. Now, I think there are several possible outcomes of the COVID pandemic. New products will likely be developed based on what we’ve learned, not necessarily about COVID 19 specifically, but maybe around sharing statistics faster or data, in general, to help curb and manage future pandemics.

Can you think of any challenges for startups in your domain?

It would be very difficult for a startup to be in the same space. They could probably most likely be in a peripheral space and possibly even work with us and use our network to achieve their own goals. 

There are internal conversations that we have within my team as we start talking about what the future looks like for Availity, and how do we help if the ultimate goal is to make healthcare better? How do we enable other companies with similar goals to make healthcare better, achieve their goals, and not necessarily compete with us? It goes back to data and making that data accessible. Therefore, if we can present an API that a new startup could use to access the data that we are allowed to share with them, we would become a partner and an enabler. I think we all benefit from it. As a patient, I deal with the healthcare system, and I want it to get better.

Technology evolves constantly. When there is a breakthrough, I know what everybody else knows, the basics. So when I prepare a technology shift towards something drastically new, I invest hundreds of hours of learning. It may mean working almost every night, every weekend. What is important is all the knowledge that I get that I did not even know that I did not have. It is what leads to standing in front of everybody at Availity and being able to say, “I know where we’re going, come with me.” When it comes to effecting change, it falls upon everyone to exercise passion and acquire the necessary knowledge. 

Often a company’s first reaction is to go seek consultative arrangements outside to come and help. In my opinion, that is a recipe for disaster.

You need to know where you want to go, then go and possibly get help to achieve it. Do not get help to be told where you want to be because the company’s culture will not be part of the solution. The company’s DNA is not going to be part of that solution because those consulting companies simply do not know it. If you want a truly powerful outcome, then you need to be able to blend that culture, company capabilities, and the vision you are pushing for.

Michael, thank you for providing your view on the healthcare services and your determination to make them smoothly connected.

Stay tuned for the next interviews!

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