A conversation between Geoffrey Kuhn, Chief Actuary and Analytics leader within Aon’s EMEA health practice and Prof Mike Rosenberg, member of DocHQ’s Advisory Council, Strategic Management Professor at IESE Business School.Employee health and wellbeing and decision making based on analytics A conversation between Geoffrey Kuhn, Chief Actuary and Analytics leader within Aon’s EMEA health practice and Prof Mike Rosenberg, member of DocHQ’s Advisory Council, Strategic Management Professor at IESE Business School,
DocHQ is a health tech business that offers a range of digital health solutions for companies with the aim of improving employee health and productivity and also caters to individual health needs. Our mission is to provide patient-centred healthcare with scalable and secure technologies to enable better health outcomes for everyone.
We have recently launched a new podcast series called ‘Health Tech for Businesses’ where we will be exploring topics affecting healthcare like AI, Data privacy, health equity and digital health solutions for businesses.
The fifth episode of Health Tech for Businesses is a conversation between Geoffrey Kuhn, Chief Actuary and Analytics leader within Aon’s EMEA health practice and Prof Mike Rosenberg, member of DocHQ’s Advisory Council Strategic Management Professor at IESE Business School in Barcelona, where they talk about the meaning of employee health and wellbeing and decision making driven by data science and modelling.
An edited transcript of the podcast follows. For more such conversations, subscribe to the series on Apple Podcasts or Spotify.
Gopika Sampat : Hello to everyone from DocHQ. I am Gopika and welcome to our podcast ‘Health Tech for Businesses. In continuation with our COVID series, our discussion today will closely focus on how Aon handled the crisis. Aon is the leading professional services firm offering a range of financial risk mitigation products, including insurance and health insurance plans. And we will also be looking into other areas like decision making based on data science and modelling, the meaning of employee health and wellness in these times, and more. So today, we will be doing things a bit differently. I will be taking a backseat and this episode will be more of a conversation with our guest, Geoffrey Kuhn from Aon insurance and this will be driven by none other than Professor Mike Rosenberg from IESE Business School. Geoff is the Chief Actuary and Analytics leader within Aon’s EMEA health practice, and he has nearly 20 years of Employee Benefits experience. He holds the strategic responsibility for the direction of Aon’s global health analytics solutions and is also responsible for the rollout of analytics solutions across EMEA. His expertise lies in several areas with health and benefit program design, claims analytics, and actuarial analysis being some of them. So, it is great to have you here, Geoff, and thank you for being a part of our podcast today.
Geoffrey Kuhn : Thank you. Great to be here.
Gopika Sampat : Moving on to Mike. Mike is a professor in the strategic management department at IESE, where he lectures both in the MBA and the Executive Education programs on the topics of strategy, geopolitics, and sustainability. He is also a member of DocHQ’s Advisory Council and has led several webinars and thought leadership sessions on the COVID pandemic, and its impact on businesses. Happy to have you here once again, Mike, and thank you for joining us.
Mike Rosenberg : Thank you, Gopika.
Gopika Sampat : Yes, over to your Mike.
Mike Rosenberg : Okay, thank you so much. So, Geoff, thanks so much for being with us today. Maybe you can tell us a little bit. What is global health analytics? What does that really mean in English?
Geoffrey Kuhn : Yeah, it is a great question. It is a great place to start, Mike. So from my perspective, in my role, what we do is we work with a lot of employers across all different industries, to help them really understand the health of their people, and how to address their population health needs. So, some of that will come through employee benefits. They are offering medical coverage; they are offering disability. Some of it will come from how you design the workplace. Some of that will come from wellbeing programs, but we are really looking overall at an employer – employees being a key part of what they bring and what makes them really different as a company. And then how did that employer best take care of the health of their people.
Mike Rosenberg : Now this thing – SARS CoV-2 or COVID-19, or the Coronavirus or whatever people are calling it these days, has infected something like 21 million people, there’s three quarters of a million people that have died of this thing. How has that impacted the world of professional health? I mean, companies are trying to keep their people healthy. And now this this thing is sweeping across the world. We have had shutdowns, we have had health measures, you guys must have been pretty busy over the last six months.
Geoffrey Kuhn : It has been a busy six months for us. And for everyone, I am sure. So, the impacts have been big, and they have been felt by obviously employers across the board. The way this is going to impact industries, it is huge. But from the health area where we focus it, I say there are two primary impacts. There is obviously the direct COVID-19 impact of it. So how do you manage that? And what do you do to keep people safe? And as you start to bring people back, how do you look after their safety? And how do you kind of measure and monitor all that? How do you deal with all of the uncertainty that goes along with it? But then the other piece that really comes to the forefront is overall employee wellbeing. And that’s something that companies have talked about for a while, but COVID has really kind of thrust at the forefront in terms of now that people are no longer in the office, how do you look after their mental wellbeing? How do you deal with their physical needs, their emotional needs, all those things that as we become more disconnected, as a lot of us are working from home and working remotely and connections, they’re kind of slipping back a little bit, that’s become a bigger focus to it. So, it is how do you deal with the immediate impacts of COVID from a health perspective, but then there is also a broader focus on overall employee wellbeing and really how employers can play a role in shaping that. And really, they are doing it in a way now that is very different. Go back 12 months, you would have planned a program in the office, and you would have had people there and a completely different world that we are working in.
Mike Rosenberg : Let me start with that first issue about keeping people safe because I guess the impact has been so different in different industries. You have got some companies which have people facing the general public. Everybody is in the back office. How have you seen that play out in terms of the different industries and even the different countries, which you guys are working with?
Geoffrey Kuhn : It varies quite a bit by industry, by country, by type of population that you have. So, a lot of what we have seen companies do is to really measure different scenarios here, there are some things that we have done with companies. And there’s different ways to do it. But we have done some employee impact modelling, where we will help take an employer’s population and model out what the COVID impact could look like. We will do it in terms of mild cases versus more severe cases and that will be specific to their demographics and their industries. So, you can see that there is obviously a ton of unknowns. So, my advice with that is, there is a lot of uncertainty that will involve multiple scenarios, but we can definitely show a company how this will look over different times. And then you have the industry differences, too, you have places where we’re working with financial firms, for example, and their experience is a lot better than what you’re going to see an average because maybe they shut down early, they’ve kept their people home versus you have people that are on the front lines, and you’re looking at much higher infection rates and how to manage it. So, it starts with shaping up for the employer, probably the next place to go is helping them to understand the underlying health risk apps in COVID-19. And what I mean by that, as we know, a lot of the risks that people have for diabetes to name one makes COVID worse. So really doing a health risk assessment or looking at your medical claims data to understand how prevalent some of these risks are, then helps you get another way.
Mike Rosenberg : Sorry to interrupt you, do companies know, the health risk profile of all their people, I mean, do they know what percentage of the people have diabetes? What percentage have existing lung conditions? I mean, isn’t that information private?
Geoffrey Kuhn : So that is and so you are not going to know it at an individual level to be clear. So, you know, you will never know that at the individual level. What you can get from a carrier from a management level reporting from your insurer usually is a population profile view, you’ll know by location, yes, 20% here, 15% here, but you’re not able to track it back to the individual.
Mike Rosenberg : Okay, so my business school won’t know anything about me, but they might know that in the professor community, so many professors over the last few years have filed claims in this area, so they can do some statistics based on that, I guess.
Geoffrey Kuhn : Definitely. Right. So as an example, I would not know a certain person has diabetes but around 50% of people have a complex diabetic condition. And employers typically will want to know that because they are going to put in place programs to manage it, so they will know if this is our biggest risk and offer a program to manage it.
Mike Rosenberg : Sure. And now on the second part of this whole story wellbeing – because wellness and okay yoga classes and maybe fresh fruit in the cafeteria, that’s kind of like level zero. When you talk about wellbeing you’re going way past that, I guess, and you’re talking about psychological health and all this stuff, and then you have the stress of everybody working at home, or just being worried about what’s going on in the world or with loved ones. Is that all part of wellbeing?
Geoffrey Kuhn : Yeah, so that is all part of wellbeing. So, when we talk about wellbeing, we do it from five different dimensions. And this is one of those things that different people are going to place it in different ways. But we will talk about it from a physical perspective. So now the physical stuff that goes with it, there is an emotional component to it, there is a financial component to it. And these things all start to interrelate. There is a social component to it, which is extremely stressed during this time. And then there is the kind of the professional career development component. And so holistically how are people’s needs being addressed across all five of those. And you see a lot of connections, there is some data out there. And this is consumer financial protection data, that they looked at. They look at finance, and then people’s self-reported health scores. So, people in the lowest 20th percentile from a financial score perspective, their health scores are far lower than somebody who is doing better financial wellbeing. So, there is those connections that we can see across the data. They are really key that employers are looking across all of those things.
Mike Rosenberg : In these series of webinars, we are doing with the business school and the press and many different things, what we see very clearly is that different types of people have been going through this process better than others. It has not been very fair. So that if you live in a big house with a nice garden and plenty of Wi Fi and plenty of money, you know, your experience has been one and if you live in a tiny apartment with two little kids, you know, it’s just different. Have you seen that in your data in your work with companies that this is just not very fair, the way this thing has been playing out?
Geoffrey Kuhn : Yeah, definitely seen differences. It impacts different people differently based on the environment that they have been set up in and kind of what they have available to them. So that is it as we kind of reached this thought, now we are in different places, different segments are going back to work and some people always have to be at work, you know, essential workers. That is something that does come to the forefront. There are probably people who can adapt better, maybe fine working from home. But then there are people where it is just not the right thing, personally because of the work environment that they have.
Mike Rosenberg : Because of the home environment, you know, because we are working in our house, and some people have more house than others. In terms of management, and this was one of the questions that Gopika wanted me to touch on – the managerial responsibility and the role of the CEO and the head of human resources and these kinds of folks, I guess you’ve seen lots of different characteristics of different senior management’s responses. Can you talk a little bit about what best ones have been doing? I am not sure I am going to ask you about the worst ones. But some of the most, you know, the leaders who say these guys get it, what are the ones who get it? What are they been doing? What questions have they been asking you to help them solve? And what have you seen them doing with their work?
Geoffrey Kuhn : Yeah, that is a good question. And the first thing that comes to mind, and this is always going to come to mind – communication has been critical in terms of getting the right message out to the right people. I think that has been tough. I think the other thing that has been helpful is companies that have had more of a focus on their employees from the wellbeing perspective, were a little bit able to transition a bit quicker.
Mike Rosenberg : So companies are already thinking about some of these five dimensions that you mentioned, rather than ones which are just strictly on a, you know, you call in sick or you show for work kind of people, I guess?
Geoffrey Kuhn : Correct. Employees can feel that they can be most productive in this environment where they feel like their employer cares about them. So, it is, you know, showing that you have that level of care and connection to your employees – you build that up over time. And it is helped to transition as best you can give for what everyone is going through.
Mike Rosenberg : And then what else have the best leaders been doing? They have been communicating, they have been looking at wellness as a holistic thing. What else would you say that they have been doing well?
Geoffrey Kuhn : I think those pieces are there, I mean, this is perhaps my bias as an actuary, so I am a data guy. So, it is not always going to go for the people who use data. But I think that has been another key thing that has come up here is looking at what you can do from a data perspective. So, understanding modelling out how the impact of this is going, I think that just helps you prepare for different scenarios, different future outcomes. And this is something that early on, there was some thought and discussion that we are going to have one wave and things will kind of tail off in there and die off. I think we have seen spikes up in parts of Spain or we have seen spikes in the UK, we have seen local lock downs. And I think it is the kind of that data mindset of ‘okay, let’s work out different scenarios been really helpful in planning to some of these things’.
Mike Rosenberg : Now, I am told by the experts that these spikes we see at least in this country, are more about better testing, perhaps, or just as much about better testing is actually more people getting sick. Because in fact, the intensive care units are not overwhelmed. You know, the situation is not as bad as it was here in March. But anyway, on this issue of data, because the guys at DocHQ, I mean, they’ve got this tremendously sophisticated model where they can kind of model a workforce and estimate the likelihood of this and then kind of test different actions to maximize the ability for people to continue to work and for the company to continue to run to minimize the health risks. Is this the kind of data analytics, data mining that you see people using?
Geoffrey Kuhn : Yeah, it is. I think there is a need for data and a fit for data. I think that is something that’s kind of getting more and more focused now. It’s also one of those where we’ve talked a lot about data but data is not used as much in terms of designing benefits and kind of overall strategy, probably, as it should be, again, admit my bias in this one, but I think most companies that we talk to, whenever we do surveys, 20%, 30%, maybe 40% of employers will tell us that they have a strategy that’s based on data and that’s just a general comment and that’s not COVID-19 specific. But I think employers get the importance of it. They are slowly adopting more and more things that will pull data in just to how they design their overall benefit program. I think COVID in a way has pushed that and it’s pushed in some good ways, in a sense, it has pushed that there is a lot more focus on data and managing things and the dashboard that you’ve talked about will come into play.
Mike Rosenberg : Now, you know, we look at the five dimensions that you guys measure for wellbeing, I can understand you get lots of data on physical, tons of data on financial, maybe on professional, how do you get data on people’s emotional state and their social wellbeing?
Geoffrey Kuhn : So, there are a few different ways that we do it, it is going to depend who a company is working with. There are different apps, there are different platforms that a lot of employers will offer. We have something called Well One as an example, which is an app any employer can get you to offer to your people. This is based on some AI coaching, it is going to pop up, it is going to give me a message every day asking me a different question. Some of them are going to be around health, I get a question on nutrition and some of them are going to be around how I feel on that particular day. So, there’s ways you can engage through apps, there’s other apps out there, that will do it. So, it is things like that. That is the typical way to capture some of that information. Some of it you can get from claims data, although by the time you see it in a claim, it has been a problem for a while. So that is where some of these apps and some of that digital technology is going to capture far more quickly than you will actually see it flowing through the claim.
Mike Rosenberg : And then the data do you see people happier when they go to work? For example, I was teaching online for months. And I know people who have never been to their new office. And have got a new job after graduating the business school and everything has been virtual. Do you see an impact? Are there correlations between being at home and doing so much zoom and not having enough social interaction? Or do you see people happier when they go to work? Is it too early to tell? Or do we have data on that kind of stuff?
Geoffrey Kuhn : I think it is probably too early to say that we have anything really solid that locks us down. I think, for a lot of people, it is a struggle. And you are going to have different people who view it in different ways. But I think there definitely is a bit of a struggle with being at home. I think one thing that we did recently, we did a survey of 2500 different employees across UK, Bangor in Maine, and couple other major European countries, and it was all around what makes people be resilient. So, what are the things that helped to lead to resilient workers and one of the keys was having strong social connections with your workers essentially feeling like you have friends in the workplace. And that’s something that I think is easy to do when you’re there, you know, I’m sitting next to you, Mike, we can chat far more often, if we have zoom to do this and it’s going to be a different relationship. So that is where I think there is some concerns for it. Not a ton of data around it. But just the idea that that is such an important part of resilience is a concern.
Mike Rosenberg : One of the things that I have heard from executives through the crisis is that they have actually, in some cases grown closer to their direct reports than ever before. Because they are speaking to them deliberately, because they are making time to check in with them. And they are saying, no, no, I want to talk to you and see how you are rather than just assuming that they are going to have that conversation eventually. And they are speaking to people in their homes. So, if you are talking to someone in their home, and you are asking them about the picture on the wall, you ask them about their little baby. And this is anecdotal. But I get some sense of senior executives who are saying, this has been amazing for me, because first time I’m actually recognizing some of my people as people, rather than financial directors, or sales directors or manufacturing directors. I do not know if that data has gotten through your actuarial tables or not, but I have heard that several times.
Geoffrey Kuhn : I can definitely see that I think it is where you are going to have very different experiences based on who you are in person.
Mike Rosenberg : And for you guys, are you guys virtual? Are you guys face to face? How is Aon been dealing with this? What’s been your own company’s path through this whole thing? You guys measure your own wellness, I mean, you have a whole thing in place?
Geoffrey Kuhn : So yes, we do. Early on, at some point in March, we went to remote working, essentially everywhere. So, across all of our global offices, you know, countries around the world, we move to a full remote working environment. And so that has been the norm. And that’s kind of been the case across all our countries since March. I think more recently, what we’ve done in different places, as things have become a bit more under control, we’ve started to open up some offices, we’ll do some at 25% capacity, somewhere, we’ll rotate people in there for a week, and then somebody else will come in there for the next week. So, try and fill them with the capacity, starting to open stuff up a little bit more. But yeah, from a work environment, we are all here, we are all working from home. From an engagement perspective, we have done a lot of things that we were talking to our clients about doing we have had a big focus on emotional wellbeing and mental wellbeing. We have done a lot to train our managers on how to talk to people in a different way. So this maybe gets a little bit to your point but a lot of times the person now they’re having contact with their manager but maybe not too many people around them and their co-workers so how their managers have different discussions with people to really check in on them in different ways. So, we focus a lot on that. We have done some wellbeing challenges.
Mike Rosenberg : Challenges around eating right and getting exercise these kinds of things, yeah?
Geoffrey Kuhn : Eating right ,doing you know certain little bits of exercise. You can do some social connection bits as part of our wellbeing platform, you’re able to kind of tag friends and take photos around your house or your garden and like other people’s photos, you can track and all that stuff is going on.
Mike Rosenberg : Some companies are having like cocktail hours where everybody gets a cocktail in their kitchen and comes in and gets on zoom and has a cocktail together, which isn’t very healthy, perhaps but it’s socially very beneficial perhaps.
Geoffrey Kuhn : It is, yeah, I mean, I’ve been on a few calls with my remote team where it’s like, you know, it’s a Friday at five o’clock, we’re going to sit there and have a social call.
Mike Rosenberg : Okay, now where do you think this is going? Because you know, there is a lot of work on the future of work before the crisis. And you know, the advent of AI and automation in general, the ability to work from home, which we had already developed, and then the real question of whether we need offices at all. And many people have said that this whole thing brought 10 years of digitalization, in just a matter of months. Do you guys see already some trends where maybe you have extra office space and don’t actually need five floors anymore in this building? And can do with one floor? Have you seen companies starting to make those kinds of choices yet? Or is it still too soon to tell?
Geoffrey Kuhn : I think, yeah, I think you would be interested in what you are hearing from others as well. But I think we are seeing that already. And I think already we are seeing some of the companies we are talking to that is not going to be going back to business as usual. By the end of December, we will be back in the office at a 100% capacity, but we only need X percent of the capacity that we had before. So, I do think that changes the dynamics of people being kind of remote and working remote, I do think that is a change. And is a lasting one that would have taken years and years to fully come about that was pushed pretty quickly. But I don’t see things slowly going back, I think, same thing in terms of business travel, most likely, a lot of companies that were heavily invested in business travel before, are going to turn to a different way to communicate and connect with people.
Mike Rosenberg : I run a program for CEOs, and one of them told me he is never traveling again, he is typically going from country to country because he has got different people in different countries. And he has not done that in six months. And he says, you know what, I do not have to, anymore. If you look at even the business school, so I do not think any of my colleagues in the faculty are planning to go back to work every day forever. And then the question becomes, if not everybody is going to be in the office every day, do they need an office? So, can they share offices and have pools of offices and just have a desk and have a little box? And then you say, well, actually, I do not need all this space. And then the implications are enormous, for actually the way cities are built and the way we organize ourselves as a society. So, this thing could have, you know, tremendous impact over time. Now, I am not sure if it has hit the actuarial tables yet. Because I guess, statistics come after reality. Right?
Geoffrey Kuhn : Yeah, we are not going to be thinking that for a bit. But I mean, if we just look at what’s going on around, I can easily see the case where people are not coming back, you know, it’s a different environment, it’s a different working environment, from that perspective. And the other thing that I think is interesting, and that I could see playing out pretty heavily here is more of a shift towards virtual nature in terms of healthcare. Are there things that you can do to talk to the healthcare provider remotely, that can work for everything clear on that, but are there places where I could hop on a zoom call with a doctor near me, far away from me, whatever kind of talk through some problem I’m having pretty quickly, pretty simply, rather than having to lug over to an office and wait and see them and come back. And I think that we are going to see a lot of continued shift in terms of virtual healthcare and how we can provide it again. Does not work for everything, clearly won’t, but I think you will suddenly see that the basic ways to interact with the healthcare system are going to probably change as a result of this as well.
Mike Rosenberg : Absolutely. We had the lady running a Chinese virtual session on my other series of webinars with the business school. Biggest year ever, they have had five years of growth in months. What other changes do you see happening in the healthcare business? Because you know, as an insurer, you guys have you know, the role to assist the government, the insurance companies, and the providers? What are the changes you see or does Aon see in health care over the next five to 10 years?
Geoffrey Kuhn : I think, if we look at it, obviously, the impact of covid has been huge, anything, what we’re seeing now is generally, and this is probably true across most countries, a large drop in some of the services for the first half of 2020. So very low utilization of other services, because COVID has been such a big focus. So that’s kind of pushed things down, I think then what we see from here, then it becomes a lot of discussion around how we see things, services ramping back up and coming back up, but maybe not all the way up to where they used to be. So, there is probably a bit of a new normal, where things are up but not up to earlier level a little bit different, a little bit more virtual going forward. I think we see kind of that ongoing effect throughout the healthcare system there. And that I think, really the biggest thing that we see and this is going to link back a little bit more to the overall focus on employee and their health is just that focus on how you keep people healthy. I think that has kind of been one of the things that COVID has exposed – unfortunately, it has the biggest impact on people with chronic condition. Some of those are lifestyle related. So, it is a bit more focused on preventive care.
Mike Rosenberg : And the other side of that, of course, is the data, which you mentioned earlier, which is a lot of what I guess healthcare is going to be in the future and understanding who has which conditions and what the probabilities are, is going to be very heavily data driven to make sure people get the care they need. And then not to spend money on people who do not need it.
Geoffrey Kuhn : Yeah, definitely.
Mike Rosenberg : Fantastic, Geoff. So, our friends at DocHQ are developing a whole suite of products and services to help companies do exactly that. Any other comments that you have on where all this stuff is going? And what do you think is important?
Geoffrey Kuhn : You know, we have had a ton of thought, and we are seeing so many different ways that this is going from an employer’s perspective. Maybe a couple of other comments and thoughts in terms of, we spent a while talking with different employers around what the employee value proposition looks like, as we start to move back into a recovery phase and you start to bring people back and you’re still looking for work and for talent – what’s going to be key in how you differentiate yourself as an employer? And the things that come up on the top are things that, you know, are in some ways, probably not surprising, but I still think that there is a really strong sentiment around employee safety. So, 91% of people said employee safety was going to be more important, communication was right up there. And then it gets back to the wellbeing and it being 84% around wellbeing. Flexible work life balance and work environment are up in the top. So, it is that view that we want to make sure people feel safe, and then feel we are looking after them holistically. Some of the other more traditional things, you know, more traditional benefits, retirement benefits, those things that are lower on the list of how employers will define the employee value proposition going forward. So I think it’s interesting always, for me to think about those stats and show you just how strongly employers across the board are feeling this in terms of changing you know, what their employee means to them.
Mike Rosenberg : And I guess part of it is to do the right thing for employee wellbeing and the other thing is to tell the employees what you are doing and make sure that they believe you. Because you know Glassdoor and all that kind of stuff is what people think, not necessarily what you know. So, you can make sure that the communication is there. And people say this is a wonderful place to work, it keeps me safe, they care about me as an individual. And they are worried about my wellbeing, which is to do it, but also to make sure people know you are doing it and make sure that they perceive benefit.
Geoffrey Kuhn : At the same point, you can go back to one of our other surveys. One of the things that we surveyed, we surveyed 2500 people from different countries, we also surveyed employers. So, we did a similar survey of employees and employers. Employers feel like they are doing much more for their employees than the employees feel like the employers are doing for them.
Mike Rosenberg : Yeah.
Geoffrey Kuhn : And then every employer feels like they do something for their employee health and wellbeing. A lot of employers do not feel like the employer is doing that. So there definitely is a gap from what has been delivered and to the communication piece of it.
Mike Rosenberg : Sure if you’re going to win the war for talent, you’re not only going to have to do stuff, you’re going to have to make sure people know you’re doing stuff and that they value that otherwise, they’re not going to tell their friends to please come work here, because it’s a wonderful place and they are keeping us safe. And they have all these great algorithms, and they have all this great data. You got to do both.
Geoffrey Kuhn : Yeah.
Mike Rosenberg : Geoff, thanks so much for joining us on the webinar. And really, I wish you luck with all of your projects. I think the work you guys are doing is very important for employers and very important for employees and very important for the planet. So, thanks, for all the work you are doing.
Geoffrey Kuhn : Thanks, Mike. Thanks, Gopika