Driving Disruption: Virgil Bretz Of MacroHealth On The Innovative Approaches They Are Taking To Disrupt Their Industries

An Interview With Cynthia Corsetti

Change the Mindset: we want healthcare payers, plan sponsors such as employers, and consumers to stop reactively paying medical bills and claims, and instead start seeing themselves as professional buyers that must proactively and intelligently buy healthcare — the right healthcare for them — by leveraging data and building smarter and more connected supply chains.

In an age where industries evolve at lightning speed, there exists a special breed of C-suite executives who are not just navigating the changes, but driving them. These are the pioneers who think outside the box, championing novel strategies that shatter the status quo and set new industry standards. Their approach fosters innovation, spurs growth, and leads to disruptive change that redefines their sectors. In this interview series, we are talking to disruptive C-suite executives to share their experiences, insights, and the secrets behind the innovative approaches they are taking to disrupt their industries. As part of this series, we had the pleasure of interviewing Virgil Bretz.

Virgil is co-founder and CEO of MacroHealth, a platform healthcare fintech company. He has more than 25 years of entrepreneurial and executive experience in the American and international health technology and insurance industry. Previously he was a co-founder and Partner at VIDA Health Ltd, a health insurance, technology and capital advisory firm which was merged into MacroHealth in 2017.

Thank you so much for joining us in this interview series. Before we dive into our discussion about disruption, our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?

I always knew that I wanted to be an entrepreneur. To help pay for school, I worked at a health insurance company while attending university in Toronto, Canada. I loved learning about business but wasn’t a very good student, because I was always working and thinking about the business of business. I was an “Alex P. Keaton” type of kid who wore a tie in public school and read the Wall Street Journal. After annoying my friends and family with dozens of ideas, I finally had one worth acting on. I pitched a classmate on the idea, and we ultimately quit our jobs and leveraged our student loans as seed capital to set up a healthcare IT business that managed healthcare costs for Canadian health insurance companies. At the time, our families were disappointed that we dropped out of university to pursue this ‘crazy’ idea. It made sense to us, of course, and thankfully it all worked out. A dozen years later we successfully sold that business to a large health insurance company, and our families finally relaxed on the topic.

What do you think makes your company stand out? Can you share a story?

Most of us can relate to all or part of this storyline in the current US healthcare system: I had a hard time finding the right healthcare provider, it took a long time to get an appointment, and I had no idea how much it really cost or how much I was supposed to pay; and it was expensive. I think everyone has a strong opinion on how ‘broken’ the US healthcare system is, and that it desperately needs disruption. However, what most people outside the industry do not fully appreciate is how inefficient and disconnected the administrative and financial side of the healthcare industry is. Most data moves between healthcare payers, providers, and thousands of supporting intermediaries on 30-year-old technology that simply cannot support the real time information and consumer experiences that we all expect in all other dimensions of our lives. For example, we expect our mobile phones to deliver a trusted car ride in five minutes and securely take care of all the payment settlement details. That is mostly impossible in healthcare today.

MacroHealth is a B2B company working with healthcare payers and other health market partners to optimize and connect their healthcare marketplace ecosystems. Our vision is to use data and modern system connectivity to help create a healthcare system that is transparent, efficient, and affordable- where all people get the right care, at the right provider, at the right price.

You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

The first ‘character trait’ that I need to credit is actually a real ‘character’: nearly 30 years later and across companies, I still work every day with the same co-founder from our first business, David Angelone. I don’t think I would have experienced the same success without David, and I know it would not have been as much fun.

A second trait for company or organizational founders- the people who try to turn nothing into something, is the concept of ‘entrepreneurial naivete’. You have to be just dumb enough to start a company, because if you knew what you were about to get into, you would never do it! (i.e. trying to make payroll in your 20’s…not fun).

If I can only choose one more character trait, then it would have to be the ability to seek out and surround yourself with people who are smarter and more capable than you are. I have been, and am, incredibly fortunate to be able to work with teams of talented people.

Leadership often entails making difficult decisions or hard choices between two apparently good paths. Can you share a story with us about a hard decision or choice you had to make as a leader? I’m curious to understand how these challenges have shaped your leadership.

Several years ago, MacroHealth’s founders were sitting around a dining table celebrating the strong year we had just completed. We were a small, yet very profitable and growing, tech-enabled solution that was 100% founder owned. Work was fun and life was good. The decision ahead of us was whether to continue on that path, growing incrementally on our own, or to make a larger bet by taking on outside capital to transform our business into a scalable SaaS platform that could have a greater impact on optimizing and connecting the healthcare marketplace. Choosing to go bigger meant investing many millions in a strategy and technology that might not be successful; it meant dilution of equity and control, and the unknown of bringing on new partners. After that dinner, we decided that those risks were small compared to the opportunity to do our part to help change the healthcare marketplace. A bigger mission to realize disruptive change would require a larger organization with more people, partners, capital and technology.

In the context of a business, what exactly is “Disruption”?

Disruption can come in many forms, but I’ll focus on a positive meaning: new opportunities to create better lives and value from innovation and technology. In our case, we are applying innovations in data science and interoperability to create a more intelligent healthcare marketplace.

How do you perceive the role of ‘disruption’ within your industry, and how have you personally embraced it? Is it a necessity, a strategy, or something else entirely in your view?

In the healthcare industry, embracing disruption is 1000% necessary today because multiple disruptive technologies, and their marketplace ripple effects, are already all around us and impacting every part of our lives and organizations. We are all seeking clarity on how to make sense of our industry’s digital transformation. I know ‘digital transformation’ already seems like an old term, but I still hear it regularly from many of our customers who struggle with the challenge and opportunity of health industry data creation that is massive, accelerating, ubiquitous, and liquid. What should they do when consumers want real time provider appointment scheduling on their phones (and you have 100,000+ providers in your provider network)? What should they do when petabytes of competitive healthcare pricing data are suddenly made available online, and everyone can see each other’s competitive position at a micro level? Rapid change is happening whether we like it or not. To survive, let alone succeed, we are all investing to lead in our respective areas of focus.

What lessons have you learned from challenging conventional wisdom, and how have those lessons shaped your leadership style?

I have often learned the hard way that creating change is a team sport. To turn an idea that is in your head into reality, you will have to communicate that idea to other people successfully enough that they will join you in what might seem like a counterintuitive or even crazy idea. Just as important, you must be open to listening carefully to the input of your team to adapt the idea to allow it to become a little bit better, every day.

Disruptive ideas often meet resistance. Could you describe a time when you faced significant pushback for a disruptive idea? How did you navigate the opposition, and what advice would you give to others in a similar situation?

Back in the 1990’s, there was greater separation between healthcare payers and providers. In the marketplace, there was an atmosphere of antagonism between these parties when negotiating business terms and prices. There was a pervasive zero-sum, win/lose approach to these relationships. We wrote a white paper about the value of building win/win relationships between payers and providers (an exact opposite approach) and received some cynical ‘get real’ pushback from some people on both sides. Our response was to simply keep working to build a company that leveraged this different mindset to deliver strong results. The lesson there was to stay committed to our mission, and deliver.

What are your “Five Innovative Approaches We Are Using To Disrupt Our Industry”?

• Change the Mindset: we want healthcare payers, plan sponsors such as employers, and consumers to stop reactively paying medical bills and claims, and instead start seeing themselves as professional buyers that must proactively and intelligently buy healthcare — the right healthcare for them — by leveraging data and building smarter and more connected supply chains.
• Build a Platform that Creates Intelligent Health Markets: we have built a unique SaaS business model that we call a Health Marketplace as a Service, or ‘HMaaS’. To compete, every healthcare payer has to build out their own unique marketplace ecosystem of providers, networks, and other health market partners. We are the first to build the software and data platform to intelligently manage this ecosystem.
• Disruption Should Pay for Itself: We have deliberately built a maturity model for our customers and our industry that identifies measurable marketplace waste and savings, eliminates this waste, and then reinvests these savings to fund the next wave of innovation to identify more savings, creating a virtuous cycle.
• Optimization is Ten Times as Valuable as Analysis: there are many companies gathering, organizing, analyzing, and presenting data. This is necessary. But we find confusion, and frankly frustration, from health market participants on what to do with the data to make it actionable. We focus on identifying and operationalizing the actions necessary to realize the suggestions identified in our analysis. We call this Optimization.
• Replace Custom Code Development: we have built a platform to connect health marketplace partners within an ecosystem. We replace custom, non-reusable point-to-point connections between partners with cloud-based, reusable connection components. The long-term goal is to achieve real time data liquidity and visibility. This is necessary for our industry to deliver the experience that consumers demand.

Looking back at your career, in what ways has being disruptive defined or redefined your path? What surprises have you encountered along the way?

Like so many other people, after the last 30+ years of working during a period of great change, disruption and change feels like the only constant! Perhaps the greatest surprise is that disruption is accelerating. There are so many disruptive technologies now that are compounding on each other to accelerate change. For example, innovations in AI enable innovations in gene sequencing, which then drive new business models in medicine, which then drive changes in healthcare finance. It is tough to keep up. So, this increases the fundamental responsibility of organizational leaders to ensure that they help their teams and partners to grow and come along for the journey at the same accelerating pace.

Beyond professional accomplishments, how has embracing disruption affected you on a personal level?

Personally, disruption can be a lot of fun. Throwing myself into the potential risk and discomfort of new challenges is exciting. It has also built resiliency in a world that is rapidly changing anyway. My wife and I have moved our family cross-continent three times over the past three decades. Each of these transitions were ultimately for the benefit of our kids, but the benefits of change rarely came without challenges. We had to leave our comfortable environment, habits, and relationships. There were tears and frustration. But we also met new friends, saw new places, and had new experiences that have been emotionally and experientially rewarding.

In your role as a C-suite leader, driving innovation and embracing disruption, what thoughts or concerns keep you awake at night? How do these reflections guide your decisions and leadership?

My greatest concern is the happiness of the people that trust us: our teammates, the people who work in our customer and partner organizations, our shareholders, our community. Our leadership team has to constantly question how the application of these disruptions will benefit the people who care about MacroHealth’s success. Are the people within our customer organizations happy with the new platform products we have built? Are we helping them navigate a very disruptive healthcare marketplace? Are the people on my team happy with what we are doing and why? I want people to be happy.

If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

At MacroHealth, I get to be a part of an organization of people and partners with a vision of optimizing and connecting the healthcare marketplace. Our work is important. That said, I wish society could wave a magic wand to ensure that every person has the opportunity to eat nutritious food and the time to adequately sleep and exercise. The healthcare industry is a modern miracle of skills and technology to cure and heal, but many of us in this industry appreciate the larger underlying need to keep people healthy in the first place. Our collective mindset is still prioritizing fixing problems instead of preventing them.

How can our readers further follow your work online?

To learn more and stay up to date on MacroHealth, visit our website (www.macrohealth.com) and follow us on LinkedIn: https://www.linkedin.com/company/macrohealth

Thank you for the time you spent sharing these fantastic insights. We wish you only continued success in your great work!

About the Interviewer: Cynthia Corsetti is an esteemed executive coach with over two decades in corporate leadership and 11 years in executive coaching. Author of the upcoming book, “Dark Drivers,” she guides high-performing professionals and Fortune 500 firms to recognize and manage underlying influences affecting their leadership. Beyond individual coaching, Cynthia offers a 6-month executive transition program and partners with organizations to nurture the next wave of leadership excellence.