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Dave’s Daily English Transcript

5.22.2020 Dave Wichmann: Good morning and welcome on Friday. This is going to be our first edition of Wick’s Weekly and it's a special edition today. We’ll be going weekly once we get into the month of June, leading up until then it'll be a few times a week that we get together. Today my swag is self-made. I decided to wear red tie, a white shirt and blue slacks, really representing the colors of our flag, which I think is the ultimate symbol of the freedoms that we all share as Americans here together. Obviously, I wanted to center the recognition and the gratitude that we have to those that have fallen so that we could be free. I also wanted to have a very strong shout out to our active men and women in the military, our active women and men in the reservist and then also the women and men that serve so bravely and are now our veterans across the United States of America. So, thank you so much. We are deeply indebted to you for the greatest gift we could all ask for and that's to be free. So, I'd also like to have a shout-out to our mask makers. There should be an image coming up, but this was one of the suggestions coming off of Wednesday's meeting is to recognize our mask makers and there are many of them.

These are just some of the pictures that we had. Our mask makers are servant leaders. They've decided on their own to serve others first and to protect the lives of the individuals they serve. They are supporting community first responders, retirement communities. Remember retirement communities are some of the most at-risk populations out there so important to help protect them. The Navajo Nation, which has been besieged by COVID-19 and doesn't necessarily have

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the same resources we do, so great support there as well. Pueblo natives in New Mexico, same situation and many more as well. So, thank you to our mask makers. As you all know I have a mask from a mask maker as well and this is the one that I used in the office here when we're in common locations. A couple of announcements that I might add to that. UnitedHealthcare has donated $6 million, really $6 million plus a lot of services, people that will be supporting those services to support the underserved across the nation. This is in Los Angeles, Philadelphia, Orleans Parish and also the Navajo Nation as well. The $6 million will actually be closer to $15 million we approved this about a week ago. So, this will be a series of initiatives around better serving the underserved populations across the United States. I think we not only learn a lot about COVID-19 and how to better serve these markets but also how we can better serve the underserved populations and their regular medical care as well. I think we talked about it before that I've been discussing COVID-19 and the response with each of the governors across the U.S. as well. This week I’ve talked with the Governor Ducey in Arizona. Arizona is a very large market for us as a company. We have OptumCare practices there, but we also are very vibrant with UnitedHealth Group benefits offerings. We recently won the state account there. But the reason for my call wasn’t about any of that. It was basically to inform the governor what we've been doing so he can get an idea of the types of things that may be able to assist him and his market. I asked him at the end, “What is your greatest concern today, and how can we help?” He asked us for help around food insecurity. So, we'll be making a sizable donation to assist with food insecurity across the state of Arizona as well. So, I'm glad he answered the call because many don't and what we’re really here to do is to serve in these situations. That food insecurity is largely created from the economic deceleration that's occurred across the United States. Some 40 million people now are unemployed and that has a rippling effect across these communities. So, one of the other things were doing in order to respond to that and make sure unemployment doesn't result in uninsured status, we launched our national “Get Covered” campaign this week, which is a public service announcement basically letting people know that there is likely an affordable coverage option available to people and to call us. We use Health Markets branding but it isn’t a single payer initiative. This is an initiative that’s funded by us that is geared towards ensuring that people know that there are affordable coverage options available. So yes, we’ll be enrolling them in UnitedHealthcare coverage, but equally so if not more so, Blue Cross Blue Shield, Aetna, Cigna, all of our competitors’ coverage as well. Whatever coverage option is best for those individuals, we’ll make sure that we enroll them, whether it's Medicaid if it's exchanged-based coverages, short-term limited duration offering, spousal coverage, Cobra, you name it. We’re aiming to get them all covered. And then last, I’ll just end that we won a very big case in Texas. The Texas Employees Retirement System, which is a hundred thousand lives, this is a huge case. They are our nation's seniors under Medicare Advantage type benefits. It’s a sizable case for us, a big win for our M&R team but as you know, it's not just the M&R team. It takes all of UnitedHealth Group to bring home a big case like that. So, congratulations to all of us for the great work that we've done. Now, to the real reason we’re here today which is to bring Trip Hofer in. He’s the CEO of AbleTo and I know for many of you, this name sounds familiar. He joined us in 2006. He joined Optum actually, but back then it wasn’t the Optum it is today. Back then it was a Nurse Line and maybe a Care Engagement Segment or Facilitation Platform. We loved the name so much we adopted it for what is our fastest growing segment at UnitedHealth Group, which is the constellation of the Optum-based companies.

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He departed in 2012, but Trip left us with an impression. That impression was for the strength of his leadership, the strength of his character, his potential as a human being and a service-minded one. He is clearly oriented toward serving others first, which you know we’re a servant-led organization. That's the idea here and so we've always kept in close contact with Trip. In fact, in thinking about Trip, we dug up a picture from 2011. So, this is just before he left. I'm hoping you can see this well enough. I’d index you, the gentleman with the red tie. That’s Karl Ulfers, believe it or not. Hard to imagine that Karl could look like that one day. To his left is Trip Hofer and you can see he’s standing there very studious and appropriately. He was in our general manager program at the time. This is a program that we do to develop our leaders and Trip was a part of that team that graduated in 2011. I left it up here just a little bit longer because you'll see a lot of lot of familiar faces on this picture and a lot of really great leaders across UnitedHealth Group that are that are there, Trip obviously one of them. Now Trip is the CEO of AbleTo, and AbleTo is a New York-based virtual health platform, which I am sure has come under great demand here through the COVID-19 crisis. We’ll touch on that in a moment but Trip, welcome. Trip Hofer: Thank you very much Dave. It’s great to be here. Thanks for inviting me to the broadcast. You warned me about the picture, I haven’t seen it, but I always remind myself to stand next to the best-looking person, hence why I was next to Karl. But anyway, it’s great to be back. I’ve gotten so many great emails and texts from folks I used to work with welcoming me back to the Optum Family. So, it’s great to be back with you all. Dave Wichmann: Well, the pressure is high. On the Friday show at 11, we usually get tens of thousands of people live, so don’t blow it man, alright? Trip Hofer: I’m hoping everyone’s on vacation already, or half day. At least that’s what I’m telling myself to maintain my composure.

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Dave Wichmann: No problem. So, you joined AbleTo two years ago as the CEO. You look like you’re holed up in a family residence or something. So, where are you at? Yeah, so turns out my brother actually lives very close to me, we’re in Needham, Massachusetts. We’re actually quarantining together with his family. He’s got small kids. I actually had a Town Hall on Monday that I broadcast from my house and the internet went out which was fantastic. So, I decided to come over here today. So, I’m in my brother's kitchen of all places. Dave Wichmann: So, is that a house swap or something, is that what that is? Trip Hofer: House swap, exactly. He’s got six kids in that house, I’m by myself. So, if you want to go all day Dave that would be great for me, we can sort of hang out and you know I’ll see the kids in six, seven hours. That would be perfect. Dave Wichmann: I don’t think our viewing audience will appreciate that, but let’s give it a shot. So, how’s your family holding up? Trip Hofer: Great, great. I've got a 12-year-old daughter, a 10-year-old daughter and an 8-year-old son. All, by the way, born in Minneapolis. I used to live there, Fairfield Southdale. But they’re doing well, thanks for asking. We decided to shut down our offices in New York fairly early, around 12th, 13th of March. So, I've been back in Boston since then. But everyone’s doing the best we can. Like everyone else that's out there hearing this, sort of the new normal. But we appreciate the quarantine, the social distancing. We’ll keep doing that. Dave Wichmann: Good. Good. So, let’s cut to the company if that’s okay? I briefly introduced AbleTo. A lot of people know about it because we joined forces some time ago. Maybe tell us a little bit about what AbleTo does, what its mission is and generally speaking what, as an entrepreneurial business leader, what attracted you to that business or that space. Trip Hofer: Yeah, so I joined AbleTo really like you said roughly two years ago. AbleTo's actually been in existence for about ten years, almost a decade. I decided to join AbleTo for a couple of reasons. First and foremost was, I’d actually been approached by one of the venture capitalists on the board two years prior, and it didn't really work for me at the time. But the two years that transpired, so you think between 2016 to 2018, 2019, what was interesting is just you saw the industry

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response to mental health and mental health needs. I was at Optum when Mental Health Parity passed. We were all very excited by it. But the reality is the market didn’t really embrace it and there's still some things related to parity that we need to work through. What I started to see in the past several years was, especially employers that are payers, recognizing that there's a real need for mental health services. So, that was one reason I thought the company was interesting. Secondly, you just are starting to hear so much more about mental health and stigma. Companies like your own, the public personas and figures that are out there talking about it, it’s coming to the forefront. I think I spoke to you about this, Dave. I know you’re in front of a whole bunch of payers, employers. I think you told me that one of the top three concerns in almost every single conversation you have was around mental and behavioral health and what are you doing with that to help your partners? So, it’s obviously become very topical. When I was at Optum, 10-years-ago, 12-years-ago, it was at the bottom of the list. And the reality was because if you look at a PNL, if you look at cost of care, out of $100 spend, $95 is physical health and $5 is mental health. Back then, you’d talk to a CFO who would say, “Why do I care about the 5%? I care about the 95%.” What everyone now knows is that that 5% has a huge impact on the 95%. And if you can impact the five, you’ll impact the 95. So, there's a recognition that mental health is necessary to focus on. So that brought me there. Then I did a lot of introspection work to think through the clinical model and look at the clinical model and I found it to be very impactful which was important to me. I wanted to go to a company that showed true results. So, that’s why I decided to move over about 18 months ago, over to AbleTo. In terms of just talking about the company itself. So, AbleTo at its core is basically a provider of virtual mental health services. It’s been doing this again for about a decade and really focused on those individuals that have a mental health need but also have a physical comorbidity. So, think about a patient who's got chronic pain and is anxious or a patient that just had a heart attack and is coming out of the hospital and is depressed. You can come up with several types of scenarios. The reality is that, what AbleTo does is work on the head. Once the person gets right mentally, then they start taking care of themselves physically. It’s funny. I had Dr. Migliori come to our Innovation Summit last year. He put it great, he said to the crowd, “I’m not sure, the last time I checked the head was attached to the body. We just decided as a medical profession to detach the two, to say we’ll deal with mental health over here and physical health over here.” He’s like, “We need to bring those things back together.” That point really resonated not only with me but the audience. That's basically what AbleTo is, it’s an organization that provides virtual mental health to individuals that are suffering physical comorbidities and have mental health needs. Again, once you help that individual get past their depression, stress, anxiety or at least see some skills to cope with it, they take care of themselves physically and you see a reduction in total cost of care which is obviously very important to payers. We want to not only take care of the individual mentally, but also have to look at the bottom line and ensure they get some kind of return. Dave Wichmann: Yeah, well two things kind of intersected that build on what you just said for me. One was that we were discovering in our R&D Group, which we formed at the end of 2017, but we are discovering there that a brain first approach was probably the most important approach. About that same time, I was at a Customer Advisory Council meeting, which we hold periodically, largely represented by national account base customers. I always spend one on many time with them and usually Dr. Migliori is in there and Andrew Witty and Dirk McMahon. But I asked them, “What are your priorities? What are

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the things that are unsolved issues for you today?” Unbelievably, so during the year last year they said behavioral health, mental health issues were there number one priority. Then when I asked a question, usually I ask, “Okay, well what are you seeing out there that's kind of new and innovative that's really making a difference today?” They came right back to behavioral health and they came to digital behavioral health or virtual behavioral health and the services and the way in which they are finally connecting the mind in the body together and helping people overcome you know the stigma as well because these virtual methods make the make the biggest difference. So, then I asked them, this is how I usually get my list of target companies to align with. I said, “Well, name one that’s the best of the bunch.” AbleTo. AbleTo. AbleTo AbleTo. I was like, “Who is the AbleTo?” And Dick says, “Well we’re working with them.” It just goes to show the viewing audience that often times I have no on earthly idea what's going on at this company. So, you have a kindred spirit in that. It's also a good reflection of the solid work you’ve done and the value of the platform that you're in and how it’ll work with our behavioral health business, but frankly the whole body and the whole person care. A lot of people talk about, but we're actually doing now and through the alignment with AbleTo now. As we get to even closer alignment, that’ll even be greater. So, this crisis, let's just jump to that and then we’ll come back to your business, if I can? So, are you seeing increased demand for behavioral health services? In particular, how’s that showing up on your platform? Trip Hofer: Yeah, I mean I think it comes as no surprise that we’re seeing an absolutely increase in what's going on with folks and dealing with their mental health. Since COVID-19, if we look at our data back through March, we’ve seen about a 52% increase in our engagement rates. So, what’s interesting about AbleTo for those that don’t know the company well is that we actually proactively outreach to the individuals who we believe need help. So, most behavioral health, they offer services and then people come to that service. AbleTo’s core is we look at the information, like claims and what not and then we reach out to individuals who we believe need support and ask them if they would like to talk to a therapist. We’ve seen about a 52% increase in the number of people who say, “Yes.” Part of that is because they’re at home, so, they're basically there to take the call. But a large part of it is because of the stressful times. In addition to that, we have an anxiety and panic program, we saw about a 41% increase in that program. Again, none of this I don’t think would come as a surprise to folks. I will give you one surprising data point, which I think we should be happy about. So, we measure what’s called loneliness, especially in our senior population. We’re working with some of your senior population at United right now. Before COVID-19, on a scale of either moderate to severe loneliness, about 60% of our elder population was registering at a moderate or severe loneliness which is not good by any stretch of the imagination. I mean when people get lonely, they tend to get depressed and they tend to get stressed, anxious, et cetera, et cetera. We’ve actually seen since COVID that go down from 60% down to 52%. Still unsatisfactory, but it’s interesting to look at the data and say, “Wait a second. Why is that happening?” I honestly think it’s because we're making more calls to our parents. I know I am. We’re actually reaching out to people, you know neighbors and others who might be lonely, which is again a great credit to what we’re all doing. That was a surprise for us, the data, but actually a good surprise.

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Dave Wichmann: Well UnitedHealthcare recognizes that there could be an issue there. That's why in the first 30 days I believe they made 7.7 million calls to seniors and then held pretty long call times with them as well. This is a program that continues on. Really it was to help address, you know make sure they had enough food, had proper shelter, enough contact. Basically, dealing with social isolation and food insecurity which is two things that burden seniors and those with the critical illness the most. Maybe it’s because of that kind of outreach that’s happened, too. Interesting, you said a couple things. You talked about stress and anxiety, I think you used just slightly different words. We’ve been talking about Sanvello. Do you have a piece of your business that crosses over with Sanvello? Trip Hofer: Yeah. So, basically what happened, so I joined in 2018. At the end of 2018, we decided to make an acquisition of a company called Joyable. The reason we did that was a couple-fold. First, Dave you did a really nice job of talking about the employers and the people you talk to who we're really looking at “how do I think about mental health solutions?” It’s interesting. I think the market has shifted now where those same purchasers are now like, “This is great, but I got too many fragmented point solutions? How can I bring them together?” One of our clients, they have 12 vendors that do mental health for example, that’s too many, right? So I bring this up together, and so they came to us and they said, “Hey listen, can you take the same secret sauce of AbleTo, if you will, and bring that down to a patient that's got mild or moderate severity, for example?” And that was really the impetus to us buying and acquiring Joyable, which is a digital application very similar to AbleTo in the sense that it's CBT cognitive behavioral therapy-based, eight weeks, really sort of a rigorous focus on quality and outcomes. That allowed us to basically, if you will, serve more patients. So, we went from a high-severity patient cohort and we were able to start supporting mild and moderate. That said, I think, and I know the Sanvello company well and the company that was acquired and renamed Sanvello. I think the combining and integrating and working together with Sanvello is something that’s on my radar because I think that they provide fabulous services. I think together with Joyable, we can do one of those ideas that common stain, that one plus one equals three. I really do believe that bringing those assets together, along with other assets that are at United, give us tremendous opportunity. Dave Wichmann: Talk a little bit more about the one plus one plus three. What do you see is the value of this combination, not just with us. Frankly, we’re a multi-payer company and you do serve other payers and you’re going to continue serving other payers? In fact, UnitedHealthcare is not your largest payer client. I believe it’s CVS Aetna, if I'm not mistaken, who is a terrific customer of a lot of our services across UnitedHealth Group, mostly coming from Optum, of course. What do you see as the opportunities of the two companies coming together? Trip Hofer: It’s funny, when I started my health care career with a start up in Boston called Health Dialogue, that was in 2002, roughly. So if you sort of think about be being at this for almost two decades, I'm mostly focused on payers and so I see a lot of payers and it’s convenient for me to say this since we're talking, Dave. But having gone from payer to payer to payer,

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there’s just no other payer that's out there that has the depth and breadth of resources that UnitedHealth Group brings to any individual, whether it’s a patient, a provider system, a self-funded employer or the government. We typically hear the term mosaic, and everyone says, “How do I weave a mosaic together?” A mosaic is like this. My belief is at UnitedHealth Group, the mosaic is outside the frame of the possibilities here, and that's just the reality of what's going on. The challenges are making sure that you can weave that mosaic together efficiently and effectively. But if you think about stuff like, you have a Genoa, for example, right? Data telepsychiatry. You think about the Sanvello asset, you think about t OptumCare, which has got tremendous opportunity in my opinion. We do exactly what we started talking about which is bringing together the mind and the body. No one else has those assets. To me, that’s what’s most exciting. That’s what got my team most excited, was to continue to serve external payers, but really trying to revolutionize how we deliver mental health as part of a “brain first.” I love that. I love that term as part of our brain first fabric, and no better place to do that with an entity that has a lot of assets that can make that a reality. Dave Wichmann: And the mosaic is available to everybody. So, our third-party payers oftentimes take advantage of that same thing. We have several of them that are deep users of the integrated services and offerings of our company, and what’s key for all of us is to figure out how to make that all work together. So, you’ve got to take a customer-first approach or consumer-first approach, build your designs and serve them and serve them well. Trip Hofer: I couldn’t agree more. Dave Wichmann: It’s great to see you. Thanks for joining us today. Trip Hofer: Yes, thanks for the trip down memory lane, especially 2011. That was great. I appreciate that. Dave Wichmann: I think you have the same shirt on right now as a matter of fact. Trip Hofer: It still fits. Dave Wichmann: Exactly. I haven’t had a chance to meet your team yet, so I’m looking forward to as things clear up here. It would be great to get together in New York, Boston, wherever. I'd love to have the opportunity to do that. I know we talked, probably last

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fall or winter in Boston but I didn't get a chance to thank you. It's been about a week since we closed, but thank you for entrusting your business with us. I think you know that's probably the most difficult decision for a CEO to make because yes, you've got shareholders and those things, but you have constituents you serve. One of the most important constituents that you serve are your team members and your employee-base and the families that they have. I just want you to know we take that responsibility very seriously. We are super-excited to bring the companies together and drive the results for patients, for people, for members. I also hope to work with you to provide your leadership team and all your team members the opportunity to achieve their life's ambitions here with UnitedHealth Group and at home. So, we are being committed to that, so I thank you for that gracious act on your part to join forces with us. Trip Hofer: The team, Dave, first of all, thanks for saying that. My team is incredibly excited at the prospects and the opportunities that are ahead of us and if you believe as we do very strongly that we are here to help people on their journey to better cope with their mental health, then there's no better vehicle by which to do that, a partnership with to do that, than UnitedHealth Group. The reach and the touch is just non-comparable. And back over with our other external relationships, most of which you said you’re already supporting as well, just gives tremendous opportunity to deliver around really superior high quality medical and health services. So again, thanks for the opportunity. Dave Wichmann: Our pleasure. Well, hang on. I’m going to close now and then I’d just like to spend a couple of minutes with you, so just make sure you hang on. Clay dropped right after this last time, so I didn't get a chance to have a conversation with him afterwards, of which I do with all of our guests. So anyway, thanks to Trip. Thanks to the AbleTo team. AbleTo team, if any of you are on or can watch this rebroadcast, I just want to welcome you to the UnitedHealth Group family. It's an honor and a privilege to have you to work with such a progressive company and we look forward to really making a difference in people's lives together. I would also like to thank all of you, the listening audience for another great week at UnitedHealth Group. I think we've already gone through several of those announcements already, but those are just a small example of the number of great things that we've done. This is a special weekend and carries all the way through and including Monday. Actually, I am grateful for the fact that there will be less parades, less outside barbeques, less and less and less. The reason I think of less and less as good is because then we could spend more time doing what I think is most appropriate during this time and that’s remembering those who were fallen in the course of battle so that we could be free. I believe that to be the greatest gift that anybody could give somebody else is to give them their freedom to be, in this case, an American. There are obviously several countries that have a similar construct to that, but this is a unique opportunity, I think, to be very introspective about the women and men of the armed services and those that paid the ultimate sacrifice that gave their lives for all of us. I've been thinking a lot about that this morning and will commit to doing so throughout the weekend.

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Serving others first is a very difficult thing. It's hard to think about somebody else's life in front of your own. But that's what these brave women and men did for us as a nation is to give us that that freedom. So please support your veterans, support your armed services, support your reservist. Support all the first responders. They’re putting their lives at risk every day and we have a unique set of first responders today. That's the health care workers as well, and we all know too well that they're also putting their lives at risk. We've lost 11 of our team members, inception to date, most of them in a clinical setting. As you know, that's a very difficult thing as a leader of a company to bear, but I'm just one of 325,000. I feel exactly the same way about them, and I appreciate they and their families for paying that ultimate price to help serve and save the lives of so many others as well. So, I'm proud of them and I'm proud of all of you for stepping up in this time of need as well. This is a very difficult time. It's kind of hard to find your bearings and your focus and your compass and you've done so. You've supported United Health Group through it all and importantly what you've done is you have supported our patients and our members. You’ve just put it all their needs in front of your own and have served them so generously. So, thank you for that. But I would encourage you to not only reflect on them, but also make sure that we spend Memorial Day memorializing those who paid the ultimate price. Tuesday, we’re going to get together. We’re back to Tuesday’s with Dr. Migliori. So, Tuesday’s with Migliori as I’ve referred to it. It will be a great session. I will make sure we update you on the latest in new discoveries and give you the facts and they myths of COIVD-19. It’s a difficult thing to do these days because there's a lot of information out there, but hopefully we can get through a good session with him. Please have a wonderful and relaxing Memorial Day weekend and I'll see you on Tuesday. Until then, please keep it steady. Keep it strong. And always be United. Take care.