Wellness Reimagined: Author Jeff Margolis On 5 Things That Should Be Done To Improve and Reform The Health & Wellness Industry

In our world of constant change, and with life moving faster than ever, topics such as mental health, self-care, and prevention have become popular buzzwords. People are looking to live healthier lives, and there is superb care out there that is being offered.

At the same time, there are misconceptions about the meaning of self-care and exercise. Many opt for quick solutions — surgery, pills — to dull the problem without adequately addressing the underlying cause.

Meanwhile, many parts of the health and wellness industries are unregulated and oversaturated. People with years of training are competing with people with weekend training. Many providers are overworked, overwhelmed, and underpaid. The general public is not educated about asking the right questions when selecting a wellness provider. In the face of all this, what can be done to correct the status quo?

In this interview series, we are seeking to hear from a variety of leaders in the health and wellness industries who agree that the wellness industry is in need of an overhaul and offer suggestions about what can be done moving forward. As a part of this series, I had the distinct pleasure of interviewing Jeff Margolis, the Forbes Books author of Not Just in Sickness … But Also in Health: Moving Beyond Sickcare to Health Optimization for All. Margolis is widely recognized as a healthcare IT entrepreneur and innovator based on his 35-year track record of successfully applying technologies to address the complex problems facing the healthcare industry.

Thank you so much for doing this interview. It is an honor. Our readers would love to learn more about you and your personal background. Can you please share your personal backstory? What has brought you to this point in your life?

I grew up in Boulder, Colorado and had the opportunity to develop my skills as an Eagle Scout, a rock, jazz and classical guitarist, and as a running back on the state champion high school football team. My father was an intellectual property attorney and my mother led the freshman orientation program at the University of Colorado. Both were instrumental in creating Boulder’s first synagogue, where I studied Hebrew and Torah.

At age 13, I started a landscaping company with an older friend who could drive semi-legally, and this business grew to a point where it funded a good portion of my higher education. As a high school junior, I began dating the most amazing senior lady. And although I attended the University of Illinois in Urbana- Champaign and she went to the University of Northern Colorado, we maintained a long-distance

relationship. I graduated from U of I in 1984 with a B.S. in business administration — management information systems and also sat for and passed the CPA exam.

My wife and I married soon thereafter. We just celebrated our 38th wedding anniversary. We have two married daughters and two grandchildren.

Starting at a young age professionally, I led a Forrest Gump-like life where I was at the advent of the intersection of information technology and business, and information technology and healthcare. Working at companies that eventually became Accenture and United Health Group, I was a young executive who was managing over 600 people by age 31. Soon thereafter, I co-founded a healthcare information technology company called TriZetto that went public, and I was a public company CEO and chairman from age 36–45, whereupon we took the company private and then had a multi-billon dollar exit to Cognizant.

I remained as CEO for a while and chairman a bit longer through age 49, as I began serving on other company boards both public and private. At age 50, against my wife’s better judgment, I became the CEO of a company I chaired, called Welltok, and served as CEO for seven years and chairman an additional year until the company was

sold to Virgin Pulse. I retired from a full-time operating role in 2020 at age 57. Soon thereafter, I became a senior advisor to Blackstone in their healthcare vertical and currently serve on six for-profit and several not-for-profit boards. Next year, I look forward to turning 60.

I spend my non-business travel time either at my home in Corona del Mar, California or my mini-ranch in Steamboat Springs, Colorado. I have few hobbies, but I am a bit intense about skiing and my interest in wine. I have been blessed to be surrounded by amazing family members, friends and professional associates who form the central core of my life. I do not believe much in “me-time” as life is too short to not be in service to others. Interacting with others is what delights me, although given my intensity, they may not always enjoy it so much.

What is your “why” behind the work that you do? What fuels you?

I was diagnosed with Crohn’s disease, a still incurable digestive disease, at age 19, and many people believe that this is my inspiration to fix the healthcare system. That is not the case, however; my exposure to how healthcare works in reality was greatly benefited by experiencing seven major surgeries and over 100 days in the hospital before age 30.

The “why” that drives me is the passion to solve complex problems that negatively impact millions, if not billions of people. It just so happens that my background in information systems, accounting, technology and healthcare put me in a strong position to address challenges at scale. What could possibly be more meaningful in a person’s life than helping as many people as possible enjoy better health and total well-being, regardless of their economic status, ethnicity, location, or social determinants?

I spend most days shaking my head at the lack of cohesive architecture across the U.S. healthcare system that results in poor access to appropriate healthcare resources and the dogma that persists even among the top executives in the industry. The irony is that across the thousands of clinicians, administrators, executives and consultants I

have met in my career, I have met less than a handful of people who were not genuinely wanting to make things “better.” But, I have met an even smaller handful of people who understand enough about how all the parts fit together to overcome the damaging and siloed thinking that pervades the healthcare industry. And, because healthcare is a $4 trillion plus industry in the U.S. alone, capital flows relatively freely to the reinforcement of sub-optimal ideas — and this is important — regardless of whether the healthcare entity is for-profit or not-for-profit.

Profit motive is not the problem in healthcare, but rather, the lack of a clear objective as to what the healthcare system should deliver. In short, the healthcare system should be designed to deliver the highest health status for an individual or population at the lowest reasonable cost that preserves quality.

What are some of the most interesting or exciting new projects you are working on now?

My life is extremely rich with exciting and interesting efforts in the companies where as I serve as a board member. These include: the architecture of a multiomics data platform (e.g., genomics, metabolomics, etc.) that will allow for research, diagnosis and treatment alternatives that far surpass the abilities of today’s medical records and claims systems; the introduction of AI-based primary care with intelligent referrals to specialists; low-cost dental imaging technology via smartphones that can give oral health access to billions of people; a world-wide platform to develop clinical trials much faster and much less costly; the ability to offer complex mental health treatments on a 24 X 7 basis to avert unnecessary levels of suffering and high costs; and a senior

care platform that is designed to ensure people are treated as you would want a family member to be treated both clinically and from an experience perspective. I have the rare opportunity to work across providers, health plans, pharma, employers and information technology with amazing people every day!

It has been said that our mistakes can be our greatest teachers. Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

It wasn’t very funny at the time, but coming out of school, I entered the workforce with a “get straight A’s” mentality. On my very first staff assignment, I found some mistakes that had been made by unknown peers at Accenture on a very detailed computer programming routine. Out of pure naivety, I informed a partner at the firm, who happened to be doing a “friendly” walk-by, of my discovery because I wanted them to ensure that we corrected the answer. I had no concept of chain-of-command or repercussions on people who I had no intention of hurting. I was simultaneously labeled as “bright” for having identified the intricate coding error and banished to a remote project so that the people I inadvertently embarrassed would not try to kill me.

I got to spend about 18 months in a remote town of several thousand people developing my skills and pondering what I had done. Fortunately, I was allowed to return to Denver after triumphantly teaming with others on a highly successful implementation.

This very early lesson in my career taught me in business what I already knew from music and athletics — that there is no “I” in team. And that if you are good at what you do, you don’t need to take credit for it. Ironically, when you become a CEO and know that it’s always about the team, the media and establishment always gives you credit and expects you to present as an authority figure, or they pick you apart. But rest assured, I learned very early that no single person can accomplish much on their own, and that being right is far less important than doing the right thing.

OK, thank you for all of that. Let’s now shift to the core focus of our interview. From where you stand, why are you passionate about the topic of reimagining the health and wellness industries? Can you explain what you mean with a story or an example?

It’s very simple, really! The entire healthcare system has been built as a “sickcare” system to reactively treat illness and ensure that those who treat you get paid. Medical doctors are trained to understand the human body as a system, or series of sub-systems (e.g., circulatory, digestive, etc.) They are taught, to the best of current science’s understanding, how the body works, what can go wrong with it, how to diagnose illness, and how to fix it procedurally or with medication therapies. This is not unimportant to be sure! I would not be alive were it not for such skills. However, much less training and investment focus is put on how to prevent illness or disease, and unlike clinical studies, human life does not take place in a controlled study. As my book, Not Just in Sickness but Also in Health explains, total well-being is a combination of physical health, mental health, social health, financial health, and purpose. Just dealing with the diagnosis and treatment of disease in physical health is a necessary, but highly insufficient approach to health.

Nothing in my philosophy is meant to diminish the sacred and skilled role played by physicians, but they are human beings, too, despite their “straight A’s.” In fact, I suspect you would be hard-pressed to find a physician who isn’t concerned at times about their own mental health, their social relationships, their financial situation, and the burnout factor that can cause them to question their purpose … not to mention their personal fitness and nutrition.

This brings us to the issue of personalization versus segmentation. In order to get a person the resources they need, you cannot use one variable about their life and just label them for health purposes. As an example of how to think about this, I would suggest that the issue of health has been politicized such that most people believe that all low-income people are always disadvantaged when it comes to healthcare. And while that can certainly be the case for some, a lower-income person in a stable relationship, with a reliable circle of friends, some faith, and just enough cash-flow to keep a roof over their head and food on the table may experience far better

total well-being than a wealthy person whose money may lead to a litany of problems. Money can neither buy happiness nor total health and well-being.

When I talk about reimagining the wellness industry, I am talking about reimagining it from the perspective of the providers as well as from the perspective of the recipients and patients. Can you share a few reasons why the status quo is not working for both providers and patients?

We just talked about how doctors are human beings, too. I am a big advocate for ensuring every individual has connection to a primary care physician (e.g., a family practitioner, internist, OB/GYN or geriatrician) to serve as the hub or quarterback for distributing a patient to appropriate specialty care, but there are limits to what a physician can do from both a time and economic standpoint. It would be very helpful for doctors to put a standardized set of social determinant data in front of them along with the standard EMR data, so they can have a better sense of other dimensions in their patients’ lives. But because the patient is a “prisoner” to their health plan benefits and network, in most cases, there needs to be an easy way for the doctor to refer the person to their health plan’s available resources along the dimensions of mental health, social health, fitness, nutrition, condition management, etc.

What we’re talking about here is a clear delineation of clinical resources that occur through the medical side, and daily living resources that need to be curated and connected to the person through their health plan benefits. The design of the healthcare benefits plan has to rapidly evolve to become more holistic in the support it can provide to help an individual achieve total well- being. This is explained in detail in my book, Not Just in Sickness but Also in Health.

Why do you think there is a good opportunity now to improve and reform the health and wellness industry?

Because there is not disagreement about the principles I am espousing. It’s about execution, not philosophy. But in order to accomplish this, at least five percent of the resources that currently focus on building out the sickcare system at health plans and health systems need to be shifted to the curation and connection of health improvement resources for total well-being.

Can you please share your ‘5 Things That Should Be Done To Improve And Reform The Health And Wellness Industry”? Please share an example or story for each if you can.

• A wider perspective in benefit plans. Medicare, Medicaid, military and commercial plans need to be looked at through the lenses of physical health; mental health; social health; financial health; and to the extent possible, individual purpose. These categories should start to show up more clearly in descriptions of benefits in addition to doctors visits, hospital visits, drugs, ER visits, etc.
• Better communication by employers. Employers, who by and large already have a belief system in total well-being, need to communicate the broader set of total health and well-being benefits more clearly and educate their employees on what is available.
• An understandable mental health table of contents for consumers. The problem is that even the people arranging the mental health solutions have a hard time classifying them, never mind the individual consumer that needs access to the resources. My challenge to those that provide health benefits is to drive out a standard classification system or “table of contents” so that the average human being can quickly know how to access resources that can assess and offer treatments, or re-navigate as necessary if the self-diagnosis is incorrect. Assembling a network of full-spectrum, easily accessible mental health solutions should be an imperative in every benefit plan.
• Cost focus by CMS. The Centers for Medicare & Medicaid Services (CMS) needs to take a step back and look at how less costly support for lifestyle and daily living (e.g., nutrition and reducing loneliness) can dramatically reduce the cost of traditional medical care.
• Combined data usage. Consumer permissions to combine non-health-care data with health-care data in the best interest of their health need to become commonplace when enrolling in health benefits.

From the recipient and patient side of the industry, can you please share a few ways that patients and recipients should reimagine what the wellness and healthcare industry should provide?

It’s important to keep in mind that entities that provide proactive health and wellness solutions have a monumental challenge to reach consumers with appropriately personalized offerings. This is due to several reasons. First, there is little to no connection between what clinicians suggest patients should do in between visits and their ability to enroll or monitor patients in any of those programs. Second, consumers are bombarded with direct-to-consumer offerings that may or may not be relevant, and once they begin in such programs, the data from these programs rarely makes it back to the physicians or health plan of the consumer. And third, health plans and employers have been only moderately successful at curating appropriate health and wellness solutions and matching those up with the people who need them. Adding to the challenge is that payers generally think of such programs as additional costs instead of overall healthcare value drivers.

What consumers should want and imagine is that they are offered a suggested set of health and wellness solutions from their insurer across the dimensions of physical, mental, social and financial health at the time of enrollment in their normal sickcare insurance. They should expect that these suggestions are data-driven, relevant and localized. They should further expect that an appropriate mix of digital, virtual and physical solutions are made available based upon their health status and social determinants. Finally, they should expect that their participation in these types of programs will be incentivized and that they will receive rewards based on their participation in and completion of health improvement activities. This is the path to proactive health optimization.

What do you think are the biggest roadblocks to reforming the industry? What can be done to address those hurdles?

Healthcare is a regulated industry. In basic terms, there are activities that can be counted in what is known as the “medical cost ratio,” meaning that regulators agree that the dollars spent count towards healthcare. The other two categories are administrative costs and profits/surplus/loss. We need to ensure that the broader set of daily living support resources are counted in the medical cost ratio, so that they do not become an impediment to profitability by driving up administrative costs. Almost everybody understands that it is best to keep people away from the sickcare system, but if the money to do so is on the wrong side of the ledger, health plans and value-based care providers will not do it.

I’m very passionate about the topic of proactive versus reactive self-care and healthcare. What do you think can be done to shift the industries towards a proactive healthcare approach? How can we shift the self-care mindset for consumers and providers alike?

Ensuring that people become proactive in the management of their total health and well-being can easily be enabled today through technology and incentives. If Amazon has the data to know when you need to re-order toilet paper, and can give you an electronic nudge and reward you points if you do so, certainly the same can be done in healthcare. Healthcare is the second- or third-largest category of spending for many Americans, and linking the completion of consumer actions that address and improve a person’s total well-being with incentives and rewards is not rocket science.

By simply using technology to provide contextual reminders and allowing people to participate in the economics of healthcare, the system can be flipped from reactive to proactive. But this will need to be provided by the entities that design and administer benefit plans, meaning self-funded and fully-insured health plans.

Thank you for all that great insight! Let’s start wrapping up. Can you share your favorite “life lesson quote”? Why does that resonate with you so much?

“To be truly innovative, you must first be steeped in tradition.” This quote is important because the world is full of smart people and there is plenty of capital to chase both good and bad ideas. To assume that you have invented or created a new idea without knowing what came before you is, in my view, the epitome of arrogance and leads to wasted time, effort, and money… often at great cost to investors. This quote was on the wall of the practice room for the jazz bands at the University of Illinois … and that was in the context of improvisation. Breakthroughs in science, technology, education and business are all a form of improvisation, built on the principles that preceded them.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we both tag them :-)

I am not much of a celebrity-chaser and am fortunate to be able to access many business leaders. However, I once wrote Warren Buffett over a matter where I was trying to help him see what was happening in one of his businesses. He called me, and we had a trustful conversation. He ended up eventually making changes accordingly, perhaps with the benefit of some of my input. I would enjoy meeting with him to gather up some pearls of wisdom, as I share a midwestern ethos with him.

I appreciate your time and valuable contribution. One last question, how can people reach or follow you?

People can see a compilation of my activities at jeffreyhmargolis.com or margolisenterprises.com as well as follow me on LinkedIn.

Thank you for these really excellent insights, and we greatly appreciate the time you spent with this. We wish you continued success.

About The Interviewer: Maria Angelova, MBA is a disruptor, author, motivational speaker, body-mind expert, Pilates teacher and founder and CEO of Rebellious Intl. As a disruptor, Maria is on a mission to change the face of the wellness industry by shifting the self-care mindset for consumers and providers alike. As a mind-body coach, Maria’s superpower is alignment which helps clients create a strong body and a calm mind so they can live a life of freedom, happiness and fulfillment. Prior to founding Rebellious Intl, Maria was a Finance Director and a professional with 17+ years of progressive corporate experience in the Telecommunications, Finance, and Insurance industries. Born in Bulgaria, Maria moved to the United States in 1992. She graduated summa cum laude from both Georgia State University (MBA, Finance) and the University of Georgia (BBA, Finance). Maria’s favorite job is being a mom. Maria enjoys learning, coaching, creating authentic connections, working out, Latin dancing, traveling, and spending time with her tribe. To contact Maria, email her at angelova@rebellious-intl.com. To schedule a free consultation, click here.