Toward the end of our inaugural Drive for Better Care, we stopped in Atlanta to meet with Yubin Park, CEO of Mimi Labs and formally Chief Data and Analytics Officer at Astrana Health, a leading provider-centric, technology-powered healthcare company, and one of Pearl’s Top 50 Value-Based Care Thinkers of 2024.
Read on for Pearl Head of Marketing Madison Klein’s chat with Yubin about his journey from academia to founding healthcare tech companies, the role of technology and fresh perspectives in tackling healthcare challenges, and the importance of asking “why” in value-based care.
This transcript has been edited for length and clarity.
Yubin Park: The truth is I’m not a planner, I’m a very spontaneous person. At the time, when I was about to graduate, I was dating a girl, who became my wife. She had about a year left in her school, about ten years ago from now. I was studying machine learning in my Ph.D. And there were a lot of machine learning researchers at the time. You know, the only job they can get is mostly, I think, in big tech — Facebook, Google, those are the places you go. At the time, it was actually before all these large language models — if you study machine learning, basically what you do is advertisement optimization. That’s where that technology came from. I wasn’t particularly interested in advertisement too much.
I also felt that I also wanted to stay in Austin, waiting for my wife to graduate. So, I was debating what to do in Austin — you know, Austin now is a tech hub, but back then it was not. They had some semiconductor industries there, but not much there. So, the logical choice for me at the time was to do my own [thing] and I really had nothing to lose.
So I started, and I picked healthcare because I underestimated the complexity around it because, you know, to some degree, I am a foreigner. I came from Korea and I came to the US for my Ph.D. and I knew nothing about US healthcare. The only thing I knew about US healthcare was some of the news articles I read. Healthcare seemed to have a lot of problems. I felt that it was a kind of low hanging fruit at the time. I studied something cutting edge technology. seems like, nobody in my kind of group or in my circle, do not seem to working in healthcare.
Maybe I can bring something new. It was a wrong decision — I think it was too early. So I started a business with government funding, actually, back then. The National Science Foundation has this small business funding called SBIR. So we applied for it. At the time, the focus was on digital health. So I think our theme kind of fit the government theme at the time. So we started the business with government funding.
I explored a lot of different areas in healthcare with machine learning. I couldn’t quite understand the dynamics of healthcare. So I actually looked at the price transparency back then 10 years ago. And they gave up fairly quickly and I think it was the right decision. One thing that is true about startups is, I think, you just continue to pivot what you do. So, I did that, until I actually found one paying customer in the Medicare Advantage market.
That essentially set the course for the later decade. There was one client who actually was asking for help in star rating and risk adjustment. So that kind of got me studying the area. It was fascinating, you know, to some degree, the way actually government pays these plans and how they are setting the incentives. It’s a combination of the policy and statistics and all these different things that are really complex and just studying that kind of made me realize that I think this area is so deep.
Essentially the product that we sold in the first company, Accordion Health. That company got acquired by Avalon Health, who did a lot of ACO work back then, so I moved to Avalon and after that, you know, I just continued to be in this space. Because I started my career outside of healthcare I still feel that I’m an outsider in healthcare.
Value-based care is so complex. I think, even if I study right now for another decade, I would feel that I’ve probably been an outsider.
Madison Klein: You certainly do like to push the boundaries on conversations.
You’re a LinkedIn top voice, and I think you’re being a little bit self-effacing, but as Chief Data and Analytics Officer, and with your background, you’ve really distilled some complex ideas down to some very simple ones and made some provocative statements that have shaken people’s assumptions.
I think long held assumptions are often incorrect assumptions about the industry. As you waded through this complexity, trying to figure out what your business model would be and pivoting along the way early on, you learned about price transparency, you learned about direct to consumer, you learned about the insurance space, you finally learned about Medicare Advantage.
What were some of the sort of best kept dirty secrets in healthcare that you were uncovering through the data that you thought, “wow, this doesn’t need to be this way?”
Yubin Park: I think the biggest problem in our industry is it’s accumulated a lot of complexities over time.
In many ways, I think a healthcare industry is a regulated industry. So we actually need to work in a collaboration between private and public sectors. And when you have that kind of industry, it’s easier to add more processes than remove processes. I think we kept adding different things over decades.
And at this point, when a new generation of people is coming into work in this industry, I don’t know who actually understands any of this. I try to uncover one layer by layer every day. But even for me I actually don’t know if I know anything, to be honest. And yeah, I try to remain that way because I think what the industry needs at this point is people who ask “why.”
I wish people would actually question why we are doing this, why we are doing value-based care, why things are implemented this way, is there a different way? I think we actually are very used to the way we have been doing things, without asking why, because it’s easy to just ignore the why because it’s so complex, but I think we should just keep pushing the limit and asking why.
Madison Klein: I’d like to ask you, as you established yourself in the industry and you were no longer purely in the building and growing phase of your career and you were really scaling a company — for those who are interested in your journey at Apollo and Astrana — what advice would you have for people who are taking those earlier stage, entrepreneurial ventures in disrupting the space and expanding them into the bigger companies that they ultimately become
Yubin Park: First of all, I don’t know if I’m the right person to answer. I did some startups — I don’t think I scaled up business to like a large size. I should just put that out because there are a lot of people who are very successful out there. I don’t want to put myself to the same level like that. But Healthcare is an umbrella term.
The healthcare expenditure compared to GDP is about 20 percent. What that means is, one out of five things we do is actually healthcare, which is a very broad term. Working in healthcare can mask a lot of details about what we actually cannot do in our day to day lives, and there is usually a gap. You know, the stuff we are working on, does that even have meaning? Does it actually affect the overall health care? I think people should realize you’re talking about the 20 percent of GDP. I think it’s really good to have a grand vision to change health care.
But at the same time, I think I’m not losing the focus on what you do, because every small piece actually connects to each other and they affect each other.
For those people who work in startups to scale the business, as long as they understand how their work relates to the bigger piece of the puzzle, and as long as they focus on what they do, I think that will help them survive and thrive maybe.
A lot of healthcare businesses expand to different small sectors one by one because, it’s tough, you know, that selling something in healthcare is very tough and it’s very easy to get distracted.
The survival is definitely a big factor. That’s why they try to expand different offerings, different services. At that point, there is no differentiator with the other big companies at the moment. It’s tough because the sales cycle is hard. Changing people’s ideas is hard. In the end, I view that the healthcare is actually about changing the ideas of people. But changing ideas is very tough. It takes time.
Madison Klein: Now, you’ve recently gone out and started Mimi Labs, which speaks to beautiful small projects that fit together to make a larger impact. Can you tell us more about what inspired Mimi Labs and your founding of it, and how that ties in with testing and learning and having the patience to change the way that the conversation is had?
Yubin Park: It’s more about, can I know my personal inclination? I tend to like, let’s say, a rock band or something like that.I usually like the first album, before they get popular — like Nirvana and all those things. I usually like the first albums. I actually am inherently attracted to those things people do not pay attention to, the things that I think people are undervaluing. I like those things because I think, you know, to some degree it’s more special to me that I actually make a connection to those people. And those are stuff for projects that actually people do not appreciate. I usually kind of leave those programs when people start to like it.
Madison Klein: Do you think the conversation around some of these concepts changes fundamentally when more attention is paid to them?
Yubin Park: I think actually a bit more later. I think as a subject becomes popular, I think, it’s a kind of mutual. Instead of the interactions of that subject and the popularity, well, you know, just the audience. I think it changes, it muddies — it loses its original intent.
Madison Klein: There are so many different stakeholders across the system, across healthcare. It can become an exercise in not only changing the conversation but an exercise in coalition building and getting people to change the way that we’re all relating to how healthcare is paid for, how it’s delivered, the data that’s feeding policy, the data that policy makers have when they’re making decisions, and a lot of the stakeholders aren’t nerds, right?
So how can we, if we are trying to shape the conversation, bring the uninitiated, so to speak, along? And do you think that the rise of casual analysis and machine learning can power the advancements in value-based care in some way or help to develop that sort of data and understanding?
Yubin Park: I think we are touching two things, if I’m understanding correctly. So yeah, I think machine learning definitely can help value-based care in multiple domains. Administrative burden, reducing those, you know, there are different things.
But the latter part you mentioned, bringing outsiders like me to this field, itneeds to be done because, as I said earlier, we accumulate a lot of burdens in this system. Different processes, all these different, legacy processes, legacy computing, legacy regulations, and all those things are accumulated. To some degree, I think that nerds are very optimal beings to clean them up. I think we are trained to analyze complex data and figure out how to clean them up. And that’s what we do, cleaning codes, all the time. I also debate that a lot: how to make this feel more interesting for people like me or others out there.
How can you make healthcare always has a kind of nice purpose, helping people and all those things. But I think we need a bit more than that. I think we need to make this industry more energizing or exciting enough for those people right now who are motivated by the good cause.
I think that’s all good. But I think it’s not just enough to actually bring a lot of people in this field. I think it needs to be more, you know, of a “happening” place.
Madison Klein: Sure, sure. You said earlier in this conversation that healthcare is 20% of GDP.
Changes in policy not only affect people’s lives directly in a one-to-one basis in the way that they’re interacting with or attempting to interact with the system, but it also has huge impacts on GDP, and on the economy, on the sustainability of the social safety net.
Without making it more engaging, without making it more exciting, how do you get people to coalesce around it and care? How do you get the patients to care? How do you touch people across a complex system?
Yubin Park: What I’m about to say may be a little bit controversial. Reaching out all these people aligned, the beneficiaries and the doctors, it’s tough. And, to be honest, actually, if I were given that task, I don’t know if I actually will say yes to take on. So, yeah, it’s a tough task. But what I think is possible is [concerning] new Medicare enrollees.
Before this recording, I think we were chatting about our in-laws and all those things, you know, being of Medicare age. For example, my in-laws, they are very good at using mobile phones. They both have iPhones and they use Mac and all those things and are fairly skilledYou know, my father-in-law was a programmer, too. I think, people who are getting on to Medicare, I think they’re actually, not that different from you and I. I mean, of course, ages are a little bit different, maybe 20, 30 years.
But I think in terms of using technology, they use Facebook. Some of them use LinkedIn. They use Twitter, and they look around a lot of different websites. You know, they actually shop a lot on Amazon. They actually are not afraid of getting on the Zoom call with the grandkids and all those things.
Things are changing, with the new generation of the Medicare population. I think that population will be the starting point to actually adopt. The reason I said what I’m saying is controversial is, I don’t want to view this as keeping up with the older population. I think those are really changing, but I view practically the change in that the population may be a little bit slower. Because later in life, adopting new technology, adopting different ways of thinking and communication methods or kind of changing their ideas may be more challenging than the new Medicare generations.
But the baby boomers coming in, I think, things may be possible and the way to do it is, giving the most familiar medium for them, which is digital technologies.
Madison Klein: Yeah. I’ve heard you talk a lot and write a lot about the impacts of demographic shifts. Both the population getting older, the baby boomer generation, but also the way that both providers and beneficiaries are moving around the country. You know, we’ve seen all these heat maps — what are some of the major demographic shifts that we should be watching for? What are some of the things that our system may or may not be prepared to take on as these shifts happen?
Madison Klein: What does value-based care mean to you?
Yubin Park: Value-based care to me, I also question myself often. The meaning of the word got tainted over time a little bit, but I believe the original intent of the word value-based care is essentially getting the high quality care at the lower cost, and that’s kind of the objective.
How to implement value based care, there are a lot of different ways, probably there are almost an infinite number of ways out there. People view value-based care with a specific implementation.
That’s kind of concerning, to be honest, because I think value-based care is just a principle. Let’s get high quality care at a lower cost —should be the goal. I mean, capitation is one way of doing it, but I don’t think capitation equals value-based care, to be honest. But how to implement it? I think my view is that we still are experimenting. That’s kind of the way I view it.
So coming back to your original question, what is value-based care? We know our objective, but we are still searching for the right solutions.
Madison Klein: What are you seeing working and what are you seeing that you feel we need to move away from?
Yubin Park: A lot of those are case by case. I think one way that works in one company doesn’t quite translate. That’s kind of, at least empirically, that’s what I have been seeing. I want people to understand the sustainability of those solutions. To make a particular implementation sustainable that implementation must make the provider’s work life sustainable. That’s probably the biggest missing point at this point. I think a lot of our value-based implementation, I think actually it’s making providers life miserable to some degree.
Madison Klein: Yeah, why is that, for the uninitiated? I’d love for you to tease out what you’re seeing.
Yubin Park: Yeah, because it’s kind of starting from how to measure the value idea. Coming back to the original value based care ideas, it’s high quality care and that’s a little bit abstract and vague. So how to measure high quality care? To measure, people develop a lot of proxy metrics, and there are a lot of surrogate metrics, derivative metrics coming out, and those usually trickle down as additional paperwork for providers. And, usually, those things are driven by people who actually do not quite understand the actual workplace, how the clinic is run, which is a little bit sad, but I don’t blame them because, you know, in the end, it’s very difficult to understand. And even I don’t quite understand either.
Madison Klein: You’ve written a lot about this administrative burden and additional paperwork, and a huge amount of time and effort is devoted to claims in healthcare, and recently you wrote a paper for the Duke Margolis Institute of Health Policy, I believe, about moving away from claims toward EHR data, for things like risk adjustment.
Do you think that technology is already solving some of these problems? Or do you think that there’s still a long way to go, to get the claims data and measures where it is making providers’ life easier?
Yubin Park: Technology-wise, I think, it’s about to be ready. And as we talked about, it’s about changing people’s ideas. We’ve been doing things the way we’ve been doing them for decades and I think a lot of fears are there. Doing new things is, tough and the new way of doing things, especially in healthcare, bears a lot of risk.
So let’s say we contract with the one provider group and I don’t want to get claims, I’ll just get your EHR hooked in my system, and I’ll use all these crazy technologies, and that’s how I’m going to pay you, and all those things, let’s get on a contract. Probably technology-wise, maybe we are ready to do that, although there are a lot of other small parts, and the details need to be developed.
To actually make people, stakeholders, comfortable with doing it, I think that it will take time.
Madison Klein: Well, Yubin, I’ve really enjoyed this conversation. A big takeaway has been that it’s not only the policy, it’s not only the data, but it is also about changing the way that we’re having the conversation and changing the ideas and trying to push the boundaries of our imagination to make some innovative things happen.
Thank you so much for joining us today and for taking the time to step onto our roving recording studio here.
Yubin Park: Thanks for inviting me, and thanks for guiding the conversation — it’s very easy for me to digress.
Madison Klein: Well, it’s been a real pleasure.
Yubin Park: Thank you so much.