Chapter 16: As VP of Business Development: Today’s Initiatives and What the Future Holds for MD Anderson
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Description
Her current work focuses on refining the model of how MD Anderson establishes partnerships with other institutions in the U.S. and abroad. She talks about the need to develop payer products to address changes in the healthcare reimbursement arena. She talks about the need to diversify MD Anderson’s income streams beyond patient care revenue and lists roles that the Office of Business Development serves as other offices take on this challenge as well.
Ms. Hay explains that in future she will focus on visioning business possibilities facilitated by technology and gives an example of discussions with Elekta about providing mobile treatment planning for radiation oncology.
Ms. Hay notes that “we should be a cancer knowledge network” in a nation that focuses on genetic testing, molecular immunology, and the democratization of cancer care dovetail with MD Anderson goals.
Identifier
HayAC_02_20150602_C16
Publication Date
6-2-2015
City
Houston, Texas
Interview Session
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; Leadership; MD Anderson in the Future; Building/Transforming the Institution; Multi-disciplinary Approaches; Growth and/or Change; Research, Care, and Education; Institutional Mission and Values; MD Anderson Culture; The Business of MD Anderson; The MD Anderson Brand, Reputation; Business of Research; Fiscal Realities in Healthcare; The Healthcare Industry; Technology and R&D
Transcript
Tacey Ann Rosolowski, PhD:
Yeah, okay. So, I wanted to make sure that I’ve covered everything, you know, so that, you know, we understand, for the record, you know, what’s the scope of your responsibility. And I guess—I guess the way I want to start that, rather than kind of going with the official line, is, you know, did you have a personal set of goals when you took on that new, expanded role? You know, there’s the—what was my mandate? What was my—what were my marching orders? But, versus, you know, did you have a personal sense of what you wanted to accomplish in this particular role?
Amy Carpenter Hay:
Yes, I mean, I think that my—their—the task that was put in front of me was to mature our partnership model, to gain partners, and, quite frankly, to grow our international business. The goal, in my opinion, has always been really four-field. It’s been, one, we need a consumer-facing product. Two, we need a provider-facing product. Three, we need a corporate product. And four, we need a payer product. And so, those are the categories I typically think through. So, in the consumer, those are all of the cancer prevention and screening and wellness things we’re doing. In the provider, those are the partner members and the international associate members. In the corporate, that’s what we’re focused on—the employer membership and large corporate alliances. And then, on the payer side, I think there’s a lot of work still to be done there. Now, the way that I personally have always viewed Business Development is that we should really be the conduit for every other piece of the organization. Meaning I, as Business Development, should be opening the doors to Marketing and Communication and Corporate Alliances and Industry Ventures and Development. So, I should be kind of the tool that they utilize in order to accomplish their goals. So, to me, it was never about just opening up the next partner. It was always about kind of a bigger vision of how do you—going back to the word—democratize cancer across consumers, providers, corporations, and payers?
Tacey Ann Rosolowski, PhD:
Talk to me a little bit about the payer piece, because, you know, we’ve talked a little bit about the other ones. But what about the payers?
Amy Carpenter Hay:
The payer piece is still, you know, something that, institutionally, we have devoted a lot of time and effort to. My role on the payer side is more support. So, a good example of that is that, institutionally, we are starting to get involved in bundled payments. We currently have a relationship with United for a bundled-payment plan in Head and Neck for four specific disease sites there. So, these are the type of innovative payment mechanisms that we have to start looking into. Now, as—from a Business Development standpoint, I think that those payment initiatives are gonna have an impact on everything else. I think they’re gonna have an impact on who we’re partnering with, and who we’re working with on the employer side. Because the payer community is really changing. We’re seeing that not only within the changes in healthcare regulations, but also in the managed-care environment as well. You know, if—when people ask me, “What kind of keeps you up at night?” One of the things that does keep me up at night, specific to MD Anderson, is that we have had quite the luxury of living in an environment in which we continue to be paid for our fee-for-service. Most people don’t have that luxury anymore. We continue to be paid a “hold harmless” payment, meaning we’re kept whole with Medicare.
Tacey Ann Rosolowski, PhD:
What was that phrase again? The hold—
Amy Carpenter Hay:
“Hold harmless” payment, which is our Medicare exemption. So, we have a lot of luxury based on our designation as a comprehensive cancer center, which we deserve. The healthcare politics and the gravity of the healthcare financial situation in the United States is going to continue to erode our bottom line. It just is. And we know that. And so, we, as an organization—while we are not feeling that pressure as much as typical acute-care providers, we have to start preparing for it. I think part of my job in Business Development is to continue to support the institution in thinking through these things. The ways that I do that are really twofold. First, a lot of our partners are already dealing with this, so we can learn from them. Our relationship at Banner, for example—they are very active in risk-sharing with managed-care companies. They’re very active in the ACO [accountable care organization] environment. We need to be learning from that.
Tacey Ann Rosolowski, PhD:
ACO?
Amy Carpenter Hay:
Accountable care organization—
Tacey Ann Rosolowski, PhD:
Oh, okay, mm-hmm.
Amy Carpenter Hay:
—environment. And the other way that I think that we have a responsibility in Business Development is that we have to continue, as an institution, to diversify our bottom line. We are—in the future environment of healthcare delivery, we cannot be completely reliant upon patient-care revenue. We have to have other revenue streams. Some of that will come from the partnerships that I’m talking about. Some of that will come from transactions with big pharma on drug development. Some of that will come from innovation. But as an organization, we need to continually be identifying opportunities to diversify our revenues, to plan for the day when we maybe don’t get paid the way we are paid today and, therefore, our patient-care revenue is significantly decreased. If that happens, we have to find another way to fund our research. If we don’t, we won’t continue to be who were are.
Tacey Ann Rosolowski, PhD:
What are some of the things you’re working on now, to anticipate that?
Amy Carpenter Hay:
I guess I don’t understand your question.
Tacey Ann Rosolowski, PhD:
Revenues—I mean, what—are there specific opportunities that you’re looking into now to develop—
Amy Carpenter Hay:
I think it’s everything we’ve been talking about.
Tacey Ann Rosolowski, PhD:
Okay, mm-hmm.
Amy Carpenter Hay:
I mean, it’s the partner memberships. It’s the employer program. It’s the big data and the implementation of, you know, technology tools. So, it’s—all of these components contribute to how are we diversifying our bottom line.
Tacey Ann Rosolowski, PhD:
Okay, okay, yeah. Okay. And so, the way that, financially, that would work is the fee that MD Anderson would receive goes, first of all, to pay the bills for the people who have actually, you know, helped support that initiative. And then, the surplus goes into research.
Amy Carpenter Hay:
No, as I—as I stated earlier, you know, the fees that we get paid go directly to the mission. In addition to that, we get paid for our time and attention.
Tacey Ann Rosolowski, PhD:
Oh, okay.
Amy Carpenter Hay:
So, all of that time and expense attention is a direct payment.
Tacey Ann Rosolowski, PhD:
Okay, gotcha.
Amy Carpenter Hay:
So all of the fixed and variable fees across all programs just go directly to the bottom line. It’s pure margin.
Tacey Ann Rosolowski, PhD:
Okay, wow. That’s great.
Amy Carpenter Hay:
So that helps us. And, you know, I think, as to your question, the other component is not just the new programs Business Development is creating and trying to mature and sell. It’s the support Business Development provides across the entire institution. You know, for example, Development. You know, we have a very large philanthropic base. I see as part of my job—is to support the people in Development, whether it’s talking to donors or whether it’s introducing them to major international entities and organizations, there’s a support component that needs to be done across the institution. And that’s—I think part of our role in Development is to ensure that those conduits are open. So, it’s not just about a new product. It’s also about how can we leverage it for philanthropic dollars? How can we leverage it for marketing? How can we leverage it for tech transfer? How can we leverage it for clinical-trials accrual?
Tacey Ann Rosolowski, PhD:
Now you mentioned that you’ve hired another person—another you, or almost you. [laughter]
Amy Carpenter Hay:
I did. I did. And you can talk to him when he comes [inaudible].
Tacey Ann Rosolowski, PhD:
Yeah, but I’m just wondering—I’m anticipating, you know, like, so, in July, when this individual comes. And his name is?
Amy Carpenter Hay:
His name is Mike [Michael] Brown. He actually has a history with the organization as well. Mike Brown was an administrative fellow, as I was, back in the day. I don’t know the specific years. He was an administrative fellow, and then after his fellowship started working the network on the clinical side. He then transitioned to the Business Development side. I had him working over our analytics and our financials, and really was quite remarkable. He was actually so remarkable that he got recruited away to be the vice president for Business Development for the University of Chicago. He’s been there for approximately one to two years and done some really innovative things up there. It’s given him the chance to do some things that are more diverse, that I think we can really learn from. Had a chance these last few months to recruit him back to MD Anderson. So, he’ll be returning in July as the associate vice president for Business Development.
Tacey Ann Rosolowski, PhD:
So how will your spheres of influence be constructed after he arrives?
Amy Carpenter Hay:
You know, really, at this point, the growth is so tremendous [laughs] that we’re—he and I partner very well together, so he likely will start working on a day-to-day basis on our regional growth—so, here in Houston. And I will continue focusing a lot of my time on the partners in the partners in the US. We likely will split the international. And where I, personally, have—want to find time is, to spend much more time on the vision component—on thinking about the future, where we’re going, collaborating with the new chief innovation officer, specifically in the area of big data and democratization. So, I’m hoping that he’ll come in and be able to do a lot of the day-to-day management, so that will allow me to be able to elevate on a more visionary—what’s com—what’s next five years? What’s next ten years? What do we need to be thinking about, and how can we prepare ourselves, today, to accomplish that?
Tacey Ann Rosolowski, PhD:
Mm-hmm. Now, I am aware that we’re at three o’clock, and we were supposed to stop today at 3:00.
Amy Carpenter Hay:
That’s okay.
Tacey Ann Rosolowski, PhD:
Well, sure, thanks for today. And I’m just—for the—for purposes of the recorder, I’m turning off the recorder at about one minute after 3:00.
Amy Carpenter Hay:
Sure.
Tacey Ann Rosolowski, PhD:
It’s okay? Because I thought— you know, and we can probably finish up if we go another half hour or so. Does that work?
Amy Carpenter Hay:
Yeah, no, that’s great.
Tacey Ann Rosolowski, PhD:
Okay, cool.
Amy Carpenter Hay:
Yeah.
Tacey Ann Rosolowski, PhD:
Great. So, let’s—I—let’s talk a little more about that vision component. I mean, if there’s some pieces of that that we haven’t hit already, because you’ve kind of talked a little bit about future of MD Anderson. But what are you really excited about pursuing for a future vision?
Amy Carpenter Hay:
Well, I mean, I—to me, it goes back to the innovation side. You know, as we create what I—what I call the interchange, which is really this cloud-based repository of knowledge, I think that is the future. You know, I envision that will hold our telemedicine in the future. I envision that will hold very disease-specific quality-assurance tools, metrics, tracking of everyone across the MD Anderson network, whether it’s regionally, nationally, or internationally.
Tacey Ann Rosolowski, PhD:
Now you’re looking at an image here. Is this—
Amy Carpenter Hay:
[laughter] Oh, I’m sorry.
Tacey Ann Rosolowski, PhD:
Oh, no, I was just wondering if it was relevant—
Amy Carpenter Hay:
It is.
Tacey Ann Rosolowski, PhD:
—’cause I could take a picture.
Amy Carpenter Hay:
Oh, no, it’s—no, it’s just something that I have been playing with. You know, kind of, how does this interchange work, and how do consumer access it? How do providers access it? How do payers and corporations access it? How does it become this huge repository of knowledge that kind of fuels the future of oncology? And that’s —that, I think, is the key, you know? So, how do you leverage technology in a meaningful way? And it has to be meaningful, because I think the challenge—and I was—actually had a meeting on this, this morning. The challenge is that we can all sit in a room—brilliant people—and all agree on the vision. And I see the vision. But the hard part is how do we get to the vision? You know if I—if I don’t have a widget. If I don’t have something that encompasses that vision, all I have is a vision. And it might be wonderful, but it needs to have the backing and the development behind it. It has to be accessible to patients. It has to be accessible to providers. It has to show outcomes. It has to show value. And those are the drivers that I think that we need to start orchestrating in a very meaningful way. And it’s where the big-data component gets in. You know, how do we learn every single time from every single patient in order to do the next patient better? That’s the future, in my opinion, of where we need to be going.
Tacey Ann Rosolowski, PhD:
So how are you—how are you working on that? I mean, that—making it accessible, making it meaningful, making it implementable? What’s happening with that?
Amy Carpenter Hay:
Yeah, I mean, that’s where, you know, with a little bit more time—but we’re doing it now—is collaboration. It’s collaboration with Dr. Chin, with what she’s doing with Watson and the Oncology Expert Advisor. It’s collaboration with corporations like IBM, like AT&T. It’s collaborations—this morning, my—this morning, my meeting was with an equipment company—Elekta. And they traditionally are a LINAC [linear accelerator] neuroscience company. But they’ve come back and said, “We’re interested in big data. What if we could come and partner with you and think through how do—how do we provide mobile treatment planning for radiation oncology?” What if you, as a physician in small-town Arkansas, had a patient that you s—put that patient on the CAT [computerized axial tomography] scan. You’ve uploaded the CAT scan. And on our interchange, we did the treatment plan for you. And then you know you’re delivering a treatment plan that has been reviewed and approved by MD Anderson. So, it all kind of gets back to how do we impact? How do we reach these people? And so, I think it’s the combination of finding corporations that are interested in this and want to have innovation in programs and collaborating with our doctors here at MD Anderson to do things like we’re doing with Watson, teaching Watson oncology; tracking those outcomes; pushing it out into our network to test it. So those are the types of ways in which we’re trying to push into this space.
Tacey Ann Rosolowski, PhD:
Do you find—I mean, is it generally younger physicians at MD Anderson who want to do this? You’re nodding, yeah.
Amy Carpenter Hay:
It’s generally younger to mid-range, you know, kind of back to your culture question. Some of this is a little difficult for those that have been practicing medicine for a long time, because, you know, the criticism that I often hear is, “Well, a computer will never be able to tell me how to treat a patient.” Well, yes, you’re right. Absolutely right. But that computer might be able to access 10,000 clinical trials around the world, and at least give you a list of ten that your patients would be appropriate for. And no human brain can do that. We can’t, you know? So I think, culturally, you’re looking at the assistant-to-associate mid-range, with kind of the innovation at the division-head level. And, you know, as an institution, we have the right division heads now that understand this. And they’re willing to not only contribute, but also advocate for resources to assist. You know, tomorrow’s consumer—tomorrow’s cancer patient is going to get on their app, and they’re gonna say, “Who’s the best provider of breast cancer?” And they’re gonna wait for an answer, and then they’re gonna say, “Okay, show me your outcomes.” And they’re gonna get an answer. And they’re gonna say, “Okay, show me where I can go to get that—to get that therapy.” And that’s what we have to be preparing for now.
Tacey Ann Rosolowski, PhD:
You sound very excited when you talk about this.
Amy Carpenter Hay:
Oh, it’s—I think it’s fantastic. I mean, I really think that I, as—in my role at MD Anderson, I think that I have no laid the groundwork, from a business perspective, on how we do partners and how we do, you know, international associate members. And we’ve done that. I—you know, we’ve done—I’ve negotiated three partners now. I’ve negotiated multiple international contracts. We know how to do that. It’s time for me to let someone else do that, and it’s time for me to start thinking about what’s the next generation of this. So how do we leverage all of these partners? How do we have them not only contribute, but also be part of this global expansion of knowledge? You know, and I kind of go back to one of the things that I’ve really, kind of, continued to think about—is the precision-medicine initiative that Obama has. He has legislated $215 million to precision medicine. Seventy-one, I believe, millions of it is specifically for the National Cancer Institute. There are only three goals to that $70 million. It is genetic-based testing and treatment. It is molecular immunology. And it is—and the democratization of cancer care around the world—exactly what we do. And it’s—it—you know, it struck me when I read it. I mean, it’s—we should be a cancer knowledge network. That’s what we’re doing. And I think that if we are able to coordinate and to have the right resources and the right, brilliant people—which we have within Anderson—this is something that can become a reality. But it will take thought and innovation and collaboration.
Tacey Ann Rosolowski, PhD:
It’s a great vision. This kind of sounds like what keeps you getting up in the morning—
Amy Carpenter Hay:
It does.
Tacey Ann Rosolowski, PhD:
—and coming in. Yeah.
Amy Carpenter Hay:
It does.
Recommended Citation
Hay, Amy Carpenter and Rosolowski, Tacey A. PhD, "Chapter 16: As VP of Business Development: Today’s Initiatives and What the Future Holds for MD Anderson" (2015). Interview Chapters. 965.
https://openworks.mdanderson.org/mchv_interviewchapters/965
Conditions Governing Access
Open
