Interview with Kate Musler

“Our providers are our customers. Orienting ourselves to try to understand the challenges that providers face — and to meet them where they are, to work with them to make the system function better as a whole — that is really critical to our success,” said Kate Musler, Senior Vice President of Provider Network and Payment at Highmark Inc.

Musler transitioned into her new role in January after leading the underwriting team at Highmark since 2019. She has more than 20 years’ experience in the health insurance industry — working primarily in actuary and underwriting. That unique perspective shapes how she approaches provider contracting and relationships.

“I have that [sort of] first-person understanding of how the costs impact our members and that helps me put in context the mission of why we need to be good stewards — balancing the dollar spend on care with the value delivered,” she said.

Highmark’s value-based care (VBC) strategy emphasizes shared accountability for patient outcomes and expenses with our network providers. Aligning incentives to ensure everyone is working toward common care and cost goals is one of the drivers for Musler’s collaborative approach.

“We want to collaborate with providers in a way that enables us to meet our fiduciary duties to our members and enables us to manage their care, but at the same time, doesn't make life hard without reason,” Musler said. "We want to ensure we are only asking for and requiring what’s needed, and that the way in which we obtain that information and the way in which we share information back is useful and efficient. We’re certainly not there — but that's the path we’re walking.”

The acknowledgement that there are opportunities to drive meaningful change are evident from VBC programs to technology platforms. Highmark is currently working on enhancements to our self-service tools — like the provider portal and Provider Resource Center — and finding ways to make the exchange of information more readily available to our network providers using their preferred channels.

Musler said, “When you think about the fact that it's 2023 and if I have a question for my cell phone provider, my preferred solution is:

  1. Just log into my account,
  2. Do an online customer service chat while watching a baseball game, or
  3. Make a phone call.

“The feedback we hear from providers,” she continued, “is that they don’t want to get on the phone and have a long, involved conversation. They want answers at their fingertips. That is where we are trying to move.”

Better self-service tools will reduce administrative burden, improve office workflows, and simplify complex transactions — allowing providers to focus on delivering care to our members.

“For the provider organization, I think Living Health really means taking that mission of enabling the member-provider interaction and thinking through what that needs to mean for the provider experience everywhere we touch the providers,” Musler said. “And we do not intend to operate as a one-way loudspeaker. We would like this to be a conversation. As providers have ideas, we are evaluating how we can potentially incorporate those into our future strategy.”

This month, the federal government officially ended the Public Health Emergency (PHE). Musler said that for her, this is a time of reflection on the last three years and the changing issues we’ve all faced.

“The healthcare system is in many ways coming out of that period a very different system. Our role is to help support a healthy community of providers, meaning a healthy system available to our members to access care that they need,” she said. “We recognize that providers have been through a lot of disruption and have navigated many challenges. We’re here to help as much as we can.”