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Idea Machines

Mar 5, 2019

In this episode I talk to Torben Nielsen about creating new products and systems in health insurance. We touch on the tension between insurer's well-founded risk aversion and trying new things, the process of insurance companies working with startups, and how to even know if things are working.

Torben runs programs at Premera Blue Cross with both internal teams and external startups to build new products and systems. Premera is one of the largest health insurers in Alaska and the northwest US, so even small changes can impact many people. Torben spent many years working in healthcare and built his tech chops at Xerox and Lego. Much to my chagrin, we spent zero time talking about the latter because of time constraints. His official title is "VP of Innovation" which I do poke at a bit in the podcast.


My major takeaways

  1. I'm starting to sound like a broken record on this, but in health insurance, like so many places, the process of creating new products and systems ultimately hinges on the opinion of a few decision makers.

  2. Startups trying to work with health insurance providers are often frustrated by the providers' speed. This conversation helped unpack why the providers move slowly and what they're trying to do to change that - I hope it works!




What does being a VP of Innovation in a large org do? What are your incentives?

Incentives in the system?

Who are the players in the process of innovating within healthcare?

Why is healthcare slow to change? I assume there must be good reasons.

How would you deal with a situation where an innovation challenges the core of the company?


  • Primero test kitchen

How do you assess/quantify risks? What are expected ROI timelines? How should startups engage in partnerships in healthcare ecosystem?

Hard Question. Are there moral limits on cost per treatment / monopolies to drug therapies?

What have innovations in health insurance looked like in the past?

Let's talk about the elephant in the room: from the startup world, working with insurance companies is notoriously dangerous because of getting stuck in pilots,

Insurance companies are inherently a hedge against risk. Innovation has built in risk. How do you manage this conflict? It makes sense that

Where do you see the biggest areas for innovation?