Leader Spotlight: How first principles tie into ruthless prioritization, with Ben Hackett

Ben Hackett is Senior Vice President, Product Management at Accolade, a personalized healthcare company for employers health plans, government agencies, and consumers. He began his career as a product manager at Blacktee Systems, an integrated technology services firm, before transitioning to LabKey Software. Prior to joining Accolade eight years ago, Ben co-founded jydo, an IoT platform that helped facility managers manage, monitor, and control thousands of conference room devices.

In our conversation, Ben talks about how ruthless prioritization begins with first-principles thinking, as well as how revenue needs to be constantly balanced by overall core cultural cornerstones. He also shares how he helped facilitate Accolade’s acquisition of PlushCare and worked to foster trusting relationships to bridge the two companies together.

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Using data to create sustained patient outcomes

To start can you provide an overview of Accolade and your role as Senior VP of Product Management?

Accolade is an advocacy, virtual primary care, and expert medical opinion company. We support all of the member services within that to improve clinical outcomes for all our members and their families. We also reduce the overall healthcare cost trend for customers.

In addition, we support the consumer side with virtual primary and mental healthcare via our acquisition of PlushCare. That component still lives under that brand and we do anything from urgent care requests to longitudinal virtual primary care.

In my role, I oversee our recommendations platform known as the True Health Engine. It takes things like patient traits, which medications they're on, and conditions they have, groups them together, and ties that into interventions we call True Health Actions. These interventions are opportunities to introduce a member to something like a clinical program, point solution, etc. All of the care recommendations that members receive are personalized based on what they might need and would create the best outcome for them.

I also oversee our data platform, which is how we ingest and share data with clinical partners, health plans, or back to employers, as well as customer reporting.

How is Accolade differentiating itself from other offerings in the space? What do users benefit from in working with Accolade?

Our differentiation is in the technology piece and how that ties to improved outcomes. We have designed a digital health platform for a people-friendly experience that enables healthcare that is personalized, trusted, enhanced by AI, and connected. Our technology enables us to make impactful recommendations that are personalized to each individual to guide them on the next best step in their health journey.

Our ability to integrate data from many sources allows us to drive conversions, enrollments, and clinical outcomes for patients. That is only possible when you can ingest claims, utilization management data, contact information for our patients, etc., to get the right personalized recommendation.

Also, a high percent of referrals to specialists come from a primary care physician, so our ability to have longitudinal relationships with patients is vital. The primary care component goes beyond advocacy for sustained patient outcomes, and that fills a huge gap in the US regarding access to physicians.

A marriage between two companies

You helped lead Accolade’s closing and integration of nearly $1 billion in acquisitions during 2021. Can you talk about that experience?

We had the privilege of looking to expand beyond ourselves and identify our overall strategy. We felt that expanding care opportunities within our populations and providing that to employers was in everyone’s best interest.

Once we decided where we wanted to head strategically, we looked into which companies we could come together with as one and solve clinical issues for our populations. We evaluated our options based on whether or not the other company was growing, if they were a leader in their space, etc. There was also a secondary component of whether the company had a technology platform that we could easily integrate with. We needed to create a seamless experience for patients and members, so that was a big factor as well.

There was also the aspect of how aligned the other company’s culture was with ours. At the end of the day, this is a marriage. There has to be a willingness to make trade-off decisions — either related to the product or business — to achieve the goals that you define together.

We were lucky to have integrated well with PlushCare and 2nd.MD, the companies we chose for primary healthcare delivery and expert medical opinions. The trust we built together allowed us to focus on the problems we're trying to solve together — improving patient outcomes and increasing the number of people who have access to our primary care physicians.

How did you approach the cultural component of bringing two teams working on separate projects or products together?

I learned that the best way to bring the culture together is to identify a project that we both work on together. Initially, we allowed both companies to define their product roadmap separately. The PlushCare virtual primary care team was working on their thing, and Accolade was working on ours. We allowed those things to exist in parallel, but eventually, we needed to get to one single experience.

Part of the problem many companies have during M&As is how to join to create one solution. For us, we identified the piece of the roadmap that we're going to do together. I invested a great deal of time in building relationships and trust and figuring out how we would build a virtual primary care experience together. That meant having a rough date in mind, and having engineering and product teams define their specs, timelines, and roadmaps together.

What tactics did you deploy to help foster that trust and build strong relationships?

I think this comes down to soft skills and going to bat for the company that you're bringing into the fold. I did my best to represent their interests and speak on their behalf when they weren’t in the room. Also, I made sure we were open to compromising around dates and experiences. Sometimes, the acquiring company’s teams have different views, so letting go, saying yes, or disagreeing and committing was important.

In general, it was key to be honest and open. I focused on investing my time and listening in a lot of ways. You would think that the product role in this regard revolves around defining roadmaps or helping set priorities, but honestly, so much of my time was spent translating the organization. I was sort of a facilitator, and in that way, I tried to be a trusted resource. This didn’t result from playing some larger political game, I just spent a lot of time being with people and listening to them.

‘Prioritization always comes down to math’

In working with people, one important trait for PMs is the ability to say no. Can you talk about your strategies for prioritizing initiatives in this way?

Ruthless prioritization is something I care a lot about. To me, it always starts with first principles. Revenue is important, and that has to be balanced by your overall core values. The core values should always check the decisions you make to grow.

Let's talk about our recommendation engine success rates, for example. From a prioritization perspective, we're always going to try and maximize our top-level goal. If the goal is to be the best at identifying the right populations for improved clinical outcomes, we're going to break that down from our current status to achieve that goal. What’s our current identification success rate? What are our current improved outcomes from our interventions? And what's the conversion rate when we make an intervention? If that breaks down to achieve our target of improving outcomes and savings, where are we dropping off within recommendations?

To me, prioritization always comes down to math. If we have the right high-level, first principles objective we're trying to achieve — which, in this case, is improving outcomes — we can look through the full funnel, see where the low-hanging fruit is, and optimize there. We'll have tools to change directions as needed, but a lot of this goes back to the basics.

When you're talking about ruthless prioritization, how do you ensure that your decisions are received constructively? You don’t want to deter people or diminish the collaborative environment, so what methods do you employ for this?

I can spend so much time figuring out the scope and size of a request. Instead of pouring time into that, I am consistently reprioritizing my list. I communicate that out with my stakeholders and say, “Here's what I have, 1 through 10. Are you aligned?” Because, hopefully if my stakeholders are aligned to the most valuable items, I know whether they're going to say yes or no to a request if I bring it to them. If I know they're going to say no, I'll go back to the person who asked and let them know we can’t do it.

To maintain my relationships, I’ll let them know that I don't want to waste anyone's time by going into an investigation, but if they disagree, this is my top 10 list. They can talk to their boss, who’s my stakeholder and already knows my roadmap, and see if they can get a different answer.

The push for stable conversation rates

In your current initiatives, what are you focused on right now to drive the company forward?

I’m focused on the fundamentals. When customers purchase Accolade, they expect to be able to increase the right types of utilization within their populations to specific clinical programs. For example, Virta is a clinical solution for diabetes. Right now, we're measuring the percentage of the population that would be a good match for Virta and diabetes. We know from our current data that anywhere between 3 and 7 percent of an employer's population will be a good match for Virta.

We have trusted partners we've vetted and know have good clinical outcomes. For all those trusted partners, we're saying, “OK, what's our target population?” I'm focused on getting to a strong baseline measure of the right amount of people to engage because only so many people we send emails to will then call us. What does that next step of the funnel look like? What conversion rate is good to get someone into that program? And for those who are interested, how many people actually enroll?

As we've gotten better with this, we’ve seen that we drive 3–4x as many enrollments when we make the right recommendations. I'm really focused on getting to stable conversion rates that we can measure and improve on in these specific, high-impact clinical programs. From there, we’ll continue to expand to more and more intervention types.

How are you incorporating customer feedback into the products to improve them and drive these outcomes?

I try to talk to at least one or two customers per week. When I do that, I put my best product hat on and ask open-ended questions. It’s standard, but you learn so much new information. We offer reporting to customers to show them how things are going. One mistake we made was not providing context to the data. For example, we’d show how many people have called Accolade, but there was no way of knowing if that number was good or bad.

We’d talk to customers and they’d say that they wanted to see increased utilization of clinical partner point solutions like Virta. We’d ask them, “How will you know if you’re successful in the partnership?” They’d say that they wanted to see the number go up, but they didn’t know the threshold for going up “enough.” We learned through those interviews and conversations that we need to help our customers understand what a good target is for their numbers with context — whether that’s via industry standards, conversation rates within the TAM, external data, etc.

Lastly, what strategies do you use to stay informed about industry trends and emerging technologies that could impact Accolade's product strategy?

I’m on a lot of great Substack email lists. Health Tech Nerds is a fantastic healthcare-related one, but I also love The Diff, which is an interesting take on a bunch of different industries and patterns. I also like Money Talk from Bloomberg, by Matt Levine. He's an incredible writer on topics that I personally don't have expertise in. He makes complex topics so digestible that I find them orthogonally related to the work that I do.

This sounds funny, but I also like to read Hacker News — mostly because I love to read engineering's take on product. I love reading those threads because I like hearing either criticism or support regarding what works in product.