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Welcome to The Culture Code podcast. On this podcast, you’ll learn how to grow, shape, and sustain a high-performance culture with the CEO of LEADx, Kevin Kruse. From designing and delivering highly effective leadership development programs, to measuring and improving the employee experience, you will understand what it takes to cultivate a thriving company culture. Through interviews with Chief People Officers, deep dives into key topics, and recordings of our invite-only community sessions, we bring you cutting-edge, data-backed insights from the most desirable companies to work for in the world.
Kevin Kruse - LEADx: Hello, everyone! I'm Kevin Kruse. Welcome to the Culture Code. Our guest today is the Chief People Officer at Collective Health, Abby Buck. Abby, welcome. Thanks for joining us.
Abbie Buck: Thank you so much for having me, Kevin. I really appreciate it.
Kevin Kruse - LEADx: Now, I commented before I started recording that you have a beautiful background. Where are you joining us from today? Where are you doing this podcast from?
Abbie Buck: Well, I am taking advantage of the fact that it is Friday, and I am up in the Sierras in California, near Lake Tahoe.
Kevin Kruse - LEADx: Yeah, I was born in Southern California and still have tons of friends and family there. I was just talking to my daughter about how California is one of those rare states where you could say, "Hey, it's Saturday, let's go to the beach. It's Sunday, let's go to the mountains." It's just a beautiful area, an ideal area that you live in. So congrats on that.
Abbie Buck: Yes, thank you. Thank you.
Kevin Kruse - LEADx: For those who might not be familiar with Collective Health, how big is your organization and in plain language, what do you do?
Abbie Buck: Sure. We are a healthcare technology company. We have about 750 employees right now. And we are focused on fundamentally making health benefits work better for everyone, and that really starts with the millions of Americans who are covered through their employer. So we know that the healthcare system in the U.S. is convoluted and costly, and the burden of navigating, understanding, and paying for healthcare typically falls to the individual, and that can really lead to poor utilization. It can lead to unnecessary cost and, frankly, poor healthcare outcomes for people. I think we all probably know someone, either in our family or amongst our friends, who has really had to work hard to advocate for themselves in that system, and Collective Health wants to change that. We do that through proprietary and highly configurable technology. We have a robust partner ecosystem and, frankly, industry-leading member advocacy that is intended to simplify the Health Benefit Plan Administration for self-insured employers and those that want a better and higher quality healthcare experience for their employees and their families.
Kevin Kruse - LEADx: This is incredible and important work. And when I was just doing prep for this interview, Abby, I was on your website and was blown away by the 70 Net Promoter Score that you have, because most of us in a normal health insurance or health system are not given NPS of 70s. In this country, no, in some cases, they're negative, of course. And most people don't know this about me, but decades ago, I started a sort of a conference, a group that lasted for about 5 years. It was called E-Patient Connections. It was all about empowerment, the advocacy that patients have to sometimes unfortunately do for themselves. So it's great that you have a great practice in that area as well. That's such important work. Abby, we're talking about culture today, and before we dive into it, I know the paramount or top of mind for many CPOs is still this hybrid work, remote first, etc., and there's no one right way. Otherwise, we'd already be all doing it the same way, and we're not. So before we talk about culture, where have you landed on that issue at Collective Health?
Abbie Buck: So we have landed on a hybrid arrangement where we're asking employees to come into the office 2 to 3 days a week, and then work from home. Our rationale for that really is to, like many companies, balance the strong employee preference for having maximum flexibility and the need, particularly in our business. It's both a product and a service, and so there is a really high degree of collaboration that is required across the company that we feel is served by having people see each other in person.
Kevin Kruse - LEADx: That makes a lot of sense. How would you describe your company culture in just a few words?
Abbie Buck: Yes, it is a hard question to answer, especially in a few words, but I thought about it, and I would describe us as first of all, mission-driven. I would say, if you asked a hundred employees why they're at Collective Health, a hundred would say that part of the reason they're here is because of the mission of the company. They feel it really resonates with them. And I would say, customer-focused. I will tell you, I have never... We were in an all-hands meeting yesterday, and we were telling some customer stories, and I actually cried because we're talking about people in their most vulnerable moments. I don't think I've ever cried about something that we have done. I've cried about things that companies have done for employees. But the impact on members is really heartwarming and important. And then I would say, lastly, two words: curious and collaborative.
Kevin Kruse - LEADx: Curious and collaborative. What are some of the ways you foster or sustain this culture? Any unique rituals or traditions related to your culture?
Abbie Buck: Yeah, it's a great question, and one that we spend a lot of time thinking about, especially in a growth-stage company, where you're constantly changing and evolving. So, like most companies, we start with the basics and really believe that nurturing culture is multidimensional. There's not just one thing. So we start with the basics, and those include things like anchoring on values and then reinforcing those values through levers like peer recognition. Another thing that we do that is unique to this company is at every monthly all-hands, we share customer and member love. We call them "love letters," and they are direct feedback from clients and members to reinforce our values and that customer focus, and share the impact that we're having down to the individual level. As I said, I was teary yesterday, because it's so profound.
Kevin Kruse - LEADx: Yeah, I'm always listening for stealable ideas, you know, that anyone can take. And you actually gave me a stealable idea, because even at LEADx, you know, we're a tiny company. We have Slack, and we have a Slack channel for when customers say nice things, send us a nice note. And it was just yesterday I was like, "Where is that channel? What's it called?" And finally, I'm like, "Oh, yeah, it's just customer feedback." It's like, so boring. Customer feedback, love letters. So I'm going to hang up on this as soon as we're done, and I'm going to tell our Slack manager to change that to customer love letters.
Abbie Buck: I love them. And then let me just add, because there's some other stuff that we've been doing that I think is also really important. So, you've got the basics, and you really need to reinforce those core values of the company. But I think, you know, I, along with the rest of the executive team, am cognizant of the fact that there's a need to both preserve but also evolve culture over time. And as we get bigger, just as an example, it's more challenging to stay coordinated and collaborate with the right people at the right time. And that's a challenge for any growing business. So we've done a lot of work focused around our internal ways of working, and specific examples include things that are, frankly, they're easy to say, but they're sometimes really hard to do well, consistently. And so we've refined and clarified the purpose of internal key meetings, operating meetings, and the attendees for those meetings, and then coming out of those meetings, what are the key messages that need to be received by others in the company who weren't in attendance, and that requires shared clarity. It requires intentionality. And we've been doing a lot of work around that. We have more work to do. I don't think that this is ever done, but these types of efforts really help us improve collaboration, communication, and then aligning on outcomes and accountabilities. And that is also really important for us. Right? So we don't leave meetings and have people pointing in different directions about who's on first. Given in my mind that culture shows up in the minutiae of everyday, these are the types of efforts that I think are really subtle, but so critical to both the nurturing of culture, but also the evolving of culture, because what you pay attention to ends up being part of your culture.
Kevin Kruse - LEADx: Okay, so much gold there, Abby. I've got to dig into this a little. I want to dig for the gold. First of all, I think it's genius that you talk about culture. It's not just preserve, but preserve and evolve, especially in a growing, growth-stage organization. And with all these interviews I do, no one's ever like, "People should really challenge me more." It's like, Kevin, it's not just about preserving it, you know, it's about preserve and evolve it in the right direction. And the fact that you dove right into like, you said, the minutiae. You're talking about operationalizing aspects that drive culture. In the LEADx survey of employee engagement, manager effectiveness, I've been doing this for 30 years, and it was about 3 or 4 years ago where, for the first time, meeting efficiency, that's our label, meeting efficiency, showed up as a top 10 driver of employee engagement. People always complain about meetings, right? Too many meetings, too long meetings, too boring meetings, whatever it is. But I think post-pandemic, it's more critical than ever before. It's hard to do good virtual meetings, when people are in the office, you want that time to count, etc. So this is fascinating that the example you gave was really looking at the meeting. Meeting efficiency is my word, not yours. But you know, some of the operational aspects of those meetings. And I'm curious, Abby, like, was it sort of just a casual thing of, "Hey, everybody, let's just be more thoughtful about who we're inviting to meetings, cause we don't want to waste their time. And let's be more thoughtful about accountability, who does what," or is it like, "Pretty specific, like, oh no, no, no! We've got this monthly, whatever meeting, fill in the blank. Let's make sure at the end we write out. Here's the action items, and there's going to be one name on each list." Like, how detailed do you go with it?
Abbie Buck: Right. No, thanks for the follow-up question. So, I would say, it depends on the meeting. So I'll give you 2 examples. So we have a monthly company operating review, and in that, we used to include effectively all of leadership, all directors and above. And we decided that it was becoming just ungainly. It was hard to manage that number of people and sort of get to the right depth in these conversations, and so we then narrowed it very substantially. It went from, you know, maybe 50 attendees to 15, and then we have tasked those folks with. First of all, we, the Ops team, will summarize key takeaways from the meeting and then give it to the attendees, who are then tasked and really responsible for cascading those messages. So we do try to be really crystal clear with the messages, the key takeaways, at least at a sort of holistically. And then there may be things that are specific to a particular team that they could elaborate on, but really trying to just make it easy for leaders to do that right. It's about trying to remove the friction from it, and trying to remove all of the interpretation that we each bring to any given topic. And then on the, I'll give you another example with our, we have sort of like a product council meeting where we review progress against our technology roadmap, and on that one, the key players have been identified. Right? So if we're working on something related to our value story for clients, we know who's involved in that, and who is accountable for the work, and so it's less about discussing that stuff or assigning action items which we will do in the operating review. But more about, "Hey, are we all aligned on this? And if we're making trade-offs, are the right people in the discussion to make those trade-offs and prioritize customer needs?" And so that'll take a little bit of a different flavor. But we've been really intentional about who is in those meetings so that those types of conversations can happen. And then we've all summarized and understood and documented what's been agreed to.
Kevin Kruse - LEADx: That's great stuff. Let me shift gears. 70% of engagement is correlated to the manager, and front-line managers touch more employees than any other leadership group. What are some of the ways you develop your front-line managers?
Abbie Buck: Yes, it's an excellent question. So from a management development perspective, let me just say I'm in violent agreement with you about this being such a critical group to look after. I mean, everybody is a first-line manager to someone. However, our true first-line managers, I mean, that is a hard job. And so it is so important, I think, to start with core management training just to set them up for success. And, you know, we have a mix of people who have grown up here professionally. We've just rang in our tenth year anniversary, to people who are very seasoned leaders. But we really do start with the core. How do you, I mean just basic things. I call them Management 101, right? How do you give effective feedback? How do you make sure that you're delegating effectively? How do you support the development of your team members? Etc., etc. And so we do all of that. But you're right. We don't, I mean, I think back to my days at IBM, or PayPal, or eBay, or Splunk and gosh, I mean, we had more resources, right? They were much bigger companies. So one thing that we've done, and it's tailored to our needs, but we operate in an incredibly complex industry and the learning curve for people who aren't experts in healthcare is steep. And so one of the things that we've done for all managers is we've implemented a program that's really intended to build acumen around our industry and our business, and we do it with all managers, regardless of what department they're in, and it covers everything from Healthcare 101, and healthcare economics, to how we position ourselves externally, how we sell to clients, to a complete understanding of our product and services suite. It's very well attended. And then we've also, much like this webcast or this podcast, we've been able to record that for posterity, so that as we have an ever-changing, ever-growing management team, others can tap into that as well. And so that's one place where we've gotten scrappy just because we're smaller. But I think it really filled a need for the company to build business acumen amongst that group.
Kevin Kruse - LEADx: The success that your company has had, you can't have a successful outcome in the long term without a successful culture. How do you solicit feedback from employees about the culture and their engagement (e.g., engagement or other surveys, town halls, ?)
Abbie Buck: So we do pulse surveys every quarter. And those are, we ask two standard questions around engagement and belonging, and then each quarter we have thematic questions, an additional two to three questions that we ask. They are sort of precursors to what's ahead in the business. So, for instance, in the next survey, we will ask people about their experiences with being supported by their manager from a performance and development perspective, and that will be very helpful feedback for us as we then head into our performance cycle, so that we can use that data and prime managers to show up in the very best way for their team members. That's an example. So we do pulse surveys. We do monthly all-hands. We do exit interviews with everyone. Those are automated, however, we will also follow up where there's an opportunity to dig in and understand something a little bit more deeply. We'll do live exit interviews as well. And then, during our performance cycle, employees also have an opportunity to provide upward and peer feedback. And so that's another rich area of feedback in terms of people's experiences every day.
Kevin Kruse - LEADx: That's great. I love that you talked about the pulse surveys as using them as sort of precursors to things that are going on in the company.
Related to culture, are there any special initiatives or results you’re most proud of? I'm looking for more things to steal, Abby. I'm just shameless about it.
Abbie Buck: I'm happy. Steal away. I love stealing as well. Well, one thing, and I mean, frankly, I stole this from experiences I had at other companies. But you know, being in a growth-stage company is, and I'm sure you can appreciate this, given your role in your company, it's not always for the faint of heart. Right? I mean, it can be a really intense environment. And so one of the things that I introduced last year, which I'm very proud of, is the notion of having a sabbatical, allowing employees after 5 years of employment to take a dedicated chunk of time off, just to recharge and recommit. And we have, you know, we're 10 years old, and we are adding new people all the time. So it's not like we don't have an avalanche of people taking it every year. But, gosh, it's been really well received, and everybody has returned. And the power of that big, I know people get worried, "Oh, if people take a sabbatical, they're going to leave." That has not been my experience at two companies now. And it's really been fantastic. It's re-energizing, it's recommitting. And obviously, it's well received, and it's a great recruiting tool as well.
Kevin Kruse - LEADx: Hmm! Do you recall a sabbatical that someone's taken? Most people just sort of, like, renovate their kitchen for a few months, or does anybody go off and learn to, you know, climb a mountain or something else?
Abbie Buck: Oh, yeah. I mean, even I have had the opportunity to take a sabbatical at another company, and a lot. I traveled with my family. I know people who have dedicated, if you take 4 weeks, they've done a week for themselves, a week with family, a week with friends, and then a week just to sort of putter around the house as examples. And so they've done things like a silent retreat, a special trip with their family, time with friends. And so people get really creative with them. It's fun to hear the stories.
Kevin Kruse - LEADx: Yeah, Abby, you just tickled some neurons as you talk about that, breaking down the time, whether it's 4 weeks or something else, into different, almost themes, like for self, family, friends. I had never thought about that before. And there's this old story about Bill Gates, as busy as he was back in the Microsoft days, he'd always take a "think week" where it was just himself in a cabin with a stack of books and papers, or whatever, to think ahead. And I've often, as you said, in growth-stage companies, it's a million things going on. I cannot imagine sitting in a cabin alone for a week just reading. But you've given me an idea of, like, okay, if I take some extended time, it doesn't have to be like, quote unquote, "selfish me time" or "oh, it's the family vacation time." There are ways to chunk it into a few different things. I really like that idea a lot.
Abbie Buck: Actually, you know where that inspiration came from is the person that I had first heard of doing that, or first knew who did that, was John Donahoe, who was the CEO at eBay, and is now the CEO at Nike, and he spent his sabbatical at eBay doing those, doing that sort of thematic sabbatical.
Kevin Kruse - LEADx: Oh, that's great. What book would you recommend that your colleagues read? (or podcast, video, etc.)
Abbie Buck: I knew you were going to ask me this question, and it was hard to choose, honestly. I'm a big reader, mostly for pleasure, honestly, but I do sprinkle in workbooks as well. And what I would say, I'd offer a classic and one that, at least for me, is a classic, which is "The Advantage" by Patrick Lencioni. And one of the reasons I love that book is, first of all, for crystallizing the concept of team number one. And it's been highly resonant with me recently, just because, as I said, we require a high degree of collaboration to put forward a product and service experience that is cohesive and connected. And people often think of team number one as the team that you're reporting into, right, and not necessarily that cross-functional team that is delivering something together. And so I love the concept of that team number one, and also the importance of clarity. As I said, we've been spending a lot of time on clarity. And it's such a helpful touchstone right now when I think about cross-functional leadership effectiveness. Right? Even a simple prompt, for example, "Okay, what have we agreed to? And then to whom does it need to be communicated?" And it is amazing how quickly that can root out varying interpretations or misunderstandings about what we've actually agreed to. And like many things in my world, for me, the book just speaks to things that are easy to say but hard to do well, or hard to do consistently.
Kevin Kruse - LEADx: Yeah. And you raise, first of all, a gold star for not automatically doing the Lencioni book "Five Dysfunctions," right? This is the normal knee-jerk reaction. But this idea of also being, for any manager, for any leader, pausing to really think about who your first team is, and how you're showing up, what your level of responsibility is to different teams. Sometimes, in the engagement work we do, we'll see a company that overall... Well, let's just talk about a team. The team's engagement score is rock bottom, really low, and yet the manager has a very high manager effectiveness or NPS score. And often, you know, back when I was young and dumb, it's like, "Oh, wow! A great leader in a tough environment." It's like, maybe, or that's a leader who thinks his or her first team is the direct reports rather than the people who are sending them the check. And so it's really easy to be a popular boss, right? It's easy to be like, "Yeah, we have to roll out, you know, y'all have to switch from this tool to that tool. It stinks. I hate it, too. It wasn't my decision," right? It's so easy to blame the Board, blame the CEO, blame the Home Office, blame marketing, right? It's really easy to be a popular boss if you want to be. It's harder to be a boss that drives engagement, especially in tough times, and just understanding the team that reports to you, the team of peers, the team of the company. It's a really good thought exercise, and something worth talking about. Let me ask you this, Abby. So, with all the experience you've had as Chief People Officer, I'm sure you do things and think of things differently today than on day one. So imagine if you were sending a Slack message or a Teams message, whatever you're using, to a younger version of yourself. What advice would you give to the day one Chief People Officer Abby?
Abbie Buck: Oh, yeah, it's a good question. And I happen to start this gig right at the beginning of the pandemic. So, you know, it's been a great learning journey, and we know, right, people leaders over the last several years have had such a moment in terms of helping companies navigate a tumultuous period and this incredible change management journey that we've been on, and obviously, pandemic and return to office being top of mind when I say that. So, what I would say to my younger self is, yes, you're accustomed to working in a very ambiguous environment, not necessarily having all the facts, and trying to piece together the puzzle of what will be most impactful for employees who have a gazillion different opinions and needs. What I would say is, this whole journey has reinforced for me first principles thinking, and that is something I got to it quickly, but it's almost like a mantra now, much more so than it was in the past, where, you know, when we think about our decisions, about whatever it is - vaccine policy, business direction, return to office plans, or any number of other topics, right? It's important to ask, "What is most important? What are you solving for? And how is that prioritized? How do these actions square with our values?" And it can be incredibly clarifying. We knew, for example, when we implemented a vaccine policy that required vaccinations, that it was going to be controversial. We operate in California, Utah, and Texas, and not everybody's in agreement with these decisions. But for us, as a healthcare company, we were data-driven about that and felt that that was the best way to keep our employees safe, and the safety and well-being of our employees was a first principle for us as we were thinking about that. And so we were prepared to sort of take the heat for that decision, knowing where we were grounded. So that's one of those things where I've just become almost obsessive about it, whereas maybe in the past, I was not as much.
Kevin Kruse - LEADx: Yeah. I think this idea of first principles thinking is certainly more popular in the Silicon Valley tech company community. I really don't hear it in most other industries or parts of the country, and I think that's a shame, because it's almost as useful as a personal tool as well. I mean, I think too often any decision, if it's not automatic, there's going to be pros and cons, there's going to be winners and losers, or people with different opinions, but rather than weighing the outcomes and all that, go back to the first principle. What are you really trying to solve for, and from what position? And it can clear things up quite a bit. Abby, we're doing this interview, it's the middle of November. We're a week away from Thanksgiving, so I know you already have your people's plan for next year laid out. What are you and your team going to really prioritize or lean into more for next year?
Abbie Buck: Right. So we are really leaning into enabling the growth of the business, right? I mean, that, just broadly speaking, occupies a lot of my attention. So scaling a business, it's everything from enabling growth through expanding our real estate footprint, which seems odd to say, but we are because we have a hybrid workforce, to making sure that we're talking about what capabilities we need not just now, but in the future. So a lot of focus on talent and the capabilities that we need to support our growth, and then everything from that to some of the business work to build new capability, the innovation and expansion of products that support our ability to take on an ever-increasing number of very large clients. And so, you know, it's all about growth for me, and it's a fantastic place to be. It's fun. That is really fun and rewarding work. And that is what we are focused on for the next year.
Kevin Kruse - LEADx: Growth problems are the best problems. What excites you the most about your company right now?
Abbie Buck: You know, for me, I'm just so proud of the work that we've done to really bring this mission to life. And I told you, we just rang in our tenth anniversary, and you know, we know so many startups fail, and to have gotten this far and know that it's really resonating with people, both individuals on the member servicing side, but also with clients. For me, you know, among the many details I could highlight, you know, as the target customer too, which is another really fun part of my role. Right? We are selling to HR leaders and also finance leaders to some extent. Obviously, it's a big line item on a balance sheet. We are making a difference in terms of managing the trend of cost over time. We are beating industry standards on that. And that is so important for everyone. I mean, these are expensive pieces of employee compensation, and to add that value to clients feels so great.
Kevin Kruse - LEADx: Yeah, I'm again, you guys are doing amazing work. As you said, whether it's a startup or other small, mid-sized business, it's harder than ever before out there. And you know, I think entrepreneurs, small business people are really heroes of the economy and society, and health care costs and providing value are just so critical. So we're going to leave it on that note. I'm glad you're out there doing the work you're doing, Abby. Thanks for spending time on a Friday afternoon, giving me and others stealable ideas.
Abbie Buck: Thanks, my pleasure and my pleasure.