Marian Cabanillas, CEO of UnitedHealthcare Texas, looks back at the record-breaking cold snap in her home state and its effect on vulnerable populations.
Last February, an unprecedented cold-snap hit Texas – an event that was particularly impactful for vulnerable populations, including UnitedHealthcare members who were unable to evacuate their homes or access needed medical services. Marian Cabanillas, CEO of UnitedHealthcare Texas, looks back and offers lessons learned.
Evan Sweeney 00:05
Hello, and welcome to UnitedHealth Group’s Weekly Dose Podcast where we’ll get you up to speed on the latest trends shaping the future of health care. I'm your host, Evan Sweeney. Today we're going back in time to take a closer look at an unprecedented event in the state of Texas. In February, a sudden Deep Freeze through the state's power grid into crisis, leaving millions without power in freezing temperatures for several days. The Deep Freeze will become one of the costliest and most disruptive natural disasters in the state's history, shutting down water systems and leaving people susceptible to hypothermia and carbon monoxide poisoning. And it was particularly impactful for vulnerable populations, including UnitedHealth care members who are unable to evacuate their homes or access needed medical services. Joining us today to talk about responding to one of the worst natural disasters in Texas is Marian Cabanillas is CEO of UnitedHealthcare Texas, Marian, welcome to the podcast.
Marian Cabanillas 01:01
Thank you. It's a pleasure to be here today.
Evan Sweeney 01:04
Let's go back to I want you to take me back to February when this deep freeze occurred in Texas, and really just a massive disruption to the entire state. But I'm curious from sort of your perspective, and I know you've probably dealt with a number of natural disasters in recent years. But when did you sort of realize that this was kind of a once in a lifetime challenge for the organization?
Marian Cabanillas 01:30
Yeah, you know, we do have quite a few natural disasters here in Texas. And so it's not something that's foreign to us. And, you know, frankly, when this this freeze happened, at first, it seemed like we were just going to have a cold snap, forecasters here had warned us that we were going to have about a week of you know, really cold weather, that it might even snow. So we thought we knew what to expect, you know, all the kids were excited, you know, there was a lot of excitement in the air about it. And you know, all of a sudden, we have this huge, massive frigid air that crept over to Texas from the Arctic. And, you know, it's sent our temperatures here plummeting. And frankly, as those temperatures started to plunge Texans did what anybody would do in that situation, we cranked up the heat. And you know, of course, that led to a bigger issue, because our demand for power overwhelmed the power grid. And within the first day, much of Texas had lost power. And in 1000s, and 1000s, of homes here in Texas, pipes started to freeze, and then they burst, the lack of power left millions of people, you know, desperately trying to find warmth. And for us, you know, it became a crisis because we have 1000s of medically fragile members. And for them power, our power outages really become a matter of life and death.
Evan Sweeney 02:52
Right. Right. So tell me a little more about sort of the members that were impacted. I mean, you described sort of the vulnerable populations that that that your organization cares for. But what impact does that have on them? I mean, you know, somebody who, you know, is sort of any, anybody could sort of, you know, have a stroke or did struggle with pipes, burst Tang, and he and all these things, but for these populations, in particular, what were the challenges that they were facing?
Marian Cabanillas 03:26
Sure, you know, you know, if we hadn't been through a hurricane not that long ago, back in 2017, Hurricane Harvey, and, you know, we, we already know, right, we deal with hurricanes on a regular basis here in the Gulf. And so we always know that our first response has to be to make sure that we've got a plan for our members, and that we've contacted all of our vulnerable members to make sure that you know, that they're safe, that they've got a plan for what they're going to do if things go south. And so we really, you know, started to see the same impacts that we saw similar to, you know, Hurricane Harvey, where, you know, its widespread impacts, our resources are taxed to the maximum. And the biggest need was really identifying locations with power, so that we could make sure that our vulnerable members had the ability to continue to utilize their life supporting equipment. And, you know, just making sure that we were doing all of that in the middle of a public health emergency with COVID. So we have to take that into account as well, of course, many of our nursing facilities, as well as hospitals and people's homes, right lost power for days. And so, you know, we, for those members, we make sure that they've got backup generators that they've got, you know, resources that will continue, do what will allow those machines to continue to operate. But as the week went by, what ended up happening was that we started to see people get really low on supplies such as gas to, you know, power those generators. Or, you know, for example, water, you know, I mean, just basic necessities. And so our biggest need was to find a place for those members to go, that they could, you know, ride out the storm until we, we could get power back on for them
Evan Sweeney 05:18
and made that much harder because of the pandemic. I mean, this happened any other year would be obviously a major disaster, and then you sort of layer on these restrictions and considerations around a global pandemic.
Marian Cabanillas 05:32
That's exactly right. And, you know, it's not just the fact that you have to take into consideration social distancing. And the fact that, you know, you've got to find a place that has enough room for our members. But on top of that, you have to remember that people were really hesitant to go to shelters, or go to hospitals, because normally what we do is that we'll look for a facility, a hospital, and emergency room, you’re or a shelter that's got space for our members, and that has power, but with the pandemic, you know, obviously, again, our resources are limited, because there's a space issue. But then on top of that, we also have the hesitancy of our members. And these are members who are medically compromised, and they're very vulnerable. So you can imagine for them, having the thought of having to go to a hospital, or to a shelter in the middle of a pandemic, is a life-or-death decision. And so you know, that, that complicated things a lot more, you know, of course, on top of that, our nurses, they want to go out and help, you know, they want to go out there and, you know, get in front of our members. And again, it just wasn't an option. We couldn't physically go out there, again, because of the pandemic and the fact that we just, you know, we weren't we, our state was not allowing us to go in and go into member's homes. So it just, it became a complicating factor for us.
Evan Sweeney 06:55
Were there challenges to in terms of just medical facilities, though, they were clearly impacted by this, what were their challenges in terms of getting people to the care they needed, because, you know, hospital was out of power, or running on a generator or something like that?
Marian Cabanillas 07:10
Absolutely. We had multiple nursing facilities that we had to, you know, work with, because they were on their generators, right in many hospitals to right there on generators, which so they were prepared for this. But as time, we didn't expect this to go on so long. So as time went on, those facilities, were also starting to run low on supplies. And so you know, it just complicated the situation, because of the time and how long, you know, it took for us to be able to restore power across the state.
Evan Sweeney 07:45
What does your I mean, you mentioned sort of past hurricanes, and you mentioned some of the work that you do in preparation for those types of disasters? How did that sort of inform your response to this one, and coming out of this sort of massive, impactful disaster? What sort of things are you thinking about now? You know, prepare for the next one?
Marian Cabanillas 08:09
Absolutely. So you know, we're, we always like to say that we're in a continual steady state approach to disaster planning. You know, we've got a business continuity plan, of course, just like all of you know, UnitedHealth Group does. And so that's essential to us here in the Gulf Coast. But, you know, past disasters actually really did help prepare us for this, because we learned a lot from Hurricane Harvey, and from other, you know, events that we've had here in the state, we, you know, we know that we have to be proactive, and that we have to outreach to our members early to make sure that you know that they've got a plan, we have to be diligent about knowing where our members are located. So that we can, you know, make sure that we know where they are at all times, even if they get, you know, moved to another location. But we also do other proactive things. For example, after Harvey, we analyzed our call support requests that we received. And we found that our members really the number one issue that they needed help with, was getting emergency prescription refills in the middle of a, you know, an emergency like this. So they really needed support with some of the drugs that they need to take. And so we created, you know, some tools for our members around how to prepare for your pharmaceutical needs during a disaster. And we proactively distribute those to those members.
Evan Sweeney 09:34
So I'm curious, you know, what advice you would have to some of your partners and other states who might be experiencing or could experience a disaster of this magnitude thinking, you know, folks in Florida or even the Northeast where you might have a significant snowstorm? What advice would you have for them sort of preparing for something like that or planning for it?
Marian Cabanillas 09:56
Yeah, absolutely. I think you know, what's really important is to make sure that we're taking the business continuity planning process very seriously, right? I'll admit it, I know that, you know, we tend to look at it as just another thing that we have to do. And, you know, it's this annual process that you have to go through, and you just kind of want to check the box and move on. But frankly, for us, what we've realized is that that business continuity process is actually it's critical for our ability to, you know, meet the needs of our employees, and our members. It's a living breathing document for us, we're constantly looking at it and looking at how we can improve it. What more can we do? You know, how do we think outside of what we traditionally always look at around that business continuity process?
Evan Sweeney 10:44
Yeah, I mean, I suppose one sort of benefit from this is that it does sort of expose, you know, kind of the worst-case scenario for you, right, some of the things that you probably couldn't imagine would have happened did, and now you sort of, you're able to reframe that that preparedness approach?
Marian Cabanillas 11:01
Yeah, it really does. You know, I think that what happens is, is that, you know, every single time that something like this happens, we always go back to that, you know, does to that disaster plan, or to our business continuity plan. because, frankly, you know, like I said, we never expected for something like this to happen. You know, if you had told me a couple of years ago, that we'd have a freeze that would take over the entire state and that we lose power for, you know, for some areas, up to a week and no water for over a week, in many cases, I would have laughed at you, right? Because there's just it's never literally never happened here. I mean, we're not even talking like a once in 100 years situation. This has literally never happened in the state of Texas. Right. And so, you know, you kind of have to get yourself out of that comfort zone of always thinking about like, Oh, I know what a disaster in my state looks like.
Evan Sweeney 11:51
Well, Marian, thank you so much for joining us. Really interesting to hear, hear how you guys handled that.
Marian Cabanillas 11:58
Thank you. It was a pleasure.
Evan Sweeney 12:00
That's it for this week's episode of UnitedHealth group's weekly dose podcast. Join us next week. For a closer look. Now analytics is reshaping the health care industry and the role OptumInsight plays in that shift. Thanks for listening and have a great rest of your week.