2019: Building a Health Plan Around What People Actually Do | Tami Wilson-Ciranna. CFO, Curative

Tammy Wilson-Serrana shares her career journey from Arthur Anderson partner through roles in commercial real estate and biotech before joining Curative in April 2020 on a three-month contract that extended to a permanent transformation of the company. She describes how her experiences in public accounting, Prolacta Bioscience, and Commonwealth Partners prepared her for leadership roles emphasizing execution, consistency, and building organizational structures rather than relying on singular great ideas.

The core of Curative's business model centers on a novel health insurance approach: zero deductibles, zero copays for in-network care, and mandatory baseline visits within 120 days of enrollment. Wilson-Serrana explains that this model removes financial barriers that traditionally deter people from seeking preventive care and filling prescriptions. She notes that 97% of pharmacy fills occur at zero copay by placing one drug from each class at no cost, including expensive medications without biosimilars. The philosophy is that if patients need medications or care, cost should not be a deterrent to engagement.

The company pivoted from pandemic testing (36 million tests conducted) to health insurance because, as Wilson-Serrana states, "what people pay for, people do, and what they don't pay for, people don't do." This required rolling $500 million from prior capital raises into the insurance startup to maintain an A- AMBEST rating. The revenue model operates on standard actuarial pricing based on premiums, member engagement, manual rating by risk factors and geography, and claims management.

Wilson-Serrana details key performance metrics the company monitors: medical loss ratio by county and geography, network provider costs, and wellness program efficacy. She emphasizes data-driven decision-making and the willingness to abandon assumptions when market feedback contradicts them, such as discovering that clients needed three plan options rather than the single zero-deductible plan initially offered.

AI implementation across Curative has addressed multiple operational challenges. In credentialing, an AI agent reduced processing time from six months to 24-48 hours, replacing an outsourced Philippines-based operation. In finance, AI enables customized analytics on large datasets, automated coding to appropriate GL accounts, and streamlined business intelligence and variance analysis processes. She notes that AI allows people to ask questions and drill down only when results appear problematic.

A critical strategic insight Wilson-Serrana shares involves state market expansion. Rather than concentrating in a single state, she recognized that entering a market requires three years: year one brings trial clients, year two brings mid-sized groups (100-500 members), and year three brings broader opportunities. Consequently, Curative stages entry into new states annually, maintaining a pipeline of markets at different development stages to sustain consistent growth.

Wilson-Serrana reflects on her earlier CFO role at Commonwealth Partners, advising that new CFOs should expect resistance from existing staff and must maintain conviction about organizational direction while staying calm and clear about expectations. She emphasizes that CFOs are hired for independent thinking and should share opinions despite potential disagreement with leadership.

On the broader healthcare mission, Wilson-Serrana argues that current system economics prevent engagement in preventive care, ultimately costing society more through crisis-driven healthcare utilization. She positions Curative as addressing this by making preventive care, medication compliance, and early engagement financially frictionless. She notes that studies show even when preventive services are free, confusion about coverage deters utilization—a problem Curative eliminates through transparency and zero copays.

Personally, Wilson-Serrana describes herself as an operational CFO who enjoys learning new areas and fixing operational challenges. She raises seven children while pursuing active hobbies like Tough Mudders and 5Ks. She credits Dale Carnegie's "How to Make Friends and Influence People" and the Wall Street Journal as intellectual influences.