Kara Trott holds nothing back when describing the thrill she has experienced over the past decade watching Quantum Health grow.
“It’s like an extreme sport, like bungee jumping off the highest bridge,” says Trott, the company’s founder and CEO, reflecting on a decade of high growth that’s been entirely organic.
The company has always had a growth rate of 30 percent or higher, and doubling its workforce isn’t uncommon. For example, Quantum Health had approximately 300 employees at the beginning of 2014. The company hired 190 people throughout the year and 130 of them started between Aug. 15 and Nov. 1.
“There’s a thrill to it,” Trott says. “And it requires equal amounts of courage and humility to do, and tons of energy and a lot of self-management.
“You have to really set the example within your organization of what kinds of behaviors you’re going to tolerate, what kinds of attitudes you’re going to tolerate — and you have to really stick to it. It’s not always easy.”
Quantum Health is a care coordination company that guides large self-funded employers and their health plan members through the complex health care process. It uses proven research to reorganize benefit delivery to improve outcomes, increase satisfaction and lower costs.
And Trott says they will likely add another 150 to 200 people this year, as well.
“At our rate of growth, it’s almost like each year, you’re building a whole new company,” she says.
There’s little time to sit around and ruminate; Trott says the pace strips away a lot of emotion. And while change management is a big buzzword in business, it doesn’t resonate with Trott.
“We don’t have a change management problem at Quantum Health,” she says. “Change is our constant, and people who work here thrive and relish change. You can’t work here unless you’re very comfortable in a high pace, fast growth and rapidly changing environment.
“We actually don’t devote any time or effort to change management because change, for us, is the norm.”
The vetting process
Dealing with big business step-ups in a compressed period of time means not only accepting the pace, but also being disciplined and strategic.
Trott says new business and renewals start coming in during the summer. The company hires from August to November, and the new hires are on-boarded and trained in what she calls a cultivation process in order to be ready by January.
Quantum Health has 15 applicants for every position, and therefore uses a strategic vetting process.
“We use a tool called the Predictive Index. Our COO would describe it as we’re looking for what starves and feeds people,” Trott says. “There are certain things they really enjoy and certain things they don’t enjoy. It doesn’t work to put somebody in a position, even if they interview well, that they’re not going to enjoy.”
Job candidates go through the Predictive Index first and then are evaluated for baseline or potential skills. Only after that do they go through the interview process, she says.
Once they are hired, people are weeded out in the first 60 days during the cultivation process. By following this methodology, most of the turnover occurs before new employees start dealing with members and providers.
“We’ve been pretty successful,” Trott says. “Our turnover is between 15 and 20 percent in an industry where aspirational turnover is 30 to 35 percent.
“We have ways to figure out very quickly whether or not somebody’s going to be able to fit and perform well in this environment.”
By finding the right employees before they deal with customers, there’s less disruption and more time to build relationships.
Delivering caring service
Quantum Health’s organizational structure of pods also supports strong connections.
Trott says they came up with the idea about five years ago, partly because of the executive team’s retail background.
“I think we had like 70 or 80 employees and we started to see where people were siloing a bit,” she says. “You get to a point where nobody feels special and anonymity sets in.
“I think that’s a specific killer to a business built on caring because if I don’t really feel cared for, I’m not really going to care that much, and you’re not going to get that extra effort or connection (to clients) that you want.”
Today, dedicated teams of customer service and clinical staff — between 27 and 30 people — deliver the services to members and providers. One pod services about 50,000 to 70,000 member lives, which generally means working for no more than eight clients.
In order to break down barriers and create strong teams, Trott’s executive team researched military strategy. She says the military has good insights on where certain size teams break down.
Although Quantum Health isn’t dealing with life and death situations, Trott says it could model after military structure to create right-sized teams that would have each other’s back and be able to work in a fluid fashion.
The pods also have a certain configuration and flow that’s been proven to work, which can be stamped out like a retail chain’s store locations.
“We grow in pod units,” she says. “It allows us to stay small at the delivery level where these multidisciplinary teams function on a highly individual accountability level. There’s no hiding and the team self polices.”
Quantum Health invests in and trains its pod managers, who are similar to store managers prior to when they are needed. Trott says there’s always a queue of employees ready to step in and lead a pod.
“It has allowed us to keep the best of both worlds,” she says. “We grow big while staying small with that kind of structure.”
The pods don’t become isolated because subject matter experts like clinical experts support all of the pods. Also, multiple pod managers report to one director — who operates like retail’s district managers — and these directors share best practices and provide support.
Juggling the decision-making
Quantum Health’s strategic and disciplined approach carriers over to management, as well. The company only has a short window each year to make strategic decisions, before the day-to-day management of its growth takes over.
Trott says it’s important to let your people know how you want to be involved. Sometimes it’s a matter of letting your employees know that they need to go away and work on it. If they want your opinion, they can ask, but they are in charge.
She uses five levels to differentiate the decision-making:
1. A pure execution issue that you don’t need to be involved with. The executive trusts the staff to execute it well and make changes, as long as they are aligned with strategy.
2. Things an executive would like to be informed about but doesn’t want staff to wait for him or her.
3. The executive wants to weigh in but his or her opinion is not the controlling factor.
4. Strategic, directional and impactful decisions that cannot be made without the executive.
5. Important strategy decisions where the execution makes the decision, while taking some limited input.
Trott says you can only delegate to this extent if you have other leaders you trust.
“We’ve worked really hard as a team to kind of build that trust,” she says. “And, trust is multidimensional, so there isn’t blanket trust. You trust for specific reasons and for specific competency.”
By building a strong support team with strategic and execution functions, Trott doesn’t need to be involved with everything. She knows what she really has to dedicate time to, which frees her up to focus on the big picture.
In fact, her board has asked her to set aside 30 percent of her time for unassigned strategic thinking.
“I use a lot of that time to talk to a lot of people, get ideas, explore things, meet with key leaders outside of the company — that kind of thing where you’re mentally thinking about strategy and direction,” she says.
While still dealing with day-to-day issues and helping secure strategic sales, Trott says it’s critical to keep space free for forward thinking — what will be the next version of Quantum Health in the marketplace and what will be the next iteration of its organizational structure, and product and service model.
“It’s quite a juggling act,” she says, “and it requires a lot of transitions during the course of a day and, you know, it requires a lot of self-mastery in terms of how you go about doing that.”
- Weed out new hires before they deal with customers.
- The right-sized teams will break down barriers, apathy.
- Build trust so you can delegate day-to-day decisions.
The Trott File:
Name: Kara Trott
Title: Founder and CEO
Company: Quantum Health
Education: Bachelor’s degree in politics and philosophy from Ohio Wesleyan; law degree from The Ohio State University
What was your first job and what did you learn from it? My father was an architect. Richard Trott and Partners Architects was his firm and I worked for my dad doing office work and running the blueprint machine that was twice my size.
I was like my dad’s oldest son. He had me shadow him. I learned how to conduct myself in a professional manner.
My dad was very successful — much loved and had a great style about him that was low-key. He was creative and extremely professional. He just sort of drilled that into me. He had me sit through a lot of meetings that he had with clients and internally. I was able to observe how he did things.
With degrees in politics, philosophy and law, how did you end up as a CEO for a health care company? I originally started at Retail Planning Associates. I did consumer research strategy for large retail clients like Coca-Cola, Wal-Mart and Kmart.
Then, after law school, I practiced in corporate law at Bricker & Eckler. The health care landscape was changing rapidly and Bricker has a very significant health care practice. They decided to form a consulting subsidiary that did strategic consulting with their health system clients. Because I’d had experience doing that in the past, the partner charged with creating that practice asked me to help.
I had not actually worked with health care providers before, but I was tasked with going out and helping provider organizations develop their ‘managed care strategy.’ I observed the challenges that the delivery system and consumers have, and I saw some interesting parallels between solutions we had provided in the consumer goods services and retail space.
What do you like to do outside of the office? Do you have hobbies? I don’t have a whole lot of time. I have a really great circle of friends and we have a lot of fun together. And I do like to travel.
For many years, my son was my priority. He’s almost 23 now.