1219: Building a Health Plan Around What People Actually Do | with Tami Wilson-Ciranna. CFO, Curative

0:00CFO THOUGHT LEADER: Support for CFO Thought Leader comes from OneStream, Trusted Data, Faster Decisions, and Salesforce. Explore new research on the future of finance and AI at Salesforce.com slash CFO Report. Hello, this is Ross Granger, CFO of Masooney, and you are listening to the CFO Thought Leader podcast. This is episode 1219.

0:29Tami Wilson-Ciranna: We were, you know, we're setting up the company and the insurance company. And there was a large belief by a lot of people that we just needed to be in one state and really work that state and grow that state. And I was like, no, because when you play this out, it takes, I'd talk to a lot of people in the industry and brokers and other things. It takes about three years to get into a market. The first year you get tried on a couple little clients. The second year, maybe they give you your, you know, their 100 to 500 member groups. And then the third year is when you really get more invited to everything.

1:05Tami Wilson-Ciranna: And so you can't decide, I'm going into Florida this year and we're just going to take it. It doesn't work that way. You have to start Florida three years in advance. So we've been very measured about adding new states every year because that way you keep the growth going. You have to anticipate, you know, what do I need to do for the long term for long term growth?

1:28CFO THOUGHT LEADER: Hi, it's Jack. On today's show, we speak with Tammy Wilson-Serrana, CFO of Curative. Health insurance has spent years asking people to make more cost conscious decisions about their care. But what happens when the cost itself becomes one of the reasons people avoid care? That question sits beneath much of our conversation today with Tammy Wilson-Serrana. Curative is making a very different bet. Zero deductibles, zero co-pays, and fewer financial reasons for members to postpone seeing a doctor or filling a prescription. Of course, removing those barriers doesn't remove the economics. It changes them.

2:18CFO THOUGHT LEADER: And for a CFO, that creates an interesting challenge. How do you prove that spending sooner can ultimately mean spending less? Our talk with CFO Tammy Wilson-Serrana begins after this.

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3:47CFO THOUGHT LEADER: Hello, CFO Tammy Wilson Serrano is with us. Tammy's career has taken her from partnership at Arthur Anderson into commercial real estate, high growth biotech, and ultimately curative. Along the way, she helped scale a biotech business from 8 million to more than$90 million in sales. Today, as president and CFO of Curative, she brings that breadth of experience to a company that has itself undergone a transformation from pandemic testing to healthcare or health insurance. Tammy, welcome. Thank you. Good to have you with us. Interesting journey. If you wouldn't mind, take a look back. And now that you've been this seasoned CFO, tell us what part of the journey helped prepare you best for that.

4:42Tami Wilson-Ciranna: I think definitely working in public accounting was a huge benefit. And also my time at Prolacta Bioscience, as well as even the lessons you continue to learn throughout your career. And I've learned plenty of lessons at Curative, too. So I think in public accounting, you really learn to be analytical. you get to see a lot of different companies. So when I was working at Anderson, you know, I saw a lot of different companies in a lot of different industries, smaller startup companies, and huge Fortune 500 companies. And so I think you learn how to really dig into details, analyze financial statements from an overall perspective, and kind of read into what's happening with that business.

5:25Tami Wilson-Ciranna: And I think you just learn a lot about boards and presentations and how to present what you want people to understand in a concise manner. So I think that was really helpful. And then at Prolacto Bioscience, we're really taking a company that wasn't profitable to becoming profitable and growing it. Actually, what we thought was very fast, which most people think is very fast, but being a curative seems slow now. And really, the things that you need to do, you realize it's not a lot of times the great ideas. You just really need to execute day to day, which is sometimes hard, you know, to keep consistently doing the right things, building the structure, getting the right people in place and and just doing an overall, you know, good job being consistent with your customers and your operations and building for the future.

6:17Tami Wilson-Ciranna: and curative of course you know i think that was high growth being flexible how to pivot it's a very very interesting company in that we do try experiments and if we fail we fail and we move on and we don't nobody gets too married to their ideas at curative and i think it's good because i think everybody has that permission to fail and that's important you know you don't need to spend five years you know proving your idea and then you're super committed to it when it's not quite working the way you hypothetically thought it would. Instead, you can let it go and move on or pivot that idea or modify that idea.

6:56Tami Wilson-Ciranna: And I think that's really important, especially in growth businesses, especially in startups. You have to be willing to modify what you're doing based on the market and the other factors that are coming into play.

7:09CFO THOUGHT LEADER: Timmy I just want to point out to the listener just regarding if we look back in time from 2002 forward you've had multiple CFO chapters curated being the latest where you're both president and CFO but I have to ask and forgive me because I'm sure it's a chapter that you had to talk about from time to time. You are a partner at Arthur Anderson. So congratulations. We have so many people who have that accounting house experience, but very few partners. The fact is, though, you were there nearly 14 years. You paid your dues, but you're one of those partners who were there when it collapsed, I believe.

7:55CFO THOUGHT LEADER: You are very close to it. So how do you pick yourself up, brush yourself off and launch yourself as a CFO?

8:04Tami Wilson-Ciranna: Look, I had already gotten my MBA from UCLA. So I was already interested in business in a broader sense. And as a partner and as an accountant, honestly, I think I was always very conservative. And you always got to have a backup plan, in my opinion. And so I think it was sad. I think it was unwarranted to a certain extent. I think a lot of people, it disrupted a lot of people's lives who are far more impacted than I was. I was able to pivot and go into a different, yeah, and go be, you know, I think it was SVP of finance and accounting and then promoted to CFO pretty quickly after that at Commonwealth.

8:46Tami Wilson-Ciranna: So I was fortunate in that regard. That's a fun company. Real estate's really fun. But yeah, you just, I think you should always have a backup plan. That's what I would say That when you're dealing with these types of things, it is traumatic, but you're if you're always planning in the background of what's the worst that could happen Then if something bad does happen, you're prepared for it And I think that it applies to business as well, you know What what's your backup plan if things don't go the way you plan them to go? And I think if you think through those ahead of time and you think through the scenarios ahead of time, then you're not as much in a panic when these things happen.

9:26Tami Wilson-Ciranna: And I've had people say to that to me, why aren't you panicked? It's fine. You're going to you figure it out.

9:35CFO THOUGHT LEADER: So if I understand when you said you were already studying, you're already going after your MBA, you were already thinking industry is what you're you're saying in part. Is that correct?

9:46Tami Wilson-Ciranna: Yeah, I think as long as things were interesting at Anderson, you know, I was enjoying it. But ultimately, I think I did. I was very interested in going into industry and business in general.

9:58CFO THOUGHT LEADER: When you became a CFO, again, at Anderson, you probably knew a number of CFOs personally. But finally getting the role, you know, what was different about the role than maybe what you originally believed?

10:13Tami Wilson-Ciranna: I would say I think you you think when you're an auditor looking at CFOs that I'd really be on top of those accounting pronouncements and really understand all of that and then when you become a CFO you're like wow I don't have time for that I gotta delegate that off to the controllers so I think that is more interesting because I think the role does become a little broader than what you see when you're just on the accounting or audit side. There are a lot of things you do related to capital, related to personnel. I, in my roles, have always taken more of a broad view. So I've not had just finance and accounting reporting to me.

10:52Tami Wilson-Ciranna: It's also usually been HR or IT. And so, or like a curative, I do different operations, network, actuary, risk. So there's different things that are compliance legal. So, my roles do tend to be broader, which means the scope of which I'm digging into accounting and finance is much more limited.

11:15CFO THOUGHT LEADER: When you look back, who might have influenced how you lead?

11:21Tami Wilson-Ciranna: Is it how I lead in general? I think there were a lot of people that I dealt with. I think there were partners at Anderson that were very good. Marshall Matheson would be one that, you know, it's sit and explain things. You know, this is how I discovered this. This is how I found this. So you would learn that too. And that helps build your analytical skills. There's controllers, Sam Dominick at Occidental Petroleum, just a really great professional guy. And, you know, I just learned so much from the way he dealt with things and how professional he was, even when, you know, maybe somebody failed, didn't quite execute on something they were supposed to.

11:59Tami Wilson-Ciranna: I mean, I think he was just a really calm, great guy to deal with.

12:05CFO THOUGHT LEADER: Was there, and again, I mentioned that you've had a number of CFO chapters now, but I'm wondering if there was a particular career move that felt like a real leap, like, you know, you were into something you hadn't experienced before.

12:23Tami Wilson-Ciranna: A pandemic.

12:26CFO THOUGHT LEADER: definitely that's a great yeah no that's a great uh it because let's see you arrive when do you

12:33Tami Wilson-Ciranna: arrive at curative is it about 2020 or right at the start of the pandemic yeah on a three-month contract because we thought it was all going to be over in three months

12:44CFO THOUGHT LEADER: and and i do think there has been a transformation there which if i was to ask you tell us about curative today, it's very different from the curative you arrived at. Would that be correct? Absolutely.

12:57Tami Wilson-Ciranna: When I arrived, it was a COVID company. We had one lab. We grew up very fast during COVID and ended up with three labs, a bunch of locations, 36 million COVID tests. So very, very rapid growth.

13:13CFO THOUGHT LEADER: You arrive in April 2020. I mean, COVID's just 30 days arrived. So you must have been interviewing for a very different job or a very different company at the time, I suppose. I was.

13:27Tami Wilson-Ciranna: I had retired and I had gotten bored. So I was all, I think I should do something with my life. And I was talking to a bunch of different companies and I met with Fred on a Tuesday and I started on Thursday and I was like, this is great. I'm going to help out with the pandemic. Yeah, but yeah, it lasted much longer than we thought. Three months turned into three years. And then we made, as you referred to, a very important pivot. And that was we were looking at different, what was phase two for curative? And we were looking at different options. And we really wanted to move health. But in order to move health, you really need to be the payer.

14:05Tami Wilson-Ciranna: Because what people pay for, people do. And what they don't pay for, people don't do. And so that's how we came to be at Curative. which is a very interesting product. It's for employer, large group health insurance, zero deductible, zero copay. We want people to engage in care. We set you off. You have to do a baseline visit within the first 120 days. So you have your no deductible, no copay when you start. That continues. But we do want you to do that baseline visit. And it is, one, somebody talking to you about your insurance. A lot of people don't understand their insurance And we want people to understand you can go in network, you can get care, you can get your prescriptions filled.

14:47Tami Wilson-Ciranna: And the other thing is a clinician. And the clinician just wants to know where you are on your health journey and to remind you of the guidelines. So many people don't know that the guidelines have changed, that there is a new vaccine you need to get, that, you know, colonoscopies have now moved to 45. And so I think those are important things to communicate to people and then help get them the resources to get those things done.

15:13CFO THOUGHT LEADER: Now, could you help us understand about this pivot to health insurance? What made that possible from a financial standpoint? What were, you know, financially, what were you up to? What did you have to do to make that pivot a reality?

15:30Tami Wilson-Ciranna: We had done a capital raise early on in COVID. And after that, we were pretty much self-funded. So we did take care of our investors during that time period. And our investors believed in us and what we were doing. And so we used some of those funds to really fund this insurance startup.

15:57CFO THOUGHT LEADER: And to boil that on down, as far as allocating, you know, dollars to make it happen, can you give us some sense of what you were doing?

16:10Tami Wilson-Ciranna: We probably rolled$500 million over to start up the insurance entity Insurance entities are not easy to start You have to have a significant amount of capital You have to have a significant amount of capital to get and maintain your A - rating from A and best And that's very important to us So that's really what we needed to start this process

16:40CFO THOUGHT LEADER: Now, let's understand that the revenue model today, if you could help us understand, where should we look first? And I know it's the premium model, member engagement, or is it something else?

16:53Tami Wilson-Ciranna: We underwrite every employer group. So they get individual pricing and it's based on their claims experience and, you know, depending on the size, there's also a manual rating based on risk factors and geography and other things. So it's a pretty standard actuarial model to price this insurance policy. and then on the other side of that is the claims and our belief is if you which is most of the industry believes this also that if you engage people in preventive care you can lower the cost and the issue is how do you do that and I think people have tried to say okay preventive care is zero copay but then you go in and the doctor runs some lab you weren't anticipating and then all of a sudden you get a$500 bill so people get kind of paranoid about engaging in care It's also confusing.

17:41Tami Wilson-Ciranna: So there are studies that were done, you know, even though colonoscopies were free, the amount decreased once people were on a copay plan because they didn't know that there wasn't a copay on that one, you know, that it was okay to go get it. So that's the interesting thing is that we really try to take the complexity out so that people engage in that care and feel comfortable just going to the doctors because we do firmly believe going to the doctor sooner is helpful. The same with the pharmacy. 97 % of our fills are at zero copay. And that's because we put one of each class of drug at zero copay.

18:19Tami Wilson-Ciranna: Now, sometimes there's brands that don't have a biosim or generic. If there's a BioStem or Generic, we'll put that on tier one and zero copay. But if they don't have one, we'll still put that drug on zero copay, even if it's expensive. And dealing with people in this industry, they did not understand why wouldn't, that's an expensive drug. You should put a copay on that. But if somebody needs the drug, they need the drug. So we really believe if you need to take the drug, you should be able to take it at zero cost. So that's, it's a very different philosophy. we view it as a very holistic system because if somebody's on their medication, then they're not going to end up in crisis situations.

18:54Tami Wilson-Ciranna: They're not going to end up in the hospital. But to somebody who has to pay a$50,$250 copay on that medication, that's a deterrent. One, we talk ourselves out of stuff. We all go like, I feel fine. I didn't really want to take that drug anyway. So it's just one more excuse to not take it. Or for some people, it's just not affordable. They need to cut pills in half. They can't afford it. They got to pay their utilities, their grocery bills. So I think it's very important that we have this kind of setup and we get people to engage and to take care of themselves, engage with the system.

19:36CFO THOUGHT LEADER: Before the environment or circumstances impact the financials, what are you looking at early to determine, you know, is it member engagement? And we're curious about your lines of sight into the business, I should say. We always try to understand what is it that you're looking at to make sure the company's performing the way it should?

19:58Tami Wilson-Ciranna: The way we want it to go? We definitely look at, we look at the, as the company's evolved and we have more data, we look, is our model working, right? So, you know, the actuaries go in there and they go, look at these members, that they started back in the day, you know, what does their cost profile look like? And how does that compare to other places? And what we found is that, yeah, they use services and then they, they go down. And with other insurance companies, they start to soar because if you put off all your preventive care, you end up in these crisis situations. And so I think we look at that, we look at medical loss ratio, we look at that by counties, geographies, states, you know, What are the medical costs within different zones?

20:45Tami Wilson-Ciranna: Because we're constantly contracting. So if that's changing some of our cost profiles, we want to adjust for that. We've dug a lot into wellness programs. Are they beneficial? Is this something that has a cost benefit that will benefit our members? Because ultimately, that's what this is about. We want to save these members money. So I don't want to provide a wellness program that then doesn't provide any benefit to them. So we analyze those. We were very data-driven at Curative. I think there's a lot of different things we look at. But, you know, medical loss ratio is a big one, monitoring the costs, and monitoring how these members are doing across time.

21:25CFO THOUGHT LEADER: Along the way, whether it was looking into those wellness programs or other measurements, were there certain assumptions that you've maybe disregarded now, that you realized we had, you know, they didn't fit?

21:42Tami Wilson-Ciranna: certain assumptions. Yes. I mean, I think it's more market feedback, right? So we thought we would just have one plan because you don't need anything else because you don't have a deductible and copay. And the market was like, no, we need three. We'd get bids. We'd get what they were called requests for proposals and be like, you have to have these three plans. And so we're like, okay. So we created two other plans. One is PPO Max, which has some extra benefits, It's, you know, gym and other things. And one is EPO, which is, you know, in-network care only. And then the standard PPO plan. I think the costing of some of the rental networks was definitely a surprise to us.

22:22Tami Wilson-Ciranna: We didn't have any claims for them to run through. And, you know, they tell you what the discounts are. So I think that was a little bit different than what we anticipated. So we're very focused on getting our own contracts. but yeah I mean I think there's always things that you learn along the way that make you adjust what you're looking at and how you're looking at it so are you including all the elements that you need to be including to analyze that are you accidentally dropping off some things that really make a difference and are costing you money now curative has uh been putting ai uh

22:59CFO THOUGHT LEADER: directly into the member experience. Is it creating value, meaningful value there today? Oh, AI is amazing.

23:09Tami Wilson-Ciranna: We, across the company, I would say people have definitely embraced AI and we do it in a few ways. Data analytics, you know, it's easy. We have everything in a data lake so people can access their own, on their own, the information that they need. you know it's made coding right for the tech team much faster you know people are using Claude now to write code and then you know kind of reviewing and making sure they're giving Claude the right instructions so we've able to customize and replace systems that you know were really not functional for us they may be great systems for other people but it was very frustrating us because like I said we're very data driven and so not being able to connect well to system APIs that didn't quite work the way we wanted them to and get that information transferred amongst systems in a seamless way was very frustrating.

24:02Tami Wilson-Ciranna: So having our own key operating systems has been really important. It's really accelerated our ability to move things faster and automate things. And then, of course, AI agents. I think we have a variety. One example would be in credentialing. Credentialing was traditionally outsourced. You need to check that that doctor has a proper license, right? So outsourced to a company and their software. They had people in the Philippines doing this. Took six months. It was awful. We built a system with an agent that now does all the credentialing. And so it's very automated. It's very fast. It's 24 to 48 hours to get someone credentialed.

24:45Tami Wilson-Ciranna: everybody loves the agent, responsive, you know, updates the provider directory right away, gets back to you. And so I think that's been a really, really huge example of a huge benefit where it's made things go faster and made the process better for people outside of the company.

25:08CFO THOUGHT LEADER: We wonder about inside finance, where AI has perhaps gone beyond efficiency and actually improved how you understand the business, perhaps.

25:25Tami Wilson-Ciranna: Yes, I think the data analytics that you can do, if you remember back in the day, they used to talk about big data. And AI allows you to really manipulate big chunks of data into much more manageable terms and spreadsheets and analytics. And I think that's huge. And you could do very customized screenshots of like what you want at a point in time. Because a lot of times I'm asking my team, what are we seeing here? And if it looks good, we don't need to go any farther. And if it looks bad, then we'll dig in. And so it really has made those analytics better. Also on even like your BVA and everything, you can automate a lot of stuff that, you know, before, you know, you had to have somebody responding to all these emails, you can have more auto responses.

26:18Tami Wilson-Ciranna: You can have your financial information automatically dropped into your monthly analytic package. There's just a lot of really great things I think you can do on the finance side. I mean, my favorite is the analytics. I'm sure the rest of my team has other things that they like about it. I know on the accounts payable side, they're using it to code, get things into the right GL accounts and departments. So I think there's just so many different uses for it that you see across departments. We wonder, as Curative has scaled this model, what's proved harder to predict?

26:59CFO THOUGHT LEADER: Healthcare utilization or economics of expansion?

27:05Tami Wilson-Ciranna: No, amazingly enough, the utilization was good. The utilization's fine. It's really, I think, the networks and the provider costs are sometimes harder to predict. And I think a lot of providers are great and you contract with them and everybody's kind of at market. And then I think there's providers in the marketplace that are, were smaller, so it's harder to get their attention to contract with them. so I think that's been kind of interesting in the way the rental networks work where you're literally renting from your competitor of course at a 30 percent markup that gets a little challenging so I think those are things that we we came to understand more fully I think we we do but then when you're actually living it it gets different but AI has definitely changed I think a lot of things and allowed a lot more integration of systems, which is great.

28:01CFO THOUGHT LEADER: Do you see AI as possibly or eventually changing the economics of the health plan itself? I mean, it's already becoming part of the member experience, but could it eventually change the economics, the pricing, whatever it is?

28:17Tami Wilson-Ciranna: I think it makes you much more efficient and allows you to accelerate a lot more, like in that credentialing example, right? You can accelerate much faster. Same with other areas that we're using AI in. It allows you to make changes to systems faster. I mean, before I'd have an error in a system and I'd have to submit a ticket to the owner of that system and be, you know, so, you know, the outside vendor. You'd have to submit a ticket. You'd submit a high level ticket. It would still be ignored. You'd have these weekly meetings really need these tickets resolved. You know, this is just not functioning right in your system.

28:55Tami Wilson-Ciranna: And so now it's so much easier to correct those things because it's in-house. So I think that's huge. I think it's going to make admin costs more efficient. I think it's going to make things move faster and better. I think ultimately the dream is that it also helps you in this care navigation and helping people engage in care. You know, what kind of reminders you're giving, how are you helping them schedule appointments at different providers for the things that they need. So I think that's where, and ultimately, if you want to go really, you know, Buck Rogers here, you know, there's a lot of online, you know, telehealth and medicine and, you know, magic wands that scan you to give you the doctor all the information they need.

29:41Tami Wilson-Ciranna: And those are, you know, probably much further out, but also I think very valuable tools. I mean, people in rural locations, they're not near doctors, they're not near hospitals, you know, how do you get better care to them? And I think it's always a bit of a hybrid model. There's a lot that's in person, but there's a lot of times where if you could get that person care sooner, that's better. And so you're already seeing it with telehealth, you know, where you're going on and doing telehealth. And I think that gets more and more sophisticated. And I think we're set up to really allow people to engage in those types of services.

30:15CFO THOUGHT LEADER: Some interesting ideas here. Thank you for those. We are up to what we like to refer to as our finance strategic moment. And this might have happened any time during the course of your career. Might have been in your Anderson days. I don't know. Might have happened last week. What comes to mind when we ask for a finance strategic moment?

30:34Tami Wilson-Ciranna: Oh, there's so many. but I think the one I picked was we were setting up the company and the insurance company, and there was a large belief by a lot of people that we just needed to be in one state and really work that state and grow that state. And I was like, no, because when you play this out, I'd talk to a lot of people in the industry and brokers and other things. It takes about three years to get into a market. the first year you get tried on a couple little clients the second year maybe they give you your you know their 100 to 500 member groups and then the third year is when you really get more invited to everything and so you can't decide i'm going into florida this year and we're just going to take it doesn't work that way you have to start florida three years in advance so we've been very measured about adding new states every year because that way you keep the growth going You have to anticipate, you know, what do I need to do for the long term for long term growth?

31:39Tami Wilson-Ciranna: And so, you know, once I made my pitch, you know, then it was like, oh, sales was like, ah. So and then that's what we've really done is really get our, you know, our compliance teams and our other licensing teams to start moving into these states and then stage into them. And so you always have new states coming online and different states at different stages.

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33:37CFO THOUGHT LEADER: Take you back again, probably to your first CFO tour of duty. So you were at Commonwealth. I think you mentioned to us Commonwealth Partners. You were an SVP originally, and it seems like sort of the ideal way to enter the CFO office, get to know the company a little bit, get to know the board, and then make your entry. But tell us about that first 60 or 90 days as a CFO after you arrived there. There must have been something you wish you knew something more about. And what we're going to offer you is the opportunity to give yourself some advice way back when. And what would it have been as you entered that office?

34:17Tami Wilson-Ciranna: Way back then. That's a long time ago. I think, yeah, it's interesting. I think that sometimes there's people who were there before you were that may not enjoy your presence. And so I think you just have to stay your course and keep saying, like, this is the way we need to do it. This is the expectations. And, you know, it's either going to be a fit or not. But you can't not move the organization forward. you you and it's sometimes difficult because you know there may be people that you know it's just it's just not a great fit for where the organization is growing and um and so you just want to be clear and calm on the expectations and continue to do that and i think you just have to not um it does make you a little sad but you you still have to stick to your guns and i think that's the important part is that if you continue on the path, I think it does eventually get recognized and get you where you need to be.

35:33CFO THOUGHT LEADER: We've had other finance leaders tell us that you should be confident in yourself because you know people have that confidence. You wouldn't be there otherwise. So knowing that, I mean, is that where you got the confidence? Again, it would be people who disagree different styles of individuals surrounding you, but you have to be confident.

35:56Tami Wilson-Ciranna: I will tell you that, yeah, look, I had a CEO look at me and say, we're paying you for your opinion. Like, so we want to hear your opinion. And I was like, okay, that's fair. Because, you know, you're like, are they going to take this well when I disagree with them, when I point things out? And so, yeah, I think now people would be like, oh, she has no problem giving her opinion. But I think that's important to realize that's why they brought you in. They brought you in because they want your independent thought. They want to know what you see that they're not seeing and what your thoughts are.

36:33Tami Wilson-Ciranna: And I think that's important because I think anybody in the CEO role or leading an organization, you're not going to be able to see everything. And so when you have other people that have a different angle, they can they can help you with those those areas and say look I think this is going to be a problem over here We need to deal with it or this is what I see us in the future and that's why we need to go in that direction also And I think you have a healthy discussion about it, you know, not Every thought you know you have is right or wrong I think it's more important to have the discussion and really Kind of spitball ideas and let people get their thoughts out because, and that goes across the board, honestly, for people that work with you, you wanna hear their opinions.

37:18Tami Wilson-Ciranna: I literally would ask people like, okay, what would make your job easier? What is the thing you don't like about your job? What are different things? And it's crazy sometimes you're like, oh my gosh, we could totally fix that. And so it's getting people to communicate what they're thinking and what they're seeing and allowing that to make a difference in the organization.

37:39CFO THOUGHT LEADER: You mentioned, again, you mentioned the CEO and that experience. And I think up front, you mentioned you left retirement because of an opportunity here where maybe the CEO approached you. Can you reflect a little on the confidence you had? I mean, I guess you understood that you two communicated well and that this was a good opportunity.

38:03Tami Wilson-Ciranna: I, yeah, look, I mean, I think I'd done at Prolacta a lot of building and building of an organization. I thought it was a great opportunity to help with the pandemic that was really impacting all of us. And so I was, I didn't have any problem digging in. I was told everything was in a box, which wasn't quite true. and so it was really it was a little more ground up than I had thought but we get we got there we got there and so I think you just yeah I think there's always times where you're like oh my gosh this is not what I thought I was walking into but then you go okay well what resources do I have who can I call what consultant can I get who could I bring in who could I hire and so you just get those pieces in place.

38:52Tami Wilson-Ciranna: It's okay not to know everything. You're not going to. And it's important that you then seek out other resources. Like, hey, I've never dealt with this before. Have you dealt with this? You know, so sometimes I'd ask friends, colleagues, sometimes consultants, you know, reach out to your vendors too. Sometimes they have great resources. You're like, hey, have you ever dealt with this? Do you know people? Can you introduce me? And I think that's huge, you know, recognizing it's okay not to know. I think it's important. It's important to just say it and then, and learn it and get the information.

39:25CFO THOUGHT LEADER: Given you joined Curative. You can ask Claude now

39:28Tami Wilson-Ciranna: though.

39:28CFO THOUGHT LEADER: I was thinking you joined Curative really at the very beginning of something. And I'm wondering if the other companies were similar or this, because it's given you an opportunity to lead more broadly than perhaps your earlier chapters, or would you look at it

39:45Tami Wilson-Ciranna: differently oh i think it's i definitely lead more broadly here although i would say it was progression also because at um commonwealth it was more of a traditional cfo and then proactive biosciences where i got more into operations i had um we had to build a plant so i was heavily involved in the construction of the plant and i think you and then at um curative i've definitely done a lot more on the operational side, network reports to me, actuary risk. So I have a lot more operational type departments, which I enjoy. And sometimes we swap them off among us, Fred and I. And I think it's just really interesting to learn something new.

40:34Tami Wilson-Ciranna: I mean, I don't necessarily, I didn't know those areas coming in, but it's like, how can I get up to speed? And I think you learn. And I think insurance is an interesting place because the rules change all the time. So you always have to, people give you advice And you go and you look it up And you're like, oh, they repealed that law Or like, oh, that only applies to Medicare And so you really have to take an approach of You know, does this make sense and should we be doing it? And I think that carries across organizations And across departments and operations You know, how do you get this thing functioning well On a consistent basis?

41:08Tami Wilson-Ciranna: How do you build the platform?

41:10CFO THOUGHT LEADER: Are you, you would widely, I think be recognized as an operational CFO today.

41:19CFO THOUGHT LEADER: Do you miss being a traditional CFO? No, no, no.

41:27Tami Wilson-Ciranna: I'm an adrenaline junkie. I love it. I love learning new things. I like fixing things. Look, there's a lot of CFOs like me that love to get in there and, you know, how do we make this run better? How do we do this? How can we fix it? You know, this isn't working well. And, you know, in startups and growth companies in particular, you know, I always tell my teams, whoever can should do it. And eventually, if it's not ours, we'll hand it off to whoever it belongs to. But if it needs to be done, we are the people, assume you're the one who needs to get it done. And I think that's an important philosophy.

42:05Tami Wilson-Ciranna: But yeah, no, I love the operations. It's really interesting. You learn so much. It's kind of satisfying to have stuff and make it work better.

42:14CFO THOUGHT LEADER: For young executives who want, finance executives who want to become financially, excuse me, operationally minded CFOs, would you recommend a different path than the one you took?

42:27Tami Wilson-Ciranna: No, I think just the ability to be there and do what needs to be done and not say, oh, I need to stay in my lane or I don't have time for that or that's not mine. I'm touching on that accounting house experience.

42:44CFO THOUGHT LEADER: Should they begin in an accounting house? And I would think you would still be.

42:49Tami Wilson-Ciranna: Oh, I think it's great. I think public accounting is such a great place to learn. It's a very accelerated learning path. You get exposed to so many different businesses, I think. But there's so many paths you can take in life. I mean, yeah, I think it's a great path because that's the one I did, but that doesn't mean that's your great path and that's okay. I think the attributes are the same, you know, that you have to get in there and be helpful and work hard. But yeah, no, look, public accounting is great. I mean, you're dealing with really smart people. You're working on really great companies.

43:25Tami Wilson-Ciranna: You're learning a lot about analytics and the way different companies work. So yeah, I'd say that that's a great path, but it's not the only path.

43:35CFO THOUGHT LEADER: Timmy we always like to ask our guests to reflect a little on the personal side what's something that most of your colleagues might not know about you is there some feat from your past some accomplishments some

43:45Tami Wilson-Ciranna: interest that you had I do from my past wow oh I have seven kids and we like to do these tough mutters and 5ks so we like to do these things kind of together. So that's always fun. I know most people wouldn't think of me crawling around in the dirt under barbed wire and thinking that's fun, but it's so fun. We did a 5k the other day and I went to so many of my kids' events. I'm like, you all need to be at the finish line cheering me on because they're way faster than I am. So they cheered me on and I was like, wow, that's so great. Does that what that feels like? I love that. But yeah, it's, you know, look, Like being active and working out and doing physical things are really great.

44:34Tami Wilson-Ciranna: As a CFO, I mean, as a president, you have to have stamina for this, for these growth companies. And I think that's important to get out there and engage in those type of activities.

44:44CFO THOUGHT LEADER: So you became a mom during your Arthur Anderson days as a partner?

44:50Tami Wilson-Ciranna: In my Commonwealth days.

44:52CFO THOUGHT LEADER: Wow.

44:53Tami Wilson-Ciranna: And my prolacta days. Oh, yeah. Oh, yeah.

44:54CFO THOUGHT LEADER: Everything gone forward. Yeah. Okay. I just wanted to get the timing down. So seven children. Wow. Okay. You might have a record for us here. I don't think we've had that recently.

45:06Tami Wilson-Ciranna: Yeah, right?

45:07CFO THOUGHT LEADER: Someone will correct me, but that's pretty good. We always wonder, too, what about, is there a book or something that's influenced your thinking? Or maybe it's something you escape with? Or maybe it's just a resource and not a book, something you turn to. Anything you can recommend to the audience?

45:26Tami Wilson-Ciranna: for some reason i remember um the how to how do you um how to make friends and influence people for some reason there's certain aspects of that book that i found really interesting and really helpful you know using people's names you know not using but using and so i think there were some great takeaways from that book i think the wall street journal is always fascinating the banners show up on my phone and I pick the articles I want. I'm not reading it cover to cover. But I think there's just some really interesting things that end up being applicable that I'm like, then no way that will happen to my business.

46:05Tami Wilson-Ciranna: And I'm like, wow, okay. We had one the other day that they're like, this is exactly the thing Tammy forwarded us to us. So it is interesting. They just, they, I don't know how they find this stuff out, but it's really, really interesting. and yeah I like to read for pleasure too and that's always fun

46:23CFO THOUGHT LEADER: great selections Dale Carnegie comes up frequently I don't know what it is with finance leaders has something to do with listening as well he was a big one to emphasize the importance of listening to your audience well we are up to our final question we've had some really interesting responses so thank you for those we want to know about the coming 12 months and what would your priorities be as a CFO for the coming 12?

46:53Tami Wilson-Ciranna: Well, I think continue to support the capital of the company, really grow our network, and continuing to grow into other states and add more members. I think this is a really important product. People need to be able to engage in preventive health and take care of themselves. As a society, we need to fix this system Because right now, it's costing us all more money because we're not engaging in care. And that's really why I'm here. That's really why a lot of people are curative, because we really believe in this mission of changing health care in the U.S.

47:30CFO THOUGHT LEADER: Tammy Wilson-Serrana, thank you for joining us on CFO Thought Leader.

47:36Tami Wilson-Ciranna: Thank you so much for having me. It was nice speaking with you.

47:49CFO THOUGHT LEADER: Hello, we're benchmarking the CFO path. Join 500 finance leaders helping define how today's CFOs rise and lead. If you're a CFO or senior finance executive, contribute your experience. It takes just a few minutes and you'll receive early access to the findings. visit cfothoughtleader.com benchmarking.