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- This is Chanel Bunger
with the Becker's Healthcare Podcast,
and I'm recording live at the eighth annual Becker's Health,
it Digital Health and RCM conference in Chicago.
Right now I'm sitting with Ven Moer from HCSC.
Then, thank you so much for joining me today.
Could you take a moment and please introduce yourself
and tell us a bit about your background?
- Of course. Uh, it's a great pleasure to be with you.
Thank you for having me. Um, my name is Dr. Ven Moer.
My background is, uh, technically in, uh, family medicine,
but, uh, spent about a decade in, uh,
hospital administration with Franciscan Health, uh,
covering quality and patient safety, value analysis,
care management, as well as revenue cycle management.
Uh, I, but recently moved to the payer to HCSC, uh,
where I'm working on key provider contracting, um,
which has been very exciting and edifying.
- And can you tell me what that transition's been like?
- Yeah, I think the transition has been ex very interesting.
Um, you know, being on the provider side
and administration frequently, uh,
we don't unders have a full understanding of the pain points
and challenges that the payers are going through.
Um, and there's often, uh, a disconnect there.
And so, being on the provi on the payer side now, um,
it's really a great learning experience to see, uh,
the challenges that the payers have
and how they're trying to work within the constraints
of the healthcare landscape that exists today.
Um, while keeping members at the forefront, members
and patients at the forefront,
and also trying to be collaborative with health systems.
- That's a really unique perspective that you have.
Thank you so much for walking us through that.
Moving forward, what is your growth strategy
for the next couple of years?
- Um, I think, you know, growth strategy
from a payer standpoint obviously is, uh,
gaining market share.
I think HTSC is in its evolution, uh, as the,
as the blues are.
Um, I think certainly Medicare Advantage is an area
of growth, um, as well as making sure we, we, uh,
maintain our footprint and our, um,
market share in our existing markets.
Beyond that, of course, gaining more commercially insured,
uh, employer contracts,
but more than anything, we're really
from the contracting standpoint with providers looking
to move into arrangements that are more collaborative,
more focused on value-based care, really focusing on
CMSs initiatives to, uh, go in the Learning Action network,
uh, models three and four with upside and upside
and downside risk as well.
- Got it. And can you tell us about the most exciting
and impactful initiative
or project that you're working on right now?
- Yeah, I would say the, uh,
most exciting project I'm working on now is, um,
for commercially insured patients, really, uh, doing, uh,
a deep dive into some
of the really high cost new emerging treatments that are,
uh, a lot of the academic medical centers
and now community medical centers are, um, administering
to patients, uh, like cell and gene therapy.
Uh, they're so new, so emerging, so high cost, um,
but they're rapidly scaling.
So there's definitely pressure from, uh, employer groups
to figure out, um,
cost control mechanisms either pharmacy vented, uh,
but, uh, as, uh, an insurer.
It's really, uh, the impetus is, is on us to, um, kind
of figure out alternative payment bo models
and value-based care around really high cost treatments
that our members need.
But we wanna make sure we can do it in a cost-effective
and efficient way collaboratively with health systems.
- Well, Dr. Macare, I wanna thank you
for joining me today on the Becker's Healthcare Podcast.
But before I let you go, can you tell me
what is the most important thing healthcare executives
should do right now to make sure
that their organizations are successful in the future?
- Certainly, I think healthcare executives need
to be conscientious of the rapidly evolving, um,
healthcare landscape.
You know, post covid, the CL clinical workforce is heavily
burnt out burdened.
There are workforce shortages across the board.
So really thinking outside the box and innovating.
Uh, there's a lot of new technology, there's a lot
of new vendors out there
that have very promising, uh, products.
That being said, uh, I think it's imperative
for healthcare executives to really examine their existing
business models and figuring out which vendors
and which tools are best used for them
to execute their their own strategies.
- Thank you for that. And Dr.
Mather, I wanna thank you for your time and insights today
and for joining me today on the Becker's Healthcare
Podcast. Thank you.
- It's my great pleasure. Thank you so much for having me.
- It's so important for leaders at the top of organizations
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