WEBVTT 1 00:00:01.919 --> 00:00:04.740 - The payer provider relationship has never been simple, 2 00:00:04.799 --> 00:00:06.980 - but what's happening now is something different. 3 00:00:07.359 --> 00:00:09.539 - Value based models are maturing unevenly, 4 00:00:10.000 --> 00:00:10.980 - prior authorization 5 00:00:11.279 --> 00:00:14.445 - reform is reshaping workflows on both sides, and 6 00:00:14.445 --> 00:00:16.304 - affordability pressure is intensifying. 7 00:00:17.085 --> 00:00:19.425 - The organizations that figure out how to collaborate 8 00:00:19.725 --> 00:00:21.265 - genuinely, not just contractually, 9 00:00:21.725 --> 00:00:23.244 - are the ones that will set the terms 10 00:00:23.244 --> 00:00:24.464 - for what comes next. 11 00:00:24.845 --> 00:00:27.619 - Becker's fifth annual fall payer issues round table 12 00:00:27.619 --> 00:00:30.359 - brings together more than 500 executive level attendees 13 00:00:30.820 --> 00:00:32.820 - and 70 plus speakers for two days of 14 00:00:32.820 --> 00:00:34.679 - focused senior level conversation 15 00:00:35.059 --> 00:00:38.039 - on benefit design, network strategy, transparency, 16 00:00:38.500 --> 00:00:41.335 - and the financial and regulatory dynamics that are 17 00:00:41.335 --> 00:00:44.295 - redefining how care gets paid for. Join us 18 00:00:44.295 --> 00:00:46.534 - November second and third at the Swiss Hotel 19 00:00:46.534 --> 00:00:47.034 - Chicago. 20 00:00:47.414 --> 00:00:50.954 - For the agenda and event details, visit beckerspayer.com 21 00:00:51.015 --> 00:00:52.774 - and click on the events tab in the 22 00:00:52.774 --> 00:00:53.594 - upper right. 23 00:00:54.549 --> 00:00:57.030 - Hi, everyone. This is Elizabeth Caslow with the 24 00:00:57.030 --> 00:00:58.649 - Becker's Payer Issues podcast. 25 00:00:59.189 --> 00:01:01.109 - I'm excited today to be joined by David 26 00:01:01.109 --> 00:01:04.629 - D'bono, oncology medical director at Carillon Health. Doctor 27 00:01:04.629 --> 00:01:06.790 - D'bono, thank you so much for joining us 28 00:01:06.790 --> 00:01:09.209 - today. Thank you. Appreciate the opportunity. 29 00:01:09.655 --> 00:01:11.734 - Of course. And so before we jump into 30 00:01:11.734 --> 00:01:13.415 - some of the questions here, I would love 31 00:01:13.415 --> 00:01:15.575 - to hear a little bit more about your 32 00:01:15.575 --> 00:01:17.734 - career at Carillon and also just your general 33 00:01:17.734 --> 00:01:20.234 - health care background and what you currently do. 34 00:01:21.015 --> 00:01:21.495 - Well, 35 00:01:21.895 --> 00:01:23.575 - again, thank you so much for, 36 00:01:24.055 --> 00:01:25.194 - for the time today. 37 00:01:26.310 --> 00:01:27.049 - I trained 38 00:01:28.069 --> 00:01:30.150 - at Indiana University, so I did all my 39 00:01:30.150 --> 00:01:31.129 - internal medicine 40 00:01:31.750 --> 00:01:33.689 - residency, oncology fellowship. 41 00:01:34.310 --> 00:01:36.810 - During the time of my internal medicine residency, 42 00:01:37.269 --> 00:01:38.489 - there was a lot of 43 00:01:39.204 --> 00:01:42.025 - oncology research being done at Indiana University. 44 00:01:43.525 --> 00:01:44.984 - And I got to know 45 00:01:45.364 --> 00:01:46.584 - many of those investigators 46 00:01:46.965 --> 00:01:49.444 - and and so made a decision to to 47 00:01:49.444 --> 00:01:50.504 - go into oncology. 48 00:01:51.604 --> 00:01:52.504 - And I practiced 49 00:01:53.469 --> 00:01:54.530 - community oncology 50 00:01:55.310 --> 00:01:58.269 - in a small community in Illinois, South Of 51 00:01:58.269 --> 00:02:00.370 - Chicago for about thirteen years. 52 00:02:01.229 --> 00:02:03.569 - And during that time also became interested 53 00:02:04.590 --> 00:02:07.965 - in palliative care and supportive care. And and 54 00:02:07.965 --> 00:02:09.884 - so for about seven years, I did palliative 55 00:02:09.884 --> 00:02:10.384 - care 56 00:02:10.764 --> 00:02:12.384 - in an oncology setting, 57 00:02:13.164 --> 00:02:14.625 - here in Detroit, Michigan. 58 00:02:15.724 --> 00:02:17.805 - And for the last nine years, I've been 59 00:02:17.805 --> 00:02:20.305 - with Carolina and Elevance Health. 60 00:02:20.764 --> 00:02:22.544 - And I guess I would say that 61 00:02:23.270 --> 00:02:23.930 - my motivation 62 00:02:24.310 --> 00:02:25.129 - has been, 63 00:02:26.069 --> 00:02:26.569 - to 64 00:02:27.269 --> 00:02:28.250 - try to optimize 65 00:02:29.349 --> 00:02:30.489 - the way we support, 66 00:02:31.430 --> 00:02:32.169 - our members, 67 00:02:33.030 --> 00:02:33.769 - and patients 68 00:02:34.469 --> 00:02:36.489 - who are undergoing cancer care. 69 00:02:37.104 --> 00:02:38.705 - And so we do that in a variety 70 00:02:38.705 --> 00:02:39.365 - of ways. 71 00:02:39.745 --> 00:02:40.245 - Certainly, 72 00:02:40.544 --> 00:02:42.064 - one of the ways is something that we'll 73 00:02:42.064 --> 00:02:43.444 - be talking about today, 74 00:02:44.145 --> 00:02:44.965 - with navigation, 75 00:02:46.145 --> 00:02:48.724 - but are also trying to make key connections 76 00:02:49.340 --> 00:02:50.959 - with our palliative care resources 77 00:02:51.580 --> 00:02:53.919 - and behavioral health resources. So 78 00:02:54.219 --> 00:02:55.759 - our team actually works 79 00:02:56.060 --> 00:02:57.840 - one on one with oncology 80 00:02:58.219 --> 00:02:58.719 - providers, 81 00:03:00.060 --> 00:03:00.879 - and practices 82 00:03:01.180 --> 00:03:02.079 - around the country, 83 00:03:03.099 --> 00:03:03.919 - to optimize, 84 00:03:05.104 --> 00:03:07.584 - not only the quality of care, but also 85 00:03:07.584 --> 00:03:08.084 - trying 86 00:03:08.705 --> 00:03:10.084 - to make these connections 87 00:03:10.784 --> 00:03:13.185 - with some of these supportive care resources that 88 00:03:13.185 --> 00:03:16.164 - we have in order to overall optimize, 89 00:03:16.544 --> 00:03:18.324 - the care that our members are getting. 90 00:03:19.240 --> 00:03:21.960 - So let's dive into that initiative you hinted 91 00:03:21.960 --> 00:03:24.840 - at earlier. So we're gonna discuss Elvance's cancer 92 00:03:24.840 --> 00:03:27.819 - care engagement initiative. So at a high level, 93 00:03:28.039 --> 00:03:29.659 - can you break down this program, 94 00:03:30.120 --> 00:03:32.905 - when it started, what drove it, who has 95 00:03:32.905 --> 00:03:33.405 - access 96 00:03:33.784 --> 00:03:36.044 - to it, and what it actually includes? 97 00:03:37.145 --> 00:03:38.125 - Sure. So it 98 00:03:38.664 --> 00:03:40.444 - it started with some conversations, 99 00:03:41.305 --> 00:03:41.805 - back, 100 00:03:43.224 --> 00:03:45.224 - in kinda 2018, 101 00:03:45.224 --> 00:03:46.365 - 2019. 102 00:03:47.219 --> 00:03:49.159 - There was growing evidence, 103 00:03:50.419 --> 00:03:50.919 - that 104 00:03:51.379 --> 00:03:51.879 - navigation 105 00:03:52.419 --> 00:03:53.639 - in cancer care 106 00:03:54.259 --> 00:03:55.239 - makes a difference. 107 00:03:56.580 --> 00:03:58.680 - It makes a difference in care quality. 108 00:03:59.715 --> 00:04:02.134 - It makes a difference in patient experience, 109 00:04:03.235 --> 00:04:04.134 - and it improves, 110 00:04:05.314 --> 00:04:07.334 - the things that are important to patients, 111 00:04:08.194 --> 00:04:08.935 - such as 112 00:04:09.634 --> 00:04:12.055 - staying at home, not having to be hospitalized, 113 00:04:12.860 --> 00:04:14.000 - avoiding complications, 114 00:04:15.419 --> 00:04:18.399 - being able to continue to be employed, 115 00:04:19.100 --> 00:04:22.139 - if we can get the optimal supportive care 116 00:04:22.139 --> 00:04:24.060 - for them. So we had a lot of 117 00:04:24.060 --> 00:04:24.560 - conversations 118 00:04:24.939 --> 00:04:26.319 - about the the data 119 00:04:26.665 --> 00:04:27.645 - that was supporting 120 00:04:28.024 --> 00:04:29.404 - this type of work 121 00:04:30.105 --> 00:04:31.485 - and decided that, 122 00:04:32.024 --> 00:04:34.665 - we should launch our own navigation program. At 123 00:04:34.665 --> 00:04:35.404 - that time, 124 00:04:36.185 --> 00:04:38.685 - most practices didn't have navigation. 125 00:04:39.529 --> 00:04:42.410 - What you see now is that practices and 126 00:04:42.410 --> 00:04:44.829 - cancer centers are starting to adopt, 127 00:04:46.089 --> 00:04:47.310 - this type of work. 128 00:04:47.849 --> 00:04:49.069 - But I think we were, 129 00:04:49.449 --> 00:04:50.269 - pretty unique, 130 00:04:50.889 --> 00:04:52.829 - in trying to get this done early, 131 00:04:53.129 --> 00:04:54.884 - in the in the payer space. 132 00:04:55.665 --> 00:04:56.165 - And 133 00:04:56.785 --> 00:04:57.925 - our thought process, 134 00:04:58.464 --> 00:05:00.564 - primarily really was to 135 00:05:01.024 --> 00:05:03.365 - to understand that the care 136 00:05:03.985 --> 00:05:06.725 - that our members are going through 137 00:05:07.220 --> 00:05:09.800 - when they're diagnosed with cancer is complex, 138 00:05:11.139 --> 00:05:13.560 - has a big impact on their families, 139 00:05:14.740 --> 00:05:16.600 - and that navigating 140 00:05:16.900 --> 00:05:19.080 - the entire experience is difficult. 141 00:05:19.460 --> 00:05:20.900 - And we thought we could really make a 142 00:05:20.900 --> 00:05:22.120 - difference in that regard. 143 00:05:22.824 --> 00:05:25.805 - So which members have access to this initiative 144 00:05:25.944 --> 00:05:28.524 - right now, or is there not really anyone 145 00:05:28.585 --> 00:05:29.964 - left out of it right now? 146 00:05:30.745 --> 00:05:32.605 - So our our large local 147 00:05:33.305 --> 00:05:33.805 - groups, 148 00:05:35.064 --> 00:05:36.524 - are part of the program. 149 00:05:36.824 --> 00:05:39.040 - Our Medicare Advantage Plans are part of the 150 00:05:39.040 --> 00:05:39.540 - program, 151 00:05:40.480 --> 00:05:41.620 - and it is available, 152 00:05:42.879 --> 00:05:43.939 - for employer 153 00:05:44.240 --> 00:05:45.300 - funded plans, 154 00:05:46.400 --> 00:05:49.220 - if that's a program that they're interested in, 155 00:05:49.680 --> 00:05:51.220 - in buying up for. 156 00:05:51.954 --> 00:05:53.654 - Got it. And so 157 00:05:54.035 --> 00:05:56.514 - cancer care engagement has an eighty four percent 158 00:05:56.514 --> 00:05:58.935 - engagement rate. So what has been the key 159 00:05:59.314 --> 00:06:00.134 - to unlocking 160 00:06:00.514 --> 00:06:02.754 - such a high rate, and how can other 161 00:06:02.754 --> 00:06:06.935 - navigation programs, other clinical programs replicate those results? 162 00:06:08.040 --> 00:06:10.379 - Well, I think it it speaks to, 163 00:06:11.480 --> 00:06:11.980 - identifying 164 00:06:12.920 --> 00:06:13.980 - the right patients. 165 00:06:15.319 --> 00:06:16.540 - We do use, 166 00:06:17.240 --> 00:06:18.699 - some analytic resources 167 00:06:19.724 --> 00:06:22.224 - to identify what we believe are the highest 168 00:06:22.284 --> 00:06:23.185 - risk patients 169 00:06:23.724 --> 00:06:25.584 - and the highest need patients. 170 00:06:26.925 --> 00:06:27.824 - So if you're 171 00:06:28.365 --> 00:06:29.344 - if you're contacting, 172 00:06:31.084 --> 00:06:32.224 - a group of patients, 173 00:06:33.324 --> 00:06:33.985 - that are 174 00:06:34.520 --> 00:06:37.819 - likely to be receptive to a navigation program, 175 00:06:38.120 --> 00:06:41.100 - I think you're gonna have high engagement rates. 176 00:06:41.560 --> 00:06:42.220 - The other 177 00:06:42.680 --> 00:06:45.100 - key point, I think, with our program 178 00:06:45.400 --> 00:06:46.540 - is that it is 179 00:06:47.604 --> 00:06:49.384 - human directed, if you will. 180 00:06:50.164 --> 00:06:52.185 - You're not getting a call from, 181 00:06:53.365 --> 00:06:55.064 - you know, an automated bot. 182 00:06:55.925 --> 00:06:56.824 - And so 183 00:06:57.204 --> 00:07:00.084 - so when we when we get somebody on 184 00:07:00.084 --> 00:07:02.990 - the phone or through our digital apps, etcetera, 185 00:07:04.170 --> 00:07:05.149 - knowing that, 186 00:07:06.009 --> 00:07:07.790 - they are speaking to 187 00:07:08.410 --> 00:07:10.430 - a oncology certified navigator, 188 00:07:10.889 --> 00:07:11.790 - someone who, 189 00:07:12.569 --> 00:07:13.949 - understands the space, 190 00:07:15.014 --> 00:07:16.955 - who has a very comprehensive 191 00:07:17.335 --> 00:07:19.355 - way of evaluating the situation, 192 00:07:20.775 --> 00:07:22.875 - I think patients respond to that. 193 00:07:23.654 --> 00:07:26.615 - Families respond to that. And so I think 194 00:07:26.615 --> 00:07:27.115 - the 195 00:07:27.490 --> 00:07:28.709 - the idea of, 196 00:07:30.050 --> 00:07:31.909 - making a simple connection, 197 00:07:32.849 --> 00:07:34.629 - making a human connection 198 00:07:35.569 --> 00:07:37.990 - really contributes to the idea that 199 00:07:38.370 --> 00:07:39.509 - patients are interested. 200 00:07:40.455 --> 00:07:42.875 - They find the program to be helpful, 201 00:07:43.254 --> 00:07:44.714 - and they remain engaged. 202 00:07:45.814 --> 00:07:48.774 - So cancer care engagement has been associated with 203 00:07:48.774 --> 00:07:50.154 - a seven percent reduction 204 00:07:50.855 --> 00:07:54.235 - in avoidable inpatient admissions for Medicare Advantage members 205 00:07:54.560 --> 00:07:57.920 - and fifteen percent for commercially insured. So why 206 00:07:57.920 --> 00:08:00.319 - do you think there is variation with those, 207 00:08:00.720 --> 00:08:02.180 - between those types of plans? 208 00:08:03.040 --> 00:08:04.980 - And also, are you looking to 209 00:08:05.360 --> 00:08:07.620 - get any more concrete data on ROI 210 00:08:08.000 --> 00:08:08.900 - when it comes, 211 00:08:09.725 --> 00:08:10.785 - to the solution? 212 00:08:11.964 --> 00:08:13.645 - So your first question, I think, is a 213 00:08:13.645 --> 00:08:16.464 - good one. And I think it it's 214 00:08:17.085 --> 00:08:19.585 - it zero in zeros in on 215 00:08:19.964 --> 00:08:22.705 - the differences in populations that we serve. 216 00:08:23.329 --> 00:08:25.669 - When we think about a commercial population 217 00:08:26.129 --> 00:08:27.110 - in the oncology 218 00:08:27.410 --> 00:08:27.910 - space, 219 00:08:28.769 --> 00:08:29.509 - we are 220 00:08:29.889 --> 00:08:31.269 - primarily talking about 221 00:08:32.049 --> 00:08:33.029 - younger patients 222 00:08:33.570 --> 00:08:34.789 - who may have families. 223 00:08:35.730 --> 00:08:36.370 - They may be, 224 00:08:37.365 --> 00:08:38.585 - have full time employment. 225 00:08:40.325 --> 00:08:40.825 - And 226 00:08:41.445 --> 00:08:44.085 - so it's a different population than, let's say, 227 00:08:44.085 --> 00:08:45.544 - a Medicare population 228 00:08:46.485 --> 00:08:47.705 - who are intrinsically 229 00:08:48.245 --> 00:08:48.745 - older, 230 00:08:50.139 --> 00:08:51.200 - maybe retired, 231 00:08:51.980 --> 00:08:53.279 - may have more comorbidities, 232 00:08:53.660 --> 00:08:54.160 - and 233 00:08:54.940 --> 00:08:57.200 - so I think the populations are different. 234 00:08:57.580 --> 00:09:00.080 - But I would say that the difference in, 235 00:09:01.420 --> 00:09:03.519 - the inpatient admission rates are 236 00:09:04.054 --> 00:09:06.154 - are not large. So I think the 237 00:09:07.095 --> 00:09:08.714 - the fact that we're impacting 238 00:09:09.414 --> 00:09:12.074 - inpatient admission rates for both populations 239 00:09:12.934 --> 00:09:14.794 - is probably the take home message, 240 00:09:15.735 --> 00:09:17.574 - and I think we do that in a 241 00:09:17.574 --> 00:09:18.554 - number of ways. 242 00:09:19.480 --> 00:09:20.299 - Number one, 243 00:09:20.759 --> 00:09:21.259 - our 244 00:09:21.720 --> 00:09:22.220 - navigators 245 00:09:22.679 --> 00:09:24.379 - are specifically trained 246 00:09:25.240 --> 00:09:26.059 - to connect 247 00:09:26.440 --> 00:09:27.259 - with oncology 248 00:09:28.200 --> 00:09:28.700 - practices 249 00:09:29.240 --> 00:09:31.500 - when there are significant issues identified. 250 00:09:33.240 --> 00:09:33.740 - So, 251 00:09:34.845 --> 00:09:36.924 - and they'll do this on a three way 252 00:09:36.924 --> 00:09:39.725 - call. They'll they'll keep the the member on 253 00:09:39.725 --> 00:09:42.625 - the call while they're contacting the practice. 254 00:09:43.485 --> 00:09:45.485 - So when the navigator is concerned about a 255 00:09:45.485 --> 00:09:46.544 - particular symptom, 256 00:09:47.485 --> 00:09:47.985 - or, 257 00:09:48.940 --> 00:09:51.679 - concerns about not being able to get to 258 00:09:52.139 --> 00:09:52.879 - an appointment, 259 00:09:53.580 --> 00:09:55.759 - they make that connection with the practice, 260 00:09:56.539 --> 00:09:58.620 - and try to solve that problem on the 261 00:09:58.620 --> 00:10:00.720 - spot. And I think that impacts, 262 00:10:01.804 --> 00:10:02.705 - things like, 263 00:10:03.404 --> 00:10:05.024 - inpatient admission rates, 264 00:10:05.884 --> 00:10:06.384 - and, 265 00:10:07.404 --> 00:10:08.705 - those kinds of 266 00:10:09.085 --> 00:10:10.945 - issues that, again, I think are 267 00:10:11.485 --> 00:10:12.544 - not only important 268 00:10:12.924 --> 00:10:15.644 - to overall quality, but I think specifically important 269 00:10:15.644 --> 00:10:16.304 - to patients. 270 00:10:17.110 --> 00:10:19.690 - So I think this the the provider 271 00:10:20.309 --> 00:10:23.129 - partnership is an important part of the program. 272 00:10:24.870 --> 00:10:26.250 - With regards to ROI, 273 00:10:27.350 --> 00:10:29.990 - that continues to be a work in progress 274 00:10:29.990 --> 00:10:31.129 - as far as calculations. 275 00:10:31.725 --> 00:10:32.225 - And 276 00:10:33.644 --> 00:10:35.824 - though I don't have anything to share publicly 277 00:10:35.884 --> 00:10:36.544 - right now, 278 00:10:37.084 --> 00:10:38.304 - I would say that, 279 00:10:39.004 --> 00:10:41.345 - what we are seeing is positive, 280 00:10:42.204 --> 00:10:44.944 - and it's certainly something that we're interested in. 281 00:10:45.149 --> 00:10:47.649 - But I think what we're seeing kind of 282 00:10:48.110 --> 00:10:50.450 - it over the program evaluation, 283 00:10:50.830 --> 00:10:51.649 - if you will, 284 00:10:52.910 --> 00:10:53.649 - is that 285 00:10:54.750 --> 00:10:55.250 - impacting 286 00:10:56.190 --> 00:10:59.330 - engagement rates. So having a high engagement rate, 287 00:11:00.115 --> 00:11:00.615 - impacting 288 00:11:01.634 --> 00:11:02.134 - important 289 00:11:02.514 --> 00:11:03.495 - outcome measures 290 00:11:04.995 --> 00:11:06.774 - is likely to deliver 291 00:11:07.154 --> 00:11:07.894 - an ROI. 292 00:11:09.154 --> 00:11:11.315 - All things are sort of lining up that 293 00:11:11.315 --> 00:11:11.815 - way. 294 00:11:12.600 --> 00:11:13.419 - So I think 295 00:11:13.960 --> 00:11:17.159 - the execution of the program, the design of 296 00:11:17.159 --> 00:11:17.899 - the program, 297 00:11:18.600 --> 00:11:19.659 - I think, is 298 00:11:20.039 --> 00:11:20.539 - is 299 00:11:21.000 --> 00:11:24.139 - making a complex journey for the member, 300 00:11:25.879 --> 00:11:26.379 - easier. 301 00:11:27.335 --> 00:11:28.475 - It is definitely 302 00:11:28.855 --> 00:11:29.355 - impacting 303 00:11:29.735 --> 00:11:30.235 - outcomes, 304 00:11:31.335 --> 00:11:32.475 - and I think the 305 00:11:32.855 --> 00:11:35.115 - the overall value of the program will follow. 306 00:11:35.975 --> 00:11:38.375 - So I know earlier, you were talking about 307 00:11:38.375 --> 00:11:40.215 - how your team had been mulling over this 308 00:11:40.215 --> 00:11:42.959 - idea since a little bit before 2020. 309 00:11:43.259 --> 00:11:45.279 - Can you talk about some of the 310 00:11:45.899 --> 00:11:48.079 - early learnings from this program? 311 00:11:48.379 --> 00:11:50.079 - What have you had to adapt? 312 00:11:50.860 --> 00:11:51.839 - What's changed? 313 00:11:52.220 --> 00:11:54.639 - How have you adjusted to accommodate members? 314 00:11:55.644 --> 00:11:58.304 - Yeah. So good question because I think any 315 00:11:58.365 --> 00:12:01.345 - any program like this is going to evolve. 316 00:12:02.605 --> 00:12:03.105 - And 317 00:12:03.565 --> 00:12:05.424 - I think some of the key learnings 318 00:12:06.284 --> 00:12:06.784 - was, 319 00:12:07.565 --> 00:12:08.384 - number one, 320 00:12:08.779 --> 00:12:10.879 - we have to continue to refine, 321 00:12:12.059 --> 00:12:14.540 - our ability to find the right member at 322 00:12:14.540 --> 00:12:15.440 - the right time, 323 00:12:16.139 --> 00:12:17.519 - in their cancer journey. 324 00:12:18.059 --> 00:12:19.040 - So adopting 325 00:12:19.740 --> 00:12:21.040 - our predictive analytics 326 00:12:21.674 --> 00:12:24.955 - to identify patients, I think, is is, an 327 00:12:24.955 --> 00:12:28.335 - ongoing process that we continue to monitor. 328 00:12:28.955 --> 00:12:30.254 - The idea of 329 00:12:30.955 --> 00:12:32.975 - making provider connections, 330 00:12:34.809 --> 00:12:35.549 - as a 331 00:12:36.009 --> 00:12:37.870 - inherent part of the program, 332 00:12:39.690 --> 00:12:41.950 - came from feedback from practices. 333 00:12:43.129 --> 00:12:44.190 - So our team 334 00:12:44.809 --> 00:12:47.309 - now I'm talking not about our navigator 335 00:12:47.845 --> 00:12:51.205 - team, but our provider enablement team, you know, 336 00:12:51.205 --> 00:12:53.445 - speaks to this program whenever we meet with 337 00:12:53.445 --> 00:12:54.504 - oncology practices. 338 00:12:56.245 --> 00:12:58.184 - And feedback we got was 339 00:12:59.125 --> 00:13:01.384 - this looks like a great program. 340 00:13:02.629 --> 00:13:03.129 - However, 341 00:13:03.830 --> 00:13:04.970 - we need to know 342 00:13:06.309 --> 00:13:09.929 - if one of our patients is being navigated 343 00:13:09.990 --> 00:13:10.970 - in your program. 344 00:13:11.670 --> 00:13:13.610 - We are interested in knowing 345 00:13:14.149 --> 00:13:15.129 - when your navigators 346 00:13:15.509 --> 00:13:16.649 - identify problems, 347 00:13:18.225 --> 00:13:20.725 - and that directly led to, 348 00:13:21.904 --> 00:13:23.845 - enhancing provider partnerships, 349 00:13:24.785 --> 00:13:25.764 - in the program. 350 00:13:26.705 --> 00:13:28.384 - So I think that was a a a 351 00:13:28.384 --> 00:13:29.764 - really key learning. 352 00:13:31.039 --> 00:13:32.019 - And then thirdly, 353 00:13:33.200 --> 00:13:34.179 - as the program, 354 00:13:35.039 --> 00:13:36.659 - has developed and grown, 355 00:13:37.519 --> 00:13:39.059 - we felt like 356 00:13:39.440 --> 00:13:41.299 - we have a number of oncology 357 00:13:41.679 --> 00:13:42.740 - clinical resources 358 00:13:43.120 --> 00:13:43.860 - at Carillon. 359 00:13:44.334 --> 00:13:45.955 - We're talking about physicians, 360 00:13:46.894 --> 00:13:48.034 - physician assistants, 361 00:13:48.654 --> 00:13:51.794 - oncology nurses, oncology pharm d's. 362 00:13:52.254 --> 00:13:53.475 - And we felt like 363 00:13:54.575 --> 00:13:57.475 - the navigation program, the CCE program, 364 00:13:58.254 --> 00:13:59.075 - could benefit 365 00:14:00.389 --> 00:14:03.269 - from the expertise of the clinicians within our 366 00:14:03.269 --> 00:14:03.769 - organizations. 367 00:14:05.590 --> 00:14:08.330 - So we have developed an advisory board, 368 00:14:09.670 --> 00:14:10.170 - where 369 00:14:10.870 --> 00:14:13.370 - the oncology clinicians have an opportunity, 370 00:14:14.470 --> 00:14:15.129 - to provide 371 00:14:15.674 --> 00:14:18.014 - feedback to the navigation team, 372 00:14:19.195 --> 00:14:20.095 - provide them 373 00:14:20.715 --> 00:14:22.955 - updates on what's going on in the medical 374 00:14:22.955 --> 00:14:24.815 - literature with regards to navigation 375 00:14:25.274 --> 00:14:26.735 - or other important issues. 376 00:14:27.355 --> 00:14:29.034 - And what we have found is this has 377 00:14:29.034 --> 00:14:29.754 - led to, 378 00:14:31.379 --> 00:14:32.519 - specific educational 379 00:14:33.059 --> 00:14:34.360 - opportunities for, 380 00:14:34.980 --> 00:14:35.720 - our navigators, 381 00:14:37.139 --> 00:14:38.600 - as well as their leadership, 382 00:14:39.539 --> 00:14:41.799 - and it's also led to specific 383 00:14:42.659 --> 00:14:43.159 - changes 384 00:14:43.855 --> 00:14:44.674 - in a program. 385 00:14:45.695 --> 00:14:48.014 - One thing that we are concentrating on now 386 00:14:48.014 --> 00:14:48.754 - as a result, 387 00:14:49.695 --> 00:14:51.235 - is how can we optimize 388 00:14:52.174 --> 00:14:53.475 - the support of 389 00:14:53.855 --> 00:14:54.514 - the caregiver 390 00:14:55.615 --> 00:14:56.195 - of the 391 00:14:56.779 --> 00:14:58.080 - the member with cancer. 392 00:14:58.860 --> 00:15:00.879 - And so this was a a direct 393 00:15:01.340 --> 00:15:03.360 - result of discussions that we had, 394 00:15:03.740 --> 00:15:06.720 - within this oncology clinician advisory board. 395 00:15:07.179 --> 00:15:07.679 - So 396 00:15:08.059 --> 00:15:08.715 - I think 397 00:15:09.195 --> 00:15:12.175 - a lot goes into the background of programs 398 00:15:12.475 --> 00:15:13.134 - like this. 399 00:15:13.915 --> 00:15:17.134 - We recognize that cancer care is complicated. 400 00:15:18.394 --> 00:15:19.855 - Members need navigation 401 00:15:20.715 --> 00:15:22.575 - to get, through their journey. 402 00:15:24.350 --> 00:15:26.210 - And if I had to sort of summarize 403 00:15:26.350 --> 00:15:29.090 - the ideas here, I would say that 404 00:15:29.629 --> 00:15:31.730 - what we've really tried to do 405 00:15:32.029 --> 00:15:34.370 - is to take advantage of all the resources 406 00:15:34.429 --> 00:15:35.490 - that we have available, 407 00:15:36.509 --> 00:15:38.985 - to really optimize this program over time. 408 00:15:39.784 --> 00:15:42.024 - What are you looking to next when it 409 00:15:42.024 --> 00:15:44.365 - comes to cancer care at Elevance? 410 00:15:45.704 --> 00:15:46.845 - Well, cancer care, 411 00:15:47.384 --> 00:15:49.304 - is a big, you know, it's a big 412 00:15:49.304 --> 00:15:49.804 - field. 413 00:15:50.264 --> 00:15:50.764 - And 414 00:15:51.290 --> 00:15:53.370 - I think when you read the headlines about 415 00:15:53.370 --> 00:15:57.230 - cancer care, you primarily read about new drugs. 416 00:15:58.250 --> 00:16:00.269 - You know, a national meeting occurs. 417 00:16:01.210 --> 00:16:02.429 - A new drug is, 418 00:16:03.050 --> 00:16:06.509 - presented as a new drug as a new 419 00:16:06.754 --> 00:16:09.495 - a new optimal care for particular patient, 420 00:16:10.195 --> 00:16:11.095 - patient population. 421 00:16:11.634 --> 00:16:13.554 - I'm just giving you an example. There was 422 00:16:13.554 --> 00:16:16.514 - a new drug for pancreas cancer that was 423 00:16:16.514 --> 00:16:17.014 - presented 424 00:16:17.634 --> 00:16:20.115 - at our June meetings this year, and that 425 00:16:20.115 --> 00:16:21.174 - made a lot of headlines. 426 00:16:22.440 --> 00:16:23.179 - Our work 427 00:16:24.440 --> 00:16:25.899 - and our team's work 428 00:16:26.840 --> 00:16:27.820 - is concentrating 429 00:16:28.360 --> 00:16:28.860 - on 430 00:16:29.639 --> 00:16:30.620 - taking advantage 431 00:16:31.320 --> 00:16:33.580 - of all the knowledge that has been developed 432 00:16:33.639 --> 00:16:35.740 - over the last thirty years or so 433 00:16:36.284 --> 00:16:38.144 - and how we better support 434 00:16:38.684 --> 00:16:39.904 - members with cancer. 435 00:16:40.445 --> 00:16:42.865 - So we've talked about navigation today, 436 00:16:43.964 --> 00:16:47.105 - which has proven to be a successful program. 437 00:16:48.205 --> 00:16:49.264 - We believe it 438 00:16:49.740 --> 00:16:52.399 - simplifies the experience for for members. 439 00:16:53.100 --> 00:16:55.279 - It optimizes provider partnerships 440 00:16:56.299 --> 00:16:59.019 - and, ultimately, I think, delivers outcomes that are 441 00:16:59.019 --> 00:16:59.519 - important, 442 00:17:00.139 --> 00:17:01.039 - to our members. 443 00:17:01.835 --> 00:17:04.654 - There are other types of supportive measures 444 00:17:05.195 --> 00:17:07.134 - that we can continue to optimize. 445 00:17:08.394 --> 00:17:09.134 - We have 446 00:17:09.515 --> 00:17:10.015 - considerable 447 00:17:10.394 --> 00:17:11.775 - palliative care resources 448 00:17:12.394 --> 00:17:13.134 - at Carillon, 449 00:17:14.750 --> 00:17:15.649 - And we believe 450 00:17:16.349 --> 00:17:16.849 - formally 451 00:17:17.390 --> 00:17:17.890 - connecting 452 00:17:19.149 --> 00:17:20.690 - palliative care and oncology, 453 00:17:21.950 --> 00:17:22.769 - is extraordinarily 454 00:17:23.149 --> 00:17:23.649 - important. 455 00:17:25.230 --> 00:17:27.169 - And if you go to a big hospital 456 00:17:27.230 --> 00:17:27.970 - right now, 457 00:17:28.545 --> 00:17:30.965 - in a big city, an academic center, 458 00:17:31.505 --> 00:17:32.965 - there's up there's 459 00:17:33.505 --> 00:17:34.965 - plenty of resources 460 00:17:35.585 --> 00:17:36.805 - in palliative care. 461 00:17:37.664 --> 00:17:39.585 - But most of the care that patients are 462 00:17:39.585 --> 00:17:40.805 - getting in this country 463 00:17:41.184 --> 00:17:42.644 - are outside of academic 464 00:17:43.380 --> 00:17:44.119 - medical centers, 465 00:17:44.660 --> 00:17:47.320 - and palliative care resources are scarce. 466 00:17:48.339 --> 00:17:49.720 - We believe we can, 467 00:17:50.660 --> 00:17:51.559 - help connect 468 00:17:52.820 --> 00:17:55.400 - practices that don't have a lot of access 469 00:17:55.700 --> 00:17:57.000 - to palliative care 470 00:17:57.714 --> 00:18:00.214 - to care on resources in this regard. 471 00:18:00.755 --> 00:18:03.974 - The same thing is true about behavioral health 472 00:18:04.355 --> 00:18:05.174 - in oncology. 473 00:18:06.355 --> 00:18:07.255 - There's a 474 00:18:07.714 --> 00:18:09.014 - a a large literature 475 00:18:09.900 --> 00:18:12.320 - on the importance of optimizing mental 476 00:18:12.700 --> 00:18:14.000 - health, behavioral health, 477 00:18:14.619 --> 00:18:16.559 - in members who have cancer. 478 00:18:17.420 --> 00:18:18.480 - We have considerable 479 00:18:18.859 --> 00:18:21.279 - resource in behavior behavioral health, 480 00:18:22.380 --> 00:18:24.720 - and making a formal connection, 481 00:18:25.924 --> 00:18:27.144 - we believe has 482 00:18:27.845 --> 00:18:28.664 - great possibilities, 483 00:18:29.684 --> 00:18:30.664 - and we're just 484 00:18:31.125 --> 00:18:32.505 - starting those conversations. 485 00:18:34.644 --> 00:18:36.505 - And then lastly, physical activity, 486 00:18:37.444 --> 00:18:39.625 - in oncology patients who 487 00:18:39.940 --> 00:18:42.680 - have undergone particularly curative intent treatment, 488 00:18:43.539 --> 00:18:46.599 - is a is a growing part of oncology, 489 00:18:47.539 --> 00:18:49.940 - and we believe we can do more to 490 00:18:49.940 --> 00:18:50.440 - support 491 00:18:51.539 --> 00:18:52.279 - that realm. 492 00:18:52.904 --> 00:18:55.565 - And so, again, having some initial conversations 493 00:18:56.505 --> 00:18:57.805 - on how we can 494 00:18:58.505 --> 00:18:59.965 - optimize these connections. 495 00:19:00.664 --> 00:19:03.005 - And I would say the theme here is 496 00:19:04.345 --> 00:19:04.845 - that 497 00:19:05.740 --> 00:19:09.119 - there are ways to support members with cancer 498 00:19:10.059 --> 00:19:12.159 - outside of the drugs that they receive. 499 00:19:13.819 --> 00:19:14.319 - And 500 00:19:14.940 --> 00:19:17.519 - to optimize these types of supportive 501 00:19:17.900 --> 00:19:18.400 - measures 502 00:19:19.325 --> 00:19:19.825 - requires 503 00:19:20.365 --> 00:19:20.865 - strong 504 00:19:21.565 --> 00:19:22.065 - partnerships, 505 00:19:23.565 --> 00:19:26.525 - whether it's internal resources and palliative care or 506 00:19:26.525 --> 00:19:27.505 - behavioral health, 507 00:19:28.045 --> 00:19:30.065 - external resources and exercise, 508 00:19:31.244 --> 00:19:32.545 - or just simply 509 00:19:33.259 --> 00:19:36.799 - partnering with oncology providers and finding out 510 00:19:37.259 --> 00:19:38.240 - what they need. 511 00:19:38.859 --> 00:19:39.919 - That, I think, 512 00:19:40.779 --> 00:19:42.079 - is going to unlock, 513 00:19:43.179 --> 00:19:43.679 - considerable 514 00:19:45.179 --> 00:19:45.679 - opportunity 515 00:19:46.379 --> 00:19:47.679 - for quality improvement, 516 00:19:48.615 --> 00:19:49.914 - as well as patient 517 00:19:50.295 --> 00:19:51.434 - experience improvement, 518 00:19:52.375 --> 00:19:53.755 - in the years to come. 519 00:19:54.295 --> 00:19:55.734 - As we wrap up, I know we have 520 00:19:55.734 --> 00:19:56.875 - a few minutes left. 521 00:19:57.174 --> 00:19:58.875 - Do you have any final thoughts 522 00:19:59.174 --> 00:19:59.674 - for, 523 00:20:00.454 --> 00:20:03.835 - industry leaders either in the payer space or 524 00:20:04.150 --> 00:20:05.130 - at their services 525 00:20:05.670 --> 00:20:06.170 - subsidiaries? 526 00:20:07.589 --> 00:20:09.589 - Yes. Well, first of all, again, thanks so 527 00:20:09.589 --> 00:20:10.410 - much for 528 00:20:10.869 --> 00:20:12.410 - for inviting us 529 00:20:12.789 --> 00:20:14.490 - and to give us this opportunity 530 00:20:15.029 --> 00:20:15.529 - to, 531 00:20:16.309 --> 00:20:18.390 - to explain sort of what we are doing 532 00:20:18.390 --> 00:20:18.890 - in 533 00:20:19.474 --> 00:20:20.855 - in the cancer care, 534 00:20:21.955 --> 00:20:23.494 - models that we are developing. 535 00:20:24.355 --> 00:20:26.214 - I think the key message here, 536 00:20:27.555 --> 00:20:28.375 - is that 537 00:20:29.634 --> 00:20:32.615 - cancer care in 2026 538 00:20:33.269 --> 00:20:35.609 - is vastly different than it was 539 00:20:36.470 --> 00:20:39.350 - even fifteen years ago, but certainly twenty five 540 00:20:39.350 --> 00:20:40.570 - or thirty years ago. 541 00:20:41.990 --> 00:20:43.369 - And in many ways, 542 00:20:44.390 --> 00:20:48.009 - that experience of the member is vastly improved. 543 00:20:49.085 --> 00:20:51.904 - Our drugs are better. Our knowledge is better. 544 00:20:52.605 --> 00:20:54.224 - Our hospitals are better. 545 00:20:55.005 --> 00:20:56.144 - But the experience 546 00:20:56.765 --> 00:20:57.585 - is increasingly 547 00:20:58.684 --> 00:20:59.184 - complicated. 548 00:21:00.845 --> 00:21:03.265 - It can be fragmented at times. 549 00:21:04.000 --> 00:21:06.980 - The needs of members change over time. 550 00:21:07.599 --> 00:21:08.980 - So the the navigation 551 00:21:09.359 --> 00:21:09.859 - needs 552 00:21:10.319 --> 00:21:12.179 - of a member who's first diagnosed 553 00:21:12.559 --> 00:21:14.720 - and is working full time and has small 554 00:21:14.720 --> 00:21:15.220 - children 555 00:21:16.000 --> 00:21:17.299 - is very different 556 00:21:18.045 --> 00:21:19.424 - in that same patient 557 00:21:20.045 --> 00:21:21.184 - ten years later 558 00:21:21.644 --> 00:21:22.465 - who might be 559 00:21:23.085 --> 00:21:27.025 - developing recurrent cancer or develop or has developed 560 00:21:27.325 --> 00:21:27.985 - a toxicity, 561 00:21:29.085 --> 00:21:31.244 - from the treatments that they got ten years 562 00:21:31.244 --> 00:21:31.744 - ago. 563 00:21:32.450 --> 00:21:35.570 - So the the needs of members change over 564 00:21:35.570 --> 00:21:36.070 - time, 565 00:21:36.450 --> 00:21:37.509 - and you absolutely 566 00:21:37.890 --> 00:21:39.029 - have to be able, 567 00:21:39.809 --> 00:21:41.109 - to, number one, 568 00:21:41.809 --> 00:21:43.349 - identify those members 569 00:21:45.585 --> 00:21:46.644 - to be able 570 00:21:47.984 --> 00:21:48.724 - to determine 571 00:21:49.424 --> 00:21:51.204 - what are their key needs, 572 00:21:52.384 --> 00:21:54.085 - and then have the resources, 573 00:21:55.585 --> 00:21:56.884 - to be able to 574 00:21:58.130 --> 00:21:59.190 - figure out ways, 575 00:21:59.970 --> 00:22:01.349 - to meet those needs. 576 00:22:02.130 --> 00:22:04.149 - It's going to require partnerships, 577 00:22:05.169 --> 00:22:05.669 - with, 578 00:22:06.769 --> 00:22:07.909 - community resources, 579 00:22:09.089 --> 00:22:11.589 - with the local oncology practices, 580 00:22:12.404 --> 00:22:12.904 - with 581 00:22:13.365 --> 00:22:15.384 - other cancer supportive care organizations, 582 00:22:16.565 --> 00:22:18.184 - within the patient's community, 583 00:22:18.644 --> 00:22:20.984 - or within our internal resources. 584 00:22:22.805 --> 00:22:24.984 - Making that cancer journey 585 00:22:25.730 --> 00:22:26.230 - simpler 586 00:22:27.410 --> 00:22:29.830 - for members as well as their families 587 00:22:31.009 --> 00:22:31.910 - to make it 588 00:22:32.609 --> 00:22:33.109 - understandable, 589 00:22:34.049 --> 00:22:35.509 - to avoid complications, 590 00:22:36.690 --> 00:22:38.070 - to avoid toxicities, 591 00:22:39.414 --> 00:22:40.555 - and maximize 592 00:22:40.934 --> 00:22:43.195 - the quality of life for that member. 593 00:22:44.615 --> 00:22:45.674 - It takes work. 594 00:22:46.535 --> 00:22:49.494 - It takes commitment. It takes a program that 595 00:22:49.494 --> 00:22:50.394 - is sustainable 596 00:22:51.414 --> 00:22:53.115 - over time for that member. 597 00:22:53.680 --> 00:22:55.299 - So my advice is 598 00:22:56.880 --> 00:22:59.539 - to whether you're an employer, whether you're, 599 00:23:00.080 --> 00:23:03.359 - an organ a local community organization, whether you're 600 00:23:03.359 --> 00:23:04.660 - in the payer space, 601 00:23:05.279 --> 00:23:05.779 - is 602 00:23:06.454 --> 00:23:06.954 - commit, 603 00:23:07.974 --> 00:23:09.355 - to a program that 604 00:23:09.815 --> 00:23:11.674 - you have resources for, 605 00:23:12.934 --> 00:23:15.195 - that where your skill sets lie, 606 00:23:16.214 --> 00:23:17.914 - and jump in and 607 00:23:18.615 --> 00:23:19.115 - and 608 00:23:19.494 --> 00:23:21.195 - commit to making a difference. 609 00:23:21.960 --> 00:23:24.200 - Not every organization is gonna be able to 610 00:23:24.200 --> 00:23:27.099 - to do all things, including our own. 611 00:23:27.880 --> 00:23:28.380 - However, 612 00:23:29.079 --> 00:23:30.700 - we can each have a part, 613 00:23:31.720 --> 00:23:34.220 - in making the member experience 614 00:23:35.325 --> 00:23:36.065 - with cancer 615 00:23:36.924 --> 00:23:37.424 - easier, 616 00:23:39.005 --> 00:23:39.505 - simpler, 617 00:23:41.005 --> 00:23:41.505 - and 618 00:23:42.605 --> 00:23:44.704 - maximizing the quality of life 619 00:23:45.005 --> 00:23:46.625 - for the member and the family. 620 00:23:47.164 --> 00:23:49.424 - There's a lot of information out there. 621 00:23:49.779 --> 00:23:51.240 - There are a lot of organizations 622 00:23:51.619 --> 00:23:52.759 - doing this work, 623 00:23:53.380 --> 00:23:53.880 - and 624 00:23:54.420 --> 00:23:54.980 - I think, 625 00:23:55.460 --> 00:23:56.759 - at the end of the day, 626 00:23:57.140 --> 00:23:58.759 - we have to figure out ways 627 00:23:59.299 --> 00:24:01.079 - to support the whole person, 628 00:24:01.940 --> 00:24:02.839 - to partner 629 00:24:04.375 --> 00:24:06.954 - with the care team that the member has, 630 00:24:07.894 --> 00:24:08.394 - and 631 00:24:08.775 --> 00:24:11.515 - to ultimately make a complex 632 00:24:12.295 --> 00:24:12.795 - experience 633 00:24:13.894 --> 00:24:14.394 - simpler, 634 00:24:14.775 --> 00:24:15.755 - less fragmented, 635 00:24:17.174 --> 00:24:17.674 - and, 636 00:24:18.460 --> 00:24:21.200 - overall, a better quality experience 637 00:24:21.900 --> 00:24:23.600 - for the member and their family. 638 00:24:24.460 --> 00:24:26.620 - Doctor Debona, thank you so much for joining 639 00:24:26.620 --> 00:24:27.360 - us today. 640 00:24:27.740 --> 00:24:29.600 - Thank you. I appreciate the opportunity. 641 00:24:30.429 --> 00:24:32.749 - Of course. And to our listeners, if you'd 642 00:24:32.749 --> 00:24:35.069 - like to hear more podcasts from Becker's Health 643 00:24:35.069 --> 00:24:38.189 - Care, you can visit beckershospitalreview.com. 644 00:24:38.189 --> 00:24:38.849 - Thank you.