Hello, everyone, this is Jacob Emerson with the
Becker health care podcast. Thanks so much for
tuning in today where we're thrilled to be
joined by a very special guest. Doctor Sac
and Jai is the President and Ceo of
Scan Group.
Doctor Jane, thanks so much for taking the
time to be with us on the podcast
today. Thank you, Jacob. It's great to deal
with you. Yeah. Likewise. And before we dive
in, hoping you can tell us a little
bit more about scan group for those that
may not be familiar and what it is
that you all do there.
Scan group was founded in 19 77 by
a group of community activists that we affectionately
called 12 angry seniors.
This was a group of individuals who believed
that there had to be a better way
to age in Long Beach, California.
And
they built a network of services,
called the senior care action network
that was aimed to better address the needs
of older adults in the Long Beach community
and adjacent areas.
The the scene of imagination that they had
in 19 77
has grown into a movement
we now are,
diversified healthcare care entity that serves
over 300000 people, in California,
Arizona, Nevada, New Mexico, Texas and
Pennsylvania.
We operate a large not for profit, Medicare
advantage plan. We operate medical groups, including welcome
health, My place health, health care and action,
and Home based Medical.
It is
incredibly gratifying
to be scans leader
at a time of a lot of change
in health care, where where there's is greater
focus on
health equity, greater focus on
the sustainability
of not for profit health care,
greater focus on segmentation to serve distinct populations,
and it's it's really excited to be representing
scan on your podcast today.
Yeah. And you mentioned such a that the
that the root of the organization is addressing
the needs of seniors. And this month's scan
released its first environmental social and governance report,
showcasing
your impact on seniors and the un house
population. Can you share key takeaways or notable
statistics from that report that resonated with you
most.
Look, I'm I'm very proud of this report.
But I will tell you we initially resisted
putting it together in the first place.
You know, that... It's become, you know, I
I think a pro form a activity in
a lot of organizations to write an es
report and know, when 1 of our board
members, Rosemary Turner asked us to do 1?
We said, well, everything we do is Es.
Why are we... Why do we need to
do this report. We, of course, didn't tell
her that, but we went ahead and, you
and did the report. And we've had to
thank her since then because it allowed us
to really think about everything that we're doing
and in the collective. And everything that we're
doing to
serve the populations that matter most to us.
And when you take a big step
it's it's something that we're all really, really
proud of. The deep investments we made in
the homeless services.
The investments we made in health plans that
focus on populations that others have forgotten, like,
our affirm product, which is focused on Lgbt
lgbtq plus seniors.
The efforts that we're really making to enhance
our employee experience and
be a health plan that actually provides good
health benefits to its employees. Imagine that.
So, you know, I think when we when
we start to think about all of the
pieces that come together. It really helps us
feel like we're an exe in
organization to the industry. We're... By no means
perfect. We have lots of things we can
do better, But I think when you put
it all together, what it really represents is
a blueprint for an ethical company that's trying
to do the right things.
Us for data, And what I can tell
you is we we now provide medical services
to about 2000
unique individuals every month.
Through our health care and action medical group
that's focused on providing clinical services and housing
support services
to people experiencing homelessness.
So we're we're in a pretty exciting place
of impact.
You know, we have a... The affirm product
has now grown to sort of, you know,
over a thousand
Lgbtq plus seniors or or people who are
attracted to that that plan.
We're helping people who are unseen, feel seen.
And that is, you know, honestly, just very
gratifying.
2000 unique services provided per month to those...
Experiencing homelessness. That's an amazing statistic. And it's
so fascinating in hear that you were hesitant
to even do this report at first,
I do wanna talk about your care delivery
models, though. And as I understand that they're
designed to care for some of the most
vulnerable seniors that you serve.
From from your perspective such, and I know
you just touched on this a bit, But
why is it so important for scan group
to to serve these populations? And what inroads
have you made with tackling the homeless crisis
in the states that you serve.
Look, you know, so I think that the
the you know, health care and action was
really inspired by, you know, some early career
work that I did
with,
Cambridge Health alliance,
which,
offered a a program called Cambridge healthcare for
the homeless.
And, you know, what you quickly saw when,
you know, you're providing homeless
health services to
people who are experiencing homelessness
is that their homelessness is either caused by
health care problems or exacerbated
by health care problems.
And,
you know, in when we think about the
scourge that is homelessness. And when you think
about the embarrassment that we all feel or
should feel about homelessness.
You realize that we have just an incredible
opportunity, to address the needs of of
homeless older adults
through
you know, a medical group that's actually focused
on their needs Now we started out with
the intent of serving homeless older adults, you
know, a list consistent with our mission. But
something happened along the way, which is, you
know, in search of
older adults, you know, who are the fastest
growing portion of the homeless population,
you know, we couldn't ignore everyone else in
the community. And
you know, now
health action has contracts with,
the city of C City, the city of
West Hollywood,
you know, various other health plans,
you know, various
private for profit health plans various public,
not for profit health plans,
we even received a a very generous donation
from, Ben post to 2 of a million
dollars
to actually bring,
you know, our our services to the County
of San Mateo.
And, you know, the we talk a lot
about product markets fit in health care. There's
unfortunately fantastic product market fit for health care
and action where People are looking for a
solution that's gonna address some of the root
causes of homelessness, and that's really what we're
what we're delivering.
Yeah. It's amazing. And it's clearly very impactful
work and it's it's good to know that
a group like scan is is on the
ground doing this work. In these communities.
Let's talk about, the health plan side of
the business for a second, such and your
tier 6 formula offers
13 commonly prescribed brand name drugs at 0
dollars to 11 dollars per month 4 seniors,
10 of which are on the Biden administration's
negotiation list.
What went into being able to offer this
to your members and and what are you
hearing in terms of the affordability that you're
offering for these drugs? Look, every every whole
plan can... You know, decide where it's gonna
put its dollars, and we truly believe that
we wanna make sure that the drugs
that we would want for ourselves or for
our family members are available
you know, in an affordable way for
our our members. And, you know, the truth
is is that we know that high c
pays are a huge barrier
to members actually, you know, receiving the drugs
that are prescribed by their doctors. So many
people,
for go filling their prescriptions or taking their
medicines
because their
prescriptions cost too much money, and these are
people on fixed incomes. And you know, the
ultimate long term impact of not taking your
medicine is poor health outcomes. And so when
we think about benefit design it's, when we
think about what we wanna do for the
people we serve,
we do everything we possibly can to try
to reduce dan barriers to the things that
we think are gonna move the needle the
most. It's why we have the generous, you
know, tier 6, 0 dollar copay for those
expensive drugs,
but it's also why we have 0 dollar
c pay for primary care, 0 dollar c
pay for
specialty, 0 dollar c pay for
hospitalizations, in in some of our most popular
products
because we really wanna make sure that, you
know, people don't have,
a sense of a barrier. And which brings
me to a really important point, which is
there's a lot of criticism of Medicare Advantage
today.
And I I just wanna make sure that
people recognize that 1 of the things that
Medicare Advantage is doing is really increasing affordability
of care to a population of seniors who
really need their affordability to to be improved
because traditional Medicare if if you haven't looked
at it recently,
actually covers very little
And so I think there's a lot of
misplaced nostalgia for traditional Medicare,
you know, when plans like scan are using
instruments like tier 6.
To really make, you know, drugs affordable
and drive
improvements in health outcomes.
Yeah. And your point is... Heard loud and
clear as well as the fact that you
mentioned in the past to me directly of
the amount of low income people that are
on Medicare Advantage plans, and and they receive
care, through these services.
But in that vein such and, we've also
previously discussed scans
population specific Medicare advantage plans designed to meet
the unique needs of women of Lgbtq plus,
older adults. You have your partnership with Apollo
Med to provide care, to Asian and Hispanic
adults,
you know, you don't hear
initiatives like this from health plans often. So
anything new to share here on these on
these plans, how has enrollment been so far?
Yeah. We're we're in early innings. I would
say, you know, the most popular of these
products so far has really been our firm
product which
you know, is our Lgbtq plus product. When
we started it, we we thought we were
doing something, you know, symbolically,
which you know, supportive of
Lgbtq plus seniors thinking we might get a
hundred members, maybe 200 members. And when we
got 500 in our first year and now
thousand.
We realized we might be beyond to something,
which really I think spurred us to think
about other groups of people who are not
necessarily well represented in the Medicare Advantage
product portfolios.
1 of which is women which is probably
shocking to people because, you know, more than
50 percent of seniors are women, But how
many of those products actually speak to their
needs? How many of their... Those products
actually specifically have interventions and programs to design
to support the health needs of women.
Very few. How many have actually
you know,
I'd identify a bunch of services that could
actually
improve the health of, you know, hispanic patients
or Asian patients know, I think clover
clever care in our market has been an
example of a really successful
Asian focused health plan. But, you you know,
I I throw a lot of inspiration. III
see competition there, but I also see
inspiration, which is
opportunities for us. To do better for specific
populations who probably
don't necessarily be, you know, feel seen or
heard
by traditional, you know, health plan marketing and
traditional health plan products. So
you know, I think the future of all
health care is really segmentation.
Segmented approaches to interacting with patients, providers,
communities,
vendors,
And and so, you know, I I would
say it's a core
foundational principle of how we organize and manage
the company. Is to really think in terms
of of populations. Some people say, well, you
know, how does that align with health equity,
you know, if you're slicing and d the
population that way, And I would say, it...
We're aligning with health equity by really,
you know, allowing people to feel seen in
ways that they aren't necessarily seen.
You know, in traditional products where
they don't necessarily feel like their distinctive attributes
and qualities aren't necessarily reflected.
Absolutely. And then let's say on the topic
of of the future of health care specifically,
Medicare Advantage. As you know, the the industry
is facing big reimbursement and audit changes from
Cms. You mentioned there's increasing
segmentation and market competition. So beyond these population
specific health plans, how is scan navigating these
industry changes over the next few years. Look,
I I frequently stated the the Golden days.
Of Medicare advantage are over. And I kinda
I kinda like that in a lot of
ways. Because I think, you know, this business
was
probably too easy for to for a long
time.
You know, if if if reimbursement were cut,
it forces you to do more with less,
forces you to be sharper from forces to
forces you to refine your thinking.
And so, you know, we're taking a hard
look at our products and trying to understand
what's really needed and what's not really needed.
We're taking a hard look at our administrative
cost structure and asking hard questions about you
know, whether, you know, some of our vendor
relationships, make the most sense for us for,
you know, whether there's opportunities to disrupt them
you know, obtain lower prices, and then frankly,
you know, better serve our members or maintain
benefits.
So I I think,
you know, pressure is a privilege. I think
there's an ability to
ultimately,
use that pressure to try to drive, you
know, sharper approach to things, and and that's
the kind of muscle that we're building its
skin.
I like that That pressure is a privilege.
That's a really,
fantastic perspective. I didn't come up with it.
That's that's philly bill billie Jean King. So...
But but I believe it. Right? So Yeah.
Good hit a star billie jean king pressure
is a privilege.
And as a tennis player myself, you know,
I I feel that. It's... You know, when
your
standing in the baseline and and, you know,
you're getting a ball hit at you at
a hundred miles an hour. Mh. That's that's
fun. But you'll also... You'll also need to
have an approach to really really manage it.
And I think that's what's going on in
our industry right now is is the pace
of play is increasing,
the intensity of play is increasing, And I
think we all have to get a little
bit more competitive a little bit tougher and,
have our heads a little bit more fully
in the game. Yeah. Yeah. No. It's great
advice. And in that vein, any any final
thoughts or final pieces of advice you would
offer all the health plan, health system leaders
listening to us today.
Look, I, you know, 1 of the things
I'm reflecting on increasingly these days is
is why it's so hard to change in
health care. And I...
Have to say that we're...
I'm I'm now almost 2 decades into a
career trying to
make health care better, and I feel like
it's it's
you know, mostly getting worse. I think it's
getting better in terms of there's silos scientific
innovations, you know, lots of ideas are maturing
and so we have better therapies for diseases
that were previously death sentences.
But we're delivering, you know, 20 first century
science you know, through nineteenth century delivery systems.
And we're patti ourselves on the back for
it.
And so, you know, I think we need
a leadership revolution in health care. I think
we need to get out of the toxic
positivity
that you know, kinda traps us
and start seeing things clearly, which is
things can be better. Things should be better.
And we have to stop, you celebrating
great top line, you know, and bottom line
financial results,
what do we know that patient care could
be better.
And that the experience of being a clinician
could be better and the experience of being
a a patient could be so much better.
And so that, that's the mission that I'm
on. That's the mission I'm inviting everyone else
to be on with me,
because I think,
we need to stop... Normalizing
abnormal things in health care. So I will
leave this podcast on that note.
Your candidate perspective is very much appreciated, Doctor
Jane, and I also just wanna thank you
for taking the time to sit down with
us. And for sharing more about the very
impactful work that you, your team and at
scan group are are clearly doing. So thank
you. It's it's an honor. Thank you so
much.
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