This is Laura Diet with the Becker Health
care podcast.
I'm thrilled today to be joined by a
doctor Tim Ama, Chief Medical Officer at Uc
care. Doctor Ama, it's a pleasure to have
you on the podcast today.
Thank you for having me.
Now I'm really looking forward to our discussion
and knowing, you know, what, your experience in
the medical field as well is now being
with you care. Some of the biggest things
that you're looking at, how you're thinking about
growth and development in the health care space
and then, you know, what's the store for
the future. So it'll be great to get
your perspective on those things. But before we
dive in, can q tossing a little bit
more about yourself and your background
or Yes. Absolutely.
I am an executive Vice President and she's
Medical Officer at Uc care,
located in Minneapolis, Minnesota.
I lead
the areas that include medical director or office,
clinical services, mental health, substance use disorder services,
pharmacy
population health,
quality management, health equity and our long term
services and support areas.
I am a practicing physician, a critical care
neurologist by training,
and I have been at You care for
almost sears now.
Of fascinating. You know, all of those areas
are so important, especially right now is a
healthcare care system is really transforming me into
a space where,
we're able to recognize
mental health and and behavioral health care and
and bring that into the whole person care,
and then to bridging the gaps in terms
of disparities in health care in ideally achieving
more health equity. So I'm excited to hear
your perspective. What are some of the big
trends that you're watching right now as well
as the headwind
top of mind for you?
Yes, we are following a few trends and
headwind that will potentially have significant impacts on
how we take care of our members.
To start off,
we're looking at the increased medical
utilization, particularly in the Medicare Advantage
population.
It is really not clear if it's pent
up demand, you know, from the pandemic area
versus a new trend or a new normal.
As you know, the population
is aging and growth in the Medicare eligible
people
could certainly be a factor
certain medical diagnoses
and subsequent
complications become more common as new age. And
then there is a need for specialized services,
that becomes greater as we age.
In addition to that, emerging concerns, including social
isolation and its impact on mental health particularly
in the post pandemic area, is significant for
seniors.
So increasing medical costs in this
population would likely need to lead to higher
premiums and
potentially reduced benefit so that's really important to
us, and we are watching that trend and
headwind.
Another 1 is advancement
in
therapeutics and pharmaceuticals
are changing the lives of many, and it
is really
a wonderful trend to witness.
It's not just Gl ones. There are a
number of life altering
medications such as biologic
and anti inflammatory drug. And gene therapies
that are more expensive than
we've ever seen in the past. And we
may have to find a different way of
paying for them. So we're again following that
trend.
Another 1 is there is an ever increasing
need for mental health services that is really
unmatched by the current capacity.
There's also a significant disparity
in mental health services
we have to take an all hands on
deck approach.
And
Uc care, for example, the Uk foundation granted,
more than 500000 dollars to 11 mental halt
and substance use disorder initiatives
that address a crisis in act us an
equity for underserved
population. And
you know, even though we are all doing
everything we can, this particular trend is a
significant headwind in the way that we take
care of our members.
And along that same line, we are following
closely the land gate to
access to help services in general. For example,
access to some services in your rural areas
is challenging with the closure of Vape
critical assets hospitals and other health centers at
alarming rate.
We're paying attention to the recent announcements of
Dbs walgreens Walmart rite aid,
exiting primary care models sits Really not certain
yet, whether that will improve
The
fragmentation of healthcare delivery,
particularly with primary care that is not integrated
into the larger ecosystem that's a big health
plan for a big health system.
And another trend is increased
competition and
consolidation between the health systems and between health
plans.
So there's
consolidation in both areas. And so that trend
is interesting to watch
and monitor.
And and finally, because I am a practicing
physician,
this 1 is particularly important to me.
Shortage of physicians and other healthcare professionals, particularly
in rural Areas is a definite headwind.
Demand and supply are simply mismatched,
healthcare care is a tough and
know, challenging
industry to have a career in,
especially right now. And there continues to be
a high rate of, burnout and
particularly in the direct patient facing
professions within healthcare,
recruitment
burnout and more importantly,
retention
have proven difficult for some health systems.
And so those are those are the things
that we are watching and
and monitoring very closely.
That makes a lot of sense. You know,
and I I know all of these issues
are...
Across the board, something that executives are thinking
about, both on the health plan as well
as a health system side as you said.
And, you know, from your perspective, when you
look out of the landscape and see
some of those critical access hospital closures
and or,
you know, other areas where
access is disappearing in spaces and then 2
looking at
consolidation in in costing cr for a hospitals
and health systems.
How does that inform the conversations that you're
having on the health plan level,
to really make sure that, you know, you're
you're able to
provide access to care work with
patients think, you know,
innovative, I guess it in terms of how
you can, really, you know, fill some of
those gaps and then,
work with the hospitals and health systems to
to to make sure
that you're able to to provide care, I
guess, in the communities were as possible.
Yeah. We we have...
Multiple
avenues that we approach that particular issue, But
the more important 1 that I'd like to
mention is,
our approach to
partnership
with our provider
systems.
We
we approach it from a perspective of
partnering with our provider systems in the way
that is reached will
beneficial. And more importantly put the members
that we care about at the center.
I think the future would probably bring
some innovative approaches such as
how could we put our resources together so
that we can eliminate
services, for example,
care management is a program that is often
duplicated on both the payer side and the
health system side services or some clinical programs
such as read admission prevention measures that are
implemented on both the payer side and the
health system inside. So
what does it take for us to come
together and partner in a way that is
mutually
beneficial putting the member in the patients? At
the center so that we eliminate
services and
gain some savings that way, but also at
partners strongly.
Absolutely. You know, I I think that's so
helpful to know and understand and think about
those types of partnerships and,
innovative. Approaches to
addressing the care and access to care issues.
Now from your perspective, in looking ahead, how
are you thinking about growth for the future?
Yeah.
You care we are growth oriented
organization and I am thrilled about that.
We want to expand geographically to be able
to do what we want to do for
our members at a scale.
Scalability and being able to spread our administrative
costs, so we can deliver valuable product
to our members is critical at this time.
But we also think of growth as much
more than just geographic expansion. Like I said,
finding
innovative ways of partnering with our provider systems
is a way of growth. We want to
grow out approach, and
sophistication to value based agreements
is another 1. We also want to grow
in our ability to get the moat out
of what everyone is talking about nowadays
emerging technologies, such as Ai.
But we want to do it in a
way that is responsible and equitable. We want
to, you know, grow our capabilities
in Ai robotic process
automation and machine