1 00:00:00,240 --> 00:00:02,720 Imagine this. You're at the Swiss Hotel in 2 00:00:02,720 --> 00:00:06,399 Chicago surrounded by top executives from leading insurance 3 00:00:06,399 --> 00:00:08,099 companies and health systems. 4 00:00:08,480 --> 00:00:12,099 Welcome to Becker's fall pair issues roundtable, November 5 00:00:12,160 --> 00:00:13,859 4th through 6, 2024. 6 00:00:14,625 --> 00:00:17,345 Picture the excitement as you gather business cards 7 00:00:17,345 --> 00:00:20,005 from over 500 executive level attendees, 8 00:00:20,545 --> 00:00:22,164 building invaluable connections. 9 00:00:22,704 --> 00:00:25,345 Feel the energy as you participate in over 10 00:00:25,345 --> 00:00:29,285 26 educational sessions led by 90 elite speakers. 11 00:00:29,769 --> 00:00:32,969 Envision yourself engaging in lively discussions about new 12 00:00:32,969 --> 00:00:36,409 health plans, hospital at home models, behavioral health, 13 00:00:36,409 --> 00:00:37,549 and price transparency. 14 00:00:38,170 --> 00:00:41,690 Now imagine being inspired by keynotes from boxing 15 00:00:41,690 --> 00:00:45,045 legend, Sugar Ray Leonard, and 4 time NBA 16 00:00:45,184 --> 00:00:47,744 All Star, Chris Webber. Their stories will leave 17 00:00:47,744 --> 00:00:50,004 you motivated and ready to innovate. 18 00:00:50,384 --> 00:00:53,024 Don't miss out on this unique opportunity. Get 19 00:00:53,024 --> 00:00:55,204 registered today. Visit beckershospital 20 00:00:55,600 --> 00:00:56,100 hospitalreview.com 21 00:00:57,199 --> 00:00:59,039 and click on the events page to find 22 00:00:59,039 --> 00:01:01,539 the conference website. That's the beckershospitalreview.com 23 00:01:03,600 --> 00:01:05,700 events page. See you in Chicago. 24 00:01:06,479 --> 00:01:08,719 Hello, everyone. This is Jacob Emerson with the 25 00:01:08,719 --> 00:01:10,579 Becker's Payer Issues podcast. 26 00:01:10,924 --> 00:01:12,704 Thrilled today to be joined by 27 00:01:13,005 --> 00:01:17,165 CleverCare's interim CEO, Karen Walker Johnson. Karen, thanks 28 00:01:17,165 --> 00:01:18,844 so much for taking the time to be 29 00:01:18,844 --> 00:01:20,305 with us on the podcast today. 30 00:01:20,685 --> 00:01:22,444 Hi. Thank you. Thanks so much for having 31 00:01:22,444 --> 00:01:23,505 me. It's a pleasure. 32 00:01:24,150 --> 00:01:25,670 So, Karen, there's a lot we wanna talk 33 00:01:25,670 --> 00:01:27,350 with you about and a lot we wanna 34 00:01:27,350 --> 00:01:30,150 hear about, in terms of CleverCare, but can 35 00:01:30,150 --> 00:01:31,829 you tell us a little bit more about 36 00:01:31,829 --> 00:01:35,350 yourself and what your career background in health 37 00:01:35,350 --> 00:01:36,329 care entails? 38 00:01:37,594 --> 00:01:40,495 Happy to do so. I started my career, 39 00:01:41,115 --> 00:01:42,895 as a pediatric nurse, and, 40 00:01:43,835 --> 00:01:45,915 subsequent to that, decided to go to law 41 00:01:45,915 --> 00:01:47,615 school. But I always had, 42 00:01:48,314 --> 00:01:51,420 a very keen interest in health care and 43 00:01:51,420 --> 00:01:52,879 had spent some time doing, 44 00:01:53,739 --> 00:01:56,560 a number of of of varied things, primarily 45 00:01:56,859 --> 00:01:59,979 in what I would say spaces with vulnerable 46 00:01:59,979 --> 00:02:01,760 populations. I worked in peds. 47 00:02:02,459 --> 00:02:05,104 I did some work in a veteran's hospital. 48 00:02:06,204 --> 00:02:08,764 And and so what was really important to 49 00:02:08,764 --> 00:02:10,365 me was to be able to do something 50 00:02:10,365 --> 00:02:12,844 in health care where I felt that I 51 00:02:12,844 --> 00:02:14,625 could have a positive impact 52 00:02:15,084 --> 00:02:15,584 on 53 00:02:16,599 --> 00:02:17,979 groups that historically 54 00:02:18,280 --> 00:02:20,199 may not have had as as great of 55 00:02:20,199 --> 00:02:20,699 access. 56 00:02:21,800 --> 00:02:24,040 Growing up in, I grew up right outside 57 00:02:24,040 --> 00:02:25,099 of Detroit, Michigan, 58 00:02:25,560 --> 00:02:28,040 and had had the opportunity to, be a 59 00:02:28,040 --> 00:02:29,659 public health nurse as well. 60 00:02:30,040 --> 00:02:32,305 And so all of that kinda just kept 61 00:02:32,305 --> 00:02:34,305 me in that health care that health care 62 00:02:34,305 --> 00:02:34,805 space. 63 00:02:35,745 --> 00:02:37,905 Once I got myself really involved in health 64 00:02:37,905 --> 00:02:38,305 care, 65 00:02:38,784 --> 00:02:40,165 I went to work for, 66 00:02:40,944 --> 00:02:43,590 some hospital systems, and so I I got 67 00:02:43,590 --> 00:02:45,110 to learn what it meant to be on 68 00:02:45,110 --> 00:02:46,409 the provider side of things, 69 00:02:47,110 --> 00:02:49,509 and and seeing people at their most vulnerable 70 00:02:49,509 --> 00:02:52,729 when they were hospitalized, and and caring for 71 00:02:53,189 --> 00:02:55,509 myself, feeling that I needed to care for 72 00:02:55,509 --> 00:02:57,269 those people who cared for the patients that 73 00:02:57,269 --> 00:02:58,009 we served. 74 00:02:58,870 --> 00:03:01,264 And somehow, I kinda fell into managed care. 75 00:03:01,564 --> 00:03:04,044 And, when I reflect back now, I think 76 00:03:04,044 --> 00:03:06,044 it was because I had this kinda unique 77 00:03:06,044 --> 00:03:09,344 background, you know, that having both the clinical 78 00:03:09,405 --> 00:03:11,405 side as well as, you know, kinda the 79 00:03:11,405 --> 00:03:13,569 the training from law school. And so I 80 00:03:13,569 --> 00:03:16,290 found myself in a risk management role over 81 00:03:16,290 --> 00:03:18,689 at a a managed care organization more years 82 00:03:18,689 --> 00:03:20,229 than I wanna admit to. 83 00:03:20,689 --> 00:03:22,449 And that's when I really got the bug 84 00:03:22,449 --> 00:03:22,949 about, 85 00:03:24,210 --> 00:03:27,090 insurance and and managed care. And so I 86 00:03:27,090 --> 00:03:27,854 spent the next 87 00:03:28,814 --> 00:03:30,914 15, 20 years, if you will, 88 00:03:31,215 --> 00:03:33,555 in various roles in managed care, 89 00:03:34,014 --> 00:03:36,414 in in various lines of business as well. 90 00:03:36,414 --> 00:03:36,914 So, 91 00:03:37,294 --> 00:03:38,974 I had the opportunity to work in the 92 00:03:38,974 --> 00:03:39,955 commercial space, 93 00:03:40,894 --> 00:03:41,520 in the 94 00:03:42,000 --> 00:03:44,180 Medicaid space, and then ultimately, 95 00:03:44,719 --> 00:03:46,659 over in the Medicare space. And so 96 00:03:47,040 --> 00:03:49,060 I have spent my time, you know, primarily 97 00:03:49,280 --> 00:03:50,659 on the operation side, 98 00:03:50,960 --> 00:03:52,719 but I did do a few stints when 99 00:03:52,719 --> 00:03:54,500 I was with a couple of payers 100 00:03:54,800 --> 00:03:56,659 learning about sales and marketing, 101 00:03:57,875 --> 00:03:58,375 underwriting, 102 00:03:58,995 --> 00:04:01,074 etcetera. So, really, I would say that I 103 00:04:01,074 --> 00:04:01,895 probably have 104 00:04:02,194 --> 00:04:03,574 a pretty well rounded 105 00:04:03,875 --> 00:04:06,435 view and set of experiences in the managed 106 00:04:06,435 --> 00:04:07,175 care space. 107 00:04:07,794 --> 00:04:09,474 And then the final thing I would say 108 00:04:09,474 --> 00:04:11,955 that I think kinda ties into my interest 109 00:04:11,955 --> 00:04:14,500 in how probably I ultimately ended here, 110 00:04:14,900 --> 00:04:16,680 in this interim role at CleverCare 111 00:04:17,540 --> 00:04:19,139 is I also worked in the post acute 112 00:04:19,139 --> 00:04:21,779 care space. And in that space, I had 113 00:04:21,779 --> 00:04:25,079 the opportunity to work with hospice patients and, 114 00:04:25,699 --> 00:04:27,079 palliative care programs 115 00:04:27,379 --> 00:04:28,725 and long term care patients. 116 00:04:29,444 --> 00:04:32,185 And so, you know, again, coming back 117 00:04:32,805 --> 00:04:34,824 to my interest and my desire 118 00:04:35,205 --> 00:04:36,185 to work with 119 00:04:36,564 --> 00:04:39,524 vulnerable populations and, you know, when you look 120 00:04:39,524 --> 00:04:41,305 at people who are either in 121 00:04:42,069 --> 00:04:43,990 care or in long term care, they are 122 00:04:43,990 --> 00:04:45,370 definitely at their most vulnerable. 123 00:04:45,830 --> 00:04:48,949 And so that's that has, you know, kinda 124 00:04:48,949 --> 00:04:51,610 kept my north star, if you will, around 125 00:04:52,069 --> 00:04:55,384 wanting to do things that could impact populations 126 00:04:55,685 --> 00:04:57,064 who are most vulnerable, 127 00:04:57,604 --> 00:04:59,764 those who don't necessarily have the same type 128 00:04:59,764 --> 00:05:01,224 of access as others. 129 00:05:01,845 --> 00:05:04,324 And, and then I found my way into 130 00:05:04,324 --> 00:05:05,544 this really awesome, 131 00:05:06,164 --> 00:05:07,464 health plan called CleverCare. 132 00:05:09,410 --> 00:05:12,449 Fantastic. So clearly a very diverse career background 133 00:05:12,449 --> 00:05:14,050 that, like you said, has brought you to 134 00:05:14,050 --> 00:05:16,870 this point as as interim CEO of CleverCare, 135 00:05:17,250 --> 00:05:19,669 Karen. For those who might not be familiar 136 00:05:19,810 --> 00:05:21,169 with the company, can you give us a 137 00:05:21,169 --> 00:05:23,865 rundown of of what CleverCare is and what 138 00:05:23,865 --> 00:05:25,704 it offers? How long have you been around 139 00:05:25,704 --> 00:05:27,544 for? What kind of markets do you serve, 140 00:05:27,544 --> 00:05:29,084 and how many members, 141 00:05:29,704 --> 00:05:31,004 are you are you now serving? 142 00:05:31,625 --> 00:05:33,865 Yes. I'm I'm happy to do that. So 143 00:05:33,865 --> 00:05:35,544 we were founded in, 144 00:05:35,944 --> 00:05:37,500 2,000 and 18, actually, 145 00:05:38,600 --> 00:05:40,379 by a group of founders who, 146 00:05:40,919 --> 00:05:41,579 are Asian, 147 00:05:42,439 --> 00:05:45,399 ethnicity wise. And what was really behind the 148 00:05:45,399 --> 00:05:46,540 founding of the company 149 00:05:46,919 --> 00:05:49,160 was, in their minds, a way to honor 150 00:05:49,160 --> 00:05:50,834 family and to honor culture. 151 00:05:51,615 --> 00:05:53,634 They knew from their own personal experiences 152 00:05:53,935 --> 00:05:55,474 with their loved ones 153 00:05:55,854 --> 00:05:56,354 that, 154 00:05:56,974 --> 00:05:59,454 they had had that firsthand experience of watching 155 00:05:59,454 --> 00:06:00,914 them struggle, if you will, 156 00:06:01,294 --> 00:06:03,555 because of their limited English proficiency. 157 00:06:04,273 --> 00:06:04,421 What you find in the Asian American Pacific 158 00:06:04,421 --> 00:06:05,245 Islander communities are that about 30% 159 00:06:06,389 --> 00:06:07,129 Pacific Islander 160 00:06:07,829 --> 00:06:09,610 communities are that about 30% 161 00:06:10,069 --> 00:06:10,569 of, 162 00:06:11,269 --> 00:06:11,769 individuals, 163 00:06:12,229 --> 00:06:14,870 you know, English is really much a struggle 164 00:06:14,870 --> 00:06:16,490 for them. And so here, 165 00:06:16,949 --> 00:06:18,490 these founders had 166 00:06:19,254 --> 00:06:21,274 loved ones who were aging into Medicare 167 00:06:21,894 --> 00:06:23,035 and were facing, 168 00:06:23,495 --> 00:06:25,415 you know, some of the struggles that come 169 00:06:25,415 --> 00:06:27,975 along with not being able to manage from 170 00:06:27,975 --> 00:06:29,035 a language perspective. 171 00:06:29,495 --> 00:06:30,954 But they also knew that 172 00:06:31,254 --> 00:06:33,480 it also would hinder, if you will, their 173 00:06:33,639 --> 00:06:36,199 access and and access to the quality of 174 00:06:36,199 --> 00:06:38,199 health care that they would get. And from 175 00:06:38,199 --> 00:06:39,900 there, Clever Care was born. 176 00:06:40,680 --> 00:06:43,100 We are, here in Southern California. 177 00:06:43,960 --> 00:06:44,779 We serve, 178 00:06:45,319 --> 00:06:47,400 5 counties, one of which is the largest 179 00:06:47,400 --> 00:06:49,935 county in in California, Los Angeles County. 180 00:06:50,714 --> 00:06:51,214 But 181 00:06:51,595 --> 00:06:52,894 everything about CleverCare 182 00:06:53,274 --> 00:06:54,014 has been 183 00:06:54,555 --> 00:06:56,875 developed, and what we do each and every 184 00:06:56,875 --> 00:06:59,295 day is really to serve a pretty unique 185 00:06:59,754 --> 00:07:01,589 population. We currently have about, 186 00:07:03,350 --> 00:07:04,410 28,000 lives. 187 00:07:04,790 --> 00:07:06,889 Even though we were founded in 2018, 188 00:07:07,509 --> 00:07:10,089 we didn't actually go into our first, 189 00:07:10,949 --> 00:07:13,050 annual election period until 190 00:07:13,884 --> 00:07:16,305 2020 right at the height of the pandemic 191 00:07:16,764 --> 00:07:17,504 of of course. 192 00:07:17,964 --> 00:07:20,125 And so we got a a slow start, 193 00:07:20,125 --> 00:07:22,285 but since that time, we have had pretty 194 00:07:22,285 --> 00:07:23,185 rapid growth. 195 00:07:23,884 --> 00:07:25,324 And I think a lot of that is 196 00:07:25,324 --> 00:07:27,165 due to the fact that we serve this 197 00:07:27,165 --> 00:07:29,800 niche market, if you will. What I love 198 00:07:29,800 --> 00:07:31,759 to talk about is the fact that when 199 00:07:31,759 --> 00:07:34,479 you look at our our our staff, the 200 00:07:34,479 --> 00:07:35,699 team that helps 201 00:07:36,079 --> 00:07:37,439 for us to be able to take care 202 00:07:37,439 --> 00:07:38,819 of the people that we serve, 203 00:07:39,759 --> 00:07:40,259 70% 204 00:07:40,719 --> 00:07:41,685 of our staff 205 00:07:42,884 --> 00:07:44,904 reflect the populations that we serve. 206 00:07:45,444 --> 00:07:46,165 And so, 207 00:07:46,644 --> 00:07:48,824 that in itself is pretty unique. 208 00:07:49,845 --> 00:07:52,264 The what we do and how we provide 209 00:07:52,404 --> 00:07:55,560 our services through our Medicare Advantage Plan is 210 00:07:55,560 --> 00:07:57,360 a little different than most of the larger 211 00:07:57,360 --> 00:07:57,860 plans. 212 00:07:58,800 --> 00:08:01,779 We have really built a culturally customized 213 00:08:02,639 --> 00:08:03,939 patient center approach. 214 00:08:05,120 --> 00:08:07,279 The providers in our network are reflective of 215 00:08:07,279 --> 00:08:08,579 the members that we serve. 216 00:08:08,959 --> 00:08:09,939 We have built 217 00:08:10,345 --> 00:08:11,865 our tech stack in a way that we 218 00:08:11,865 --> 00:08:14,444 are able to service our members in language. 219 00:08:14,904 --> 00:08:17,725 When we think about, my member services team, 220 00:08:18,024 --> 00:08:20,665 we are able to service members in 6 221 00:08:20,665 --> 00:08:21,165 languages. 222 00:08:21,785 --> 00:08:24,665 All of our staff are bilingual. In fact, 223 00:08:24,665 --> 00:08:26,340 many of them are trilingual, 224 00:08:26,879 --> 00:08:28,400 and so when you think about some of 225 00:08:28,400 --> 00:08:31,139 those large groups, like, whether it be Korean 226 00:08:31,759 --> 00:08:33,460 or Chinese or Vietnamese, 227 00:08:34,639 --> 00:08:36,639 our materials go out to them in language. 228 00:08:36,639 --> 00:08:38,080 When they call us and they have a 229 00:08:38,080 --> 00:08:39,860 problem, we answer them in language. 230 00:08:40,320 --> 00:08:40,820 The 231 00:08:41,254 --> 00:08:44,134 doctors and and facilities in our networks are 232 00:08:44,134 --> 00:08:46,294 in language. And then the last piece I 233 00:08:46,294 --> 00:08:48,054 would share with you that I think is 234 00:08:48,054 --> 00:08:50,315 pretty unique about CleverCare is that 235 00:08:51,575 --> 00:08:53,914 we are very much engaged in the communities 236 00:08:54,134 --> 00:08:56,629 that we serve, and so we have community. 237 00:08:57,090 --> 00:09:00,470 We have health centers and, community health centers 238 00:09:01,090 --> 00:09:03,649 in the communities that we serve, where our 239 00:09:03,649 --> 00:09:06,529 members can walk in, and they can do 240 00:09:06,529 --> 00:09:08,074 things like take Tai 241 00:09:08,454 --> 00:09:10,534 Chi, but they're also open to the community, 242 00:09:10,534 --> 00:09:12,375 and so it's a way for the community 243 00:09:12,375 --> 00:09:14,154 to come in and learn more about us, 244 00:09:15,014 --> 00:09:17,254 and it it really resonates with the people 245 00:09:17,254 --> 00:09:18,074 that we serve. 246 00:09:18,375 --> 00:09:19,889 And then finally, when you look at our 247 00:09:20,049 --> 00:09:21,490 benefits, one of the things we've been able 248 00:09:21,490 --> 00:09:23,889 to do is we offer a lot of 249 00:09:23,889 --> 00:09:25,509 Eastern medicine types 250 00:09:25,889 --> 00:09:28,610 of services. So, we've got one of the 251 00:09:28,610 --> 00:09:29,750 largest acupuncturist 252 00:09:30,290 --> 00:09:31,590 networks, if you will. 253 00:09:32,610 --> 00:09:33,315 We have, 254 00:09:33,875 --> 00:09:36,774 herbal supplements that are available that people, 255 00:09:37,154 --> 00:09:39,315 and this is their preference in terms of 256 00:09:39,315 --> 00:09:42,434 what they like to, to do when they 257 00:09:42,434 --> 00:09:44,595 have a health challenge, and so we make 258 00:09:44,595 --> 00:09:47,715 all that easily available to them. And, for 259 00:09:47,715 --> 00:09:50,039 us, that's what makes us unique. It's it's 260 00:09:50,039 --> 00:09:50,539 what 261 00:09:50,919 --> 00:09:51,899 I think drives 262 00:09:52,200 --> 00:09:54,279 each of of our employees to come to 263 00:09:54,279 --> 00:09:57,179 wanna work with CleverCare because they are serving 264 00:09:57,799 --> 00:10:00,279 their families and their friends and people who 265 00:10:00,279 --> 00:10:01,339 look like them. 266 00:10:02,545 --> 00:10:05,024 Yeah. Absolutely. Well, that's amazing to to hear 267 00:10:05,024 --> 00:10:06,165 about. So clearly, 268 00:10:06,705 --> 00:10:09,345 a relatively new company, but one that is 269 00:10:09,345 --> 00:10:11,904 built around serving the unique needs of this 270 00:10:11,904 --> 00:10:13,685 population in in Southern California. 271 00:10:15,019 --> 00:10:16,620 Karen, as I understand it in that vein, 272 00:10:16,620 --> 00:10:19,759 you're you're intensifying the company's efforts to address 273 00:10:19,820 --> 00:10:20,720 health disparities 274 00:10:21,179 --> 00:10:23,980 among this population that you serve. Why is 275 00:10:23,980 --> 00:10:25,740 that so important to you? Both both from 276 00:10:25,740 --> 00:10:28,539 a personal perspective, but also from a business 277 00:10:28,539 --> 00:10:30,240 perspective now as a CEO. 278 00:10:31,544 --> 00:10:33,644 Well, from a a personal perspective, 279 00:10:34,985 --> 00:10:36,504 you know, I as I shared with you 280 00:10:36,504 --> 00:10:39,304 earlier, you know, having grown up in, 281 00:10:39,705 --> 00:10:41,945 in in the Detroit Greater Detroit area and 282 00:10:41,945 --> 00:10:45,100 having worked as a pediatric nurse, as a 283 00:10:45,100 --> 00:10:46,159 public health nurse, 284 00:10:46,779 --> 00:10:49,339 I saw firsthand health disparities. I'm an African 285 00:10:49,339 --> 00:10:50,159 American woman, 286 00:10:51,100 --> 00:10:53,179 you know, who has grown up in in 287 00:10:53,179 --> 00:10:54,480 a community where, 288 00:10:55,179 --> 00:10:56,355 there has been a lack of 289 00:10:57,315 --> 00:10:58,054 access, where 290 00:10:58,754 --> 00:10:59,254 disproportionately 291 00:10:59,794 --> 00:11:01,894 there are chronic illnesses that impact, 292 00:11:02,514 --> 00:11:04,274 people who look like me. And and and 293 00:11:04,274 --> 00:11:06,355 so as a result of that, it has 294 00:11:06,355 --> 00:11:08,514 been something that has been really important to 295 00:11:08,514 --> 00:11:09,975 me throughout my career 296 00:11:10,355 --> 00:11:14,089 in terms of how to help make access, 297 00:11:15,110 --> 00:11:16,789 available to to, 298 00:11:17,190 --> 00:11:19,370 disadvantaged individuals. It's about 299 00:11:19,829 --> 00:11:22,789 how I have been able to, really work 300 00:11:22,789 --> 00:11:23,289 proactively 301 00:11:24,069 --> 00:11:26,205 to help build networks that are inclusive 302 00:11:26,665 --> 00:11:27,404 and reflective 303 00:11:27,865 --> 00:11:30,264 of the the the patients that we serve. 304 00:11:30,264 --> 00:11:31,565 And so it's really important, 305 00:11:32,184 --> 00:11:33,404 because it's been proven 306 00:11:33,865 --> 00:11:35,085 that cultural competency 307 00:11:35,545 --> 00:11:36,605 really does help, 308 00:11:37,304 --> 00:11:39,919 bridge gaps, help address health disparities, 309 00:11:40,299 --> 00:11:42,079 and ultimately get you better outcomes. 310 00:11:42,539 --> 00:11:45,659 So when you can have the provider look 311 00:11:45,659 --> 00:11:48,379 like and have shared experiences of patients that 312 00:11:48,379 --> 00:11:49,120 they're serving, 313 00:11:49,659 --> 00:11:51,600 it works out better. And so for me, 314 00:11:54,334 --> 00:11:56,674 that has resonated with me, and having 315 00:11:57,855 --> 00:12:00,195 been here in Southern California now, 316 00:12:00,815 --> 00:12:02,995 for greater than 10 years, 317 00:12:03,534 --> 00:12:05,700 when I came here, I was I was 318 00:12:05,779 --> 00:12:08,580 exposed to, if you will, this this whole 319 00:12:08,580 --> 00:12:09,720 new population, 320 00:12:10,580 --> 00:12:12,919 in terms of, you know, really getting myself 321 00:12:13,700 --> 00:12:16,500 very much ingrained in the Asian communities. I 322 00:12:16,500 --> 00:12:18,820 was I was I was leading another health 323 00:12:18,820 --> 00:12:22,205 plan where we had, you know, similar demographics. 324 00:12:22,904 --> 00:12:25,065 And so it gave me a firsthand look 325 00:12:25,065 --> 00:12:26,924 and an appreciation for the similarities 326 00:12:27,625 --> 00:12:29,085 that were being faced 327 00:12:29,945 --> 00:12:30,664 by those, 328 00:12:31,065 --> 00:12:31,565 populations, 329 00:12:32,264 --> 00:12:34,044 as as compared to 330 00:12:35,050 --> 00:12:37,309 the personal experience I had had myself. 331 00:12:37,769 --> 00:12:40,970 So that's really why this is something that 332 00:12:40,970 --> 00:12:42,029 is just so 333 00:12:42,889 --> 00:12:44,809 personal to me and resonates with me. And 334 00:12:44,809 --> 00:12:45,950 then I had the fortune, 335 00:12:46,809 --> 00:12:49,365 about a year ago to be asked to 336 00:12:49,365 --> 00:12:50,904 join the Clever Care board. 337 00:12:51,285 --> 00:12:53,605 And so, I currently serve as as the 338 00:12:53,605 --> 00:12:56,004 exec chair for the board, and and then 339 00:12:56,004 --> 00:12:58,024 during that time, it gave me an opportunity 340 00:12:58,404 --> 00:12:59,865 to really see how 341 00:13:00,725 --> 00:13:02,565 by way by virtue of the way that 342 00:13:02,565 --> 00:13:05,200 our benefits were structured, by those supplemental things 343 00:13:05,200 --> 00:13:07,220 that I mentioned earlier that we were offering, 344 00:13:07,519 --> 00:13:09,940 by the fact that the staff, 345 00:13:10,879 --> 00:13:13,120 were reflective of the people we were serving, 346 00:13:13,120 --> 00:13:13,940 and how 347 00:13:14,879 --> 00:13:17,415 how that really helped to advance, 348 00:13:18,434 --> 00:13:19,715 some of the things that we were trying 349 00:13:19,715 --> 00:13:20,455 to accomplish. 350 00:13:21,315 --> 00:13:23,394 I was honored to have the opportunity to 351 00:13:23,394 --> 00:13:25,715 then step into the interim CEO role. And 352 00:13:25,715 --> 00:13:26,215 so, 353 00:13:26,915 --> 00:13:28,674 it has now allowed me to get even 354 00:13:28,674 --> 00:13:30,295 closer if you will to 355 00:13:30,674 --> 00:13:32,049 our chief medical officer, and officer 356 00:13:32,669 --> 00:13:33,610 and everyone else on our team who works 357 00:13:33,610 --> 00:13:34,516 to help us identify how best we can 358 00:13:34,516 --> 00:13:35,629 close some of those health equity gaps. And 359 00:13:35,629 --> 00:13:36,129 so, 360 00:13:37,629 --> 00:13:38,129 that's 361 00:13:38,509 --> 00:13:40,769 why it's personal. From a business perspective, 362 00:13:41,230 --> 00:13:42,689 why is that important? 363 00:13:46,245 --> 00:13:48,345 For several reasons. First of all, 364 00:13:49,044 --> 00:13:51,304 you know, it may sound all altruistic, 365 00:13:51,764 --> 00:13:53,205 but, you know, at the end of the 366 00:13:53,205 --> 00:13:53,705 day, 367 00:13:54,164 --> 00:13:56,345 we do this. The reason we have CleverCare 368 00:13:56,804 --> 00:13:57,304 is 369 00:13:58,004 --> 00:14:00,730 to take care of people. It is it 370 00:14:00,730 --> 00:14:01,929 is is it at the core of what 371 00:14:01,929 --> 00:14:02,589 we do? 372 00:14:02,970 --> 00:14:05,789 And so the ability for us to 373 00:14:06,329 --> 00:14:08,169 be able to look and say that in 374 00:14:08,169 --> 00:14:10,669 the populations we serve, there is a greater 375 00:14:10,889 --> 00:14:12,509 propensity of, for example, 376 00:14:13,365 --> 00:14:14,504 pulmonary disease. 377 00:14:15,044 --> 00:14:17,065 The fact that we see in our populations, 378 00:14:17,845 --> 00:14:19,865 a greater incidence of tuberculosis, 379 00:14:20,245 --> 00:14:20,745 etcetera. 380 00:14:21,605 --> 00:14:24,664 We can address that because we have providers 381 00:14:25,284 --> 00:14:27,284 who look like and speak the language of 382 00:14:27,284 --> 00:14:28,745 our members. And so those 383 00:14:29,049 --> 00:14:30,590 those patients, those members 384 00:14:31,129 --> 00:14:31,870 are more 385 00:14:32,250 --> 00:14:32,750 willing 386 00:14:33,850 --> 00:14:36,029 to come in to see a provider. 387 00:14:36,410 --> 00:14:38,830 They're much more apt to be, 388 00:14:39,450 --> 00:14:42,034 adherent to whatever that provider, 389 00:14:42,674 --> 00:14:45,815 prescribes for them. They are keeping their appointments, 390 00:14:46,194 --> 00:14:48,534 and all of those things are helping us 391 00:14:48,674 --> 00:14:51,235 to close that gap around health equity. We 392 00:14:51,235 --> 00:14:53,174 are making things accessible, 393 00:14:54,274 --> 00:14:55,735 to them. We are, 394 00:14:56,690 --> 00:14:59,330 and that's from a business perspective. That's good 395 00:14:59,330 --> 00:15:02,210 business for us. That's good that's good business 396 00:15:02,210 --> 00:15:03,029 for communities. 397 00:15:04,210 --> 00:15:06,549 That's good business for the overall, 398 00:15:07,970 --> 00:15:08,950 health care space, 399 00:15:09,730 --> 00:15:11,914 because if we can help around, 400 00:15:12,774 --> 00:15:15,754 reducing the the cost curve, if you will, 401 00:15:16,534 --> 00:15:17,575 if we are, 402 00:15:18,054 --> 00:15:18,554 providing 403 00:15:18,934 --> 00:15:19,754 good service, 404 00:15:20,695 --> 00:15:23,095 if we are able to show that our 405 00:15:23,095 --> 00:15:24,235 clinical outcomes, 406 00:15:24,934 --> 00:15:27,309 and our patients do better, if you will. 407 00:15:27,450 --> 00:15:30,190 Then from a business perspective, that means that 408 00:15:30,409 --> 00:15:33,049 providers want to participate and be a part 409 00:15:33,049 --> 00:15:35,230 of my network. It means that 410 00:15:35,690 --> 00:15:38,985 the government, who is my my only contract. 411 00:15:38,985 --> 00:15:41,465 Right? That means then that they are much 412 00:15:41,465 --> 00:15:43,325 more supportive of my health plan, 413 00:15:43,945 --> 00:15:45,245 in terms of my investors. 414 00:15:45,705 --> 00:15:48,125 That helps them to get a better return. 415 00:15:48,424 --> 00:15:50,585 So all of those are, to me, the 416 00:15:50,585 --> 00:15:53,139 best of both worlds. We are 417 00:15:53,600 --> 00:15:56,559 serving a community need. We are helping to 418 00:15:56,559 --> 00:15:57,059 improve, 419 00:15:58,160 --> 00:16:01,139 the health outcomes for people that we're serving, 420 00:16:01,279 --> 00:16:02,419 but we are also, 421 00:16:02,879 --> 00:16:03,379 creating 422 00:16:03,919 --> 00:16:05,139 a thriving business. 423 00:16:06,514 --> 00:16:09,154 Absolutely. Thank you so much, Karen. And I 424 00:16:09,154 --> 00:16:11,554 appreciate the the the nuance and the complexity 425 00:16:11,554 --> 00:16:14,115 of your answers. It's really great insights for 426 00:16:14,115 --> 00:16:16,914 our listeners right now. I wanna continue to 427 00:16:16,914 --> 00:16:19,095 follow-up with you in terms of, 428 00:16:20,139 --> 00:16:22,339 the business perspective that you were just sharing 429 00:16:22,339 --> 00:16:23,839 and some of your experiences, 430 00:16:24,539 --> 00:16:25,039 throughout, 431 00:16:25,740 --> 00:16:28,000 the last few decades within managed care. 432 00:16:28,620 --> 00:16:31,179 As you know, the Medicare Advantage Industry is 433 00:16:31,179 --> 00:16:33,659 facing a lot of challenges right now, especially 434 00:16:33,659 --> 00:16:36,105 as we head into the annual enrollment period 435 00:16:36,105 --> 00:16:36,845 this fall. 436 00:16:37,225 --> 00:16:39,065 So I wanted to ask you a little 437 00:16:39,065 --> 00:16:42,264 bit about how CleverCare is is navigating these 438 00:16:42,264 --> 00:16:43,485 these industry headwinds, 439 00:16:43,865 --> 00:16:47,084 especially as we've seen other, large national carriers, 440 00:16:47,784 --> 00:16:50,330 really make some some moves recently in the 441 00:16:50,330 --> 00:16:52,090 last few weeks and even today in terms 442 00:16:52,090 --> 00:16:54,750 of how they'll be pricing and and navigating 443 00:16:54,809 --> 00:16:55,549 their business, 444 00:16:56,009 --> 00:16:58,649 over the next months and and and years 445 00:16:58,649 --> 00:16:59,230 to come? 446 00:17:00,490 --> 00:17:00,794 Yes. 447 00:17:01,514 --> 00:17:03,834 Well, there is no secret that, 448 00:17:04,634 --> 00:17:06,634 CMS likes to keep us on our toes. 449 00:17:06,634 --> 00:17:07,615 That's for sure. 450 00:17:07,994 --> 00:17:09,994 And so a couple of the things that 451 00:17:09,994 --> 00:17:11,615 that that that we've been doing, 452 00:17:11,994 --> 00:17:13,914 you know, as as you heard earlier, you 453 00:17:13,914 --> 00:17:16,734 know, we have a smaller membership as compared 454 00:17:16,769 --> 00:17:18,390 to the larger carriers, 455 00:17:18,849 --> 00:17:20,710 and we have a a more nuanced 456 00:17:21,009 --> 00:17:22,309 membership as well. 457 00:17:22,690 --> 00:17:24,769 And so when you think about the fact 458 00:17:24,769 --> 00:17:26,630 that we are serving primarily, 459 00:17:27,490 --> 00:17:28,789 you know, Asian Americans, 460 00:17:29,490 --> 00:17:30,390 Island Pacificers, 461 00:17:31,805 --> 00:17:34,684 In terms of how health is approached is 462 00:17:34,684 --> 00:17:36,545 much more from a preventive perspective. 463 00:17:37,005 --> 00:17:38,704 And so our membership, 464 00:17:39,164 --> 00:17:40,464 they actually prefer, 465 00:17:40,845 --> 00:17:43,005 if possible, to not end up in the 466 00:17:43,005 --> 00:17:44,305 hospital, for example. 467 00:17:44,765 --> 00:17:46,819 And so when you think about, you know, 468 00:17:46,819 --> 00:17:49,259 what you hear a lot in in in 469 00:17:49,539 --> 00:17:51,640 out in the in in the nationals 470 00:17:52,019 --> 00:17:52,839 are around 471 00:17:53,299 --> 00:17:54,200 increased utilization, 472 00:17:54,500 --> 00:17:55,000 etcetera. 473 00:17:55,619 --> 00:17:57,720 That's not necessarily our biggest challenge, 474 00:17:58,259 --> 00:17:59,960 because again, that isn't 475 00:18:00,259 --> 00:18:03,445 historically where our populations end up. 476 00:18:03,904 --> 00:18:05,125 We are instead 477 00:18:05,984 --> 00:18:09,664 much more focused on quality, for example. You 478 00:18:09,664 --> 00:18:11,744 know, and and in our world, it's all 479 00:18:11,744 --> 00:18:13,765 about the stars. Right? And so, 480 00:18:14,625 --> 00:18:16,890 we are focused on what can we do 481 00:18:16,890 --> 00:18:18,430 to ensure that we are driving, 482 00:18:19,289 --> 00:18:21,930 the best outcomes in our HEDIS measures, for 483 00:18:21,930 --> 00:18:22,430 example. 484 00:18:23,049 --> 00:18:24,110 How do we 485 00:18:24,570 --> 00:18:26,910 continue to ensure that 486 00:18:27,210 --> 00:18:29,144 on that part d, on on on the 487 00:18:29,144 --> 00:18:32,264 medication adherence, for example, that our that our 488 00:18:32,264 --> 00:18:34,825 that our members are picking up their meds. 489 00:18:34,825 --> 00:18:37,244 So we are very, very focused 490 00:18:37,784 --> 00:18:38,524 on quality. 491 00:18:39,224 --> 00:18:39,944 We are, 492 00:18:40,345 --> 00:18:42,390 making sure that our benefit design 493 00:18:43,029 --> 00:18:45,910 is marketable, but yet we don't wanna be 494 00:18:45,910 --> 00:18:48,549 out front of everyone else. And, again, from 495 00:18:48,549 --> 00:18:51,269 a benefits perspective for us, it's more about 496 00:18:51,269 --> 00:18:52,170 Eastern medicine, 497 00:18:52,549 --> 00:18:53,049 etcetera. 498 00:18:53,589 --> 00:18:55,750 We are leveraging technology, you know, so we 499 00:18:55,750 --> 00:18:57,654 know some of the things that are headwinds. 500 00:18:57,654 --> 00:19:00,454 And so we're leveraging technology so that we 501 00:19:00,454 --> 00:19:02,855 can have smarter solutions, so that we can 502 00:19:02,855 --> 00:19:03,355 become, 503 00:19:04,134 --> 00:19:06,634 more streamlined from an administrative perspective. 504 00:19:07,494 --> 00:19:09,355 We're also thinking more strategically 505 00:19:10,134 --> 00:19:11,115 about our investments. 506 00:19:11,494 --> 00:19:13,329 So, you know, whereas I would tell you, 507 00:19:13,329 --> 00:19:15,429 you know, my team probably would like 508 00:19:15,730 --> 00:19:17,269 to, you know, to implement 509 00:19:17,569 --> 00:19:19,889 6 or 7 new things next year, but 510 00:19:19,889 --> 00:19:21,109 we're saying, look. 511 00:19:21,490 --> 00:19:22,950 We are going to be extremely 512 00:19:23,329 --> 00:19:26,149 strategic about what investments we need to make, 513 00:19:26,210 --> 00:19:28,305 what investments are gonna really drive 514 00:19:28,945 --> 00:19:29,445 quality, 515 00:19:29,985 --> 00:19:32,945 what investments are gonna drive us to be 516 00:19:32,945 --> 00:19:35,605 much more efficient from an administrative perspective. 517 00:19:36,465 --> 00:19:37,904 And then the the other thing I would 518 00:19:37,904 --> 00:19:40,164 say that's really important is just around 519 00:19:40,625 --> 00:19:41,684 how you engage, 520 00:19:42,705 --> 00:19:45,980 your your members and your and your employees. 521 00:19:46,279 --> 00:19:47,980 You know, with the headwinds coming, 522 00:19:48,279 --> 00:19:51,000 it's about keeping people focused. It's about keeping 523 00:19:51,000 --> 00:19:51,740 your membership 524 00:19:52,440 --> 00:19:53,660 happy, if you will, 525 00:19:53,960 --> 00:19:54,859 and satisfied. 526 00:19:55,160 --> 00:19:57,559 And so the things that we do around 527 00:19:57,559 --> 00:19:58,220 that is 528 00:19:58,519 --> 00:19:59,875 for members specifically, 529 00:20:00,255 --> 00:20:02,994 we we have an advisory board of members. 530 00:20:03,295 --> 00:20:05,795 And so, you know, we're using the insights 531 00:20:05,855 --> 00:20:07,875 and the intel and the inputs 532 00:20:08,255 --> 00:20:11,055 from our membership to help us to ensure 533 00:20:11,055 --> 00:20:13,455 that we are staying relevant, to make sure 534 00:20:13,455 --> 00:20:13,955 that 535 00:20:14,335 --> 00:20:16,599 we can, if you will, and sometimes 536 00:20:17,139 --> 00:20:19,539 kinda test the waters with them about changes 537 00:20:19,539 --> 00:20:21,720 we may be considering making 538 00:20:22,659 --> 00:20:24,419 because of some of the headwinds are coming, 539 00:20:24,419 --> 00:20:26,980 but that are coming towards us, but wanting 540 00:20:26,980 --> 00:20:29,059 to make sure that we're not going to, 541 00:20:29,059 --> 00:20:29,639 you know, 542 00:20:30,605 --> 00:20:31,664 put off, if you 543 00:20:32,125 --> 00:20:34,464 will, our our members or potential new 544 00:20:34,845 --> 00:20:37,565 members. And then finally, again, around the employee 545 00:20:37,565 --> 00:20:38,625 engagement piece, 546 00:20:38,924 --> 00:20:42,045 I think that your most valuable asset is 547 00:20:42,045 --> 00:20:43,105 your human capital. 548 00:20:43,679 --> 00:20:46,000 And so with that in mind, you know, 549 00:20:46,000 --> 00:20:48,480 we wanna keep employees engaged. We don't we 550 00:20:48,480 --> 00:20:50,339 don't we wanna reduce turnover. 551 00:20:51,119 --> 00:20:53,519 We don't want people running scared because they're 552 00:20:53,519 --> 00:20:55,839 hearing everything that's going on in the news 553 00:20:55,839 --> 00:20:57,045 about Medicare Advantage. 554 00:20:57,924 --> 00:20:59,924 Right? And so those those are the things 555 00:20:59,924 --> 00:21:00,744 that we're doing. 556 00:21:02,644 --> 00:21:03,445 It's really, 557 00:21:03,924 --> 00:21:06,244 great insights, but it's really interesting to hear 558 00:21:06,244 --> 00:21:08,184 that you're not facing some of these same, 559 00:21:08,565 --> 00:21:11,205 challenges around rising inpatient costs as some of 560 00:21:11,205 --> 00:21:13,640 the other carriers simply because of the unique 561 00:21:13,640 --> 00:21:15,400 population that you serve and and and their 562 00:21:15,400 --> 00:21:17,960 preferences. So Yeah. That's really interesting to hear 563 00:21:17,960 --> 00:21:18,460 about. 564 00:21:19,480 --> 00:21:21,480 What else are we missing? Karen, any any 565 00:21:21,480 --> 00:21:24,359 final thoughts that you wanna share while you 566 00:21:24,359 --> 00:21:26,039 have the ears of of a lot of 567 00:21:26,039 --> 00:21:28,304 health plan leaders from from all over the 568 00:21:28,304 --> 00:21:28,804 country? 569 00:21:30,625 --> 00:21:32,224 You know, I guess the a couple things 570 00:21:32,224 --> 00:21:34,304 I would say in that regards is that 571 00:21:34,464 --> 00:21:35,924 I'm gonna go back to 572 00:21:36,304 --> 00:21:39,265 your best asset to me, and that is 573 00:21:39,265 --> 00:21:41,236 your human capital, your people. And so, you 574 00:21:41,236 --> 00:21:41,869 know, I I would 575 00:21:42,170 --> 00:21:43,470 just advise 576 00:21:43,769 --> 00:21:43,876 that that you express gratitude and you recognize 577 00:21:43,876 --> 00:21:44,990 them and you acknowledge them because 578 00:21:45,609 --> 00:21:47,950 they are working in difficult times, 579 00:21:48,730 --> 00:21:50,650 and, often, they are going over and above. 580 00:21:50,650 --> 00:21:51,150 And 581 00:21:51,509 --> 00:21:52,009 so 582 00:21:52,370 --> 00:21:52,870 it's 583 00:21:53,230 --> 00:21:53,730 so 584 00:21:54,090 --> 00:21:56,494 important to often, they are going over and 585 00:21:56,494 --> 00:21:58,734 above. And so it's so important to say 586 00:21:58,734 --> 00:22:00,134 thank you. I will tell you I had 587 00:22:00,255 --> 00:22:02,194 when I was working on the hospital side, 588 00:22:02,494 --> 00:22:04,674 I had a great leader, and, 589 00:22:05,134 --> 00:22:07,660 I was lamenting one day about the fact 590 00:22:07,660 --> 00:22:10,059 that I was doing hospital rounds, and and 591 00:22:10,059 --> 00:22:12,460 I kinda felt inadequate because I would go 592 00:22:12,460 --> 00:22:14,240 on the critical care unit and 593 00:22:14,539 --> 00:22:16,779 see the nurses, and they were working so 594 00:22:16,779 --> 00:22:19,259 hard. And and I was like, I don't 595 00:22:19,259 --> 00:22:20,779 do that anymore. You know, I I I 596 00:22:20,779 --> 00:22:23,454 just felt like, gosh, am I really doing 597 00:22:23,454 --> 00:22:24,734 much? And you know what he said to 598 00:22:24,734 --> 00:22:27,055 me? He said, Karen, if you aren't taking 599 00:22:27,055 --> 00:22:28,654 care of a patient, then you need to 600 00:22:28,654 --> 00:22:30,815 be taking care of someone who is. And 601 00:22:30,815 --> 00:22:32,894 I will tell you that that has stuck 602 00:22:32,894 --> 00:22:33,555 with me 603 00:22:34,095 --> 00:22:36,734 for years years, and I try to use 604 00:22:36,734 --> 00:22:37,079 that 605 00:22:37,559 --> 00:22:40,539 analogy no matter where I'm working about taking 606 00:22:40,679 --> 00:22:41,500 care of 607 00:22:41,880 --> 00:22:42,700 your teams. 608 00:22:43,079 --> 00:22:45,079 So that's one thing is if you do 609 00:22:45,079 --> 00:22:47,399 that, they will follow you. You know, give 610 00:22:47,399 --> 00:22:48,220 them a vision, 611 00:22:48,759 --> 00:22:51,640 say thank you, acknowledge them, and they they 612 00:22:51,640 --> 00:22:53,974 will follow you, and they will bend over 613 00:22:53,974 --> 00:22:55,974 backwards to make sure that you can execute 614 00:22:55,974 --> 00:22:56,714 on your business. 615 00:22:57,815 --> 00:22:59,894 Another I would I would share is, you 616 00:22:59,894 --> 00:23:01,674 know, is is just how you 617 00:23:02,134 --> 00:23:04,554 manage your your your board dynamics. 618 00:23:04,934 --> 00:23:07,730 That's so important. I feel very fortunate. We 619 00:23:07,730 --> 00:23:09,589 have an extremely supportive board 620 00:23:10,369 --> 00:23:12,769 very much who believe in the work that 621 00:23:12,769 --> 00:23:15,109 we're doing, and that is so vitally important, 622 00:23:15,410 --> 00:23:17,269 and my team knows that as well. 623 00:23:17,994 --> 00:23:20,234 So that's another thing just to to make 624 00:23:20,234 --> 00:23:22,015 sure that you have that healthy, 625 00:23:22,634 --> 00:23:25,275 that board interaction, and that you that you 626 00:23:25,275 --> 00:23:27,275 leverage your board and that you partner with 627 00:23:27,275 --> 00:23:27,775 them. 628 00:23:28,394 --> 00:23:30,315 And then finally, I I think I would 629 00:23:30,315 --> 00:23:31,694 say is that, you know, 630 00:23:32,470 --> 00:23:34,730 it's turbulent for our business right now, 631 00:23:35,110 --> 00:23:36,950 but but I've seen, I've been around long 632 00:23:36,950 --> 00:23:38,570 enough to know that that's cyclical. 633 00:23:39,110 --> 00:23:41,509 You know? So right now, it's a bit 634 00:23:41,509 --> 00:23:42,250 more challenging, 635 00:23:42,950 --> 00:23:44,330 but we will come out, 636 00:23:44,710 --> 00:23:46,710 you know, to the other side. And so 637 00:23:46,710 --> 00:23:48,090 it's about it's about 638 00:23:48,414 --> 00:23:48,914 tenacity. 639 00:23:49,694 --> 00:23:52,595 It's about, you know, not getting too discouraged, 640 00:23:53,535 --> 00:23:54,994 and and just kinda 641 00:23:55,694 --> 00:23:58,414 staying focused and and and and doing the 642 00:23:58,414 --> 00:23:59,154 right thing. 643 00:24:00,509 --> 00:24:03,490 Wonderful. Really great advice and perspective. 644 00:24:03,789 --> 00:24:06,509 So, Karen, thank you so much for taking 645 00:24:06,509 --> 00:24:08,430 the time to sit down with us and 646 00:24:08,430 --> 00:24:11,150 for sharing your insights with our listeners. We 647 00:24:11,150 --> 00:24:12,369 truly appreciate it. 648 00:24:12,964 --> 00:24:15,045 Thank you. It's been a pleasure. If you'd 649 00:24:15,045 --> 00:24:17,365 like to listen to more podcasts from Becker's 650 00:24:17,365 --> 00:24:18,984 Healthcare, you can visit beckershospitalreview.com.