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 --> 00:00:12,160 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 --> 00:01:02,820 the conference website. That's the beckers hospital review.com 23 00:01:03,600 --> 00:01:05,700 events page. See you in Chicago. 24 00:01:06,560 --> 00:01:08,799 This is Laura Dirdle with the Becker's Healthcare 25 00:01:08,799 --> 00:01:09,299 podcast. 26 00:01:09,854 --> 00:01:11,694 I'm thrilled today to be joined by Joanne 27 00:01:11,694 --> 00:01:14,915 McFall, market president of Keystone First and AmeriHealth 28 00:01:15,134 --> 00:01:16,354 Caritas, Pennsylvania 29 00:01:16,655 --> 00:01:19,075 at AmeriHealth Caritas family of companies. 30 00:01:19,375 --> 00:01:20,655 Joanne, it's a pleasure to have you on 31 00:01:20,655 --> 00:01:23,055 the podcast today. Thank you so much, Laura. 32 00:01:23,055 --> 00:01:24,494 I really am glad to be here today 33 00:01:24,494 --> 00:01:25,155 with you. 34 00:01:25,689 --> 00:01:27,769 Now I'm looking forward to our conversation. I 35 00:01:27,769 --> 00:01:30,189 think it'll be just amazing to hear more 36 00:01:30,329 --> 00:01:31,769 about some of the great things that you're 37 00:01:31,769 --> 00:01:33,609 doing and really to share how you're thinking 38 00:01:33,609 --> 00:01:35,609 about the future as well. But before we 39 00:01:35,609 --> 00:01:37,369 dive into that discussion, can you tell us 40 00:01:37,369 --> 00:01:38,890 a little bit more about yourself and your 41 00:01:38,890 --> 00:01:39,390 background? 42 00:01:40,435 --> 00:01:41,334 Sure. Absolutely. 43 00:01:41,875 --> 00:01:43,875 As the market president for, 44 00:01:44,194 --> 00:01:47,795 essentially our Pennsylvania Medicaid business, we we operate 45 00:01:47,795 --> 00:01:50,694 under two plan names, Keystone First and AmeriHealth 46 00:01:50,754 --> 00:01:53,015 Caritas, but we both plans, 47 00:01:53,395 --> 00:01:56,590 are part of the Pennsylvania Health Choices Medical 48 00:01:56,590 --> 00:01:59,230 Assistance Program. So just to set the stage 49 00:01:59,230 --> 00:02:01,390 on that. And so I have been with 50 00:02:01,390 --> 00:02:04,670 the organization for 24 years now. I I 51 00:02:04,670 --> 00:02:06,850 came in from the provider side 52 00:02:07,155 --> 00:02:08,055 working for, 53 00:02:08,594 --> 00:02:10,615 a Philadelphia based hospital system 54 00:02:10,995 --> 00:02:12,294 and then a large 55 00:02:13,074 --> 00:02:13,574 outpatient 56 00:02:14,034 --> 00:02:15,094 outpatient therapy 57 00:02:15,395 --> 00:02:16,615 organization. So 58 00:02:16,915 --> 00:02:19,155 24 years ago, I came to the payer 59 00:02:19,155 --> 00:02:19,655 side 60 00:02:20,120 --> 00:02:21,580 and have had the opportunity 61 00:02:21,960 --> 00:02:22,780 to work 62 00:02:23,080 --> 00:02:24,939 in a variety of different 63 00:02:26,040 --> 00:02:28,780 types of roles in within our organization, 64 00:02:29,960 --> 00:02:32,760 starting as a business analyst in our IS 65 00:02:32,760 --> 00:02:33,260 department 66 00:02:33,775 --> 00:02:36,094 and then worked my way up through our 67 00:02:36,094 --> 00:02:37,555 project management organization 68 00:02:37,935 --> 00:02:38,435 and, 69 00:02:38,895 --> 00:02:41,375 a few other roles on the sort of 70 00:02:41,375 --> 00:02:43,555 corporate side of of our organization 71 00:02:44,335 --> 00:02:46,655 before switching over to the health plan side 72 00:02:46,655 --> 00:02:49,090 about 10 years ago. And so for me, 73 00:02:49,090 --> 00:02:51,090 it's been a really amazing journey to be 74 00:02:51,090 --> 00:02:51,590 able 75 00:02:51,969 --> 00:02:54,689 to bring both of those parts together because 76 00:02:54,689 --> 00:02:57,349 we still exist in an organization where 77 00:02:57,650 --> 00:02:59,030 our local health plans, 78 00:03:00,129 --> 00:03:01,990 have a a set of responsibilities, 79 00:03:02,930 --> 00:03:04,229 and then we're supported 80 00:03:04,664 --> 00:03:07,224 by our corporate organization for a lot of 81 00:03:07,224 --> 00:03:09,944 the back office functions. So I've kinda played 82 00:03:09,944 --> 00:03:12,025 in both worlds, and and my job now 83 00:03:12,025 --> 00:03:14,444 is to really bring those 2 together. 84 00:03:15,544 --> 00:03:17,884 Well, that sounds like quite a huge responsibility 85 00:03:18,185 --> 00:03:19,484 indeed and and certainly 86 00:03:19,960 --> 00:03:21,879 something very needed within the health care space 87 00:03:21,879 --> 00:03:25,419 right now. Given that role, and your focus, 88 00:03:25,560 --> 00:03:27,159 what are some of the biggest issues that 89 00:03:27,159 --> 00:03:28,620 you're following in health care? 90 00:03:29,800 --> 00:03:32,199 Absolutely. I can, dig into that. You know, 91 00:03:32,199 --> 00:03:33,719 one of the things just to sort of 92 00:03:33,719 --> 00:03:34,520 set the stage, 93 00:03:34,895 --> 00:03:36,194 currently in Pennsylvania, 94 00:03:36,735 --> 00:03:38,835 through those two health plans, we support, 95 00:03:40,175 --> 00:03:41,474 just about 833,000 96 00:03:43,375 --> 00:03:43,875 Pennsylvanians, 97 00:03:44,735 --> 00:03:46,835 who are part of the HealthChoices, 98 00:03:48,014 --> 00:03:49,474 medical assistance program. 99 00:03:49,950 --> 00:03:50,450 So, 100 00:03:50,909 --> 00:03:53,310 you know, for for us, really, the the 101 00:03:53,310 --> 00:03:54,210 big challenge 102 00:03:54,830 --> 00:03:55,310 that, 103 00:03:55,710 --> 00:03:58,349 that we've been facing is, you know, the 104 00:03:58,349 --> 00:04:00,210 impact of the post pandemic 105 00:04:00,750 --> 00:04:01,969 Medicaid unwinding. 106 00:04:02,795 --> 00:04:03,935 So, you know, 107 00:04:04,955 --> 00:04:07,034 as over the course of the last, you 108 00:04:07,034 --> 00:04:08,735 know, 14 months or so, 109 00:04:09,355 --> 00:04:10,415 more than 23,000,000 110 00:04:10,955 --> 00:04:11,455 Americans 111 00:04:12,075 --> 00:04:13,855 have lost Medicaid coverage 112 00:04:14,314 --> 00:04:15,694 during this unwinding 113 00:04:16,074 --> 00:04:17,535 of of the pandemic, 114 00:04:19,360 --> 00:04:21,220 essentially, in an a a disenrollment 115 00:04:21,520 --> 00:04:24,980 freeze. So during the the publicly declared pandemic 116 00:04:25,040 --> 00:04:25,540 emergency, 117 00:04:26,160 --> 00:04:27,379 states could not 118 00:04:28,240 --> 00:04:31,060 implement their regular disenrollment processes, 119 00:04:31,680 --> 00:04:32,500 due to 120 00:04:32,814 --> 00:04:34,274 the pandemic. And so 121 00:04:34,654 --> 00:04:36,495 over the course of the little over a 122 00:04:36,495 --> 00:04:39,154 year now, the states have been restarting 123 00:04:39,855 --> 00:04:43,394 those disenrollment activities and that has resulted in 124 00:04:43,694 --> 00:04:44,754 that significant 125 00:04:45,134 --> 00:04:47,009 drop in the 23,000,000 126 00:04:47,629 --> 00:04:50,769 Americans who no longer have that Medicaid coverage. 127 00:04:51,149 --> 00:04:54,349 So we've been seeing as as as we 128 00:04:54,349 --> 00:04:57,009 support our our members and our population 129 00:04:57,789 --> 00:05:00,509 through that unwinding and working with individuals and 130 00:05:00,509 --> 00:05:04,225 families to ensure that those individuals who are 131 00:05:04,225 --> 00:05:07,444 still eligible for those state programs remain eligible. 132 00:05:08,545 --> 00:05:09,045 But 133 00:05:09,504 --> 00:05:12,245 having seen that significant drop in the enrollment, 134 00:05:12,785 --> 00:05:15,365 what we're seeing is that the remaining enrollees 135 00:05:16,079 --> 00:05:18,800 are tending to be sicker and having higher 136 00:05:18,800 --> 00:05:20,259 rates of utilization 137 00:05:21,360 --> 00:05:24,079 than what the states may have anticipated when 138 00:05:24,079 --> 00:05:26,259 they were setting Medicaid budgets. 139 00:05:26,879 --> 00:05:29,759 So we have the challenge there of, you 140 00:05:29,759 --> 00:05:31,060 know, the state funding 141 00:05:31,774 --> 00:05:34,675 not meeting the reality of of current utilization, 142 00:05:35,534 --> 00:05:37,935 and then we also have the impact of 143 00:05:37,935 --> 00:05:38,435 inflation. 144 00:05:39,055 --> 00:05:41,714 And, you know, across the health care industry, 145 00:05:41,774 --> 00:05:43,875 we're seeing higher costs for staff, 146 00:05:44,209 --> 00:05:47,270 for real estate, for supplies and other essentials, 147 00:05:47,970 --> 00:05:50,850 and health care providers are seeing those higher 148 00:05:50,850 --> 00:05:51,750 costs for 149 00:05:52,050 --> 00:05:54,470 equipment, medications, and the other supplies 150 00:05:54,850 --> 00:05:56,790 that they need for their work. So 151 00:05:57,134 --> 00:05:59,074 we have a little bit of a challenge 152 00:05:59,134 --> 00:05:59,634 navigating, 153 00:06:00,014 --> 00:06:01,074 you know, between 154 00:06:01,615 --> 00:06:03,375 the realities of the state funding and the 155 00:06:03,375 --> 00:06:05,935 realities of the cost of doing business in 156 00:06:05,935 --> 00:06:07,074 the health care industry. 157 00:06:08,334 --> 00:06:10,414 You know, that's such a fascinating point and 158 00:06:10,414 --> 00:06:11,794 especially thinking about, 159 00:06:12,610 --> 00:06:14,850 everything that's occurred over the last 4 years 160 00:06:14,850 --> 00:06:16,870 from the pandemic and then, you know, 161 00:06:17,889 --> 00:06:19,029 the period afterwards, 162 00:06:20,370 --> 00:06:23,009 certainly for the Medicaid enrollees and trying to 163 00:06:23,009 --> 00:06:25,250 figure out, you know, as you mentioned, how 164 00:06:25,250 --> 00:06:27,250 to make sure people that need coverage still 165 00:06:27,250 --> 00:06:29,654 or are eligible still for coverage have it, 166 00:06:30,115 --> 00:06:32,774 what to do, for those, you know, who, 167 00:06:33,634 --> 00:06:35,475 are no longer eligible. And then 2, for 168 00:06:35,475 --> 00:06:37,875 those who are eligible, with those costs increasing, 169 00:06:37,875 --> 00:06:39,414 I can imagine it just really, 170 00:06:39,794 --> 00:06:41,414 shifts the way you're thinking about, 171 00:06:41,979 --> 00:06:44,079 coverage and funding and everything else. 172 00:06:45,019 --> 00:06:48,300 Absolutely. Absolutely. And and recognizing that the providers 173 00:06:48,300 --> 00:06:51,180 themselves, the hospitals, the physicians, you know, all 174 00:06:51,180 --> 00:06:52,000 of the ancillary 175 00:06:52,699 --> 00:06:55,180 providers, you know, are are really dealing with 176 00:06:55,180 --> 00:06:56,399 that reality of, 177 00:06:56,735 --> 00:06:57,875 you know, the 178 00:06:58,254 --> 00:07:01,615 the increase in in costs associated with the 179 00:07:01,615 --> 00:07:02,675 delivery of services 180 00:07:03,295 --> 00:07:05,134 and then trying to be able to match 181 00:07:05,134 --> 00:07:06,514 that, you know, with 182 00:07:06,975 --> 00:07:09,375 paying for those services, you know, as an 183 00:07:09,375 --> 00:07:09,875 insurance, 184 00:07:10,335 --> 00:07:11,955 organ you know, a payer organization. 185 00:07:13,590 --> 00:07:14,090 Absolutely. 186 00:07:14,790 --> 00:07:16,889 Definitely a huge, huge challenge, 187 00:07:17,670 --> 00:07:19,509 and something that I can imagine will continue 188 00:07:19,509 --> 00:07:21,590 to evolve in the next couple years. And 189 00:07:21,590 --> 00:07:22,970 speaking of the future, 190 00:07:23,270 --> 00:07:25,030 what are you most excited about, and what 191 00:07:25,030 --> 00:07:25,930 makes you nervous? 192 00:07:27,110 --> 00:07:27,610 Well, 193 00:07:28,384 --> 00:07:30,544 what I'm most excited about is, 194 00:07:31,584 --> 00:07:33,604 the opportunity that we have, 195 00:07:34,225 --> 00:07:35,604 as as a 196 00:07:36,225 --> 00:07:38,805 Medicaid, you know, managed care organization 197 00:07:39,584 --> 00:07:40,084 to 198 00:07:41,300 --> 00:07:44,579 really address the social factors that impact health 199 00:07:44,579 --> 00:07:46,519 in a in a more structured way. 200 00:07:47,139 --> 00:07:49,560 You know, as a as a a very 201 00:07:49,620 --> 00:07:51,399 community based and mission driven 202 00:07:51,939 --> 00:07:55,139 managed care organization, you know, for over 40 203 00:07:55,139 --> 00:07:55,639 years, 204 00:07:56,024 --> 00:07:57,725 we have been focusing 205 00:07:58,824 --> 00:08:00,524 on supporting our members 206 00:08:00,824 --> 00:08:04,584 and our communities in addressing those needs. So 207 00:08:04,584 --> 00:08:05,964 we're not new to 208 00:08:06,425 --> 00:08:09,084 helping people who need assistance with, 209 00:08:09,850 --> 00:08:13,310 with housing or housing related issues, people who 210 00:08:13,529 --> 00:08:16,750 are looking for education and and workforce 211 00:08:17,129 --> 00:08:21,289 development and employment opportunities, or people who simply 212 00:08:21,289 --> 00:08:24,485 have challenges in accessing healthy food for themselves 213 00:08:24,485 --> 00:08:27,464 and their families. So what is exciting is 214 00:08:28,004 --> 00:08:30,564 that states the the states with which we 215 00:08:30,564 --> 00:08:33,065 contract are now looking at 216 00:08:33,605 --> 00:08:34,105 incorporating, 217 00:08:34,565 --> 00:08:36,105 you know, those efforts 218 00:08:36,509 --> 00:08:38,850 and reimbursement for those efforts into, 219 00:08:39,230 --> 00:08:41,170 you know, state Medicaid programs, 220 00:08:41,710 --> 00:08:43,410 with the recognition for 221 00:08:43,950 --> 00:08:47,250 how collectively we can address those social factors 222 00:08:47,629 --> 00:08:49,090 and then have a corresponding 223 00:08:49,470 --> 00:08:52,654 impact on improved health and life outcomes for 224 00:08:52,654 --> 00:08:54,975 the people that we serve, which in theory 225 00:08:54,975 --> 00:08:56,894 then, you know, can put people on a 226 00:08:56,894 --> 00:08:57,714 path for 227 00:08:58,254 --> 00:09:01,294 not having to remain dependent on government programs. 228 00:09:01,294 --> 00:09:03,074 So, you know, we all recognize 229 00:09:03,839 --> 00:09:06,079 that by putting the resources in the right 230 00:09:06,079 --> 00:09:06,579 place, 231 00:09:06,879 --> 00:09:09,679 we can, you know, have an impact not 232 00:09:09,679 --> 00:09:12,000 only on the individuals we serve, but the 233 00:09:12,000 --> 00:09:14,639 future of these programs as a whole. So 234 00:09:14,639 --> 00:09:16,559 that to me is what's really exciting and 235 00:09:16,559 --> 00:09:17,779 being able to 236 00:09:18,345 --> 00:09:19,804 focus our collective 237 00:09:20,184 --> 00:09:20,684 resources 238 00:09:21,384 --> 00:09:24,125 on those programs. You know, we've worked with 239 00:09:24,424 --> 00:09:27,565 a number of different food based organizations 240 00:09:27,945 --> 00:09:29,164 in, Pennsylvania 241 00:09:29,865 --> 00:09:30,365 to 242 00:09:31,009 --> 00:09:33,190 address food insecurity and implement 243 00:09:33,649 --> 00:09:36,370 food as medicine programs in which people have 244 00:09:36,370 --> 00:09:37,190 access to 245 00:09:37,889 --> 00:09:38,950 medically tailored 246 00:09:39,409 --> 00:09:43,110 meals that can help prevent readmission for conditions 247 00:09:43,169 --> 00:09:45,990 related to diabetes or heart disease. 248 00:09:47,014 --> 00:09:48,235 We've worked with 249 00:09:49,014 --> 00:09:52,375 local health systems and nonprofit organizations, and we 250 00:09:52,375 --> 00:09:54,955 we implemented a program in 2021 251 00:09:55,654 --> 00:09:58,075 called housing smart that was aimed at reducing 252 00:09:58,535 --> 00:09:59,915 emergency room utilization 253 00:10:00,615 --> 00:10:01,115 by 254 00:10:01,679 --> 00:10:02,179 supporting 255 00:10:02,720 --> 00:10:05,679 stable housing and support services for people who 256 00:10:05,679 --> 00:10:06,899 are experiencing 257 00:10:07,600 --> 00:10:08,100 homelessness 258 00:10:08,879 --> 00:10:10,419 and also comorbid, 259 00:10:11,440 --> 00:10:12,580 mental health conditions. 260 00:10:13,040 --> 00:10:13,540 So 261 00:10:14,160 --> 00:10:15,059 these investments 262 00:10:16,424 --> 00:10:18,684 make a a very big difference in, 263 00:10:19,225 --> 00:10:21,485 you know, the overall health of our population, 264 00:10:22,585 --> 00:10:25,404 and and create that path forward for individuals. 265 00:10:26,504 --> 00:10:28,184 I also wanna say that one of the 266 00:10:28,184 --> 00:10:31,144 exciting things that we've been doing, is is 267 00:10:31,144 --> 00:10:32,159 working with 268 00:10:33,039 --> 00:10:34,500 what we're calling a pardon 269 00:10:34,959 --> 00:10:35,459 program 270 00:10:36,159 --> 00:10:39,919 where we have individuals who participate in our 271 00:10:39,919 --> 00:10:42,639 workforce development programs. And one of the things 272 00:10:42,639 --> 00:10:45,860 that we've we hear constantly is that people 273 00:10:46,000 --> 00:10:47,860 face the barrier of having 274 00:10:48,184 --> 00:10:50,904 a criminal background or a criminal record even 275 00:10:50,904 --> 00:10:51,725 after having 276 00:10:52,264 --> 00:10:54,664 served their, you know, their debt to society, 277 00:10:54,664 --> 00:10:57,144 so to speak. And the existence of that 278 00:10:57,144 --> 00:10:57,644 record 279 00:10:58,345 --> 00:11:01,084 precludes people from certain certifications 280 00:11:01,704 --> 00:11:02,445 and jobs, 281 00:11:03,600 --> 00:11:04,419 getting educational 282 00:11:04,879 --> 00:11:07,679 opportunities or getting loans or being a foster 283 00:11:07,679 --> 00:11:10,820 parent or coaching a child's sports program. 284 00:11:11,279 --> 00:11:12,339 So in Pennsylvania, 285 00:11:13,200 --> 00:11:14,500 our former governor, 286 00:11:15,360 --> 00:11:17,360 really worked over the last few years to 287 00:11:17,360 --> 00:11:17,860 transform 288 00:11:18,634 --> 00:11:20,095 the process by which, 289 00:11:20,794 --> 00:11:24,634 an individual can seek an application for pardon 290 00:11:24,634 --> 00:11:25,615 from the governor. 291 00:11:26,075 --> 00:11:27,054 And by 292 00:11:27,514 --> 00:11:29,534 streamlining and improving that process, 293 00:11:29,835 --> 00:11:31,914 we've seen a much higher success rate of 294 00:11:31,914 --> 00:11:34,095 people who have been applying for pardons, 295 00:11:34,529 --> 00:11:36,929 who are granted those pardons, who can then 296 00:11:36,929 --> 00:11:39,089 have their record expunged, who can then move 297 00:11:39,089 --> 00:11:41,490 forward with those opportunities that may have been 298 00:11:41,490 --> 00:11:43,490 out of reach for them because of the 299 00:11:43,490 --> 00:11:46,370 existence of that record. So our role is 300 00:11:46,370 --> 00:11:49,409 to ensure that everyone is aware of those 301 00:11:49,409 --> 00:11:49,909 programs, 302 00:11:50,475 --> 00:11:51,695 that people are, 303 00:11:52,235 --> 00:11:55,214 trained to coach individuals through the process, 304 00:11:56,154 --> 00:11:57,914 because you have to follow all the all 305 00:11:57,914 --> 00:11:59,695 the steps and and be eligible 306 00:12:00,235 --> 00:12:01,454 and tell your story 307 00:12:01,754 --> 00:12:03,754 in order to move forward with the process. 308 00:12:03,754 --> 00:12:06,139 And so the success of that has been 309 00:12:06,139 --> 00:12:08,539 really inspiring in terms of being able to 310 00:12:08,539 --> 00:12:12,240 connect people back into those workforce or educational 311 00:12:12,539 --> 00:12:13,039 opportunities. 312 00:12:14,620 --> 00:12:16,940 That's fascinating to hear. You know, and really, 313 00:12:17,419 --> 00:12:20,294 innovative to have that opportunity to connect with 314 00:12:20,294 --> 00:12:21,274 folks as you mentioned, 315 00:12:21,975 --> 00:12:23,975 and really, you know, bring up these programs, 316 00:12:23,975 --> 00:12:24,615 bring up the, 317 00:12:25,254 --> 00:12:27,335 available services to them so they can get 318 00:12:27,335 --> 00:12:28,475 their jobs. They can, 319 00:12:29,095 --> 00:12:30,955 have access to other opportunities, 320 00:12:31,335 --> 00:12:33,495 you know, and not have some things in 321 00:12:33,495 --> 00:12:35,429 their past stand in their way. So that's 322 00:12:35,429 --> 00:12:37,350 really fascinating to hear and a cool thing 323 00:12:37,350 --> 00:12:38,490 you're doing for the community. 324 00:12:39,190 --> 00:12:41,830 Yeah. Absolutely. And, again, you know, really looking 325 00:12:41,830 --> 00:12:43,029 at how we can, 326 00:12:43,429 --> 00:12:44,889 focus our efforts on 327 00:12:45,350 --> 00:12:47,769 the things that can be most success successful 328 00:12:47,909 --> 00:12:49,769 in in helping people to 329 00:12:50,205 --> 00:12:53,085 not only address health issues, but also those 330 00:12:53,085 --> 00:12:55,264 barriers that they face on a regular basis 331 00:12:55,325 --> 00:12:56,384 in in getting, 332 00:12:57,165 --> 00:13:00,465 connected with the supports they need for overall 333 00:13:00,764 --> 00:13:02,384 health and life outcomes. 334 00:13:05,490 --> 00:13:07,909 Absolutely. Fascinating and it's just amazing to hear. 335 00:13:07,970 --> 00:13:10,289 Now, before we wrap up our conversation, I 336 00:13:10,289 --> 00:13:12,129 was wondering what do you think the most 337 00:13:12,129 --> 00:13:13,970 effective health care leaders will need in order 338 00:13:13,970 --> 00:13:15,730 to be successful over the next 2 to 339 00:13:15,730 --> 00:13:17,269 3 years or so? What's 340 00:13:17,705 --> 00:13:19,465 top of mind for you especially as, you 341 00:13:19,465 --> 00:13:21,325 know, health care industry changes, 342 00:13:21,705 --> 00:13:24,184 communities change, and, you know, really the way, 343 00:13:24,504 --> 00:13:26,825 people think about and approach health care is 344 00:13:26,825 --> 00:13:27,884 rapidly evolving. 345 00:13:28,904 --> 00:13:31,500 Oh, absolutely. And, you know, I think that 346 00:13:31,740 --> 00:13:32,480 for me, 347 00:13:32,779 --> 00:13:35,580 especially someone that, that came up through, you 348 00:13:35,580 --> 00:13:36,799 know, to this opportunity, 349 00:13:37,179 --> 00:13:37,679 without, 350 00:13:38,460 --> 00:13:41,019 you know, a fundamental finance background. Right? 351 00:13:42,139 --> 00:13:44,700 The the biggest, you know, key area is 352 00:13:44,700 --> 00:13:46,000 gonna be, you know, 353 00:13:46,334 --> 00:13:48,914 being able to focus even more 354 00:13:49,454 --> 00:13:49,954 minutely 355 00:13:50,654 --> 00:13:52,975 on the financial aspects of our business. You 356 00:13:52,975 --> 00:13:55,054 know? As I said, we're facing, you know, 357 00:13:55,054 --> 00:13:55,875 we're facing 358 00:13:56,254 --> 00:13:58,434 challenges with, you know, 359 00:13:59,049 --> 00:14:01,769 state funding opportunities because we exist at the 360 00:14:01,769 --> 00:14:04,330 mercy of of state budgets and and states 361 00:14:04,330 --> 00:14:06,970 are challenged with those budgets and the funding 362 00:14:06,970 --> 00:14:08,429 that is available for 363 00:14:09,049 --> 00:14:11,309 managed care and and Medicaid programs. 364 00:14:11,715 --> 00:14:14,115 And then you couple that with the reality 365 00:14:14,115 --> 00:14:16,274 that we talked about in terms of rising 366 00:14:16,274 --> 00:14:18,995 costs and rising utilization and higher acuity of 367 00:14:18,995 --> 00:14:21,975 our membership. So really being able to 368 00:14:22,434 --> 00:14:22,934 focus 369 00:14:23,555 --> 00:14:26,295 in great detail on the specific 370 00:14:26,940 --> 00:14:27,440 drivers, 371 00:14:28,220 --> 00:14:31,179 that impact, you know, the the the financial 372 00:14:31,179 --> 00:14:33,919 aspects of the business. So related to, 373 00:14:34,540 --> 00:14:37,519 you know, where are we seeing increasing utilization 374 00:14:37,580 --> 00:14:40,160 trends? Where you know, what are the specific 375 00:14:40,379 --> 00:14:41,679 services or, 376 00:14:42,825 --> 00:14:43,485 you know, 377 00:14:44,345 --> 00:14:44,845 benefits 378 00:14:45,544 --> 00:14:46,044 that 379 00:14:46,664 --> 00:14:49,384 are driving those increases in the trends and 380 00:14:49,384 --> 00:14:51,865 then being able to take that information and 381 00:14:51,865 --> 00:14:52,845 develop programming 382 00:14:53,625 --> 00:14:54,345 that doesn't 383 00:14:55,429 --> 00:14:58,389 it's not successful because it's limiting benefits and 384 00:14:58,389 --> 00:15:01,610 services that are available, but in fact, targeting 385 00:15:01,750 --> 00:15:02,490 and implementing 386 00:15:03,110 --> 00:15:05,289 the types of programs that can then 387 00:15:05,990 --> 00:15:09,190 impact, you know, the the the health services 388 00:15:09,190 --> 00:15:10,629 that people utilize or, 389 00:15:11,485 --> 00:15:13,904 you know, the the care that they need. 390 00:15:14,684 --> 00:15:16,764 We can make, you know, the the better 391 00:15:16,764 --> 00:15:19,825 we do at making investments in providing 392 00:15:20,365 --> 00:15:21,184 really good, 393 00:15:22,044 --> 00:15:24,865 strong, and consistent prenatal care for our members, 394 00:15:25,325 --> 00:15:26,065 then that 395 00:15:26,429 --> 00:15:26,929 prevents, 396 00:15:27,470 --> 00:15:28,129 you know, 397 00:15:28,669 --> 00:15:30,909 premature births and having babies that have to 398 00:15:30,909 --> 00:15:31,409 be, 399 00:15:31,789 --> 00:15:34,269 in the NICU for, an extended period of 400 00:15:34,269 --> 00:15:35,809 time and who may then face 401 00:15:36,190 --> 00:15:39,710 lifelong physical health challenges as a result. So, 402 00:15:39,710 --> 00:15:41,169 you know, it's targeting 403 00:15:41,784 --> 00:15:44,764 the best places to create those interventions 404 00:15:45,544 --> 00:15:47,784 to be able to create you know, to, 405 00:15:49,225 --> 00:15:51,664 promote better outcomes on the end. So it 406 00:15:51,784 --> 00:15:54,745 it's really about slicing and dicing the data 407 00:15:54,745 --> 00:15:55,565 that's available, 408 00:15:56,539 --> 00:15:59,179 for our business and then using that data 409 00:15:59,179 --> 00:16:02,379 to target programs that can have the biggest 410 00:16:02,379 --> 00:16:04,000 impact for us. So, 411 00:16:04,940 --> 00:16:06,620 that's really, you know, if I had my 412 00:16:06,620 --> 00:16:09,259 crystal ball, it's really about, you know, being 413 00:16:09,259 --> 00:16:10,159 able to 414 00:16:10,495 --> 00:16:12,495 put all of those pieces together in a 415 00:16:12,495 --> 00:16:15,375 way that allows us to to do more 416 00:16:15,375 --> 00:16:18,095 and have greater impacts in light of the 417 00:16:18,095 --> 00:16:18,595 changing, 418 00:16:19,695 --> 00:16:21,795 health care financing and cost, 419 00:16:22,335 --> 00:16:22,835 environment. 420 00:16:24,289 --> 00:16:25,409 That's an amazing, 421 00:16:25,889 --> 00:16:27,570 thing to think about and and certainly, I 422 00:16:27,570 --> 00:16:29,730 can imagine easier said than done, but so 423 00:16:29,730 --> 00:16:30,470 so crucial, 424 00:16:31,250 --> 00:16:33,429 to understand the global picture, 425 00:16:34,210 --> 00:16:36,049 bird's eye view of what's happening in the 426 00:16:36,049 --> 00:16:38,309 industry and then be able to proactively 427 00:16:38,850 --> 00:16:39,225 take 428 00:16:40,105 --> 00:16:42,824 action, and and create those programs and initiatives 429 00:16:42,824 --> 00:16:45,625 that are going to most, impact the community 430 00:16:45,625 --> 00:16:46,684 and be most needed. 431 00:16:47,304 --> 00:16:48,745 You know, I I just think I I 432 00:16:48,745 --> 00:16:51,964 appreciate your example, especially thinking about the prenatal 433 00:16:52,105 --> 00:16:55,160 care in the babies and new families, being 434 00:16:55,160 --> 00:16:57,800 able to, serve them in an important way 435 00:16:57,800 --> 00:17:00,279 just gets things started off on the right 436 00:17:00,279 --> 00:17:02,360 side and then, going from there. So a 437 00:17:02,360 --> 00:17:04,599 crucial, crucial part of building community and and 438 00:17:04,599 --> 00:17:05,099 connections. 439 00:17:06,494 --> 00:17:06,994 Absolutely. 440 00:17:07,934 --> 00:17:09,615 Well, thank you so much, Joanne, for joining 441 00:17:09,615 --> 00:17:11,214 us on the podcast today. This has been 442 00:17:11,214 --> 00:17:13,134 such a fun conversation, and I look forward 443 00:17:13,134 --> 00:17:14,674 to connecting with you again soon. 444 00:17:15,328 --> 00:17:17,088 Absolutely. Same for me as well, and I 445 00:17:17,168 --> 00:17:19,808 I'm really grateful for the opportunity to to 446 00:17:19,808 --> 00:17:21,328 speak with you and to share this kind 447 00:17:21,328 --> 00:17:23,268 of information with your audience.