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Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast.
Thrilled today to be joined by the 1st
chief health equity officer at Blue Shield of
California Promise Health Plan, Valerie Martinez.
Valerie, thank you so much for taking the
time to be with me on the podcast
today.
Absolutely. I'm so grateful for the invitation to
be here.
So, Valerie, before we dive into everything we
wanna talk with you about, can you tell
us a little bit more about yourself, your
health care career background,
and what it is that you're doing today
at Blue Shield of California?
Certainly.
I am a native of Southern California. So
having grown up in Los Angeles County, I've
been afforded the opportunity to work in, I
would say, the clinical space. I worked at
federally qualified health centers and ambulatory care setting,
mostly in roles of risk management, quality improvement
at, the executive and director levels.
And then I during this time, I just
found my passion
for advocating for communities in need, and I
recognize the opportunity to move into managed care
where my reach and the scope and the
impact of the work that we do would
be recognized at a greater level. And so
I started in managed care about,
10 years ago, and I appreciate that I
can bring the experience having worked in the
clinical setting, bridging that now with the managed
care setting, and understanding what it's like for
provider practices for patients and some of the
challenges
or issues with access to care, let's say,
or to quality healthcare.
And so I love the opportunity
about being able to serve, in this position,
the Medi Cal population.
Absolutely.
And like we mentioned in the intro, to
our conversation today, Valerie, you're the 1st chief
health equity officer,
for one of the state's largest medical plans.
Can you share with us a little bit
about what the scope of your responsibilities
entail and ultimately why Blue Shield decided to
create this role?
Yes, certainly.
Starting first, I report to Blue Shield's Promise,
President and Chief Health Equity Officer, Kristin Cerf.
And I think that that is indicative of
the level of importance of this role and
recognizing how critical this role will be to
meeting and exceeding some of our goals when
it comes to ensuring that our members
have the best opportunities to be able to
reach their full potential.
That said, in my role, I'm responsible for
meeting all of the equity related regulatory requirements,
and this is a new focus for our
regulator in California.
And so I'm working to lead a lot
of cross functional work coordinating
across the organization
and even externally with our partners and some
of our practices and community based organizations
with whom we partner. And so my focus
is mostly on regulatory,
but we're also working to integrate health equity
internally across some functional areas and then working
on enhancing those relationships with our members, the
communities we serve, our providers,
to be able to truly listen,
hear from them, hear about some of their
perceived needs and challenges,
and be able to drive programming
that helps to bridge those gaps or those
inequities.
Absolutely. And I appreciate you, bringing up California's,
really strong focus on health equity right now
for its Medicaid program, and I I definitely
wanna dive into that a little bit more.
But, Valerie, before we do, I think it
would be helpful for our audience to ask
you,
what your view of health equity is. How
do you define that both personally, but also
from the lens of Blue Shield and the
really important population that you serve?
Yeah, I would define equity if we just
look at the the standard definition, right? It's
making sure that we're affording opportunities
so individuals can achieve their best optimal health.
And we recognize that everybody's best optimal health
varies per person. Right? Your your best health
state is gonna be very different from my
health state. So what can we do to
remove barriers
to improve access,
look at cultural concordance? Are folks
seeing a provider who's gonna best meet their
needs and listen and be able to support
them? And so
to me, that's the definition, right? Everybody is
achieving their best version of their health, and
as a health plan, we're working to remove
those barriers or help to improve or make
accommodations,
and create those custom,
plans, if you will, to be able to
help people get to that end state.
Absolutely. And what would you say are some
of the challenges you faced, Valerie, in terms
of removing some of those barriers to access
optimal health?
Well, when we look at access, right, we
recognize that there,
there in some areas are gaps,
to be able to have providers
just within time and distance standards. Right? There
there are not enough providers that exist, so
this can lend to,
maybe a longer wait than than we would
hope to see.
So just, you know, just looking at geographically,
time distance standards lends to, inequitable
access to care.
But when we look at even understanding our
populations and the needs of our communities, I
would say that data is a challenge.
Having that information at the ready,
to be able to identify
who is in need of what and when
so we can be able to provide that
support immediately to help bridge those gaps and
maybe not 30, 60, 90 days after we
after that point in time occurs. So looking
at the data, understanding our populations, I think,
is critical. It's gonna be critical to the
work that we're leading in equity to be
able to create those tailored interventions
for the populations who are in need. Right?
Looking at certain demographic variables, maybe it's certain
subpopulations
like members who speak Vietnamese. What are the
challenges that our Vietnamese speaking members are having,
and what can we do to help them
again to reach that equity goal that we
have. So for us, I think that data
is an opportunity to be able to enhance
the the data connections, health, equity
data, looking at disaggregation
of some of the demographic variables, or maybe
it's infrastructure
looking at connection with HIEs or health information
exchanges to be able to get information from
our partners and send information to our partners.
So again, we're able to be able to
help members at the time that they need
it. Right? It's all about providing the right
care at the right time.
Absolutely. So you're really digging into the data
to find out what your members need across
what is a very diverse state and population
that you serve. Any other specific innovations you
you'd mentioned, Valerie, in terms of what's taken
place over, let's say, the last year or
so,
at Blue Shield's Promise Health Plan?
Certainly. I would say we have a a
focus on serving our communities,
supporting our providers,
looking at our internal infrastructure and workforce,
and then also working with our members directly,
right, as we look at our quality outcomes.
So I can give you one example. When
we look at our community focus, we have
community resource centers down in Los Angeles County,
and this year marks the 5 years of
having launched those community resource centers. And with
these resource centers, we're able to bring support
services into
areas that are in vital need of support
or even it's activity engagement education.
So the CRCs, the Community Resource Centers, they
offer workshops, we have fitness classes, nutrition classes,
there's cooking classes.
We offer CPR certification
and first aid to our community members.
We even bring in health screenings or assistance
with social services and helping people fill out
any applications
if there's a linguistic barrier or, a literacy
barrier as well.
And so, we have, by the end of
the year, we will have 14 community resource
centers, and they're just they're amazing,
offerings that we're able to bring the community.
And we are seeing some some value with
that. Right? Members are feeling better connected
to to Blue Shield. They're getting the vital
education, vital support services that without these community
resource centers, they would not be able to
have the support within the community.
And speaking of the the community work and
outreach that Blue Shield does, Valerie, can you
tell us a little bit more about the
company's mobile mammography clinics? We've heard about that,
from your leadership in the past. We would
love, your perspective on this and any updates
on those clinics to date.
Certainly.
And first, let's just talk about that from
an equity perspective. Blue Shield using the data.
Right? We identified that there were areas who
were in need of mammograms
where as we talked about the top of
the call,
with the access issues. Right? Just not having
enough providers in certain areas. So we use
that data to identify where we can bring
mobile mammography on the road and bring it
to the very streets and communities that we
serve who are in most need. And so
we offered mobile mammogram vans, and then there
were the units that are taken to locations.
This was in Los Angeles County and also
at some of our community resource centers. We
went to shopping centers and some of our
neighborhood clinics as well, or
federally qualified health centers. And so each week
before the event, we would identify members who
were due for their mammogram screening, and then
we would help to coordinate an appointment, and
then we even offer transportation to bring them
in when these on-site mammogram
services would be available. And then we also
stressed that the screenings were offered at no
cost to our members. And what we found
is that we we hosted 72 mobile clinics,
and we were able to provide over 1300
mammograms
to members who would previously have very little
access or have challenge to being able to
complete those screenings.
Wow. I mean, some great numbers you just
shared. 1300 members that access to service they
may not have been able to before. Really
great example. So I I appreciate you sharing
that with us, Valerie.
Before we go, I I earlier, you had
briefly touched on, California's work with its Medicaid
program to try and make it a more
equitable
program across the state. Can you give a
brief overview to our listeners who might not
be familiar with the transformation that the state
has has been undergoing,
recently, and why it's so important for a
role like yours to exist within one of
the largest managed care plans?
Yeah. The the state, our regulators, the Department
of Health Care Services, and they've incorporated into
their mission and vision the need to integrate
equity. Right? Quality and equity are are they
go hand in hand, right? We cannot have
quality
without equity, and that's critical
to understand, and we're so grateful that our
regulator acknowledges that and is now holding managed
care plans accountable for equity essentially.
And so what the regulator has done is
created on our boilerplate contract. There is an
entire section now for equity goals that we
must achieve. One of those is managed care
health plans actually must have NCQA
health equity accreditation
by the end of 2025.
So we're moving from this is a nice
to do, really great, we applaud you for
doing equity. We're now moving from that philanthropic
perspective
into this is required and you must do
this. And so I think that's a shift
as we look at the regulatory landscape,
recognizing now that we must do equity
to be able to drive our quality scores,
to be able to increase member satisfaction,
or looking at some of our health outcomes
and acknowledging that we must have health equity
and this equity focus on our work, right?
Driving program planning, looking at the data and
being able to understand the needs of our
populations
to drive towards some of those better or
optimal health outcomes. And so the state has
recognized this and now it's a it's a
requirement in California. And then also that mandated
role, the chief health equity officer role is
now mandated where we are required to have
somebody at the helm who is leading this
equity program.
Wow. Well, it's exciting changes and clearly a
lot of important work for you and your
team, in the year ahead. So we we
look forward to hearing more about it. But
before we go, Valerie, you have the ears
of a lot of other health plan leaders
from around the country.
Any other final words or or bits of
advice you'd like to offer,
to them?
One bit of advice I would say is
organizations are looking to begin to integrate equity
or begin to apply
whether it's this role or that equity lens
into the work that we do, is recognizing
that this is a huge undertaking, right? We're
up against systemic racism and implicit bias that
exists And so some organizations
are ready to do this work and some
are in, I would say the pre contemplation
phase, right, where we're thinking about how do
we structure this work and make it a
critical component to what we do. And so
it's just, I think important, I would acknowledge
how important this work is, but how significant
in terms of the administrative lift it is
to get this going.
And so I would applaud any organization that
is choosing to center equity into their operations,
into their program planning, into their strategic plans.
And there are tools available,
for organizations that are beginning to do this
work and just recognizing that this will, this
is a journey. This is not a one,
I often say it's not, we don't want
this to fizzle out. Right? It's not a
1, 3, 5 year hot topic that's gonna
fizzle out. This is a journey now, and
so we're all on board to be able
to support
this this new idea of integrating HealthEquity into
the day to day operations of health systems,
health plans, even hospitals. This is kind of
the the new charter where we're headed and
I would suspect that we're gonna see other
regulators across the state getting on board with
those health equity mandates as we've seen in
California.
Fantastic. Well, Valerie, thank you so much for
taking the time to be with us and
for sharing your insights with our listeners. We
really appreciate it.
Thank you. Thank you, Jacob, for having me
today.
Absolutely. And to our listeners, if you'd like
to listen to more podcasts from Becker's Healthcare,
you can visit beckershospitalreview.com.