Evernorth brings the power of wonder and relentless
innovation to create world class pharmacy care and
benefit solutions. Our connected health services make the
treatment, prediction, and prevention of health care's most
complex conditions
easier and more accessible as we drive organizations
and people forward. Ever North Home Based Care
provides value based care that helps patients with
multiple chronic conditions
and social determinant of health barriers get the
care they need and the personalized experience they
deserve. We serve patients who struggle to navigate
the health care system by bringing high quality
primary
and preventative care services to the home. By
providing clinical care and support services that provide
whole person care, we improve health equity, access,
and outcomes for the populations we serve.
Hello, and welcome to the Becker's Healthcare podcast.
My name is Chanel Bunger. And right now,
I'm thrilled to be joined by doctor Yvette
Lefebvre,
the chief medical officer, home based care, Ever
North Health Services.
Thank you so much for joining me today.
Thank you. Thanks for having me. Perfect. Well,
to get us started, could you please tell
us a little bit about your background? Sure.
So I'm an emergency medicine physician by background.
And as you said, I'm I'm currently the
chief medical officer for home based care at
EverNorth.
And so kind of an interesting,
I'd say circuitous route to get here. Started
off my career in emergency medicine and have
now transitioned into home based care. And it's
kind of a a great full circle experience,
if you will, because I feel like now
so at EverNorth home based care, we provide
in home care in a few different programs.
We have an in home primary care program.
We have a health risk solutions program, and
we have a post acute care and transitions
of care program. And so if I think
back to my days in the emergency room
where I
struggled with giving the time and attention to
patients with a lot of chronic conditions who
would come into the emergency room for care,
usually in the middle of the night when
there was a lot going on because they
weren't getting the primary care that they needed,
That was a stressful time for me. And
so now I feel like working at EverNorth
home based care, I'm actually starting to
address the root causes of the problems that
those patients were having. And so it's it's
a great program and happy to talk more
about that offline at some time. Perfect. And
speaking of problems,
from a clinical perspective,
how would you describe the biggest barriers to
effectively serving and engaging members? And what opportunities
do you have for large scale improvements?
And how are you applying this in your
current strategies?
That's a lot, and probably more than we
can cover in a 15 minute podcast. But
so high level, I think some of the
biggest challenges that we're facing together when we're
looking at health care across the country right
now, we're looking at an aging population. The
population reference bureau is telling us that by
the year 2050, we're going to have
85,000,000
people who are aged 65 or over. That's
a 47%
increase over what we saw in 2022. Wow.
Yeah. So that's a lot of aging patients
that we need to be prepared to take
care of.
And then coupled with that, we're actually seeing
a sicker younger generation, if you will. So
when you look at patients who are under
45,
we're seeing
an increase in obesity. We're seeing an increase
in cancers. We're seeing an increased risk of
death from heart failure, and that's patients under
45.
So we've got sicker patients, and we've got
patients who are aging.
So we've got a lot of challenges in
how we're going to deliver the care that
those patients need.
And then coupled with that, there's 2 other
things that I think it's worth addressing or
trying to address. We're not gonna fix it
again in 15 minutes, but we need to
acknowledge that there's been an erosion of trust
of the health care system.
I think it's been happening gradually over time,
but I think over the last 5 to
10 years, we've really seen a lot of
erosion of trust in the traditional health care
relationships
with our patients.
And then last but not least, I would
call out the fact that we've got a
a provider shortage in our country, and that's
only going to get worse. First of all,
providers are not immune to aging. Right? So
we're gonna see more and more providers getting
ready to retire in the coming years. And
we've also got providers who are burning out.
Right? Probably as a result of all those
other challenges that we've been facing.
So those are what I would highlight as
kind of my my hit list, my top
five challenges.
And then as far as opportunities and how
we're addressing that from home based care, I
would say,
flip those on their head. Right? So if
we look at those challenges as as opportunities,
at Evernorth home based care, we're doubling down
on population health. And so if you think
about population health as the health outcomes for
a group of individuals,
including the spectrum of
outcomes for those patients across the group. Okay?
By identifying the patients who are at highest
risk or rising risk, like the ones I
just outlined. Right? The patients who are aging,
the patients who are younger and sicker,
patients who are disenfranchised for one reason or
another from the health care system, patients who
don't have access to providers because they're leaving
health care,
standing up population health. First of all, identifying
where they are, who they are, and having
the data to show us where we need
to focus our efforts,
and then working to stand up programs to
help specifically
assist those patient populations.
That's how we're starting to tackle some of
those challenges,
and I think it's a great opportunity for
us to meet those patients where they are
and to start addressing kind of the challenges
that they're facing.
Got it. Thank you so much for walking
us through that. Now kind of switching gears
here. In an ever evolving regulatory environment, what
tools or key strategies have helped your organization
improve quality
and clinical outcomes for members while staying compliant?
Yeah. So, that's another big one to tackle
in few minutes. But,
at Evernorth, I would say actually that home
based care is a live living, breathing example
of one way that that larger
organizations are starting to address that challenge.
By leaning into care delivery, and that's what
home based care is, we are we are
actually providing care to these patients. We're sending
our in home primary care providers and our
nurses and our social workers into the home
to take care of patients, to touch them,
and to help them through their care journey.
That's a great way that a lot of
larger organizations
are really
leaning in to drive quality outcomes
for their membership as a whole.
I would also say that for our health
plan clients,
taking advantage of the of the drive towards
value based care is is a great opportunity.
And, actually, it's a great opportunity for both
providers and the health plan clients. Right? Because
the health plan clients have the opportunity
to support providers in those value based care
arrangements.
The value based care arrangements enable these providers
to provide the care that they always wanna
deliver in order to drive great outcomes. And
so I think, obviously, we've been talking about
value based care for, what, at least a
decade? Probably more now. And so
it's definitely going to happen. We're definitely going
in that direction. And then so I see
that as another great opportunity for organizations
to drive quality outcomes
even though we're seeing more and more regulation
around
how health plans can interact with providers and
with patients.
That makes sense. Absolutely. And you spoke on
a panel focused on fostering health equity.
How do you define what health equity truly
means in practice?
And how would how should health plans redefine
strategies to ensure
equitable outcomes across diverse patient populations?
That's another good one. So if we think
about health equity as a state in which
everyone has a fair and just opportunity to
be as healthy as possible,
And then we recognize
that
equity and equality are 2 different things. Right?
So health care
equality
is,
unfortunately, what we've seen in the past in
this country, right, where we build a care
model, we build a health care system delivery,
and we try to spread it peanut butter
across the country.
And then we wonder why wait. These patients
are doing well with that, but these patients
aren't. Right?
Equity says, you know what? We need to
look at those patients who aren't doing as
well and figure out what additional resources, what
different care models they need because they're starting
from an uneven starting point. Right? They're it's
not even playing ground, so to speak. So
they're starting from a different place. And so
there are populations who need different programs. There
are populations who need additional resources in order
to attain the same outcomes. Right? So we
can't just say, here's how we treat CHF
across the country. We need to figure out
what each population needs. Equity, not equality. Exactly.
Exactly.
And so how do we do that and
how do health plans do that? I would
I would come back to where I started,
which is with population health. Right? So coming
back to the idea that population health is
looking at the outcomes of a group of
patients,
but also looking at the individuals across that
continuum to see how they're responding to programs.
Another way to think about population health is
how do we treat individuals at scale?
And so
population health, I started earlier saying that we
need data. Right? So we can identify the
populations who need different programs that need additional
resources to obtain health care equity.
But I would also submit that once we
have that data, we also need to spend
time with the individuals. And we need to
spend time with the caregivers, and we need
to spend time in the communities because I
can't
I shouldn't. Sitting in my office, look at
data and say, okay. Here's a population that
needs a a different program. I'm gonna design
it in my program and and send it
in my office and send it out to
be, you know, implemented. Right? We need to
spend time with those communities
so that we can hear from them what
they need. Because I don't know what they
need. They know what they need. So so
getting back to the root of where health
care started. Right? Spending time with our patients,
hearing from them, hearing from what they need,
and then taking that back and saying, okay.
This is how now we can operationalize that
at scale.
I think that's how we're going to start
to really address health equity
within our care models, and then that can
spread right across the country as far as
our health care system goes. Got it. Got
it. Well, Yvette, I wanna thank you for
sharing your insights today on the Becker's healthcare
podcast. And to our listeners, thank you for
joining us, and please be sure to check
out other Becker's podcast. Have a wonderful rest
of your day. Thanks so much for having
me.