1 00:00:00,160 --> 00:00:02,899 Evernorth brings the power of wonder and relentless 2 00:00:02,960 --> 00:00:05,919 innovation to create world class pharmacy care and 3 00:00:05,919 --> 00:00:09,199 benefit solutions. Our connected health services make the 4 00:00:09,199 --> 00:00:12,080 treatment, prediction, and prevention of health care's most 5 00:00:12,080 --> 00:00:13,059 complex conditions 6 00:00:13,605 --> 00:00:16,344 easier and more accessible as we drive organizations 7 00:00:16,725 --> 00:00:19,524 and people forward. Ever North Home Based Care 8 00:00:19,524 --> 00:00:22,004 provides value based care that helps patients with 9 00:00:22,004 --> 00:00:23,384 multiple chronic conditions 10 00:00:23,844 --> 00:00:26,085 and social determinant of health barriers get the 11 00:00:26,085 --> 00:00:28,804 care they need and the personalized experience they 12 00:00:28,804 --> 00:00:31,660 deserve. We serve patients who struggle to navigate 13 00:00:31,660 --> 00:00:34,060 the health care system by bringing high quality 14 00:00:34,060 --> 00:00:34,560 primary 15 00:00:35,020 --> 00:00:37,739 and preventative care services to the home. By 16 00:00:37,739 --> 00:00:40,619 providing clinical care and support services that provide 17 00:00:40,619 --> 00:00:44,105 whole person care, we improve health equity, access, 18 00:00:44,105 --> 00:00:46,605 and outcomes for the populations we serve. 19 00:00:47,065 --> 00:00:49,465 Hello, everyone, and welcome to the Becker's Health 20 00:00:49,465 --> 00:00:51,865 Care podcast. We're thrilled today to be joined 21 00:00:51,865 --> 00:00:54,265 by John Young, chief strategy and development officer 22 00:00:54,265 --> 00:00:57,070 at Evernorth Health Services Home Based Care. John, 23 00:00:57,070 --> 00:00:58,850 thank you so much for joining us today. 24 00:00:59,229 --> 00:01:00,850 Yeah. Thank you. It's great to be here. 25 00:01:01,149 --> 00:01:02,850 So let's jump into today's conversation. 26 00:01:03,549 --> 00:01:04,750 Can you please tell us a little bit 27 00:01:04,750 --> 00:01:06,290 about yourself and your background? 28 00:01:07,150 --> 00:01:10,209 Yeah. So I'm with Evernorth Home Based Care, 29 00:01:10,604 --> 00:01:13,564 and we are, in home primary care group 30 00:01:13,564 --> 00:01:16,204 that does value based care work for health 31 00:01:16,204 --> 00:01:18,144 plans focusing mainly on their, 32 00:01:18,844 --> 00:01:21,424 critical and chronic care, patients 33 00:01:22,204 --> 00:01:24,590 that need more attention in the home, need 34 00:01:24,590 --> 00:01:26,689 clinical care and services in the home. 35 00:01:27,149 --> 00:01:28,750 And so I've been in health care for 36 00:01:28,750 --> 00:01:31,390 30 plus years now, and always have had 37 00:01:31,390 --> 00:01:33,229 a passion for looking at how might we 38 00:01:33,229 --> 00:01:35,890 deliver better care and better solutions 39 00:01:36,435 --> 00:01:38,114 to solve the big challenges that we have 40 00:01:38,114 --> 00:01:39,954 in health care. One of them is the 41 00:01:39,954 --> 00:01:41,734 rising chronic condition patients, 42 00:01:42,354 --> 00:01:43,875 and on top of that is just the 43 00:01:43,875 --> 00:01:45,254 escalating cost of care. 44 00:01:45,795 --> 00:01:47,555 Can you speak a little bit more about 45 00:01:47,555 --> 00:01:49,635 the mission of Evernorth home based care, and 46 00:01:49,635 --> 00:01:51,234 why is this mission important to both you 47 00:01:51,234 --> 00:01:53,310 and your team? Yeah. So for me, it 48 00:01:53,310 --> 00:01:54,209 goes way back. 49 00:01:54,510 --> 00:01:56,770 You know, primary care is essential 50 00:01:57,950 --> 00:02:00,430 to our health care system, and I think 51 00:02:00,430 --> 00:02:01,329 really powerful 52 00:02:01,630 --> 00:02:04,030 option for us to continue to double down 53 00:02:04,030 --> 00:02:04,530 on 54 00:02:04,974 --> 00:02:07,454 in order to decrease the the cost of 55 00:02:07,454 --> 00:02:09,794 care, but also improve the outcomes. Because 56 00:02:10,094 --> 00:02:12,354 a lot of the focus of our practice 57 00:02:13,134 --> 00:02:15,614 is taking a brick and mortar primary care 58 00:02:15,614 --> 00:02:16,114 group 59 00:02:16,414 --> 00:02:19,219 and truly bringing that into the home such 60 00:02:19,219 --> 00:02:21,620 that we can deliver as many visits, as 61 00:02:21,620 --> 00:02:22,439 many services, 62 00:02:23,299 --> 00:02:25,860 and as much care and other support that 63 00:02:25,860 --> 00:02:27,239 that individual needs 64 00:02:27,539 --> 00:02:29,699 so that they're not going to the urgent 65 00:02:29,699 --> 00:02:32,655 care or going to the emergency room or 66 00:02:32,655 --> 00:02:34,835 going up into the acute care 67 00:02:35,215 --> 00:02:37,694 because they're not getting primary care. And a 68 00:02:37,694 --> 00:02:39,794 lot of the members just have many issues, 69 00:02:40,175 --> 00:02:42,354 social determinants that they're dealing with. 70 00:02:42,814 --> 00:02:43,875 They also have, 71 00:02:44,415 --> 00:02:45,875 you know, other challenges, 72 00:02:46,254 --> 00:02:46,754 transportation, 73 00:02:48,280 --> 00:02:48,780 medications. 74 00:02:49,080 --> 00:02:51,080 Many of them are on 20 plus medications. 75 00:02:51,080 --> 00:02:52,919 They don't know how to balance that. So 76 00:02:52,919 --> 00:02:55,080 being in their home and helping in their 77 00:02:55,080 --> 00:02:55,979 home is important. 78 00:02:56,439 --> 00:02:58,120 For me, it goes way back. My dad 79 00:02:58,120 --> 00:02:59,020 was a pediatrician. 80 00:02:59,814 --> 00:03:01,735 Growing up in the seventies, I remember him 81 00:03:01,735 --> 00:03:02,875 doing house calls. 82 00:03:03,254 --> 00:03:05,435 And the way that he created trust 83 00:03:05,895 --> 00:03:07,574 and the way that he was able to 84 00:03:07,574 --> 00:03:10,534 individually serve each of his patients and our 85 00:03:10,534 --> 00:03:12,694 neighbors really resonated with me, and I think 86 00:03:12,694 --> 00:03:14,455 it's one of the biggest solutions that we 87 00:03:14,455 --> 00:03:16,439 have to to really double down on to 88 00:03:16,439 --> 00:03:18,840 improve health care. Right. Right. Yeah. Exactly. That 89 00:03:18,840 --> 00:03:21,080 that trust is really key there. So what 90 00:03:21,080 --> 00:03:22,919 what are some of the industry barriers and 91 00:03:22,919 --> 00:03:25,500 opportunities that your team is currently focused on? 92 00:03:26,040 --> 00:03:27,260 Yeah. I I think 93 00:03:27,724 --> 00:03:30,685 one is really just the the continued rise 94 00:03:30,685 --> 00:03:33,164 and complexity of the the patients and their 95 00:03:33,164 --> 00:03:33,664 needs. 96 00:03:34,125 --> 00:03:35,724 I think how do you how do you 97 00:03:35,724 --> 00:03:37,025 build the right 98 00:03:37,485 --> 00:03:39,905 care plan and clinical team 99 00:03:40,330 --> 00:03:42,750 that truly can impact in a meaningful way 100 00:03:43,209 --> 00:03:45,610 the the individuals that we serve. So just 101 00:03:45,610 --> 00:03:47,930 getting a handle of everything that's going on. 102 00:03:47,930 --> 00:03:50,669 How many chronic conditions can one person have? 103 00:03:50,810 --> 00:03:53,209 They can have 5, 6 plus. You know? 104 00:03:53,209 --> 00:03:54,889 And so how do you build that right 105 00:03:54,889 --> 00:03:55,389 team, 106 00:03:55,735 --> 00:03:57,574 ensure that the patient who can't get out 107 00:03:57,574 --> 00:03:59,894 of their home or struggles to get to 108 00:03:59,894 --> 00:04:02,134 any level of care, we can bring that 109 00:04:02,134 --> 00:04:03,675 into the door. So that's 1. 110 00:04:04,055 --> 00:04:06,555 2, really building the trust with the individuals 111 00:04:06,614 --> 00:04:08,474 and the caregivers of those individuals 112 00:04:09,219 --> 00:04:11,000 such that they let us into their home. 113 00:04:11,300 --> 00:04:12,759 It's it's really critical. 114 00:04:13,300 --> 00:04:15,319 You can't do this virtually. You can't 115 00:04:16,019 --> 00:04:17,860 see everything that's going on in the home. 116 00:04:17,860 --> 00:04:20,419 You can't build a relationship with the folks 117 00:04:20,419 --> 00:04:22,019 that really know what's going on with the 118 00:04:22,019 --> 00:04:23,399 individuals, their caregivers, 119 00:04:23,935 --> 00:04:25,454 And so you have to build that trust. 120 00:04:25,454 --> 00:04:27,314 So we spend a lot of time focusing 121 00:04:27,375 --> 00:04:30,654 on, you know, gaining that trust, getting our 122 00:04:30,654 --> 00:04:32,975 teams into the home, and then building that 123 00:04:32,975 --> 00:04:35,535 relationship with them. You know, the third thing 124 00:04:35,535 --> 00:04:38,095 is, obviously, we we face, like everybody else, 125 00:04:38,095 --> 00:04:41,229 just supply chain issues with clinic clinical teams. 126 00:04:41,689 --> 00:04:43,449 And so, you know, we have the rising 127 00:04:43,449 --> 00:04:45,849 chronic conditions, building the trust so that we 128 00:04:45,849 --> 00:04:46,990 can truly become 129 00:04:47,449 --> 00:04:49,370 a partner in their home for their clinical 130 00:04:49,370 --> 00:04:52,504 care, and then ensuring and protecting our clinicians 131 00:04:52,504 --> 00:04:53,944 so they can practice at the top of 132 00:04:53,944 --> 00:04:54,444 their 133 00:04:54,824 --> 00:04:56,504 license. It sounds like there's a lot going 134 00:04:56,504 --> 00:04:57,964 on in your space right now. 135 00:04:58,264 --> 00:04:58,584 And, 136 00:04:59,145 --> 00:05:01,064 with your years of experience, what are some 137 00:05:01,064 --> 00:05:03,225 of the biggest pieces of advice you'd have 138 00:05:03,225 --> 00:05:03,725 for, 139 00:05:04,129 --> 00:05:06,389 your peers in the health care industry? Yeah. 140 00:05:06,529 --> 00:05:07,829 I think, you know, 141 00:05:08,209 --> 00:05:10,930 having been around the block for 30 years 142 00:05:10,930 --> 00:05:13,430 and really focusing on how do we transform 143 00:05:13,730 --> 00:05:15,329 our health system, how do we make it 144 00:05:15,329 --> 00:05:16,069 more efficient, 145 00:05:16,584 --> 00:05:18,444 effective, how do we get it to deliver 146 00:05:19,225 --> 00:05:19,884 better outcomes, 147 00:05:20,504 --> 00:05:22,824 mainly don't give up. We we will solve 148 00:05:22,824 --> 00:05:25,064 this at some point, I hope. And I 149 00:05:25,064 --> 00:05:26,345 hope we do it, you know, and I 150 00:05:26,345 --> 00:05:28,504 hope the the angle that we're taking with 151 00:05:28,504 --> 00:05:29,485 home based care 152 00:05:29,865 --> 00:05:30,524 and true, 153 00:05:30,829 --> 00:05:33,709 you know, MDs and MPs and pharmacists and 154 00:05:33,709 --> 00:05:36,449 RNs getting into the home and delivering care 155 00:05:36,670 --> 00:05:38,589 is one of the answers that's gonna help 156 00:05:38,589 --> 00:05:40,449 us maybe truly bend 157 00:05:40,990 --> 00:05:44,189 the cost curve, increase outcomes, and and bring 158 00:05:44,189 --> 00:05:46,064 value based care. So don't give up. 159 00:05:46,785 --> 00:05:48,625 I think the other thing is really think 160 00:05:48,625 --> 00:05:50,644 creatively. You know? The brick and mortar, 161 00:05:51,665 --> 00:05:52,805 the fee for service, 162 00:05:53,584 --> 00:05:56,545 the other challenges that we faced. I I 163 00:05:56,545 --> 00:05:58,865 mean, truly, they haven't changed for 30 years 164 00:05:58,865 --> 00:06:01,345 even though the big promises that CMS has 165 00:06:01,345 --> 00:06:01,845 made, 166 00:06:02,160 --> 00:06:04,319 the big initiatives that many of the payers 167 00:06:04,319 --> 00:06:04,819 have 168 00:06:05,199 --> 00:06:06,100 put forward, 169 00:06:06,720 --> 00:06:09,840 are are are slowly changing the dynamics of 170 00:06:09,840 --> 00:06:11,759 our health care system. But I think we 171 00:06:11,759 --> 00:06:13,520 really have to think a bit radical and 172 00:06:13,520 --> 00:06:16,464 think differently and and not be bound by 173 00:06:16,464 --> 00:06:18,384 the the biases that have held us, you 174 00:06:18,384 --> 00:06:21,345 know, kind of, you know, stuck for so 175 00:06:21,345 --> 00:06:21,845 long. 176 00:06:22,785 --> 00:06:25,365 So how does Evernorth home based care differentiate 177 00:06:25,504 --> 00:06:27,824 itself from other home based care providers in 178 00:06:27,824 --> 00:06:28,404 the industry? 179 00:06:28,819 --> 00:06:30,180 And, what what would you say are some 180 00:06:30,180 --> 00:06:32,339 unique advantages that you bring to your patients 181 00:06:32,339 --> 00:06:33,479 and health care partners? 182 00:06:33,860 --> 00:06:34,919 Yeah. I think, first, 183 00:06:35,300 --> 00:06:38,019 just being able to go into a true 184 00:06:38,019 --> 00:06:38,519 full, 185 00:06:38,899 --> 00:06:40,919 capitated global risk model 186 00:06:41,459 --> 00:06:43,639 is a a a really big advantage. 187 00:06:44,165 --> 00:06:45,625 We are truly putting, 188 00:06:46,404 --> 00:06:48,485 our money where our mouth is, you know, 189 00:06:48,485 --> 00:06:49,144 to say. 190 00:06:49,444 --> 00:06:51,785 And we we believe that 191 00:06:52,564 --> 00:06:53,064 providers 192 00:06:53,524 --> 00:06:55,144 and our clinical team 193 00:06:55,524 --> 00:06:57,605 should be allowed to make their decisions and 194 00:06:57,605 --> 00:07:00,569 not be bound by the OMI billing the 195 00:07:00,569 --> 00:07:01,709 right code, OMI, 196 00:07:02,089 --> 00:07:03,850 you know, billing something that I'm gonna get 197 00:07:03,850 --> 00:07:06,009 reimbursed for. So I think that's one of 198 00:07:06,009 --> 00:07:08,269 our our big advantages. I think to, 199 00:07:08,970 --> 00:07:10,509 being a part of Evernorth 200 00:07:11,209 --> 00:07:13,845 and the full suite of solutions that exist 201 00:07:14,165 --> 00:07:15,625 from the the benefits 202 00:07:16,245 --> 00:07:16,745 management's 203 00:07:17,045 --> 00:07:18,824 aspects in pharmacy and medical 204 00:07:19,444 --> 00:07:20,884 to all of the things that we do 205 00:07:20,884 --> 00:07:22,725 on our side of the house and the 206 00:07:22,725 --> 00:07:23,464 air delivery 207 00:07:24,084 --> 00:07:25,384 and pharmacy side. 208 00:07:26,004 --> 00:07:28,745 We're able to leverage the knowledge, for 1, 209 00:07:29,339 --> 00:07:31,740 the resources and support that give us a 210 00:07:31,740 --> 00:07:33,520 no another layer of clinical 211 00:07:34,620 --> 00:07:36,860 competencies and teams and skills that we can 212 00:07:36,860 --> 00:07:38,480 surround that patient by, 213 00:07:39,020 --> 00:07:40,860 as well as, you know, doing some of 214 00:07:40,860 --> 00:07:42,080 the virtual 247 215 00:07:42,914 --> 00:07:44,754 If it's critical and we need to get 216 00:07:44,754 --> 00:07:46,774 in touch or get someone to that home, 217 00:07:46,914 --> 00:07:48,914 we're able to do that. So, you know, 218 00:07:48,914 --> 00:07:50,514 a lot of those things are are really 219 00:07:50,514 --> 00:07:52,694 important. The other big thing is, 220 00:07:53,074 --> 00:07:55,974 you know, truly getting into the home, 221 00:07:56,319 --> 00:07:59,139 being a trusted part of the family caregiver 222 00:07:59,279 --> 00:07:59,779 team, 223 00:08:00,240 --> 00:08:02,800 and seeing all of the social determinants of 224 00:08:02,800 --> 00:08:05,360 health, and then building a care plan that's 225 00:08:05,360 --> 00:08:06,899 unique to each individual 226 00:08:07,600 --> 00:08:08,899 based on their conditions, 227 00:08:09,564 --> 00:08:11,745 based on their social determinants, 228 00:08:12,285 --> 00:08:14,925 based on their caregiver and other support, and 229 00:08:14,925 --> 00:08:17,745 becoming kind of that Sherpa of their ecosystem 230 00:08:17,884 --> 00:08:18,785 for their health. 231 00:08:19,324 --> 00:08:20,685 John, I wanna thank you again for joining 232 00:08:20,685 --> 00:08:22,680 us today on the Becker's Healthcare podcast. But 233 00:08:22,680 --> 00:08:23,639 before I let you go, do you have 234 00:08:23,639 --> 00:08:24,920 any final thoughts you'd like to leave with 235 00:08:24,920 --> 00:08:27,400 our listeners? Yeah. I think this is just 236 00:08:27,400 --> 00:08:30,040 an exciting time for health care, and it's 237 00:08:30,040 --> 00:08:32,040 an exciting time for leaders in health care 238 00:08:32,040 --> 00:08:33,100 to really rethink 239 00:08:33,720 --> 00:08:35,259 where should the clinical 240 00:08:35,799 --> 00:08:37,019 models be delivered, 241 00:08:37,495 --> 00:08:38,875 how is care shifting 242 00:08:39,175 --> 00:08:41,894 and getting into the home, and how am 243 00:08:41,894 --> 00:08:44,615 I as a a leader going to respond 244 00:08:44,615 --> 00:08:47,115 to that and become a champion of it 245 00:08:47,254 --> 00:08:49,254 versus protecting kind of the biases of the 246 00:08:49,254 --> 00:08:51,335 past. And I I just applaud everybody who's 247 00:08:51,335 --> 00:08:54,089 doing it, and, the energy's there. So let's 248 00:08:54,089 --> 00:08:56,169 get on it. Awesome. I really appreciate those 249 00:08:56,169 --> 00:08:56,990 insights today. 250 00:08:57,370 --> 00:08:59,470 John, thank you again for joining us today. 251 00:08:59,610 --> 00:09:01,129 To our listeners, thank you for joining us, 252 00:09:01,129 --> 00:09:02,490 and be sure to check out other Becker's 253 00:09:02,490 --> 00:09:04,490 Healthcare podcast. Thank you, and have a wonderful 254 00:09:04,490 --> 00:09:06,110 rest of your day. Yeah. Thank you.