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, everyone, and welcome to the Becker's Health
Care podcast. We're thrilled today to be joined
by John Young, chief strategy and development officer
at Evernorth Health Services Home Based Care. John,
thank you so much for joining us today.
Yeah. Thank you. It's great to be here.
So let's jump into today's conversation.
Can you please tell us a little bit
about yourself and your background?
Yeah. So I'm with Evernorth Home Based Care,
and we are, in home primary care group
that does value based care work for health
plans focusing mainly on their,
critical and chronic care, patients
that need more attention in the home, need
clinical care and services in the home.
And so I've been in health care for
30 plus years now, and always have had
a passion for looking at how might we
deliver better care and better solutions
to solve the big challenges that we have
in health care. One of them is the
rising chronic condition patients,
and on top of that is just the
escalating cost of care.
Can you speak a little bit more about
the mission of Evernorth home based care, and
why is this mission important to both you
and your team? Yeah. So for me, it
goes way back.
You know, primary care is essential
to our health care system, and I think
really powerful
option for us to continue to double down
on
in order to decrease the the cost of
care, but also improve the outcomes. Because
a lot of the focus of our practice
is taking a brick and mortar primary care
group
and truly bringing that into the home such
that we can deliver as many visits, as
many services,
and as much care and other support that
that individual needs
so that they're not going to the urgent
care or going to the emergency room or
going up into the acute care
because they're not getting primary care. And a
lot of the members just have many issues,
social determinants that they're dealing with.
They also have,
you know, other challenges,
transportation,
medications.
Many of them are on 20 plus medications.
They don't know how to balance that. So
being in their home and helping in their
home is important.
For me, it goes way back. My dad
was a pediatrician.
Growing up in the seventies, I remember him
doing house calls.
And the way that he created trust
and the way that he was able to
individually serve each of his patients and our
neighbors really resonated with me, and I think
it's one of the biggest solutions that we
have to to really double down on to
improve health care. Right. Right. Yeah. Exactly. That
that trust is really key there. So what
what are some of the industry barriers and
opportunities that your team is currently focused on?
Yeah. I I think
one is really just the the continued rise
and complexity of the the patients and their
needs.
I think how do you how do you
build the right
care plan and clinical team
that truly can impact in a meaningful way
the the individuals that we serve. So just
getting a handle of everything that's going on.
How many chronic conditions can one person have?
They can have 5, 6 plus. You know?
And so how do you build that right
team,
ensure that the patient who can't get out
of their home or struggles to get to
any level of care, we can bring that
into the door. So that's 1.
2, really building the trust with the individuals
and the caregivers of those individuals
such that they let us into their home.
It's it's really critical.
You can't do this virtually. You can't
see everything that's going on in the home.
You can't build a relationship with the folks
that really know what's going on with the
individuals, their caregivers,
And so you have to build that trust.
So we spend a lot of time focusing
on, you know, gaining that trust, getting our
teams into the home, and then building that
relationship with them. You know, the third thing
is, obviously, we we face, like everybody else,
just supply chain issues with clinic clinical teams.
And so, you know, we have the rising
chronic conditions, building the trust so that we
can truly become
a partner in their home for their clinical
care, and then ensuring and protecting our clinicians
so they can practice at the top of
their
license. It sounds like there's a lot going
on in your space right now.
And,
with your years of experience, what are some
of the biggest pieces of advice you'd have
for,
your peers in the health care industry? Yeah.
I think, you know,
having been around the block for 30 years
and really focusing on how do we transform
our health system, how do we make it
more efficient,
effective, how do we get it to deliver
better outcomes,
mainly don't give up. We we will solve
this at some point, I hope. And I
hope we do it, you know, and I
hope the the angle that we're taking with
home based care
and true,
you know, MDs and MPs and pharmacists and
RNs getting into the home and delivering care
is one of the answers that's gonna help
us maybe truly bend
the cost curve, increase outcomes, and and bring
value based care. So don't give up.
I think the other thing is really think
creatively. You know? The brick and mortar,
the fee for service,
the other challenges that we faced. I I
mean, truly, they haven't changed for 30 years
even though the big promises that CMS has
made,
the big initiatives that many of the payers
have
put forward,
are are are slowly changing the dynamics of
our health care system. But I think we
really have to think a bit radical and
think differently and and not be bound by
the the biases that have held us, you
know, kind of, you know, stuck for so
long.
So how does Evernorth home based care differentiate
itself from other home based care providers in
the industry?
And, what what would you say are some
unique advantages that you bring to your patients
and health care partners?
Yeah. I think, first,
just being able to go into a true
full,
capitated global risk model
is a a a really big advantage.
We are truly putting,
our money where our mouth is, you know,
to say.
And we we believe that
providers
and our clinical team
should be allowed to make their decisions and
not be bound by the OMI billing the
right code, OMI,
you know, billing something that I'm gonna get
reimbursed for. So I think that's one of
our our big advantages. I think to,
being a part of Evernorth
and the full suite of solutions that exist
from the the benefits
management's
aspects in pharmacy and medical
to all of the things that we do
on our side of the house and the
air delivery
and pharmacy side.
We're able to leverage the knowledge, for 1,
the resources and support that give us a
no another layer of clinical
competencies and teams and skills that we can
surround that patient by,
as well as, you know, doing some of
the virtual 247
If it's critical and we need to get
in touch or get someone to that home,
we're able to do that. So, you know,
a lot of those things are are really
important. The other big thing is,
you know, truly getting into the home,
being a trusted part of the family caregiver
team,
and seeing all of the social determinants of
health, and then building a care plan that's
unique to each individual
based on their conditions,
based on their social determinants,
based on their caregiver and other support, and
becoming kind of that Sherpa of their ecosystem
for their health.
John, I wanna thank you again for joining
us today on the Becker's Healthcare podcast. But
before I let you go, do you have
any final thoughts you'd like to leave with
our listeners? Yeah. I think this is just
an exciting time for health care, and it's
an exciting time for leaders in health care
to really rethink
where should the clinical
models be delivered,
how is care shifting
and getting into the home, and how am
I as a a leader going to respond
to that and become a champion of it
versus protecting kind of the biases of the
past. And I I just applaud everybody who's
doing it, and, the energy's there. So let's
get on it. Awesome. I really appreciate those
insights today.
John, thank you again for joining us today.
To our listeners, thank you for joining us,
and be sure to check out other Becker's
Healthcare podcast. Thank you, and have a wonderful
rest of your day. Yeah. Thank you.