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 00:00:16,644 --> 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 00:00:47,704 --> 00:00:50,045 Hello, and welcome to the Becker's Healthcare podcast. 20 00:00:50,344 --> 00:00:52,745 I'm joined today by Erin Henderson Moore, president 21 00:00:52,745 --> 00:00:55,280 and CEO of Fidelis Care. Erin, welcome to 22 00:00:55,280 --> 00:00:56,920 the show. And, can you please tell us 23 00:00:56,920 --> 00:00:58,840 a little bit about your background and what 24 00:00:58,840 --> 00:01:00,760 your role at your organization is? Yeah. Hey, 25 00:01:00,760 --> 00:01:01,260 everyone. 26 00:01:01,640 --> 00:01:03,479 Like he said, my name is Erin Henderson 27 00:01:03,479 --> 00:01:05,000 Moore, and I'm the president and CEO of 28 00:01:05,000 --> 00:01:06,620 Fidelis Care New Jersey. 29 00:01:07,234 --> 00:01:08,614 We serve a 150,000 30 00:01:09,075 --> 00:01:11,075 people across the state of New Jersey. That 31 00:01:11,075 --> 00:01:13,715 includes our Medicaid business, our Medicare business, and 32 00:01:13,715 --> 00:01:15,094 our marketplace business. 33 00:01:15,634 --> 00:01:17,715 And it is a wholly owned subsidiary of 34 00:01:17,715 --> 00:01:18,614 Centene Corporation. 35 00:01:19,170 --> 00:01:21,890 What's exciting about Centene Corporation and Fidelis Care 36 00:01:21,890 --> 00:01:23,829 is that we serve 1 in 15 individuals 37 00:01:23,969 --> 00:01:26,930 across the United States through our government services 38 00:01:26,930 --> 00:01:27,430 platform. 39 00:01:28,209 --> 00:01:31,090 From improving member experience and expanding value based 40 00:01:31,090 --> 00:01:32,629 care to controlling costs, 41 00:01:33,004 --> 00:01:35,564 Executives in the payer space have ambitious growth 42 00:01:35,564 --> 00:01:36,844 goals for the rest of the year and 43 00:01:36,844 --> 00:01:37,744 in next year. 44 00:01:38,125 --> 00:01:40,204 As president and CEO, what is your top 45 00:01:40,204 --> 00:01:40,704 priority, 46 00:01:41,004 --> 00:01:42,944 and, how are you planning to get there? 47 00:01:43,164 --> 00:01:45,244 Yes. I have 5 priorities that I'm really 48 00:01:45,244 --> 00:01:47,990 focused on. One of my top priorities is 49 00:01:47,990 --> 00:01:49,049 definitely growth. 50 00:01:49,590 --> 00:01:52,490 Besides growth, one of my top other priorities 51 00:01:52,710 --> 00:01:54,650 really focus on our external reputation, 52 00:01:55,430 --> 00:01:56,890 quality, and member experience. 53 00:01:57,350 --> 00:01:59,109 The reason these are really important is that 54 00:01:59,109 --> 00:02:00,950 without all of those, you're not gonna grow 55 00:02:00,950 --> 00:02:03,564 in a way that is meaningful and that 56 00:02:03,564 --> 00:02:06,525 drives down disparities and really focuses on health 57 00:02:06,525 --> 00:02:08,145 equity. So, you know, 58 00:02:08,444 --> 00:02:10,044 one of those things that we're seeing coming 59 00:02:10,044 --> 00:02:11,805 out of the pandemic is that people are 60 00:02:11,805 --> 00:02:14,205 sicker and that they are using health care 61 00:02:14,205 --> 00:02:16,865 services at a much higher rate. And so 62 00:02:17,129 --> 00:02:19,530 really focusing on making sure that we can 63 00:02:19,530 --> 00:02:21,689 do all that we can to connect people 64 00:02:21,689 --> 00:02:24,090 with both health care, but also social care 65 00:02:24,090 --> 00:02:25,069 to meet their needs. 66 00:02:25,530 --> 00:02:27,689 At the industry level, what would you say 67 00:02:27,689 --> 00:02:30,729 are the biggest barriers to effectively serving and 68 00:02:30,729 --> 00:02:31,629 engaging members? 69 00:02:31,935 --> 00:02:34,655 And what opportunities are there for large scale 70 00:02:34,655 --> 00:02:36,094 improvements? And and what are you doing in 71 00:02:36,094 --> 00:02:38,175 your organization to address these with your current 72 00:02:38,175 --> 00:02:38,675 strategies? 73 00:02:39,295 --> 00:02:41,635 Well, one is really the rates and understanding 74 00:02:42,015 --> 00:02:44,175 about how that we think about health care 75 00:02:44,175 --> 00:02:46,520 curve services in the Medicaid space. So what 76 00:02:46,520 --> 00:02:47,800 we're seeing in that is coming out of 77 00:02:47,800 --> 00:02:48,459 the pandemic 78 00:02:48,919 --> 00:02:51,000 that members are sicker. And so that we 79 00:02:51,080 --> 00:02:53,639 there's really working with our state partners to 80 00:02:53,639 --> 00:02:55,400 figure out how do you really pay us 81 00:02:55,400 --> 00:02:57,159 appropriately so that we can care for those 82 00:02:57,159 --> 00:02:58,780 people. So that's just an ongoing 83 00:02:59,375 --> 00:03:01,454 learning curve that we're really talking about. This 84 00:03:01,454 --> 00:03:03,614 is a never seen before situation that we're 85 00:03:03,614 --> 00:03:05,854 really looking at. So that's one. The second 86 00:03:05,854 --> 00:03:07,775 is really how do we think about doing 87 00:03:07,775 --> 00:03:09,375 more with less so that we can be 88 00:03:09,375 --> 00:03:10,674 more community oriented 89 00:03:11,260 --> 00:03:13,580 to continue to focus on how do we 90 00:03:13,580 --> 00:03:15,120 reach members where they are 91 00:03:15,420 --> 00:03:17,500 to drive health care literacy and to drive 92 00:03:17,500 --> 00:03:19,260 engagement with the health care system in a 93 00:03:19,260 --> 00:03:22,000 different way because traditional ways are not working. 94 00:03:22,379 --> 00:03:24,044 And so, you know, you'll see that across 95 00:03:24,044 --> 00:03:25,965 the industry are really how do we partner 96 00:03:25,965 --> 00:03:28,144 and work as a convener to drive, 97 00:03:28,525 --> 00:03:29,504 systemic change. 98 00:03:30,364 --> 00:03:32,844 So, you know, technology in the healthcare space 99 00:03:32,844 --> 00:03:34,305 is rapidly evolving. 100 00:03:34,604 --> 00:03:36,379 How is it kind of currently playing a 101 00:03:36,379 --> 00:03:38,620 role in your organization's growth strategies? And do 102 00:03:38,620 --> 00:03:40,319 you have any examples you can share? 103 00:03:40,860 --> 00:03:42,379 Yeah. One of the things that we're really 104 00:03:42,379 --> 00:03:44,860 proud of is leveraging AI in a different 105 00:03:44,860 --> 00:03:46,939 way to give us more information about our 106 00:03:46,939 --> 00:03:48,985 members. Because you know, one of the things 107 00:03:48,985 --> 00:03:51,224 that managed care organizations have are we have 108 00:03:51,224 --> 00:03:53,144 a lot of data. We don't always know 109 00:03:53,144 --> 00:03:54,584 how to what to do with all that 110 00:03:54,584 --> 00:03:56,344 data and how do we use that to 111 00:03:56,344 --> 00:03:58,985 help predict and help support our members across 112 00:03:58,985 --> 00:03:59,644 their journey. 113 00:04:00,104 --> 00:04:02,424 So, you know, we use we're leveraging AI 114 00:04:02,424 --> 00:04:04,379 as a tool in our toolbox to really 115 00:04:04,379 --> 00:04:06,780 spur and help growth. But, also, do we 116 00:04:06,780 --> 00:04:08,379 have the right providers in our network? Do 117 00:04:08,379 --> 00:04:09,840 we have the right point solutions? 118 00:04:10,219 --> 00:04:12,860 Are we thinking about, you know, making sure 119 00:04:12,860 --> 00:04:15,819 that all of the interactions with our health 120 00:04:15,819 --> 00:04:16,319 plan 121 00:04:17,384 --> 00:04:20,125 are appropriate and are used in the most 122 00:04:20,185 --> 00:04:22,985 efficient and effective way possible. So we're really 123 00:04:22,985 --> 00:04:25,704 excited about that. Typically, you know, AI has 124 00:04:25,704 --> 00:04:27,464 been a scary thing of, like, how do 125 00:04:27,464 --> 00:04:29,544 we prevent people? But we just think it's 126 00:04:29,544 --> 00:04:31,324 a really interesting way in our toolbox 127 00:04:32,120 --> 00:04:34,539 to drive innovation at the local level. 128 00:04:34,919 --> 00:04:36,360 One of the things I I am hearing 129 00:04:36,360 --> 00:04:39,000 pretty frequently is how excited people are about 130 00:04:39,000 --> 00:04:41,240 all the new technologies out there. Mhmm. Is 131 00:04:41,240 --> 00:04:42,759 there anything that really jumps out to you 132 00:04:42,759 --> 00:04:44,759 that you're particularly excited about when it comes 133 00:04:44,759 --> 00:04:47,345 to technology and how it can improve, your 134 00:04:47,345 --> 00:04:48,485 your member's experience? 135 00:04:49,024 --> 00:04:50,564 Yeah. I mean, I would say, again, 136 00:04:51,425 --> 00:04:52,944 I will techno there's a lot of them 137 00:04:52,944 --> 00:04:55,024 out there. And so I I lump them 138 00:04:55,024 --> 00:04:57,125 as, like, yes, technology is 139 00:04:57,664 --> 00:05:00,785 exciting, and it is a solution for some 140 00:05:00,785 --> 00:05:02,580 but not for all. I think health care 141 00:05:02,580 --> 00:05:03,560 is so local, 142 00:05:04,020 --> 00:05:05,779 and and I really think it's member to 143 00:05:05,779 --> 00:05:07,620 member, kind of like voting. Right? You gotta 144 00:05:07,620 --> 00:05:10,180 knock on doors and get people out and 145 00:05:10,180 --> 00:05:12,100 engage and talk to them in the community 146 00:05:12,100 --> 00:05:14,680 and leverage community health workers. So, yeah, 147 00:05:15,214 --> 00:05:17,134 I am excited about a lot of the 148 00:05:17,134 --> 00:05:19,295 point solutions that we're evaluating. And when I 149 00:05:19,295 --> 00:05:21,134 mean that, it's all the different vendors out 150 00:05:21,134 --> 00:05:22,975 there. But what I'm most excited about is 151 00:05:22,975 --> 00:05:24,754 how do we, as a healthcare organization, 152 00:05:25,375 --> 00:05:27,455 really tie all those together to really focus 153 00:05:27,455 --> 00:05:28,435 on member experience. 154 00:05:29,180 --> 00:05:31,580 I love that. I love that. And with 155 00:05:31,580 --> 00:05:32,319 your experience, 156 00:05:32,939 --> 00:05:35,180 you know, especially with as rapidly as the 157 00:05:35,180 --> 00:05:36,879 health care landscape is changing, 158 00:05:37,339 --> 00:05:38,779 what would you say are your, you know, 159 00:05:38,779 --> 00:05:40,620 maybe top one or two pieces of advice 160 00:05:40,620 --> 00:05:42,379 for other other leaders in the health care 161 00:05:42,379 --> 00:05:42,879 space? 162 00:05:44,334 --> 00:05:46,495 Yeah. That's a really good question. The first 163 00:05:46,495 --> 00:05:49,475 one is do not forget the member. 164 00:05:49,935 --> 00:05:51,375 You know, a lot of times we can 165 00:05:51,375 --> 00:05:53,854 focus on profits. We can focus on point 166 00:05:53,854 --> 00:05:56,014 solutions. We can focus on digital. There's a 167 00:05:56,014 --> 00:05:57,819 lot of there's a lot of things that 168 00:05:57,819 --> 00:05:59,500 we can focus on in the shiny things. 169 00:05:59,500 --> 00:06:00,699 But the end of the day, it's a 170 00:06:00,699 --> 00:06:03,180 person centered business. And so that when we 171 00:06:03,180 --> 00:06:05,579 move away from that, we've lost sight of 172 00:06:05,579 --> 00:06:07,199 really our most important customer. 173 00:06:08,220 --> 00:06:09,819 So one of the things that we do 174 00:06:09,819 --> 00:06:12,194 in in meetings and in town halls and 175 00:06:12,194 --> 00:06:14,035 different things in our local organization is we 176 00:06:14,035 --> 00:06:15,574 always start with a member story. 177 00:06:15,955 --> 00:06:18,115 We spend a lot of time tracing how 178 00:06:18,115 --> 00:06:20,595 the member journeys through our internal health plan 179 00:06:20,595 --> 00:06:22,834 and where that we can change operations to 180 00:06:22,834 --> 00:06:24,295 focus back to the member. 181 00:06:24,919 --> 00:06:26,599 And then the bells and whistles are just 182 00:06:26,599 --> 00:06:28,839 an an addition. You know, again, a tool 183 00:06:28,839 --> 00:06:31,319 in our toolbox with something shiny, and they 184 00:06:31,319 --> 00:06:33,399 add to the member experience. But sometimes it's 185 00:06:33,399 --> 00:06:35,560 just, does your call center work? Mhmm. Can 186 00:06:35,639 --> 00:06:37,560 are we speaking our does our team speak 187 00:06:37,560 --> 00:06:39,719 in the correct languages? Those simple things like 188 00:06:39,719 --> 00:06:40,154 that. 189 00:06:40,555 --> 00:06:42,394 So that that's one of the things that 190 00:06:42,394 --> 00:06:44,714 I've been really focused on and really changing 191 00:06:44,714 --> 00:06:47,035 my mindset and and encouraging my team to 192 00:06:47,035 --> 00:06:48,794 do the same to make sure that we 193 00:06:48,794 --> 00:06:51,055 have that we're grounded in the member experience. 194 00:06:51,435 --> 00:06:53,449 I really like that that that focus on 195 00:06:53,449 --> 00:06:55,610 the people as opposed to that overreliance on 196 00:06:55,610 --> 00:06:57,710 technology. I think I think that's important. 197 00:06:59,050 --> 00:07:01,050 Erica, I really appreciate you joining us today. 198 00:07:01,050 --> 00:07:02,170 But before I let you go, do you 199 00:07:02,170 --> 00:07:03,529 have any final thoughts you'd like to leave 200 00:07:03,529 --> 00:07:04,350 with our listeners? 201 00:07:04,895 --> 00:07:06,415 Yes. I would say that this is a 202 00:07:06,415 --> 00:07:08,254 really exciting time to be in health care 203 00:07:08,254 --> 00:07:10,654 and especially in government sponsored health care. I 204 00:07:10,654 --> 00:07:13,154 would encourage everybody to not forget that Medicaid 205 00:07:13,215 --> 00:07:13,715 is, 206 00:07:14,895 --> 00:07:16,814 you know, pays for more births across this 207 00:07:16,814 --> 00:07:19,375 country than any other payer. And that one 208 00:07:19,375 --> 00:07:21,990 in you know, more than 1 in 15 209 00:07:21,990 --> 00:07:24,069 individuals are on Medicaid. And that this is 210 00:07:24,069 --> 00:07:24,970 really the backbone 211 00:07:25,589 --> 00:07:28,310 of really a healthy society and a society 212 00:07:28,310 --> 00:07:30,629 that we really wanna can see continue to 213 00:07:30,629 --> 00:07:31,370 do transformative 214 00:07:32,229 --> 00:07:34,069 things across the country. So I would say 215 00:07:34,069 --> 00:07:36,535 that stay tuned. This is a super exciting 216 00:07:36,535 --> 00:07:38,214 time, and I'm excited to see how it 217 00:07:38,214 --> 00:07:40,535 continues to evolve. Right. Thank you again for 218 00:07:40,535 --> 00:07:41,975 joining us today on the Becker Self Care 219 00:07:41,975 --> 00:07:43,334 Podcast, and you have a lovely rest of 220 00:07:43,334 --> 00:07:45,115 your day. Thank you. My pleasure.