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This is Gracelyn Keller with the Becker's Health
Care podcast, and we are recording live at
the 2024
fall payer issues roundtable.
I'm joined right now by Eric Sharp, who's
the CEO of value based care at Clover
Health. So, Eric, thank you for being here
today. We'd love to have you start off
by introducing yourself and telling us a little
bit more about your role.
Sure. It's great to be here.
In my role as CEO of value based
care with Clover Health,
I'm really charged with
driving value based care for payers and providers
out in the industry. So at Clover,
we're very technology centric
and have developed our own
technology stack that we use to drive value
based care.
Again, my challenge is to help others outside
of Clover Markets
do that very same thing.
So it's been a, a fun role. I've
been here for about 3 years now.
Wonderful. Well, thank you for taking the time
to sit down with me today.
And let's start our conversation talking about,
at an industry level, what opportunities are you
seeing for large scale improvements?
Sure. So one of the things that that
I've observed
from my experience in being involved in value
based care for the past,
decade, really, probably closer to 12, 13 years
now,
is that while there's a lot of approaches
to try to drive performance improvement,
as an industry, we're actually making that pretty
difficult on physicians.
So if you think of that about that
from the payer lens,
we have a lot of different insurance companies
action asking physicians to do a lot of
additional work
and do it in a lot of different
ways. So,
forms are different, processes are different,
websites are different. And it creates,
a lot of chaos, a lot of administrative
burden.
And I think that there's opportunity to try
to streamline that,
in in ways that can be easier for
physicians.
Pull back some of that administrative burden, begin
to provide them
the tools to do better clinically
and really harness the data that's available
now in the industry and is increasingly
it's growing, as there's more transparency and there's
more interoperability,
to really leverage those things. So I think
that's the next season coming,
in value based care. And it's something we've
been focusing on at Clover Health.
And let's shift a little bit toward digital
innovation. So I'd love to know what role
technology is playing in your organization's growth strategies.
And if you could share specific examples, that'd
be great.
Yeah. So, just building off of the,
the points around how to improve things in
the industry, particularly with value based care.
At Clover, we're a very tech centric organization
with a very tight focus on driving clinical
improvement. We wanna improve,
the health of every life.
And so we set out years ago to
build a technology stack
that would make it easier for physicians
to diagnose,
chronic disease earlier.
To have better insights at the point of
care as to what was going on with
the patient, a more holistic view.
And so this technology that we've built,
we are going out and harnessing a 100
plus sources of data.
We're pulling that together,
normalizing it, putting it into our warehouse, running,
hundreds of AI algorithms, machine learning algorithms to
surface insights right at the point of care
at the visit,
where the physician,
and the patient are face to face.
And what we're finding,
from a results perspective, just to double click
into one example,
is that physicians are truly diagnosing earlier.
They're also also
able to see insights into medication adherence and
transitions in care and close gaps in care.
But that double click, I'll just share with
you around diabetes.
Where we see our physician users of the
technology when compared to those that are not
using the technology.
And we have this out on a white
paper.
Are diagnosing diabetes about 3 years earlier.
That's allowing them to then intervene,
and treat 3 years earlier.
And you sort of, you know, ask the
the follow-up questions to that of is it
really producing a difference in outcomes? And we're
finding that it is.
It's leading to,
better
control of blood sugar earlier. About again, about
3 years earlier because we're treating earlier.
Lower complications like hypoglycemia,
lower insulin use.
All these things are important. And the physicians
that are using the technology see that as
a value add. It's not uncommon for them
to share stories about,
the insights they were sharing that they just
didn't know existed
for the patients that they serve every day.
Patient could have had a cancer diagnosis. They
may have been in the hospital. They may
have had an elevated lab study at a
different health care facility.
And so harnessing that big data
and making it
easy for the physician to use has been
a differentiator for us.
We're a 4 star Medicare Advantage plan.
We have,
we looked at the recent HEDIS metrics.
And,
our HEDIS score on the core quality metrics
is 4.94.
We've shared that publicly.
That is one of the top, if not
the top, HEDIS score, in the country for
plans that are greater than 2,000 lives.
And it really underscores the value of what
we're doing
and why we're continuing to improve the technology,
for physicians at at the point of care
each and every day.
And how is technology supporting value based care
or member focused initiatives at your organization? And
what is exciting you in this space? Yeah.
So this really is exciting for me because
it's, right in the wheelhouse of what I've
been charged to do.
Is we've now taken that technology that we've
been using for some time,
for our,
Clover Medicare Advantage members,
in New Jersey and and in Georgia.
And we've we've moved that technology into a
subsidiary called Counterpart Health.
We did that intentionally because
we believe that the technology
is not only proven, but it can make
a difference at an industry level.
It's it's designed in a way that it
can be scalable.
And so the exciting part is, is I
get to help lead the effort
to take that technology
out to providers
and to payers to help them also drive
performance improvement like we've seen at at Clover.
And, the the real exciting part about it
is that today, physicians get inundated
again from multiple insurance companies about these processes
and things that they wanna drive and improve.
And as we're deploying it, we're we're hearing
from them of we want to do this
type of work,
value based care work in the same way,
in a common way, in a similar workflow.
And so the technology now is available,
not just to implement our providers, but other
payers can plug into it as well. They
can make that decision to say, let's make
this easier on on the physician.
Let's allow them to work in a common
format and leverage the technology,
that we've made available.
And I think that that over time in
the coming years
is not just gonna set us apart. It's
gonna set a new,
standard for best practice in the industry
as an increasing number of,
providers and payers plug into the technology. So
we're just super excited about that.
Wonderful. Well, Eric, thanks so much for joining
me today on the Becker's Healthcare Podcast and
sharing your insights on these topics. Again, we
are recording live at the 2024
fall payer issues roundtable. Thanks so much. Thank
you.