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Hello, and welcome to the Becker's Health Care
podcast. I'm joined today by Edward Jung, chief
quality officer at Inland Empire Health Plan. Edward,
can you take a brief moment to, tell
us a little bit about your background and
your organization? Sure. Happy to. Again, my name
is Ed Jung. I serve as chief quality
officer at Inland Empire Health Plan, often referred
to as IHP.
IHP is a large Medi Cal or Medicaid
organization serving about 1,500,000
members
in the Inland Empire, which is made up
of Riverside and San Bernardino counties. Just to
give it a little context,
the Inland Empire is very large. It's about
27,000
square miles, making us larger than 10 states.
And so we work really hard to ensure
that our members receive the highest quality of
care in our region.
So from improving member experience and expanding value
based care, to controlling fair costs,
care executives have ambitious growth goals for the
rest of the year and next year. In
your role, what would you say is your
top priority, and, how are you planning on
getting there? Well, I think for us, our
top priority is focusing on quality outcomes for
our members and ultimately doing the right thing
to ensure that these members get those quality
outcomes that they deserve.
For us, whether it's in focusing on how
to support our providers
to better enable them to provide these high
quality services or walking alongside our members to
provide them their needs, I think that's something
that our entire organization
is rallying and focusing on. For example, internally
within our organization, we have a quality starts
with me campaign
because we recognize that every interaction is an
opportunity for us as a health plan to
do what's right for our members.
At an industry level, how would you describe
the biggest barriers to effectively serving and engaging
members?
And, what opportunities are you currently seeing for
large scale improvements, and how are you implying
all this in your current strategies?
Well, I think
a barrier,
for example, in our region is our low
provider to patient's ratio.
For us,
our opportunity
is to find ways to bring more providers
into the region to care for the most
vulnerable.
So I think the provider to patient's,
ratio is one thing. Definitely, that's an opportunity.
We also recognize that access and access to
care is an opportunity. I think that stems
from,
the opportunity for us to bring on more
highly qualified providers
into our region,
to serve our members.
Keeping up to, with today's
dynamic health care landscape is challenging.
You know, with your experience, what would you
say are some of your top pieces of
advice for other peer leaders, in in your
in your industry right now? I think one
of the things that we always have to,
keep our minds focused on is the member.
At the end of the day, there's a
lot of data out there. There's a lot
of analytics out there. But for us at
IHP,
these numbers represent people, families, and communities. And
for us to always remember that
the work that we do is a privilege.
It's an honor in service to serving some
of the most vulnerable people.
And so for us to always keep that
in mind and not be distracted by some
of the other things that might come with
that. Mhmm. Mhmm.
In an ever evolving
regulatory
environment, you know, what are some of the
tools and strategies that have helped your organization
improve quality and clinical outcomes for members that
are staying compliant with this regulatory change?
Well, I think for us, it's,
as I shared before, finding ways
to walk alongside our providers to ensure that
that they're meeting,
some of the requirements that are
asked from us as health plans, whether it's
finding ways to support,
their clinical practice, whether it's billing, coding, or
workflow opportunities,
whether it's finding ways to improve the way
that we engage with our members and how
they experience care,
whether it's the way that we outreach to
them, whether it's the support services we provide.
I think, we really focus on all those
pieces and everything in between.
I also think it's important for us to,
never lose the sight of the fact that
we always have to evolve and get better
and do better and be better
for the people that we serve, whether it's
leveraging
new tools and technologies,
such as AI, machine learning, whether it's finding
ways to leverage things such as automation.
I think just finding the right tools at
the right place is really going to be
important for us as an industry to move
forward, again, to better serve the people that
we have an opportunity to serve and deliver
the high quality outcomes that we want for
them.
You talked about some of these emerging technologies
such as AI.
How are they playing a role in your
organization's growth strategies? And can you elaborate a
little more on maybe a couple examples?
Sure. So one of the things that we
actually did as an organization,
over the past couple years
was focused on how to be better stewards
of our data.
With all the big push for big data,
predictive analytics, AI, machine learning, we recognize that
there was an ethical stewardship of that piece.
So one of the things that we've done
is actually conducted
algorithmic bias audits
on our care management algorithms
to ensure that the outputs
were, being
appropriately,
assessed and evaluated
to minimize and mitigate to the extent possible
any biases
and unintended biases that might have been generated
by the algorithms themselves. It's a continual process
that our teams are, working on, but I
know that we were ahead,
of starting that process,
about a few years ago.
Ed, I really appreciate all your insights today.
But before I let you go, do you
have any final thoughts for our audience?
Again, I think for us, especially for us
at IHP,
you know, for us, our mission is to
heal and inspire the human spirit, and our
vision is to do the right thing for
our members.
And just to keep that
at the forefront of everything that we do,
I think, is gonna be critically important with
everything that's going on. Because at the end
of the day, it's about our members. It's
about their health, and it's about their quality
outcomes.
Perfect. Thank you again for joining us today
on the Beckers Healthcare Podcast. I really appreciate
it. Thanks so much for having me. I
think you have a lovely rest of your
day. You too.