1 00:00:00,160 --> 00:00:02,399 This is Laura Dierdo with the Becker's Healthcare 2 00:00:02,399 --> 00:00:04,639 podcast. I'm thrilled today to be joined by 3 00:00:04,639 --> 00:00:07,759 doctor Edward Judd, chief quality officer at Inland 4 00:00:07,759 --> 00:00:10,000 Empire Health Plan. Edward, it is a pleasure 5 00:00:10,000 --> 00:00:12,000 to have you on the podcast today. Thanks 6 00:00:12,000 --> 00:00:13,335 so much for having me. 7 00:00:13,894 --> 00:00:16,054 Now I'm excited for our conversation because I 8 00:00:16,054 --> 00:00:17,894 know that you really have a lot of 9 00:00:17,894 --> 00:00:20,934 fascinating things going on in the Empire and, 10 00:00:21,254 --> 00:00:23,494 truly, you know, our our model for how 11 00:00:23,494 --> 00:00:24,954 other organizations can 12 00:00:25,255 --> 00:00:27,839 aim to troubleshoot the big challenges within the 13 00:00:27,839 --> 00:00:29,920 Medicaid system, but also be able to care 14 00:00:29,920 --> 00:00:32,239 for their communities in a meaningful way. So 15 00:00:32,239 --> 00:00:33,679 I'm excited to talk a little bit more 16 00:00:33,679 --> 00:00:35,679 about some of the things that, you've been 17 00:00:35,679 --> 00:00:36,960 up to in the last year and what 18 00:00:36,960 --> 00:00:38,799 your plans are for the future. But before 19 00:00:38,799 --> 00:00:40,565 we do that, I'm wondering, could you tell 20 00:00:40,565 --> 00:00:42,005 us a little bit more about yourself and 21 00:00:42,005 --> 00:00:42,664 your background? 22 00:00:44,484 --> 00:00:47,204 Sure. Well, again, my name is Edward Judd, 23 00:00:47,365 --> 00:00:49,925 and I serve as the chief quality officer 24 00:00:49,925 --> 00:00:52,265 at Inland Empire Health Plan, oftentimes 25 00:00:52,565 --> 00:00:53,945 referred to as IEHP, 26 00:00:55,230 --> 00:00:57,870 where I'm responsible for leading the advancement of 27 00:00:57,870 --> 00:01:00,450 IHPs quality journey through transformative 28 00:01:00,910 --> 00:01:01,410 incentives, 29 00:01:02,429 --> 00:01:05,170 initiatives, and innovative solutions and partnerships. 30 00:01:05,790 --> 00:01:07,310 In this role, I work to ensure that 31 00:01:07,310 --> 00:01:09,954 our health plan's commitment in providing the highest 32 00:01:09,954 --> 00:01:11,814 quality of care for the members 33 00:01:12,194 --> 00:01:14,935 and the communities we serve alongside providers 34 00:01:15,234 --> 00:01:16,854 is top tier. 35 00:01:17,155 --> 00:01:18,534 As a little bit of background, 36 00:01:19,075 --> 00:01:20,915 IHP is one of the top 10 largest 37 00:01:20,915 --> 00:01:23,430 Medicaid health plans in the country and supports 38 00:01:23,430 --> 00:01:24,250 about 1,500,000 39 00:01:25,269 --> 00:01:27,769 Riverside and San Bernardino County residents 40 00:01:28,069 --> 00:01:29,209 enrolled in Medicaid, 41 00:01:29,670 --> 00:01:30,569 Covered California, 42 00:01:30,950 --> 00:01:33,750 and decent for those with both Medicaid and 43 00:01:33,750 --> 00:01:34,250 Medicare. 44 00:01:34,629 --> 00:01:37,509 And we also have nearly 9,000 providers in 45 00:01:37,509 --> 00:01:39,594 our network. And for those who might be 46 00:01:39,594 --> 00:01:40,094 curious, 47 00:01:41,034 --> 00:01:42,954 as to who I am with a little 48 00:01:42,954 --> 00:01:43,935 bit more background, 49 00:01:44,555 --> 00:01:46,254 I'm an internal medicine physician, 50 00:01:46,635 --> 00:01:48,635 and I've been sitting at the intersection of 51 00:01:48,635 --> 00:01:52,474 clinical care, data innovation and technology, and also 52 00:01:52,474 --> 00:01:53,534 in public health. 53 00:01:54,729 --> 00:01:56,009 That's great to hear it. And, you know, 54 00:01:56,009 --> 00:01:58,569 what a perfect position to be in, in 55 00:01:58,569 --> 00:02:00,170 this day and age as you're looking at, 56 00:02:00,170 --> 00:02:02,890 you know, so many changes within public policy 57 00:02:02,890 --> 00:02:05,369 and information and data really playing a meaningful 58 00:02:05,369 --> 00:02:07,450 role in how health care and health care 59 00:02:07,450 --> 00:02:09,389 delivery is moving forward. 60 00:02:09,844 --> 00:02:11,444 From your perspective, what are some of the 61 00:02:11,444 --> 00:02:13,284 biggest issues that you're following in health care 62 00:02:13,284 --> 00:02:14,025 right now, 63 00:02:14,324 --> 00:02:16,344 and especially headed into the new year? 64 00:02:17,205 --> 00:02:19,604 Well, I'd say a new year is a 65 00:02:19,604 --> 00:02:20,344 new opportunity 66 00:02:20,645 --> 00:02:23,064 to learn how we can best meet patients 67 00:02:23,125 --> 00:02:24,104 where they're at. 68 00:02:24,460 --> 00:02:26,379 One of the issues I'm following this year 69 00:02:26,379 --> 00:02:28,860 is how technology will continue to improve the 70 00:02:28,860 --> 00:02:31,419 delivery of health care and the positive impact 71 00:02:31,419 --> 00:02:32,560 it'll have on patients. 72 00:02:32,939 --> 00:02:35,180 The great thing is consumers are driving this 73 00:02:35,180 --> 00:02:37,740 demand and that's shifting the expectations of the 74 00:02:37,740 --> 00:02:39,104 health care industry as a whole. 75 00:02:39,584 --> 00:02:42,784 I anticipate seeing continued demand for both in 76 00:02:42,784 --> 00:02:45,044 person and virtual doctors visits, 77 00:02:45,905 --> 00:02:46,884 increased expectations 78 00:02:47,264 --> 00:02:50,625 for digital communications like texts, emails, and web 79 00:02:50,625 --> 00:02:51,125 chats, 80 00:02:51,469 --> 00:02:53,949 and the desire to supplement a doctor's visits 81 00:02:53,949 --> 00:02:55,250 with patient technology 82 00:02:55,629 --> 00:02:56,370 and engagement, 83 00:02:56,750 --> 00:02:59,310 all in service to improving our patients' health 84 00:02:59,310 --> 00:03:00,129 and outcomes. 85 00:03:00,830 --> 00:03:02,830 And I think this also impacts the health 86 00:03:02,830 --> 00:03:04,530 care delivery system itself, 87 00:03:05,394 --> 00:03:07,875 which means we'll continue to see increased access 88 00:03:07,875 --> 00:03:09,174 points for patients. 89 00:03:09,555 --> 00:03:11,894 And I believe these trends will evolve throughout 90 00:03:11,955 --> 00:03:12,455 2025 91 00:03:13,074 --> 00:03:14,995 and even to the next decade as health 92 00:03:14,995 --> 00:03:17,474 plans catch up to all other industries where 93 00:03:17,474 --> 00:03:19,254 consumer experience is king. 94 00:03:20,230 --> 00:03:22,409 That makes a lot of sense. And, certainly, 95 00:03:22,469 --> 00:03:25,030 thinking about that consumer experience, you know, is 96 00:03:25,030 --> 00:03:26,629 top of mind for so many folks in 97 00:03:26,629 --> 00:03:29,110 the health care space as it becomes more 98 00:03:29,110 --> 00:03:31,590 competitive and and people really have more control 99 00:03:31,590 --> 00:03:32,090 over 100 00:03:32,615 --> 00:03:35,014 their choices and decisions for where they're receiving 101 00:03:35,014 --> 00:03:37,254 their care or how they're, moving through the 102 00:03:37,414 --> 00:03:38,555 their health care journeys. 103 00:03:38,854 --> 00:03:40,854 From your perspective, when you're looking at the 104 00:03:40,854 --> 00:03:43,414 technology, some of the things you've tried, whether 105 00:03:43,414 --> 00:03:45,354 it's the virtual visits or 106 00:03:45,740 --> 00:03:48,060 the text and and emails and different ways 107 00:03:48,060 --> 00:03:50,780 for to connect with, members. What have you 108 00:03:50,780 --> 00:03:51,680 seen really 109 00:03:51,979 --> 00:03:54,479 been most successful, and how do you especially 110 00:03:54,699 --> 00:03:56,959 troubleshoot some of the challenges with the Medicaid 111 00:03:57,020 --> 00:03:59,919 patient population in integrating technology into, 112 00:04:00,474 --> 00:04:01,534 your care delivery? 113 00:04:02,555 --> 00:04:04,634 Yeah. I think for us, it's always putting 114 00:04:04,634 --> 00:04:07,034 members at the center of everything that we 115 00:04:07,034 --> 00:04:08,875 do. And at the end of the day, 116 00:04:08,875 --> 00:04:09,775 it's finding 117 00:04:10,155 --> 00:04:12,314 ways for us to improve the outcomes for 118 00:04:12,314 --> 00:04:14,629 the people that we all have a privileged, 119 00:04:15,169 --> 00:04:16,550 opportunity to serve. 120 00:04:16,850 --> 00:04:19,089 So, for example, when it comes to things 121 00:04:19,089 --> 00:04:22,069 such as artificial intelligence and machine learning, 122 00:04:22,930 --> 00:04:25,089 we here at IHP have actually started to 123 00:04:25,089 --> 00:04:25,910 think through 124 00:04:26,224 --> 00:04:28,944 what it means to be responsible and thoughtful 125 00:04:28,944 --> 00:04:31,745 when we leverage these types of techniques. And 126 00:04:31,745 --> 00:04:33,204 one of the things that we introduced, 127 00:04:33,904 --> 00:04:34,884 almost a 128 00:04:35,185 --> 00:04:37,104 a a a year or 2 ago is 129 00:04:37,104 --> 00:04:39,759 how we can address algorithmic bias in our 130 00:04:39,759 --> 00:04:40,500 care algorithms 131 00:04:40,879 --> 00:04:42,720 just to make sure that we're being good 132 00:04:42,720 --> 00:04:45,439 stewards of the information and the data that 133 00:04:45,439 --> 00:04:47,920 we have. We've also started to push on 134 00:04:47,920 --> 00:04:48,420 transformative 135 00:04:48,800 --> 00:04:50,180 initiatives around automation. 136 00:04:51,004 --> 00:04:53,164 And I think it's important to note that 137 00:04:53,164 --> 00:04:55,805 we must continually figure out how to make 138 00:04:55,805 --> 00:04:58,444 our processes better and to learn from one 139 00:04:58,444 --> 00:05:00,384 another as we step through some of these 140 00:05:00,685 --> 00:05:02,865 new concepts and solutions and technology 141 00:05:03,649 --> 00:05:05,889 because we need to ensure that everything that 142 00:05:05,889 --> 00:05:08,610 we do, again, improves care and outcomes for 143 00:05:08,610 --> 00:05:10,310 our members, providers, and community. 144 00:05:11,250 --> 00:05:12,930 That's great to hear. And, you know, really 145 00:05:12,930 --> 00:05:15,669 cool to have that ability as you're implementing 146 00:05:15,810 --> 00:05:16,870 artificial intelligence 147 00:05:17,245 --> 00:05:19,425 to think through the the ways that, 148 00:05:19,884 --> 00:05:21,884 you know, the the potential biases that it 149 00:05:21,884 --> 00:05:24,285 could have and and then being able to 150 00:05:24,285 --> 00:05:26,125 avoid them as much as possible or at 151 00:05:26,125 --> 00:05:27,724 least get ahead of some of those very 152 00:05:27,724 --> 00:05:30,459 real challenges. I know so many organizations in 153 00:05:30,459 --> 00:05:32,220 the health care space are really paying very 154 00:05:32,220 --> 00:05:32,959 close attention 155 00:05:33,500 --> 00:05:34,779 to what they need to do in order 156 00:05:34,779 --> 00:05:36,240 to safely apply AI 157 00:05:36,939 --> 00:05:38,399 and get the right algorithms, 158 00:05:38,860 --> 00:05:40,620 in place. And so that's really cool to 159 00:05:40,620 --> 00:05:42,939 hear. Now in looking ahead, what are you 160 00:05:42,939 --> 00:05:45,039 most excited about, or what makes you nervous? 161 00:05:46,084 --> 00:05:48,004 Well, I think what excites me the most 162 00:05:48,004 --> 00:05:50,485 and also gives me the greatest pause, revolves 163 00:05:50,485 --> 00:05:53,365 around our region's significant provider shortage. You know, 164 00:05:53,365 --> 00:05:55,204 on one hand, I'm very excited about the 165 00:05:55,204 --> 00:05:58,345 outcomes from IHP's health care scholarship fund. 166 00:05:58,889 --> 00:06:01,610 This program is a program that IHP launched 167 00:06:01,610 --> 00:06:02,350 in 2020, 168 00:06:03,290 --> 00:06:05,149 that provided about $40,000,000 169 00:06:05,930 --> 00:06:08,589 in full tuition scholarships for medical students, 170 00:06:09,209 --> 00:06:11,709 and later grew to also include nurse practitioners 171 00:06:11,850 --> 00:06:12,509 in psychiatry. 172 00:06:13,204 --> 00:06:14,345 In the past 5 173 00:06:14,964 --> 00:06:18,564 years, IHPS supported nearly 240 local students who 174 00:06:18,564 --> 00:06:21,045 were able to begin their journeys as medical 175 00:06:21,045 --> 00:06:23,464 professionals right here in the Inland Empire, 176 00:06:24,324 --> 00:06:26,985 and continue serving where they were raised. 177 00:06:27,349 --> 00:06:29,689 What's also exciting is that we're building relationships 178 00:06:29,910 --> 00:06:32,310 with our health care scholars in addition to 179 00:06:32,310 --> 00:06:33,370 funding their education. 180 00:06:33,750 --> 00:06:36,310 For example, they attend our IHP events to 181 00:06:36,310 --> 00:06:37,129 better understand 182 00:06:37,430 --> 00:06:39,050 the nuances of our region, 183 00:06:39,509 --> 00:06:41,110 and they have also gone to know our 184 00:06:41,110 --> 00:06:43,964 IHP leaders on a personal level, adding more 185 00:06:43,964 --> 00:06:45,725 meaning to what it means to serve our 186 00:06:45,725 --> 00:06:46,225 community. 187 00:06:47,084 --> 00:06:49,165 At the same time, what makes me most 188 00:06:49,165 --> 00:06:51,644 nervous is knowing that our region remains at 189 00:06:51,644 --> 00:06:53,964 the lowest provider to patient ratio in all 190 00:06:53,964 --> 00:06:54,625 of California 191 00:06:55,084 --> 00:06:57,985 with 39 providers per 100,000 residents, 192 00:06:58,430 --> 00:07:01,649 far below the recommended 70 providers per 100000 193 00:07:02,029 --> 00:07:02,529 people. 194 00:07:03,069 --> 00:07:04,050 You know, this statistic, 195 00:07:04,589 --> 00:07:06,529 is one that keeps me up at night 196 00:07:06,750 --> 00:07:08,670 as we strive to care for our most 197 00:07:08,670 --> 00:07:09,649 vulnerable residents. 198 00:07:10,915 --> 00:07:13,555 Well, that's fascinating. I didn't realize, you know, 199 00:07:13,555 --> 00:07:15,714 how big of a discrepancy there was between 200 00:07:15,714 --> 00:07:18,615 that patient provider ratio within the Inland Empire. 201 00:07:19,074 --> 00:07:21,235 So when you look out at and obviously 202 00:07:21,235 --> 00:07:22,995 doing what you can to play the long 203 00:07:22,995 --> 00:07:24,860 game in training additional, 204 00:07:25,560 --> 00:07:28,839 clinicians to jump in and and really help 205 00:07:28,839 --> 00:07:30,860 in the future. But how do 206 00:07:31,399 --> 00:07:33,480 you troubleshoot the challenges that are right in 207 00:07:33,480 --> 00:07:36,120 front of you today and manage and balance 208 00:07:36,120 --> 00:07:38,279 being able to look into the future and 209 00:07:38,279 --> 00:07:39,020 see where, 210 00:07:39,605 --> 00:07:41,365 long term you can shore up some of 211 00:07:41,365 --> 00:07:41,845 those, 212 00:07:42,245 --> 00:07:45,285 shortages or or close that gap, while also 213 00:07:45,285 --> 00:07:45,785 managing, 214 00:07:46,085 --> 00:07:47,764 you know, what you have, in front of 215 00:07:47,764 --> 00:07:50,324 you and the patients that really truly need 216 00:07:50,324 --> 00:07:51,305 health care today. 217 00:07:52,129 --> 00:07:54,050 Yeah. I think for me, I think, you 218 00:07:54,050 --> 00:07:56,149 know, over the next 2 to 3 years, 219 00:07:56,849 --> 00:07:59,329 the most effective health care leaders are going 220 00:07:59,329 --> 00:08:01,409 to be able to increase their skills and 221 00:08:01,409 --> 00:08:01,909 comfort, 222 00:08:02,449 --> 00:08:03,909 with innovation and technology, 223 00:08:04,610 --> 00:08:06,629 as well as building their resilience 224 00:08:07,175 --> 00:08:09,334 and strategic mindset to face some of the 225 00:08:09,334 --> 00:08:11,834 numerous challenges and opportunities in our industry. 226 00:08:12,214 --> 00:08:14,055 And it's one thing to know about these 227 00:08:14,055 --> 00:08:16,375 concepts that I just shared, but it's another 228 00:08:16,375 --> 00:08:17,274 thing to practically, 229 00:08:17,574 --> 00:08:18,714 ethically and effectively 230 00:08:19,014 --> 00:08:20,930 implement them. So I do think that it's 231 00:08:20,930 --> 00:08:22,449 going to be really important for all of 232 00:08:22,449 --> 00:08:22,949 us, 233 00:08:23,490 --> 00:08:26,050 in the industry to leverage our learnings, both 234 00:08:26,050 --> 00:08:27,569 small and large, because at the end of 235 00:08:27,569 --> 00:08:29,410 the day, we're all able to make a 236 00:08:29,410 --> 00:08:30,949 positive impact on our communities. 237 00:08:31,410 --> 00:08:32,470 You know, for example, 238 00:08:33,485 --> 00:08:36,205 you know, IHP has also started to use 239 00:08:36,205 --> 00:08:37,345 advanced data modeling 240 00:08:37,804 --> 00:08:39,884 to better understand how to provide the right 241 00:08:39,884 --> 00:08:41,804 care at the right time by the right 242 00:08:41,804 --> 00:08:43,964 provider in the right setting. You know, whether 243 00:08:43,964 --> 00:08:45,985 it's preventive or chronic care opportunities, 244 00:08:46,519 --> 00:08:48,539 we wanna make sure that we're as proactive 245 00:08:48,679 --> 00:08:49,340 as possible. 246 00:08:49,720 --> 00:08:50,940 And it's about leveraging 247 00:08:51,559 --> 00:08:53,179 the best of our internal capabilities, 248 00:08:53,799 --> 00:08:55,340 our provider network capabilities, 249 00:08:56,120 --> 00:08:57,980 and all available tools and technologies, 250 00:08:58,919 --> 00:09:00,759 to help people get the care that they 251 00:09:00,759 --> 00:09:03,514 need. And I guess I'll close with saying 252 00:09:03,514 --> 00:09:04,654 that the most effective 253 00:09:05,195 --> 00:09:06,415 health care leader 254 00:09:06,795 --> 00:09:08,634 and health care, I would say, 255 00:09:09,195 --> 00:09:09,695 partner 256 00:09:10,075 --> 00:09:12,394 in the future will also be fearless in 257 00:09:12,394 --> 00:09:14,475 learning new ways to serve our industry and 258 00:09:14,475 --> 00:09:16,654 unlearning what no longer serves our industry 259 00:09:17,019 --> 00:09:18,959 because both these concepts are crucial 260 00:09:19,419 --> 00:09:21,579 to transforming our health care delivery system that 261 00:09:21,579 --> 00:09:23,279 desperately needs our best efforts, 262 00:09:23,740 --> 00:09:25,339 for the best cause of all, which is 263 00:09:25,339 --> 00:09:25,919 our members. 264 00:09:27,100 --> 00:09:29,419 I love that. What a way to, really 265 00:09:29,419 --> 00:09:30,879 think through the future and 266 00:09:31,315 --> 00:09:33,095 understand what's gonna be necessary 267 00:09:33,554 --> 00:09:34,695 as you move forward. 268 00:09:35,315 --> 00:09:36,674 Edward, thank you so much for joining us 269 00:09:36,674 --> 00:09:38,355 on the podcast today. This has been such 270 00:09:38,355 --> 00:09:40,355 a fascinating conversation, and I look forward to 271 00:09:40,355 --> 00:09:41,894 connecting with you again soon. 272 00:09:42,434 --> 00:09:44,454 Absolutely appreciate it. Thanks so much.