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 --> 00:00:13,139 complex conditions 6 00:00:13,605 --> 00:00:16,344 easier and more accessible as we drive organizations 7 00:00:16,725 --> 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 00:00:23,765 --> 00:00:26,085 and social determinant of health barriers get the 11 00:00:26,085 --> 00:00:28,884 care they need and the personalized experience they 12 00:00:28,884 --> 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 00:00:34,939 --> 00:00:37,739 and preventative care services to the home. By 16 00:00:37,739 --> 00:00:40,700 providing clinical care and support services that provide 17 00:00:40,700 --> 00:00:44,185 whole person care, we improve health equity, access, 18 00:00:44,185 --> 00:00:46,605 and outcomes for the populations we serve. 19 00:00:47,785 --> 00:00:49,945 This is Gracelyn Keller with the Becker's Healthcare 20 00:00:49,945 --> 00:00:51,885 podcast, and we are live at the 2024 21 00:00:52,185 --> 00:00:53,405 payer issues roundtable. 22 00:00:53,960 --> 00:00:56,440 I'm joined right now by Mihir Kamdar who 23 00:00:56,440 --> 00:00:58,940 is the chief medical officer at Tuesday Health. 24 00:00:59,079 --> 00:01:00,679 So thank you for being here. We'd love 25 00:01:00,679 --> 00:01:02,520 to have you start off by introducing yourself 26 00:01:02,520 --> 00:01:04,359 and telling us a little bit more about 27 00:01:04,359 --> 00:01:06,564 your role. Thanks, Grace. So my name is, 28 00:01:06,885 --> 00:01:09,365 Mihir Kamdar. I am a palliative care physician 29 00:01:09,365 --> 00:01:11,284 and serve as the chief medical officer for 30 00:01:11,284 --> 00:01:13,924 Tuesday Health. And Tuesday Health is a value 31 00:01:13,924 --> 00:01:16,805 based care, supportive, and palliative care company, and 32 00:01:16,805 --> 00:01:19,030 we really seek to provide comprehensive, 33 00:01:20,130 --> 00:01:22,530 supportive care for patients with serious illness, particularly 34 00:01:22,530 --> 00:01:23,810 in the last 1 to 2 years of 35 00:01:23,810 --> 00:01:24,310 life. 36 00:01:25,409 --> 00:01:27,409 Wonderful. Well, thank you for taking the time, 37 00:01:27,409 --> 00:01:29,984 and let's start our conversation here about 38 00:01:30,305 --> 00:01:33,265 growth goals. So from improving member experience and 39 00:01:33,265 --> 00:01:36,145 expanding value based care to controlling costs, payer 40 00:01:36,145 --> 00:01:38,944 executives have ambitious growth goals for the rest 41 00:01:38,944 --> 00:01:40,704 of the year and as we look into 42 00:01:40,704 --> 00:01:41,685 the new year ahead. 43 00:01:42,239 --> 00:01:43,920 So in your role, what is your top 44 00:01:43,920 --> 00:01:45,840 priority and how are you planning to get 45 00:01:45,840 --> 00:01:46,340 there? 46 00:01:46,719 --> 00:01:48,479 Yeah. It's it's a great question. And, you 47 00:01:48,479 --> 00:01:50,319 know, what we know about patients with serious 48 00:01:50,319 --> 00:01:52,579 illness is this is a really challenging population 49 00:01:52,640 --> 00:01:53,379 for payers. 50 00:01:53,920 --> 00:01:55,519 We know, particularly in that last year of 51 00:01:55,519 --> 00:01:58,244 life, Grace, there's a significant amount of, 52 00:01:58,805 --> 00:02:01,525 challenges with, member experience that can spill over 53 00:02:01,525 --> 00:02:02,424 onto their caregivers 54 00:02:02,805 --> 00:02:04,584 and all of that leads to an exorbitant 55 00:02:04,644 --> 00:02:06,484 amount of cost. Right? The cost of care 56 00:02:06,484 --> 00:02:08,584 in the last year of life are significant. 57 00:02:09,199 --> 00:02:11,039 And so what we're trying to do is 58 00:02:11,039 --> 00:02:13,519 really be able to, get involved earlier in 59 00:02:13,519 --> 00:02:15,120 the course of these patients, you know, 12 60 00:02:15,120 --> 00:02:17,759 to 24 months before patients pass away to 61 00:02:17,759 --> 00:02:20,419 be able to provide evidence based palliative care, 62 00:02:20,560 --> 00:02:23,115 which we know can improve the quality and 63 00:02:23,115 --> 00:02:24,955 that journey for that member and their loved 64 00:02:24,955 --> 00:02:27,854 ones, but also significantly reduce those those exorbitant 65 00:02:27,995 --> 00:02:29,995 costs of care in that last year of 66 00:02:29,995 --> 00:02:31,995 life. And and so, you know, we we 67 00:02:31,995 --> 00:02:34,895 know payers are really struggling with admissions recently. 68 00:02:35,540 --> 00:02:36,819 We know that a lot of those admissions 69 00:02:36,819 --> 00:02:38,500 are gonna be concentrated in that last year 70 00:02:38,500 --> 00:02:39,719 of life. We know that, 71 00:02:40,099 --> 00:02:42,580 you know, patient experience matters a lot. And 72 00:02:42,580 --> 00:02:44,180 so those are all things that we are 73 00:02:44,180 --> 00:02:46,020 in particularly focused on. We're we're a new 74 00:02:46,020 --> 00:02:46,520 company. 75 00:02:47,379 --> 00:02:47,939 We launched, 76 00:02:48,995 --> 00:02:49,574 you know, 77 00:02:50,114 --> 00:02:52,514 clinically just earlier this year. We're fortunate to 78 00:02:52,514 --> 00:02:53,495 announce a $60,000,000 79 00:02:54,674 --> 00:02:57,394 initial raise. And so what we're doing, we're 80 00:02:57,394 --> 00:02:58,914 we're alive now in Ohio, and what we're 81 00:02:58,914 --> 00:03:00,775 really doing is is, delivering 82 00:03:01,129 --> 00:03:03,370 our care and our clinical model. And our 83 00:03:03,370 --> 00:03:05,129 priority for next year is really be able 84 00:03:05,129 --> 00:03:07,050 to to scale from there and create access 85 00:03:07,050 --> 00:03:08,110 to evidence based, 86 00:03:08,409 --> 00:03:10,189 palliative care and forging 87 00:03:10,650 --> 00:03:11,469 even greater, 88 00:03:11,849 --> 00:03:12,750 payer partnerships. 89 00:03:13,344 --> 00:03:14,864 You know, one other thing I think for 90 00:03:14,864 --> 00:03:16,224 payers to keep in mind is we're also 91 00:03:16,224 --> 00:03:16,724 anticipating, 92 00:03:17,185 --> 00:03:18,864 you know, some point in the future that 93 00:03:18,864 --> 00:03:21,685 hospice will be carved back into, Medicare Advantage. 94 00:03:21,905 --> 00:03:23,985 And so, that's another thing I think is 95 00:03:24,224 --> 00:03:25,905 and it really should be on the the 96 00:03:25,905 --> 00:03:26,405 radar, 97 00:03:26,705 --> 00:03:28,965 of payers as we think about growth. 98 00:03:30,199 --> 00:03:30,699 Absolutely. 99 00:03:31,159 --> 00:03:33,080 And going off of that, at an industry 100 00:03:33,080 --> 00:03:35,480 level, how would you describe the biggest barriers 101 00:03:35,480 --> 00:03:36,219 to effectively 102 00:03:36,760 --> 00:03:39,560 serving and engaging members? And what opportunities do 103 00:03:39,560 --> 00:03:41,560 you see for large scale improvements, and how 104 00:03:41,560 --> 00:03:43,500 are you applying this in your current strategy? 105 00:03:43,865 --> 00:03:46,205 Yeah. This is another really important question. 106 00:03:46,665 --> 00:03:48,905 You know, engagement is critical, and it's something 107 00:03:48,905 --> 00:03:50,504 we spend a lot of time focusing in 108 00:03:50,504 --> 00:03:53,385 it, at Tuesday Health. Our our patients with 109 00:03:53,385 --> 00:03:55,145 serious illness are they have a lot of 110 00:03:55,145 --> 00:03:57,064 challenges, and it's not just medical. It can 111 00:03:57,064 --> 00:03:58,050 be psychosocial, 112 00:03:58,590 --> 00:04:00,909 a lot of social determinant challenges. And so 113 00:04:00,909 --> 00:04:02,830 we think about we really think about engagement 114 00:04:02,830 --> 00:04:04,349 in 2 ways. 1 is obviously with the 115 00:04:04,349 --> 00:04:05,090 the patient, 116 00:04:05,550 --> 00:04:07,629 and their loved ones. Their caregivers are critically 117 00:04:07,629 --> 00:04:08,689 important to engage. 118 00:04:08,990 --> 00:04:11,645 As patients get sicker, oftentimes, the caregivers making 119 00:04:11,645 --> 00:04:12,305 the decisions, 120 00:04:13,004 --> 00:04:14,764 you know, are really key moments in their 121 00:04:14,764 --> 00:04:16,865 in their journey for that their loved one, 122 00:04:17,004 --> 00:04:18,305 but also for providers. 123 00:04:18,605 --> 00:04:20,925 And, you know, supportive care study after study 124 00:04:20,925 --> 00:04:22,925 shows it can be incredibly helpful but sometimes 125 00:04:22,925 --> 00:04:24,865 the biggest barrier is some of the stigma 126 00:04:24,870 --> 00:04:27,110 associated with supportive and palliative care. People confuse 127 00:04:27,110 --> 00:04:28,250 it with hospice. 128 00:04:28,870 --> 00:04:30,790 And so, what we'd really try to do 129 00:04:30,790 --> 00:04:32,629 is is go in market and hire both 130 00:04:32,629 --> 00:04:34,649 provider and patient engagement specialists, 131 00:04:35,269 --> 00:04:37,509 to really understand the needs, understand where are 132 00:04:37,509 --> 00:04:39,269 the pain points are, understand where we can 133 00:04:39,269 --> 00:04:40,089 offer value. 134 00:04:40,634 --> 00:04:42,794 As it relates to both providers and patients, 135 00:04:42,794 --> 00:04:44,634 we really aim to solve a problem for 136 00:04:44,634 --> 00:04:46,014 both providers and patients, 137 00:04:46,474 --> 00:04:46,974 within 138 00:04:47,274 --> 00:04:49,995 that, you know, the first, visitor to, so 139 00:04:49,995 --> 00:04:51,995 we can show our value and we find 140 00:04:51,995 --> 00:04:54,574 that as incredibly helpful. We're we're excited because, 141 00:04:54,870 --> 00:04:57,189 we're really seeing high levels of engagement so 142 00:04:57,189 --> 00:04:58,730 far with our clinical deployment. 143 00:05:00,230 --> 00:05:03,509 And switching gears slightly to the leadership side 144 00:05:03,509 --> 00:05:05,910 of things, keeping pace in today's dynamic health 145 00:05:05,910 --> 00:05:07,370 care landscape is challenging. 146 00:05:08,055 --> 00:05:09,814 So what's one piece of advice you'd share 147 00:05:09,814 --> 00:05:12,134 with peer leaders to grow their businesses while 148 00:05:12,134 --> 00:05:13,595 keeping members top of mind? 149 00:05:14,535 --> 00:05:15,975 Yeah. I you know, I think it's a 150 00:05:15,975 --> 00:05:18,375 it's a simple answer. It's exactly what you 151 00:05:18,375 --> 00:05:19,814 said at that end of that question. It's 152 00:05:19,814 --> 00:05:21,415 really how do we keep the the patient? 153 00:05:21,415 --> 00:05:23,160 And I'd also say they're loved when they're 154 00:05:23,160 --> 00:05:23,660 caregiver 155 00:05:24,279 --> 00:05:26,439 at at really as their north star. People 156 00:05:26,439 --> 00:05:29,180 oftentimes forget about really thinking about that dyadic 157 00:05:29,240 --> 00:05:31,160 relationship, which I think is critical in health 158 00:05:31,160 --> 00:05:32,699 care. And I think 159 00:05:33,080 --> 00:05:34,694 I think the challenge for leaders is how 160 00:05:34,694 --> 00:05:36,694 do you actually, live and breathe that as 161 00:05:36,694 --> 00:05:38,694 an organization instead of having it just be 162 00:05:38,694 --> 00:05:41,034 something that kinda sounds like a Hallmark card. 163 00:05:41,574 --> 00:05:43,254 And so for us, we really try to 164 00:05:43,254 --> 00:05:43,754 integrate 165 00:05:44,134 --> 00:05:46,615 keeping the patient and their caregiver first really 166 00:05:46,615 --> 00:05:48,615 into the fabric of our company. We start 167 00:05:48,615 --> 00:05:50,569 every meeting where we're gonna need to make, 168 00:05:50,810 --> 00:05:52,990 important decisions with a patient's story. 169 00:05:53,610 --> 00:05:55,209 And that I think really helps ground and 170 00:05:55,209 --> 00:05:57,290 center us. And I think what's nice in 171 00:05:57,290 --> 00:05:59,610 in palliative and supportive care, we have an 172 00:05:59,610 --> 00:06:02,009 opportunity where the Venn diagrams of doing the 173 00:06:02,009 --> 00:06:03,930 right thing for a patient and their loved 174 00:06:03,930 --> 00:06:07,464 ones also overlaps with, being able to reduce 175 00:06:07,464 --> 00:06:10,185 unwanted medical spend that oftentimes isn't isn't helpful. 176 00:06:10,185 --> 00:06:12,425 So we really try to, you know, keep 177 00:06:12,425 --> 00:06:14,104 that, front and center. We know if we 178 00:06:14,104 --> 00:06:16,345 can deliver for the member and their loved 179 00:06:16,345 --> 00:06:18,845 ones, everything else will fall into place. 180 00:06:20,000 --> 00:06:22,500 And as we are wrapping up our conversation, 181 00:06:22,639 --> 00:06:26,100 I'd love to just visit technology quickly. So 182 00:06:26,160 --> 00:06:28,959 how is tech supporting value based care member 183 00:06:28,959 --> 00:06:30,819 focused initiatives at your organization? 184 00:06:31,439 --> 00:06:33,839 And what's most exciting for you here and 185 00:06:33,839 --> 00:06:36,055 why? Yeah. I love this question. It's a 186 00:06:36,055 --> 00:06:37,754 really interesting question to me because 187 00:06:38,134 --> 00:06:39,574 a lot of people think a lot of 188 00:06:39,574 --> 00:06:41,034 palliative care clinicians, supportive 189 00:06:41,414 --> 00:06:41,914 clinicians, 190 00:06:42,615 --> 00:06:44,694 you know, really see that field really built 191 00:06:44,694 --> 00:06:46,474 over the last 20 years on the humanness 192 00:06:46,854 --> 00:06:49,350 of Medicare, really, that personal touch, really, 193 00:06:49,830 --> 00:06:51,750 being with patients at the bedside in these 194 00:06:51,750 --> 00:06:53,129 in these challenging moments. 195 00:06:53,750 --> 00:06:55,990 And so sometimes thinking about technology can seem 196 00:06:55,990 --> 00:06:58,790 antithetical to that, but we really think about 197 00:06:58,790 --> 00:07:01,189 technology as as something that we can harness 198 00:07:01,189 --> 00:07:02,490 to really pull in 199 00:07:02,790 --> 00:07:04,649 our clinicians at key points, 200 00:07:05,095 --> 00:07:07,254 to be able to optimize care. One of 201 00:07:07,254 --> 00:07:09,335 the challenges that we see in palliative and 202 00:07:09,335 --> 00:07:11,095 supportive care is there's not enough clinicians out 203 00:07:11,095 --> 00:07:14,375 there. There's only about 5,000 to 6000 palliative 204 00:07:14,375 --> 00:07:17,355 care physicians out there. We estimate by 2050, 205 00:07:17,975 --> 00:07:19,975 80 to 90,000,000 people will need some type 206 00:07:19,975 --> 00:07:21,860 of palliative supportive care, and and the needs 207 00:07:21,860 --> 00:07:24,599 are present now. And so we use technology 208 00:07:24,659 --> 00:07:27,159 at several key points, in a patient journey. 209 00:07:27,459 --> 00:07:29,399 One is we have a highly accurate 210 00:07:29,860 --> 00:07:31,159 identification algorithm. 211 00:07:31,539 --> 00:07:32,899 One of the challenges that a lot of 212 00:07:32,899 --> 00:07:34,824 payers experience is how do we really identify 213 00:07:34,884 --> 00:07:36,725 the right patients who could benefit from this 214 00:07:36,725 --> 00:07:37,545 type of care? 215 00:07:37,925 --> 00:07:40,485 And so we start by using, thoughtful predictive 216 00:07:40,485 --> 00:07:42,504 analytics to be able to identify patients. 217 00:07:43,125 --> 00:07:45,444 And then along the care journey, we also 218 00:07:45,444 --> 00:07:45,944 incorporate, 219 00:07:46,324 --> 00:07:48,870 2 2 important things. 1 is telepalliative care. 220 00:07:49,110 --> 00:07:50,709 Members of our team, we were fortunate to 221 00:07:50,709 --> 00:07:53,050 publish an article in JAMA showing that telepalliative 222 00:07:53,269 --> 00:07:56,229 care can be, almost as effective actually as 223 00:07:56,229 --> 00:07:58,310 in person, palliative care. How we use that 224 00:07:58,310 --> 00:08:00,229 is and think about the nuance there is 225 00:08:00,229 --> 00:08:00,944 really important, 226 00:08:01,345 --> 00:08:03,585 but we're excited about our telepalliative care delivery 227 00:08:03,585 --> 00:08:05,985 to reach, you know, to really reach more 228 00:08:05,985 --> 00:08:08,464 patients in need. Another is how we think 229 00:08:08,464 --> 00:08:10,004 about continuous monitoring, 230 00:08:10,384 --> 00:08:13,105 and we actually published a study showing that 231 00:08:13,105 --> 00:08:15,209 we can use continuous monitoring in patients with 232 00:08:15,289 --> 00:08:16,889 serious illness to not only improve their care, 233 00:08:16,889 --> 00:08:18,269 but also reduce hospitalizations. 234 00:08:19,050 --> 00:08:21,610 And then lastly, one challenge for clinicians is 235 00:08:21,610 --> 00:08:24,009 really knowing when someone is getting sicker and 236 00:08:24,009 --> 00:08:25,870 really getting into that end of life phase. 237 00:08:25,930 --> 00:08:28,169 And so we also use technology to better 238 00:08:28,169 --> 00:08:28,669 predict 239 00:08:28,970 --> 00:08:31,194 as patients are getting sicker. So we can 240 00:08:31,194 --> 00:08:33,434 not only leverage greater resources to help with 241 00:08:33,434 --> 00:08:35,595 things like symptom management, keep folks out of 242 00:08:35,595 --> 00:08:36,174 the hospital, 243 00:08:36,554 --> 00:08:38,634 but make sure that we're having those important 244 00:08:38,634 --> 00:08:41,274 conversations that oftentimes don't happen. And in that 245 00:08:41,274 --> 00:08:43,590 way, we can really help folks, you know, 246 00:08:44,070 --> 00:08:46,149 transition to hospice when the time is right, 247 00:08:46,149 --> 00:08:47,990 not too early and not too late, and 248 00:08:47,990 --> 00:08:49,910 really help folks and their loved ones have 249 00:08:49,910 --> 00:08:51,590 a soft landing at the end of life. 250 00:08:51,910 --> 00:08:53,750 So we're really trying to help folks from 251 00:08:53,750 --> 00:08:54,649 the point of identification 252 00:08:55,350 --> 00:08:56,629 all the way through that end of life 253 00:08:56,629 --> 00:08:58,870 journey using technology at key points along the 254 00:08:58,870 --> 00:08:59,370 way. 255 00:09:00,125 --> 00:09:02,284 Wonderful. Well, thank you so much for taking 256 00:09:02,284 --> 00:09:03,644 the time to join me today on the 257 00:09:03,644 --> 00:09:06,044 Becker's healthcare podcast. Again, we're live at the 258 00:09:06,044 --> 00:09:06,544 2024 259 00:09:06,924 --> 00:09:08,065 payer issues roundtable. 260 00:09:08,845 --> 00:09:10,144 K. Thank you so much.