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 --> 00:00:12,160
treatment, prediction, and prevention of health care's most

5
00:00:12,160 --> 00:00:13,139
complex conditions

6
00:00:13,605 --> 00:00:16,344
easier and more accessible as we drive organizations

7
00:00:16,644 --> 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 --> 00:00:28,884
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
00:00:35,020 --> 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
00:00:47,625 --> 00:00:49,784
This is Gracelyn Keller with the Becker's Healthcare

20
00:00:49,784 --> 00:00:51,945
Podcast, and we are recording live at the

21
00:00:51,945 --> 00:00:52,445
2024

22
00:00:52,825 --> 00:00:53,965
payer issues roundtable.

23
00:00:54,500 --> 00:00:56,500
I'm currently joined by Brad Riley, who is

24
00:00:56,500 --> 00:00:58,979
the VP of clinical delivery at Longevity Health

25
00:00:58,979 --> 00:01:00,739
Plans. So, Brad, thank you for joining me

26
00:01:00,739 --> 00:01:02,739
today. We'd love to start our conversation by

27
00:01:02,739 --> 00:01:04,420
having you introduce yourself and tell us a

28
00:01:04,420 --> 00:01:07,079
little bit more about your role. Sure. Absolutely.

29
00:01:07,140 --> 00:01:09,755
Well, first off, appreciate you having me. Thank

30
00:01:09,755 --> 00:01:12,155
you. So like, Grace said, I'm the vice

31
00:01:12,155 --> 00:01:15,355
president of clinical delivery at Longevity Health Plan.

32
00:01:15,674 --> 00:01:18,075
We're the fastest growing iSNP in the nation

33
00:01:18,075 --> 00:01:18,734
right now,

34
00:01:19,435 --> 00:01:22,829
and we are both a, clinical services organization

35
00:01:23,210 --> 00:01:26,329
and an institutionalized special needs plan. And what

36
00:01:26,329 --> 00:01:28,750
that means is we place advanced practice

37
00:01:29,049 --> 00:01:32,250
providers within skilled nursing facilities. We have 13

38
00:01:32,250 --> 00:01:33,070
different markets,

39
00:01:33,450 --> 00:01:34,189
and, ultimately,

40
00:01:34,890 --> 00:01:37,645
they are there to help patient centered care

41
00:01:37,645 --> 00:01:40,284
and drive, better health outcomes and goals of

42
00:01:40,284 --> 00:01:42,064
care for our iSNP,

43
00:01:42,685 --> 00:01:43,185
members.

44
00:01:44,045 --> 00:01:46,204
Wonderful. Well, thank you for being here. And

45
00:01:46,204 --> 00:01:48,685
let's start our conversation with growth goals. So

46
00:01:48,685 --> 00:01:51,564
from improving member experience to expanding value based

47
00:01:51,564 --> 00:01:53,369
care to controlling costs,

48
00:01:53,750 --> 00:01:55,049
payer executives

49
00:01:55,349 --> 00:01:57,670
have ambitious growth goals for the rest of

50
00:01:57,670 --> 00:01:59,769
this year and looking into 2025.

51
00:02:00,390 --> 00:02:01,909
So in your role, what is your top

52
00:02:01,909 --> 00:02:03,750
priority, and how are you planning to get

53
00:02:03,750 --> 00:02:04,250
there?

54
00:02:04,629 --> 00:02:06,170
Absolutely. I I think

55
00:02:06,715 --> 00:02:08,794
for me, specifically, in my role, one of

56
00:02:08,794 --> 00:02:10,254
the big things that I do is

57
00:02:10,794 --> 00:02:13,194
the, VP of clinical deliveries. I help liaison

58
00:02:13,194 --> 00:02:13,694
between

59
00:02:14,155 --> 00:02:14,895
our IT

60
00:02:15,194 --> 00:02:18,235
department and our integrations with predictive modeling and

61
00:02:18,235 --> 00:02:20,175
different things and our clinical teams.

62
00:02:20,510 --> 00:02:22,990
And so for me, specifically, I think one

63
00:02:22,990 --> 00:02:23,969
of the big things,

64
00:02:24,270 --> 00:02:27,069
obviously, AI, Gen AI, predictive analytics is big

65
00:02:27,069 --> 00:02:27,729
right now.

66
00:02:28,110 --> 00:02:29,870
Figuring out how we can,

67
00:02:30,189 --> 00:02:32,510
position ourselves to better leverage that as an

68
00:02:32,510 --> 00:02:33,010
organization,

69
00:02:33,395 --> 00:02:35,014
I think, is something a lot of organizations

70
00:02:35,074 --> 00:02:37,014
are trying to find figure out right now.

71
00:02:37,395 --> 00:02:39,175
One of the biggest obstacles

72
00:02:39,715 --> 00:02:42,115
organizations are running into is you have these

73
00:02:42,115 --> 00:02:44,854
legacy systems, but these legacy systems weren't built

74
00:02:45,155 --> 00:02:47,314
with this kind of technology in mind all

75
00:02:47,314 --> 00:02:49,759
the time. And so there's plenty of data,

76
00:02:49,900 --> 00:02:52,780
but the data is not particularly available or

77
00:02:52,780 --> 00:02:54,459
it's not organized in the right way or

78
00:02:54,459 --> 00:02:56,459
it's not refreshed at the right cadence. And

79
00:02:56,459 --> 00:02:58,959
so aggregating and setting up infrastructure

80
00:02:59,979 --> 00:03:02,139
to support the ability of having a good

81
00:03:02,139 --> 00:03:02,639
foundational

82
00:03:03,099 --> 00:03:04,754
dataset that you could help drive some your

83
00:03:04,754 --> 00:03:06,675
operations off of is something I'm definitely gonna

84
00:03:06,675 --> 00:03:08,854
be pushing through 20 the end of 2024

85
00:03:09,155 --> 00:03:10,055
and and 2025.

86
00:03:11,314 --> 00:03:14,435
And shifting our conversation towards the digital realm,

87
00:03:14,435 --> 00:03:17,009
how is technology supporting value based care for

88
00:03:17,009 --> 00:03:19,590
member focused initiatives at your organization?

89
00:03:20,209 --> 00:03:22,209
And what is exciting you most in this

90
00:03:22,209 --> 00:03:22,709
space?

91
00:03:23,729 --> 00:03:24,229
So,

92
00:03:24,689 --> 00:03:26,629
you know, I think, first off,

93
00:03:27,250 --> 00:03:27,750
longevity

94
00:03:28,735 --> 00:03:30,294
our our entire business model is built off

95
00:03:30,294 --> 00:03:32,754
of a value based care. Right?

96
00:03:33,775 --> 00:03:35,235
We firmly believe that

97
00:03:35,614 --> 00:03:36,114
driving

98
00:03:37,134 --> 00:03:39,455
health outcomes and ensuring that our members meet

99
00:03:39,455 --> 00:03:40,194
their care,

100
00:03:40,655 --> 00:03:43,294
their goals of care and their better care

101
00:03:43,294 --> 00:03:45,120
outcomes can to be driven both by clinical

102
00:03:45,120 --> 00:03:45,620
intervention,

103
00:03:46,000 --> 00:03:46,819
but also,

104
00:03:47,599 --> 00:03:48,099
informed

105
00:03:48,479 --> 00:03:51,060
through proper data driven decisions.

106
00:03:51,520 --> 00:03:52,819
And I think right now,

107
00:03:53,840 --> 00:03:55,680
you know, there's a really good opportunity, and

108
00:03:55,680 --> 00:03:57,120
I'm I've referenced it a little bit in

109
00:03:57,120 --> 00:03:59,614
our last, question. But there's a really good

110
00:03:59,614 --> 00:04:02,834
opportunity right now to leverage available data

111
00:04:04,735 --> 00:04:05,474
in helping

112
00:04:05,775 --> 00:04:08,735
inform decision making without using the data to

113
00:04:08,735 --> 00:04:10,254
make decisions. And what I mean by that

114
00:04:10,254 --> 00:04:10,754
is,

115
00:04:11,230 --> 00:04:13,069
you know, I think the big buzz right

116
00:04:13,069 --> 00:04:15,150
now is generative AI, chat g p t,

117
00:04:15,150 --> 00:04:17,389
you know, Copilot, whatever whatever people have access

118
00:04:17,389 --> 00:04:19,730
to. And I think, you know, that that's

119
00:04:20,110 --> 00:04:21,490
fun, but it's also

120
00:04:22,029 --> 00:04:24,129
it's not controlled. It's not standardized.

121
00:04:24,485 --> 00:04:26,485
There's a lot of exciting work that is

122
00:04:26,485 --> 00:04:28,404
going to, be available to us in the

123
00:04:28,404 --> 00:04:30,884
next few years. And I think, 1, building

124
00:04:30,884 --> 00:04:33,285
a foundational data structure to help support that's

125
00:04:33,285 --> 00:04:35,285
key. But in the interim, we can use

126
00:04:35,285 --> 00:04:37,764
other types of analytics. Advanced analytics is what

127
00:04:37,764 --> 00:04:39,540
I'd call it. Right? It's not technically AI,

128
00:04:39,620 --> 00:04:41,860
but you could use advanced analytics like predictive

129
00:04:41,860 --> 00:04:44,279
modeling and other things to really drive

130
00:04:44,580 --> 00:04:48,339
clinical outcomes and to understand your patient population

131
00:04:48,339 --> 00:04:50,580
a lot more. And I think the biggest

132
00:04:50,580 --> 00:04:52,680
key here, right, is is building opportunities

133
00:04:53,935 --> 00:04:54,514
for payers

134
00:04:56,095 --> 00:04:57,774
to assess all the data that they have

135
00:04:57,774 --> 00:05:00,115
available to them and then equip it,

136
00:05:00,574 --> 00:05:02,514
put it in the hands of the clinicians

137
00:05:03,294 --> 00:05:05,214
to operate at the top of their license.

138
00:05:05,214 --> 00:05:06,914
And so if we're able to,

139
00:05:07,689 --> 00:05:09,389
take data and take analytics

140
00:05:09,849 --> 00:05:12,569
and use it to allow our clinicians to

141
00:05:12,569 --> 00:05:14,829
do less administrative work or more informed

142
00:05:15,209 --> 00:05:17,769
administrative work, every single day, I would opt

143
00:05:17,769 --> 00:05:19,370
for a clinician to be able to spend

144
00:05:19,370 --> 00:05:21,389
more time with the patient talking to them

145
00:05:21,449 --> 00:05:22,269
rather than

146
00:05:22,935 --> 00:05:23,675
spending time

147
00:05:24,375 --> 00:05:26,535
going through files and trying to figure out

148
00:05:26,535 --> 00:05:27,754
what information is where

149
00:05:28,295 --> 00:05:30,795
through many different platforms. So that's, I think,

150
00:05:30,855 --> 00:05:33,574
the big thing we're driving is is leveraging

151
00:05:33,574 --> 00:05:36,189
data, making sure it's it's accurate, making sure

152
00:05:36,189 --> 00:05:38,750
it's consistent, and giving it to clinicians to

153
00:05:38,750 --> 00:05:40,350
allow them to operate at the top of

154
00:05:40,350 --> 00:05:41,009
their license.

155
00:05:41,709 --> 00:05:42,209
Absolutely.

156
00:05:42,750 --> 00:05:43,250
And

157
00:05:44,110 --> 00:05:45,810
when we look at leadership

158
00:05:46,189 --> 00:05:46,689
growth,

159
00:05:47,069 --> 00:05:49,944
keeping pace in today's dynamic health care landscape

160
00:05:50,004 --> 00:05:52,245
is challenging. So what is a piece of

161
00:05:52,245 --> 00:05:54,644
advice you'd like to share to peer leaders

162
00:05:54,644 --> 00:05:56,485
to help grow their business and keep members

163
00:05:56,485 --> 00:05:57,305
top of mind?

164
00:05:57,925 --> 00:06:00,084
Sure. So sticking with the theme, I think

165
00:06:00,084 --> 00:06:00,584
establishing

166
00:06:01,204 --> 00:06:01,704
a

167
00:06:02,629 --> 00:06:03,129
foundational

168
00:06:03,669 --> 00:06:06,709
dataset, reassessing your legacy systems that you're using,

169
00:06:06,709 --> 00:06:07,209
understanding

170
00:06:07,910 --> 00:06:10,810
how potential current integrations or future integrations

171
00:06:11,350 --> 00:06:12,970
could impact or drive

172
00:06:13,430 --> 00:06:15,915
factors for technologies that may not be,

173
00:06:16,235 --> 00:06:18,314
widely available right now, but might be in

174
00:06:18,314 --> 00:06:19,675
the next few years, I think, is gonna

175
00:06:19,675 --> 00:06:21,835
be key. We should be a couple years

176
00:06:21,835 --> 00:06:22,814
ahead. Traditionally,

177
00:06:23,115 --> 00:06:25,595
the the payer industry is is 3 years

178
00:06:25,595 --> 00:06:28,095
behind the technology industry, right, at least.

179
00:06:28,475 --> 00:06:30,875
I think some instances, maybe a little more.

180
00:06:30,875 --> 00:06:33,160
But I think the big thing is

181
00:06:33,939 --> 00:06:36,020
every I I think every leader needs to

182
00:06:36,020 --> 00:06:37,080
be thinking about,

183
00:06:37,540 --> 00:06:38,040
specifically,

184
00:06:38,660 --> 00:06:40,339
all the work that they're doing now and

185
00:06:40,339 --> 00:06:42,259
they're doing next year. They need to be

186
00:06:42,259 --> 00:06:44,600
thinking about how that's gonna impact their foundational

187
00:06:44,740 --> 00:06:47,000
data that they use at an enterprise level

188
00:06:47,435 --> 00:06:49,754
in 3, 4 years to make sure that

189
00:06:49,754 --> 00:06:52,314
there aren't any unintended consequences that could hinder

190
00:06:52,314 --> 00:06:54,014
their ability to leverage technologies

191
00:06:54,395 --> 00:06:56,154
that are, you know, not quite available yet,

192
00:06:56,154 --> 00:06:57,214
but on their way.

193
00:06:57,915 --> 00:07:00,074
And as we wrap our conversation today, are

194
00:07:00,074 --> 00:07:01,675
there any parting words you'd like to share

195
00:07:01,675 --> 00:07:02,415
for the podcast?

196
00:07:03,509 --> 00:07:05,610
I think if you're not aware of longevity

197
00:07:05,669 --> 00:07:07,509
health, I recommend you you take a minute

198
00:07:07,509 --> 00:07:10,009
and check us out. Really great organization.

199
00:07:10,550 --> 00:07:12,069
Like I said, it's the fastest growing I

200
00:07:12,069 --> 00:07:13,930
SNP in the in the nation right now.

201
00:07:14,149 --> 00:07:16,649
And as a clinical services organization,

202
00:07:17,110 --> 00:07:19,050
institutionalized special needs plan.

203
00:07:19,485 --> 00:07:21,745
We partner with both national insurers,

204
00:07:22,204 --> 00:07:23,425
long term care facilities,

205
00:07:23,884 --> 00:07:25,104
skilled nursing facilities,

206
00:07:25,564 --> 00:07:27,345
and our goal is to meet the unique

207
00:07:27,564 --> 00:07:29,824
medical, social, and emotional needs

208
00:07:30,444 --> 00:07:33,410
of our nursing home residents. And there's no

209
00:07:33,410 --> 00:07:35,970
other space or place I'd like to to

210
00:07:35,970 --> 00:07:37,569
be in to be able to make that

211
00:07:37,569 --> 00:07:39,889
impact. I think sometimes it's it's really hard

212
00:07:39,889 --> 00:07:41,410
to when when you work in data and

213
00:07:41,410 --> 00:07:44,210
when you work in, analytics to to understand

214
00:07:44,210 --> 00:07:45,430
your impact to

215
00:07:46,735 --> 00:07:49,074
members is a little hard. But I think

216
00:07:49,455 --> 00:07:52,574
absolutely recommend, check out longevity health. There's a

217
00:07:52,574 --> 00:07:53,955
lot of good things going on.

218
00:07:54,495 --> 00:07:56,254
Wonderful. Well, Brad, thanks for being on the

219
00:07:56,254 --> 00:07:58,735
Becker's Healthcare podcast today. Again, we are live

220
00:07:58,735 --> 00:08:00,995
at the 2024 payer issues roundtable.

221
00:08:01,572 --> 00:08:02,472
Appreciate it. Thanks.