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This is Gracelyn Keller with the Becker's Healthcare
podcast, and we are live at the 2024
payer issues roundtable.
I'm currently joined by Anne Groves who serves
as market president, Arcos
Health. Anne, thank you for being here. Would
love to have you start off by introducing
yourself and telling us about your current role
and organization.
Hi. My name's Anne Groves. I am the
market president for Illinois for Arcos Health. I'm
also the chief medical officer in the market.
We are a value based startup company.
We take full risk on
populations
contracting with insurance companies
to provide
wraparound services outside of the hospital
in order to drive down utilization
costs.
Our model is built on the idea that
most health care
is actually delivered at home
and not in the hospital or clinic.
And too many patients leave the doctor's office
and then don't follow-up on care plans for
whatever reason.
Wonderful. Well, thank you for being here. And
let's start our conversation
with growth goals. So from improving member experience
and expanding value based care to controlling costs,
payer executives have ambitious growth goals for the
rest of this year and looking ahead into
2025.
So in your role, what is your top
priority, and how are you planning to get
there?
So our top priority
is member engagement.
All of the challenges that you just described
have this similar route.
Patients don't understand
why it's important for them to
do all of the health care measures that
we're asking of them. They don't understand why
their annual exam matters.
We have a Medicare Advantage population.
Our members don't understand why they need to
do their blood pressure screening, get their hemoglobin
a one c checked, or any of the
other HEDIS measures that play into
the payers star ratings.
So we need to get out and talk
to our members 1 on 1
in order to
educate them and in order to get their
cooperation.
Absolutely.
And going off of that at an industry
level, how would you describe the biggest barriers
to effectively serving and engaging members? And what
opportunities do you see for large scale improvements
and how you're applying these to your current
strategies?
So by far, the biggest barrier is data.
This is a theme that I'm seeing over
and over again here at Becker's.
Data management is so very difficult.
It's
the root cause is the fact that data
is coming from multiple different sources.
These sources are not integrated.
It is difficult to
tell what is accurate
in the data. And so
the old maxim of garbage in garbage out
applies. We've got to make sure that our
data is
trustworthy
before we act on it.
So
we are
concentrating
on building out a platform where we can
compile data from multiple different payers and then
draw our own conclusions as to where we
need to focus our attention.
When we're looking at large scale improvements,
we have to remember that health care is
personal. So large scale improvements
only come from engaging individual members.
We are working on forms of outreach that
actually get patients
to communicate with us and where we can
educate
as to
our case management services.
And shifting gears slightly toward leadership growth. Keeping
pace in today's dynamic health care landscape
mission, and you have to remember your mission.
You've got to keep also a mission. And
you have to remember your mission. You've got
to keep it front and center with everything
you do. It is absolutely possible to make
money in health care, but you can't forget
why you're doing what you're doing.
Absolutely.
And is there anything else you'd like to
share as a closing remark while we finish
up the podcast here?
So I am a physician by training. I'm
a neonatologist.
And
one theme that I've seen over and over
again is how very siloed
health care is.
We have 3 primary groups
that needs to all interact with each other.
We have our patient,
our providers, and our payers.
And what I'm seeing at the moment is
that the silos don't interconnect
at all.
Even here at a big payer conference, the
number of physicians I've seen
who are
practicing
is so few. It's a little scary. We've
got to have all the voices sitting at
the same table.
Otherwise,
we're never gonna make the changes that we
need to.
Absolutely. Well, Anne, thank you for being here
today and sharing your insights on the Becker's
healthcare podcast. Again, we are recording live at
the 2024 payer issues roundtable. It was my
pleasure. Thank you.