This is Laura Dirda with the Becker's Healthcare
Podcast. I'm thrilled today to be joined by
Catherine Barresi, chief health services officer at Partnership
Health Plan of California.
Catherine, it's a pleasure to have you on
the podcast today.
Likewise. Thanks for having me.
Absolutely. Now I am looking forward to digging
into some of the cool things that you're
doing out there in California, as well as
what you're planning for the future. But before
we dive in, could you please introduce yourself
and tell us a little bit about your
background?
Great. Thanks, Laura, and thanks again for having
me.
So, again, I'm Catherine Brassy. I'm a nurse
executive,
at Partnership Health Plan of California. And in
my current role, I'm the chief health services
officer.
And what that means is that I oversee
a huge,
piece of clinical operations and and strategic initiatives,
for the health plan, really with the focus
of including the out, and improving outcomes of
our members.
I be began my career as a nurse,
and worked specifically in case management and public
health. And this gave me a really strong
clinical foundation,
and and structure,
for what members experience,
in the outpatient world, in health care.
Well, that's great to hear. And, you know,
really cool that you've got this,
role now at Partnership Health Plan of California.
Could you tell us a little bit about,
some of the biggest issues that you're following
in health care and where it's headed in
the new year?
Yeah. There's,
as you know, health care really is top
of mind for everybody, especially after, the latest
election cycle. And really, the top five things
that I'm following and my teams are following
both at Partnership and in our work are,
of course, first and foremost, the big changes
or impacts to Medicaid,
with the new administration.
While we hear rumors, at this point, we
don't have any specific
policies or guidance. We know that the budget
reconciliation process is is upon us,
and there's discussions going on at a federal
level.
California has a lot of individuals on Medicaid
or Medi Cal as it's known in our
state.
In fact, I think the latest poll shifts
something around the order of about 14,000,000,
Californians are on Medicaid.
Partnership, we cover 24 counties in Northern California
with about 900,000
lives,
providing services and benefits,
and high quality health care. So this is
something
that we are are watching and tracking very,
very closely.
The other big focus for partnership,
as I just described, we are in Northern
California, and we have very large communities that
are rural communities,
that often
experience health disparities,
just due
to scale of cost,
economy.
And so for us, this is even more
important to make sure
that
infrastructure and healthcare delivery such as our rural
hospitals and our public hospitals in those communities
are are not disproportionately affected by some of
these policy and access changes.
And then the two and three other areas
that we're focusing on, obviously, improving access to
health care in general across our 24 county
network with things and innovations using technology like
telehealth,
with creative solutioning with our specialty network and
our primary care providers,
but also,
with strong emphasis on member engagement and member
experience,
and use of those those new technologies.
And then the two or three other areas
that we're looking at, as I just described,
AI. We've got an AI committee at partnership,
and looking about, how that technology can improve,
the operations within the health plan and the
service and experience and quality of care that
our members experience,
and then member choice and member voice
as they experience health care.
Because, again, I think that ultimately,
everybody in the health care space knows the
system only works when the system works for
for the people it serves. And so how
we engage and elevate them in in every
aspect of the work we do is is
a high focus for us.
That's great to hear. And, you know, really
helpful to understand some of the challenges that
are ahead. I know as you mentioned, it's
a lot of uncertainties
right now with how things will proceed in
the health care space.
And and how do you look ahead, at
some of these initiatives that you're talking about,
expanding access to care and planning for the
future,
while knowing, you know, that things could change
at any moment?
I think we we we stay true to
the partnerships that we've built and the communities
that we partner with to do that,
and we look towards the opportunities.
Granted, yes, it's it's a lot of change
management and it's a lot of uncertainty.
But the goals and values are the same
no matter which community you look at, when
it comes to health care. People want
doctors and specialists and providers and hospitals that
they can access easily when they need to.
People want low cost health care.
That doesn't mean lesser quality. It just means
lower cost, whether it be for prescriptions
or for,
specialist visits.
Our members on Medicaid, Medi Cal, many do
not have a a share of cost because
they qualify for income or disability.
And so
that is,
a common thread. And I think as long
as we remain focused on that work,
where the policy lies in that, as long
as our principles are the same, we'll get
to that end goal together.
That is a really great perspective, and I
I think a strong way to approach times
like these. Now looking ahead, what are you
most excited about, or what makes you nervous?
I'm most excited,
in three areas. I think first would be
the technology.
We've seen some rapid gains,
as I mentioned earlier with AI, but also
other technologies and technology partners in this space
bringing new solutions into health care.
Health care is, by far and wide, no
matter where you're at within the delivery system,
whether you're in an outpatient setting, a hospital
setting, on the payer side,
The data and the exchange of information is
becoming more and more relevant and key to
optimizing clinical decision making outcomes,
risk adjustments, payments, better use of resources. And
so it's great to see technology partners in
that space to enhance the work that we
do and not hamper clinicians or or operations.
I'm also really excited about rural health support.
I I think when,
groups or coalitions use words and terms like,
equity or disparity,
we often use that in connotation
of, you know, somebody's
race or ethnicity.
I think of rural health disparities. I think
of community disparities,
areas where there has been lack of infrastructure
investment,
business opportunity growth,
for example.
And how they experience and use,
and navigate health care is very different than
suburban or urban settings.
And so there's some really great best practices
coming out of there that I'm excited about
working and potentially scaling those, not just across
partnerships,
network, but really elevating those as a best
practice within Medicaid.
And then lastly,
our member engagement.
Again, member voice is incredibly important, and I
think there is a disconnect between what people
understand health care to be,
and how it is currently working for them
and and that translation and bringing them to
make sure that they have a seat at
the table and that they understand things
about how how benefits get decided, how,
how prior authorization works, what, you know, who
qualifies for what.
The system is set up ideally to be
working for them, and right now, it's not.
And so having those voices at the table
as as key partners is is actually really,
really exciting because the insights they lend
only improve the the quality of the output.
And then it's really great to hear. I'm
curious.
You know, in talking about the ability to
connect with, the broader community and engage with
them and and and,
figure out, you know, how you can improve
and have additional engagement. Is there anything you
learned from some of those efforts? Or how
did you go about,
making those connections, in a way that yielded
results?
Well, in terms of the, you know, the
member engagement piece, partnership has a multitude of
existing committees and coalitions
made up of,
stakeholders for the the folks that we serve.
So, in fact, even our our board of
commissioners is comprised of county behavioral health directors,
hospital CEOs, clinic CMOs,
community based organization partners and leaders. And so
it really is a tapestry
of everybody
within the community and and health care delivery
network that is meeting,
deciding,
leading efforts to improve care. And in terms
of our members, we have a community,
advisory group where we've got our actual members
who sit in and provide feedback directly to
the health plan on what we are doing,
whether it be policies or benefits or experience.
We have three of our members on our
board as well,
who who sit and power share along with
our board of commissioners around our finances and
strategic operations and vision.
So it's it really is ingrained in in
our company's culture and mission to make sure
that,
that engagement piece is there.
Lastly, I will add, we have special
committees of, subpopulations within our membership,
that are unique, that that need,
a more strategic and intentional focus. So for
example, in California, there is a program called
California Children's Services, and it is for children
and youth and young adults with, special and
complex healthcare needs. And at Partnership,
we are,
we have a majority of them within our
membership in the counties that we serve. And
so, we have a special committee of just
those clients, their parents, and or their caregivers,
to have bidirectional feedback about about their experiences
and how we can improve their health care
outcomes being that they are unique within the
health care delivery system and they are also
high users of health care delivery. And so
who best to talk to than them, in
terms of making sure that we're getting it
right?
That's such a great point. Thank you for
walking us through that. Now before we wrap
up our conversation, I'm wondering, what will the
most effective health care leaders need in order
to be successful in the next two to
three years, especially given some of the big
themes we've talked about today?
Yeah. I
first and foremost, my best piece of advice
is health care leaders, as always, you've gotta
be agile.
Things are constantly changing in health care and
and more so. The pace feels more more
frenetic.
But, agile, tech savvy, and financially strategic,
and deeply committed to the member voice, as
I explained,
with having them always at the center for
for high quality outcomes.
The best leaders will champion quality and accessibility,
with personalized approaches.
And they're they're gonna need to stay ahead
of these policy changes,
compliance requirements, reimbursement models.
That that's going to be a key component,
in order to leverage
the existing funding streams and and key partners,
that are out there.
With the rapid shifts in potential regulations that
are coming,
leaders in healthcare are really going to have
to kind of think outside
their existing coalitions,
for for broader opportunities for partnership.
I think and believe and have seen that
we are more more alike than we are
different.
And so we're gonna need health care leaders
that that can work together on the similarities,
resources more appropriately.
Catherine, thank you so much for joining us
on the podcast today. This has been such
a fun and fascinating conversation, and I look
forward to connecting with you again soon.
Sounds great. Thank you so much, Laura, for
having me.