Hello, everyone. This is Jacob Emerson with the
Becker's Pay Your Issues podcast.
Thrilled today to be joined by a special
guest. Doctor Shantanu Agrawal is the chief health
officer at Elevance Health. Doctor Agrawal, thanks so
much for taking the time to be with
me on the podcast today.
Happy to do so, Jacob. Thanks for having
me. Yeah. And before we dive into everything
we wanna talk with you about, can you
tell us a little bit more about yourself,
your background in health care, and what it
is that you're doing today at Elevance Health?
Sure.
So I've been fortunate to have kind of
an interesting journey in health care.
I'm an emergency medicine physician by training, so
I I sort of started my health care
journey as a practicing clinician.
From there, I went into healthcare consulting for
a few years and that really helped me
pivot out of sort of being a %
clinician,
learning some different skills that could be applied
to different companies and organizations.
I spent about six years at the Centers
for Medicare and Medicaid Services,
working on,
program integrity issues there.
From CMS,
I ultimately kind of ended my role there
in a political appointment.
And so at the end of the,
administration, I went over and became the chief,
executive officer of the National Quality Forum, which
is a nonprofit,
based in DC that focuses on quality measurement
and improvement.
And then from there, I came to Hellevance
Health, the role that I'm in now, as
chief health officer.
And here, I I get to work on
a lot of, I think, very interesting things.
I I focus on our whole health strategy,
across the enterprise.
I
work my team works on, quality improvement across
all of our,
member populations.
And then one of the things that I
oversee, which we'll get to talk about today,
is the Hellevance Health Foundation.
Fantastic. Yeah. So let's dive right in and
talk about that, doctor Agarwal, because we we
we wanna hear a little bit about Elavance
Health Foundation's impact investment in site services.
It's a great example for the rest of
the industry in terms of,
what we've been seeing as a growing trend
of health insurers taking a more active role
in supporting social determinants of health, such as
mental health services and access to care in
underserved communities.
So from your perspective,
how do you see the role of of
health insurers evolving in addressing
these broader social needs? And what are some
of the long term benefits for the industry
and for a company like Elevance Health when
when you invest in these community based initiatives?
Yeah. That is a a great question, a
big question. So just, taking a step back,
you know, I think we increasingly realize
that,
social health is just as important as mental
health and physical health. And in fact, those
three components are really the center of our
whole health strategy,
in our company.
So we believe if you address whole health,
you will address quite naturally health care value
and affordability
because it will allow,
us in this case to go beyond sort
of the traditional health care environment and address
the root causes of what often shows up
in traditional health care. And so, you know,
again, I think it's commonly known now in
the field that 80% of what affects a
person's health really isn't about what happens in
the doctor's office. And I say that, of
course, as a doctor, and I I think
doctors are are incredibly important for the work
that they do.
They can't be responsible for everything that happens
that ultimately affects a person's health.
But I think we as a company really
need to play our role in doing that.
So whole health is really central to what
we do. Why I think
social,
care matters is because
a a big chunk of that whole health
paradigm
is, the social resources that a person has.
That might be
their social supports and whether or not they're
socially isolated. It might be their access to
healthy food.
It it it might be their access to,
you know, clean air, clean water, a clean
environment, a place to work out, walk, exercise.
So there's, you know, like, sort of that
entire social ecosystem
that surrounds a person. I've often said, you
know, no one is really healthier than the
community that that they're in.
And so there's a lot that you can
do as a company like ours to address
some of these social context. I think it's
critical to do because, ultimately,
if you don't address root issues like the
quality of the food that a person is
eating, they will invariably develop chronic conditions like
diabetes or hypertension
that then show up in the ER or
show up at the doctor's office. And as
a payer, we're we'll certainly be responsible
for the entirety of that journey. So why
not put our, resources
earlier where we can really affect a person's
life, hopefully stem chronic diseases from developing or
worsening,
and ultimately, you know, provide value for that
member.
Certainly. And I know, from our coverage and
our readership,
Elavance Health is really on the forefront of
addressing social determinants of health among your members
and within the communities you serve.
Shanti, let's let's specifically talk about this most
recent $300,000
investment in mental health services for children and
families, which really underscores the increasing importance of
behavioral health within
overall health outcomes.
Given, as you know, the rising mental health
crisis all over the country, what are some
of the further steps you think insurers should
be taking right now to better integrate mental
health support into their broader health benefits offerings?
Yeah. So, again, let me just remind the
audience a little bit like,
this,
work is being conducted through the foundation. Now
I think addressing mental health,
behavioral health is incredibly important for our company
as a whole, even of course outside of
the foundation and for the industry.
And really integrating mental health with other kinds
of healthcare delivery, including social is really important
because oftentimes
these issues hang together.
What the foundation is doing very differently that
I I just want people to know about
is, you know, the foundation is has existed
for years and in the vast majority of
that time, it's been a grant making organization,
which means we invite nonprofit partners to come
in and apply for grants, and then we
we provide those grants for specific areas of
programmatic work. As a former CEO of a
nonprofit, I know exactly what that feels like
from the
applying and receiving side, and now I get
to sort of do it on the foundation
side.
What I wanted to do is to try
to open the aperture of the foundation a
little bit. We're we're never gonna move away
from being a grant making organization.
But, you know, grant grants are wonderful for
a variety of things. What it also unfortunately
does is it can limit the kinds of
organizations we can work with.
They have to be specifically programmatic in nature
and they have to be nonprofits in order
to really take advantage of a grant. So
we opened up a brand new program
putting initially a $10,000,000
kind of investment into that program
for the purposes of providing impact investment
to downstream recipients. You can basically think of
this as loans.
So one of the first loans that we
have,
made as part of this program is to
in the organization that you cited, Sykes Services
in California. We gave them an initial loan.
This is truly a loan. Now we made
sure that we construct these loans working really
closely with
a partner
to be to have a very low interest
rate. The goal is to be well below
the market so that we make sure we
are getting,
funds to organizations that can really use those
dollars to aid their communities and and drive
health improvement,
but not burden them with a high interest
rate. So Sykes services has gotten that. I'm
really excited about it.
And and to your point, they are in
the kind of behavioral health, mental health space.
And what's really exciting is that what they
really seek to do is provide services for
children,
for their caregivers,
and educators,
starting in California, but they're also now virtual
in, I think over 30 states around the
country.
They offer a lot of different therapeutic solutions,
including counseling and group therapy,
specialized programs for adolescents.
So it's it's just really interesting. They work
closely with schools. They work closely with kids
and caregivers,
and we thought they would just be a
fantastic organization to help grow and support through
this loan program.
Absolutely. That's amazing, and I'm sure it's going
to be a very impactful investment for for
those individuals.
As the Elavance Health Foundation continues to expand
its impact investing program to address health disparities
and and to promote economic development,
how do you think the wider insurance industry
can scale similar initiatives?
What are some of the lessons that
everyone should be taking from Ellevance
from the Ellevance model in terms of structuring
investments to create meaningful change?
That that's a that's a really kind way
of putting it, and thank you for that.
I look. I think
one of our main drivers for doing this
is,
again, working with a wider variety of organizations
and companies
that could be benefited by a loan program,
maybe even more so than a grant making
program. And to any of our nonprofit partners
who who may listen to this, again, I'll
reiterate grants are gonna be central to our
mission as well.
We just wanted to widen the the scope
of who we could work with and what
they could get funding from us to do.
You know, we are I think I believe
we're the first in our industry to do
this. I know there are other industries that
have taken this kind of approach.
I encourage it. I think if it makes
sense for the the strategic goals of of,
an organization, it makes sense to offer this.
I'm really excited to see businesses thrive based
on the loans that they're getting. So my
mental model is often, hey. Imagine we're in
a community.
We could help to give a grant to
the local food bank, which we do all
the time. And then in addition, we could
help to grow a community grocery store
through this loan program that is truly a
business that is thriving, you know, striving to
be a a self sustaining grocery store, perhaps
in a food desert. And it's sort of
the opportunity to bring those two together, these
these two different approaches
in in the same community,
encourage entrepreneurship
in one,
bolster the social safety net in the other.
I mean, I think this is the sort
of complete approach that we're trying to take.
And in all of the work that we
do, we really focus on socially disadvantaged populations
and, social areas that we know matter a
lot to community. So, again, I hope to
see we're really early in the loan program.
I hope to see many, many more of
these dollars go out the door, supporting small
businesses,
supporting,
organizations that then are doing great work in
their community,
and and fingers crossed, they will be sustainable
over time. So we'll really be improving those
communities for generations to come.
Certainly. Well, I hope you will keep us
updated as these investments continue and as as
you continue to see outcomes
through them.
But before we go, Shantanu, what else are
we missing? Any final tidbits of advice you
wanna offer, the health plan leaders listening in?
Yeah. I mean, you know, I think people
understand the the basic concept here. If there's
questions about it or if people wanna know
how to how to maybe get their own
companies involved, I'd be happy to serve as
a resource. I know my team would be,
I think as a big company ourselves,
we take our role in
in this area really seriously. We take our
role in improving health very seriously. We also
take our role as being an economic engine
for society really seriously. It's really bad thinking
that I wanted to bring to this, impact
investing program.
So we measure things, of course, like, hey.
How are we improving health? But we also
measure things that are employ important as an
employer. We want you to be sustainable. We
want you to grow the number of employees
that you are,
employing in your community.
So those kinds of KPIs matter as well.
I mean, this is this can be the
thing that I that I think can really
be a broad strategy
for putting more resources in communities
through sustainable enterprises that then actually aim to
improve the health of those communities. So if
that idea is interesting, I'd certainly love to
stay in touch, but invite anyone,
listening to this to also reach out, and
we're we're happy to be a a guide
wherever that's helpful.
Fantastic. Well, doctor Agrawal, thank you so much
for taking the time to sit down with
us and for sharing about the latest work
happening at Dilavance and and under your leadership.
We really appreciate it. Thank you. It's been
it's been great. Thank you for the opportunity.
And if you'd like to listen to more
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