Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues Podcast.
Thrilled today to be joined by a special
guest. Doctor Puja Mittal is vice president and
chief health equity officer at Health Net. Doctor
Mittal, thank you so much for taking the
time to be with me on the podcast
today.
Sure. Thanks for having me.
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 in terms of your career,
and what it is that you're doing today
at HealthNet.
Sure.
So,
I am a family doctor.
I came to that through,
my mom, who was also a family doctor.
I grew up in Southern California, and,
she was working at an FQHC there with
primarily farm workers.
And, through just watching her my entire childhood,
that that became my goal as well. And
so,
I went to medical school, school, became a
family doctor, did residency in Southern California working
with farm workers,
and,
really since then have had a career that's
focused on caring for the underserved. And so,
I was an academic clinician working at Boston
Medical and then after that, UCSF
for many years before coming over to the
plan side. And so
I have been at Health Net for,
eight and a half years.
I've had a lot of different positions here,
a lot of different
roles, and have had the opportunity to learn
a lot of different aspects of health care,
I think, Medicaid, commercial,
and Medicare. And for the last four years
or so, have been the chief health equity
officer.
And so
that means that,
I have three essential areas of focus at
Health Net. One is broad population health, so
really looking at the health of the individual
and the populations we serve and improving,
disparities in health outcomes amongst those populations.
The second is more broadly equity focused benefits,
so things like ensuring that we are,
have enough community health workers, enough doulas,
and other
sort of surround staff that we call nontraditional
providers supporting our members and ensuring the quality
of those benefits.
And then the third is is more broadly
health equity strategy. How do we ensure that
everything that we're doing at the plan really
takes an equity focus and an equity lens,
to ensure that we're meeting the needs of
those who are most vulnerable across the state?
And so
Health Net really has a pretty broad footprint.
We're in 14 counties,
everything from very urban counties such as Los
Angeles County to very rural counties like Imperial,
and,
some of the northern
rural counties. And so our
populations are are quite diverse.
And we have, in different regions of the
state, different populations that we really hone in
on, from my team's perspective to ensure that
we're meeting the needs of those who are
most vulnerable, those communities.
Wonderful. Well, I I really appreciate that overview,
Puja, and, and really appreciate you taking the
time to sit down with us and share
your insights with our listeners.
I wanna get started by,
asking you what are some of the biggest
issues that you're following within health care right
now. And I and I ask that question
given that it's a time of transformative
change, both for private organizations like yours, but,
of course, also,
policy wise, both the state and federal levels
when it comes to Medicaid and things that
will affect your members. So,
what's top of mind for you? What are
you keeping an eye out for in the
media, in in the latest data?
What are you keeping an eye out for
in terms of what's gonna be impacting your
your membership?
Yeah. There there are a handful of things.
One,
big one, of course, is, federal funding for
Medicaid,
because that directly impacts what we're able to
do,
in our day to day work. And so,
I'm keeping an eye on that broadly. What
does that look like? Are we going to
have to change within our state,
who's covered with Medi Cal? And so that's
a big one.
Another is
also looking at federal funding and federal funding
subsidies for the Exchange population
and where that might shift things.
If there is less federal funding for,
for,
the members on the exchange,
that will shift
some of the things that I know Covered
California has been really successful in doing in
terms of
supporting
benefits and subsidies so that people are not
having to pay as much out of pocket
for their benefits.
And so that's another thing that I'm keeping
an eye on, just in terms of trying
to understand
what type of health care will be accessible
to people and if we're going to see
any shifts in
who is able to access
broader health care.
Another thing that I'm keeping an eye on
is
telehealth solutions
and,
the shift and how those are permeating in
different regions
of the state and of the country. And
so, I think there's been a bit of
a push and pull in using telehealth as
a way of extending access,
particularly in rural areas,
and then
how that is affecting
those who are practicing in those areas and
what that does to the way that patients
are shared. And so just trying to understand
better and kind of keep an eye on,
you know, how do we best use telehealth
and what does it really mean for access,
particularly for those who are
underserved.
And, you know, there's good data that shows
that a lot of the
changes in telehealth,
availability of,
therapy, for example behavioral health therapy, has not
necessarily benefited those who are most vulnerable. It
really does end up supporting,
higher socioeconomic
populations. And so really trying to see how
that continues to change, if see that become
more equitable over time or if there's something
that we're gonna need to do from a
policy perspective
to support that.
Absolutely. That's three major topics that I think
most health care executives right now are keeping
their eyes on. Medicaid reimbursement changes,
ACA subsidies, and whether those will be allowed
to expire, and then what you just mentioned,
Puja, as well, the the telehealth shifts that
we're seeing all over the country, especially when
it comes to Medicare right now. Yeah.
So
when you think about your your member population
and what you're in charge with in terms
of serving them, what what gives you the
most concern right now in terms of health
equity trends that you are seeing,
in the California counties that you serve?
I'm gonna come back to the technology piece
because I think equitable access to technology is
a really important one.
And,
you know, I think there's real policy implications
around
the access of broadband,
for example,
and the inequitable access to broadband.
You know, I I we used to talk
about,
Internet service or broadband access as being something
that's a nice to have but not a
need to have. And more and more in
today's world, it's essential. It's an essential part
of our,
you know, social drivers of health. If we
don't have access to broadband internet, we don't
have access to being able to really function
in the world, particularly when it comes to
health care where so much of it requires
that type of access. And so
I'm, I'm looking at, you know, what does
it look like to really make that
broadband access accessible and
affordable
because we know that it's often more expensive
in poorer communities.
And then
so the broadband access is one piece of
it, but then the other piece of it
is how are we taking all these innovations
that are occurring in
technology
and being able to apply those to our
communities that are most in need? And so
looking at, you know,
telehealth access to,
behavioral health therapy and ensuring that those huge
gains that we've made, right, there are many,
many providers that are now,
bringing in really diverse
sets of therapists so that whatever
whatever type of background you're seeking in your
therapist, you can find. If you're a veteran
and you're looking for a veteran therapist, you
can find that. If you are,
you know,
a queer
Asian woman, for example, you can go in
and find a therapist that sort of understands
your culture and reflects that. But how are
we ensuring that those
technologies, those advancements,
are getting out to those, in the Medicaid
community
who may actually have less access to that
type of care already.
And so, that's something that continues to be
top of mind for me because it's so
important
in terms of
really being able to meet the needs of
our communities in the most equitable way.
Absolutely. And so you're you're focused on democratizing
access to new technologies for for the underserved
populations,
that's that HealthNet serves.
And and I imagine, that access to broadband
Internet is a major challenge, especially in some
of those far Northern California and
coastal counties. So really interested to hear you
talk about
that. On the flip side of my my
last question,
what are some of the trends among your
your member population that you're really seeing,
improvements in terms of health outcomes or technology
access,
trends where you're you're excited about where things
are moving for you and your Health Net
members?
You know,
I've been really excited to see that people
are in more and more engaged with care.
I mean, really, one of the biggest struggles
that,
we as a plan have and and most
plans have is driving engagement, sort of engaging
those unengaged members.
And so I think because
of our
flexibility
in multimodal outreach
and being able to leverage technology in a
way that meets the needs of the people
that we're serving,
we've been able to drive engagement in new
ways. And that's really exciting to me because
the first step in improving any outcome
is driving engagement.
And then the second is making sure that
when they are engaging with us that they're
having a good experience.
And I think we're making progress in both
of those
both of those, and so that to me
is really encouraging.
I am also particularly
excited about, just from a systems perspective and,
like, as a as an industry,
the potential for
AI to help
improve and extend
clinical
care. And I think that's a really interesting,
forefront that we're at now is how we're,
how we're going to be able to use
AI to
extend our reach, right? Can we use it
to,
build large language models to pull
unstructured data from an EMR
and then use that to drive insights that
we can use to better engage our members,
right? So I think there's a we're on
the precipice of a huge amount of potential
to
better use the data that already exists
to to meet the needs of our members
and give them a better experience.
Yeah. And it's so exciting to hear leaders
like yourself talking about the potential
for AI and and, what it could do
to improve
health outcomes among your members. Because, you know,
I know sometimes it can be very easy
for for for media organizations like us to
focus on some of the negative aspects, but
it's you know, we're we're hearing from leaders
constantly about, how this is going to continue
to transform the industry and and health outcomes.
So really exciting to to hear you talk
about that as well, Puja.
I I should ask, you know, you've been
in this industry for a long time, and
you've you've clearly been very successful to to
the to where you've gotten.
So for our audience of health plan leaders
listening in for all all from all over
the country, what would you tell them in
terms of what, the most effective health care
leaders need to be successful,
especially moving forward over these next two to
three,
what are sure to be very transformative
years for the industry?
Yeah. Thank you for the question. I
you know, I think in the equity space,
generally, there's always this need to
focus on an overall
or overarching set of strategies,
but be flexible
in how you're getting there. Because as things
shift, there's different resourcing available for certain things,
and there's different interest in focusing on certain
pieces.
And so I would say a foundation of
strength in terms of an understanding a clear
understanding of strategic focus,
but the ability to be flexible and pivot
as needed to to achieve that focus. And
I think for us,
equity strategy. One is place based work. How
are we able to
look at a particular region or a particular
population,
understand what their
what their assets are in that community, and
then understand where the opportunities are, and then
be able to come in as a plan
and support
to improve outcomes in that particular community. And
that really requires
being aligned to where the needs are in
that community and responding.
And so I think place based work is
one thing that allows us to like hone
in on a goal of improving outcomes, but
be flexible about the path to get there.
And then the second is really member experience
and honing in on
member experience being at the center of everything
we do, because if we know that we're
getting
people engaged and they're having a good experience,
their outcomes will improve.
And so
the other is keeping member experience at the
center of everything we do and then being
creative and flexible
about how we
influence that.
And so,
you know, we do have a clear overarching
set of strategies, but I've had to be
very flexible and pivot many times to be
able to continue to drive the work forward,
as the environment changes, as resourcing changes,
and,
and as our focus,
continues to to move us forward.
Wonderful. I some great advice for our audience
and I think a great place to leave
things. So, Doctor. Mittal, I wanna thank you
for taking the time out of your day
to sit down with us and and for
sharing your insights with our listeners. We truly
appreciate it.
Thank you so much, Jacob, for the opportunity.
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