Hello, everyone. This is Jacob Emerson with the
Becker's Pay Your Issues podcast.
Thrilled today to be joined by a special
guest. Doctor Dirk Slaker is the chief medical
officer at Sonder Health Plans. Dirk, thanks so
much for taking the time to be with
me on the podcast today.
Well, Jacob, thank you for inviting me. It's
my pleasure to be here. Yeah. Absolutely. And
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 Sonder Health Plans?
Yeah.
I've I've had quite a a extensive journey
in health care. My first half of my
professional career
was in the clinical world.
I graduated from Emory,
as a gastroenterologist
and hepatologist.
When completing my fellowship, I segued into a
position with a large single specialty GI group
in
the Atlanta Metro Area. While working there, I
became involved in a project,
a research project that was looking at developing
a device to treat hepatitis c using hyperthermia.
The FDA approved our submission, but would not
let it be, tested
in a clinic in a private sector. So
I transitioned to Emory,
back to Emory as an academician,
and where I continued with the project
as well as being a
regular hepatologist and a transplant hepatologist
that continued,
until about 02/2004,
at which time I sustained a pretty catastrophic
c spine injury,
that left me as a functional quadriplegic,
for several years.
After a protracted recovery, I decided I wasn't
ready to retire. So
without possessing the physical attributes to be a
gastroenterologist
anymore, I segued into the business of medicine
first with a company called r one out
of Chicago,
where I became the, chief of Medicare compliance.
Basically, the company
was a vendor who would assess
both facilities and providers and
help them increase their, Medicare compliance.
After a time there,
I transitioned to a job as a medical
director with UnitedHealthcare.
I first worked, there as a medical director
in appeals and grievances Medicare appeals and grievances.
That was followed by a stint in,
specialty drugs,
and genetic testing.
And then my last position with United was
as a national medical director for transplant
and cellular and gene therapies
contemplating
retirement, but then a friend came to me
and said,
hey. Do you have interest in becoming our
chief medical officer? I work with, Saundra Health
Plans
out of Atlanta. We're a Medicare Advantage Plan,
and, we need a chief medical officer.
So I thought with my business expertise and
my clinical years of clinical,
training and practice that that was a good
fit. And so as of November eighteenth
of twenty twenty four, I became the chief
medical officer for Songer.
Fantastic. So a long career both on the
clinical and business side of health care.
You're now working at a Medicare Advantage company,
Derk. And as you know, the market here
continues to grow year after year with seniors
enrolling in more Medicare Advantage plans. But we're
hearing from insurers all over the country this
year, especially, of some of the challenges that
they're facing in this market, especially as they
they work to meet the complex needs of
this population,
certainly as the as the country continues to
to age.
So what do you personally think are are
some of the biggest hurdles for Medicare Advantage
Plans today
in terms of providing comprehensive
age appropriate care to seniors?
Yeah. I mean, you already touched on some
of the major points.
One,
what concerns the payers always is the rising
health care costs.
As you said, the population is aging, and
with it, you know, the prevalence of chronic
conditions, diabetes, heart disease,
Alzheimer's increases as well.
And of course, this is gonna result in
higher health care costs.
Attempting to manage these costs while maintaining quality
care, which is what Medicare mandates,
is probably
the major challenge that we we come across.
Also,
complex care needs. These seniors have multiple chronic
conditions. It's not like you're treating somebody basically
for diabetes alone. They have multiplicity of disorders,
and this requires coordinated and complex care,
ensuring that all aspects of, of a patient's
health are managed.
You know, that can be difficult.
You know, financial sustainability, probably. The financial sustainability
of Medicare Advantage Plans is a concern
in light of the rising health care costs
and increasing number of beneficiaries.
Plans must find, you know, plans like ours,
which is a small plan,
must find ways to remain financially viable while
providing,
you know, the highest quality of care,
Technology and the integration of such,
integrating new technologies such as telehealth and,
you know, more expansive electronic user friendly electronic
health records into care delivery
can improve,
can improve outcomes.
But again, with money at at the center
of the conversation,
these require require significant investment
just for the systems themselves as well as
the cost of training.
And last, probably, I would say member education
engagement.
If you've ever looked at an EOC
for any type of,
benefits, any type of insurance benefit, they're complex,
and we need to do a better job
in educating members about their benefits and engaging
them in their own care for, you know,
having the best,
optimal health outcomes.
But that can be difficult because, you know,
health literacy
is limited across the large sector of our
population.
Absolutely. And speaking of benefits that seniors receive,
we we have seen from some insurers in
different parts of the country rolling out caregiver
benefits,
to their members, especially as we see more
people become caregivers
for aging loved ones.
But as this this caregiving crisis,
is expected to grow, Dirk, how do you
think Medicare Advantage Plans can better support
caregivers and and ensure that they have the
resources and guidance needed to manage their responsibilities
alongside the health care of their family members?
Yeah.
That's a very, very, very important topic. And,
I can say from personal experience,
I had to be the sole caregiver for
my father
who had progressive idiopathic pulmonary fibrosis, and I
took care of him until end of life.
And and
it wasn't easy. It was a challenge. So
in in discussing of what we need to
do for the caretakers first is,
most people don't know what it means to
be a caretaker. So training
and education,
providing, you know, training programs for caregivers on
how to manage
specific health conditions, Medicare administrations, and,
other tasks,
you know, how to use,
DME that's related to improving
somebody's life, can empower them with the knowledge
and skills they need,
you know, helping them again,
understand technology at the core of this again,
you know, utilizing technology,
so the caregivers can also participate in telehealth
services,
remote monitoring, and electronic health records,
can make it easier for caregivers to manage
their loved ones and stay connected with the
providers, which is critical.
Respite care,
offering respite care services can provide caregivers,
you know, temporary leave, allowing them to rest
and recharge. It's a twenty four seven
additional
job when you when you become a caregiver.
And
most people nowadays,
have have jobs in addition to be being
a caregiver. So, you know, offering respite care
can help prevent burnout and ensure caregivers can
continue to provide the high quality care that's
required.
You know, possibly financial assistance, you know, offering
financial
support or or subsidies for caregiving related expenses,
you know, travel and things like that can
alleviate some of the financial burdens that, you
know, caregivers are gonna face on a daily
basis
and include also assistance with medical supplies or
modifications,
ramps for wheelchairs, things like that, and and
transportation outside of what Medicare covers.
So, Dirk, let's talk a little bit about
how Sander Health Plan specifically is is tackling
some of these challenges that you just explained
for us. You've got a new partnership with
Clio to help address some of these caregiving
crisis pains.
How do you see Clio's integrated care coordination
and family caregiving support aligning with the needs
of your members, and what's some of the
impact that you're anticipating
in terms of,
what your members and your caregivers are are
really gonna get from this?
Well, so, you know, Clio
is an organization
that offers integrated
care coordination
and family caregiving support.
By doing this, this really aligns well with
the needs of our Medicare Advantage members,
in particular addressing, you know, the complex and
multifaceted
challenges that most of these seniors and their
caregivers face. And specifically
for Clio, they kind of offer holistic care
coordination.
They are a proactive
care model, and they focus on managing chronic
conditions,
elder care conditions, and end of life care.
They They really have a comprehensive approach that
ensures that members receive tailored care plans to
address,
both their physical and mental health needs, which
most people tend to ignore.
Clio fits well with us because they, as
I said earlier, you need to have
caregiver support in addition to patient support.
And Clio helps these caregivers manage their responsibilities,
more effectively than they provide.
In some
aspects, they provide virtual coaching, they provide care
navigation,
and accesses to resources
for the caregiver
that can alleviate that stress and burden of
caregiving.
I think that
by doing so, we see improved health outcomes.
Clio's approach is, you know, aims to improve
adherence to treatment plans.
And by doing so, we reduce hospital admissions
and ensure that members receive the right care.
That's a real important point because
reducing hospital admissions is not only good for
the patient, but it's also good for
the payer. Right?
I mean,
an inpatient hospital state is a very costly
event for a payer.
And,
so this is a win win for the
payer and the patient
because it leads to better overall outcomes for
the member, but also leads to cost reductions
for,
us, the payer.
And, you know, one of the things is
they also
by involving Clio, we see, you know, enhanced
member satisfaction.
We streamline the care coordination by comprehensive
supports partnership
should enhance member satisfaction
and improve key outcomes,
within the Medicare star rating system. So,
you know, that
that for a Medicare Advantage organization is huge.
One one star
increase or decrease
can cost
hundreds of millions of dollars either positively
or negatively.
And
last, probably, you know, to try and achieve
equity and health outcomes,
this collaboration between our our groups focuses on
closing those gaps in care
that disproportionately affect vulnerable populations,
and
our members
fall into those categories. And by doing so,
we try to ensure that all members have
access
to high quality
care and support.
So addressing those social determinants of health.
Absolutely. Well, it sounds like from everything you
just said, Dirk, this is going to be
a very impactful relationship for both Sonder
and and your members' health outcomes. So it's
it's fantastic to hear.
Speaking of of care coordination more broadly as
a key issue for seniors,
especially those with chronic conditions,
what do you think other Medicare Advantage Plans
can do in terms of improving care coordination
for their for their older members
and ensure that these seniors receive timely and
appropriate care without being overwhelmed by what we
know is a very complex
health care system?
It's so we are a small plan. Right?
We we have 13,000 members. You look at
people like United where I came from, and
they have 3,000,000 Medicare Advantage members.
They,
are going to have greater resources
to allow us to address,
to address care coordination.
For us,
you know, to do this effectively,
we we needed to partner with somebody else
to have kind of end to end care.
We provide
the benefits and the payment for benefits, and,
you know, you need those other supportive
entities
to ensure
that those steps are taken care of. Right?
Like, any cardiologist can prescribe drugs for heart
failure, but when when it starts to become
you can have as many as six medications
for chronic congestive heart failure.
Who's gonna ensure that those members understand
what it takes there to be compliant? Or
if they have side effects, what step should
they next take?
That's
that's what we're seeing now in the Medicare
Advantage world is
this comprehensive care. Right? It's not just
identifying a condition and providing a treatment.
It's making sure that those treatments are put
into effect
and everything to support treatment of those conditions
are also available.
Yeah. No. It's a great explanation of of
what seniors are facing and some of the
solutions
available to them. Dirk, before we go, we've
got a lot of health plan leadership listening
in, including Medicare Advantage Plans.
Any final thoughts for them or or final
tidbits of advice you wanna offer based off
of your your career expertise?
No. I well, yeah. Always always have something
to say, but,
you know,
I think
this this is not
the Medicare Advantage taking care of Medicare Advantage
members is not
as simple as it once was. I think
that's now why you're seeing
some of the major plans,
the Blues,
United
starting to withdraw
from the Medicare Advantage space.
I think
that
for me,
change could be effective
when it's done on a smaller scale. Right?
I I think with a plan that we
have in the tens of thousands of members,
we're able to be more effective
in providing
that comprehensive care to our members. And it's
not just even in treatment of
medical conditions alone. It's for,
also food security.
You know, we we provide a grocery cart
for our members. You know, nutrition is a
critical
variable in in in the wellness of any
individual.
And so making sure that people have adequate,
nutrition through supplemental food benefits,
those are the kind of things. So you
can see this is like I said in
when you asked me the last question,
this is not,
you know, step a, diagnose, step b, prescribe
treatment. This is
much more complex
and has many more directions that need need
to be focused upon to be successful.
Fantastic. Well, doctor Slacker, it's it's been a
pleasure. I wanna thank you for taking the
time to sit down with us and for
sharing your insights with our listeners. We really
appreciate
it. I appreciate it, Jacob.
You know, it's, our aging seniors really
deserve the best that we can provide for
them, and, I think it can be done.
But but there's a lot to be done
with it.
Wonderful. Well, if you'd like to listen to
more podcasts from Becker's Healthcare, you can visit
beckershospitalreview.com.