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Hello, everyone. This is Jacob Emerson with the

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Becker's Pay Your Issues podcast.

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Thrilled today to be joined by a special

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guest. Doctor Dirk Slaker is the chief medical

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officer at Sonder Health Plans. Dirk, thanks so

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much for taking the time to be with

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me on the podcast today.

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Well, Jacob, thank you for inviting me. It's

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my pleasure to be here. Yeah. Absolutely. And

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and before we dive into everything we wanna

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talk with you about, can you tell us

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a little bit more about yourself, your background

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in health care, and what it is that

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you're doing today at Sonder Health Plans?

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Yeah.

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I've I've had quite a a extensive journey

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in health care. My first half of my

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professional career

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was in the clinical world.

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I graduated from Emory,

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as a gastroenterologist

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and hepatologist.

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When completing my fellowship, I segued into a

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position with a large single specialty GI group

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in

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the Atlanta Metro Area. While working there, I

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became involved in a project,

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a research project that was looking at developing

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a device to treat hepatitis c using hyperthermia.

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The FDA approved our submission, but would not

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let it be, tested

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in a clinic in a private sector. So

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I transitioned to Emory,

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back to Emory as an academician,

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and where I continued with the project

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as well as being a

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regular hepatologist and a transplant hepatologist

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that continued,

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until about 02/2004,

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at which time I sustained a pretty catastrophic

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c spine injury,

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that left me as a functional quadriplegic,

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for several years.

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After a protracted recovery, I decided I wasn't

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ready to retire. So

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without possessing the physical attributes to be a

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gastroenterologist

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anymore, I segued into the business of medicine

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first with a company called r one out

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of Chicago,

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where I became the, chief of Medicare compliance.

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Basically, the company

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was a vendor who would assess

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both facilities and providers and

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help them increase their, Medicare compliance.

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After a time there,

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I transitioned to a job as a medical

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director with UnitedHealthcare.

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I first worked, there as a medical director

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in appeals and grievances Medicare appeals and grievances.

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That was followed by a stint in,

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specialty drugs,

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and genetic testing.

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And then my last position with United was

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as a national medical director for transplant

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and cellular and gene therapies

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contemplating

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retirement, but then a friend came to me

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and said,

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hey. Do you have interest in becoming our

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chief medical officer? I work with, Saundra Health

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Plans

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out of Atlanta. We're a Medicare Advantage Plan,

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and, we need a chief medical officer.

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So I thought with my business expertise and

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my clinical years of clinical,

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training and practice that that was a good

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fit. And so as of November eighteenth

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of twenty twenty four, I became the chief

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medical officer for Songer.

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Fantastic. So a long career both on the

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clinical and business side of health care.

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You're now working at a Medicare Advantage company,

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Derk. And as you know, the market here

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continues to grow year after year with seniors

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enrolling in more Medicare Advantage plans. But we're

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hearing from insurers all over the country this

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year, especially, of some of the challenges that

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they're facing in this market, especially as they

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they work to meet the complex needs of

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this population,

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certainly as the as the country continues to

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to age.

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So what do you personally think are are

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some of the biggest hurdles for Medicare Advantage

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Plans today

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in terms of providing comprehensive

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age appropriate care to seniors?

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Yeah. I mean, you already touched on some

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of the major points.

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One,

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what concerns the payers always is the rising

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health care costs.

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As you said, the population is aging, and

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with it, you know, the prevalence of chronic

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conditions, diabetes, heart disease,

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Alzheimer's increases as well.

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And of course, this is gonna result in

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higher health care costs.

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Attempting to manage these costs while maintaining quality

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care, which is what Medicare mandates,

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is probably

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the major challenge that we we come across.

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Also,

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complex care needs. These seniors have multiple chronic

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conditions. It's not like you're treating somebody basically

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for diabetes alone. They have multiplicity of disorders,

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and this requires coordinated and complex care,

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ensuring that all aspects of, of a patient's

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health are managed.

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You know, that can be difficult.

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You know, financial sustainability, probably. The financial sustainability

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of Medicare Advantage Plans is a concern

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in light of the rising health care costs

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and increasing number of beneficiaries.

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Plans must find, you know, plans like ours,

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which is a small plan,

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must find ways to remain financially viable while

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providing,

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you know, the highest quality of care,

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Technology and the integration of such,

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integrating new technologies such as telehealth and,

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you know, more expansive electronic user friendly electronic

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health records into care delivery

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can improve,

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can improve outcomes.

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But again, with money at at the center

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of the conversation,

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these require require significant investment

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just for the systems themselves as well as

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the cost of training.

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And last, probably, I would say member education

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engagement.

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If you've ever looked at an EOC

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for any type of,

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benefits, any type of insurance benefit, they're complex,

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and we need to do a better job

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in educating members about their benefits and engaging

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them in their own care for, you know,

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having the best,

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optimal health outcomes.

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But that can be difficult because, you know,

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health literacy

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is limited across the large sector of our

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population.

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Absolutely. And speaking of benefits that seniors receive,

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we we have seen from some insurers in

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different parts of the country rolling out caregiver

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benefits,

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to their members, especially as we see more

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people become caregivers

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for aging loved ones.

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But as this this caregiving crisis,

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is expected to grow, Dirk, how do you

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think Medicare Advantage Plans can better support

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caregivers and and ensure that they have the

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resources and guidance needed to manage their responsibilities

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alongside the health care of their family members?

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Yeah.

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That's a very, very, very important topic. And,

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I can say from personal experience,

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I had to be the sole caregiver for

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my father

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who had progressive idiopathic pulmonary fibrosis, and I

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took care of him until end of life.

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And and

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it wasn't easy. It was a challenge. So

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in in discussing of what we need to

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do for the caretakers first is,

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most people don't know what it means to

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be a caretaker. So training

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and education,

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providing, you know, training programs for caregivers on

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how to manage

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specific health conditions, Medicare administrations, and,

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other tasks,

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you know, how to use,

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DME that's related to improving

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somebody's life, can empower them with the knowledge

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and skills they need,

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you know, helping them again,

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understand technology at the core of this again,

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you know, utilizing technology,

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so the caregivers can also participate in telehealth

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services,

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remote monitoring, and electronic health records,

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can make it easier for caregivers to manage

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their loved ones and stay connected with the

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providers, which is critical.

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Respite care,

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offering respite care services can provide caregivers,

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you know, temporary leave, allowing them to rest

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and recharge. It's a twenty four seven

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additional

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job when you when you become a caregiver.

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And

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most people nowadays,

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have have jobs in addition to be being

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a caregiver. So, you know, offering respite care

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can help prevent burnout and ensure caregivers can

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continue to provide the high quality care that's

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required.

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You know, possibly financial assistance, you know, offering

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financial

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support or or subsidies for caregiving related expenses,

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you know, travel and things like that can

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alleviate some of the financial burdens that, you

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know, caregivers are gonna face on a daily

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basis

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and include also assistance with medical supplies or

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modifications,

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ramps for wheelchairs, things like that, and and

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transportation outside of what Medicare covers.

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So, Dirk, let's talk a little bit about

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how Sander Health Plan specifically is is tackling

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some of these challenges that you just explained

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for us. You've got a new partnership with

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Clio to help address some of these caregiving

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crisis pains.

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How do you see Clio's integrated care coordination

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and family caregiving support aligning with the needs

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of your members, and what's some of the

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impact that you're anticipating

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in terms of,

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what your members and your caregivers are are

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really gonna get from this?

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Well, so, you know, Clio

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is an organization

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that offers integrated

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care coordination

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and family caregiving support.

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By doing this, this really aligns well with

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the needs of our Medicare Advantage members,

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in particular addressing, you know, the complex and

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multifaceted

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challenges that most of these seniors and their

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caregivers face. And specifically

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for Clio, they kind of offer holistic care

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coordination.

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They are a proactive

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care model, and they focus on managing chronic

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conditions,

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elder care conditions, and end of life care.

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They They really have a comprehensive approach that

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ensures that members receive tailored care plans to

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address,

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both their physical and mental health needs, which

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most people tend to ignore.

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Clio fits well with us because they, as

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I said earlier, you need to have

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caregiver support in addition to patient support.

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And Clio helps these caregivers manage their responsibilities,

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more effectively than they provide.

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In some

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aspects, they provide virtual coaching, they provide care

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navigation,

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and accesses to resources

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for the caregiver

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that can alleviate that stress and burden of

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caregiving.

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I think that

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by doing so, we see improved health outcomes.

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Clio's approach is, you know, aims to improve

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adherence to treatment plans.

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And by doing so, we reduce hospital admissions

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and ensure that members receive the right care.

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That's a real important point because

278
00:11:05,455 --> 00:11:07,934
reducing hospital admissions is not only good for

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the patient, but it's also good for

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the payer. Right?

281
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I mean,

282
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an inpatient hospital state is a very costly

283
00:11:17,294 --> 00:11:18,595
event for a payer.

284
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And,

285
00:11:20,100 --> 00:11:21,860
so this is a win win for the

286
00:11:21,860 --> 00:11:22,840
payer and the patient

287
00:11:23,220 --> 00:11:25,620
because it leads to better overall outcomes for

288
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the member, but also leads to cost reductions

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for,

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us, the payer.

291
00:11:33,485 --> 00:11:35,485
And, you know, one of the things is

292
00:11:35,485 --> 00:11:36,225
they also

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by involving Clio, we see, you know, enhanced

294
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member satisfaction.

295
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We streamline the care coordination by comprehensive

296
00:11:45,700 --> 00:11:46,679
supports partnership

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should enhance member satisfaction

298
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and improve key outcomes,

299
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within the Medicare star rating system. So,

300
00:11:56,019 --> 00:11:57,080
you know, that

301
00:11:57,634 --> 00:12:01,315
that for a Medicare Advantage organization is huge.

302
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One one star

303
00:12:03,235 --> 00:12:04,534
increase or decrease

304
00:12:04,835 --> 00:12:05,894
can cost

305
00:12:06,355 --> 00:12:08,774
hundreds of millions of dollars either positively

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or negatively.

307
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And

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last, probably, you know, to try and achieve

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00:12:14,289 --> 00:12:15,649
equity and health outcomes,

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this collaboration between our our groups focuses on

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closing those gaps in care

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that disproportionately affect vulnerable populations,

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and

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our members

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fall into those categories. And by doing so,

316
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we try to ensure that all members have

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access

318
00:12:33,585 --> 00:12:34,565
to high quality

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care and support.

320
00:12:36,450 --> 00:12:39,269
So addressing those social determinants of health.

321
00:12:40,129 --> 00:12:41,809
Absolutely. Well, it sounds like from everything you

322
00:12:41,809 --> 00:12:43,490
just said, Dirk, this is going to be

323
00:12:43,490 --> 00:12:46,470
a very impactful relationship for both Sonder

324
00:12:46,850 --> 00:12:48,929
and and your members' health outcomes. So it's

325
00:12:48,929 --> 00:12:50,384
it's fantastic to hear.

326
00:12:51,264 --> 00:12:53,825
Speaking of of care coordination more broadly as

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00:12:53,825 --> 00:12:55,285
a key issue for seniors,

328
00:12:55,665 --> 00:12:57,285
especially those with chronic conditions,

329
00:12:57,745 --> 00:12:59,904
what do you think other Medicare Advantage Plans

330
00:12:59,904 --> 00:13:02,325
can do in terms of improving care coordination

331
00:13:02,465 --> 00:13:04,004
for their for their older members

332
00:13:04,409 --> 00:13:07,370
and ensure that these seniors receive timely and

333
00:13:07,370 --> 00:13:10,250
appropriate care without being overwhelmed by what we

334
00:13:10,250 --> 00:13:11,470
know is a very complex

335
00:13:11,850 --> 00:13:12,750
health care system?

336
00:13:14,250 --> 00:13:17,450
It's so we are a small plan. Right?

337
00:13:17,450 --> 00:13:19,845
We we have 13,000 members. You look at

338
00:13:19,924 --> 00:13:22,404
people like United where I came from, and

339
00:13:22,404 --> 00:13:24,904
they have 3,000,000 Medicare Advantage members.

340
00:13:25,764 --> 00:13:26,264
They,

341
00:13:26,964 --> 00:13:28,985
are going to have greater resources

342
00:13:29,365 --> 00:13:31,144
to allow us to address,

343
00:13:32,324 --> 00:13:33,625
to address care coordination.

344
00:13:34,004 --> 00:13:34,745
For us,

345
00:13:35,204 --> 00:13:37,279
you know, to do this effectively,

346
00:13:37,899 --> 00:13:41,019
we we needed to partner with somebody else

347
00:13:41,019 --> 00:13:43,440
to have kind of end to end care.

348
00:13:44,139 --> 00:13:44,960
We provide

349
00:13:45,500 --> 00:13:48,240
the benefits and the payment for benefits, and,

350
00:13:48,714 --> 00:13:51,455
you know, you need those other supportive

351
00:13:52,154 --> 00:13:52,654
entities

352
00:13:52,955 --> 00:13:53,695
to ensure

353
00:13:54,475 --> 00:13:56,794
that those steps are taken care of. Right?

354
00:13:56,794 --> 00:14:00,075
Like, any cardiologist can prescribe drugs for heart

355
00:14:00,075 --> 00:14:02,154
failure, but when when it starts to become

356
00:14:02,990 --> 00:14:05,169
you can have as many as six medications

357
00:14:05,389 --> 00:14:07,169
for chronic congestive heart failure.

358
00:14:07,549 --> 00:14:10,209
Who's gonna ensure that those members understand

359
00:14:11,069 --> 00:14:13,230
what it takes there to be compliant? Or

360
00:14:13,230 --> 00:14:15,149
if they have side effects, what step should

361
00:14:15,149 --> 00:14:16,209
they next take?

362
00:14:16,990 --> 00:14:17,490
That's

363
00:14:18,065 --> 00:14:20,065
that's what we're seeing now in the Medicare

364
00:14:20,065 --> 00:14:21,284
Advantage world is

365
00:14:21,745 --> 00:14:24,565
this comprehensive care. Right? It's not just

366
00:14:25,024 --> 00:14:27,605
identifying a condition and providing a treatment.

367
00:14:27,985 --> 00:14:30,304
It's making sure that those treatments are put

368
00:14:30,304 --> 00:14:31,284
into effect

369
00:14:31,825 --> 00:14:34,759
and everything to support treatment of those conditions

370
00:14:34,820 --> 00:14:35,799
are also available.

371
00:14:36,899 --> 00:14:38,740
Yeah. No. It's a great explanation of of

372
00:14:38,740 --> 00:14:40,259
what seniors are facing and some of the

373
00:14:40,259 --> 00:14:40,759
solutions

374
00:14:41,299 --> 00:14:43,940
available to them. Dirk, before we go, we've

375
00:14:43,940 --> 00:14:46,100
got a lot of health plan leadership listening

376
00:14:46,100 --> 00:14:48,200
in, including Medicare Advantage Plans.

377
00:14:48,545 --> 00:14:50,305
Any final thoughts for them or or final

378
00:14:50,305 --> 00:14:52,305
tidbits of advice you wanna offer based off

379
00:14:52,305 --> 00:14:54,325
of your your career expertise?

380
00:14:55,904 --> 00:14:58,545
No. I well, yeah. Always always have something

381
00:14:58,545 --> 00:14:59,524
to say, but,

382
00:15:00,545 --> 00:15:01,205
you know,

383
00:15:01,769 --> 00:15:02,350
I think

384
00:15:03,209 --> 00:15:04,669
this this is not

385
00:15:05,370 --> 00:15:08,649
the Medicare Advantage taking care of Medicare Advantage

386
00:15:08,649 --> 00:15:09,949
members is not

387
00:15:10,409 --> 00:15:12,649
as simple as it once was. I think

388
00:15:12,649 --> 00:15:14,429
that's now why you're seeing

389
00:15:14,945 --> 00:15:16,485
some of the major plans,

390
00:15:17,264 --> 00:15:18,004
the Blues,

391
00:15:18,384 --> 00:15:18,884
United

392
00:15:19,424 --> 00:15:20,644
starting to withdraw

393
00:15:21,105 --> 00:15:23,284
from the Medicare Advantage space.

394
00:15:24,384 --> 00:15:25,125
I think

395
00:15:25,904 --> 00:15:26,404
that

396
00:15:26,705 --> 00:15:27,445
for me,

397
00:15:28,279 --> 00:15:29,659
change could be effective

398
00:15:30,439 --> 00:15:33,259
when it's done on a smaller scale. Right?

399
00:15:34,519 --> 00:15:36,519
I I think with a plan that we

400
00:15:36,519 --> 00:15:39,339
have in the tens of thousands of members,

401
00:15:39,924 --> 00:15:42,264
we're able to be more effective

402
00:15:42,884 --> 00:15:43,705
in providing

403
00:15:44,085 --> 00:15:47,924
that comprehensive care to our members. And it's

404
00:15:47,924 --> 00:15:49,865
not just even in treatment of

405
00:15:50,485 --> 00:15:53,065
medical conditions alone. It's for,

406
00:15:53,889 --> 00:15:55,269
also food security.

407
00:15:55,730 --> 00:15:58,709
You know, we we provide a grocery cart

408
00:15:59,009 --> 00:16:01,490
for our members. You know, nutrition is a

409
00:16:01,490 --> 00:16:01,990
critical

410
00:16:02,850 --> 00:16:05,889
variable in in in the wellness of any

411
00:16:05,889 --> 00:16:06,389
individual.

412
00:16:06,845 --> 00:16:09,745
And so making sure that people have adequate,

413
00:16:10,605 --> 00:16:13,024
nutrition through supplemental food benefits,

414
00:16:13,404 --> 00:16:15,725
those are the kind of things. So you

415
00:16:15,725 --> 00:16:17,565
can see this is like I said in

416
00:16:17,805 --> 00:16:19,425
when you asked me the last question,

417
00:16:19,965 --> 00:16:20,865
this is not,

418
00:16:21,320 --> 00:16:24,440
you know, step a, diagnose, step b, prescribe

419
00:16:24,440 --> 00:16:25,580
treatment. This is

420
00:16:25,959 --> 00:16:27,339
much more complex

421
00:16:27,799 --> 00:16:30,600
and has many more directions that need need

422
00:16:30,600 --> 00:16:33,179
to be focused upon to be successful.

423
00:16:34,504 --> 00:16:36,665
Fantastic. Well, doctor Slacker, it's it's been a

424
00:16:36,665 --> 00:16:38,745
pleasure. I wanna thank you for taking the

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00:16:38,745 --> 00:16:40,184
time to sit down with us and for

426
00:16:40,184 --> 00:16:42,264
sharing your insights with our listeners. We really

427
00:16:42,264 --> 00:16:42,764
appreciate

428
00:16:43,144 --> 00:16:44,904
it. I appreciate it, Jacob.

429
00:16:45,384 --> 00:16:48,684
You know, it's, our aging seniors really

430
00:16:49,409 --> 00:16:51,730
deserve the best that we can provide for

431
00:16:51,730 --> 00:16:54,149
them, and, I think it can be done.

432
00:16:55,169 --> 00:16:57,250
But but there's a lot to be done

433
00:16:57,250 --> 00:16:57,990
with it.

434
00:16:58,586 --> 00:17:01,146
Wonderful. Well, if you'd like to listen to

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00:17:01,146 --> 00:17:03,466
more podcasts from Becker's Healthcare, you can visit

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00:17:03,466 --> 00:17:05,886
beckershospitalreview.com.