This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Jane Brown, head of Medicaid operations at Aetna.
Jane, it's a pleasure to have you on
the podcast today. Thank you, Laura. Very excited
to be here today.
Now I'm looking forward to our conversation because
I know you're doing some really cool things
at Aetna, and certainly,
Medicaid is a huge topic of conversation nationally,
and hospital and health systems as well as
health plans in general are are really interested
to see how things unfold over the next
several months. And so I'm excited for this
conversation. But before we dive in, can you
tell us a little bit more about yourself
and your background?
Absolutely, Laura. I am a sort of Medicaid
dork, self avowed.
I'm, somebody who graduated law school, and right
after law school right went right into the
Medicaid program.
I started working for managed care organizations over
a decade ago.
I've worked for a number of the larger
payers in the country who all support Medicaid
beneficiaries.
And for me, the growth and the the
trajectory, I suppose, through the business has been
primarily through the compliance,
legal, and operational channels.
But as I started working,
into more sort of the operational,
pathways,
Medicaid health plan in Kansas.
So I think I've probably sat in a
lot of the health plan chairs that one
could sit
in the Medicaid space. And I, I really
love this area of the business, and I,
plan to spend probably the greater majority of
the rest of my career continuing to support
Medicaid and Medicaid beneficiaries.
That's fantastic to hear. And, you know, where
does your passion for Medicaid come from?
For me, I think it's just having a
lived experience in the program.
As a kid, my family immigrated actually from,
Belarus in the early nineteen nineties.
And when we first came to this country,
the Medicaid program was how we, you know,
gained access to health care services.
It's how we got support with translation
services.
It was pretty much,
you know, like a bedrock in our community
and certainly the thing that my parents had
to rely on while they got their feet
under them in sort of pursuit of the
American
dream.
So my Medicaid experience
comes from, you know, being on Medicaid as
a kid
and really having a front row seat to
what good that program could do and what
some of the challenges of it, can also
be.
That's really, you know, great to hear. And
certainly, I I can imagine,
like you said, it's such a passion area
for you as you can see where the
program is headed and how it can be
beneficial as well as the challenges that it
faces. From your perspective, what are some of
the biggest issues that you're following in health
care
headed into the next several months?
You know, I think right now, I'm working
a lot with understanding,
how to best enable our provider community in
terms of, for example, value based arrangements.
What are the data and technology
and information
that they need in order to,
get to members in a timely manner and
help members make the right decisions around their
health their their health care? It really it's
about empowerment. And I think as the managed
care organization
at the table,
the onus is on us to really bring
some of that data together and really incentivize
the right actions within the provider community to
ensure that members in turn get the services
and supports that they need at the right
time.
So I think that infrastructure
in terms of how we share information
is where I plan to spend the bulk
of my year
and making sure that the information is, you
know, shared timely in a way that's understood
in a clear way.
All of that can't be taken for granted
because when we think about health care information,
you know, the pool of it is it's
humongous. It's millions of records coming from millions
of different places.
And and trying to create harmony in that
process and ensuring that the right information gets
to the right place at the right time,
it's almost like a full time job, you
could say. So we're spending,
quite a lot of time,
on that work within Aetna and certainly within
our Medicaid space this year.
That's great to hear. You know? And, certainly,
I know no small task to troubleshoot that
type of connection, support the technology needed, and
ability to communicate
in in a meaningful way. And then, too,
it's great to hear that you're looking at
the, value based arrangements. I know that's something
that certainly seems like it could be a
great opportunity for,
health care overall to make a meaningful transition
in that direction.
Yeah. Definitely. I think that if we can
crack this piece of it,
really get everybody on the same page, we
have an opportunity to align
goals and incentives. Right? And I think when
you align goals and incentives across the health
care industry,
that's, you know, the opportunity for us to
do the greatest good and have the greatest
impact because we're all going in the same
direction
together and at the same time. Absolutely. That
is a really great point. Now I'm curious
in looking ahead, what are you most excited
about or what makes you nervous?
I'm really excited about some of the emerging
technologies that are all,
that are all,
aimed at sort of member enablement. I think
that in the Medicaid space, you know, historically,
you know, there's some misconceptions,
in the industry that, for example, maybe Medicaid
beneficiaries
don't have cell phones or they don't have
the same, data access.
And I think that, like, legacy historically, that
that some of that was true, but I
think it's also rapidly changing.
And I think that we have to, really
leverage the opportunity ahead of us and really
figure out how to provide tools and resources
directly to members, really,
to empower them to make the right decisions
for their health care, to really make sure
that there's education and empowerment so that when
they're thinking about how to interact with the
health care system,
you know, they're driving they're driving towards a
healthier outcome into a healthier lifestyle.
So I'm really excited about some of the
technologies and opportunities and even partners that are
emerging who are all spending time trying to
crack, that piece of the puzzle.
That's great to hear. And and, certainly,
having that ability to connect with so many
different people. And as you said, I love
the idea of empowering the patients and bringing
them into the fold for making decisions within
their own care process and treatments and journeys.
It seems,
really, really, like, an amazing,
way to think about health care and health
care delivery.
I'm curious too, when you look
look at the, broader landscape overall, what challenges
are you anticipating or is there anything that
you're preparing for,
that, you know, could make you a little
bit nervous in the future?
Well, I think that that the health care
system is it's big, broad, and it's fraught
with challenges, you know, in every step of
the way. But I think, ultimately,
connectivity is gonna be the thing
that unites us and really helps us,
sort of go forward in a consistent and
unified
manner. And so how do we create connectivity?
How do we make sure we have even
something as basic as the right phone numbers
for members or the right email addresses?
You know, it it it makes me nervous,
right, because in Medicaid, so much of
our work depends on, for example, enrollment files
coming in from regulators.
And if those enrollment files don't have the
right information on them, then we're stymied with
how to then reach out to the member.
But I think we have an opportunity to
work with all of the parties involved, including
regulators, and say, hey. You know, here's the
correct information we obtained from the members.
Let's update your systems. Let's make sure that
at the source of truth, the information upstream
is correct, and that everything that flows downstream
from that is also correct.
And that connectivity
is ultimately what's gonna, I think, set us
up for some of the exciting stuff I
mentioned earlier, which is, you know, member empowerment,
members taking control of their journey, members having
access
to the information that they need in order
to make really good decisions at the time
that they're making them.
That makes a lot of sense, you know,
and and really,
fascinating challenge, but also it sounds like, you
know,
very much a possibility to,
gather this information and and put the systems
in place,
to make sure that those that type of
information is flowed upstream and downstream as well.
Before we wrap up here, I'm wondering what
do you think the most effective health care
leaders will need to be successful over the
next two to three years, especially given some
of the things we've talked about today
around the communication,
transition into value based arrangements, and really truly
taking care of those in the Medicaid program?
You know, leadership
is
such a, like, multifaceted
thing. And it and I don't think it's
just one type of skill or personality
type that can,
sort of deliver on that leadership that is
needed.
But I do think that resiliency
is gonna be a key feature. You know,
I think that that that Medicaid continues to
be a very hard program
to administer and manage,
and I think to continue to evolve it
into the future and really think about,
you know, what best practices to bring in,
how to change really
older legacy systems that take a lot of
investments and a lot of time. I think
all of that is gonna take a lot
of resiliency,
is gonna take a lot of grit, quite
frankly. I think we're all gonna have to,
look at look at ourselves, you know, with
our best critical thinking hats and really assess
where we are and really figure out how
to move forward.
And I think, I think to do that
well, you're gonna have to be sort of
very honest with yourself, honest with your team,
and then, again, bring in that resiliency
and that grit to get you through the
harder parts of change management
so that, ultimately, we come out in a
more nimble,
model, in a more nimble environment where we
can do, you know, hopefully,
more and more with member empowerment, with provider
empowerment, really putting the health care back into,
the the the hands of the people who
it impacts the most, the beneficiaries,
right, of the program.
I love that. Jane, thank you so much
for joining us on the podcast today. This
has been such a fantastic conversation, and I
look forward to connecting with you again soon.
Laura, thank you so much for having me.
I look forward to coming back anytime you'd
like. Have a wonderful day. Take care.