1 00:00:00,480 --> 00:00:02,639 This is Laura Dierda with the Becker's Healthcare 2 00:00:02,639 --> 00:00:04,799 podcast. I'm thrilled today to be joined by 3 00:00:04,799 --> 00:00:07,679 Jane Brown, head of Medicaid operations at Aetna. 4 00:00:07,679 --> 00:00:08,880 Jane, it's a pleasure to have you on 5 00:00:08,880 --> 00:00:11,519 the podcast today. Thank you, Laura. Very excited 6 00:00:11,519 --> 00:00:12,500 to be here today. 7 00:00:13,175 --> 00:00:15,174 Now I'm looking forward to our conversation because 8 00:00:15,174 --> 00:00:16,535 I know you're doing some really cool things 9 00:00:16,535 --> 00:00:17,754 at Aetna, and certainly, 10 00:00:18,054 --> 00:00:20,695 Medicaid is a huge topic of conversation nationally, 11 00:00:20,695 --> 00:00:23,015 and hospital and health systems as well as 12 00:00:23,015 --> 00:00:25,015 health plans in general are are really interested 13 00:00:25,015 --> 00:00:26,934 to see how things unfold over the next 14 00:00:26,934 --> 00:00:28,760 several months. And so I'm excited for this 15 00:00:28,760 --> 00:00:31,160 conversation. But before we dive in, can you 16 00:00:31,160 --> 00:00:32,760 tell us a little bit more about yourself 17 00:00:32,760 --> 00:00:33,500 and your background? 18 00:00:34,520 --> 00:00:37,560 Absolutely, Laura. I am a sort of Medicaid 19 00:00:37,560 --> 00:00:38,859 dork, self avowed. 20 00:00:39,320 --> 00:00:42,545 I'm, somebody who graduated law school, and right 21 00:00:42,545 --> 00:00:44,385 after law school right went right into the 22 00:00:44,385 --> 00:00:45,365 Medicaid program. 23 00:00:45,984 --> 00:00:48,625 I started working for managed care organizations over 24 00:00:48,625 --> 00:00:49,685 a decade ago. 25 00:00:50,065 --> 00:00:52,484 I've worked for a number of the larger 26 00:00:52,545 --> 00:00:55,284 payers in the country who all support Medicaid 27 00:00:55,344 --> 00:00:55,844 beneficiaries. 28 00:00:57,020 --> 00:00:59,820 And for me, the growth and the the 29 00:00:59,820 --> 00:01:02,219 trajectory, I suppose, through the business has been 30 00:01:02,219 --> 00:01:04,239 primarily through the compliance, 31 00:01:04,619 --> 00:01:06,640 legal, and operational channels. 32 00:01:07,340 --> 00:01:08,959 But as I started working, 33 00:01:09,420 --> 00:01:11,439 into more sort of the operational, 34 00:01:11,900 --> 00:01:12,400 pathways, 35 00:01:17,634 --> 00:01:19,254 Medicaid health plan in Kansas. 36 00:01:19,954 --> 00:01:21,954 So I think I've probably sat in a 37 00:01:21,954 --> 00:01:24,194 lot of the health plan chairs that one 38 00:01:24,194 --> 00:01:24,935 could sit 39 00:01:25,450 --> 00:01:28,490 in the Medicaid space. And I, I really 40 00:01:28,490 --> 00:01:30,810 love this area of the business, and I, 41 00:01:31,049 --> 00:01:33,530 plan to spend probably the greater majority of 42 00:01:33,530 --> 00:01:35,850 the rest of my career continuing to support 43 00:01:35,850 --> 00:01:37,630 Medicaid and Medicaid beneficiaries. 44 00:01:39,064 --> 00:01:40,905 That's fantastic to hear. And, you know, where 45 00:01:40,905 --> 00:01:43,325 does your passion for Medicaid come from? 46 00:01:44,104 --> 00:01:46,025 For me, I think it's just having a 47 00:01:46,025 --> 00:01:47,724 lived experience in the program. 48 00:01:48,504 --> 00:01:51,885 As a kid, my family immigrated actually from, 49 00:01:52,640 --> 00:01:54,819 Belarus in the early nineteen nineties. 50 00:01:55,120 --> 00:01:56,880 And when we first came to this country, 51 00:01:56,880 --> 00:01:59,920 the Medicaid program was how we, you know, 52 00:01:59,920 --> 00:02:02,340 gained access to health care services. 53 00:02:02,959 --> 00:02:05,219 It's how we got support with translation 54 00:02:05,520 --> 00:02:06,020 services. 55 00:02:06,704 --> 00:02:08,164 It was pretty much, 56 00:02:09,025 --> 00:02:11,344 you know, like a bedrock in our community 57 00:02:11,344 --> 00:02:13,344 and certainly the thing that my parents had 58 00:02:13,344 --> 00:02:15,664 to rely on while they got their feet 59 00:02:15,664 --> 00:02:17,985 under them in sort of pursuit of the 60 00:02:17,985 --> 00:02:18,485 American 61 00:02:18,784 --> 00:02:19,284 dream. 62 00:02:19,650 --> 00:02:21,189 So my Medicaid experience 63 00:02:21,490 --> 00:02:24,770 comes from, you know, being on Medicaid as 64 00:02:24,770 --> 00:02:25,349 a kid 65 00:02:25,650 --> 00:02:28,310 and really having a front row seat to 66 00:02:28,370 --> 00:02:30,689 what good that program could do and what 67 00:02:30,689 --> 00:02:33,090 some of the challenges of it, can also 68 00:02:33,090 --> 00:02:33,590 be. 69 00:02:34,605 --> 00:02:36,925 That's really, you know, great to hear. And 70 00:02:36,925 --> 00:02:38,544 certainly, I I can imagine, 71 00:02:39,085 --> 00:02:41,085 like you said, it's such a passion area 72 00:02:41,085 --> 00:02:42,925 for you as you can see where the 73 00:02:42,925 --> 00:02:44,844 program is headed and how it can be 74 00:02:44,844 --> 00:02:46,764 beneficial as well as the challenges that it 75 00:02:46,764 --> 00:02:49,189 faces. From your perspective, what are some of 76 00:02:49,189 --> 00:02:51,269 the biggest issues that you're following in health 77 00:02:51,269 --> 00:02:51,769 care 78 00:02:52,069 --> 00:02:54,009 headed into the next several months? 79 00:02:54,870 --> 00:02:56,789 You know, I think right now, I'm working 80 00:02:56,789 --> 00:02:58,090 a lot with understanding, 81 00:02:59,030 --> 00:03:01,829 how to best enable our provider community in 82 00:03:01,829 --> 00:03:04,414 terms of, for example, value based arrangements. 83 00:03:05,275 --> 00:03:07,134 What are the data and technology 84 00:03:07,514 --> 00:03:08,254 and information 85 00:03:08,555 --> 00:03:10,655 that they need in order to, 86 00:03:11,354 --> 00:03:13,514 get to members in a timely manner and 87 00:03:13,514 --> 00:03:16,074 help members make the right decisions around their 88 00:03:16,074 --> 00:03:19,000 health their their health care? It really it's 89 00:03:19,000 --> 00:03:21,960 about empowerment. And I think as the managed 90 00:03:21,960 --> 00:03:22,860 care organization 91 00:03:23,159 --> 00:03:23,900 at the table, 92 00:03:24,439 --> 00:03:26,360 the onus is on us to really bring 93 00:03:26,360 --> 00:03:29,020 some of that data together and really incentivize 94 00:03:29,319 --> 00:03:32,355 the right actions within the provider community to 95 00:03:32,355 --> 00:03:35,314 ensure that members in turn get the services 96 00:03:35,314 --> 00:03:37,235 and supports that they need at the right 97 00:03:37,235 --> 00:03:37,735 time. 98 00:03:38,435 --> 00:03:39,974 So I think that infrastructure 99 00:03:40,275 --> 00:03:41,974 in terms of how we share information 100 00:03:42,355 --> 00:03:44,194 is where I plan to spend the bulk 101 00:03:44,194 --> 00:03:45,014 of my year 102 00:03:45,360 --> 00:03:48,400 and making sure that the information is, you 103 00:03:48,400 --> 00:03:51,139 know, shared timely in a way that's understood 104 00:03:51,199 --> 00:03:52,340 in a clear way. 105 00:03:52,719 --> 00:03:54,560 All of that can't be taken for granted 106 00:03:54,560 --> 00:03:56,900 because when we think about health care information, 107 00:03:57,905 --> 00:03:59,504 you know, the pool of it is it's 108 00:03:59,504 --> 00:04:02,224 humongous. It's millions of records coming from millions 109 00:04:02,224 --> 00:04:03,205 of different places. 110 00:04:03,745 --> 00:04:06,224 And and trying to create harmony in that 111 00:04:06,224 --> 00:04:08,705 process and ensuring that the right information gets 112 00:04:08,705 --> 00:04:10,564 to the right place at the right time, 113 00:04:11,040 --> 00:04:12,560 it's almost like a full time job, you 114 00:04:12,560 --> 00:04:14,260 could say. So we're spending, 115 00:04:14,719 --> 00:04:15,840 quite a lot of time, 116 00:04:16,160 --> 00:04:18,560 on that work within Aetna and certainly within 117 00:04:18,560 --> 00:04:20,180 our Medicaid space this year. 118 00:04:21,120 --> 00:04:23,120 That's great to hear. You know? And, certainly, 119 00:04:23,120 --> 00:04:25,764 I know no small task to troubleshoot that 120 00:04:25,764 --> 00:04:28,584 type of connection, support the technology needed, and 121 00:04:28,725 --> 00:04:30,024 ability to communicate 122 00:04:30,324 --> 00:04:32,404 in in a meaningful way. And then, too, 123 00:04:32,404 --> 00:04:34,404 it's great to hear that you're looking at 124 00:04:34,404 --> 00:04:37,125 the, value based arrangements. I know that's something 125 00:04:37,125 --> 00:04:39,170 that certainly seems like it could be a 126 00:04:39,170 --> 00:04:40,550 great opportunity for, 127 00:04:41,410 --> 00:04:43,730 health care overall to make a meaningful transition 128 00:04:43,730 --> 00:04:44,629 in that direction. 129 00:04:45,730 --> 00:04:47,730 Yeah. Definitely. I think that if we can 130 00:04:47,730 --> 00:04:49,110 crack this piece of it, 131 00:04:49,569 --> 00:04:51,884 really get everybody on the same page, we 132 00:04:51,884 --> 00:04:53,664 have an opportunity to align 133 00:04:54,365 --> 00:04:56,444 goals and incentives. Right? And I think when 134 00:04:56,444 --> 00:04:59,324 you align goals and incentives across the health 135 00:04:59,324 --> 00:05:00,144 care industry, 136 00:05:00,925 --> 00:05:03,004 that's, you know, the opportunity for us to 137 00:05:03,004 --> 00:05:04,764 do the greatest good and have the greatest 138 00:05:04,764 --> 00:05:06,604 impact because we're all going in the same 139 00:05:06,604 --> 00:05:06,899 direction 140 00:05:08,100 --> 00:05:10,419 together and at the same time. Absolutely. That 141 00:05:10,419 --> 00:05:13,300 is a really great point. Now I'm curious 142 00:05:13,300 --> 00:05:15,220 in looking ahead, what are you most excited 143 00:05:15,220 --> 00:05:16,600 about or what makes you nervous? 144 00:05:18,019 --> 00:05:19,839 I'm really excited about some of the emerging 145 00:05:19,839 --> 00:05:20,269 technologies that are all, 146 00:05:21,454 --> 00:05:22,334 that are all, 147 00:05:22,654 --> 00:05:25,535 aimed at sort of member enablement. I think 148 00:05:25,535 --> 00:05:28,194 that in the Medicaid space, you know, historically, 149 00:05:28,334 --> 00:05:29,714 you know, there's some misconceptions, 150 00:05:30,735 --> 00:05:33,555 in the industry that, for example, maybe Medicaid 151 00:05:33,615 --> 00:05:34,115 beneficiaries 152 00:05:34,460 --> 00:05:36,139 don't have cell phones or they don't have 153 00:05:36,139 --> 00:05:37,759 the same, data access. 154 00:05:38,139 --> 00:05:41,100 And I think that, like, legacy historically, that 155 00:05:41,100 --> 00:05:42,780 that some of that was true, but I 156 00:05:42,780 --> 00:05:44,560 think it's also rapidly changing. 157 00:05:44,939 --> 00:05:47,365 And I think that we have to, really 158 00:05:47,365 --> 00:05:49,764 leverage the opportunity ahead of us and really 159 00:05:49,764 --> 00:05:52,504 figure out how to provide tools and resources 160 00:05:52,644 --> 00:05:54,504 directly to members, really, 161 00:05:54,884 --> 00:05:57,464 to empower them to make the right decisions 162 00:05:57,524 --> 00:05:59,709 for their health care, to really make sure 163 00:05:59,709 --> 00:06:02,589 that there's education and empowerment so that when 164 00:06:02,589 --> 00:06:04,589 they're thinking about how to interact with the 165 00:06:04,589 --> 00:06:05,649 health care system, 166 00:06:06,189 --> 00:06:08,669 you know, they're driving they're driving towards a 167 00:06:08,669 --> 00:06:10,849 healthier outcome into a healthier lifestyle. 168 00:06:11,514 --> 00:06:13,355 So I'm really excited about some of the 169 00:06:13,355 --> 00:06:15,835 technologies and opportunities and even partners that are 170 00:06:15,835 --> 00:06:18,235 emerging who are all spending time trying to 171 00:06:18,235 --> 00:06:19,935 crack, that piece of the puzzle. 172 00:06:20,795 --> 00:06:22,735 That's great to hear. And and, certainly, 173 00:06:23,115 --> 00:06:25,275 having that ability to connect with so many 174 00:06:25,275 --> 00:06:26,795 different people. And as you said, I love 175 00:06:26,795 --> 00:06:29,939 the idea of empowering the patients and bringing 176 00:06:29,939 --> 00:06:32,180 them into the fold for making decisions within 177 00:06:32,180 --> 00:06:34,439 their own care process and treatments and journeys. 178 00:06:34,500 --> 00:06:35,319 It seems, 179 00:06:36,259 --> 00:06:38,120 really, really, like, an amazing, 180 00:06:38,899 --> 00:06:40,419 way to think about health care and health 181 00:06:40,419 --> 00:06:41,079 care delivery. 182 00:06:41,694 --> 00:06:44,115 I'm curious too, when you look 183 00:06:44,415 --> 00:06:47,855 look at the, broader landscape overall, what challenges 184 00:06:47,855 --> 00:06:49,855 are you anticipating or is there anything that 185 00:06:49,855 --> 00:06:51,394 you're preparing for, 186 00:06:52,095 --> 00:06:54,574 that, you know, could make you a little 187 00:06:54,574 --> 00:06:55,955 bit nervous in the future? 188 00:06:56,550 --> 00:06:58,389 Well, I think that that the health care 189 00:06:58,389 --> 00:07:02,149 system is it's big, broad, and it's fraught 190 00:07:02,149 --> 00:07:04,629 with challenges, you know, in every step of 191 00:07:04,629 --> 00:07:06,089 the way. But I think, ultimately, 192 00:07:06,389 --> 00:07:08,410 connectivity is gonna be the thing 193 00:07:08,710 --> 00:07:11,350 that unites us and really helps us, 194 00:07:12,305 --> 00:07:15,745 sort of go forward in a consistent and 195 00:07:15,745 --> 00:07:16,245 unified 196 00:07:16,704 --> 00:07:18,884 manner. And so how do we create connectivity? 197 00:07:19,024 --> 00:07:21,264 How do we make sure we have even 198 00:07:21,264 --> 00:07:23,664 something as basic as the right phone numbers 199 00:07:23,664 --> 00:07:25,764 for members or the right email addresses? 200 00:07:26,819 --> 00:07:28,419 You know, it it it makes me nervous, 201 00:07:28,419 --> 00:07:30,839 right, because in Medicaid, so much of 202 00:07:31,220 --> 00:07:34,740 our work depends on, for example, enrollment files 203 00:07:34,740 --> 00:07:36,040 coming in from regulators. 204 00:07:36,579 --> 00:07:38,819 And if those enrollment files don't have the 205 00:07:38,819 --> 00:07:41,645 right information on them, then we're stymied with 206 00:07:41,645 --> 00:07:43,345 how to then reach out to the member. 207 00:07:43,485 --> 00:07:45,485 But I think we have an opportunity to 208 00:07:45,485 --> 00:07:48,045 work with all of the parties involved, including 209 00:07:48,045 --> 00:07:50,524 regulators, and say, hey. You know, here's the 210 00:07:50,524 --> 00:07:52,865 correct information we obtained from the members. 211 00:07:53,470 --> 00:07:55,790 Let's update your systems. Let's make sure that 212 00:07:55,790 --> 00:07:58,110 at the source of truth, the information upstream 213 00:07:58,110 --> 00:08:00,930 is correct, and that everything that flows downstream 214 00:08:01,149 --> 00:08:02,770 from that is also correct. 215 00:08:03,550 --> 00:08:04,529 And that connectivity 216 00:08:04,910 --> 00:08:06,990 is ultimately what's gonna, I think, set us 217 00:08:06,990 --> 00:08:09,384 up for some of the exciting stuff I 218 00:08:09,384 --> 00:08:12,125 mentioned earlier, which is, you know, member empowerment, 219 00:08:12,264 --> 00:08:15,324 members taking control of their journey, members having 220 00:08:15,625 --> 00:08:16,125 access 221 00:08:16,745 --> 00:08:19,464 to the information that they need in order 222 00:08:19,464 --> 00:08:21,625 to make really good decisions at the time 223 00:08:21,625 --> 00:08:22,845 that they're making them. 224 00:08:23,670 --> 00:08:24,949 That makes a lot of sense, you know, 225 00:08:24,949 --> 00:08:25,830 and and really, 226 00:08:26,150 --> 00:08:28,629 fascinating challenge, but also it sounds like, you 227 00:08:28,629 --> 00:08:29,110 know, 228 00:08:29,830 --> 00:08:31,689 very much a possibility to, 229 00:08:32,549 --> 00:08:34,950 gather this information and and put the systems 230 00:08:34,950 --> 00:08:35,610 in place, 231 00:08:36,070 --> 00:08:38,125 to make sure that those that type of 232 00:08:38,125 --> 00:08:40,704 information is flowed upstream and downstream as well. 233 00:08:41,884 --> 00:08:43,964 Before we wrap up here, I'm wondering what 234 00:08:43,964 --> 00:08:45,644 do you think the most effective health care 235 00:08:45,644 --> 00:08:47,404 leaders will need to be successful over the 236 00:08:47,404 --> 00:08:49,725 next two to three years, especially given some 237 00:08:49,725 --> 00:08:51,345 of the things we've talked about today 238 00:08:51,690 --> 00:08:52,830 around the communication, 239 00:08:53,929 --> 00:08:56,570 transition into value based arrangements, and really truly 240 00:08:56,570 --> 00:08:58,669 taking care of those in the Medicaid program? 241 00:08:59,769 --> 00:09:00,750 You know, leadership 242 00:09:01,210 --> 00:09:01,710 is 243 00:09:02,090 --> 00:09:03,870 such a, like, multifaceted 244 00:09:04,855 --> 00:09:06,455 thing. And it and I don't think it's 245 00:09:06,455 --> 00:09:08,875 just one type of skill or personality 246 00:09:09,654 --> 00:09:11,035 type that can, 247 00:09:12,054 --> 00:09:14,215 sort of deliver on that leadership that is 248 00:09:14,215 --> 00:09:14,715 needed. 249 00:09:15,254 --> 00:09:16,795 But I do think that resiliency 250 00:09:17,335 --> 00:09:19,000 is gonna be a key feature. You know, 251 00:09:19,000 --> 00:09:21,320 I think that that that Medicaid continues to 252 00:09:21,320 --> 00:09:22,620 be a very hard program 253 00:09:23,000 --> 00:09:24,700 to administer and manage, 254 00:09:25,079 --> 00:09:27,079 and I think to continue to evolve it 255 00:09:27,079 --> 00:09:29,079 into the future and really think about, 256 00:09:30,200 --> 00:09:32,759 you know, what best practices to bring in, 257 00:09:32,759 --> 00:09:34,059 how to change really 258 00:09:34,574 --> 00:09:36,975 older legacy systems that take a lot of 259 00:09:36,975 --> 00:09:38,414 investments and a lot of time. I think 260 00:09:38,414 --> 00:09:39,774 all of that is gonna take a lot 261 00:09:39,774 --> 00:09:40,434 of resiliency, 262 00:09:41,134 --> 00:09:42,975 is gonna take a lot of grit, quite 263 00:09:42,975 --> 00:09:45,634 frankly. I think we're all gonna have to, 264 00:09:46,254 --> 00:09:48,674 look at look at ourselves, you know, with 265 00:09:49,649 --> 00:09:52,370 our best critical thinking hats and really assess 266 00:09:52,370 --> 00:09:55,090 where we are and really figure out how 267 00:09:55,090 --> 00:09:56,070 to move forward. 268 00:09:56,610 --> 00:09:58,690 And I think, I think to do that 269 00:09:58,690 --> 00:10:00,690 well, you're gonna have to be sort of 270 00:10:00,690 --> 00:10:03,429 very honest with yourself, honest with your team, 271 00:10:03,654 --> 00:10:05,674 and then, again, bring in that resiliency 272 00:10:06,054 --> 00:10:07,575 and that grit to get you through the 273 00:10:07,575 --> 00:10:09,595 harder parts of change management 274 00:10:09,975 --> 00:10:12,214 so that, ultimately, we come out in a 275 00:10:12,214 --> 00:10:12,955 more nimble, 276 00:10:13,654 --> 00:10:15,894 model, in a more nimble environment where we 277 00:10:15,894 --> 00:10:17,514 can do, you know, hopefully, 278 00:10:18,089 --> 00:10:21,289 more and more with member empowerment, with provider 279 00:10:21,289 --> 00:10:24,190 empowerment, really putting the health care back into, 280 00:10:25,049 --> 00:10:27,129 the the the hands of the people who 281 00:10:27,129 --> 00:10:28,829 it impacts the most, the beneficiaries, 282 00:10:29,209 --> 00:10:30,350 right, of the program. 283 00:10:31,394 --> 00:10:33,075 I love that. Jane, thank you so much 284 00:10:33,075 --> 00:10:34,674 for joining us on the podcast today. This 285 00:10:34,674 --> 00:10:36,834 has been such a fantastic conversation, and I 286 00:10:36,834 --> 00:10:38,774 look forward to connecting with you again soon. 287 00:10:39,075 --> 00:10:40,914 Laura, thank you so much for having me. 288 00:10:40,914 --> 00:10:43,075 I look forward to coming back anytime you'd 289 00:10:43,075 --> 00:10:45,254 like. Have a wonderful day. Take care.