1 00:00:00,160 --> 00:00:02,159 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,159 --> 00:00:04,019 Becker's Pay Your Issues podcast. 3 00:00:04,400 --> 00:00:06,719 Thrilled today to be joined by doctor Steve 4 00:00:06,719 --> 00:00:08,800 Friedhoff, who is the senior vice president of 5 00:00:08,800 --> 00:00:11,199 health care services at Blue Cross and Blue 6 00:00:11,199 --> 00:00:13,685 Shield of North Carolina. Doctor Friedhoff, thank you 7 00:00:13,685 --> 00:00:15,285 so much for taking the time to be 8 00:00:15,285 --> 00:00:16,664 with me on the podcast today. 9 00:00:17,204 --> 00:00:19,765 My pleasure. Thank you, Jacob. Yeah. Absolutely. And 10 00:00:19,765 --> 00:00:21,365 before we dive into everything we wanna talk 11 00:00:21,365 --> 00:00:22,725 with you about, Steve, can you tell us 12 00:00:22,725 --> 00:00:24,885 a little bit more about yourself, your background 13 00:00:24,885 --> 00:00:26,565 in health care, and what it is that 14 00:00:26,565 --> 00:00:28,849 you're doing today at Blue Cross North Carolina. 15 00:00:29,390 --> 00:00:32,109 Sure. Happy to. So I'm a family physician 16 00:00:32,109 --> 00:00:35,149 by backgrounds. I practiced for about twenty years, 17 00:00:35,149 --> 00:00:36,989 either on a full time or a part 18 00:00:36,989 --> 00:00:37,729 time basis 19 00:00:38,109 --> 00:00:41,170 in a combination of community practices and academic 20 00:00:41,309 --> 00:00:43,604 practice. I was the medical director of a 21 00:00:43,604 --> 00:00:46,424 family medicine residency program at one point. 22 00:00:46,804 --> 00:00:49,304 I've had a fair amount of experience in 23 00:00:49,364 --> 00:00:52,405 hospice and palliative care and, 24 00:00:52,965 --> 00:00:56,004 joined Blue Cross of North Carolina about four 25 00:00:56,085 --> 00:00:57,465 almost four years ago. 26 00:00:57,980 --> 00:01:00,380 And my areas of responsibility as senior vice 27 00:01:00,380 --> 00:01:01,760 president of health care services 28 00:01:02,140 --> 00:01:05,359 include all things related to medical care management, 29 00:01:05,739 --> 00:01:06,719 behavioral health, 30 00:01:07,099 --> 00:01:07,599 pharmacy, 31 00:01:08,380 --> 00:01:10,700 contracting with our provider network, including all of 32 00:01:10,700 --> 00:01:12,240 our value based care programs, 33 00:01:12,984 --> 00:01:14,604 our quality programs, including 34 00:01:14,984 --> 00:01:16,604 stars and risk adjustment, 35 00:01:17,064 --> 00:01:20,524 payment integrity and accuracy, and our affordability programs. 36 00:01:20,825 --> 00:01:23,864 So it's a pretty broad focus, but, one 37 00:01:23,864 --> 00:01:24,924 that very much 38 00:01:25,659 --> 00:01:27,920 remains, focused on affordability, 39 00:01:28,540 --> 00:01:31,040 access to health care, and quality outcomes. 40 00:01:32,459 --> 00:01:34,799 Fantastic. Well, I appreciate that overview, Steve. 41 00:01:35,420 --> 00:01:36,939 The first thing we wanted to talk with 42 00:01:36,939 --> 00:01:39,614 you about is Blue Cross of North Carolina 43 00:01:39,754 --> 00:01:42,795 being instrumental in partnering with the UNC School 44 00:01:42,795 --> 00:01:43,935 of Medicine to address 45 00:01:44,314 --> 00:01:46,415 North Carolina's health care provider shortage 46 00:01:46,875 --> 00:01:50,310 by training veterans for medical careers. So talk 47 00:01:50,310 --> 00:01:51,929 to us a little bit about this initiative. 48 00:01:52,149 --> 00:01:54,149 How has it evolved over the years, and 49 00:01:54,149 --> 00:01:56,229 and what's the impact that you've seen in 50 00:01:56,229 --> 00:01:58,890 terms of filling those critical gaps in care 51 00:01:58,950 --> 00:02:00,489 in in rural and 52 00:02:00,869 --> 00:02:02,810 underserved areas of your state? 53 00:02:03,594 --> 00:02:05,674 Sure. Happy to. UNC has been a great 54 00:02:05,674 --> 00:02:07,435 partner to us on on a number of 55 00:02:07,435 --> 00:02:08,254 different levels. 56 00:02:08,715 --> 00:02:11,514 But this specific partnership with the UNC School 57 00:02:11,514 --> 00:02:13,375 of Medicine, as you indicated, 58 00:02:14,155 --> 00:02:16,974 was to develop a physician assistant program 59 00:02:17,520 --> 00:02:19,759 that was really trying to address two different 60 00:02:19,759 --> 00:02:21,379 problems with a single strategy. 61 00:02:21,840 --> 00:02:23,919 First, you know, we know there's a statewide 62 00:02:23,919 --> 00:02:25,620 gap in health care providers, 63 00:02:26,080 --> 00:02:28,719 in North Carolina, like in many, many other 64 00:02:28,719 --> 00:02:29,219 states, 65 00:02:29,775 --> 00:02:31,555 particularly in our more rural areas. 66 00:02:31,854 --> 00:02:34,334 And then the the second is helping returning 67 00:02:34,334 --> 00:02:34,834 veterans, 68 00:02:35,375 --> 00:02:36,594 with medical training 69 00:02:36,974 --> 00:02:39,694 to define careers in civilian health care across, 70 00:02:40,094 --> 00:02:40,914 North Carolina. 71 00:02:41,719 --> 00:02:44,919 So this program was initially created in 2012. 72 00:02:44,919 --> 00:02:48,039 I believe the first class graduated in 2015. 73 00:02:48,039 --> 00:02:50,300 So this is the, the tenth anniversary. 74 00:02:50,919 --> 00:02:51,800 And the idea, 75 00:02:52,439 --> 00:02:53,979 was to recruit nontraditional 76 00:02:54,439 --> 00:02:54,939 students 77 00:02:55,245 --> 00:02:57,724 like veterans or other North Carolina residents who 78 00:02:57,724 --> 00:03:00,625 are the, over the age of 26. 79 00:03:01,085 --> 00:03:03,105 So students in this program 80 00:03:03,645 --> 00:03:04,865 train for careers, 81 00:03:05,564 --> 00:03:08,465 in fields ranging from primary care to orthopedics, 82 00:03:08,900 --> 00:03:09,400 cardiology, 83 00:03:09,780 --> 00:03:12,740 emergency care, and and mental health. And, ultimately, 84 00:03:12,740 --> 00:03:14,040 they can choose to practice, 85 00:03:14,500 --> 00:03:16,900 wherever they they want. But the program is 86 00:03:16,900 --> 00:03:19,000 designed to create a pipeline of providers, 87 00:03:19,620 --> 00:03:20,439 for medical 88 00:03:20,740 --> 00:03:23,080 medical deserts all across North Carolina. 89 00:03:23,574 --> 00:03:26,055 And since in inception in that first graduating 90 00:03:26,055 --> 00:03:28,854 class of twenty fifteen, we've had a 40 91 00:03:28,854 --> 00:03:32,215 physician assistants who graduated from the UNC physician 92 00:03:32,215 --> 00:03:33,194 assistance program 93 00:03:33,495 --> 00:03:35,495 and gone on to careers throughout the state 94 00:03:35,495 --> 00:03:37,414 in the OR, the ER, and a variety 95 00:03:37,414 --> 00:03:38,715 of different clinic settings. 96 00:03:39,949 --> 00:03:41,870 Wow. I mean, that's an amazing number that 97 00:03:41,870 --> 00:03:43,229 you just shared, and it sounds like this 98 00:03:43,229 --> 00:03:44,209 is a very impactful 99 00:03:44,509 --> 00:03:46,129 program within the states. 100 00:03:46,830 --> 00:03:48,509 I wanted to ask though, you know, many 101 00:03:48,509 --> 00:03:50,830 states, including North Carolina, as you know, they 102 00:03:50,830 --> 00:03:53,409 don't recognize military medical credentials 103 00:03:53,794 --> 00:03:56,775 despite the vast experience that military medics gain 104 00:03:56,834 --> 00:03:57,974 when they're in the service. 105 00:03:58,354 --> 00:04:01,094 So how do you envision expanding this partnership 106 00:04:01,155 --> 00:04:03,634 to further recognize and leverage the skills that 107 00:04:03,634 --> 00:04:06,754 these veterans have within the civilian health care 108 00:04:06,754 --> 00:04:07,254 system? 109 00:04:08,340 --> 00:04:09,939 Yeah. This a number of years ago in 110 00:04:09,939 --> 00:04:12,099 a different role, this was actually a pretty 111 00:04:12,099 --> 00:04:12,599 significant 112 00:04:13,219 --> 00:04:14,759 moment, for me. 113 00:04:15,139 --> 00:04:17,459 In in a prior role, I I worked 114 00:04:17,459 --> 00:04:19,079 near a very, very large, 115 00:04:19,699 --> 00:04:20,199 military 116 00:04:20,660 --> 00:04:23,654 base, and we recruited a significant 117 00:04:23,955 --> 00:04:25,014 number of 118 00:04:25,475 --> 00:04:25,975 veterans, 119 00:04:26,995 --> 00:04:28,535 from that that population. 120 00:04:29,235 --> 00:04:31,254 And to your point, I never realized 121 00:04:31,955 --> 00:04:32,455 that 122 00:04:32,835 --> 00:04:34,694 there was no crosswalk between 123 00:04:35,129 --> 00:04:36,350 military medical credentials 124 00:04:36,730 --> 00:04:37,230 and 125 00:04:38,009 --> 00:04:40,730 in civilian life. And, you know, one story 126 00:04:40,730 --> 00:04:43,129 in particular that just I've hit home with 127 00:04:43,129 --> 00:04:44,569 me and really carried with me to this 128 00:04:44,569 --> 00:04:47,449 day is I interviewed and ultimately hired an 129 00:04:47,449 --> 00:04:47,949 individual 130 00:04:48,410 --> 00:04:50,189 who is the only medic 131 00:04:50,944 --> 00:04:52,165 on a destroyer. 132 00:04:53,105 --> 00:04:53,605 And, 133 00:04:54,225 --> 00:04:55,985 you know, as part of that role, I 134 00:04:55,985 --> 00:04:57,685 mean, fortunately, it 135 00:04:58,384 --> 00:05:00,644 it it was less about, you know, treating 136 00:05:00,704 --> 00:05:03,584 injuries and anything related to combat, but more 137 00:05:03,584 --> 00:05:06,189 about, you know, having hundreds or thousands of 138 00:05:06,189 --> 00:05:06,689 individuals 139 00:05:06,990 --> 00:05:09,310 in a very isolated place where you didn't 140 00:05:09,310 --> 00:05:10,370 have access to 141 00:05:10,829 --> 00:05:13,569 specialists or, you know, lots of other facilities. 142 00:05:13,789 --> 00:05:16,430 And this individual is responsible for taking care 143 00:05:16,430 --> 00:05:16,930 of 144 00:05:17,254 --> 00:05:20,774 all the different illnesses and accidents and injuries 145 00:05:20,774 --> 00:05:24,134 that could happen in any small to medium 146 00:05:24,134 --> 00:05:25,115 sized population. 147 00:05:25,735 --> 00:05:27,914 Yet when he left the service, 148 00:05:28,615 --> 00:05:31,139 none of that training, none of that mattered. 149 00:05:31,139 --> 00:05:32,680 So at the end of the day, you 150 00:05:32,819 --> 00:05:34,040 know, he had tremendous 151 00:05:34,420 --> 00:05:36,520 clinical experience, and we ultimately, 152 00:05:37,379 --> 00:05:38,980 found him a role that was a great 153 00:05:38,980 --> 00:05:41,080 fit where we could leverage that experience, 154 00:05:41,939 --> 00:05:43,720 but in a way that did not require 155 00:05:43,779 --> 00:05:44,759 a a license. 156 00:05:45,074 --> 00:05:46,514 But that that was just such an eye 157 00:05:46,514 --> 00:05:49,555 opener to me. And North Carolina has several 158 00:05:49,555 --> 00:05:51,954 military bases as as you know, and the 159 00:05:51,954 --> 00:05:55,235 fourth largest military population in the country. And 160 00:05:55,235 --> 00:05:58,535 about 20,000 active military members transition to civilian 161 00:05:58,595 --> 00:06:00,050 life every year. 162 00:06:01,230 --> 00:06:03,230 And, you know, we know from the UNC 163 00:06:03,230 --> 00:06:04,050 PA programs, 164 00:06:04,910 --> 00:06:06,270 you know, a number of us from our 165 00:06:06,270 --> 00:06:09,470 own personal experience that, you know, veterans bring 166 00:06:09,470 --> 00:06:13,064 an incredible amount of, you know, discipline, resourcefulness, 167 00:06:13,605 --> 00:06:16,504 commitment, and compassion to their roles. 168 00:06:16,884 --> 00:06:18,105 And all of these characteristics, 169 00:06:18,925 --> 00:06:20,404 you know, have the potential to make for 170 00:06:20,404 --> 00:06:21,145 an exceptional 171 00:06:21,605 --> 00:06:22,745 health care provider. 172 00:06:23,205 --> 00:06:25,605 So helping them move into civilian health care 173 00:06:25,605 --> 00:06:27,420 is is really a win for our state. 174 00:06:27,500 --> 00:06:29,980 We get some great medical professionals and we 175 00:06:29,980 --> 00:06:32,939 improve access to care and we obviously help 176 00:06:32,939 --> 00:06:34,960 to further, you know, individuals, 177 00:06:35,500 --> 00:06:36,000 careers. 178 00:06:36,939 --> 00:06:39,819 So we we do support veterans and active 179 00:06:39,819 --> 00:06:42,415 military service members and their families across our 180 00:06:42,415 --> 00:06:44,655 company in a number of additional ways at 181 00:06:44,655 --> 00:06:46,035 Blue Cross North Carolina. 182 00:06:46,895 --> 00:06:49,935 In addition to the PA program, we also 183 00:06:49,935 --> 00:06:52,035 participate in the SkillBridge program, 184 00:06:52,415 --> 00:06:55,694 which provides soldiers with, civilian work experience during 185 00:06:55,694 --> 00:06:57,795 the last six months of their military career 186 00:06:57,810 --> 00:06:59,269 to help them with that transition, 187 00:06:59,730 --> 00:07:00,870 out of the service. 188 00:07:01,410 --> 00:07:04,370 We also participate in the Department of Defense's 189 00:07:04,370 --> 00:07:05,750 military spouse program, 190 00:07:06,209 --> 00:07:09,329 and that helps connect military spouses who often 191 00:07:09,329 --> 00:07:10,149 have to relocate 192 00:07:10,504 --> 00:07:12,985 you know, to find, meaningful careers in their 193 00:07:12,985 --> 00:07:13,724 new locations. 194 00:07:14,185 --> 00:07:16,125 And we also have a very, very active 195 00:07:16,185 --> 00:07:18,044 employee network called VetNet 196 00:07:18,345 --> 00:07:19,884 that's dedicated to uplifting, 197 00:07:20,664 --> 00:07:23,324 our very proud local community of veteran employees 198 00:07:23,544 --> 00:07:25,479 to increase their sense of belonging at Blue 199 00:07:25,479 --> 00:07:27,720 Cross of North Carolina. So it's through all 200 00:07:27,720 --> 00:07:30,439 these different initiatives that we really try to 201 00:07:30,439 --> 00:07:32,759 help leverage the the skills of veterans and 202 00:07:32,759 --> 00:07:34,459 all that they can bring to North Carolina. 203 00:07:35,399 --> 00:07:37,079 Absolutely. And that was such a great anecdote 204 00:07:37,079 --> 00:07:38,839 that you shared about about the medic. So 205 00:07:38,839 --> 00:07:41,084 I appreciate that, Steve. And, really, it's great 206 00:07:41,084 --> 00:07:43,024 that you're able to to turn their clinical 207 00:07:43,084 --> 00:07:43,584 expertise, 208 00:07:44,125 --> 00:07:46,125 into a benefit for the wider health care 209 00:07:46,125 --> 00:07:46,625 system. 210 00:07:47,724 --> 00:07:49,324 If we were taking a step back, can 211 00:07:49,324 --> 00:07:52,044 you explain why Blue Cross North Carolina has 212 00:07:52,044 --> 00:07:55,004 invested so much in supporting the health care 213 00:07:55,004 --> 00:07:57,139 workforce in the state? I know you briefly 214 00:07:57,139 --> 00:07:58,740 touched on this, but but why is this 215 00:07:58,740 --> 00:07:59,560 such an important, 216 00:07:59,939 --> 00:08:01,939 move for the company and and any other 217 00:08:01,939 --> 00:08:04,259 steps you'd share in terms of how Blue 218 00:08:04,259 --> 00:08:07,319 Cross is supporting providers across North Carolina? 219 00:08:08,084 --> 00:08:10,404 Sure. Well, you know, Blue Cross in North 220 00:08:10,404 --> 00:08:13,944 Carolina as a single state Blue Cross plan, 221 00:08:14,004 --> 00:08:16,884 we're committed to improving the health care for 222 00:08:16,884 --> 00:08:18,105 all of North Carolinians 223 00:08:18,644 --> 00:08:20,985 wherever they live. And and, frankly, 224 00:08:21,329 --> 00:08:23,649 you know, whether they insured are insured by 225 00:08:23,649 --> 00:08:25,829 Blue Cross of North Carolina today, 226 00:08:26,610 --> 00:08:27,269 or not. 227 00:08:27,649 --> 00:08:29,889 And right now, we know that nearly 3,000,000 228 00:08:29,889 --> 00:08:32,850 people in North Carolina live in places that 229 00:08:32,850 --> 00:08:35,589 are deemed health professional shortage areas, 230 00:08:36,105 --> 00:08:38,345 Meaning, it's not just about not having enough 231 00:08:38,345 --> 00:08:42,044 physicians, there's not enough nurses or other providers 232 00:08:42,105 --> 00:08:43,725 to meet demands, including 233 00:08:44,105 --> 00:08:44,605 physicians. 234 00:08:45,465 --> 00:08:47,144 And this is particularly true in many of 235 00:08:47,144 --> 00:08:48,044 our rural communities 236 00:08:48,830 --> 00:08:51,629 and where it's particularly difficult to attract and 237 00:08:51,629 --> 00:08:54,350 retain health care professionals in some of those 238 00:08:54,350 --> 00:08:56,350 settings. So that's one of the reasons we've 239 00:08:56,350 --> 00:08:59,410 made significant investments in the health care workforce. 240 00:09:00,029 --> 00:09:01,629 It's one of the more impactful ways we 241 00:09:01,629 --> 00:09:04,504 can keep communities healthy, keep health expenses down, 242 00:09:04,504 --> 00:09:06,184 and really try to take more and more 243 00:09:06,184 --> 00:09:07,565 of this further upstream. 244 00:09:08,345 --> 00:09:09,565 And colleges and universities, 245 00:09:09,945 --> 00:09:11,625 you know, they play a critical role in 246 00:09:11,625 --> 00:09:13,085 training this next generation. 247 00:09:13,625 --> 00:09:14,764 So it's establishing 248 00:09:15,465 --> 00:09:17,779 those kinds of partnerships where we really feel 249 00:09:17,779 --> 00:09:19,539 like we can help make a difference and 250 00:09:19,539 --> 00:09:21,720 move the needle in in North Carolina. 251 00:09:22,259 --> 00:09:24,019 So I'll highlight a couple of our key 252 00:09:24,019 --> 00:09:24,519 investments. 253 00:09:25,459 --> 00:09:28,100 One of them through, again, through UNC is 254 00:09:28,100 --> 00:09:31,080 the School of Medicine's Primary Care Rural Advancement 255 00:09:31,220 --> 00:09:31,720 Program. 256 00:09:32,534 --> 00:09:34,695 This investment has made a real difference in 257 00:09:34,695 --> 00:09:36,394 Rockingham County. It's 258 00:09:36,695 --> 00:09:37,195 increasing, 259 00:09:37,735 --> 00:09:41,115 patient centered primary care. It's recruiting more residents 260 00:09:41,174 --> 00:09:43,815 to enter the profession in Rockingham County and 261 00:09:43,815 --> 00:09:46,154 neighboring counties, and it's provided, 262 00:09:47,309 --> 00:09:50,429 many different opportunities for students studying medicine, nursing, 263 00:09:50,429 --> 00:09:54,269 pharmacy, and other health professions to better prepare 264 00:09:54,269 --> 00:09:56,509 them for practice in a in a rural 265 00:09:56,509 --> 00:09:57,009 community. 266 00:09:57,950 --> 00:10:01,384 Another example is the Winston Salem State University's 267 00:10:01,524 --> 00:10:03,845 division of nursing. It's one of the top 268 00:10:03,845 --> 00:10:05,465 nursing programs in the country. 269 00:10:06,004 --> 00:10:06,504 And, 270 00:10:06,884 --> 00:10:09,685 Winston Salem State used this funding to provide 271 00:10:09,685 --> 00:10:10,185 scholarships, 272 00:10:10,805 --> 00:10:13,365 expand access to care, and enhance some of 273 00:10:13,365 --> 00:10:14,425 their own technology 274 00:10:14,805 --> 00:10:15,305 infrastructure 275 00:10:16,160 --> 00:10:18,399 to help better prepare the nurses of the 276 00:10:18,399 --> 00:10:18,899 future. 277 00:10:19,759 --> 00:10:22,000 Third example would be North Carolina A and 278 00:10:22,000 --> 00:10:24,100 T State University School of Nursing. 279 00:10:24,480 --> 00:10:26,019 This particular investment 280 00:10:26,399 --> 00:10:29,059 worked toward, or excuse me, went towards scholarships, 281 00:10:29,855 --> 00:10:31,475 new equipment, new technology, 282 00:10:32,575 --> 00:10:33,475 all to encourage, 283 00:10:34,014 --> 00:10:34,834 student development, 284 00:10:35,695 --> 00:10:37,714 and addressing those nursing shortages 285 00:10:38,174 --> 00:10:41,134 while providing them with access to, you know, 286 00:10:41,134 --> 00:10:43,214 the most modern tools as part of their 287 00:10:43,214 --> 00:10:44,034 their studies. 288 00:10:45,089 --> 00:10:45,589 So, 289 00:10:46,049 --> 00:10:48,129 you know, as part of what we do 290 00:10:48,129 --> 00:10:49,809 to try and expand the workforce, we also 291 00:10:49,809 --> 00:10:52,049 have to focus on the workforce that exists 292 00:10:52,049 --> 00:10:53,909 and continue to make it a more attractive 293 00:10:53,970 --> 00:10:54,870 place to practice. 294 00:10:55,649 --> 00:10:56,949 And when you think about 295 00:10:57,745 --> 00:10:58,485 a physician's 296 00:10:58,865 --> 00:11:02,085 mindset or other providers mindsets, typically, 297 00:11:02,865 --> 00:11:04,625 there are three things top of mind for 298 00:11:04,625 --> 00:11:06,785 them in terms of their their goals and 299 00:11:06,785 --> 00:11:09,504 how we can hopefully best support them. One 300 00:11:09,504 --> 00:11:11,909 is, you know, certainly top of the list 301 00:11:11,909 --> 00:11:14,649 is delivering the best possible patient outcomes. 302 00:11:15,269 --> 00:11:19,350 Second is reducing their administrative burden associated with 303 00:11:19,350 --> 00:11:22,309 providing that care. And third is receiving a, 304 00:11:22,309 --> 00:11:24,230 you know, fair and reasonable payment for the 305 00:11:24,230 --> 00:11:25,394 services that they do 306 00:11:26,355 --> 00:11:27,955 provide. So we 307 00:11:28,434 --> 00:11:30,195 a lot of our strategy is how we 308 00:11:30,195 --> 00:11:31,415 collaborate providers 309 00:11:31,795 --> 00:11:33,955 to meet these three aims and put those 310 00:11:33,955 --> 00:11:35,715 kind of supports in place. And one of 311 00:11:35,715 --> 00:11:38,195 the things I'm particularly proud of is something 312 00:11:38,195 --> 00:11:39,735 called our Blue Premier program. 313 00:11:40,309 --> 00:11:41,929 That was launched in 2019, 314 00:11:42,709 --> 00:11:44,809 and it's our value based care program 315 00:11:45,350 --> 00:11:47,829 with the goal of enrolling as many of 316 00:11:47,829 --> 00:11:50,409 our members as possible with physicians 317 00:11:50,870 --> 00:11:53,110 who are in a value based relationship with 318 00:11:53,110 --> 00:11:53,610 us. 319 00:11:54,134 --> 00:11:56,634 And as of today, our Blue Premier program, 320 00:11:57,254 --> 00:11:59,575 every single one of our large systems in 321 00:11:59,575 --> 00:12:00,215 the state, 322 00:12:00,615 --> 00:12:01,915 is part of Blue Premier. 323 00:12:02,695 --> 00:12:05,274 About two thirds of our primary care physicians 324 00:12:05,575 --> 00:12:07,850 are part of Blue Premier as well. And 325 00:12:07,850 --> 00:12:10,730 about the same percentage of our commercial and 326 00:12:10,730 --> 00:12:11,790 Medicare members, 327 00:12:12,730 --> 00:12:15,610 actually see a physician who is part of 328 00:12:15,610 --> 00:12:18,250 Blue Premier. And the whole idea is to, 329 00:12:20,024 --> 00:12:23,084 provide incentives and also hold doctors and hospitals 330 00:12:23,384 --> 00:12:23,884 accountable 331 00:12:24,264 --> 00:12:27,404 for meeting, certainly first and foremost, quality measures, 332 00:12:27,464 --> 00:12:28,284 but also 333 00:12:28,745 --> 00:12:30,044 affordability measures. 334 00:12:30,584 --> 00:12:33,404 And making their payments based on, 335 00:12:33,950 --> 00:12:36,750 improving care delivery rather than just the simple 336 00:12:36,750 --> 00:12:38,769 number of tests and procedures, 337 00:12:39,549 --> 00:12:40,049 performs. 338 00:12:40,830 --> 00:12:43,149 And by doing so, we reduce the number 339 00:12:43,149 --> 00:12:46,110 of unnecessary ER visits. We reduce the number 340 00:12:46,110 --> 00:12:46,610 of 341 00:12:46,934 --> 00:12:48,075 unnecessary hospitalizations 342 00:12:48,455 --> 00:12:49,274 or rehospitalizations 343 00:12:50,375 --> 00:12:51,195 and improve 344 00:12:51,654 --> 00:12:52,955 the health of our members. 345 00:12:53,414 --> 00:12:55,575 And one of the things that, really sets 346 00:12:55,575 --> 00:12:57,195 this apart is that 347 00:12:57,735 --> 00:13:00,075 any of the cost savings we share significantly 348 00:13:00,699 --> 00:13:03,100 with with physicians and other providers who are 349 00:13:03,100 --> 00:13:04,159 part of Blue Premier. 350 00:13:04,539 --> 00:13:05,759 So since it's launched, 351 00:13:06,139 --> 00:13:09,179 we have saved over $800,000,000 352 00:13:09,179 --> 00:13:10,879 in medical medical costs. 353 00:13:11,419 --> 00:13:13,740 And about two thirds of that actually goes 354 00:13:13,740 --> 00:13:16,754 directly back to physicians as an incentive payment. 355 00:13:17,054 --> 00:13:19,375 The other third goes to keep our rates 356 00:13:19,375 --> 00:13:20,355 lower to help, 357 00:13:20,894 --> 00:13:23,294 make health care more affordable for all the 358 00:13:23,294 --> 00:13:25,075 people in in in North Carolina. 359 00:13:25,615 --> 00:13:26,115 So, 360 00:13:26,735 --> 00:13:28,335 you know, I think that's that's one of 361 00:13:28,335 --> 00:13:29,855 the ways we have really tried to work 362 00:13:29,855 --> 00:13:30,595 with providers. 363 00:13:31,700 --> 00:13:34,100 Another example of that is to help free 364 00:13:34,100 --> 00:13:35,480 them up from some of the administrative 365 00:13:35,940 --> 00:13:36,440 burden. 366 00:13:36,899 --> 00:13:38,500 And one of the ways we have done 367 00:13:38,500 --> 00:13:40,660 that was by entering into a joint venture 368 00:13:40,660 --> 00:13:41,960 in 2021 369 00:13:42,019 --> 00:13:44,920 to form an an organization called Allo. 370 00:13:45,284 --> 00:13:48,084 And the whole idea behind Allo was to 371 00:13:48,084 --> 00:13:49,464 make it a, 372 00:13:50,884 --> 00:13:52,264 make physician independence 373 00:13:52,725 --> 00:13:53,784 something that is 374 00:13:54,245 --> 00:13:55,304 financially viable 375 00:13:55,684 --> 00:13:56,824 and is administratively 376 00:13:57,365 --> 00:13:57,865 unburdensome 377 00:13:58,629 --> 00:14:01,589 as possible. So what Allo does is provide 378 00:14:01,589 --> 00:14:02,730 administrative support, 379 00:14:03,429 --> 00:14:04,569 high-tech tools, 380 00:14:04,870 --> 00:14:05,370 infrastructure, 381 00:14:06,069 --> 00:14:09,589 and similar that reduce the administrative burden on 382 00:14:09,589 --> 00:14:10,089 physicians, 383 00:14:10,709 --> 00:14:12,329 allow them to focus on 384 00:14:12,634 --> 00:14:14,714 taking care of patients, which is what most 385 00:14:14,714 --> 00:14:16,394 of them signed up, you know, to do 386 00:14:16,394 --> 00:14:17,855 anyway in the first place, 387 00:14:18,315 --> 00:14:18,815 and, 388 00:14:19,595 --> 00:14:21,455 allow them to remain independent 389 00:14:21,914 --> 00:14:23,615 in a way that is 390 00:14:24,075 --> 00:14:24,575 economically 391 00:14:25,115 --> 00:14:28,254 viable and also viable from a work life 392 00:14:28,529 --> 00:14:30,149 balance kind of, perspective. 393 00:14:31,409 --> 00:14:32,769 So, you know, I guess maybe the last 394 00:14:32,769 --> 00:14:34,449 thing I'll I'll I'll say on this topic 395 00:14:34,449 --> 00:14:36,789 is that you you may have heard that 396 00:14:37,009 --> 00:14:39,570 we have recently modernized our ninety two year 397 00:14:39,570 --> 00:14:42,389 old structure and announced the creation of Curacor 398 00:14:42,529 --> 00:14:43,029 Solutions, 399 00:14:43,524 --> 00:14:45,764 which is a North Carolina based not for 400 00:14:45,764 --> 00:14:47,065 profit parent company. 401 00:14:47,605 --> 00:14:49,065 And what this organization 402 00:14:49,445 --> 00:14:50,985 does or this reorganization 403 00:14:51,445 --> 00:14:54,024 does is allows Blue Cross of North Carolina 404 00:14:54,565 --> 00:14:56,904 to continue to make investments in 405 00:14:57,205 --> 00:14:58,825 organizations like Allo 406 00:14:59,149 --> 00:15:01,649 to deliver on making health care more affordable, 407 00:15:02,269 --> 00:15:04,210 accessible, and easier to navigate 408 00:15:04,750 --> 00:15:07,309 while still remaining a not for profit mission 409 00:15:07,309 --> 00:15:08,210 driven company. 410 00:15:08,750 --> 00:15:09,230 And, 411 00:15:10,110 --> 00:15:12,590 you know, certainly not changing anything that is 412 00:15:12,590 --> 00:15:13,889 fundamental to 413 00:15:14,225 --> 00:15:15,524 Blue Cross of North Carolina 414 00:15:15,985 --> 00:15:18,565 as a more traditional payer within the state. 415 00:15:19,425 --> 00:15:22,465 Certainly. Well, clearly, so much impactful work going 416 00:15:22,465 --> 00:15:24,465 on at Blue Cross of North Carolina. So 417 00:15:24,465 --> 00:15:27,264 appreciate you detailing everything that's happening across the 418 00:15:27,264 --> 00:15:28,870 enterprise for us, Steve. 419 00:15:29,409 --> 00:15:31,169 Before we go, what else are we missing? 420 00:15:31,169 --> 00:15:32,610 We've got a lot of other health plan 421 00:15:32,610 --> 00:15:34,870 leaders listening in from all over the country. 422 00:15:34,929 --> 00:15:36,850 Any final bits of advice or or final 423 00:15:36,850 --> 00:15:38,709 thoughts that you wanna share with them? 424 00:15:39,169 --> 00:15:40,289 Well, I think a lot of what I've 425 00:15:40,289 --> 00:15:42,929 spoken about, you know, without well, maybe saying 426 00:15:42,929 --> 00:15:45,225 the actual phrase is, you know, we're trying 427 00:15:45,225 --> 00:15:48,105 to help our members continuously find the right 428 00:15:48,105 --> 00:15:50,105 level of care at the right time, at 429 00:15:50,105 --> 00:15:52,105 the right place, and hopefully for for the 430 00:15:52,105 --> 00:15:54,424 right price at the same time. But one 431 00:15:54,424 --> 00:15:56,184 thing maybe I would love to touch on 432 00:15:56,184 --> 00:15:58,105 just because it's something I care, you know, 433 00:15:58,105 --> 00:15:59,565 very, very deeply about 434 00:16:00,089 --> 00:16:01,709 is youth mental health. 435 00:16:03,769 --> 00:16:06,569 You really can't go a day or a 436 00:16:06,569 --> 00:16:09,850 week or longer without hearing something, reading something 437 00:16:09,850 --> 00:16:11,629 about the youth mental health crisis, 438 00:16:12,329 --> 00:16:13,230 in this country. 439 00:16:13,964 --> 00:16:15,424 And when you hear statistics 440 00:16:15,804 --> 00:16:17,264 like forty percent 441 00:16:17,565 --> 00:16:20,444 of, you know, high school or similar youth 442 00:16:20,444 --> 00:16:22,384 report feeling sad or hopeless, 443 00:16:23,565 --> 00:16:27,264 every day, and an incredible number of 444 00:16:27,669 --> 00:16:30,490 youth of that age have seriously considered 445 00:16:31,110 --> 00:16:32,970 harming themselves or suicide. 446 00:16:34,070 --> 00:16:37,529 It is clear we have a significant, significant 447 00:16:37,669 --> 00:16:40,214 problem to address. And, you know, these are 448 00:16:40,214 --> 00:16:42,695 the individuals that are next generation. They're the 449 00:16:42,695 --> 00:16:45,735 next generation of adults, of parents, of of 450 00:16:45,735 --> 00:16:48,454 leaders. And it's really frightening when you hear 451 00:16:48,454 --> 00:16:49,834 those kinds of statistics. 452 00:16:50,615 --> 00:16:53,254 So one of the areas we have really 453 00:16:53,254 --> 00:16:54,750 tried to focus 454 00:16:55,050 --> 00:16:56,509 on in the last few years 455 00:16:56,889 --> 00:16:59,210 has been youth mental health and it's through 456 00:16:59,210 --> 00:17:00,269 a couple of different, 457 00:17:00,970 --> 00:17:01,470 avenues. 458 00:17:02,090 --> 00:17:04,250 One I'll just touch on briefly is a 459 00:17:04,250 --> 00:17:07,070 program called behavioral health total care. 460 00:17:07,555 --> 00:17:10,115 And that's a program that engages the parents 461 00:17:10,115 --> 00:17:10,775 of children 462 00:17:11,234 --> 00:17:14,055 who we notice are either going to emergency 463 00:17:14,115 --> 00:17:16,914 departments or other settings with with mental health 464 00:17:16,914 --> 00:17:19,410 needs. And the whole idea there is it's 465 00:17:19,650 --> 00:17:22,450 behavioral health childcare serves as a central point 466 00:17:22,450 --> 00:17:23,190 of coordination 467 00:17:23,970 --> 00:17:24,710 and support 468 00:17:25,170 --> 00:17:27,910 for the members, the youth, their parents, 469 00:17:28,210 --> 00:17:30,690 that really addresses their needs on a whole 470 00:17:30,690 --> 00:17:31,750 person health 471 00:17:32,049 --> 00:17:33,109 kind of basis. 472 00:17:34,644 --> 00:17:37,204 Operates on the principle principles of finding a 473 00:17:37,204 --> 00:17:38,744 behavioral health home 474 00:17:39,045 --> 00:17:42,424 that prioritizes things like continuity of care, integrating 475 00:17:42,484 --> 00:17:44,804 with other services that provide a much more 476 00:17:44,804 --> 00:17:47,365 personalized approach, and really helping them get the 477 00:17:47,365 --> 00:17:50,130 kind of support that meets their unique needs 478 00:17:50,190 --> 00:17:50,690 and 479 00:17:51,150 --> 00:17:52,369 meets them where they are. 480 00:17:52,670 --> 00:17:55,150 So through this team, you know, we've have 481 00:17:55,150 --> 00:17:57,789 individuals who can engage with them as care 482 00:17:57,789 --> 00:17:58,289 navigators, 483 00:17:58,590 --> 00:18:00,210 as peer support specialists, 484 00:18:01,295 --> 00:18:03,295 and a variety of other means to ensure 485 00:18:03,295 --> 00:18:04,575 that they're getting to the right 486 00:18:05,375 --> 00:18:07,454 excuse me, the right providers at the right 487 00:18:07,454 --> 00:18:07,954 times. 488 00:18:08,974 --> 00:18:09,474 And 489 00:18:09,855 --> 00:18:11,855 we're we're finding the demand for these services, 490 00:18:11,855 --> 00:18:14,674 not surprisingly, has been very, very high. And 491 00:18:14,894 --> 00:18:17,039 we also find that the parents, 492 00:18:17,500 --> 00:18:20,140 are responding because we understand that it's very, 493 00:18:20,140 --> 00:18:21,759 very challenging for them when, 494 00:18:22,259 --> 00:18:25,039 you know, one of their own children has 495 00:18:25,420 --> 00:18:26,559 mental health needs. 496 00:18:27,420 --> 00:18:29,820 Another component of this that is very much 497 00:18:29,820 --> 00:18:32,595 focused on youth behavioral health, but, is also 498 00:18:32,595 --> 00:18:34,535 available to all of our insured 499 00:18:34,994 --> 00:18:37,414 is a behavioral health care navigation service. 500 00:18:38,035 --> 00:18:38,535 And 501 00:18:39,315 --> 00:18:40,035 one of, 502 00:18:40,515 --> 00:18:42,194 the things that I would say is unique 503 00:18:42,194 --> 00:18:45,075 about behavioral health is that, yes, there's a 504 00:18:45,075 --> 00:18:45,575 workforce 505 00:18:46,035 --> 00:18:46,535 shortage. 506 00:18:47,339 --> 00:18:49,819 And yes, it's always important to find the 507 00:18:49,819 --> 00:18:50,720 right provider. 508 00:18:51,179 --> 00:18:53,259 But unlike a lot of other specialties, the 509 00:18:53,259 --> 00:18:54,400 behavioral health 510 00:18:55,019 --> 00:18:57,519 relationship with a provider, whether it's a psychiatrist 511 00:18:57,740 --> 00:18:59,579 or a social worker or other type of 512 00:18:59,579 --> 00:19:00,160 a provider, 513 00:19:00,474 --> 00:19:02,234 you know, it's it can be very intimate. 514 00:19:02,234 --> 00:19:03,454 You're sharing very, 515 00:19:04,075 --> 00:19:06,474 you know, closely held details of of of 516 00:19:06,474 --> 00:19:08,315 your life and the person really needs to 517 00:19:08,315 --> 00:19:09,774 be a good fit. 518 00:19:10,154 --> 00:19:10,654 And 519 00:19:11,194 --> 00:19:12,494 one of the best predictors 520 00:19:12,875 --> 00:19:13,375 of 521 00:19:13,859 --> 00:19:18,019 someone receiving appropriate behavioral health follow-up care is, 522 00:19:18,019 --> 00:19:19,400 you know, not surprisingly, 523 00:19:19,940 --> 00:19:22,019 you know, how they felt about their behavioral 524 00:19:22,019 --> 00:19:24,339 health provider, whether they they clicked. So the 525 00:19:24,339 --> 00:19:27,000 whole idea of our behavioral health navigators is, 526 00:19:27,220 --> 00:19:29,965 first and foremost, there's no wrong front door. 527 00:19:30,105 --> 00:19:32,585 Patients can self refer, a provider can refer 528 00:19:32,585 --> 00:19:34,345 them, one of our own case managers can 529 00:19:34,345 --> 00:19:36,744 refer them. But once our behavioral health care 530 00:19:36,744 --> 00:19:37,244 navigators 531 00:19:37,545 --> 00:19:38,285 are involved, 532 00:19:38,825 --> 00:19:41,305 we'll not only understand what their clinical needs 533 00:19:41,305 --> 00:19:43,085 are to get them to the right provider, 534 00:19:43,305 --> 00:19:45,759 we also want to understand their preferences. What 535 00:19:45,759 --> 00:19:48,000 are they looking for in a behavioral health 536 00:19:48,000 --> 00:19:48,500 provider, 537 00:19:49,359 --> 00:19:50,740 counselor, a psychiatrist? 538 00:19:51,359 --> 00:19:53,119 You know, what's important to them? Is it 539 00:19:53,119 --> 00:19:55,539 important for them to have a similar backgrounds 540 00:19:55,679 --> 00:19:57,845 to, you know, to to to look like 541 00:19:57,845 --> 00:20:00,484 them, to understand what they've gone through? And 542 00:20:00,484 --> 00:20:01,865 our our care navigators, 543 00:20:03,044 --> 00:20:04,184 you know, really leverage 544 00:20:04,484 --> 00:20:06,884 being local to understand what our network looks 545 00:20:06,884 --> 00:20:09,444 like and get them connected to the right 546 00:20:09,444 --> 00:20:10,744 behavioral health provider, 547 00:20:11,380 --> 00:20:13,539 help them get an appointment, make sure the 548 00:20:13,539 --> 00:20:14,679 appointment occurred, 549 00:20:15,059 --> 00:20:16,839 get them the follow-up they needed, 550 00:20:17,140 --> 00:20:19,779 and hopefully set them on a on a 551 00:20:19,779 --> 00:20:21,940 positive path. So I'm sorry. I know that 552 00:20:21,940 --> 00:20:23,460 was kind of a long answer to to 553 00:20:23,460 --> 00:20:25,299 your question, but, I'm just so passionate about 554 00:20:25,299 --> 00:20:27,914 behavioral health in general and, you know, youth 555 00:20:27,914 --> 00:20:30,234 behavioral health, specifically. So, 556 00:20:30,875 --> 00:20:31,855 hope that was helpful. 557 00:20:32,394 --> 00:20:34,714 Yeah. No. Absolutely. Very helpful. Your your passion 558 00:20:34,714 --> 00:20:36,875 is coming through the screen, Steve. So I 559 00:20:36,875 --> 00:20:39,355 appreciate you calling out this this pressing and 560 00:20:39,355 --> 00:20:41,930 important issue and explaining for us how Blue 561 00:20:41,930 --> 00:20:44,349 Cross of North Carolina is tackling these challenges 562 00:20:44,730 --> 00:20:46,330 head on for your members and for the 563 00:20:46,330 --> 00:20:48,890 wider communities that you serve. I also wanna 564 00:20:48,890 --> 00:20:50,890 thank you for taking the time to sit 565 00:20:50,890 --> 00:20:52,809 down with us and for sharing your insights 566 00:20:52,809 --> 00:20:55,230 with our listeners. We really appreciate it. 567 00:20:55,765 --> 00:20:57,845 Yeah. Thank you, Jacob. Appreciate the the time 568 00:20:57,845 --> 00:20:58,424 to participate. 569 00:20:58,964 --> 00:21:00,644 And if you'd like to listen to more 570 00:21:00,644 --> 00:21:04,984 podcasts from Becker's HealthCare, you can visit beckershospitalreview.com.