1
00:00:00,080 --> 00:00:02,080
Hello, everyone. This is Jacob Emerson with the

2
00:00:02,080 --> 00:00:03,939
Becker's Pay Your Issues podcast.

3
00:00:04,319 --> 00:00:06,719
Thrilled today to be joined by doctor Rama

4
00:00:06,719 --> 00:00:09,359
Labatra, who is senior vice president and chief

5
00:00:09,359 --> 00:00:12,559
medical officer at Premera Blue Cross. Doctor Batra,

6
00:00:12,559 --> 00:00:14,400
thank you so much for taking the time

7
00:00:14,400 --> 00:00:15,974
to be with me on the podcast today.

8
00:00:16,454 --> 00:00:18,614
Thanks for having me. So before we dive

9
00:00:18,614 --> 00:00:20,375
into everything we wanna talk with you about,

10
00:00:20,375 --> 00:00:21,815
can you tell us a little bit more

11
00:00:21,815 --> 00:00:24,535
about yourself, your background in health care, and

12
00:00:24,535 --> 00:00:26,214
what it is that you do today at

13
00:00:26,214 --> 00:00:26,714
Premera?

14
00:00:27,335 --> 00:00:27,835
Absolutely.

15
00:00:28,559 --> 00:00:30,879
I am a primary care physician internist by

16
00:00:30,879 --> 00:00:32,640
background. I would say I spent the first

17
00:00:32,640 --> 00:00:35,200
ten years of my professional life working in

18
00:00:35,200 --> 00:00:38,500
academic centers and federally qualified healthcare,

19
00:00:38,879 --> 00:00:41,840
centers. And, for the past, over a decade,

20
00:00:41,840 --> 00:00:43,859
I've been working on the health plan side,

21
00:00:44,125 --> 00:00:46,844
mostly in not for profit health plans. I

22
00:00:46,844 --> 00:00:49,244
joined Premera about a year back, in my

23
00:00:49,244 --> 00:00:51,585
role as a chief medical officer. I'm responsible,

24
00:00:52,364 --> 00:00:52,844
for,

25
00:00:53,484 --> 00:00:56,545
developing, I would say, clinical strategies and programs

26
00:00:56,604 --> 00:00:59,424
that improve the health care outcomes and experience

27
00:00:59,484 --> 00:01:01,460
in our populations, and I would say all

28
00:01:01,460 --> 00:01:02,280
our populations,

29
00:01:03,140 --> 00:01:05,239
with a focus on, what I would consider

30
00:01:05,299 --> 00:01:06,280
quintupil a.

31
00:01:07,299 --> 00:01:09,299
Fantastic. Well, let's talk a little bit about

32
00:01:09,299 --> 00:01:09,799
that.

33
00:01:10,340 --> 00:01:13,299
Obviously, you're you're Premera's new chief medical officer.

34
00:01:13,299 --> 00:01:14,755
So talk to us a little bit about

35
00:01:14,755 --> 00:01:17,395
how you're rethinking the health plan's approach to

36
00:01:17,395 --> 00:01:19,094
improving clinical outcomes,

37
00:01:19,635 --> 00:01:22,295
while also addressing the patient experience and provider

38
00:01:22,674 --> 00:01:23,174
satisfaction.

39
00:01:23,475 --> 00:01:25,395
And can you share with us any innovative

40
00:01:25,395 --> 00:01:28,115
strategies that you're implementing to align with that

41
00:01:28,115 --> 00:01:29,255
quintuple aim?

42
00:01:30,290 --> 00:01:31,729
You know, I would start off by saying

43
00:01:31,729 --> 00:01:33,329
when we think about health care now in

44
00:01:33,329 --> 00:01:35,569
this country, it's it's first and foremost on

45
00:01:35,569 --> 00:01:37,810
everybody's mind just because the health care costs

46
00:01:37,810 --> 00:01:38,709
are so up.

47
00:01:39,170 --> 00:01:41,250
I'm also sure people already know when you

48
00:01:41,250 --> 00:01:44,369
think about bankruptcies, medical reasons are the biggest

49
00:01:44,369 --> 00:01:47,155
reasons for bankruptcies. So affordability and access becomes

50
00:01:47,155 --> 00:01:48,055
that much bigger.

51
00:01:48,594 --> 00:01:50,834
So when we think about at Premera, when

52
00:01:50,834 --> 00:01:52,194
we think about how do we serve our

53
00:01:52,194 --> 00:01:52,694
populations

54
00:01:52,995 --> 00:01:55,635
best by and so especially focus on improving,

55
00:01:55,875 --> 00:01:58,055
quintuple on on quintuple aims and outcomes,

56
00:01:58,540 --> 00:02:01,259
We really focused on what matters to our

57
00:02:01,259 --> 00:02:01,759
populations,

58
00:02:02,619 --> 00:02:04,619
what are the drivers of poor health in

59
00:02:04,619 --> 00:02:05,439
those populations,

60
00:02:06,299 --> 00:02:09,039
how can we engage in our population alongside

61
00:02:09,099 --> 00:02:10,319
a delivery system,

62
00:02:10,699 --> 00:02:12,860
and really help them get to live their

63
00:02:12,860 --> 00:02:13,680
best life.

64
00:02:14,044 --> 00:02:15,724
And so that is also actually our our

65
00:02:15,724 --> 00:02:17,644
purpose and our vision and our mission statement,

66
00:02:17,644 --> 00:02:19,245
which is how do we really make health

67
00:02:19,245 --> 00:02:20,784
care work better for our members.

68
00:02:21,164 --> 00:02:22,465
And so that's the focus

69
00:02:22,764 --> 00:02:25,084
of our programs, and it's all,

70
00:02:25,485 --> 00:02:27,419
I would say it's driven by not only

71
00:02:27,419 --> 00:02:29,340
member needs, but it's also driven by data.

72
00:02:29,340 --> 00:02:31,120
What is our data telling us?

73
00:02:31,739 --> 00:02:34,139
And, really quickly, you know, all of us

74
00:02:34,139 --> 00:02:36,000
came on the other end of the pandemic.

75
00:02:36,299 --> 00:02:37,439
A lot of care

76
00:02:37,979 --> 00:02:40,539
was missed during the pandemic. And so as

77
00:02:40,539 --> 00:02:43,155
more people are engaging with care, our role

78
00:02:43,155 --> 00:02:45,474
at Premera is making sure people are reengaging

79
00:02:45,474 --> 00:02:48,034
with preventive care and also making sure, you

80
00:02:48,034 --> 00:02:50,354
know, access is available to our members at

81
00:02:50,354 --> 00:02:52,435
the right place and the right cost at

82
00:02:52,435 --> 00:02:54,194
the right time, and I say every time.

83
00:02:54,194 --> 00:02:55,474
So those are our big,

84
00:02:56,340 --> 00:02:58,360
areas of focus, at Premera.

85
00:02:59,540 --> 00:03:01,620
Certainly. And I know we've talked with Premera

86
00:03:01,620 --> 00:03:04,120
leaders in the past about how affordability

87
00:03:04,659 --> 00:03:07,379
and equitable access to care is a key

88
00:03:07,379 --> 00:03:10,425
challenge within today's health care landscape, and certainly

89
00:03:10,425 --> 00:03:12,105
that that's something that your leaders are always

90
00:03:12,105 --> 00:03:13,004
looking to tackle.

91
00:03:13,305 --> 00:03:14,745
So can you talk to us about how

92
00:03:14,745 --> 00:03:17,865
you're working to support providers in delivering that

93
00:03:17,865 --> 00:03:21,405
high quality care while also ensuring financial sustainability

94
00:03:21,784 --> 00:03:23,004
for the health plan?

95
00:03:23,769 --> 00:03:26,250
Yeah. So I, I, always step in two

96
00:03:26,250 --> 00:03:28,169
shoes. I think about members first, and I

97
00:03:28,169 --> 00:03:30,090
would say providers second. I'm a primary care

98
00:03:30,090 --> 00:03:32,189
physician myself, so I know how it is

99
00:03:32,330 --> 00:03:34,889
to take care of, you know, patients in

100
00:03:34,889 --> 00:03:35,709
the clinic,

101
00:03:36,169 --> 00:03:38,514
day after day. So with that lens in

102
00:03:38,514 --> 00:03:40,275
mind, we always think about how do we

103
00:03:40,275 --> 00:03:41,635
make the right thing to do, easy thing

104
00:03:41,635 --> 00:03:43,014
to do for our providers.

105
00:03:43,474 --> 00:03:45,235
And for for us, what it means is

106
00:03:45,235 --> 00:03:47,495
how do we get to data, data that's

107
00:03:47,555 --> 00:03:50,034
real and actionable and timely to our providers

108
00:03:50,034 --> 00:03:51,474
so they can really do the right thing.

109
00:03:51,474 --> 00:03:54,230
So perhaps we have more care gaps that

110
00:03:54,230 --> 00:03:57,030
providers may not know because members sometimes switch

111
00:03:57,030 --> 00:03:59,510
providers, like who needs a mammogram and who

112
00:03:59,510 --> 00:04:01,270
hasn't had a colon cancer screening. That's a

113
00:04:01,270 --> 00:04:02,090
good example.

114
00:04:02,629 --> 00:04:03,129
Similarly,

115
00:04:03,669 --> 00:04:05,669
you know, we have programs and people get

116
00:04:05,669 --> 00:04:07,965
discharged from the hospital to connect them back

117
00:04:07,965 --> 00:04:10,284
to their primary care physician because sometimes primary

118
00:04:10,284 --> 00:04:12,205
care physician are not even, you know, aware

119
00:04:12,205 --> 00:04:13,564
that people are in the hospital. So how

120
00:04:13,564 --> 00:04:15,485
do we get to do the right thing

121
00:04:15,485 --> 00:04:16,764
for our members and right thing for our

122
00:04:16,764 --> 00:04:18,764
providers? So how do we really support providers?

123
00:04:18,764 --> 00:04:19,824
That's another example.

124
00:04:20,389 --> 00:04:22,470
The third example I would say is,

125
00:04:22,870 --> 00:04:24,250
at a systems level,

126
00:04:24,550 --> 00:04:26,149
how do we make it easy and take

127
00:04:26,149 --> 00:04:26,970
away the administrative

128
00:04:27,589 --> 00:04:29,830
burden that a lot of primary care physicians

129
00:04:29,830 --> 00:04:33,189
and physicians in general face? So constantly looking

130
00:04:33,189 --> 00:04:35,914
at our systems and exchanging data, getting data

131
00:04:35,914 --> 00:04:36,654
from them,

132
00:04:37,194 --> 00:04:39,354
making sure that if we have, you know,

133
00:04:39,354 --> 00:04:41,834
if we are assessing for medical necessity, that

134
00:04:41,834 --> 00:04:44,794
that is timely, done real time. So no

135
00:04:44,794 --> 00:04:46,495
care is delayed or hampered.

136
00:04:46,870 --> 00:04:49,029
And last but not the least, rewarding for

137
00:04:49,029 --> 00:04:50,949
good quality care. So we have a lot

138
00:04:50,949 --> 00:04:52,810
of, value based care programs

139
00:04:53,189 --> 00:04:56,229
where where we incentivize our providers for, doing

140
00:04:56,229 --> 00:04:57,829
the right thing and more so so they

141
00:04:57,829 --> 00:04:59,750
can set up systems in place to help

142
00:04:59,750 --> 00:05:00,410
our members.

143
00:05:01,865 --> 00:05:02,365
Certainly.

144
00:05:02,904 --> 00:05:05,064
So let's switch gears here for a second

145
00:05:05,064 --> 00:05:07,064
and talk a little bit about health equity,

146
00:05:07,064 --> 00:05:09,705
which, of course, remains a critical priority for

147
00:05:09,705 --> 00:05:10,685
health care organizations

148
00:05:11,384 --> 00:05:13,165
nationally, including at Premera.

149
00:05:13,850 --> 00:05:15,449
How would you say that you're aligning the

150
00:05:15,449 --> 00:05:18,250
health plan strategy to advance health equity efforts

151
00:05:18,250 --> 00:05:20,569
across the communities that you serve? And can

152
00:05:20,569 --> 00:05:23,230
you share any partnerships or new initiatives,

153
00:05:23,850 --> 00:05:25,529
that you think are really proven effective in

154
00:05:25,529 --> 00:05:26,669
driving these efforts?

155
00:05:27,625 --> 00:05:30,425
Absolutely. I think we absolutely believe in, what

156
00:05:30,425 --> 00:05:32,985
I'm saying. Excellent health outcomes for all, but

157
00:05:32,985 --> 00:05:33,384
that is,

158
00:05:33,944 --> 00:05:36,584
Medicare. But that is a framework Medicare has

159
00:05:36,584 --> 00:05:38,904
adopted, and we totally believe in it. And

160
00:05:38,904 --> 00:05:40,779
for us, being a not for profit plan,

161
00:05:40,779 --> 00:05:42,860
it's based not only on our membership, it's

162
00:05:42,860 --> 00:05:45,660
also based on healthy communities as well. So

163
00:05:45,660 --> 00:05:47,899
with that in mind, we spent the last

164
00:05:47,899 --> 00:05:50,699
few years really partnering very closely with community

165
00:05:50,699 --> 00:05:51,600
based organizations,

166
00:05:51,980 --> 00:05:53,439
academic medical centers,

167
00:05:53,899 --> 00:05:56,795
in providing grants, providing data,

168
00:05:57,334 --> 00:06:00,134
creating and launching programs to address the needs

169
00:06:00,134 --> 00:06:02,235
of local population in some areas.

170
00:06:02,615 --> 00:06:04,855
It's around focus on hypertension in our black

171
00:06:04,855 --> 00:06:08,500
population. Other areas, it's, focused on serving the

172
00:06:08,500 --> 00:06:10,659
behavioral health needs of a population when we

173
00:06:10,659 --> 00:06:13,139
don't have that many behavioral health specialists. So

174
00:06:13,139 --> 00:06:15,939
giving grants around with University of Washington on

175
00:06:15,939 --> 00:06:19,300
collaborative care. And in some communities, it's around

176
00:06:19,300 --> 00:06:22,595
maternity care. So there are different areas that

177
00:06:22,595 --> 00:06:24,274
we focus on based on the needs of

178
00:06:24,274 --> 00:06:26,454
the population as, you know, many of our,

179
00:06:26,995 --> 00:06:29,555
many in our audience know that, social drivers

180
00:06:29,555 --> 00:06:31,634
of health are super important and, you know,

181
00:06:31,634 --> 00:06:33,555
what your health outcomes depend on where you

182
00:06:33,555 --> 00:06:35,819
live, work, and play. So that's where we

183
00:06:35,819 --> 00:06:38,459
are aligning ourselves to in terms of supporting

184
00:06:38,459 --> 00:06:40,620
the health. I I'm calling it excellent health

185
00:06:40,620 --> 00:06:41,600
outcomes for all.

186
00:06:42,459 --> 00:06:44,060
Absolutely. Well, it sounds like a lot of

187
00:06:44,060 --> 00:06:46,800
really impactful work happening under your leadership.

188
00:06:47,500 --> 00:06:49,954
But before we go, any other final thoughts

189
00:06:49,954 --> 00:06:52,454
or final tidbits of advice you wanna offer,

190
00:06:52,914 --> 00:06:54,034
while you have the ears of a lot

191
00:06:54,034 --> 00:06:56,514
of other health plan leaders from around the

192
00:06:56,514 --> 00:06:57,014
country?

193
00:06:57,794 --> 00:06:59,875
I think all of us across the country

194
00:06:59,875 --> 00:07:01,875
are struggling with the rising cost we see

195
00:07:01,875 --> 00:07:03,449
in our personal lives, and, of course, it

196
00:07:03,689 --> 00:07:05,290
spills over in the health care life as

197
00:07:05,290 --> 00:07:05,790
well.

198
00:07:06,250 --> 00:07:08,430
And, all of us are looking at affordability

199
00:07:08,889 --> 00:07:09,389
strategies.

200
00:07:09,930 --> 00:07:11,610
What I drive my teams to do and

201
00:07:11,610 --> 00:07:13,290
I would ask other health care leaders to

202
00:07:13,290 --> 00:07:14,730
do is, how do we make the right

203
00:07:14,730 --> 00:07:16,650
thing to do also the business excellent thing

204
00:07:16,650 --> 00:07:18,585
to do? And so looking at tactics that

205
00:07:18,585 --> 00:07:20,665
may help our members first and also help

206
00:07:20,665 --> 00:07:22,345
from driving the cost of care down and

207
00:07:22,345 --> 00:07:23,404
making it more affordable.

208
00:07:23,944 --> 00:07:25,625
Few things that jumped to my mind is,

209
00:07:25,625 --> 00:07:28,105
you know, pharmacy drugs are big drivers. If

210
00:07:28,105 --> 00:07:30,685
they're generics or biosimilars, could we do that?

211
00:07:30,930 --> 00:07:33,089
Similarly, I always tell my teams, hey. Nobody

212
00:07:33,089 --> 00:07:34,330
wants to show up in the ER or

213
00:07:34,330 --> 00:07:35,970
in the hospital unless they have to. Can

214
00:07:35,970 --> 00:07:38,529
we bring care to them? So just doing

215
00:07:38,529 --> 00:07:40,610
the right thing but also making sure the

216
00:07:40,610 --> 00:07:43,509
right thing also drives cost effectiveness and affordability.

217
00:07:44,625 --> 00:07:47,264
Wonderful. Well, doctor Batra, thank you so much

218
00:07:47,264 --> 00:07:48,785
for taking the time to sit down with

219
00:07:48,785 --> 00:07:50,705
us and for sharing your insights with our

220
00:07:50,705 --> 00:07:53,185
listeners. We really appreciate it. Thanks so much

221
00:07:53,185 --> 00:07:55,025
for having me, Jacob. And if you'd like

222
00:07:55,025 --> 00:07:57,345
to listen to more podcasts from Becker's Healthcare,

223
00:07:57,345 --> 00:08:00,245
you can visit beckershospitalreview.com.