1 00:00:00,000 --> 00:00:02,740 Evernorth brings the power of wonder and relentless 2 00:00:02,799 --> 00:00:05,599 innovation to create world class pharmacy, care, and 3 00:00:05,599 --> 00:00:06,580 benefit solutions. 4 00:00:07,200 --> 00:00:08,960 Barriers to care can lead to gaps in 5 00:00:08,960 --> 00:00:10,719 care, which can drive up the total cost 6 00:00:10,719 --> 00:00:13,839 of care. Our capabilities work seamlessly together to 7 00:00:13,839 --> 00:00:17,245 create innovative pharmacy care and benefit solutions for 8 00:00:17,245 --> 00:00:18,225 today and tomorrow. 9 00:00:18,765 --> 00:00:21,585 Our connected health services make the treatment, prediction, 10 00:00:21,644 --> 00:00:24,225 and prevention of health care's most complex conditions 11 00:00:24,765 --> 00:00:27,345 easier and more accessible as we drive organizations 12 00:00:27,565 --> 00:00:28,545 and people forward. 13 00:00:29,300 --> 00:00:31,140 Hello, and welcome to the Becker's Payer Issues 14 00:00:31,140 --> 00:00:33,859 podcast recorded, the third annual spring Payers Issues 15 00:00:33,859 --> 00:00:34,359 roundtable. 16 00:00:34,739 --> 00:00:37,379 I'm joined today by Tai Wong. Tai, can 17 00:00:37,379 --> 00:00:38,899 you please introduce yourself and tell us a 18 00:00:38,899 --> 00:00:40,520 little bit about your role in your organization? 19 00:00:40,899 --> 00:00:42,979 Yeah. And thanks for having me here again. 20 00:00:43,140 --> 00:00:46,005 I'm Tai Wong, cofounder and CEO of Angle 21 00:00:46,005 --> 00:00:48,725 Health. And, Angle Health is an AI native 22 00:00:48,725 --> 00:00:51,784 integrated health care company. Our core products are 23 00:00:51,924 --> 00:00:54,825 custom full service health plans for employers. 24 00:00:55,445 --> 00:00:57,924 We offer fully insured and level funded health 25 00:00:57,924 --> 00:01:00,672 plan products and serve thousands of small and 26 00:01:00,672 --> 00:01:02,780 medium small and medium sized, businesses and tens 27 00:01:02,780 --> 00:01:05,280 of thousands of members across the country today. 28 00:01:06,540 --> 00:01:09,340 Balancing affordability and quality is a constant challenge 29 00:01:09,340 --> 00:01:12,159 for health plans. How is your organization innovating 30 00:01:12,219 --> 00:01:14,479 to manage the cost of care while maintaining 31 00:01:14,540 --> 00:01:15,920 or improving member outcomes? 32 00:01:16,435 --> 00:01:17,734 Yeah. That's a great question. 33 00:01:18,195 --> 00:01:20,034 I think one thing that's important for us 34 00:01:20,034 --> 00:01:22,115 as a full stack health plan offering and 35 00:01:22,115 --> 00:01:24,435 especially in the level funded space where we 36 00:01:24,435 --> 00:01:26,855 are the TPA, the plan administrator, 37 00:01:27,395 --> 00:01:28,775 and the stop loss carrier, 38 00:01:29,120 --> 00:01:31,439 we really see ourselves as fully aligned with 39 00:01:31,439 --> 00:01:33,040 the member and the employer when it comes 40 00:01:33,040 --> 00:01:35,459 to improving costs and, improving, 41 00:01:36,000 --> 00:01:39,200 health outcomes. So we're constantly building and launching 42 00:01:39,200 --> 00:01:40,420 new products and partnerships, 43 00:01:40,880 --> 00:01:43,439 with the best in class solutions across health 44 00:01:43,439 --> 00:01:44,659 care access and treatment 45 00:01:45,334 --> 00:01:48,614 Through our integrated data platform and proprietary AI 46 00:01:48,614 --> 00:01:50,454 and machine learning capabilities that we've built here 47 00:01:50,454 --> 00:01:52,775 at Engle Health as well, we are able 48 00:01:52,775 --> 00:01:55,594 to surface insights for our care and advocacy 49 00:01:55,655 --> 00:01:57,734 teams who are then able to really engage 50 00:01:57,734 --> 00:01:59,790 our members into these programs that best meet 51 00:01:59,790 --> 00:02:02,109 their health care needs, whether it's chronic disease 52 00:02:02,109 --> 00:02:04,689 management or a complex course of care. 53 00:02:05,390 --> 00:02:07,310 This also serves to really ensure that our 54 00:02:07,310 --> 00:02:09,009 members access the most appropriate, 55 00:02:09,469 --> 00:02:12,110 high quality, and cost effective care available to 56 00:02:12,110 --> 00:02:15,009 them. In many cases, that means delivering preventive 57 00:02:15,264 --> 00:02:17,425 care to avoid a major future event like 58 00:02:17,425 --> 00:02:18,405 an ER admission. 59 00:02:19,424 --> 00:02:22,625 Mhmm. And so member satisfaction is obviously invention 60 00:02:22,625 --> 00:02:24,944 to thrive in today's super competitive health care 61 00:02:24,944 --> 00:02:25,444 market. 62 00:02:25,905 --> 00:02:29,019 What experience or engagement strategies have proven effective 63 00:02:29,019 --> 00:02:31,259 for your organization, and what are your KPIs? 64 00:02:31,259 --> 00:02:32,639 How are you managing success? 65 00:02:33,419 --> 00:02:35,419 Yeah. So we've learned a lot through the 66 00:02:35,419 --> 00:02:38,060 launch of our angle advocacy program, which we 67 00:02:38,060 --> 00:02:40,319 launched last year, and it's essentially a concierge 68 00:02:40,379 --> 00:02:42,400 care navigation service for our 69 00:02:42,715 --> 00:02:45,435 highest acuity members. One of the biggest learnings 70 00:02:45,435 --> 00:02:47,435 that we had was that people just want 71 00:02:47,435 --> 00:02:49,995 a real human to engage with. Ideally, someone 72 00:02:49,995 --> 00:02:52,314 that's knowledgeable that can help them navigate their 73 00:02:52,314 --> 00:02:53,055 care journey. 74 00:02:53,435 --> 00:02:55,354 And the reality is that even when someone 75 00:02:55,354 --> 00:02:56,254 has a PCP, 76 00:02:56,689 --> 00:02:57,750 a team of specialists, 77 00:02:58,770 --> 00:03:01,090 many many still feel like they're left to 78 00:03:01,090 --> 00:03:03,169 navigate the complexities of the health care system 79 00:03:03,169 --> 00:03:03,990 on their own. 80 00:03:04,449 --> 00:03:06,770 The status quo is that no one really 81 00:03:06,770 --> 00:03:08,770 expects to get help, least of all, from 82 00:03:08,770 --> 00:03:10,694 their health plan. So we found that it's 83 00:03:10,694 --> 00:03:12,775 really up to us to engage. And and 84 00:03:12,775 --> 00:03:14,155 when we do, the response 85 00:03:14,455 --> 00:03:15,995 has been overwhelmingly positive. 86 00:03:16,534 --> 00:03:18,694 To your question about how we measure that 87 00:03:18,694 --> 00:03:21,014 success Mhmm. I would say, ultimately, the feedback 88 00:03:21,014 --> 00:03:22,875 that we're getting from our members, 89 00:03:23,319 --> 00:03:25,480 these are people who are in incredibly sensitive 90 00:03:25,480 --> 00:03:28,680 situations. They're facing difficult circumstances, not just with 91 00:03:28,680 --> 00:03:30,599 their health, but also in many cases, their 92 00:03:30,599 --> 00:03:33,319 financial well-being. So Mhmm. When we're able to 93 00:03:33,319 --> 00:03:35,240 provide a service that, in the worst case, 94 00:03:35,240 --> 00:03:37,000 provides a bit of moral support and in 95 00:03:37,000 --> 00:03:38,665 the best case, really, 96 00:03:39,044 --> 00:03:41,365 saves lives and provides thousands of dollars in 97 00:03:41,365 --> 00:03:44,025 savings to our members. You can imagine 98 00:03:44,324 --> 00:03:46,564 why members and employers don't just view us 99 00:03:46,564 --> 00:03:47,844 as a health plan, but really as a 100 00:03:47,844 --> 00:03:49,384 partner in health. Mhmm. Mhmm. 101 00:03:50,050 --> 00:03:51,909 You and I chatted last year, 102 00:03:52,530 --> 00:03:53,969 on the same, I believe at the same 103 00:03:53,969 --> 00:03:56,289 conference on the same show. And, you know, 104 00:03:56,289 --> 00:03:58,289 a lot in health care has changed since 105 00:03:58,289 --> 00:04:00,289 then, and it's gonna be continuing to change 106 00:04:00,289 --> 00:04:01,830 at a super rapid pace. 107 00:04:02,504 --> 00:04:03,004 And 108 00:04:03,384 --> 00:04:05,944 looking ahead, I'm very curious. What do you 109 00:04:05,944 --> 00:04:08,205 see as the biggest opportunities for payers 110 00:04:08,504 --> 00:04:10,664 to lead the charge in transforming health care 111 00:04:10,664 --> 00:04:12,745 delivery and driving better outcomes for all of 112 00:04:12,745 --> 00:04:15,560 the stakeholders involved? And how can leaders such 113 00:04:15,560 --> 00:04:16,220 as yourself, 114 00:04:17,079 --> 00:04:18,860 take a step in this direction now? 115 00:04:19,399 --> 00:04:21,000 Yeah. That's a great question, and I think 116 00:04:21,000 --> 00:04:22,379 that's a really big question. 117 00:04:23,240 --> 00:04:25,240 I would say AI is easily the largest 118 00:04:25,240 --> 00:04:28,004 opportunity for payers today to evolve how they 119 00:04:28,084 --> 00:04:30,745 operate and and to deliver services that ultimately 120 00:04:30,805 --> 00:04:33,205 result in better, more efficient delivery of care 121 00:04:33,205 --> 00:04:34,105 to consumers. 122 00:04:35,205 --> 00:04:38,485 At angle through our integrated data platform, we're 123 00:04:38,485 --> 00:04:41,944 already seeing significant operating leverage across our operations, 124 00:04:42,004 --> 00:04:44,009 especially with the AI, 125 00:04:44,469 --> 00:04:46,310 models and the and the tools that we 126 00:04:46,310 --> 00:04:49,029 have, which result in lower administrative costs and 127 00:04:49,029 --> 00:04:51,289 ultimately savings for our members and employers. 128 00:04:52,069 --> 00:04:54,810 The AI tools that streamline operations, whether it's 129 00:04:54,870 --> 00:04:56,729 for policy management, eligibility, 130 00:04:57,029 --> 00:04:57,930 claims processing, 131 00:04:58,474 --> 00:05:00,574 clinical decision making, or anything else 132 00:05:01,035 --> 00:05:03,194 will fundamentally change the way that health plans 133 00:05:03,194 --> 00:05:04,654 and providers operate, 134 00:05:05,035 --> 00:05:07,834 which provides efficiencies back into the health care 135 00:05:07,834 --> 00:05:09,595 system, and I think will also free up 136 00:05:09,595 --> 00:05:11,310 providers to spend more time doing what's, 137 00:05:11,949 --> 00:05:14,449 most important, which is treating their patients. 138 00:05:15,069 --> 00:05:16,829 So, I think the the best thing that 139 00:05:16,829 --> 00:05:18,509 leaders can do right now to take a 140 00:05:18,509 --> 00:05:20,509 step in that direction is to really foster 141 00:05:20,509 --> 00:05:21,169 a culture 142 00:05:21,470 --> 00:05:22,990 of innovation and and, 143 00:05:23,389 --> 00:05:24,930 embrace this new technology. 144 00:05:26,125 --> 00:05:28,144 Ty, as someone who's really utilizing 145 00:05:28,524 --> 00:05:29,665 AI in this space 146 00:05:30,524 --> 00:05:32,204 and AI, you know, even where it was 147 00:05:32,204 --> 00:05:33,884 a couple years ago versus now is night 148 00:05:33,884 --> 00:05:34,544 and day, 149 00:05:34,925 --> 00:05:36,444 what are some of the things you could 150 00:05:36,444 --> 00:05:39,060 see as use cases or ways that might, 151 00:05:39,220 --> 00:05:41,379 like, totally impact your industry in a couple 152 00:05:41,379 --> 00:05:42,819 years that we might not even be thinking 153 00:05:42,819 --> 00:05:45,060 about now? Like, what are you most excited 154 00:05:45,060 --> 00:05:47,060 about that might not be being utilized right 155 00:05:47,060 --> 00:05:47,560 now? 156 00:05:47,939 --> 00:05:49,720 Yeah. That's a great question. So I think, 157 00:05:50,100 --> 00:05:52,819 the pace of advancement in AI is is 158 00:05:52,819 --> 00:05:55,805 immense. Every single day, something new comes out, 159 00:05:55,805 --> 00:05:57,745 and if you're not keeping up with it, 160 00:05:57,964 --> 00:05:59,425 you're already behind. 161 00:06:00,365 --> 00:06:02,204 I think there's still a long way to 162 00:06:02,204 --> 00:06:04,524 go when it comes to many of the 163 00:06:04,524 --> 00:06:07,084 more advanced capabilities that people are really working 164 00:06:07,084 --> 00:06:08,920 on, whether it's in, 165 00:06:09,319 --> 00:06:11,480 the ability to leverage AI to truly make 166 00:06:11,480 --> 00:06:14,920 clinical decisions or to even on kind of 167 00:06:14,920 --> 00:06:17,319 the education side where we now have companies 168 00:06:17,319 --> 00:06:17,980 that are, 169 00:06:18,360 --> 00:06:20,839 starting and trying to replace things like medical 170 00:06:20,839 --> 00:06:22,459 school with with AI. 171 00:06:23,305 --> 00:06:25,085 I think I think those I think 172 00:06:25,625 --> 00:06:27,404 some of those areas are extremely 173 00:06:28,105 --> 00:06:30,105 exciting for what it means when it comes 174 00:06:30,105 --> 00:06:32,524 to lowering the the barrier to 175 00:06:33,064 --> 00:06:35,225 accessing care and and and to more people 176 00:06:35,225 --> 00:06:36,045 really entering 177 00:06:36,349 --> 00:06:37,810 the workforce in the industry. 178 00:06:38,430 --> 00:06:40,029 And and here at Engel Health as well, 179 00:06:40,029 --> 00:06:41,870 we really believe in a human in the 180 00:06:41,870 --> 00:06:44,769 loop, philosophy when it comes to AI. And, 181 00:06:45,229 --> 00:06:47,470 I think we're really seeing that as we 182 00:06:47,629 --> 00:06:49,845 as as a lot of these new use 183 00:06:49,845 --> 00:06:50,904 cases and companies, 184 00:06:51,524 --> 00:06:52,345 form to 185 00:06:53,204 --> 00:06:55,285 to build these kinds of tools that will 186 00:06:55,285 --> 00:06:56,264 really change 187 00:06:56,564 --> 00:06:57,384 the way that, 188 00:06:57,685 --> 00:06:59,365 a health plan and and and really the 189 00:06:59,365 --> 00:07:02,084 health care system operates across the administrative side 190 00:07:02,084 --> 00:07:03,704 and across the clinical side. 191 00:07:04,240 --> 00:07:06,639 Awesome. I love that. Well, Ty, thank you 192 00:07:06,639 --> 00:07:08,639 so much. Again, it's been a pleasure chatting 193 00:07:08,639 --> 00:07:10,399 with you, and I really appreciate you joining 194 00:07:10,399 --> 00:07:12,399 us today on the Becker's Healthcare Podcast. It's 195 00:07:12,399 --> 00:07:14,800 a pleasure as always, and, we look forward 196 00:07:14,800 --> 00:07:16,719 to chatting again next year. I do too. 197 00:07:16,719 --> 00:07:17,779 Thank you so much.