Hello, everyone. This is Jacob Emerson with the
Becker's Pay Your Issues podcast. Thrilled today to
be joined by Jake Pascaglio, who is the
president of commercial business at Harvard Pilgrim Health
Care. Jake, thank you so much for taking
the time to be with me on the
podcast today.
Great to be with you, Jacob. Thank you.
Yeah. Absolutely. And before we dive into everything
we wanna talk with you about, can you
tell us a little bit more about yourself,
your background in health care, and what it
is that you do today at Harvard Pilgrim?
Certainly.
Again, I'm Jacob Viscaglio. Currently serve as a
president of commercial markets and specialty products for
Harvard Pilgrim Health Care, which is a subsidiary
company of point thirty two Health. We're based
in Massachusetts
and serve
New England markets,
Massachusetts,
Maine, New Hampshire, and Rhode Island.
And through that and in my role, I'm
responsible for sales, sales operations, product strategy innovation,
strategic business development, and the overall financial performance
of the commercial and specialty businesses.
I've been in health care the majority of
my career
with
other organizations
like Cigna, Anthem,
Blue Cross Blue Shield of Massachusetts. Been with
Irving Pilgrim Health Care for about seven months
now.
And,
I also have a stint in financial services
at Prudential Financial, and it's great to be
back in health care.
Fantastic. Well, we're glad to have you with
us. A long career in the industry,
Jake.
And we're and we're here specifically to talk
with you a little bit about Harvard Pilgrim
Health Care expanding its partnership with Progyny Health
to support your members for a full year
after NICU or special care nursery discharge. So
let's dive into that a little bit because,
as you know, neonatal care, it's getting increasingly
complex
as the year goes on. Coverage of these
services is increasingly getting more complex. And and
the challenges,
that these families face after NICU discharge,
are daunting. So
how do you see programs like this, between
Harvard Pilgrim and Progyny Health shaping the future
of post acute care management and improving those
long term outcomes for the families that you
serve?
It is complicated as you mentioned, and I
think you touched on a really important aspect
of this, which is the family aspect of
care. So certainly,
the
the child, the newborn that's in receiving care
is the one who's receiving care, but really
it's impacting the family
across the board. So it's not only about
caring for the the infant,
but it's also really taking care of the
the family,
at large.
And I'll I'll share a little bit of
the perspective in terms of why we think
this expansion is so important, but I'll also
give my own, family story because it's, something
we've we experienced now. Yeah. It's been a
while since my children are older, but, firsthand
experience
with,
twins,
that were
premature
and, spent some time in the NICU. So
for me and my family, it's very personal.
So what we're doing here is we're expanding
a program that we started,
with our great partner, Progyny.
Initially, we're sixty days after
birth,
to care for the newborn,
in the family.
I should say newborns or or more plural
there.
And,
really expanding that to the full year.
And just a little bit about the program
around Progyny. So their team includes board certified
physicians, nurses, social workers,
and to date, they've worked with more than
2,500
of our members.
And I think as most know,
there are specific life challenges that families face
following a NICU stay.
In addition to assistance with discharge planning, education,
screening for postpartum depression,
the Progyny Health team and their case managers
connect families to important resources they may
need,
things like transportation, healthy food, financial support for
utilities and rent, and even help members find
access to free items they need
for their babies like cribs, car seats, diapers,
and baby formula. So certainly, the
the care in the hospital and the coordination
there,
for the newborn or newborns, the the mom,
the dad, etcetera,
but also really beyond that and the impacts
that,
someone, a family that's going through,
this is dealing within all aspects of what's
needed
to really
launch,
the the new family,
on a path, is really important. So as
I mentioned,
my wife and I are fortunate to have
a set of twins,
that spent time in the NICU and,
programs like this were not available to us
at that time. Fortunately, we had a great
support system of family members,
friends, great doctors, nurses, etcetera. But as I
reflect back on that time,
we were just
trying to survive day to day. We actually
had, a 20 old at the time, so
trying to juggle across all that,
and care for our newborns,
and just make sure we were on top
of everything.
Looking back, was a daunting challenge. So a
program like this, would have been something that
would have been very much appreciated,
for for my family at the time. So
that's why for me, it's personal and something
that I'm really proud that our organization
stands behind for our clients, for our members,
and making this more broadly available.
Certainly. So you really understand these issues firsthand,
these issues that are also facing your members.
In that vein, Jake, what are some of
the broader implications of expanding this kind of
care management from the sixty days to a
full year for neonatal cases?
And how do you think this shift, in
care strategy is reflecting the industry evolving the
industry's evolving approach towards more,
member centered health plans?
Yeah. Absolutely. It's, it's an important
aspect of
how we really want to surround our members
with
services that are going to be helpful
over time.
And it it just makes good sense to
support the the families
with a program like this.
Additionally, as we know, the first year of
an infant's life is crucial for their ongoing
health. No surprise there.
Then a NICU stay can further compound some
of the challenges that families face during
that baby's first year.
One of the things we saw in the
data is,
more than ninety percent of our Harvard Pilgrim
members who participate in the program have reported
high satisfaction.
We saw the opportunity to do even more
for this population.
And I'd love to share an example of
one of our members from New Hampshire,
was a mother of premature twins born at
33,
and
the daughters were in the NICU. They had
a toddler at home, sounds familiar,
and the the mom had just started a
new job and had no paid maternity time
off. So certainly a challenge there just to
start.
Add a complication
of
her grandmother passing away and that she had
contracted COVID and couldn't visit the twins in
a hospital for an extended period of time.
Progyny stepped in with gift cards to help
with travel expenses, connected the mom with resources,
helped manage the cost of formula to help
her fortify her breast milk due to the
twins' prematurity.
The Progyny team also worked closely with the
hospital to clarify the twins milestones and provided
reassurances
to the mom and her husband when needed.
So the members are not just getting help
and support,
but advocacy.
And by expanding the program, we can assure
ensure that happens. Right? There is not a
timeframe of sixty days or ninety days.
Sometimes that's sufficient, but sometimes,
that first year is longer. So for us,
this isn't really a shift in strategy,
but rather it's an expansion of a program
that was
critically needed by this subset of our membership.
And for us, it was an easy decision
to expand the partnership to help our vulnerable
members and their families.
Absolutely. Well, that's a great real world example.
So appreciate you sharing that with us and
and some amazing satisfaction rates that you're you're
seeing through this.
Jake, we we hear from health plans,
all over the country about beyond Harvard Pilgrim
about,
NICU admissions and preterm births remaining a significant
concern for for their poll how they how
they cover things. And so I wonder if
you have advice for,
our our listeners in terms of, how to
integrate more comprehensive
maternity and infant care management
into into their health plans.
Yeah. Absolutely. Let me start maybe with some
of the the data
in terms of what's happening industry wide around
the, you know, the specific need around
NICU admissions and the this topic that we've
been talking about. So the stats paint a
a pretty dire picture. In The United States,
we have one of the highest maternal mortality
rates in developed world and the rates are
on the rise.
According to the March of Dimes twenty twenty
four report card, preterm birth rate in The
US remains historically high at ten point four
percent
and NICU births require specialized attention to ensure
the best outcomes during an infant's first year.
And even a short stay in the NICU
can delay family bonding, impact breastfeeding adoption.
And once an infant is discharged from the
hospital, the risk of a readmission back to
the hospital is significant without case management support
for the infant and family. Additionally, perinatal depression,
which is a condition that can have devastating
consequences, affects up to one in seven women
in The US. And some studies suggest that
this number can be even higher.
So we've seen the first hand of positive
results
of this type of program with Progyny Health,
and the impact it has on babies and
the families, broadly.
So as it relates to other,
insurance
leaders that are thinking about these programs, I
really think about it in a couple of,
important manners. One is really understanding
the needs of
the
memberships
that a membership that is covered,
by the plans
and really understanding
with those needs, what's the best way to
deliver it,
that care, that coaching, that program, whatever the
case may be,
in determining
what is the best approach to enable
that program
or the that those care pathways, etcetera.
And as we think about this, across all
aspects of our business, we really think about,
is this something that
we can do ourselves?
Is there a way to do it through
a partner relationship that has that specialized
expertise?
That's so critical.
And,
certainly with
NICU,
we saw the opportunity to
work
alongside Progyny Health, which is, you know, very
focused across,
this dimension of enabling
support and care,
for the most vulnerable members. And, again, very,
very pleased with the
results that we've delivered as our our members,
which is most important to us.
Certainly. And it's such a good call out
and a reminder for our listeners in terms
of the maternal and infant,
issues and care that that the country still
faces.
Before we go, Jake, what else are we
missing? Any final thoughts that you wanna share
with our listeners while you have the ears
of a lot of health plan leaders,
from all over the country right now? Yeah.
I appreciate the opportunity.
Yeah. So first and foremost,
Progyny Health, as I mentioned, a significant impact
positively on our members, and we're very proud
of this collaboration.
For us, this collaboration is not just a
one off program at Harvard Pilgrim Health Care.
We are always looking to sort support our
members through their entire health care journey.
Related,
obviously, is women's health, which is a large
area of focus for us. We've
we had a number of partnerships with,
organizations like Maven and Innovia Health that really
helps us to provide women with 24 access
to a variety of specialists,
personalized resources,
coaches,
lactation experts, behavioral health experts, etcetera, etcetera,
that really help us provide much needed information,
access to providers, to the right providers,
and care across the board,
for
our members,
who are
navigating
challenging life transitions
really end to end.
Additionally, something that we're really proud of that
connects in well here is
a program that was launched, which we refer
to as our behavioral health service navigation program.
This program provides personalized one to one assistance
that helps members find a behavioral health provider.
And we know finding behavioral
health providers, can be a challenge at times.
Scheduling those appointments once you find
that provider
can be a challenge at times. So our
navigators really take that burden off of the
individual and work side by side with our
members to
enable
awareness,
access to the right
provider, and
then scheduling,
to make sure that they can get what
they need. And then we follow-up to make
sure they're satisfied with their care, and then
we take those learnings and continue to iterate
and improve upon our programs.
Why that's really important,
as we're talking about the topic of,
NICU care,
for for the birth mom, for the children,
etcetera, is the connection certainly between,
behavioral health needs,
in this context,
making sure that we're able to provide that
access that's so important
to remove any barriers,
for for the moms and all the members,
quite frankly, who are looking to access vital
mental
health services when they need them.
Last thing I'll add is,
women's health month will end soon.
The yet the focus on the maternal health
crisis needs our year round attention and action.
And it's really my hope that we can
work together, broadly across the system
of health care to ensure every woman has
the opportunity
to experience a healthy pregnancy,
safe delivery, and a thriving happy life with
their baby or babies, for that matter. It's
a really important topic, and we're very focused
as I know many of,
the other insurance leaders are as well.
Absolutely. Well, I I think that's a great
place to leave things. So, Jake, I wanna
thank you for taking the time to sit
down with us and for sharing
about the impactful work going on under your
leadership at Harvard Pilgrim. We really appreciate it.
Thank you, Jake. Appreciate the opportunity to join
you today.
And to our listeners, if you'd like to
listen to more podcasts from Becker's Healthcare, you
can visit beckershospitalreview.com.