This is Haley Recker with the Becker's Payer
podcast, and we are recording live at the
Becker's third annual spring Payer Issues roundtable.
I am thrilled today to be joined by
doctor Eric Weil, who is the chief medical
officer at MDLIVE by Evernorth.
Hi, Eric. Thank you so much for having
this discussion with me today. Can you go
ahead and introduce yourself and share a little
bit about your background?
Sure. Thanks for asking. My name is Eric
Weil. I'm the chief medical officer for MD
Live by Evernorth.
I am a practicing primary care physician
who has overseen the clinical infrastructure
and strategy for our virtual solution for the
past two plus years.
My career began
in general primary care and through a relatively
circuitous path. I found myself in medical leadership,
and then in home based care.
Interestingly, though, when I went into home based
care, it was right at the beginning of
the COVID pandemic,
and we rapidly
were forced to pivot into a strategy that
was primarily
telemedicine based.
And in that context, I really learned about
both the value and the opportunity of,
virtual care
and have been running in that
race ever since. I wanna make sure that
we have an opportunity to talk a little
bit about the company that I support, MD
Live.
MD Live is an Evernorth health services company
and one of the leading providers
of telemedicine and virtual care in The United
States.
We offer services in primary care, in urgent
care, in dermatology,
in behavioral health, and we have an employee
assistance program.
The MD live intervention, the MD live program
supports 62,000,000
individuals. They have access to MD live as
a covered benefit through their health plan. And
the way that we offer services is either
through video,
through telephonic care, or through asynchronous care, which
we call e treatment.
We have over 2,000 board certified physicians and
licensed therapists that are trained to deliver care
virtually,
and we are dedicated to delivering exceptional,
accessible, and personalized health care through a seamless,
smoothly connected virtual platform.
That's awesome. Thank you so much for that
brief introduction.
Now moving on, balancing affordability
and quality is a constant challenge for health
plans. How is your organization innovating to manage
the cost of care while maintaining or improving
member outcomes?
So I like to break down
our approach to
the balance of affordability and quality into three
different domains. We use
efficiency,
prevention, and access.
Efficiency allows us to deliver a high quality
care at,
at a better price point
through,
economy of scale, but also through technologies that
streamline the experience and improve communication for patients
and providers.
We also
leverage technology
to support our administrative
responsibilities.
So for example, when you deliver over
1,500,000
visits a year, you wanna be able to
deliver quality at scale. And the way that
you do that is by using an AI
intervention, for example, to help with quality chart
reviews. And that allows us to
manage our leadership workforce and at the same
time as that support
the oversight of quality and safety,
at a volume that's much higher than one
would ordinarily be able to support.
We focus very much on optimizing processes, and
and we have a
continuous process improvement philosophy that allows us to
take any existing
programs or interventions that we have and focus
on making them even more impactful.
The second area that we focus on is
prevention.
And the concept here, of course, is that
in order to
reduce the total cost of care, you have
to keep people healthy. You have to keep
people from
utilizing more expensive health care services, and you
have to prevent them quite frankly from, needing
to miss work.
And so our interventions
not only
deal with care in the moment,
but are very strategically focused on thinking about
the future needs of an individual. So when
a patient comes in for their virtual primary
care, for example, we're not just managing their
complaint in the moment. We're thinking about what
preventive screenings they need, what we can do
to ensure that their diabetes is well controlled,
and that is
a chunk of the work that we do
at any given time.
And then the third area is access because
you can't
have good health care if you can't access
health care.
So we have a twenty four seven
strategy
that allows us to deliver primary care at
10:00 at night or on a Saturday morning.
If you have an urgent care need, you're
gonna see us within twenty minutes.
If you need routine care, even in primary
care, we have the ability to offer that
the same day. If you are in need
of behavioral health services, we can actually manage
those within
within a week. Our physicians can refer patients
to in network specialists,
which means that we can help to,
ensure access and connectivity to the health care
providers that are within an individual's network. And
because we also show cost transparency, we actually
show the cost of the visit in advance.
We allow individuals to make the decisions that
they need to make with regards to how
and when and where they wanna access care.
And then the last point I would say
is that the approach that we've chosen to
use
means that patients are not pursuing health care
in other
venues.
About twenty percent of our MD live patients
indicate that they would have delayed care if
we had not been available to them. MD
live had not been available to them as
a service.
Well, I'd love to go deeper into this
conversation about quality of care. So in an
ever evolving regulatory landscape, what best practices or
tools does your organization rely on to keep
quality of care at the forefront?
I appreciate you asking the question. It's important
to recognize that in the DNA of MD
live,
quality and safety are the top focus.
When we have a business review, when we
review
performance,
we don't start with financials. We don't start
with utilization. We start with quality and safety.
We we talk about whether or not there
have been safety events. We talk about how
our physicians are performing
from a quality point of view. That's where
we always start, And that message is delivered
to
our entire team, whether that's marketing
or strategy or product,
quality and safety come first. When we develop
clinical interventions,
we are always using evidence based guidelines.
When we develop interventions, we ensure that they
are being reviewed, embedded, and produced by licensed
health care professionals, physicians, therapists, and other.
When we select physicians or therapists to be
in our network,
they are all board certified and are robustly
vetted.
And
when we develop new clinical interventions,
they're reviewed every single year.
Nothing that we do becomes outdated because we
are constantly looking at what we offer
to ensure that it is up to date
with the most recent literature.
Finally,
what I would say is that the platform
that we've created
is designed in such a way as to
make it easier for physicians or therapists to
do the right thing.
The platform
helps to facilitate
thoughtful clinical decisions.
It helps to facilitate
ease of decision making in such a way
that we worry less
about whether or not a physician is going
to make the right decision because we are
confident that it's going to happen just because
of the way we're structured.
Thank you so much for sharing. And looking
ahead,
what do you see as the biggest opportunity
for payers to lead the charge in transforming
care delivery and driving better outcomes for all
stakeholders? How can leaders take a step in
this direction now?
You know,
I would make the argument that
we should be acknowledging and embracing the fact
that change is happening and is going to
continue to happen.
For example, if you think about the length
of stay in the hospital for a heart
attack in 1990, it was between nine and
ten days.
When you think about the length of stay
in the hospital today for a myocardial infarction,
it's three days.
A hip replacement in 1970, you were in
the hospital for seventeen to twenty days, and
now it's a same day procedure.
Every
step of the way,
care is being moved from being
in a hospital to being in an ambulatory
setting. And now health care is being moved
in an ambulatory setting from a specialist to
primary care, and then it moves into the
virtual space.
And our role is to recognize that that
is the direction that health care is is
moving in, and our role is to make
sure that we are
well positioned to support the movement of
that care to the home, to a virtual
space. And so the way that we do
this is
we focus on
enhancing and personalizing the patient experience.
We
work as much as we possibly can to
broaden the number of clinical capabilities
that we can offer even in a home
based environment through through a virtual platform, and
that includes things that you historically would have
gone into the office for. Some of those
are around managing
chronic disease,
hypertension,
diabetes,
obesity.
And some of those are focusing on other
areas that are very much priorities
for,
men and women in the course of their
daily health experience,
women's health, menopause care, contraceptive management.
Our role is to ensure that our clinical
capabilities and specialized care are expanding,
and that we're offering more optionality in terms
of referrals, for example. Absolutely. I would say
that we're also
redefining the referrals so that it's not just
to,
in person care,
but also to other virtual services.
And now you mentioned
diabetes care and weight loss
medication. So I'd really like to hear your
thoughts on the recent explosion,
in popularity of direct to consumer
virtual care services
that promote easy access to prescription medications
to treat everything from weight loss to hair
loss to ED.
Thank you for asking the question.
The first point
that is worth keeping in mind when we
think about
the trend towards direct to consumer care is
that health care
is a service industry. It's a service industry
with consequences, however, because if you're not receiving
the service you need, then you may not
be receiving crucial health care or you may
be delaying it in some fashion or another.
So that's point number one. Point number two
is that
patients want more control over their health care.
They want more control in the decisions that
are being made. They wanna be more informed
than perhaps in the past, and they're willing
to pay for it. With that, however, there
is a component of risk because
if
those decisions are not informed decisions
and a patient is willing to pay, then
they could go down a pathway of receiving
care that is not in their best interest.
So the direct to consumer
journey
is one that is going to become increasingly
more prevalent in The United States,
and our role within MD Live is going
to be to
to be a partner acknowledging
the need and the desire for control, but
to do so in a way that ensures
high levels of quality and safety.
And if an individual's priorities may not entirely
align with
what a physician might recognize
as a priority in their health care. Our
role
is to help support a journey that both
meets the patient's needs and at the same
time as that keeps them healthier, makes them
healthier.
So our model, which is
not just focused on direct to consumer, but
it's a more comprehensive and more holistic approach,
would focus on a patient's priorities
and at the same time as that, their
clinical needs.
Most of the time, that's also covered by
their insurance.
And if necessary, we have the ability, and
if desired, to share that information
with their
primary care provider or their specialist provider in
the community.
Alright. Well, thank you. Again, this is Haley
Recker with the Becker Payer Podcast recording live
at the Becker's third annual spring payer issues
roundtable. Thank you so much for joining me
today. Thanks.