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Evernorth brings the power of wonder and relentless

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innovation to create world class pharmacy, care, and

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benefit solutions.

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Barriers to care can lead to gaps in

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care, which can drive up the total cost

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of care. Our capabilities work seamlessly together to

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create innovative pharmacy care and benefit solutions for

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today and tomorrow.

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Our connected health services make the treatment, prediction,

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and prevention of health care's most complex conditions

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easier and more accessible as we drive organizations

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and people forward.

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This is Haley Recker with the Becker's Payer

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Podcast, and we are recording live at the

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Becker's third annual spring payer issues roundtable.

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I am thrilled today to be joined by

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doctor Rebecca Huie, medical director of Highmark Full

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Care.

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Doctor, thank you so much for joining us

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today. Thank you for having me.

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Alright. So before we get started, can I

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just have you go ahead and introduce yourself

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and share a little bit about your background?

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Sure. I am doctor Rebecca Huey. I'm a

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medical director with Highmark Whole Care. I've been

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there for about five years.

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I am an integrative family medicine physician by

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background

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and then have also worked, with multiple,

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types of patients, including civilians

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and military

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inpatient and outpatient.

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Oh, that's fascinating.

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I'd like to start our conversation a little

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bit off by talking about balancing affordability and

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quality of care. So how is your organization

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innovating to manage the cost of care while

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maintaining or improving member outcomes?

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So,

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well, for me and and I always say

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this. For leaders, the critical first step is

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to see the health care journey

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through the patient's eyes. So at Highmark Health,

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we have a model called living health, and

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Living Health is our strategy to redesign and

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enhance the health care experience

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by integrating insurance

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and health care delivery. So we leverage the

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technology we have

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and

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data analytics, and then we take that information

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that we gain about member behavior to create

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a system that is more proactive, is more

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personalized,

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and is more coordinated.

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And so we're accomplishing this by basically removing

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redundancies and making things more streamlined whenever we

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can.

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Living health aims to make interactions between members

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and their care teams more productive, and that

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makes things more timely.

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It makes care

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better and excuse me. Let me go back.

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Yeah. So Living Health aims to make interactions

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between members and their care teams more productive,

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providing a timely and actionable information to improve

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health outcomes and then ultimately make care more

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affordable.

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I'd like to pivot the conversation a little

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bit more towards health equity now.

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So can you share an overview of a

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key initiative here that you're involved in or

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particularly

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excited about, and what are you hoping to

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achieve?

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Absolutely.

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So health equity is fundamental to our mission

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as an organization

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at Highmark Healthcare. So we have several impactful

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initiatives.

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We're fighting food insecurity through community farmers markets.

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We're distributing tens of thousands of pounds of

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fresh produce annually. And there are a couple

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of programs also that I want to highlight.

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We're deeply invested in maternal health

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through a couple of programs. One is called

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mom matters,

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and we have this is a special program

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for pregnant women.

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And we give education and support to moms

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to help them navigate a healthy pregnancy.

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We help them find a doctor, set up

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their appointments.

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They can call as soon as they find

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out they're pregnant, and we can set them

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up. And then we answer questions,

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and we can direct them to community services.

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And we arrange home visits by nurses.

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We can provide transportation to appointments, and we

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can even help them stop smoking, which is

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very important for,

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for great outcomes for their babies.

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We also have what's called the pathway program.

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And pathway is a comprehensive program, and this

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supports pregnant women and new mothers managing substance

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use disorder.

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So it integrates

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medical care, like medically assistant treatment for withdrawal,

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but then also mental health counseling and social

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services.

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Again, transportation,

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education.

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We even help treat babies who are suffering

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from neonatal abstinence syndrome

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and any other postpartum care that the mom

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or baby might need.

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In addition, we support breast milk

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banks and diaper banks and provide doulas.

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So when very notably, just one last thing,

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we've

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scaled up

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our training significantly so that we can help

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members

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reenroll

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every year in Medicaid,

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so that they keep their benefits and they're

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not dropping benefits or losing their health care.

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And so we're doing this by partnering with

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pharmacies,

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title one schools,

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and also just through community events, letting people

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know if

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they have Medicaid that they do need to

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continue to renew that in order to maintain

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their services.

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Well, that's so refreshing to hear, especially as

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a woman. I feel like a lot of

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women centered sources,

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turn a blind eye to women's health care.

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Definitely.

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So so that kind of brings me to

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my next question, which is about member satisfaction.

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What experience or engagement strategies have proven effective

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for your organization? How are you measuring success?

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So overall, I will say, first of all,

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that our our members tend to be very

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satisfied.

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We view member satisfaction

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holistically.

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So this is all encompassing experiences with the

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health care plan and then also with providers.

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So and we consistently score well on the

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annual CAHPS surveys, which is consumer assessment of

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health care providers and systems.

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So we believe in continuous feedback and continuous

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improvement,

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and we're monitoring appeals and grievances.

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We also conduct

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immediate post call surveys in customer service so

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we can know right away

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if they had a good experience or a

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bad experience, and then what about it was

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good or bad.

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And we're currently achieving a 4.9

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out of five

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satisfaction score. So that's excellent.

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And we use these post appointment surveys for

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provider feedback,

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and we actively, again, strive to improve our

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process.

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And this is really, really important. We prioritize

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this feedback because we found that a positive

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member experience strongly correlates, of course, with better

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health outcomes because they're more willing to engage

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with us on a regular basis

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when they know that they're gonna have a

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pleasant, productive, and rewarding experience.

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Absolutely. And just to wrap up our conversation

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today, what do you see as the biggest

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opportunity for payers to lead the charge in

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transforming care delivery and driving better outcomes for

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all stakeholders?

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Well, so this is gonna resonate with a

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lot of people, but everything seems so complicated

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right now. Things are changing daily, and then

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we're inundated with constant messaging from a ton

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of different places.

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Sometimes it's hard to tell signal from noise

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just because of all the information we have,

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and it's often conflicting.

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Keeping that in mind, I believe the biggest

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opportunity for us as a plan lies in

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simplifying the health care experience for everyone.

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So payers can lead by making benefits crystal

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clear and easy to navigate,

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and technology has been our friend in this

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endeavor. So technology is a major lever here.

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We can expand access through telehealth,

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online programs, and then also using tools like

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a like AI to stream

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the processes.

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I'm gonna mention again,

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coming back to our living health model, which

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is built on this principle of integration

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and simplification.

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So, again, for leaders, the critical first step

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is to truly see the health care journey

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through the patient's eyes and then understanding their

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challenges and their needs. And this is essential

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to building a simpler, more effective, and patient

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centered system.

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Well, doctor Huie, thank you so much for

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joining me today. That was an amazing conversation.

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Again, we are live at the Becker's third

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annual spring payer issues roundtable.