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Hello and welcome to the Becker's Healthcare podcast.
My name is Chanel Banger recording live at
the Becker's third annual Spring Payer Issues Roundtable
and sitting down with Samuel Wollner, the Vice
President of Strategy and Partnerships at EmblemHealth.
Sam, thank you so much for joining me
today. Thanks for having me, Chanel. Perfect. While
we get started, could you please introduce yourself
and share a bit about your organization?
Sure. So my name is Sam Wollner. I'm
the vice president of strategy and partnerships at
EmblemHealth.
EmblemHealth is a not for profit health plan
headquartered in Manhattan in New York City.
We have, been in existence since the nineteen
thirties in the, height of the Great Depression
when we were founded by mayor Fiorello LaGuardia,
who some may be familiar with from the
airport in New York City.
We were founded with the mission of serving
hardworking New Yorkers and keeping them from financial
misfortune in the event of accident or illness.
And, we're still on that mission today. We've
expanded it a bit. We own a physician
group. But overall, we're,
$6,000,000,000
in top line revenue.
We have about 2,000,000 members.
We're in all lines of business, and so
about one in four New Yorkers actually receives
their insurance,
through EmblemHealth.
And, our physician group, Advantage Care Physicians, sees
roughly a half a million patients,
for primary and specialty care every year.
So we're a a highly New York focused
organization.
We like to think of ourselves as being
not just in the community, but of the
community, and I'm no exception. I'm a born
and raised New Yorker. I've been with EmblemHealth
for four years. I lead, strategic planning,
corporate partnerships,
and a, a small group that focuses on,
organizational alignment around strategic initiatives that we call
strategy implementation.
Got it. Thank you so much for that
introduction. Now moving forward into the meat of
the podcast, addressing health equity has become a
critical focus
for many health plans.
Can you share an overview of a key
initiative here that you're involved in or particularly
excited about, and what are you hoping to
achieve?
Great.
Happy to. So we're a we're a nonprofit
health plan. As I mentioned before. Our commitment
is to our neighbors, and not to shareholders.
And so health equity is one way we
honor that commitment.
We have established a an executive role in
the company, the chief health equity officer. His
name is Abdu Ba.
So that's our first initiative is establishing leadership
around a commitment to health equity. The second
thing I would mention is that we are
the only health, plan in New York State
who is who has received or earned an
NCQA
health equity accreditation,
and that involves
ensuring that we're collecting
demographic data about all of our members,
reporting on it, and making health equity part
of our organization. So we're we're honored to
be, accredited by NCQA for that. The third
part I would mention is that,
we have a a neighborhood
level approach to to health equity. We have,
30 locations
that, that are physician group advantage care physicians
delivers
primary and specialty care at. And at many
of those locations, we collocate,
what we call EmblemHealth Neighborhood Care, which is
staffed by,
customer service folks that are really care navigators,
that are able to
point, both our members and community members, more
broadly speaking, connecting them to community resources,
classes on nutrition,
well-being,
and some exercise classes.
Perfect. Well, moving forward, net promoter score is
a powerful indicator of members' loyalty and satisfaction.
How are you using NPS
to drive meaningful improvements across your health plan?
We look at NPS,
regularly. Our our marketing team does a wonderful
job of serving
all of our stakeholders,
for NPS scores. So not just our members,
but also,
the broker community as well as the provider
community, all folks that we consider to be
key stakeholders to our business and to our
community.
It's also embedded in our corporate incentive structure,
so we're all, incentivized to be focused on
it. And,
finally, we use it when we review it,
we we use it through to adjust our
products. For example, we identified that,
our dental solution was a pain pain point
across many of our products and especially in
the government programs business. So we're in the
process of, enhancing that solution.
So everyone's talking about how there's an imperative
to reduce costs, improve quality,
and advance health equity, none of which are
small tasks. How do you approach aligning these
priorities in your organization's strategic vision?
Well, to begin with, we have a very
structured strategic planning process.
We work on setting objectives with measurable key
results,
and checking in on those quarterly and adjusting
them as needed.
But beyond kind of establishing the what we
wanna achieve and aligning all those priorities, we're
really focused,
on building great teams,
and having a cohesive leadership team work together
because inevitably priorities,
adjust,
and you need to pivot. And it's incredibly
important to have a cohesive team that works
well together because then pivoting becomes, much more
manageable.
Absolutely. Well, Well, Sam, I wanna thank you
for your time today. But before I let
you go, I have one more question. 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? And how can leaders take a
step in this direction now?
Yeah. So what I would say is that
health care to date has become largely
a game of scale, and so the
the winners and losers of this of the
health care landscape have been determined by how
large they've become. You might think about it
as a battle of sumo wrestlers.
We are
thinking that the the next wave of health
insurer and how we wanna win in the
market
is by being a care delivery partner and
and an advocate for our stakeholders.
So to be a true advocate for your
stakeholder, you need to be,
understanding of that stakeholder in in the community.
So we no longer wanna differentiate purely on
scale. We wanna differentiate
based off of our community presence. So building
off of things like AdvantageCare Physicians and EmblemHealth
Neighborhood Care,
having a a provider networking team that doesn't
just do contract negotiations, but is also there
to form
meaningful relationships with the providers in our communities.
So that's how I see us making the
biggest impact moving into the future.
Absolutely. Well, Sam, I wanna thank you once
again for your time today and for joining
me on the Becker's Healthcare podcast.
Thank you so much, Janelle.