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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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Hello and welcome to the Becker's Healthcare podcast.

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My name is Chanel Banger recording live at

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the Becker's third annual Spring Payer Issues Roundtable

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and sitting down with Samuel Wollner, the Vice

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President of Strategy and Partnerships at EmblemHealth.

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Sam, thank you so much for joining me

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today. Thanks for having me, Chanel. Perfect. While

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we get started, could you please introduce yourself

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and share a bit about your organization?

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Sure. So my name is Sam Wollner. I'm

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the vice president of strategy and partnerships at

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EmblemHealth.

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EmblemHealth is a not for profit health plan

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headquartered in Manhattan in New York City.

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We have, been in existence since the nineteen

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thirties in the, height of the Great Depression

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when we were founded by mayor Fiorello LaGuardia,

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who some may be familiar with from the

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airport in New York City.

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We were founded with the mission of serving

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hardworking New Yorkers and keeping them from financial

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misfortune in the event of accident or illness.

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And, we're still on that mission today. We've

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expanded it a bit. We own a physician

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group. But overall, we're,

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$6,000,000,000

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in top line revenue.

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We have about 2,000,000 members.

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We're in all lines of business, and so

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about one in four New Yorkers actually receives

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their insurance,

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through EmblemHealth.

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And, our physician group, Advantage Care Physicians, sees

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roughly a half a million patients,

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for primary and specialty care every year.

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So we're a a highly New York focused

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organization.

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We like to think of ourselves as being

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not just in the community, but of the

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community, and I'm no exception. I'm a born

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and raised New Yorker. I've been with EmblemHealth

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for four years. I lead, strategic planning,

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corporate partnerships,

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and a, a small group that focuses on,

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organizational alignment around strategic initiatives that we call

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strategy implementation.

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Got it. Thank you so much for that

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introduction. Now moving forward into the meat of

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the podcast, addressing health equity has become a

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critical focus

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for many health plans.

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Can you share an overview of a key

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initiative here that you're involved in or particularly

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excited about, and what are you hoping to

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achieve?

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Great.

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Happy to. So we're a we're a nonprofit

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health plan. As I mentioned before. Our commitment

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is to our neighbors, and not to shareholders.

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And so health equity is one way we

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honor that commitment.

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We have established a an executive role in

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the company, the chief health equity officer. His

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name is Abdu Ba.

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So that's our first initiative is establishing leadership

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around a commitment to health equity. The second

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thing I would mention is that we are

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the only health, plan in New York State

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who is who has received or earned an

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NCQA

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health equity accreditation,

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and that involves

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ensuring that we're collecting

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demographic data about all of our members,

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reporting on it, and making health equity part

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of our organization. So we're we're honored to

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be, accredited by NCQA for that. The third

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part I would mention is that,

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we have a a neighborhood

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level approach to to health equity. We have,

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30 locations

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that, that are physician group advantage care physicians

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delivers

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primary and specialty care at. And at many

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of those locations, we collocate,

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what we call EmblemHealth Neighborhood Care, which is

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staffed by,

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customer service folks that are really care navigators,

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that are able to

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point, both our members and community members, more

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broadly speaking, connecting them to community resources,

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classes on nutrition,

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well-being,

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and some exercise classes.

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Perfect. Well, moving forward, net promoter score is

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a powerful indicator of members' loyalty and satisfaction.

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How are you using NPS

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to drive meaningful improvements across your health plan?

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We look at NPS,

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regularly. Our our marketing team does a wonderful

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job of serving

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all of our stakeholders,

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for NPS scores. So not just our members,

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but also,

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the broker community as well as the provider

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community, all folks that we consider to be

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key stakeholders to our business and to our

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community.

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It's also embedded in our corporate incentive structure,

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so we're all, incentivized to be focused on

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it. And,

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finally, we use it when we review it,

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we we use it through to adjust our

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products. For example, we identified that,

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our dental solution was a pain pain point

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across many of our products and especially in

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the government programs business. So we're in the

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process of, enhancing that solution.

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So everyone's talking about how there's an imperative

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to reduce costs, improve quality,

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and advance health equity, none of which are

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small tasks. How do you approach aligning these

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priorities in your organization's strategic vision?

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Well, to begin with, we have a very

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structured strategic planning process.

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We work on setting objectives with measurable key

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results,

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and checking in on those quarterly and adjusting

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them as needed.

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But beyond kind of establishing the what we

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wanna achieve and aligning all those priorities, we're

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really focused,

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on building great teams,

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and having a cohesive leadership team work together

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because inevitably priorities,

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adjust,

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and you need to pivot. And it's incredibly

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important to have a cohesive team that works

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well together because then pivoting becomes, much more

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manageable.

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Absolutely. Well, Well, Sam, I wanna thank you

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for your time today. But before I let

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you go, I have one more question. Looking

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ahead, 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? And how can leaders take a

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step in this direction now?

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Yeah. So what I would say is that

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health care to date has become largely

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a game of scale, and so the

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the winners and losers of this of the

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health care landscape have been determined by how

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large they've become. You might think about it

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as a battle of sumo wrestlers.

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We are

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thinking that the the next wave of health

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insurer and how we wanna win in the

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market

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is by being a care delivery partner and

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and an advocate for our stakeholders.

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So to be a true advocate for your

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stakeholder, you need to be,

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understanding of that stakeholder in in the community.

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So we no longer wanna differentiate purely on

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scale. We wanna differentiate

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based off of our community presence. So building

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off of things like AdvantageCare Physicians and EmblemHealth

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Neighborhood Care,

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having a a provider networking team that doesn't

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just do contract negotiations, but is also there

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to form

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meaningful relationships with the providers in our communities.

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So that's how I see us making the

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biggest impact moving into the future.

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Absolutely. Well, Sam, I wanna thank you once

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again for your time today and for joining

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me on the Becker's Healthcare podcast.

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Thank you so much, Janelle.