1 00:00:00,160 --> 00:00:02,080 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,080 --> 00:00:03,859 Becker's Pay Your Issues podcast. 3 00:00:04,240 --> 00:00:06,639 Thrilled today to be joined by doctor Jennifer 4 00:00:06,639 --> 00:00:09,199 Nuovo, who's the chief medical officer at Blue 5 00:00:09,199 --> 00:00:12,160 Shield of California's Promise Health Plan. Doctor Nuovo, 6 00:00:12,160 --> 00:00:13,759 thank you so much for taking the time 7 00:00:13,759 --> 00:00:15,460 to be with me on the podcast today. 8 00:00:15,605 --> 00:00:18,324 Well, thank you for having me. Absolutely. And 9 00:00:18,324 --> 00:00:19,925 before we dive into everything we wanna talk 10 00:00:19,925 --> 00:00:21,285 with you about, can you tell us a 11 00:00:21,285 --> 00:00:23,925 little bit more about yourself, your background in 12 00:00:23,925 --> 00:00:25,524 health care, and what it is that you 13 00:00:25,524 --> 00:00:26,984 do today at Blue Shield? 14 00:00:27,780 --> 00:00:28,280 Sure. 15 00:00:28,980 --> 00:00:32,520 I'm an internal medicine physician, and my, subspecialty 16 00:00:32,740 --> 00:00:33,560 is endocrinology. 17 00:00:34,340 --> 00:00:35,159 I practiced, 18 00:00:35,780 --> 00:00:38,659 in Seattle and in Sacramento for about twenty 19 00:00:38,659 --> 00:00:39,159 years, 20 00:00:39,620 --> 00:00:41,859 and then I came to the health plan 21 00:00:41,859 --> 00:00:42,579 side on, 22 00:00:43,594 --> 00:00:44,814 in managed care, 23 00:00:45,674 --> 00:00:48,795 particularly focused on low income populations and the 24 00:00:48,795 --> 00:00:50,975 medical population here in California 25 00:00:51,754 --> 00:00:54,475 as the phase of my career. And I've 26 00:00:54,475 --> 00:00:54,975 done 27 00:00:55,354 --> 00:00:57,674 medical director work with Health Net of Cal 28 00:00:57,862 --> 00:00:59,429 of California Health 29 00:00:59,809 --> 00:01:02,850 Net, with Sutter Health Plan in the Bay 30 00:01:02,850 --> 00:01:04,790 Area and the Sacramento area, 31 00:01:05,250 --> 00:01:05,989 with UnitedHealthcare. 32 00:01:07,010 --> 00:01:09,569 And now I've landed with, Blue Shield of 33 00:01:09,569 --> 00:01:10,069 California 34 00:01:10,450 --> 00:01:12,790 on their Promise Health Plan, which is their, 35 00:01:13,255 --> 00:01:16,954 medical medical only health plan here in California 36 00:01:17,814 --> 00:01:18,314 for, 37 00:01:18,935 --> 00:01:20,555 with lives in 38 00:01:21,015 --> 00:01:22,795 Los Angeles and San Diego. 39 00:01:23,655 --> 00:01:26,075 Fantastic. So a long career in the industry, 40 00:01:26,135 --> 00:01:26,635 Jennifer. 41 00:01:27,680 --> 00:01:29,039 And in that vein, we wanted to talk 42 00:01:29,039 --> 00:01:31,680 with you today to start out about a 43 00:01:31,680 --> 00:01:34,319 recent survey from Aflac that was showed that 44 00:01:34,319 --> 00:01:37,200 nine out of ten Americans have missed health 45 00:01:37,200 --> 00:01:39,140 checks or preventive screenings, 46 00:01:39,965 --> 00:01:41,885 at some point in their life, which and 47 00:01:41,885 --> 00:01:43,405 that's a lot of people, the majority of 48 00:01:43,405 --> 00:01:45,584 people. So from your perspective, 49 00:01:46,284 --> 00:01:48,625 how important is preventive health overall, 50 00:01:49,004 --> 00:01:51,084 and and what's what is Blue Shield Promise 51 00:01:51,084 --> 00:01:54,045 Health Plan doing to increase access to preventive 52 00:01:54,045 --> 00:01:54,545 care? 53 00:01:55,400 --> 00:01:58,619 Sure. Well, that's a long question. Two questions, 54 00:01:59,000 --> 00:01:59,500 really. 55 00:02:00,119 --> 00:02:03,180 Preventive health care is really the cornerstone 56 00:02:03,799 --> 00:02:04,299 of 57 00:02:05,239 --> 00:02:05,739 health 58 00:02:06,200 --> 00:02:06,700 in 59 00:02:07,355 --> 00:02:10,235 our culture, in our society, and really all 60 00:02:10,235 --> 00:02:10,735 societies. 61 00:02:11,034 --> 00:02:14,175 Our wealth as people is our health. 62 00:02:14,715 --> 00:02:15,215 And 63 00:02:15,675 --> 00:02:16,814 protecting health, 64 00:02:17,594 --> 00:02:18,094 ensuring 65 00:02:18,474 --> 00:02:19,615 people are healthy 66 00:02:19,995 --> 00:02:21,215 is really done 67 00:02:22,219 --> 00:02:24,939 a variety of ways, but primarily in the 68 00:02:24,939 --> 00:02:27,360 health care world, it's done through prevention. 69 00:02:27,979 --> 00:02:30,620 And, you know, I think the statistics sounds 70 00:02:30,620 --> 00:02:31,919 shocking and is 71 00:02:32,300 --> 00:02:32,959 is alarming, 72 00:02:33,419 --> 00:02:34,959 but if you think of a lifetime 73 00:02:35,574 --> 00:02:38,634 and all of the preventive services that are, 74 00:02:39,414 --> 00:02:39,914 requested 75 00:02:40,215 --> 00:02:43,034 and recommended for people, it's not surprising 76 00:02:43,814 --> 00:02:46,854 that people miss an annual well visit at, 77 00:02:46,854 --> 00:02:48,854 you know, at age of 53 and then 78 00:02:48,854 --> 00:02:51,510 their next well visit is age of 55. 79 00:02:51,510 --> 00:02:54,950 Right? So all everyone gets thrown into that 80 00:02:54,950 --> 00:02:55,450 statistic. 81 00:02:56,469 --> 00:02:57,370 Health insurance 82 00:02:57,990 --> 00:02:58,810 and physicians 83 00:02:59,189 --> 00:03:00,569 really partner together 84 00:03:01,030 --> 00:03:02,889 to try to make sure our 85 00:03:03,605 --> 00:03:06,724 members and the patients for the for our 86 00:03:06,724 --> 00:03:07,224 doctors 87 00:03:08,085 --> 00:03:09,465 know what the preventive 88 00:03:10,405 --> 00:03:10,905 service 89 00:03:11,284 --> 00:03:14,405 need is for that particular age and stage 90 00:03:14,405 --> 00:03:17,219 of life. We all know that babies, for 91 00:03:17,219 --> 00:03:20,419 example, have lots of visits their three years 92 00:03:20,419 --> 00:03:23,240 of life, much of that for vaccination 93 00:03:23,699 --> 00:03:25,560 and for developmental screenings, 94 00:03:26,500 --> 00:03:27,879 and well child visits, 95 00:03:28,514 --> 00:03:30,534 but then really annually thereafter 96 00:03:30,995 --> 00:03:33,175 for all children. And then there's another 97 00:03:33,474 --> 00:03:34,694 batch of vaccinations 98 00:03:34,995 --> 00:03:37,974 that we highly recommend for kids going into, 99 00:03:38,594 --> 00:03:41,254 junior high and then again going into college. 100 00:03:41,474 --> 00:03:41,974 Adults 101 00:03:42,560 --> 00:03:45,520 really also need preventive health care. How do 102 00:03:45,520 --> 00:03:47,060 you know if you have hypertension? 103 00:03:47,360 --> 00:03:50,080 It's a silent disease. Right? So you only 104 00:03:50,080 --> 00:03:52,560 know by testing your blood pressure, and we 105 00:03:52,560 --> 00:03:55,280 get that done through annual visits with your 106 00:03:55,280 --> 00:03:55,780 physician. 107 00:03:56,194 --> 00:03:57,814 How do you know you have diabetes? 108 00:03:58,115 --> 00:03:58,615 Again, 109 00:03:58,915 --> 00:04:01,875 very comes on slowly, very silent, quiet, 110 00:04:02,275 --> 00:04:04,514 disorders, a disorder that we know we need 111 00:04:04,514 --> 00:04:07,655 to identify early and treat early. 112 00:04:08,034 --> 00:04:11,039 But without getting the preventive screenings, very hard 113 00:04:11,039 --> 00:04:12,419 to know if you have those 114 00:04:12,799 --> 00:04:13,299 conditions. 115 00:04:14,639 --> 00:04:15,139 Absolutely. 116 00:04:15,519 --> 00:04:17,839 It makes sense. So, really, your perspective here 117 00:04:17,839 --> 00:04:19,699 is preventive health is wealth. 118 00:04:20,160 --> 00:04:21,759 And it makes sense that so many people 119 00:04:21,759 --> 00:04:24,079 have missed these these types of screens over 120 00:04:24,079 --> 00:04:25,379 the span of their lifetimes. 121 00:04:25,925 --> 00:04:27,685 I'm I'm wondering how you think the Blue 122 00:04:27,685 --> 00:04:30,084 Shield's efforts in this space are helping to 123 00:04:30,084 --> 00:04:31,144 address health disparities 124 00:04:31,524 --> 00:04:32,985 in a place like California. 125 00:04:34,004 --> 00:04:36,245 Sure. And I think I didn't even really 126 00:04:36,245 --> 00:04:38,324 answer part two of your of your last 127 00:04:38,324 --> 00:04:40,165 question, so I think I'll take a stab 128 00:04:40,165 --> 00:04:42,720 at that and then talk about health disparities, 129 00:04:43,259 --> 00:04:45,279 a little bit on top of that. But 130 00:04:45,339 --> 00:04:48,319 whether you are just a middle class person 131 00:04:48,460 --> 00:04:51,420 with employer based insurance or whether you have 132 00:04:51,420 --> 00:04:54,555 Medi Cal or whether you are in the 133 00:04:54,634 --> 00:04:56,335 one of the exchange products, 134 00:04:56,715 --> 00:04:59,835 really, prevention is an area that that that 135 00:04:59,835 --> 00:05:02,715 Blue Shield of California and Promise Health Plan 136 00:05:02,715 --> 00:05:04,095 really focus on 137 00:05:04,475 --> 00:05:05,455 making sure 138 00:05:05,835 --> 00:05:06,574 that the 139 00:05:07,009 --> 00:05:08,389 member or the patient 140 00:05:08,850 --> 00:05:11,410 knows what prevention needs to be done for 141 00:05:11,410 --> 00:05:14,050 that particular year. We do that with a 142 00:05:14,050 --> 00:05:16,550 variety of touches and outreaches, 143 00:05:17,410 --> 00:05:18,310 either telephonic 144 00:05:18,689 --> 00:05:19,589 or mailed, 145 00:05:20,415 --> 00:05:21,394 sometimes texting, 146 00:05:22,175 --> 00:05:25,134 and sometimes through our, app that we make 147 00:05:25,134 --> 00:05:28,334 available to our, membership so that you know 148 00:05:28,334 --> 00:05:30,175 what you need to get done in this 149 00:05:30,175 --> 00:05:33,875 particular year. We send very similar information 150 00:05:34,689 --> 00:05:37,170 to the patient's doctor, to their primary care 151 00:05:37,170 --> 00:05:40,209 doctor so that they know for the patients 152 00:05:40,209 --> 00:05:42,230 and the members that are assigned to them 153 00:05:42,610 --> 00:05:44,149 who needs a mammogram, 154 00:05:44,449 --> 00:05:45,750 who needs a colonoscopy, 155 00:05:46,449 --> 00:05:47,829 who's due for, 156 00:05:48,144 --> 00:05:49,125 you know, a vaccination, 157 00:05:49,584 --> 00:05:51,204 who's due for a well visit. 158 00:05:51,824 --> 00:05:52,324 Those 159 00:05:52,625 --> 00:05:53,125 notices, 160 00:05:53,664 --> 00:05:54,164 hopefully, 161 00:05:54,625 --> 00:05:57,444 align enough that the patient schedules a visit, 162 00:05:57,504 --> 00:05:59,504 the doctor knows what to get done when 163 00:05:59,504 --> 00:06:01,860 the patient comes in for that visit. So 164 00:06:01,939 --> 00:06:04,339 there is a variety of messaging done by 165 00:06:04,339 --> 00:06:06,419 the by the health plan by both Blue 166 00:06:06,419 --> 00:06:08,819 Shield of California for their lives and by 167 00:06:08,819 --> 00:06:12,019 promise for the Medi Cal lives. We also 168 00:06:12,019 --> 00:06:13,719 have a variety of incentives 169 00:06:14,254 --> 00:06:16,354 that we pay both to the provider 170 00:06:16,894 --> 00:06:19,394 as well as some incentives that we can, 171 00:06:19,935 --> 00:06:22,435 provide to the member for going in and 172 00:06:22,654 --> 00:06:23,714 going to the inconvenience 173 00:06:24,095 --> 00:06:26,814 and disruption of life of going into the 174 00:06:26,814 --> 00:06:27,314 doctor 175 00:06:28,019 --> 00:06:29,860 to get that done. And certainly on the 176 00:06:29,860 --> 00:06:33,000 medical plan, we do offer transportation benefit 177 00:06:33,779 --> 00:06:36,500 so that if transportation is an if issue, 178 00:06:36,500 --> 00:06:38,019 if you don't have a car, you're not 179 00:06:38,019 --> 00:06:39,779 on a bus line, you it's not easy 180 00:06:39,779 --> 00:06:40,919 to get to the doctor, 181 00:06:41,245 --> 00:06:41,985 we can arrange those 182 00:06:42,285 --> 00:06:44,604 visits for you to try to remove that 183 00:06:44,604 --> 00:06:45,824 barrier to access. 184 00:06:47,004 --> 00:06:49,084 Sure. Sure. It may it makes complete sense. 185 00:06:49,084 --> 00:06:50,604 So a lot of outreach, a lot of 186 00:06:50,604 --> 00:06:53,644 incentives from from the health plans, towards providers 187 00:06:53,644 --> 00:06:55,824 and towards the members to access this care. 188 00:06:56,459 --> 00:06:58,540 Jennifer, coming back to the other question, how 189 00:06:58,540 --> 00:06:59,980 do you think that these efforts are helping 190 00:06:59,980 --> 00:07:00,720 to address, 191 00:07:01,420 --> 00:07:03,600 health disparities among your members? 192 00:07:04,459 --> 00:07:07,120 Yeah. So what we do notice is that, 193 00:07:07,899 --> 00:07:10,160 in certain ZIP codes and certain, 194 00:07:11,375 --> 00:07:12,275 of our membership, 195 00:07:12,895 --> 00:07:16,035 there is lagging in getting the preventive services 196 00:07:16,095 --> 00:07:18,995 done. Some of that is due to language 197 00:07:19,055 --> 00:07:20,435 barriers, not understanding, 198 00:07:21,775 --> 00:07:24,014 what it is that's available or what it 199 00:07:24,014 --> 00:07:26,095 is you need to get done, just because 200 00:07:26,095 --> 00:07:30,040 of not having, you know, English skills here. 201 00:07:30,580 --> 00:07:31,720 Some of it is cultural. 202 00:07:32,180 --> 00:07:34,020 Some of it is, you know, people are 203 00:07:34,020 --> 00:07:35,939 new to this country and new to this 204 00:07:35,939 --> 00:07:37,639 state, and they just, you know, 205 00:07:38,020 --> 00:07:39,000 may not prioritize 206 00:07:39,379 --> 00:07:41,319 getting into the doctor in their, 207 00:07:41,704 --> 00:07:42,665 you know, in their 208 00:07:43,625 --> 00:07:45,944 year or so here. So we do, 209 00:07:46,425 --> 00:07:48,845 notice that there are a variety of populations 210 00:07:49,064 --> 00:07:50,764 that really lag behind. 211 00:07:51,144 --> 00:07:53,704 We also know that certainly in the African 212 00:07:53,704 --> 00:07:57,230 American community, for example, there is often widespread 213 00:07:57,689 --> 00:07:59,870 distrust of the medical establishment 214 00:08:00,569 --> 00:08:01,389 not believing 215 00:08:02,009 --> 00:08:05,290 that the primary care provider that you're assigned 216 00:08:05,290 --> 00:08:08,509 to is really the right person for you, 217 00:08:09,290 --> 00:08:11,149 and not knowing what their 218 00:08:11,705 --> 00:08:12,205 recommendation 219 00:08:12,745 --> 00:08:13,564 are their recommendations 220 00:08:13,865 --> 00:08:14,365 truly, 221 00:08:15,064 --> 00:08:17,225 you know, important for me? So there is 222 00:08:17,225 --> 00:08:19,324 a fair amount of distrust among, 223 00:08:20,264 --> 00:08:20,764 certain 224 00:08:21,145 --> 00:08:23,305 people in this country, and then there's just 225 00:08:23,305 --> 00:08:23,805 widespread, 226 00:08:24,185 --> 00:08:26,230 I don't know what you're talking about. I 227 00:08:26,230 --> 00:08:28,069 don't know I don't know what this is. 228 00:08:28,069 --> 00:08:29,689 Why should I do this? So 229 00:08:29,990 --> 00:08:32,070 a a lot of our focus really is 230 00:08:32,070 --> 00:08:32,570 on 231 00:08:33,029 --> 00:08:34,490 areas and populations 232 00:08:35,350 --> 00:08:37,990 that really may not have good trust or 233 00:08:37,990 --> 00:08:40,410 good understanding of what needs to be done. 234 00:08:40,504 --> 00:08:42,264 So in addition to what we talked about 235 00:08:42,264 --> 00:08:44,504 a few minutes ago of just sort of 236 00:08:44,504 --> 00:08:47,945 a peanut butter spread, I call it, giving 237 00:08:47,945 --> 00:08:51,325 messaging to everybody and giving messaging to every, 238 00:08:51,865 --> 00:08:53,004 one of our providers, 239 00:08:53,559 --> 00:08:55,340 we also do very targeted 240 00:08:55,720 --> 00:08:58,700 outreach to certain populations that we know, 241 00:08:59,399 --> 00:09:02,059 either from our own data or from just, 242 00:09:02,360 --> 00:09:04,200 you know, historical data, no, 243 00:09:04,759 --> 00:09:05,259 access 244 00:09:05,875 --> 00:09:06,695 health care 245 00:09:06,995 --> 00:09:11,315 reluctantly perhaps or or not frequently enough. And 246 00:09:11,315 --> 00:09:13,095 in those particular populations, 247 00:09:13,795 --> 00:09:16,134 at least on the Promise Health Plan side, 248 00:09:16,274 --> 00:09:17,014 we have, 249 00:09:17,795 --> 00:09:18,295 specific, 250 00:09:19,559 --> 00:09:23,100 and targeted programs to reach into those communities. 251 00:09:23,720 --> 00:09:25,160 You know, it it makes sense. There's it 252 00:09:25,160 --> 00:09:27,240 has to be very targeted outreach to reach 253 00:09:27,240 --> 00:09:30,620 different and diverse populations, but but please, continue. 254 00:09:31,355 --> 00:09:32,794 Yeah. I mean, I think for a long 255 00:09:32,794 --> 00:09:35,034 time, we didn't really think about that. Right? 256 00:09:35,034 --> 00:09:36,794 We we just thought about, well, if we 257 00:09:36,794 --> 00:09:39,115 just let people know, here's your doctor, here's 258 00:09:39,115 --> 00:09:40,414 what you need to get done, 259 00:09:40,794 --> 00:09:42,554 that folks would pick up the phone and 260 00:09:42,554 --> 00:09:43,054 schedule. 261 00:09:43,549 --> 00:09:45,629 And we have certainly found over time that 262 00:09:45,629 --> 00:09:47,870 it it takes a little more effort with 263 00:09:47,870 --> 00:09:48,769 certain populations, 264 00:09:49,629 --> 00:09:50,529 and everyone 265 00:09:51,549 --> 00:09:53,809 deserves preventive health care. Everyone 266 00:09:54,269 --> 00:09:56,304 needs to be seen, and everyone needs to 267 00:09:56,304 --> 00:09:58,965 be welcomed into the health care community 268 00:09:59,425 --> 00:10:01,285 and become comfortable and familiar, 269 00:10:01,985 --> 00:10:03,045 in those settings. 270 00:10:03,825 --> 00:10:06,144 So particularly what we have, 271 00:10:06,625 --> 00:10:09,125 launched and what we do, for, 272 00:10:09,665 --> 00:10:11,764 certain communities is we offer, 273 00:10:12,759 --> 00:10:15,500 appointment visits, well child visits, for example, 274 00:10:16,360 --> 00:10:18,919 after hours and on weekends in, 275 00:10:19,320 --> 00:10:19,820 specific, 276 00:10:21,080 --> 00:10:21,580 targeted 277 00:10:22,279 --> 00:10:24,600 ZIP codes and targeted areas where we know 278 00:10:24,600 --> 00:10:25,659 it's very difficult 279 00:10:26,045 --> 00:10:28,445 for families to get in for routine care 280 00:10:28,445 --> 00:10:29,825 to their assigned PCP. 281 00:10:30,365 --> 00:10:31,665 So we'll have these, 282 00:10:32,205 --> 00:10:32,705 events, 283 00:10:33,485 --> 00:10:35,884 in the evenings and on weekends. We also 284 00:10:35,884 --> 00:10:37,585 know that our medical population 285 00:10:38,285 --> 00:10:41,909 is often working, often very busy, and they're, 286 00:10:41,909 --> 00:10:44,549 you know, working at jobs where they can't 287 00:10:44,549 --> 00:10:45,049 really 288 00:10:45,750 --> 00:10:46,809 take time off. 289 00:10:47,589 --> 00:10:49,350 They if they take time off, they don't 290 00:10:49,350 --> 00:10:51,269 get paid, or if they take time off, 291 00:10:51,269 --> 00:10:53,110 they're told not to bother to come back. 292 00:10:53,110 --> 00:10:57,134 So sometimes scheduling during routine doctor offices just 293 00:10:57,134 --> 00:10:59,294 really doesn't work very well for a lot 294 00:10:59,294 --> 00:11:01,375 of our population, and so those are areas 295 00:11:01,375 --> 00:11:03,534 that we really target for our evening and 296 00:11:03,534 --> 00:11:04,674 our weekend clinics. 297 00:11:05,134 --> 00:11:06,975 And then we also know that there are 298 00:11:06,975 --> 00:11:07,475 certain 299 00:11:08,100 --> 00:11:10,659 services that people just don't wanna have. Right? 300 00:11:10,659 --> 00:11:14,039 Either either culturally or they're just unpleasant services. 301 00:11:14,179 --> 00:11:14,679 Mammograms 302 00:11:15,139 --> 00:11:18,179 come to mind, right, as something that that 303 00:11:18,179 --> 00:11:20,259 people will also often put up and be 304 00:11:20,259 --> 00:11:22,065 reluctant about. So we have, 305 00:11:22,705 --> 00:11:26,325 scheduled just, you know, just mammogram only visits 306 00:11:26,384 --> 00:11:29,504 in provider offices or, you know, in certain 307 00:11:29,504 --> 00:11:31,745 areas where we feel that people can get 308 00:11:31,745 --> 00:11:34,565 into and schedule fairly fairly readily. 309 00:11:34,910 --> 00:11:37,149 And we we make those events a little 310 00:11:37,149 --> 00:11:38,370 festive, honestly, 311 00:11:39,070 --> 00:11:42,350 Jacob. So, you know, balloons and a little 312 00:11:42,350 --> 00:11:44,509 gift and, you know, a flower after you 313 00:11:44,509 --> 00:11:46,769 get your mammogram done, a lot of counseling 314 00:11:46,830 --> 00:11:47,570 and coaching. 315 00:11:48,075 --> 00:11:48,815 There are, 316 00:11:49,195 --> 00:11:52,254 a lot of women who are really reluctant 317 00:11:52,475 --> 00:11:54,415 to get undressed in front of strangers 318 00:11:54,955 --> 00:11:57,855 just either because of personal experience or cultural 319 00:11:58,475 --> 00:11:59,615 beliefs. So, 320 00:12:00,235 --> 00:12:01,915 you know, we have people like myself. I 321 00:12:01,915 --> 00:12:04,110 tend to go to these events and and 322 00:12:04,110 --> 00:12:06,769 do a little counseling and coaching as well. 323 00:12:06,990 --> 00:12:09,649 My mother, for example, died of breast cancer. 324 00:12:09,709 --> 00:12:12,190 So it's a it's a issue that's important 325 00:12:12,190 --> 00:12:14,750 to me, and I know that a lot 326 00:12:14,750 --> 00:12:15,889 of our members 327 00:12:16,589 --> 00:12:18,754 get really caught up in, 328 00:12:19,134 --> 00:12:22,894 their families' lives, making sure their kids are 329 00:12:22,894 --> 00:12:25,534 doing well, making sure that everything is going 330 00:12:25,534 --> 00:12:27,315 well, but often neglect themselves. 331 00:12:27,934 --> 00:12:30,815 So we really try to work in those 332 00:12:30,815 --> 00:12:31,315 particular 333 00:12:32,039 --> 00:12:35,240 mammogram events on you're important to, your health 334 00:12:35,240 --> 00:12:37,639 matters. It's really important for you to be 335 00:12:37,639 --> 00:12:40,779 healthy because your family depends on you. 336 00:12:41,639 --> 00:12:44,120 Absolutely. And if we're sticking to this to 337 00:12:44,120 --> 00:12:46,574 this topic, Jennifer, of all the different ways 338 00:12:46,574 --> 00:12:49,154 that Promise Health Plan is reaching your membership, 339 00:12:50,014 --> 00:12:51,454 as as I understand that you have a 340 00:12:51,454 --> 00:12:53,534 brick and mortar presence across the state through 341 00:12:53,534 --> 00:12:56,014 your community resource centers. Can you talk to 342 00:12:56,014 --> 00:12:57,779 us a little bit about about that and 343 00:12:57,779 --> 00:12:59,860 and how these centers play a role in 344 00:12:59,860 --> 00:13:01,639 in what we're talking about right now? 345 00:13:02,259 --> 00:13:04,500 Yeah. Absolutely. We partner with, 346 00:13:05,460 --> 00:13:07,399 LA Care Health Plan. 347 00:13:07,860 --> 00:13:10,419 We are a a delegate to LA Care 348 00:13:10,419 --> 00:13:13,054 Health plan, the local initiative health plan in 349 00:13:13,115 --> 00:13:14,335 Los Angeles County. 350 00:13:14,715 --> 00:13:15,514 And with, 351 00:13:16,075 --> 00:13:18,014 LA Care, we have 352 00:13:18,394 --> 00:13:22,154 13 or 14 community resource centers through, throughout 353 00:13:22,154 --> 00:13:24,475 Los Angeles. We just opened, I think, our 354 00:13:25,035 --> 00:13:25,535 center. 355 00:13:25,919 --> 00:13:28,240 We have a couple of centers that are 356 00:13:28,240 --> 00:13:29,779 our own as well. 357 00:13:30,480 --> 00:13:32,799 But with the partnership with LA Care, we've 358 00:13:32,799 --> 00:13:35,839 really been able to build these hubs within 359 00:13:35,839 --> 00:13:37,059 low income communities 360 00:13:37,759 --> 00:13:38,500 that are 361 00:13:38,834 --> 00:13:41,495 places anyone in the community can walk in 362 00:13:41,554 --> 00:13:43,334 and ask a health related question. 363 00:13:43,794 --> 00:13:47,654 Classes are offered, wellness classes, fitness classes, Zumba 364 00:13:47,714 --> 00:13:48,214 classes, 365 00:13:49,235 --> 00:13:51,814 health education classes, diabetes, hypertension. 366 00:13:52,274 --> 00:13:53,574 We have after school 367 00:13:54,230 --> 00:13:56,329 places for kids to come and do homework. 368 00:13:56,549 --> 00:13:58,549 Kids can get dropped off and play while 369 00:13:58,549 --> 00:14:00,709 parents do a little bit of shopping. And 370 00:14:00,709 --> 00:14:02,309 it's a place where you can, 371 00:14:03,190 --> 00:14:05,589 learn about the Medi Cal program and get, 372 00:14:05,829 --> 00:14:08,490 assistance with enrollment in the Medi Cal program. 373 00:14:09,335 --> 00:14:11,035 So these community centers 374 00:14:11,654 --> 00:14:12,394 not only, 375 00:14:13,254 --> 00:14:15,654 really are hubs for the neighborhoods, but they're 376 00:14:15,654 --> 00:14:17,035 really a way for 377 00:14:17,415 --> 00:14:20,715 us as the health insurance company to reinforce 378 00:14:21,254 --> 00:14:24,875 the importance of health care in your life. 379 00:14:25,950 --> 00:14:27,950 Wow. So so more than a dozen of 380 00:14:27,950 --> 00:14:30,509 these centers in the Los Angeles area, it's 381 00:14:30,509 --> 00:14:32,429 amazing. And and I wonder you know, we 382 00:14:32,429 --> 00:14:34,669 hear so much from insurers today, Jennifer, about 383 00:14:34,669 --> 00:14:37,784 their their focus on whole person care, really 384 00:14:37,784 --> 00:14:39,004 providing comprehensive 385 00:14:39,464 --> 00:14:42,664 integrated services to their members. I wonder, you 386 00:14:42,664 --> 00:14:44,345 know, based on everything we've talked about today 387 00:14:44,345 --> 00:14:45,884 in terms of all the different ways, 388 00:14:46,585 --> 00:14:48,585 that's the Blue Shield and the Promise Health 389 00:14:48,585 --> 00:14:50,669 Plan is reaching its membership, How do all 390 00:14:50,669 --> 00:14:53,870 these efforts really fit into Blue Shield's focus 391 00:14:53,870 --> 00:14:55,490 on on whole person care? 392 00:14:56,190 --> 00:14:57,250 Well, we understand 393 00:14:57,629 --> 00:14:58,129 that 394 00:14:58,669 --> 00:15:00,690 health doesn't exist in a silo, 395 00:15:01,149 --> 00:15:03,730 and health care doesn't exist in a silo. 396 00:15:04,085 --> 00:15:05,945 So the more we can understand, 397 00:15:07,205 --> 00:15:07,865 the context 398 00:15:08,644 --> 00:15:11,544 of someone's social and cultural and environment, 399 00:15:12,325 --> 00:15:15,044 the better we can serve our population, whether 400 00:15:15,044 --> 00:15:15,785 that means 401 00:15:16,129 --> 00:15:18,049 that we really come up with, 402 00:15:18,610 --> 00:15:21,889 specific outreach and bringing health care to people 403 00:15:21,889 --> 00:15:23,429 who are perhaps unhoused. 404 00:15:24,850 --> 00:15:26,850 You know, as you know, I think a 405 00:15:27,250 --> 00:15:29,429 of all the unhoused people in the country 406 00:15:29,490 --> 00:15:31,269 live in Los Angeles County. 407 00:15:31,754 --> 00:15:34,894 So, you know, it and and just imagine 408 00:15:35,274 --> 00:15:37,274 living in a tent under a freeway, and 409 00:15:37,274 --> 00:15:39,355 then how are you gonna get your dental 410 00:15:39,355 --> 00:15:41,674 care? How are you gonna get your your 411 00:15:41,674 --> 00:15:43,754 annual flu shot? How are you gonna get 412 00:15:43,754 --> 00:15:46,154 your annual well visit and find out about 413 00:15:46,154 --> 00:15:49,149 your hypertension or get refills on your on 414 00:15:49,149 --> 00:15:50,529 your diabetes medication 415 00:15:51,070 --> 00:15:52,690 if we don't come to you? 416 00:15:52,990 --> 00:15:53,490 So, 417 00:15:54,029 --> 00:15:56,910 really understanding the context and that people are 418 00:15:56,910 --> 00:15:57,649 not just, 419 00:15:58,029 --> 00:16:01,004 you know, bodies for doctors to examine and 420 00:16:01,004 --> 00:16:04,204 write prescriptions for. They really are living whole 421 00:16:04,204 --> 00:16:07,324 lives. So how can we fit ourselves into 422 00:16:07,324 --> 00:16:09,324 that life? And I think some of our 423 00:16:09,324 --> 00:16:12,204 evening and weekend clinics really kind of speak 424 00:16:12,204 --> 00:16:13,424 to that a little bit. 425 00:16:14,009 --> 00:16:15,290 Our work with the, 426 00:16:16,170 --> 00:16:16,990 street medicine, 427 00:16:18,170 --> 00:16:18,670 providers, 428 00:16:19,370 --> 00:16:21,310 you know, really fits with that. 429 00:16:21,850 --> 00:16:24,190 And then really the state of California 430 00:16:24,730 --> 00:16:27,389 or the Medi Cal population has really, 431 00:16:28,375 --> 00:16:30,394 set up criteria and guidelines 432 00:16:30,695 --> 00:16:32,714 and assistance for the health plans 433 00:16:33,334 --> 00:16:34,294 for us to, 434 00:16:34,695 --> 00:16:35,514 work with 435 00:16:36,054 --> 00:16:37,595 very specific populations. 436 00:16:38,294 --> 00:16:41,414 For example, if you are justice involved, if 437 00:16:41,414 --> 00:16:43,299 you have if you are being released from 438 00:16:43,299 --> 00:16:43,799 jail 439 00:16:44,340 --> 00:16:46,420 and maybe while you were in jail or 440 00:16:46,420 --> 00:16:47,879 in prison, you were getting 441 00:16:48,259 --> 00:16:50,820 a treatment for substance abuse, and then all 442 00:16:50,820 --> 00:16:52,759 of a sudden you're out on the street, 443 00:16:52,980 --> 00:16:55,000 how do we make sure that insurance 444 00:16:55,634 --> 00:16:57,335 is available to that person 445 00:16:57,715 --> 00:16:59,715 at the time of release and that they 446 00:16:59,715 --> 00:17:02,774 can continue on their medications, whether it's medications 447 00:17:02,835 --> 00:17:06,355 for mental health, medications for diabetes, medications for 448 00:17:06,355 --> 00:17:07,335 substance abuse 449 00:17:07,714 --> 00:17:09,575 so that the health that has 450 00:17:09,960 --> 00:17:10,700 been stabilized 451 00:17:11,079 --> 00:17:11,579 in 452 00:17:12,119 --> 00:17:13,419 the incarcerated setting 453 00:17:13,720 --> 00:17:14,460 can be 454 00:17:14,839 --> 00:17:15,339 seamlessly 455 00:17:15,640 --> 00:17:17,579 continued. So there are certain populations 456 00:17:17,880 --> 00:17:20,039 that the state has asked us to focus 457 00:17:20,039 --> 00:17:20,859 on specifically. 458 00:17:21,319 --> 00:17:23,419 We've talked for a minute about the unhoused 459 00:17:23,559 --> 00:17:24,059 population, 460 00:17:24,575 --> 00:17:26,355 the justice involved population, 461 00:17:26,974 --> 00:17:28,355 also foster youth. 462 00:17:29,134 --> 00:17:31,214 You know, how how can the health plans 463 00:17:31,214 --> 00:17:31,714 really, 464 00:17:32,494 --> 00:17:34,595 lift up and work effectively 465 00:17:34,894 --> 00:17:37,315 with the foster families and the foster youth 466 00:17:37,869 --> 00:17:39,789 to make sure that those health care for 467 00:17:39,789 --> 00:17:41,970 those kids and teens is also happening. 468 00:17:42,589 --> 00:17:44,589 And, you know, in that way, I think 469 00:17:44,589 --> 00:17:47,169 we really have been asked to not just 470 00:17:47,470 --> 00:17:50,750 think about the social environment people are living 471 00:17:50,750 --> 00:17:52,845 in and how to deliver health 472 00:17:53,164 --> 00:17:56,044 effectively in that environment, but also what can 473 00:17:56,044 --> 00:17:57,585 health care provide 474 00:17:58,284 --> 00:17:58,784 that 475 00:17:59,244 --> 00:17:59,744 stabilizes 476 00:18:00,125 --> 00:18:01,585 your health? Housing, 477 00:18:01,884 --> 00:18:02,625 for example, 478 00:18:03,724 --> 00:18:04,704 sober centers, 479 00:18:06,039 --> 00:18:06,539 recuperative 480 00:18:06,920 --> 00:18:09,420 shelters. So if you're discharged from a hospital, 481 00:18:09,480 --> 00:18:11,500 but you still have some lingering, 482 00:18:12,680 --> 00:18:13,580 health needs, 483 00:18:13,960 --> 00:18:15,880 you know, you don't have to go right 484 00:18:15,880 --> 00:18:18,644 into the regular shelter system. You can go 485 00:18:18,644 --> 00:18:21,365 to a recuperative shelter and continue to get 486 00:18:21,365 --> 00:18:22,424 those health needs. 487 00:18:23,684 --> 00:18:24,505 Home modifications, 488 00:18:24,805 --> 00:18:26,884 you know, people often have to leave their 489 00:18:26,884 --> 00:18:29,445 home and go into nursing care, nursing home 490 00:18:29,445 --> 00:18:32,250 care because they don't have a ramp. So 491 00:18:32,250 --> 00:18:34,650 now we can provide ramps to people so 492 00:18:34,650 --> 00:18:36,589 they can stay in their own housing. 493 00:18:36,970 --> 00:18:39,789 That's the sort of activities that we're really 494 00:18:39,930 --> 00:18:40,430 incorporating 495 00:18:40,809 --> 00:18:43,869 into the provision of health. It's not doctors 496 00:18:44,170 --> 00:18:46,670 exactly and it's not medicines exactly, 497 00:18:47,154 --> 00:18:48,214 but it is 498 00:18:48,515 --> 00:18:50,055 it is sometimes more powerful 499 00:18:50,595 --> 00:18:53,875 than than the medication to have a secure 500 00:18:53,875 --> 00:18:54,855 place to live. 501 00:18:55,954 --> 00:18:58,275 Certainly. And it's wonderful to hear how much 502 00:18:58,275 --> 00:19:00,515 of a focus Blue Shield is placing on 503 00:19:00,515 --> 00:19:01,015 serving 504 00:19:01,420 --> 00:19:04,320 such vulnerable populations across the state, Jennifer. 505 00:19:05,339 --> 00:19:07,740 Before we go, anything else that we're missing? 506 00:19:07,740 --> 00:19:08,940 You have the ears of a lot of 507 00:19:08,940 --> 00:19:11,519 other health plan leaders from around the country. 508 00:19:11,740 --> 00:19:13,740 Is there any final thoughts or final bits 509 00:19:13,740 --> 00:19:15,599 of advice you wanna share with them? 510 00:19:15,955 --> 00:19:18,115 We wanna highlight one more program that I 511 00:19:18,115 --> 00:19:20,535 think other health plans could, you know, perhaps 512 00:19:20,595 --> 00:19:23,555 pick up on. We offer a program called 513 00:19:23,555 --> 00:19:25,634 GED Works. So we really, 514 00:19:26,275 --> 00:19:26,775 encourage 515 00:19:27,075 --> 00:19:27,815 our members 516 00:19:28,279 --> 00:19:30,139 to get their high school equivalency, 517 00:19:31,000 --> 00:19:32,299 degree accomplished 518 00:19:32,759 --> 00:19:34,440 so that they can go out into the 519 00:19:34,440 --> 00:19:34,940 workforce 520 00:19:35,639 --> 00:19:37,339 and be a more attractive, 521 00:19:38,279 --> 00:19:41,399 employee for people. So, you know, again, it's 522 00:19:41,399 --> 00:19:41,899 not 523 00:19:42,515 --> 00:19:43,575 it's not a medicine, 524 00:19:44,115 --> 00:19:46,515 but it's a lifetime and it's a lifetime 525 00:19:46,515 --> 00:19:47,015 investment 526 00:19:47,715 --> 00:19:48,615 in a person, 527 00:19:49,475 --> 00:19:51,735 so that they can have a successful 528 00:19:52,355 --> 00:19:52,855 life, 529 00:19:53,555 --> 00:19:54,615 you know, in America. 530 00:19:54,995 --> 00:19:57,470 And, so things like that. How do you 531 00:19:57,470 --> 00:19:59,250 help people with high school equivalency? 532 00:19:59,789 --> 00:20:00,929 How do you help them, 533 00:20:01,549 --> 00:20:04,349 enroll and and persist in a in a 534 00:20:04,349 --> 00:20:04,849 college, 535 00:20:05,230 --> 00:20:07,950 program or in a training program? Those are 536 00:20:07,950 --> 00:20:10,109 the kind of things I think that, health 537 00:20:10,109 --> 00:20:13,184 insurance companies should think deeply about and figure 538 00:20:13,184 --> 00:20:15,525 out how do we really get everyone 539 00:20:16,224 --> 00:20:16,724 on 540 00:20:17,025 --> 00:20:19,184 close enough to a level playing field that 541 00:20:19,184 --> 00:20:21,365 they can have a successful adult life. 542 00:20:22,305 --> 00:20:24,325 My final thoughts or my recommendations 543 00:20:24,785 --> 00:20:26,065 is we have to do 544 00:20:26,859 --> 00:20:29,099 we have to continue to figure out ways 545 00:20:29,099 --> 00:20:30,159 to reach people 546 00:20:30,619 --> 00:20:34,000 and to encourage access to care and encourage 547 00:20:34,059 --> 00:20:34,559 preventive, 548 00:20:35,819 --> 00:20:38,460 health care and make sure that we are 549 00:20:38,460 --> 00:20:39,679 following the recommendations 550 00:20:40,619 --> 00:20:41,279 of the 551 00:20:41,815 --> 00:20:43,914 United States preventive task force 552 00:20:44,295 --> 00:20:46,215 on that. And then we also have to 553 00:20:46,215 --> 00:20:48,955 think creatively about how do we make lives 554 00:20:49,414 --> 00:20:49,914 more, 555 00:20:51,015 --> 00:20:51,515 healthy 556 00:20:51,894 --> 00:20:52,394 in 557 00:20:52,775 --> 00:20:55,575 ways that aren't just doctors and pills. Right? 558 00:20:55,575 --> 00:20:56,795 How do we encourage 559 00:20:57,179 --> 00:20:57,919 healthy lifestyles, 560 00:20:59,019 --> 00:20:59,519 exercise, 561 00:21:00,619 --> 00:21:02,799 healthy eating, healthy neighborhoods, 562 00:21:03,740 --> 00:21:06,700 you know, all safety, safe neighborhoods so that 563 00:21:06,700 --> 00:21:08,619 you can, you know, take a walk every 564 00:21:08,619 --> 00:21:10,000 evening and not be frightened. 565 00:21:10,375 --> 00:21:12,474 Those are areas I think that health insurance 566 00:21:12,534 --> 00:21:14,855 can be involved in and can really think 567 00:21:14,855 --> 00:21:16,474 creatively and deeply about. 568 00:21:17,335 --> 00:21:19,974 Wonderful. Well, doctor Nuovo, thank you so much 569 00:21:19,974 --> 00:21:21,575 for taking the time to sit down with 570 00:21:21,575 --> 00:21:23,414 us on the podcast and for sharing your 571 00:21:23,414 --> 00:21:26,075 insights with our listeners. We really appreciate it. 572 00:21:26,269 --> 00:21:28,109 You are welcome, and thank you for having 573 00:21:28,109 --> 00:21:29,409 me. Absolutely. 574 00:21:29,789 --> 00:21:31,389 To our listeners, if you'd like to listen 575 00:21:31,389 --> 00:21:33,710 to more podcasts or Becker's Healthcare, you can 576 00:21:33,710 --> 00:21:36,369 visit beckershospitalreview.com.