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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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Today, I am joined by Harlan Pickett, president

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of EqualCare Health Solutions.

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Harlan, thank you so much for joining me

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today. Can you go ahead and tell us

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a little bit about yourself and your background?

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Absolutely. It's my pleasure to be here. Great

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event. I've really enjoyed it.

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I have been in the insurance and

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health care world for about eighteen years. Started

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Eagle Care back in 2019.

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We provide

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alternative solutions

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for employers

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to help control their health care spend and

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to provide better access to health care.

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These are customized plans, nothing off the shelf.

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It actually gives the employer control over what

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their health plan looks like instead of once

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in, you know, a one size fits all.

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That that's that's not

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effective in today's

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environment. It doesn't allow you to control cost

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in any way, shape, or form, and it

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certainly doesn't provide

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the access to health care that your employees

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deserve.

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Well, I'd like to start this conversation off

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by asking you what you and your team

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at Eagle Care Health Solutions

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does to

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ensure that the quality of care is kept

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at the forefront.

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Now that that is it's paramount.

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First of all, if you don't know cost

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and you don't know quality,

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there's no way you can understand what value

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is. There's a lot of talk about value

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based care right now.

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But in this health care system,

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it's almost impossible to know what the cost

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is first. Well, if you don't know the

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cost and you don't know the quality, how

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do you know it's valuable? How do you

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put a value to it? So we work

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diligently on that side of it. One of

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the major ways we do it is we

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do direct contracts with

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physicians

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that have shown

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outstanding

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outcomes and that actually care about their clients,

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so much so that it is a membership

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based model

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that is a monthly

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per member per month,

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and then any additional cost that would be

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incurred at

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that facility

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is zero.

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So it's just a monthly membership. There's no

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co pays. There's no out of pocket,

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and, therefore, any cost that happened there

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never are attributed to the plan. The plan

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doesn't have to pay anything. The employer doesn't

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have to pay anything. It's just that one

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monthly fee. This aligns

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the incentives

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for the

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patient

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and the physician

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and it rebuilds that relationship as well.

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Therefore, the patient and the physician working together

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with one goal and that is an improved

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quality of life and improved health for the

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patient.

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That's where you get the quality.

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Absolutely. You know, I'd like to keep that

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conversation going about quality.

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So improving quality and advancing health equity while

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also reducing cost seems to be a big

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priority for everyone in health care. So how

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do you approach aligning these priorities in your

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organization's strategic vision? Yeah. Imagine that the reason

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that you can't see a doctor is because

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I don't know how much it cost.

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We removed that barrier.

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So health equity in many cases is because

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folks cannot

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afford to go or they don't even know

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if they can afford to go, and there

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maybe isn't a location

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close to them.

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So doing these direct direct contracts, having a

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direct contract with a physician

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that's gonna give this individual

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not five to seven minutes, which is the

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national average, but is gonna provide them forty

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five minutes to an hour to focus just

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on them, have a conversation,

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not just about their health but about their

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lifestyle choices,

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It changes their life for a positive way.

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It brings them back into

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a relationship with a physician that they heard

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tell about, but it hasn't been available for

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so many years. It levels the playing field.

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This is a level of service that in

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most folks say, oh, you're talking about an

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executive concierge. No. No. We're not talking about

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an executive concierge. We're talking about

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a physician

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who is really invested

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in your health

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and invested so much so they wanna have

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a relationship.

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Most of our members

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don't just have an app that they work

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through to talk to their physician. They actually

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have their physician's phone number.

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They can text their physician. They can call

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their physician if something's going on. We've had

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the physician come and meet people on New

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Year's Eve

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whenever the baby

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was turning blue. What do I do? This

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would normally be an ER visit.

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It turned out it it although it sounds

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really serious, it turns out it was a

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very simple thing

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that the doctor was able to take care

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of.

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Those folks felt so much better.

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Obviously, the baby felt so much better,

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but

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they've never stopped talking about how important it

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was to them to have that relationship and

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have that opportunity to do that. Well, can

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you imagine what it was like when they

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went back to work

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to talk about their experience?

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All of a sudden,

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in that particular employer group, we started seeing

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even greater participation,

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even greater engagement than there was before. Sometimes

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all it takes is one

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isolated incident

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to make something just explode, and all of

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a sudden the uptake on it is incredible.

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Absolutely. That's amazing. And I'd like to keep

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the conversation going with HealthEquity,

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as you mentioned earlier.

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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? Yeah. There's

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there's obviously certain communities.

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And I won't just get into inner city.

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I mean, that's that's pretty well known, but

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we're talking about rural destinations right now. There's

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been a lot of talk at this conference

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about how do we affect change in rural

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areas to provide them access to. We're actually

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it it it's a pretty pretty new thing.

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It it became an opportunity for us. We're

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investing

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in a couple of physicians' offices that are

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in rural areas

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to help them change away from a fee

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for service to this membership

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based model

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because that then

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that generates your income today. What many rural

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positions

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cannot do

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is wait through the payment cycle.

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That payment cycle eats them up.

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Even if they are

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seeing a decent number,

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if you're spread across multiple health plans and

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you're continually waiting for that money to come

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in,

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they're already understaffed a lot of times, especially

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in rural areas.

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All of a sudden, now they can't afford

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to even keep the people on. It's hard

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for them to keep their practice going.

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A change in model then

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is

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an acceptable way to keep your practice going

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to help grow that practice because that that's

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what our our mission is going to be,

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is to bring then local employers

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even in those rural areas to show them,

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hey. Here's a here's a model that will

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work better, and now your folks can have

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this relationship again. The other thing we're doing

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is providing them technology so that they can

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do televisits.

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Many of them don't have that type of

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infrastructure in their practice, but we're bringing that

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technology to them so that they can provide

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that too. That helps expand their practice within

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their state.

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Amazing. Well, this has been such a fascinating

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conversation. Again, this is Haley Rucker with the

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Becker's Payer Podcast

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recorded live at the Becker's third annual spring

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payer issues roundtable. Harlan, thank you so much

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for joining me today. It's been my honor

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and my pleasure. Thank you so much,