1 00:00:00,160 --> 00:00:02,240 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,240 --> 00:00:04,099 Becker's Payer Issues podcast. 3 00:00:04,400 --> 00:00:06,639 Thrilled today to be joined by doctor Joe 4 00:00:06,639 --> 00:00:09,199 Camara, who is the chief medical officer at 5 00:00:09,199 --> 00:00:11,679 SCAN. Doctor Camara, thank you so much for 6 00:00:11,679 --> 00:00:13,039 taking the time to be with me on 7 00:00:13,039 --> 00:00:14,099 the podcast today. 8 00:00:14,785 --> 00:00:16,385 Absolutely. It's a pleasure to be here, Jacob. 9 00:00:16,385 --> 00:00:19,265 Thank you so much. Yeah. Absolutely. And before 10 00:00:19,265 --> 00:00:20,704 we dive into everything we wanna talk with 11 00:00:20,704 --> 00:00:22,225 you about, Joe, can you tell us a 12 00:00:22,225 --> 00:00:24,945 little bit more about yourself, your background in 13 00:00:24,945 --> 00:00:26,704 health care, and what it is that you 14 00:00:26,704 --> 00:00:28,005 do today at SCAN? 15 00:00:29,039 --> 00:00:30,480 Sure. Absolutely. My pleasure. 16 00:00:31,199 --> 00:00:33,520 So I serve as our chief medical officer 17 00:00:33,520 --> 00:00:35,679 here at SCAN Health Plan. And in that 18 00:00:35,679 --> 00:00:38,579 function, I oversee the development and implementation 19 00:00:39,359 --> 00:00:42,239 of SCAN's clinical strategy across not just the 20 00:00:42,239 --> 00:00:44,865 health plan, but also its affiliated medical groups. 21 00:00:44,865 --> 00:00:45,365 And, 22 00:00:45,905 --> 00:00:48,244 the my purview is over the clinical quality, 23 00:00:48,385 --> 00:00:49,445 utilization management, 24 00:00:49,984 --> 00:00:53,024 the population health care case management, pharmacy, and 25 00:00:53,024 --> 00:00:55,284 the clinical innovation functions. And so 26 00:00:55,609 --> 00:00:56,270 for me, 27 00:00:56,890 --> 00:00:59,369 I'm a primary care physician through and through. 28 00:00:59,369 --> 00:01:01,689 I trained in primary care internal medicine, did 29 00:01:01,689 --> 00:01:04,329 my fellowship training in health services research, and 30 00:01:04,329 --> 00:01:05,069 have focused 31 00:01:05,530 --> 00:01:07,790 my career really on the design and improvement 32 00:01:08,009 --> 00:01:10,965 of care, particularly in the outpatient ambulatory care 33 00:01:10,965 --> 00:01:11,944 system space. 34 00:01:12,805 --> 00:01:14,884 For the past two decades, I worked both 35 00:01:14,884 --> 00:01:16,424 as a clinician and an executive, 36 00:01:18,325 --> 00:01:20,664 really in value based provider organizations. 37 00:01:21,045 --> 00:01:23,819 Most of my time was spent in Eastern 38 00:01:23,819 --> 00:01:26,400 Massachusetts at Atrius Health and Harvard Vanguard, 39 00:01:27,420 --> 00:01:29,420 which was the provider side of the old 40 00:01:29,420 --> 00:01:31,579 Harvard Community Health Plan. And I served as 41 00:01:31,579 --> 00:01:34,635 chief medical officer there from '16 to '22. 42 00:01:35,355 --> 00:01:37,594 And prior to joining SCAN, I actually spent 43 00:01:37,594 --> 00:01:40,334 three years, within a specialty BBC 44 00:01:40,875 --> 00:01:41,375 startup, 45 00:01:41,915 --> 00:01:44,174 serving as chief medical officer for Somatas, 46 00:01:44,875 --> 00:01:47,115 which was a value based specialty care provider 47 00:01:47,115 --> 00:01:47,775 in McLean, 48 00:01:48,219 --> 00:01:50,619 really trying to help patients with chronic kidney 49 00:01:50,619 --> 00:01:51,280 and cardiovascular 50 00:01:51,659 --> 00:01:55,420 disease to avoid those downstream complications. So, kind 51 00:01:55,420 --> 00:01:57,340 of been through the circuit, mostly on the 52 00:01:57,340 --> 00:02:00,140 provider side, and, we're really excited to be 53 00:02:00,140 --> 00:02:01,814 in this space here with a health plan, 54 00:02:01,895 --> 00:02:04,055 thinking about progressive ways to really help our 55 00:02:04,055 --> 00:02:05,995 members and patients stay healthy. 56 00:02:06,775 --> 00:02:08,455 Fantastic. Well, we're really glad to have you 57 00:02:08,455 --> 00:02:10,694 here with us to get your take on 58 00:02:10,694 --> 00:02:13,655 Medicare Advantage specifically and and where you think 59 00:02:13,655 --> 00:02:16,534 that program is is going to evolve and 60 00:02:16,534 --> 00:02:17,354 keep going. 61 00:02:17,879 --> 00:02:19,719 So let's talk a little bit about that. 62 00:02:19,719 --> 00:02:22,219 Obviously, it's a MA, it's a very dynamic 63 00:02:22,280 --> 00:02:25,159 program. It's it's constantly changing. There's lots of 64 00:02:25,159 --> 00:02:26,539 headlines all the time, 65 00:02:26,919 --> 00:02:28,680 about the state of the market. And we 66 00:02:28,680 --> 00:02:29,979 continue to see SCAN, 67 00:02:30,599 --> 00:02:31,099 scale, 68 00:02:31,799 --> 00:02:34,224 there are lots of expansion into new markets. 69 00:02:35,004 --> 00:02:37,485 So from your perspective, Joe, what are some 70 00:02:37,485 --> 00:02:39,504 of the factors that you see driving 71 00:02:39,885 --> 00:02:42,064 future growth in the MA space? 72 00:02:42,365 --> 00:02:44,944 And how is SCAN position positioning itself, 73 00:02:45,325 --> 00:02:48,489 to address challenges and opportunities in in what 74 00:02:48,489 --> 00:02:50,269 we know, like I said, is a very 75 00:02:50,329 --> 00:02:51,549 evolving and dynamic 76 00:02:51,849 --> 00:02:52,349 market? 77 00:02:53,689 --> 00:02:55,609 That's a great question, Jacob. Thanks. 78 00:02:56,250 --> 00:02:56,750 So 79 00:02:57,449 --> 00:02:59,769 I I think in the Medicare Advantage space 80 00:02:59,769 --> 00:03:00,430 in particular, 81 00:03:01,289 --> 00:03:01,814 there is 82 00:03:02,615 --> 00:03:05,014 the fact that health care for our seniors 83 00:03:05,014 --> 00:03:05,995 and older Americans 84 00:03:06,294 --> 00:03:06,794 really, 85 00:03:07,574 --> 00:03:09,115 does get more complex, 86 00:03:09,415 --> 00:03:12,715 gets more complicated, and our delivery system continues 87 00:03:12,775 --> 00:03:13,354 to be 88 00:03:14,730 --> 00:03:17,050 fragmented. Although, I know coming from the provider 89 00:03:17,050 --> 00:03:19,129 side, there's lots of efforts to try to 90 00:03:19,129 --> 00:03:21,469 streamline and make things more efficient and coordinated. 91 00:03:22,169 --> 00:03:24,569 But the the reality is that we're still 92 00:03:24,569 --> 00:03:26,490 in a space where it becomes more and 93 00:03:26,490 --> 00:03:29,389 more challenging, the more complex your health becomes. 94 00:03:29,770 --> 00:03:30,270 And 95 00:03:30,794 --> 00:03:33,034 where I think MA truly does deliver better 96 00:03:33,034 --> 00:03:34,875 value than the sort of the traditional fee 97 00:03:34,875 --> 00:03:36,495 for service Medicare chassis. 98 00:03:37,275 --> 00:03:38,974 Traditional Medicare often 99 00:03:39,995 --> 00:03:41,995 exposes seniors, I would say, to sort of 100 00:03:41,995 --> 00:03:44,229 higher out of pocket costs and some of 101 00:03:44,229 --> 00:03:46,310 the things that we know are equally as 102 00:03:46,310 --> 00:03:46,810 important 103 00:03:47,110 --> 00:03:49,349 to sort of the traditional clinical care like 104 00:03:49,349 --> 00:03:50,810 vision, hearing, and dental, 105 00:03:51,269 --> 00:03:53,269 are all sort of elements of day to 106 00:03:53,269 --> 00:03:55,370 day health care for seniors that, 107 00:03:56,550 --> 00:03:59,574 are sort of if wrapped together and coordinated, 108 00:04:00,114 --> 00:04:01,014 actually provide 109 00:04:01,634 --> 00:04:03,094 better outcomes for everyone. 110 00:04:03,634 --> 00:04:06,034 MA does allow that kind of innovation, right, 111 00:04:06,034 --> 00:04:08,675 by offering that coordinated integrated care, 112 00:04:08,995 --> 00:04:09,814 and pushing 113 00:04:10,349 --> 00:04:12,509 all of us to be focusing on not 114 00:04:12,509 --> 00:04:15,069 just what we're doing, but what are the 115 00:04:15,069 --> 00:04:17,389 outcomes of what we're doing? How did those 116 00:04:17,389 --> 00:04:18,689 outcomes get better? 117 00:04:19,470 --> 00:04:21,629 And here at SCAN, I'd say that we're 118 00:04:21,629 --> 00:04:23,730 really trying to leverage that flexibility, 119 00:04:24,670 --> 00:04:27,204 to try to get the right benefits, the 120 00:04:27,204 --> 00:04:29,305 right clinical care, the right coordination 121 00:04:29,685 --> 00:04:31,845 put in place, to be sure that we're 122 00:04:31,845 --> 00:04:34,245 meeting seniors where there are, as well as 123 00:04:34,245 --> 00:04:36,745 trying to simplify the overall health care experience 124 00:04:37,044 --> 00:04:38,724 for our members, as well as for our 125 00:04:38,724 --> 00:04:39,785 provider partners. 126 00:04:40,644 --> 00:04:42,970 And you you alluded to the fact that 127 00:04:42,970 --> 00:04:45,129 sort of there are some challenges right in 128 00:04:45,129 --> 00:04:46,750 the landscape ahead. And 129 00:04:47,129 --> 00:04:48,270 as we look around, 130 00:04:48,810 --> 00:04:50,270 there are a lot of 131 00:04:50,889 --> 00:04:54,089 folks that are hesitating around Medicare Advantage and 132 00:04:54,089 --> 00:04:54,589 sometimes 133 00:04:55,394 --> 00:04:57,954 backing off a little bit. But for us 134 00:04:57,954 --> 00:04:59,334 as a non for profit 135 00:04:59,634 --> 00:05:02,214 health care plan, we do believe that, 136 00:05:02,675 --> 00:05:03,894 we have an opportunity, 137 00:05:04,355 --> 00:05:05,334 right, to really 138 00:05:05,875 --> 00:05:08,675 showcase what we can do, when we have 139 00:05:08,675 --> 00:05:11,870 this kind of coordinated care and coverage benefit 140 00:05:12,050 --> 00:05:14,029 ability, that we can invest 141 00:05:14,410 --> 00:05:17,050 more in that better care, invest in more 142 00:05:17,050 --> 00:05:18,990 stable and comprehensive benefits, 143 00:05:19,850 --> 00:05:21,770 and invest in being sure that we are 144 00:05:21,770 --> 00:05:24,410 there to provide that long term value for 145 00:05:24,410 --> 00:05:25,064 our members. 146 00:05:25,625 --> 00:05:27,305 And we could do it because of the 147 00:05:27,305 --> 00:05:29,324 ability that as a non for profit, 148 00:05:29,944 --> 00:05:31,944 we're thinking about the long game. We're not 149 00:05:31,944 --> 00:05:34,205 there necessarily for short term profits. 150 00:05:34,985 --> 00:05:37,705 And it has allowed us at SCAN to 151 00:05:37,705 --> 00:05:40,045 to really do a lot of innovative things. 152 00:05:40,589 --> 00:05:42,669 For example, you know, we've we've been out 153 00:05:42,669 --> 00:05:44,050 sort of at the forefront 154 00:05:44,430 --> 00:05:45,169 of launching, 155 00:05:46,029 --> 00:05:49,069 first of their kind plans around personalized care 156 00:05:49,069 --> 00:05:49,569 for, 157 00:05:50,029 --> 00:05:53,069 women, inspired our inspired plan for women or 158 00:05:53,069 --> 00:05:54,769 our firm plan for the LGBTQ 159 00:05:55,310 --> 00:05:58,154 plus seniors and the allied plan for our 160 00:05:58,154 --> 00:06:00,095 Asian senior population. So, 161 00:06:00,555 --> 00:06:03,774 again, right, that that creativity and the flexibility 162 00:06:04,235 --> 00:06:05,855 that MA provides, 163 00:06:06,395 --> 00:06:08,795 coupled with our commitment and our mission as 164 00:06:08,795 --> 00:06:09,455 a nonprofit, 165 00:06:09,995 --> 00:06:12,370 really allows us to be bullish about the 166 00:06:12,370 --> 00:06:14,770 fact that we can continue to serve more 167 00:06:14,770 --> 00:06:16,629 and more members across this country, 168 00:06:17,089 --> 00:06:18,770 to be able to provide that kind of 169 00:06:18,770 --> 00:06:21,009 care where it's needed, whether it's in the 170 00:06:21,009 --> 00:06:23,745 home, in the community, or even virtually. So 171 00:06:23,824 --> 00:06:26,704 super excited about the opportunity and really pushing 172 00:06:26,704 --> 00:06:28,264 forward to try to make sure that, 173 00:06:29,185 --> 00:06:32,064 we can continue to drive improvements and health 174 00:06:32,064 --> 00:06:33,604 outcomes for seniors. 175 00:06:34,785 --> 00:06:37,024 Absolutely. And to your initial point, Joe, I 176 00:06:37,024 --> 00:06:39,125 mean, we've seen study after study, 177 00:06:39,639 --> 00:06:41,800 and certainly on the ground experience like yours 178 00:06:41,800 --> 00:06:44,439 show that MA, it offers lower out of 179 00:06:44,439 --> 00:06:46,139 pocket costs, better benefits, 180 00:06:46,680 --> 00:06:48,620 better outcomes across many different, 181 00:06:49,720 --> 00:06:50,220 spaces 182 00:06:50,680 --> 00:06:53,014 for seniors. So your point is well heard. 183 00:06:53,634 --> 00:06:55,394 But I wanna follow-up on on something you 184 00:06:55,394 --> 00:06:57,875 mentioned in terms of SCAN really does stand 185 00:06:57,875 --> 00:06:59,794 out among the in the MA industry in 186 00:06:59,794 --> 00:07:02,375 terms of very specific and personalized 187 00:07:02,754 --> 00:07:04,615 plans for for certain populations, 188 00:07:05,235 --> 00:07:06,694 Asian Americans, LGBTQ, 189 00:07:07,560 --> 00:07:08,060 older 190 00:07:08,520 --> 00:07:10,439 adults. So, you know, so much of your 191 00:07:10,439 --> 00:07:12,600 career has been based in in innovation and 192 00:07:12,600 --> 00:07:13,500 value based, 193 00:07:14,439 --> 00:07:17,000 care. So as you lead scans efforts in 194 00:07:17,000 --> 00:07:17,740 this space, 195 00:07:18,439 --> 00:07:20,060 how do you envision the role of technology, 196 00:07:20,600 --> 00:07:23,404 data analytics in in shaping that more personalized 197 00:07:23,704 --> 00:07:25,725 and effective care delivery for your, 198 00:07:26,105 --> 00:07:27,564 now more than 300,000 199 00:07:27,625 --> 00:07:28,125 members? 200 00:07:28,584 --> 00:07:29,084 Yeah. 201 00:07:29,384 --> 00:07:30,845 It's a great question, Jacob. 202 00:07:31,384 --> 00:07:33,480 And and, sort of the the side that 203 00:07:33,639 --> 00:07:36,040 perhaps I missed in my intro bio is 204 00:07:36,040 --> 00:07:36,860 that I'm actually, 205 00:07:37,720 --> 00:07:39,800 boarded in internal medicine, but also boarded in 206 00:07:39,800 --> 00:07:42,779 clinical informatics. So technology and data analytics 207 00:07:43,080 --> 00:07:44,220 are a core part, 208 00:07:45,240 --> 00:07:48,375 of why I think healthcare is heading forward. 209 00:07:48,375 --> 00:07:51,415 And in this twenty first century, realizing we're 210 00:07:51,415 --> 00:07:52,694 twenty years into it now, but, 211 00:07:53,495 --> 00:07:55,095 we're really in a spot where there's some 212 00:07:55,095 --> 00:07:56,394 exciting new capabilities, 213 00:07:57,814 --> 00:08:00,620 addressing some of the challenges. Right? Of How 214 00:08:00,620 --> 00:08:02,939 do we actually make sure that not only 215 00:08:02,939 --> 00:08:03,759 the reliability 216 00:08:04,060 --> 00:08:05,680 of getting evidence based care, 217 00:08:06,379 --> 00:08:09,519 is happening more consistently across our population, 218 00:08:09,979 --> 00:08:11,740 but to your point around how do you 219 00:08:11,740 --> 00:08:14,535 then personalize that care, so it doesn't feel 220 00:08:14,535 --> 00:08:17,035 like we're doing cookbook or recipe based medicine 221 00:08:17,415 --> 00:08:20,714 on everybody. Because every every member, every 222 00:08:21,014 --> 00:08:24,214 person has unique challenges, a unique set of 223 00:08:24,214 --> 00:08:26,879 circumstances that they're dealing with. Even if there's 224 00:08:27,040 --> 00:08:29,360 they're sort of all working and trying to 225 00:08:29,360 --> 00:08:32,160 optimize the care for common disease or common 226 00:08:32,160 --> 00:08:35,279 conditions. So I think technology and analytics are 227 00:08:35,279 --> 00:08:37,860 really critical enablers of this kind of personalized 228 00:08:38,000 --> 00:08:41,120 coordinated experience. And we're a strong believer at 229 00:08:41,120 --> 00:08:44,704 SCAN that the technological abilities that we bring 230 00:08:44,704 --> 00:08:46,404 forth are gonna be foundational 231 00:08:46,784 --> 00:08:49,184 for being able to provide that kind of 232 00:08:49,184 --> 00:08:49,684 care, 233 00:08:50,065 --> 00:08:51,684 going forward. And, 234 00:08:52,065 --> 00:08:53,985 again, there's a lot of hype, Jacob. And, 235 00:08:53,985 --> 00:08:55,889 you know, and I think I've having heard 236 00:08:55,889 --> 00:08:58,230 prior podcast as well too, I think everyone 237 00:08:58,289 --> 00:08:58,789 recognizes, 238 00:08:59,409 --> 00:09:03,029 you know, artificial intelligence, all the advanced analytics 239 00:09:03,089 --> 00:09:03,589 capabilities. 240 00:09:04,209 --> 00:09:07,089 There's a lot of flash that is happening 241 00:09:07,089 --> 00:09:08,149 within our industry. 242 00:09:08,690 --> 00:09:11,075 And it's really, really important to make sure 243 00:09:11,075 --> 00:09:13,554 that, you know, we're not chasing sort of 244 00:09:13,554 --> 00:09:14,375 that Gartner 245 00:09:14,754 --> 00:09:16,774 sort of early part of the hype cycle, 246 00:09:16,995 --> 00:09:19,394 but we're really trying to target using the 247 00:09:19,394 --> 00:09:20,215 right technology 248 00:09:20,835 --> 00:09:22,914 at the right time to match the care 249 00:09:22,914 --> 00:09:25,379 and support with the members and patients that 250 00:09:25,379 --> 00:09:27,540 really need it. And there's an eye towards 251 00:09:27,540 --> 00:09:28,919 trying to use that technology 252 00:09:29,299 --> 00:09:29,960 to simplify, 253 00:09:30,340 --> 00:09:30,840 to, 254 00:09:31,700 --> 00:09:34,660 expediate the care, and try to make sort 255 00:09:34,660 --> 00:09:37,855 of care more effective for our members, but 256 00:09:37,855 --> 00:09:40,195 also our provider partners, for our workforce. 257 00:09:40,894 --> 00:09:43,454 And everyone sort of involved wrapping around the 258 00:09:43,454 --> 00:09:44,674 care for those patients. 259 00:09:45,615 --> 00:09:48,815 And technology does enable that. Right? So our 260 00:09:48,815 --> 00:09:52,509 our capability of using data, using the ability 261 00:09:52,509 --> 00:09:54,669 to sort of say, you know, you have 262 00:09:54,669 --> 00:09:57,490 one cohort of patients, say they have congestive 263 00:09:57,549 --> 00:10:00,370 heart failure, dementia, or even diabetes, 264 00:10:01,070 --> 00:10:02,529 but within that 265 00:10:03,035 --> 00:10:03,535 seemingly 266 00:10:03,995 --> 00:10:06,875 homogeneous group, you have a lot of different 267 00:10:06,875 --> 00:10:07,274 sort of 268 00:10:08,315 --> 00:10:11,355 that data analytics can help surface and make 269 00:10:11,355 --> 00:10:13,215 it more efficient and more 270 00:10:13,675 --> 00:10:16,415 effective in terms of how care teams, 271 00:10:17,179 --> 00:10:19,419 including those on our side at SCAN, but 272 00:10:19,419 --> 00:10:22,620 also collaborating with our network provider partners, can 273 00:10:22,620 --> 00:10:24,320 really wrap around the services 274 00:10:24,700 --> 00:10:26,460 where and when it's needed, whether it's in 275 00:10:26,460 --> 00:10:28,320 the home, on the street, in the clinic, 276 00:10:28,460 --> 00:10:29,820 or even virtually. And, 277 00:10:30,545 --> 00:10:31,524 that kind of capability 278 00:10:32,065 --> 00:10:34,545 was hard to do. Right? Definitely hard to 279 00:10:34,545 --> 00:10:36,625 do twenty five years ago when we're all 280 00:10:36,625 --> 00:10:37,845 on paper charts, 281 00:10:38,225 --> 00:10:40,725 but it makes it a lot easier today, 282 00:10:41,184 --> 00:10:43,745 when you've got these kinds of ability to 283 00:10:43,745 --> 00:10:45,845 interchange and exchange that data, 284 00:10:46,429 --> 00:10:47,330 and information 285 00:10:47,870 --> 00:10:49,809 across the network of providers. 286 00:10:50,509 --> 00:10:53,070 And, you know, I would say that the 287 00:10:53,070 --> 00:10:56,029 virtual capability that we're seeing post COVID, 288 00:10:56,750 --> 00:10:59,024 continues to make sort of, if I could 289 00:10:59,024 --> 00:11:01,284 say, sort of open up opportunities 290 00:11:01,664 --> 00:11:04,245 to try to really improve access and care, 291 00:11:04,625 --> 00:11:06,945 for patients and members who are in sort 292 00:11:06,945 --> 00:11:08,404 of isolated areas, 293 00:11:09,024 --> 00:11:12,480 that perhaps aren't being served as well by, 294 00:11:12,720 --> 00:11:15,600 the providers in the community, or honestly, the 295 00:11:15,600 --> 00:11:17,839 providers are overwhelmed. Right? We're seeing that a 296 00:11:17,839 --> 00:11:18,579 fair amount, 297 00:11:18,959 --> 00:11:20,980 in terms of access issues, 298 00:11:21,679 --> 00:11:24,559 across the board. And when we think about 299 00:11:24,559 --> 00:11:27,299 that virtual type care though, we do need 300 00:11:27,514 --> 00:11:29,355 to keep in mind that we need to 301 00:11:29,355 --> 00:11:31,434 make sure that that system works with our 302 00:11:31,434 --> 00:11:32,894 older adults in mind. 303 00:11:33,355 --> 00:11:35,514 So we at SCAN have also invested in 304 00:11:35,514 --> 00:11:39,294 parallel, right, to really push digital literacy, digital 305 00:11:39,355 --> 00:11:41,960 support to make sure the tools are as 306 00:11:41,960 --> 00:11:43,899 accessible and easy to use. 307 00:11:44,919 --> 00:11:46,959 And the last part of your question, Jacob, 308 00:11:46,959 --> 00:11:48,919 I think was around data analytics. And this 309 00:11:48,919 --> 00:11:50,919 is sort of an area that's dear to 310 00:11:50,919 --> 00:11:52,759 my heart around population health. 311 00:11:53,240 --> 00:11:53,740 And 312 00:11:54,679 --> 00:11:56,139 the idea of 313 00:11:56,975 --> 00:12:00,335 enabling proactive world class care is something that 314 00:12:00,335 --> 00:12:02,815 I've always been super, super passionate about. And 315 00:12:02,815 --> 00:12:05,075 as a primary care clinician, it feels like 316 00:12:05,215 --> 00:12:08,335 that's our raison d'etre, right, to really be 317 00:12:08,335 --> 00:12:10,975 at that place where I can help our 318 00:12:10,975 --> 00:12:12,195 patients and members 319 00:12:12,870 --> 00:12:14,090 prevent that hospitalization, 320 00:12:14,789 --> 00:12:16,970 prevent that rapid disease progression, 321 00:12:17,830 --> 00:12:18,330 prevent, 322 00:12:18,789 --> 00:12:20,629 sort of the aspects of, 323 00:12:21,350 --> 00:12:23,370 mental health challenges from isolation. 324 00:12:23,750 --> 00:12:26,870 Because if I can detect it sooner and 325 00:12:26,870 --> 00:12:29,014 know who is at risk, it gives me 326 00:12:29,014 --> 00:12:30,394 a chance to intervene 327 00:12:30,934 --> 00:12:33,495 probably with a sort of more efficient type 328 00:12:33,495 --> 00:12:37,035 intervention, but also a more humane intervention. Because 329 00:12:37,575 --> 00:12:40,375 when those complications happen, we all know, we 330 00:12:40,375 --> 00:12:41,595 see it all the time, 331 00:12:42,230 --> 00:12:44,970 it is wonderful to provide world class care. 332 00:12:45,110 --> 00:12:47,529 But at that time, you're kind of really 333 00:12:48,870 --> 00:12:51,029 behind the eight ball, and you're chasing to 334 00:12:51,029 --> 00:12:54,149 try to rectify situation instead of truly preventing 335 00:12:54,149 --> 00:12:56,044 it. And I think there's no one in 336 00:12:56,044 --> 00:12:57,804 the world that would argue that if we 337 00:12:57,804 --> 00:12:58,544 could just, 338 00:12:59,004 --> 00:13:00,764 you know, hold true to our adage of 339 00:13:00,764 --> 00:13:03,085 an ounce of prevention is worth more than 340 00:13:03,085 --> 00:13:04,225 a pound of a cure, 341 00:13:04,684 --> 00:13:06,605 it really does make this place, 342 00:13:07,085 --> 00:13:08,684 a lot better for all of us in 343 00:13:08,684 --> 00:13:11,220 terms of reducing suffering. And I think data 344 00:13:11,220 --> 00:13:13,559 analytics become and form the foundation 345 00:13:13,940 --> 00:13:15,620 of enabling us to be able to do 346 00:13:15,620 --> 00:13:17,799 that much more efficiently and effectively. 347 00:13:18,899 --> 00:13:22,440 Certainly. Certainly. And, you know, speaking of proactive 348 00:13:22,659 --> 00:13:24,259 care, let me let me spout off a 349 00:13:24,259 --> 00:13:25,779 stat to you that I know you're familiar 350 00:13:25,779 --> 00:13:26,235 with, 351 00:13:26,794 --> 00:13:28,315 and certainly, I would imagine most of our 352 00:13:28,315 --> 00:13:31,274 audience is familiar with it. Around 10,000 Americans 353 00:13:31,274 --> 00:13:33,615 a day are aging into Medicare. 354 00:13:34,235 --> 00:13:36,894 We expect that that number to keep growing, 355 00:13:37,434 --> 00:13:40,334 in terms of the overall ratio there. So 356 00:13:41,190 --> 00:13:43,429 how do you how how does SCAN how 357 00:13:43,429 --> 00:13:44,870 how are you thinking about that? How are 358 00:13:44,870 --> 00:13:46,570 you preparing for that, navigating, 359 00:13:47,110 --> 00:13:48,330 what's already here? 360 00:13:49,190 --> 00:13:50,950 And from your perspective, given what we were 361 00:13:50,950 --> 00:13:53,029 just talking about, Joe, in terms of population 362 00:13:53,029 --> 00:13:55,274 health and data analytics, how do you continue 363 00:13:55,335 --> 00:13:58,134 to to view where the health care landscape 364 00:13:58,134 --> 00:13:59,575 is gonna change over the next three to 365 00:13:59,575 --> 00:14:01,735 five years when it comes to meeting this 366 00:14:01,735 --> 00:14:03,595 demand for senior care? 367 00:14:04,534 --> 00:14:06,455 Yeah. It's a great question, Jacob, and something 368 00:14:06,455 --> 00:14:08,554 that definitely we think a lot about. 369 00:14:09,254 --> 00:14:09,575 And, 370 00:14:10,429 --> 00:14:13,389 you know, the the the demand side there 371 00:14:13,389 --> 00:14:14,750 with the 10,000 372 00:14:14,750 --> 00:14:17,009 patients sort of entering into Medicare, 373 00:14:17,789 --> 00:14:20,029 is coupled with the similar stat that I 374 00:14:20,029 --> 00:14:22,370 I know that you're also familiar with where, 375 00:14:22,429 --> 00:14:23,789 you know, we have a lot of our 376 00:14:23,789 --> 00:14:24,289 workforce 377 00:14:24,945 --> 00:14:28,705 stepping away, early retirements, folks sort of stepping 378 00:14:28,705 --> 00:14:31,985 away from direct care provider capabilities. And so, 379 00:14:32,304 --> 00:14:34,384 we're facing a little bit of a storm, 380 00:14:34,384 --> 00:14:35,825 right, going forward to say increasing need, decreasing 381 00:14:35,825 --> 00:14:36,965 capacity to care for, the 382 00:14:40,820 --> 00:14:41,399 the need. 383 00:14:41,860 --> 00:14:44,100 But also, I'd add that third bit, which 384 00:14:44,100 --> 00:14:46,740 says, medical science is advancing. So guess what? 385 00:14:46,740 --> 00:14:50,419 We have more effective treatments available today to 386 00:14:50,419 --> 00:14:51,700 really change the, 387 00:14:52,774 --> 00:14:55,675 trajectory of some of these clinical conditions that, 388 00:14:55,894 --> 00:14:57,894 again, in the past used to be much 389 00:14:57,894 --> 00:15:00,774 more much more difficult to manage effectively. And 390 00:15:00,774 --> 00:15:03,254 I think chronic kidney disease is one great 391 00:15:03,254 --> 00:15:06,134 example of that with, the new medications that 392 00:15:06,134 --> 00:15:07,115 are now available. 393 00:15:07,575 --> 00:15:10,450 And I do think that this is where 394 00:15:10,669 --> 00:15:12,129 we do need to partner, 395 00:15:13,230 --> 00:15:16,049 very strongly with our provider partners, 396 00:15:16,669 --> 00:15:18,909 and try to figure out how do we 397 00:15:18,909 --> 00:15:21,254 bring the strength of a health plan, with 398 00:15:21,254 --> 00:15:23,975 the strength of the provider groups to really 399 00:15:23,975 --> 00:15:26,375 try to to thread this needle of making 400 00:15:26,375 --> 00:15:27,514 sure that the members 401 00:15:28,055 --> 00:15:30,134 that really have the needs that, 402 00:15:31,654 --> 00:15:32,955 are paramount, 403 00:15:33,495 --> 00:15:36,159 overall, not just from an experience perspective, but 404 00:15:36,159 --> 00:15:38,019 clearly from a health outcomes perspective, 405 00:15:38,639 --> 00:15:40,639 get the types of care that they need 406 00:15:40,639 --> 00:15:42,980 despite the fact that access is challenging, 407 00:15:43,679 --> 00:15:46,159 everywhere that we look. And so, you know, 408 00:15:46,159 --> 00:15:46,659 we've 409 00:15:46,975 --> 00:15:50,014 announced a couple of sort of partnerships with 410 00:15:50,014 --> 00:15:52,495 large groups like Estrana and Sutter Health here 411 00:15:52,495 --> 00:15:55,215 in California, where we're really trying to figure 412 00:15:55,215 --> 00:15:56,595 out how do we work together, 413 00:15:57,215 --> 00:16:00,174 to try to address those kinds of demand 414 00:16:00,174 --> 00:16:00,835 and capacity 415 00:16:01,375 --> 00:16:01,875 challenges. 416 00:16:02,680 --> 00:16:04,120 But on top of that though, I mean, 417 00:16:04,120 --> 00:16:06,680 as a primary care clinician, I would say 418 00:16:06,680 --> 00:16:09,639 there's another aspect here that's really important for 419 00:16:09,639 --> 00:16:12,300 us, and that or it's really pushing, 420 00:16:13,399 --> 00:16:15,399 our ability to be able to help and 421 00:16:15,399 --> 00:16:16,620 coach our members, 422 00:16:17,254 --> 00:16:19,414 to be able to be as effective as 423 00:16:19,414 --> 00:16:21,034 possible as they're navigating 424 00:16:21,335 --> 00:16:23,735 through. And, you know, we think about our 425 00:16:23,735 --> 00:16:25,034 care coaching programs, 426 00:16:25,654 --> 00:16:27,514 for our SCAN inspired members, 427 00:16:28,054 --> 00:16:30,294 offers a lot of personalized one on one 428 00:16:30,294 --> 00:16:31,434 coaching to tackle 429 00:16:31,750 --> 00:16:34,330 many of the primary concerns of our members. 430 00:16:34,710 --> 00:16:37,110 And again, these kinds of programs, when you 431 00:16:37,110 --> 00:16:38,009 have activated 432 00:16:39,110 --> 00:16:41,210 engaged and educated members, 433 00:16:42,149 --> 00:16:44,629 it it enables sort of that member to 434 00:16:44,629 --> 00:16:47,204 become an active role of the care team, 435 00:16:47,745 --> 00:16:49,284 and therefore, also, 436 00:16:49,824 --> 00:16:52,304 become more effective agents of their health care. 437 00:16:52,304 --> 00:16:55,184 And, again, I think as we're looking at 438 00:16:55,184 --> 00:16:58,225 health plan and providers as two different arms, 439 00:16:58,225 --> 00:17:00,690 I do think our members provide yet a 440 00:17:00,690 --> 00:17:03,009 third arm, right, of us being able to 441 00:17:03,009 --> 00:17:03,830 work together, 442 00:17:04,529 --> 00:17:05,509 to try to, 443 00:17:06,289 --> 00:17:08,630 address some of the challenges that we're facing. 444 00:17:09,170 --> 00:17:10,549 And it is really, really, 445 00:17:11,089 --> 00:17:13,829 a challenge that, again, technology, you know, referencing 446 00:17:13,890 --> 00:17:15,154 our prior conversation, 447 00:17:15,535 --> 00:17:17,875 also begins to help us with. Because 448 00:17:18,255 --> 00:17:20,835 in the past, I would say that information 449 00:17:21,215 --> 00:17:21,715 was 450 00:17:22,494 --> 00:17:25,134 more sequestered, I would say, in the care 451 00:17:25,134 --> 00:17:26,515 delivery space overall. 452 00:17:27,279 --> 00:17:29,359 But with the information, with the kind of 453 00:17:29,359 --> 00:17:31,619 tools that are available to the general public, 454 00:17:31,759 --> 00:17:34,400 you know, health care information is democratizing. And 455 00:17:34,400 --> 00:17:36,980 that is enabling our members and our patients 456 00:17:37,200 --> 00:17:39,680 to be much more informed around what they 457 00:17:39,680 --> 00:17:41,359 should be getting, when they should be getting 458 00:17:41,359 --> 00:17:43,195 it, how they should be getting it, and 459 00:17:43,195 --> 00:17:44,475 how they prefer. And, 460 00:17:45,115 --> 00:17:47,595 we wanna empower our patients and our members 461 00:17:47,595 --> 00:17:50,315 to really be that kind of strong agent 462 00:17:50,315 --> 00:17:52,154 and advocate for their care. And I think 463 00:17:52,154 --> 00:17:54,394 all of it becomes important to address the 464 00:17:54,394 --> 00:17:55,775 challenges that you mentioned. 465 00:17:56,730 --> 00:17:58,890 Absolutely. Well, exciting things ahead, 466 00:17:59,289 --> 00:18:01,289 in the in the senior care space, and 467 00:18:01,289 --> 00:18:04,009 it'll be fascinating to watch scan continue to 468 00:18:04,009 --> 00:18:04,910 innovate there. 469 00:18:05,609 --> 00:18:07,769 Before we go, Joe, what else are we 470 00:18:07,769 --> 00:18:10,025 missing? You got a lot of health plan 471 00:18:10,025 --> 00:18:12,664 leaders and and MA leadership listening in from 472 00:18:12,664 --> 00:18:14,345 from all over the country. What do you 473 00:18:14,345 --> 00:18:16,105 wanna share with them? Any any final bits 474 00:18:16,105 --> 00:18:17,724 of advice, you'd offer? 475 00:18:18,505 --> 00:18:20,265 Yeah. No. Thank you for that opportunity. And 476 00:18:20,265 --> 00:18:22,289 thank you again, right, for this chance to 477 00:18:22,289 --> 00:18:24,690 actually speak with you and, to to share 478 00:18:24,690 --> 00:18:25,990 my 2ยข here. 479 00:18:26,610 --> 00:18:28,230 I get that at two comments. 480 00:18:28,930 --> 00:18:31,970 One is that, again, acknowledging where we're at 481 00:18:31,970 --> 00:18:32,470 today 482 00:18:32,850 --> 00:18:34,230 with the complexity 483 00:18:34,610 --> 00:18:35,110 and 484 00:18:35,714 --> 00:18:36,375 the fragmentation 485 00:18:36,755 --> 00:18:38,934 that just exists in health care, 486 00:18:39,474 --> 00:18:40,375 really to 487 00:18:40,835 --> 00:18:43,075 try to be as straightforward as possible in 488 00:18:43,075 --> 00:18:45,474 terms of keeping that member experience at the 489 00:18:45,474 --> 00:18:46,454 center of everything. 490 00:18:47,794 --> 00:18:49,335 We try to push greater 491 00:18:49,859 --> 00:18:52,819 performance in terms of clinical outcomes or other 492 00:18:52,819 --> 00:18:54,519 kinds of KPIs and metrics, 493 00:18:54,980 --> 00:18:56,920 and that can sometimes drive, 494 00:18:57,619 --> 00:18:58,440 more complexity. 495 00:18:59,380 --> 00:18:59,779 And, 496 00:19:00,180 --> 00:19:02,420 we like to say that complexity isn't the 497 00:19:02,420 --> 00:19:03,400 sign of sophistication. 498 00:19:04,244 --> 00:19:07,045 It's more signal that perhaps we lost sight 499 00:19:07,045 --> 00:19:08,964 of what we're trying to do and who 500 00:19:08,964 --> 00:19:11,285 we're trying to serve. So first point would 501 00:19:11,285 --> 00:19:14,085 be, again, to really, really keep laser focused 502 00:19:14,085 --> 00:19:15,384 on that member experience. 503 00:19:15,924 --> 00:19:16,424 And 504 00:19:17,240 --> 00:19:19,320 the second point, probably as a corollary to 505 00:19:19,320 --> 00:19:20,619 that, Jacob, is that, 506 00:19:21,000 --> 00:19:23,259 we do believe that's the next revolution 507 00:19:24,440 --> 00:19:25,660 in terms of digitalization 508 00:19:26,440 --> 00:19:27,420 of health care, 509 00:19:27,880 --> 00:19:29,740 really comes with the interoperability 510 00:19:30,805 --> 00:19:33,525 coming into its own. And I think as 511 00:19:33,525 --> 00:19:34,265 we're seeing, 512 00:19:35,045 --> 00:19:36,904 the new sort of capabilities 513 00:19:37,445 --> 00:19:39,845 really start to open up a more freer 514 00:19:39,845 --> 00:19:42,964 flow of data and information across health plans, 515 00:19:42,964 --> 00:19:44,105 providers, and patients, 516 00:19:44,690 --> 00:19:45,589 there is a tremendous 517 00:19:45,970 --> 00:19:49,089 opportunity here to reduce that friction, eliminate the 518 00:19:49,089 --> 00:19:52,309 waste, and make room for real collaboration. So, 519 00:19:53,089 --> 00:19:55,089 the second piece would be to keep an 520 00:19:55,089 --> 00:19:56,470 eye on that interoperability 521 00:19:57,009 --> 00:19:57,910 coming and 522 00:19:58,404 --> 00:20:00,404 be ready to be able to jump in, 523 00:20:00,724 --> 00:20:03,224 and be more effective partners in connecting, 524 00:20:03,924 --> 00:20:06,244 our care across all the different domains. Because 525 00:20:06,244 --> 00:20:07,785 I think it's gonna be an exciting, 526 00:20:08,164 --> 00:20:09,384 window coming forth. 527 00:20:10,259 --> 00:20:13,080 Wonderful. Well, doctor Kimura, thank you so much 528 00:20:13,140 --> 00:20:14,820 for taking the time to sit down with 529 00:20:14,820 --> 00:20:16,740 us and for sharing your insights with our 530 00:20:16,740 --> 00:20:18,680 audience. We we really appreciate it. 531 00:20:19,059 --> 00:20:21,220 Absolutely, Jacob. It was a privilege, and thank 532 00:20:21,220 --> 00:20:22,676 you so much. Yep. 533 00:20:23,136 --> 00:20:25,296 To our listeners, if you'd like to listen 534 00:20:25,296 --> 00:20:27,616 to more podcasts from Becker's HealthCare, you can 535 00:20:27,616 --> 00:20:30,276 visit beckershospitalreview.com.