1 00:00:00,160 --> 00:00:02,319 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,319 --> 00:00:04,179 Becker's Payer Issues podcast. 3 00:00:04,559 --> 00:00:07,120 Thrilled today to be joined by two special 4 00:00:07,120 --> 00:00:10,400 guests. Karen Ignani serves as the executive chair 5 00:00:10,400 --> 00:00:11,139 at EmblemHealth, 6 00:00:11,519 --> 00:00:13,994 and doctor Dan Neckt is the chief medical 7 00:00:14,054 --> 00:00:15,755 officer also at EmblemHealth. 8 00:00:16,454 --> 00:00:18,695 Karen, doctor Knecht, thank you both so much 9 00:00:18,695 --> 00:00:20,614 for taking the time to be be with 10 00:00:20,614 --> 00:00:21,835 me here on the podcast. 11 00:00:22,135 --> 00:00:23,994 Thank you, Jacob. Our pleasure. 12 00:00:24,614 --> 00:00:26,855 And before we dive into what we wanna 13 00:00:26,855 --> 00:00:28,789 talk with you both about, can you each 14 00:00:28,789 --> 00:00:30,570 tell us a little bit more about yourselves, 15 00:00:31,030 --> 00:00:32,789 your backgrounds in health care, and what it 16 00:00:32,789 --> 00:00:34,649 is that you're doing today at EmblemHealth? 17 00:00:35,030 --> 00:00:36,869 Karen, why don't you start us off? I'd 18 00:00:36,869 --> 00:00:39,590 be happy to. I'm the executive chair at 19 00:00:39,590 --> 00:00:40,090 EmblemHealth, 20 00:00:41,030 --> 00:00:43,454 which means that I chair the board and 21 00:00:43,454 --> 00:00:44,995 have management responsibilities. 22 00:00:46,094 --> 00:00:49,315 And prior to that, I was, the CEO 23 00:00:49,375 --> 00:00:50,274 here at EmblemHealth 24 00:00:51,135 --> 00:00:53,375 for about ten years. And prior to that, 25 00:00:53,375 --> 00:00:54,354 I was in DC, 26 00:00:55,039 --> 00:00:57,359 for a significant part of my career at 27 00:00:57,359 --> 00:00:59,520 AHIP, which is familiar to all of your 28 00:00:59,520 --> 00:01:00,020 listeners. 29 00:01:01,280 --> 00:01:03,280 Thank you, Karen. Glad to have you with 30 00:01:03,280 --> 00:01:04,900 us. Dan, how about you? 31 00:01:06,079 --> 00:01:07,859 Hi. So I am EmblemHealth's 32 00:01:08,224 --> 00:01:10,384 chief medical officer. I've been in this role 33 00:01:10,384 --> 00:01:10,884 for, 34 00:01:11,424 --> 00:01:13,104 more than a half a year now. I'm 35 00:01:13,104 --> 00:01:15,765 responsible for the clinical integrity of EmblemHealth, 36 00:01:16,224 --> 00:01:17,685 our programs, our initiatives, 37 00:01:18,625 --> 00:01:21,584 also driving clinical innovation around areas that really 38 00:01:21,584 --> 00:01:22,884 matter most to our members 39 00:01:23,310 --> 00:01:26,189 related to unmet health needs. In addition to 40 00:01:26,189 --> 00:01:28,769 being chief medical officer at EmblemHealth, I am 41 00:01:28,909 --> 00:01:31,469 a hospitalist at Mount Sinai Hospital where I 42 00:01:31,469 --> 00:01:33,250 take care of patients on the weekends. 43 00:01:33,709 --> 00:01:35,549 Prior to joining EmblemHealth, I've worked at a 44 00:01:35,549 --> 00:01:36,450 number of payers, 45 00:01:36,989 --> 00:01:38,849 and I am a lifelong New Yorker. 46 00:01:39,295 --> 00:01:41,774 Wonderful. Well, we're really excited to dive into 47 00:01:41,774 --> 00:01:43,694 what sounds like is going to be a 48 00:01:43,694 --> 00:01:44,594 very impactful 49 00:01:45,215 --> 00:01:47,795 program for for your patients and your members. 50 00:01:48,414 --> 00:01:50,974 And to our listeners, EmblemHealth is going to 51 00:01:50,974 --> 00:01:53,700 be the first health insurer to cover a 52 00:01:53,700 --> 00:01:56,900 new lifestyle medicine program for patients who have 53 00:01:56,900 --> 00:01:58,680 early stage Alzheimer's disease. 54 00:01:59,140 --> 00:02:00,900 So, Karen, talk to us a little bit 55 00:02:00,900 --> 00:02:03,540 about that. What inspired the organization to launch 56 00:02:03,540 --> 00:02:04,840 this groundbreaking partnership? 57 00:02:05,295 --> 00:02:07,935 And, ultimately, how do you envision this benefiting 58 00:02:07,935 --> 00:02:10,335 your members who are living with early stage 59 00:02:10,335 --> 00:02:12,754 Alzheimer's or or other cognitive impairments? 60 00:02:13,375 --> 00:02:15,615 I appreciate you're coming to me first, but 61 00:02:15,615 --> 00:02:16,594 this is really, 62 00:02:17,215 --> 00:02:18,435 Dan's brainchild. 63 00:02:18,949 --> 00:02:21,430 And I really want, Jacob, if you're okay, 64 00:02:21,430 --> 00:02:22,489 to have Dan 65 00:02:22,870 --> 00:02:25,129 start off this. It's so exciting. 66 00:02:25,669 --> 00:02:26,150 He, 67 00:02:26,469 --> 00:02:27,689 is the, 68 00:02:28,389 --> 00:02:30,489 thought leader around this initiative. 69 00:02:31,030 --> 00:02:32,955 He is the leader of it 70 00:02:33,354 --> 00:02:34,555 in terms of, 71 00:02:34,955 --> 00:02:37,134 the rollout and how it's proceeding. 72 00:02:37,514 --> 00:02:39,594 So let me yield to Dan first, and 73 00:02:39,594 --> 00:02:41,995 then I'll come behind to talk about some 74 00:02:41,995 --> 00:02:43,754 of those other questions that you asked, which 75 00:02:43,754 --> 00:02:45,870 are very important as well, if that's okay. 76 00:02:46,110 --> 00:02:48,430 Absolutely. Please, Dan, take it away. Yeah. Thank 77 00:02:48,430 --> 00:02:50,449 you, Karen. I appreciate the kind words. 78 00:02:50,830 --> 00:02:52,370 So it's increasingly 79 00:02:52,669 --> 00:02:53,169 clear 80 00:02:53,629 --> 00:02:55,489 that lifestyle choices choices 81 00:02:56,030 --> 00:02:57,889 drive a number of serious conditions. 82 00:02:58,564 --> 00:03:01,924 So we know that lifestyle choices have impact 83 00:03:01,924 --> 00:03:02,584 on cardiovascular 84 00:03:02,884 --> 00:03:03,944 health and diabetes 85 00:03:04,324 --> 00:03:05,064 and obesity, 86 00:03:05,444 --> 00:03:08,424 but there's cutting edge research actually just released 87 00:03:08,485 --> 00:03:10,264 last week that demonstrates 88 00:03:10,564 --> 00:03:11,064 that 89 00:03:11,420 --> 00:03:12,480 lifestyle modifications 90 00:03:12,860 --> 00:03:14,000 including exercise, 91 00:03:14,300 --> 00:03:15,680 diet, social connectedness, 92 00:03:16,300 --> 00:03:18,000 stress management can meaningfully 93 00:03:18,300 --> 00:03:20,159 impact the trajectory of dementia. 94 00:03:20,460 --> 00:03:22,379 This is truly groundbreaking. When I went to 95 00:03:22,379 --> 00:03:24,159 medical school not so long ago, 96 00:03:24,625 --> 00:03:26,784 we really didn't focus at all on the 97 00:03:26,784 --> 00:03:27,284 impact, 98 00:03:27,985 --> 00:03:28,885 certain lifestyle 99 00:03:29,344 --> 00:03:32,305 choices and behaviors have on this condition. And, 100 00:03:32,305 --> 00:03:34,085 frankly, there were really no 101 00:03:34,465 --> 00:03:37,240 options or very limited options to treat Alzheimer's 102 00:03:37,240 --> 00:03:39,020 and dementia. So this is incredibly 103 00:03:39,480 --> 00:03:41,800 exciting for a clinician and for the leadership 104 00:03:41,800 --> 00:03:42,620 team at EmblemHealth. 105 00:03:43,000 --> 00:03:45,400 In fact, it's now estimated that about forty 106 00:03:45,400 --> 00:03:46,780 percent of dementia cases 107 00:03:47,080 --> 00:03:48,379 are considered preventable 108 00:03:48,760 --> 00:03:49,500 or delayable 109 00:03:50,145 --> 00:03:52,705 by lifestyle choices as well. So this past 110 00:03:52,705 --> 00:03:53,925 week, there are two 111 00:03:54,224 --> 00:03:57,905 groundbreaking studies that were, announced. One was by 112 00:03:57,905 --> 00:04:00,224 our partner, doctor Dean Ornish, who revealed that 113 00:04:00,224 --> 00:04:00,724 positive 114 00:04:01,185 --> 00:04:02,245 lifestyle changes 115 00:04:02,939 --> 00:04:04,879 can impact the trajectory 116 00:04:05,340 --> 00:04:08,719 of patients living with either mild cognitive impairment, 117 00:04:09,180 --> 00:04:12,239 which is the predecessor state to Alzheimer's, 118 00:04:12,539 --> 00:04:14,479 as well as early stage Alzheimer's. 119 00:04:14,780 --> 00:04:16,319 So that was one groundbreaking 120 00:04:16,620 --> 00:04:19,574 study. The other is The US POINTER trial, 121 00:04:19,634 --> 00:04:21,334 which looked at prevention 122 00:04:22,034 --> 00:04:22,534 of 123 00:04:22,834 --> 00:04:23,814 cognitive impairment 124 00:04:24,194 --> 00:04:26,514 for a healthy but at risk population for 125 00:04:26,514 --> 00:04:27,014 dementia. 126 00:04:27,555 --> 00:04:29,654 So we saw these exciting studies, 127 00:04:30,034 --> 00:04:32,370 and we, as a health plan, saw this 128 00:04:32,370 --> 00:04:34,689 was an opportunity to step in and address 129 00:04:34,689 --> 00:04:37,889 this concept of an evidence practice gap. And 130 00:04:37,889 --> 00:04:40,770 what's an evidence practice gap? It's effectively what 131 00:04:40,770 --> 00:04:43,330 innovations have been shown to be effective, but 132 00:04:43,330 --> 00:04:45,750 they really aren't adopted in a wide 133 00:04:46,125 --> 00:04:46,625 scale, 134 00:04:47,085 --> 00:04:50,285 widespread manner. And so we thought at Emblem, 135 00:04:50,285 --> 00:04:52,625 we have clinics, we have neighborhood care centers, 136 00:04:53,324 --> 00:04:55,665 we have the privilege of caring for, 137 00:04:56,205 --> 00:04:58,384 our members, but we could bring this 138 00:04:58,919 --> 00:05:01,479 program to our population and those who need 139 00:05:01,479 --> 00:05:02,060 it most. 140 00:05:02,439 --> 00:05:05,000 And I wanna come right behind where Dan 141 00:05:05,000 --> 00:05:07,560 just took a breath and left off because, 142 00:05:07,560 --> 00:05:09,740 Dan, I think you said something really important 143 00:05:10,039 --> 00:05:13,079 that will be valuable for people listening to 144 00:05:13,079 --> 00:05:13,514 know. 145 00:05:13,995 --> 00:05:16,395 We approach this, Jacob, with, 146 00:05:16,875 --> 00:05:18,014 unique assets. 147 00:05:18,634 --> 00:05:21,754 We have an important physician group, Advantage Care 148 00:05:21,754 --> 00:05:22,254 Physicians, 149 00:05:22,715 --> 00:05:23,215 affiliated 150 00:05:23,675 --> 00:05:27,229 as a partner within our health plan ecosystem. 151 00:05:28,169 --> 00:05:31,470 We also have done something very, very unique 152 00:05:31,689 --> 00:05:32,669 around the country. 153 00:05:33,050 --> 00:05:33,709 We have 154 00:05:34,169 --> 00:05:35,389 set we have established 155 00:05:35,769 --> 00:05:37,470 invested in the establishment 156 00:05:38,250 --> 00:05:38,990 of 15 157 00:05:39,824 --> 00:05:40,324 offices 158 00:05:41,024 --> 00:05:44,245 where anybody in the community can come in, 159 00:05:44,464 --> 00:05:46,164 get help with social determinants, 160 00:05:47,024 --> 00:05:49,204 help with health care issues, 161 00:05:49,664 --> 00:05:50,884 help with transportation, 162 00:05:51,584 --> 00:05:52,084 housing, 163 00:05:52,449 --> 00:05:53,270 food insecurity. 164 00:05:53,810 --> 00:05:55,410 They can take a class. They can have 165 00:05:55,410 --> 00:05:56,389 a cup of coffee. 166 00:05:56,850 --> 00:06:00,290 So we approach this once Dan had this 167 00:06:00,290 --> 00:06:02,850 idea of doing the right thing for our 168 00:06:02,850 --> 00:06:04,754 members and being on the 169 00:06:05,154 --> 00:06:06,055 leading edge 170 00:06:06,514 --> 00:06:08,295 of change and innovation, 171 00:06:08,915 --> 00:06:11,235 we approached it with how do we partner 172 00:06:11,235 --> 00:06:14,435 with physicians, primary care physicians, to do the 173 00:06:14,435 --> 00:06:18,214 baseline cognitive tests. Our advantage care physician leaders 174 00:06:18,449 --> 00:06:19,990 and the leader of that organization 175 00:06:20,610 --> 00:06:21,110 responded 176 00:06:21,650 --> 00:06:22,629 almost immediately 177 00:06:22,930 --> 00:06:25,750 to this notion that we could do something 178 00:06:25,810 --> 00:06:26,310 important. 179 00:06:26,610 --> 00:06:28,629 So the advantage care physician 180 00:06:28,930 --> 00:06:30,629 primary care team, 181 00:06:30,930 --> 00:06:32,310 they're doing the assessments. 182 00:06:32,745 --> 00:06:34,204 They will be the benchmarking 183 00:06:34,584 --> 00:06:36,204 for us as we go through 184 00:06:36,504 --> 00:06:38,125 and chronicle the results. 185 00:06:38,504 --> 00:06:40,904 And then our what Dan described is our 186 00:06:40,904 --> 00:06:42,204 neighborhood care centers 187 00:06:42,904 --> 00:06:44,204 in the most underserved 188 00:06:44,665 --> 00:06:45,165 areas 189 00:06:45,759 --> 00:06:48,319 of the five boroughs of New York will 190 00:06:48,319 --> 00:06:49,699 be the opportunity 191 00:06:50,240 --> 00:06:50,980 for people 192 00:06:51,360 --> 00:06:53,520 not only to do, and Dan will talk 193 00:06:53,520 --> 00:06:56,800 about, the online support, the coaching we're gonna 194 00:06:56,800 --> 00:06:59,324 be doing, the food we're gonna be giving 195 00:06:59,324 --> 00:06:59,824 out, 196 00:07:00,204 --> 00:07:02,764 but to make sure that everybody is able 197 00:07:02,764 --> 00:07:03,264 to 198 00:07:03,725 --> 00:07:06,685 meet the requirements of lifestyle medicine, and we're 199 00:07:06,685 --> 00:07:08,764 doing everything we can to provide a health 200 00:07:08,764 --> 00:07:10,704 in hand. But in addition, 201 00:07:11,250 --> 00:07:14,150 they can go into our neighborhood care centers. 202 00:07:14,610 --> 00:07:17,330 They can ask questions about the program. They 203 00:07:17,330 --> 00:07:20,310 can take a class. We'll have cooking classes. 204 00:07:20,529 --> 00:07:23,589 We'll have the, kind of coaching, 205 00:07:24,689 --> 00:07:25,670 in the community 206 00:07:26,264 --> 00:07:28,425 that you would expect for this kind of 207 00:07:28,425 --> 00:07:30,604 lifestyle medicine support program. 208 00:07:30,985 --> 00:07:32,584 So we come to it with it's almost 209 00:07:32,584 --> 00:07:35,064 a three legged stool. The health plan, the 210 00:07:35,064 --> 00:07:37,485 physician group, and neighborhood care, 211 00:07:37,785 --> 00:07:39,564 all working synergistically 212 00:07:40,480 --> 00:07:43,279 to help advance the health of the people 213 00:07:43,279 --> 00:07:44,980 that we serve in New York. 214 00:07:45,759 --> 00:07:47,759 Absolutely. And it really is incredible what you 215 00:07:47,759 --> 00:07:50,080 both are describing that your members are gonna 216 00:07:50,080 --> 00:07:52,420 be able to take advantage of these groundbreaking 217 00:07:52,879 --> 00:07:53,379 clinical, 218 00:07:54,160 --> 00:07:56,514 research. And then to your point, Karen, this 219 00:07:56,514 --> 00:07:58,535 integrated care model will be able to deliver 220 00:07:58,995 --> 00:08:00,295 that even more effectively, 221 00:08:00,754 --> 00:08:01,654 to your population. 222 00:08:02,035 --> 00:08:03,795 I do wanna touch on the neighborhood care 223 00:08:03,795 --> 00:08:06,274 centers a bit more, as we go. But 224 00:08:06,274 --> 00:08:08,355 before that, Dan, I wanna come back to 225 00:08:08,355 --> 00:08:10,375 you and ask a bit more about 226 00:08:10,750 --> 00:08:11,569 doctor Ornish's, 227 00:08:12,269 --> 00:08:15,310 his his proven success with lifestyle medicine and 228 00:08:15,310 --> 00:08:15,810 reversing 229 00:08:16,269 --> 00:08:18,290 chronic conditions like heart disease. 230 00:08:19,069 --> 00:08:20,750 What what are some of the results that 231 00:08:20,750 --> 00:08:23,729 you're anticipating on the ground for the participants 232 00:08:23,790 --> 00:08:24,689 in this program? 233 00:08:25,045 --> 00:08:26,324 And and, ultimately, how are you gonna be 234 00:08:26,324 --> 00:08:28,025 measuring that success over time? 235 00:08:28,564 --> 00:08:31,125 Yeah. Great question. So I'll just start off 236 00:08:31,125 --> 00:08:33,125 by saying, you know, we're doing something that 237 00:08:33,125 --> 00:08:35,365 no other health plan has done. We're bringing 238 00:08:35,365 --> 00:08:39,044 a clinically validated Alzheimer's lifestyle program for the 239 00:08:39,044 --> 00:08:41,230 people who need it most, but we're also 240 00:08:41,230 --> 00:08:44,110 measuring it in the real world. So what 241 00:08:44,110 --> 00:08:46,610 we're doing is not just covering the program, 242 00:08:46,669 --> 00:08:48,929 we're deploying a strategic approach. 243 00:08:49,389 --> 00:08:52,209 I would compare it to coverage with evidence 244 00:08:52,269 --> 00:08:53,809 development, which is a CMS 245 00:08:54,375 --> 00:08:57,835 framework where we provide access to this breakthrough 246 00:08:58,215 --> 00:09:01,495 approach, but we're really generating real world evidence 247 00:09:01,495 --> 00:09:02,795 to determine the effectiveness 248 00:09:03,254 --> 00:09:05,595 of this program in a diverse urban population 249 00:09:05,735 --> 00:09:07,754 like we have at in New York City. 250 00:09:08,120 --> 00:09:11,000 So what we'll be doing is, we'll be 251 00:09:11,000 --> 00:09:13,080 checking in with our members who are enrolled 252 00:09:13,080 --> 00:09:13,899 in the program 253 00:09:14,600 --> 00:09:15,659 and ascertaining 254 00:09:16,200 --> 00:09:17,019 their overall 255 00:09:17,399 --> 00:09:19,799 sense of wellness and well-being here. We're gonna 256 00:09:19,799 --> 00:09:22,379 be using something called the Clinical Global Impression 257 00:09:22,600 --> 00:09:23,100 Scale, 258 00:09:23,534 --> 00:09:24,274 which assesses 259 00:09:24,975 --> 00:09:27,154 cognitive function, overall well-being, 260 00:09:27,855 --> 00:09:30,174 impact of the program, sense of health and 261 00:09:30,174 --> 00:09:30,674 well-being, 262 00:09:31,454 --> 00:09:33,134 as well. And so this is a way 263 00:09:33,134 --> 00:09:36,195 of us tracking our members through the program 264 00:09:36,334 --> 00:09:36,834 longitudinally 265 00:09:37,460 --> 00:09:40,419 to really ascertain if this program can be 266 00:09:40,419 --> 00:09:41,480 further scaled, 267 00:09:41,940 --> 00:09:42,440 nationally. 268 00:09:43,460 --> 00:09:45,860 And I think just what you said there 269 00:09:45,860 --> 00:09:47,240 is really important, 270 00:09:48,019 --> 00:09:48,759 in terms 271 00:09:49,139 --> 00:09:51,299 of wanting you're gonna be your intent is 272 00:09:51,299 --> 00:09:53,320 to publish the results, to be 273 00:09:53,804 --> 00:09:54,785 very transparent 274 00:09:55,245 --> 00:09:57,325 about how this goes. We feel that we 275 00:09:57,325 --> 00:10:00,285 have an obligation to do this, as Dan 276 00:10:00,285 --> 00:10:03,825 said, for the field and for the broader 277 00:10:03,884 --> 00:10:04,384 understanding 278 00:10:04,845 --> 00:10:05,345 about 279 00:10:05,740 --> 00:10:08,059 the importance of lifestyle medicine and what it 280 00:10:08,059 --> 00:10:10,220 can actually do. And then, Dan, as you 281 00:10:10,220 --> 00:10:12,700 were talking, it just occurred to me, doctor 282 00:10:12,700 --> 00:10:16,160 Ornish, for decades, has issued a clarion call 283 00:10:16,220 --> 00:10:18,879 about the importance of lifestyle medicine. 284 00:10:19,264 --> 00:10:21,845 And I think it's exciting now the field 285 00:10:21,904 --> 00:10:25,024 is generally beginning to catch up, and there's 286 00:10:25,024 --> 00:10:25,764 far more 287 00:10:26,384 --> 00:10:26,884 understanding 288 00:10:27,585 --> 00:10:28,085 about 289 00:10:28,544 --> 00:10:29,845 the role that lifestyle 290 00:10:30,384 --> 00:10:32,725 plays in an individual's health. 291 00:10:33,024 --> 00:10:34,965 And I think, Jacob, for us, 292 00:10:35,389 --> 00:10:37,009 that's gonna be an opportunity 293 00:10:37,789 --> 00:10:40,690 not only in this program for these members, 294 00:10:40,990 --> 00:10:43,410 but to really take account of the effects 295 00:10:43,470 --> 00:10:46,370 we're seeing so that we can determine whether, 296 00:10:47,070 --> 00:10:48,610 other clinical conditions 297 00:10:48,910 --> 00:10:50,924 can benefit from it. And, Dan, I know 298 00:10:50,924 --> 00:10:51,825 you've been thinking 299 00:10:52,204 --> 00:10:55,745 about cardiology. It's very well established, but other 300 00:10:55,884 --> 00:10:56,384 conditions 301 00:10:56,764 --> 00:10:57,264 that 302 00:10:57,644 --> 00:10:59,184 where these interventions 303 00:10:59,725 --> 00:11:00,865 could make a difference. 304 00:11:01,325 --> 00:11:03,904 And the only other point to add here 305 00:11:04,044 --> 00:11:04,544 is, 306 00:11:04,899 --> 00:11:07,559 Dan, you might talk about how intensive 307 00:11:08,500 --> 00:11:11,639 the, activity, the instruction, the support 308 00:11:12,100 --> 00:11:14,659 is going to be for members and what 309 00:11:14,659 --> 00:11:17,000 we're asking from them to participate 310 00:11:17,785 --> 00:11:20,345 and, the time we're asking them to give 311 00:11:20,345 --> 00:11:23,144 to really move the mark. So it is 312 00:11:23,144 --> 00:11:24,044 very serious, 313 00:11:24,345 --> 00:11:27,384 very scientific based program. But you might talk 314 00:11:27,384 --> 00:11:28,904 about that because I think people would be 315 00:11:28,904 --> 00:11:29,644 very interested. 316 00:11:30,720 --> 00:11:32,960 Yeah. Absolutely. So, Jacob, I'll tell you a 317 00:11:32,960 --> 00:11:35,279 little bit about how we're actually identifying these 318 00:11:35,279 --> 00:11:38,580 folks, enrolling them, and then supporting them holistically 319 00:11:38,639 --> 00:11:40,720 as Karen said. So I think first and 320 00:11:40,720 --> 00:11:43,200 foremost, we're looking into our population of Emblem 321 00:11:43,200 --> 00:11:45,700 members who could benefit from this program potentially, 322 00:11:46,134 --> 00:11:47,815 and we're doing that by looking at claims 323 00:11:47,815 --> 00:11:50,454 data and demographic data. And so we have 324 00:11:50,454 --> 00:11:52,855 a nurse who calls the member directly, you 325 00:11:52,855 --> 00:11:54,615 know, building off the trust we have with 326 00:11:54,615 --> 00:11:57,495 the with the individual, explaining the program, and 327 00:11:57,495 --> 00:11:59,815 informing them on next steps. And so the 328 00:11:59,815 --> 00:12:01,820 next step is for them to have a 329 00:12:01,820 --> 00:12:04,960 conversation with their primary care doctor at ACPNY, 330 00:12:05,980 --> 00:12:07,980 where we're able to screen them for their 331 00:12:07,980 --> 00:12:09,759 cognitive health through a validated, 332 00:12:10,220 --> 00:12:12,560 clinical screener called the MoCA test. 333 00:12:12,940 --> 00:12:14,160 And what we're really 334 00:12:14,665 --> 00:12:17,785 benefiting from is that longitudinal relationship we already 335 00:12:17,785 --> 00:12:18,764 have with the patient. 336 00:12:19,225 --> 00:12:21,625 And then from then, we can enroll them 337 00:12:21,625 --> 00:12:23,545 into this program. And so the program, as 338 00:12:23,545 --> 00:12:26,904 Karen mentioned, is quite rigorous. So it's both 339 00:12:26,904 --> 00:12:30,129 online in partnership with doctor Ornish, but also 340 00:12:30,129 --> 00:12:32,610 in person with our neighborhood care centers. And 341 00:12:32,610 --> 00:12:34,789 so participates will be, 342 00:12:35,730 --> 00:12:37,889 engaged up to forty weeks. What we'll be 343 00:12:37,889 --> 00:12:38,769 doing is, 344 00:12:39,169 --> 00:12:41,909 first and foremost, giving them access to nutritious 345 00:12:42,289 --> 00:12:44,629 plant based whole food meals and snacks, 346 00:12:45,215 --> 00:12:47,394 all while teaching them the benefits 347 00:12:47,935 --> 00:12:50,435 of preparing their own meals through cooking classes. 348 00:12:50,495 --> 00:12:53,615 Right? And what's kind of, particularly exciting for 349 00:12:53,615 --> 00:12:55,055 me because I'm a bit of a foodie 350 00:12:55,055 --> 00:12:56,835 is we've teamed up with four 351 00:12:57,399 --> 00:12:59,240 award winning chefs that are based in New 352 00:12:59,240 --> 00:13:01,080 York City, and they they will actually be 353 00:13:01,080 --> 00:13:02,220 designing the food. 354 00:13:02,519 --> 00:13:05,259 So as we know, food is very personal 355 00:13:05,559 --> 00:13:07,960 and an important element to most people's lives. 356 00:13:07,960 --> 00:13:09,799 And so we really wanna make sure their 357 00:13:09,799 --> 00:13:10,299 experience 358 00:13:11,035 --> 00:13:13,375 within this program is joyful, and, 359 00:13:13,835 --> 00:13:15,855 and it really will, we believe, 360 00:13:16,394 --> 00:13:18,095 encourage them to stay adherent, 361 00:13:18,634 --> 00:13:22,014 to the program. Right? And culturally culturally sensitive 362 00:13:22,154 --> 00:13:24,075 too. You've spent a lot of time thinking 363 00:13:24,075 --> 00:13:26,450 about that with your chefs, I know. 364 00:13:26,830 --> 00:13:28,750 Absolutely. Yeah. I mean, we live in the 365 00:13:28,750 --> 00:13:31,230 most culturally diverse, city in the world, I'd 366 00:13:31,230 --> 00:13:33,309 say. And so we acknowledge that, you know, 367 00:13:33,309 --> 00:13:34,690 food is highly culturally, 368 00:13:35,710 --> 00:13:37,710 tailored to the individuals we're caring for. So 369 00:13:37,710 --> 00:13:39,585 that's why we have four chefs that are 370 00:13:39,585 --> 00:13:41,264 based in New York City and involved in 371 00:13:41,264 --> 00:13:43,924 this program. The program will focus on, 372 00:13:44,465 --> 00:13:47,125 daily moderate exercise and strength training. 373 00:13:47,504 --> 00:13:48,565 I'm also teaching, 374 00:13:49,105 --> 00:13:50,565 the participants techniques 375 00:13:50,945 --> 00:13:52,485 designed to promote relaxation 376 00:13:52,945 --> 00:13:53,684 and stress. 377 00:13:54,159 --> 00:13:57,320 That's available online. It's also available at our 378 00:13:57,320 --> 00:13:59,600 at our neighborhood care centers across all five 379 00:13:59,600 --> 00:14:00,100 boroughs. 380 00:14:00,480 --> 00:14:02,659 So and the participants can, 381 00:14:03,120 --> 00:14:06,320 engage in group exercise, yoga, tai chi, learn 382 00:14:06,320 --> 00:14:08,799 mindfulness, and stress management at neighborhood care as 383 00:14:08,799 --> 00:14:09,914 well. We'll 384 00:14:10,215 --> 00:14:12,054 we'll even be hosting cooking classes at our 385 00:14:12,054 --> 00:14:13,195 neighborhood care centers. 386 00:14:13,815 --> 00:14:16,375 And then finally, an important component to the 387 00:14:16,375 --> 00:14:19,654 program is social connectedness. So we'll actually be 388 00:14:19,654 --> 00:14:20,154 hosting 389 00:14:20,535 --> 00:14:24,329 online small supportive groups where people can discuss 390 00:14:24,470 --> 00:14:25,929 their journey, their transformation, 391 00:14:26,629 --> 00:14:28,089 their engagement with the program. 392 00:14:28,470 --> 00:14:29,850 So this is a really 393 00:14:30,230 --> 00:14:32,009 robust holistic program, 394 00:14:32,709 --> 00:14:33,209 that, 395 00:14:33,750 --> 00:14:36,254 aims to really equip these people with the 396 00:14:36,254 --> 00:14:38,815 tools and the resources to engage on this 397 00:14:38,815 --> 00:14:41,955 lifelong journey of a more, helpful lifestyle. 398 00:14:42,654 --> 00:14:44,174 And what you just said, I think, is 399 00:14:44,174 --> 00:14:44,995 so important. 400 00:14:45,535 --> 00:14:46,035 Just 401 00:14:46,654 --> 00:14:47,475 it is, 402 00:14:48,690 --> 00:14:51,829 when you ask people to make such significant 403 00:14:51,970 --> 00:14:52,470 changes, 404 00:14:53,250 --> 00:14:54,230 having the opportunity 405 00:14:54,690 --> 00:14:57,409 to talk with other people who are going 406 00:14:57,409 --> 00:15:00,209 through the same thing you are, there's power, 407 00:15:00,209 --> 00:15:01,730 I think, in that. And I think we'll 408 00:15:01,730 --> 00:15:02,789 be learning that, 409 00:15:03,164 --> 00:15:05,565 Jacob, as we go. And I know Dan's 410 00:15:05,565 --> 00:15:07,264 gonna be very acutely 411 00:15:07,644 --> 00:15:08,845 aware and, 412 00:15:09,325 --> 00:15:12,125 very, very focused on what are the things 413 00:15:12,125 --> 00:15:14,625 we're learning, what works the best, etcetera. 414 00:15:15,004 --> 00:15:19,309 But creating groups where people can participate together 415 00:15:19,929 --> 00:15:20,429 and 416 00:15:20,730 --> 00:15:21,230 commiserate 417 00:15:21,610 --> 00:15:22,110 together. 418 00:15:22,490 --> 00:15:24,269 I think that's really important, 419 00:15:24,970 --> 00:15:25,710 to kind 420 00:15:26,570 --> 00:15:29,129 of instill the changes that are gonna be 421 00:15:29,129 --> 00:15:29,950 so important 422 00:15:30,330 --> 00:15:31,804 for these individuals 423 00:15:32,424 --> 00:15:34,605 to have a chance when heretofore 424 00:15:35,225 --> 00:15:38,205 with early stage dementia, Alzheimer's, etcetera, 425 00:15:38,585 --> 00:15:40,285 there hasn't been many chances. 426 00:15:41,144 --> 00:15:44,264 And so that's part of the excitement for 427 00:15:44,264 --> 00:15:44,745 us to, 428 00:15:45,539 --> 00:15:47,700 not only to do the right thing for 429 00:15:47,700 --> 00:15:48,360 our members, 430 00:15:48,740 --> 00:15:50,580 but to see if we can contribute to 431 00:15:50,580 --> 00:15:51,799 the broader understanding 432 00:15:52,179 --> 00:15:55,320 of exactly how to do the right thing. 433 00:15:55,620 --> 00:15:57,794 And that's what's exciting is I, you know, 434 00:15:57,794 --> 00:15:59,095 have been watching 435 00:15:59,634 --> 00:16:02,695 this program that Dan has begun 436 00:16:03,235 --> 00:16:05,735 just get from, you know, the the beginnings 437 00:16:06,034 --> 00:16:08,215 to thought stages to now actually 438 00:16:08,674 --> 00:16:10,934 rolling out for particular people. 439 00:16:12,110 --> 00:16:14,129 Certainly. This this is clearly 440 00:16:14,669 --> 00:16:17,629 so groundbreaking, what you both are describing, and 441 00:16:17,629 --> 00:16:19,789 the passion that you both have for this 442 00:16:19,789 --> 00:16:22,429 is is really coming through. I can't imagine 443 00:16:22,429 --> 00:16:24,110 a better place to launch something like this 444 00:16:24,110 --> 00:16:25,870 than what you both have described in in 445 00:16:25,870 --> 00:16:26,929 in the most diverse, 446 00:16:27,524 --> 00:16:29,684 place on the planet. And, you know, I 447 00:16:29,684 --> 00:16:31,924 think this is really going to resonate with 448 00:16:31,924 --> 00:16:34,245 with the other health plan leaders listening in 449 00:16:34,245 --> 00:16:36,084 right now, in terms of, 450 00:16:36,485 --> 00:16:38,804 eventually, the results that you publish, how it 451 00:16:38,804 --> 00:16:42,084 could impact their membership and other communities around 452 00:16:42,084 --> 00:16:44,460 the country. So I wonder if you could 453 00:16:44,460 --> 00:16:46,779 speak to that, Karen, in terms of how 454 00:16:46,779 --> 00:16:48,879 do you foresee this partnership and this program? 455 00:16:49,019 --> 00:16:51,679 What could this mean for the wider insurance 456 00:16:51,740 --> 00:16:55,360 industry in terms of incorporating more lifestyle 457 00:16:55,660 --> 00:16:56,879 interventions into 458 00:16:57,404 --> 00:17:00,544 conventional treatment plans for for diseases like Alzheimer's? 459 00:17:01,004 --> 00:17:03,004 I I'm happy to have an opportunity, and 460 00:17:03,004 --> 00:17:05,325 I know Dan's gonna wanna say have some 461 00:17:05,325 --> 00:17:07,164 very thoughtful things to say about this as 462 00:17:07,164 --> 00:17:07,664 well. 463 00:17:08,125 --> 00:17:08,625 First, 464 00:17:09,005 --> 00:17:11,265 I it it is fair to say 465 00:17:11,940 --> 00:17:14,980 that when we think about public health, when 466 00:17:14,980 --> 00:17:16,679 we think about health improvement, 467 00:17:17,539 --> 00:17:20,200 the health plan community is not the first 468 00:17:20,419 --> 00:17:23,079 community that pea that come to people's minds, 469 00:17:23,994 --> 00:17:26,154 without a doubt. But if you step back 470 00:17:26,154 --> 00:17:26,815 and think, 471 00:17:27,194 --> 00:17:30,075 we are the only entity within the health 472 00:17:30,075 --> 00:17:30,815 care ecosystem 473 00:17:31,835 --> 00:17:35,134 that actually touches patients in every encounter, 474 00:17:35,595 --> 00:17:38,174 hospitals, physicians, nursing homes, 475 00:17:38,549 --> 00:17:39,049 technology, 476 00:17:39,430 --> 00:17:41,529 you name it, we touch them, 477 00:17:41,910 --> 00:17:43,049 that we are uniquely 478 00:17:43,350 --> 00:17:43,850 suited 479 00:17:44,630 --> 00:17:46,549 not only and I think now it's become 480 00:17:46,549 --> 00:17:49,529 well established that people are beginning to understand 481 00:17:49,590 --> 00:17:52,390 how uniquely suit suited we are to address 482 00:17:52,390 --> 00:17:53,450 social determinants. 483 00:17:54,755 --> 00:17:57,875 Where uniquely because we are touching people, we 484 00:17:57,875 --> 00:17:59,815 can see, and they talk to our caregivers 485 00:18:00,115 --> 00:18:03,154 and our customer service agents. So to have 486 00:18:03,154 --> 00:18:05,634 the opportunity to provide that help back to 487 00:18:05,634 --> 00:18:08,134 them is very exciting and satisfying. 488 00:18:08,990 --> 00:18:10,850 Similarly, in this regard, 489 00:18:11,309 --> 00:18:12,609 I think, individuals 490 00:18:13,789 --> 00:18:15,009 have not policy 491 00:18:15,549 --> 00:18:16,049 leaders, 492 00:18:16,509 --> 00:18:17,009 theoreticians 493 00:18:17,950 --> 00:18:20,529 have not really thought of this health community 494 00:18:20,990 --> 00:18:23,009 that we represent and the payer community 495 00:18:23,630 --> 00:18:26,404 as a key, a secret sauce, if you 496 00:18:26,404 --> 00:18:27,785 will, to health improvement. 497 00:18:28,325 --> 00:18:29,865 But what Dan is describing 498 00:18:30,325 --> 00:18:32,184 and what we're able to marshal 499 00:18:32,644 --> 00:18:33,945 in terms of resources, 500 00:18:34,404 --> 00:18:35,945 support, the comprehensiveness 501 00:18:36,725 --> 00:18:38,825 of it, the ability to monitor, 502 00:18:39,309 --> 00:18:39,809 etcetera, 503 00:18:40,349 --> 00:18:41,490 is really a demonstration 504 00:18:42,190 --> 00:18:42,690 that 505 00:18:43,070 --> 00:18:44,450 we can actually 506 00:18:45,390 --> 00:18:47,789 play such an important role as a health 507 00:18:47,789 --> 00:18:48,289 plan 508 00:18:48,670 --> 00:18:49,970 in health improvement. 509 00:18:50,670 --> 00:18:52,289 And I think over time, 510 00:18:52,910 --> 00:18:53,384 as 511 00:18:53,785 --> 00:18:55,644 we we see more innovations, 512 00:18:56,025 --> 00:18:57,005 as we see 513 00:18:57,305 --> 00:19:01,484 more pilots, as we see more discussions about 514 00:19:01,945 --> 00:19:03,805 value based care, etcetera, 515 00:19:04,345 --> 00:19:05,964 that really moves the needle. 516 00:19:06,424 --> 00:19:08,440 I think more and more individuals 517 00:19:08,820 --> 00:19:12,119 will understand the role that we play and 518 00:19:12,339 --> 00:19:14,759 the value of that ability to touch 519 00:19:15,059 --> 00:19:15,559 individuals 520 00:19:16,019 --> 00:19:19,080 in every health care context they find themselves 521 00:19:19,460 --> 00:19:20,839 in. But it's our job 522 00:19:21,164 --> 00:19:22,144 as health plans 523 00:19:22,684 --> 00:19:23,184 to 524 00:19:23,485 --> 00:19:26,205 be not only open to that, but be 525 00:19:26,205 --> 00:19:28,525 very focused on that as part of our 526 00:19:28,525 --> 00:19:29,025 mission. 527 00:19:29,404 --> 00:19:32,465 And I think patients and members expect that, 528 00:19:32,605 --> 00:19:34,125 and I think you'll see more from the 529 00:19:34,125 --> 00:19:35,265 health plan community 530 00:19:35,680 --> 00:19:37,460 in these kinds of efforts. 531 00:19:37,920 --> 00:19:39,140 Dan, go ahead. 532 00:19:39,519 --> 00:19:41,200 No. I couldn't agree with you more. I 533 00:19:41,200 --> 00:19:42,339 think it was you said 534 00:19:42,960 --> 00:19:45,200 so many great points, Karen. I'll just, 535 00:19:45,599 --> 00:19:47,200 I guess I would just wrap by saying 536 00:19:47,200 --> 00:19:49,454 that there are too many clinical innovations that 537 00:19:49,855 --> 00:19:51,294 never make it in the hands of people 538 00:19:51,294 --> 00:19:53,634 who need it the most. Yeah. That's right. 539 00:19:54,015 --> 00:19:56,015 Yeah. I mean, I think we're flipping the 540 00:19:56,015 --> 00:19:58,974 script here at EmblemHealth by bringing brain health 541 00:19:58,974 --> 00:20:02,015 into the community, into primary care, into the 542 00:20:02,015 --> 00:20:05,619 neighborhood hoods we're caring for, in those under 543 00:20:05,920 --> 00:20:07,059 traditionally underserved, 544 00:20:08,160 --> 00:20:09,619 communities. Right? So, 545 00:20:10,079 --> 00:20:13,039 I think by deploying this lifestyle program and 546 00:20:13,039 --> 00:20:16,079 studying it rigorously through the development of evidence 547 00:20:16,079 --> 00:20:18,339 in a real world evidence study, 548 00:20:18,924 --> 00:20:20,605 where we have the opportunity to pull forward 549 00:20:20,605 --> 00:20:22,525 the future because the future really is a 550 00:20:22,525 --> 00:20:23,025 holistic, 551 00:20:23,805 --> 00:20:24,305 treatment 552 00:20:24,845 --> 00:20:26,865 approach that contemplates pharmacotherapy 553 00:20:27,244 --> 00:20:30,144 but also contemplates intensive lifestyle changes. 554 00:20:30,940 --> 00:20:33,279 That's just incredible. Before we go, 555 00:20:33,900 --> 00:20:36,059 anything else either of you wanna add? I 556 00:20:36,059 --> 00:20:37,740 know, Dan, you you mentioned that with some 557 00:20:37,740 --> 00:20:39,259 of your closing thoughts. Is there anything else, 558 00:20:39,259 --> 00:20:39,759 Karen, 559 00:20:40,140 --> 00:20:41,920 you you wanna share with our listeners? 560 00:20:42,299 --> 00:20:44,619 I would just say one thing that Dan 561 00:20:44,619 --> 00:20:46,654 and I have been talking about quite a 562 00:20:46,654 --> 00:20:47,714 lot in 563 00:20:48,255 --> 00:20:49,154 this context. 564 00:20:50,174 --> 00:20:51,954 The number one 565 00:20:52,255 --> 00:20:52,755 reason 566 00:20:53,375 --> 00:20:54,275 that individuals 567 00:20:54,734 --> 00:20:55,234 today 568 00:20:55,615 --> 00:20:58,194 are coming into our neighborhood care centers, 569 00:20:59,179 --> 00:21:00,400 It used to be 570 00:21:00,779 --> 00:21:02,480 help with health concerns, 571 00:21:02,859 --> 00:21:03,359 questions, 572 00:21:03,980 --> 00:21:05,440 wanting to take a class. 573 00:21:05,740 --> 00:21:07,279 All of that is still true. 574 00:21:07,740 --> 00:21:10,700 The number one reason for people to enter 575 00:21:10,700 --> 00:21:12,700 those doors and we serve everyone in the 576 00:21:12,700 --> 00:21:14,140 community. You do not have to be a 577 00:21:14,140 --> 00:21:14,640 member 578 00:21:15,234 --> 00:21:15,815 of EmblemHealth, 579 00:21:16,595 --> 00:21:18,375 and it's free to the community. 580 00:21:19,075 --> 00:21:21,154 The number one reason people walk into the 581 00:21:21,154 --> 00:21:23,494 doors today is food insecurity. 582 00:21:24,274 --> 00:21:25,734 So Dan's program 583 00:21:26,674 --> 00:21:30,039 to not only help people learn to eat 584 00:21:30,339 --> 00:21:31,720 healthy, how to do that, 585 00:21:32,019 --> 00:21:34,259 how to shop healthy in a bodega, for 586 00:21:34,259 --> 00:21:34,759 example, 587 00:21:35,140 --> 00:21:38,200 how to prepare healthy meals, but also to 588 00:21:38,419 --> 00:21:41,140 have the ability to give them food that 589 00:21:41,140 --> 00:21:41,640 demonstrates 590 00:21:42,019 --> 00:21:44,440 what they're learning and being taught 591 00:21:45,095 --> 00:21:48,154 and able to replicate this for their families. 592 00:21:48,855 --> 00:21:49,515 I think 593 00:21:49,894 --> 00:21:52,154 Jacob is really an opportunity 594 00:21:53,015 --> 00:21:56,234 to make significant changes for people 595 00:21:56,615 --> 00:21:57,595 who heretofore 596 00:21:58,214 --> 00:21:58,875 have had 597 00:21:59,255 --> 00:22:01,589 very little hope. So that's what makes me 598 00:22:01,589 --> 00:22:02,650 proud about 599 00:22:02,950 --> 00:22:03,450 EmblemHealth 600 00:22:03,829 --> 00:22:05,369 and what we are doing 601 00:22:05,750 --> 00:22:06,730 and to be, 602 00:22:07,190 --> 00:22:10,309 here with Dan, our chief medical officer, who's 603 00:22:10,309 --> 00:22:14,070 been so forward thinking about the opportunities here. 604 00:22:14,070 --> 00:22:16,605 How do we take advantage of them? And 605 00:22:16,605 --> 00:22:17,744 how do we do something 606 00:22:18,204 --> 00:22:19,105 that is 607 00:22:19,644 --> 00:22:20,144 really 608 00:22:20,605 --> 00:22:21,105 innovative 609 00:22:21,724 --> 00:22:25,085 for our members. And we're an ecosystem of 610 00:22:25,085 --> 00:22:25,585 innovation 611 00:22:25,884 --> 00:22:26,625 at EmblemHealth, 612 00:22:26,924 --> 00:22:30,304 but this is a a proof positive of, 613 00:22:30,519 --> 00:22:32,519 you know, just making a difference in a 614 00:22:32,519 --> 00:22:34,920 community. I think that's what we're gonna find 615 00:22:34,920 --> 00:22:36,859 here, and that excites me. 616 00:22:37,319 --> 00:22:37,980 It's wonderful. 617 00:22:38,359 --> 00:22:40,759 Well, Karen, doctor Nekt, I wanna thank you 618 00:22:40,759 --> 00:22:42,920 both for taking the time out of your 619 00:22:42,920 --> 00:22:44,839 days to to sit down with us and 620 00:22:44,839 --> 00:22:48,075 for sharing about the impactful work that's going 621 00:22:48,075 --> 00:22:50,174 on under your leadership at EmblemHealth. 622 00:22:50,475 --> 00:22:51,934 We we really appreciate it. 623 00:22:52,394 --> 00:22:54,634 Thank you. And to our listeners, if you'd 624 00:22:54,634 --> 00:22:56,955 like to listen to more podcasts from Becker's 625 00:22:56,955 --> 00:23:00,414 Healthcare, you can visit beckershospitalreview.com.