Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast.
Thrilled today to be joined by Richard Green,
who is the president of CleverCare Health Plan.
Richard, thank you so much for taking the
time to be with me on the podcast
today. Thank you, Jacob. It's my pleasure.
Absolutely. And, Richard, before we dive into everything
we wanna talk with you about, can you
tell us a little bit more about yourself,
your background in health care, and what it
is that you do today at CleverCare?
Happy to. I'm the president of CleverCare health
plan.
CleverCare was founded to provide a culturally sensitive
and competent Medicare Advantage health plan.
We give members access to care that's delivered
in their own language and with their own
unique cultural traditions in mind. And we have
a value based care model that essentially blends
eastern and western.
Moved into the role of president, where I
oversee the day
moved into the role of
president where I oversee the day to day
operations of the company as well as the
financial strategy.
Before,
joining CleverCare,
I
really dedicated my career nearly thirty years to,
financial and operations
roles across both payers as well as groups.
And most recently, I served as the COO
and CFO of AppleCare
Medical Management, which was one of the first
acquisitions
within OptumCare.
Wonderful. Well, like I said, we really appreciate
you taking the time to join us today,
Richard. And I I wanted to get started
by talking about some recent news from CleverCare.
The company has just opened its its new
flagship community center,
and which is now the fourth CleverCare community
center in California as I understand it. So
talk to us a little bit about this
new center and and what role your community
centers play in in the overall growth and
retention strategy at CleverCare and how you wanna
measure their impact on on member experience, on
outcomes,
engagement. Give our listeners a full picture of
of how you're thinking about this.
Absolutely.
You're right. The Rolling Heights Community Center is
our fourth location, and our community centers
are really at the heart of our mission.
And these centers are part of how we
invest in our members and deliver
on our commitment
of being a reliable partner.
What makes the center special is that they
blend eastern and western approaches to wellness.
Our members can attend tai chi classes,
participate in community classes on mental health
and dental care,
or come together for
community
building events that might include
lessons on technology,
book clubs, birthday celebrations.
And we even have,
found some talent within both our associates and
our members with, live music. We like to
do a lot of, sing alongs.
Everything is offered
in
languages primarily spoken by our members
covering, Mandarin, Cantonese, Vietnamese, and Korean.
The Rowland Heights Center,
as I mentioned, is our fourth center joining
our centers in Monterey Park,
Westminster,
and Koreatown.
In 2024,
our three
legacy
centers generated nearly four, 18,000 visits, which tells
generated nearly four, 18,000 visits, which tells us
our members are actively engaging,
and we're seeing that engagement,
translate into better satisfaction,
better retention,
and, you know, really increased connectivity with our
members. These centers, are actively engaging, and,
connectivity with our members.
And
these centers position us to deliver an exceptional
member experience and build deeper, more meaningful relationships
with the communities we serve.
And these centers are places
of connection and belonging, and that's
a foundation of our growth.
That's fantastic. And then it's amazing to continue
to see to build out these community centers
in the in the markets that you serve,
Richard.
I also wonder if, you know, I I
wanna talk a little bit about, the the
Medicare Advantage landscape more broadly and some of
the news and trends we've been seeing this
year,
with with companies all over the country.
We've as you know, we're seeing plans consolidate
their offerings, tighten margins heading into 2026.
So I wonder if you could explain for
us how CleverCare specifically is navigating some of
these industry headwinds while continue continuing to invest
in in what you just talked about, these
culturally tailored care and and community based services.
Yes.
We believe
our combination of eastern and western medicine,
along with teachers like the community centers resonate
with the, with our community.
And we're focused on investing and expanding
much like our Rowan Heights Center, which just
opened,
as as a as a perfect example.
We're able to do this because we've proven
our model, which honors culture and tradition, delivers
financial results.
Since '23, we've more than doubled in size,
growing to nearly 30,000
members.
As you alluded to, it's no secret
that national payers have found the transition to
value based care challenging.
Outcomes based models
tend to take time to deliver on cost
savings,
but we feel as though we're leading the
way with a sustainable
model that works.
Central to our success
is the trusted relationship
we've developed with providers in our network.
We ensure seamless claims processing,
timely and accurate claims payments.
And unique to CleverCare,
our network
includes 700
directly
contracted acupuncturists and other nontraditional
specialists.
We've also maintained stable and reliable benefits
over the last couple of years, giving
both our members and our brokers
confidence in our commitment to them. That stability
combined with our financial performance is what has
allowed us to continue to invest
in things like our community center while others
may be pulling back.
Sure. That makes a lot of sense. And
and, clearly, CleverCare is a very unique health
plan in terms of its, its offerings and
benefits, and it's clearly working in terms of
the growth you've seen in enrollment over the
last few years, Richard. I wonder in that
vein where you see the biggest openings for
innovation or or differentiation
in in Medicare Advantage over the next few
years, whether that's in,
growth in your benefit design, care delivery, member
engagement.
How do you continue to see CleverCare innovate
in in the MA space?
Sure. I think the biggest opportunity
is exactly,
what we've been doing at CleverCare
is just continuing to create a model that
blends eastern and western medicine
while focusing on removing barriers and improving outcomes.
In, benefit design, there's a real opportunity to
reflect members' actual health traditions.
As I mentioned earlier, our network includes 700
directly contracted acupuncturists,
and these aren't extras.
In fact, for many people, they are core
to how they approach
health and wellness
and help create a sense of real connection.
In care delivery,
being a reliable, transparent, and trustworthy partner matters
and creates a foundation for better care delivery.
And in member engagement, physical presence in communities
through our centers makes a difference.
Engagement,
especially when delivered
in our members'
own language, is what drives better outcome.
And the plans that will differentiate themselves are
the ones that genuinely understand and serve their
members' unique needs
while maintaining
financial stability to deliver on their commitments year
after year.
Absolutely. And and we're for sticking on that
is our is our last question, Richard, in
terms of some of the advice or final
thoughts you would offer all the other insurers
listening
what what would you
share with them? At first, I would I
would say
don't chase unsustainable growth.
Build something that lasts through strong operational
foundations,
genuine relationships
with the provider network,
and a clear understanding of the communities you
serve.
The industry is at such a critical moment,
so it's crucial to understand that sustainable growth
requires a different approach than the past.
Our approach is to focus on maintaining the
stability
that allows us to invest for the long
term.
And to that point,
we're posed for continued growth in investing.
And over the last few months, we've brought
on a new chief information officer,
vice president of operations,
and vice president of sales, all seasoned leaders
that understand Medicare Advantage. And that's the kind
of investment that
positions ourselves as well as others for sustainable
successful growth.
Wonderful. Well, Richard, I hope you keep us
posted on the continued innovations and and growth
at CleverCare.
But I wanna thank you for taking the
time to chat with us and and for
sharing your insights about all the new stuff
going on at the at your company. We
really appreciate it.
Thank you very much, Jacob. I appreciate the
opportunity.
Yeah. And to our listeners, if you'd like
to listen to more podcasts from Becker's Health
Care, you can visit beckershospitalreview.com.