Hello, everyone. This is Jacob Emerson with the
Becker's Pay Your Issues podcast. Thrilled today to
be joined by AmeriHealth Caritas' Ohio market president,
Mark Grippi. Mark, thanks so much for taking
the time to be with me on the
podcast today.
Thanks, Jacob. I'm glad to be here, and
I'm really looking forward to the conversation.
Yeah. Likewise, Mark. And before we dive into
everything, we wanna talk with you about a
an exciting,
new initiative happening at the company. Can you
tell us a little bit more about yourself,
your background in health care, and what it
is that you do today at AmeriHealth Caritas?
Sure. So my name is Mark Grippi. I
am the Ohio market president for AmeriHealth Caritas.
We are one of the Medicaid managed care
plans that the state of Ohio has selected,
to deliver benefits,
to some point 2,600,000
members across Ohio, and we have a subset
of that membership with with, with our plan.
Delivering Medicaid as a managed care entity, you
often
tend to lump us into the larger conversation
of health insurance, but Medicaid managed care is
nuanced. It's different.
I often consider the work that we do
to be more social services and we just
happen to pay claims for a living. So
our jobs are really to connect with the
community to really make investments and understand the
needs
of those living in poverty, both
in one state or our larger company where
we operate in close to 13 states.
And
that role
is pretty important to us. A lot of
us started our career
in healthcare
services. Like I started my career in hospitals
and nursing homes, actually being a provider. And
it wasn't only after I really wanted to
learn about how can I make an impact
to much broader populations
that I decided to come over to to
Medicaid managed care?
My role
at, at the plan is is pretty simple.
I work very closely,
to develop strategy with our team
and
bring great people that are extremely passionate about
making a difference in the lives of others
together. And I clear barriers and I let
them get to work and do their thing.
But it's an amazing opportunity that we have
to work with such a deserving population.
Absolutely. It sounds like such impactful work that's
going on under your leadership,
Mark. And I wanted to
dive right in today and talk a little
bit about
a really unique initiative,
something, I I've never heard of, happening within
the industry before. Yeah.
It's a mobile gaming platform that the company
launched earlier this year to address long standing
gaps in Medicaid member care and and engagement
with those members.
So for our audience that that isn't familiar
at all with this, can you can you
share some details with us? What is this
program?
Where did this all come about? And and,
ultimately, what is the company hoping to achieve
through it?
Sure. You know, I I think before I
answer that, Jacob, I have to ask you
a question. Sure.
So let's say,
something amazing happens in your life.
You and your partner may be expecting a
child in your life or, you know, maybe
the opposite of amazing as you've been informed
that you have a medical condition that's serious.
Are you gonna tell your family and your
closest friends first after you digest that information,
or do you think you're gonna pick up
the phone and say, hey. Hey, insurance company.
This just happened to me. I just wanted
to tell you about it.
That's a good question, and I I think
you know the answer, but, certainly, I can
go towards,
family and friends.
Well, I that's what we encounter every day.
The irony of of our in biz business
is that some of the most important things
that we do are dependent on us engaging
our membership
and keeping them engaged.
The irony is is that that's also one
of our biggest challenges.
Mhmm. It is difficult with people living in
poverty
to always keep the most up to date
contact information.
You know, when you're you're living on a
couple dollars a day and you have to
worry about how do I feed my children
or how do I pay rent, the last
thing you think about is, oh, I have
to go update my insurance company because I
moved last month, or I have to go
update the state because my my telephone number
changed.
And we started to see this in our
data.
And, you know, one of the the key
things is that we saw single digit engagement
levels, within, like, our applications. You know? I'm
sure we all are familiar with the the
insurance company app that has a big overwhelming
directory or maybe some language in it that
says, well, you could do this or you
might have this benefit.
So we realized that in order for us
to really be successful, and let's be clear,
success is improving outcomes for the people that
we serve,
we needed to reach a broader population.
We started to think about
what do we do?
We asked our members. I mean, that we
had this
this simple thought of
we have an audience with our members. Let's
ask them how do they go about their
day. And we we learned that almost 70%
of adults
are using mobile games, and about forty five
to 50%
of those people are playing multiple times a
week. And that's
just how they've,
how our culture has evolved and developed. And
it's much easier to do minor course corrections
versus to try to instill a brand new
behavior in someone.
So we developed this platform
in cooperation
with our partner Motive,
and we put together the common everyday games
that you play, Candy Crush, versions of Candy
Crush, I should say,
solitaire.
And
it's been a fantastic journey because what we're
seeing is that
people are already using this mode to communicate.
So instead of talking at our members, we
actually started opening a dialogue and speaking with
our members.
We developed and curated
content that was specifically designed, you know, for
the diabetic or someone suffering from chronic high
blood pressure. And in between levels of the
games, these these these, users went on missions.
And they're instead of an advertisement,
we supplement it with health care education.
And that health care education turned into a
conversation. They started answering valuable questions for us.
One of the requirements that most
plans have
is to do a health risk assessment.
The assessment isn't isn't complicated, but it's the
foundation for population health. It's the foundation for
us to get to know our members.
On average,
maybe 30%,
is our response rate because, again, you're getting
something from your insurance company, maybe or maybe
not, you fill it out. We started to
see rates as high as eighty two percent,
seventy five percent were completing the whole assessment.
I mean, this this is world class type
of of outcomes. And it really was because
we
took a minute. We learned how to communicate
with our members
and, started delivering information in a way that
they could digest. So I'll stop stop there
on that. I'm I'm sure you might have
a follow-up.
Yeah. I mean, what a great idea, Mark,
just listening to you explain this.
Really just,
seeing where your members or and what they
were engaging with and then literally as as
the health plan going to them. It's it's
fantastic. And and like I said, I've never
heard of, any anybody else in the industry
doing something like this. So it's it's really
innovative.
And and I have to ask because, you
know, I've seen some of the engagement metrics
you've recorded so far with this initiative.
Members have logged over logged in over 12,000
times. They've said more than a 100 thousand
minutes on the platform so far. So I
I think, you know, drilling down to the
to the core of this, Mark, how do
you measure the impact of this engagement on
actual health outcomes?
And what are some of the long term
benefits you're anticipating for both your members and
and the health plan overall?
You know, Jacob, I think when you start
to look at some of the data and
those those early numbers that that you just
referenced,
it becomes clear to me
that our members truly care about their health.
I think they're maybe a little bit skeptical
about their health care and the health care
delivery system.
And that that's telling us that the opportunity
is there to really make that difference. So,
you know, how are we gauging success?
You know, that that health risk assessment that
I mentioned just a minute ago,
when you can start to,
get numbers in that seventy five to eighty
percent of your total,
population,
completing a health risk assessment,
we get such valuable information and we're able
to engage them in a conversation because we're
starting to build trust now with each other.
And care management becomes
a more likely possibility, allowing us to help
them,
connect them with with a physician because we've
already developed that trust. We've identified that there
might be some sort of a chronic condition
or something else out there that they really
need the help. And we can remove social
barriers,
to getting them that help. Transportation,
we can provide them with with extra benefits
and housing assistance,
all of which they never would have known
before because they weren't at a place where
they they couldn't engage.
But from a healthcare executive standpoint,
I think it's important to recognize that we're
starting to see early signs in our data,
especially around behavioral health, that
members with a behavioral health condition or some
sort of substance use comorbidity
that are engaged in this application,
we're actually starting to see some early data
that would suggest that there's a reduction in
the total cost of care because they're adherence,
because of the fact that they're communicating with
a health plan and we know,
what those barriers are for them and we're
able to help, resolve them. And it's a
clear correlation between engagement
and the ultimate goal of improving outcomes for
our members.
That's amazing. So you're you're really already seeing
a real life impact, within your behavioral health
space and in really quite a short amount
of time.
Correct. And and as I understand it, Mark,
so the mobile gaming has replaced traditional ads
and in in app purchases with more personalized
health content
reminders for your members.
So can you share a little bit about
how the the trivia and the health related
contents that you're
offering, how is that tailored to align with
with the health plans population health strategy? And
and how do you ensure this is really
resonating,
with with, a pretty diverse member base?
Sure. So when we when we looked at
doing this, you know, the way it works
is that a member will download any one
of the the dozen or so games that
we have available, and then they have immediate
twenty four seven access to the whole suite
of games.
And as they launch a game,
it's already prepopulated
with some information
about the member. We we know some of
their their chronic conditions,
as well as some of their history. But
as they start to answer those health risk
questions,
the games learn,
and we provide that information to our partner
motive
on on what those chronic conditions are. So
let's take a diabetic
member, for example. As they're going through levels
of candy crush,
they come to
a space between the level. It's going to
ask them,
have you exercised today? Or
do you understand the importance
of
a diet
on a daily basis for someone with a
diabetic health condition?
Are you exercising?
And the amazing part is since we've started
this journey with our members,
those questions or those missions that they go
on, one, can earn them tokens to unlock
additional levels. And, you know, that definitely
caters to our competitive nature, but it also
allows them to unlock real life incentives. The
more education they take on, the more that
they connect
to providers, they're actually able to earn some
additional incentives, which keeps people coming back.
I personally think the neatest thing is that
as they answer questions,
our system tracks their amount of right answers.
And we've seen close to a 31%
increase in health literacy
with our targeted subpopulation
since the beginning of the app. That's 31%
people
that now know today that diet and exercise
and eating healthy overall is much more important
to managing their diabetes than they understood
when they first,
joined this application. And that, again,
improves outcomes for our members.
Certainly. So it's this gamification
of of health benefits, I think, is is
fair to say. It it literally is closing
care gaps, but it sounds like it's it's
improving health literacy rates. It's really amazing. Absolutely.
Absolutely. Let me let me circle back to
some some numbers you had mentioned at the
start of start of our conversation.
89 of members have provided you with their
email. Seventy five percent have completed health risk
assessments.
Yeah. So
given that, I mean, clearly, those numbers point
to real success here. How do you see
mobile gaming as a scalable solution,
that could be applied to other Medicaid populations
across the country?
So I think, you know, I'm I'm a
big believer in the science of quality improvement.
And, you know, the first thing that anyone
really needs to do is understand their population
and understand their data. And could this be
an intervention
or or or something that,
could help improve outcomes,
elsewhere?
We're actually working to scale, this program now
across our entire state and across all
of our subpopulations.
But it starts with just that ask and
understanding of what are the needs of your
members and,
do you have the capability to even test
this in small populations? If you're getting positive
feedback, then you work to scale it.
An interesting,
side note that we're finding as we promote
this opportunity to our members
is even though this is a digital solution
that's finding a lot of success,
the promotion of it, we're finding,
that members have digital fatigue. Everybody's hitting people
with text messages, email campaigns.
We're actually finding that the good old fashioned
snail mail where we're we're mailing postcards and
we're meeting with people in the communities is
a much better way to gain scale on
on the product than just
a a a one size digital solution.
That's a really great call out there, Mark,
that you have to actually go into your
communities, meet with your members in person,
versus, yeah, continuing the digital fatigue we're all
very aware of.
I think before we go, Mark, I wanna
open the floor back up to you in
terms of you've got the ears right now
of a lot of other health plan leaders
from from all over the country, many operating
in Medicaid.
What else do you wanna share with them
on this topic or or final bits of
advice that you wanna offer?
You know, I I think when we look
at,
what our ultimate goal should be, and and
that is to,
really make investments into the people that we
serve and to improve their their health outcomes.
But it's not a one labor solution.
Improving the health and wellness, especially people,
who are living on Medicaid is is complicated.
I wanna go back to a statement I
made earlier, and and I have to attribute
it,
to Scott, the owner
of our partner Motive here, is that remember,
I think people do care about their health,
but conditions both inside and outside of their
home have really complicated their relationship with health
care and certainly complicated their relationships with with
health insurance, and it's made them skeptical.
Involve your members in the conversation about what's
best for them.
Don't speak at them. Speak with them.
Create programs and products that really fit into
their daily life,
and don't try to impose something that just
doesn't fit. Remember, people living in poverty are
living minute to minute, not week to week,
month to month, or year to year.
And we have to help guide people through
this complex system,
that we've created over long periods of time.
I think if we can improve the process
of health care delivery
in such a way that it goes with
the people that we're serving,
you know, ultimately, it it has to lead
to better outcomes, and and that will ultimately
create efficiencies for companies like ours that reduce
the total cost of care. There's winners all
around. I think that's the message I would
love for people to, take away from from
this
this program that we started, this journey that
we've been on, and and share with some
of the success that we've had.
Wonderful. Well, I think that's a great last
message to leave us with. So, Mark, I
wanna thank you for taking the time to
sit down with us today and and for
sharing about, what is clearly very unique and
impactful work going on under your leadership. We
we really appreciate it.
Thank you for the opportunity,
and I think that, you know, we're just
scratching the surface
of of changing the way that we're thinking
and and how that different thinking is going
to lead to innovation and better outcomes for
people. So appreciate the opportunity and and, I
I wish you to have a great weekend.
Yeah. You as well. It sounds like exciting
things to still come from AmeriHealth Caritas.
Thanks so much, Mark, for being with us.
And and to our listeners, if you'd like
to listen to more podcasts from Becker's Healthcare,
you can visit beckershospitalreview.com.