1 00:00:00,080 --> 00:00:02,080 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,080 --> 00:00:05,120 Becker's Payer Issues podcast. Thrilled today to be 3 00:00:05,120 --> 00:00:07,620 joined by Steve Tringale, who is the president 4 00:00:07,679 --> 00:00:10,160 of Mass General Brigham Health Plan. Steve, thanks 5 00:00:10,160 --> 00:00:11,679 so much for taking the time to be 6 00:00:11,679 --> 00:00:14,025 with me on the podcast today. Thanks, Jacob. 7 00:00:14,564 --> 00:00:17,385 I am, Steve Tringale. I've been president 8 00:00:17,765 --> 00:00:20,344 of Mass General Brigham's health plan 9 00:00:20,964 --> 00:00:21,464 since 10 00:00:22,164 --> 00:00:22,904 2000. 11 00:00:24,244 --> 00:00:25,224 I have over 12 00:00:25,524 --> 00:00:26,664 thirty years experience 13 00:00:28,140 --> 00:00:31,599 working with both health systems and health plans 14 00:00:31,739 --> 00:00:32,479 as both 15 00:00:33,899 --> 00:00:35,039 the lead consultant 16 00:00:35,659 --> 00:00:36,640 and as 17 00:00:37,259 --> 00:00:38,479 a business strategist 18 00:00:39,100 --> 00:00:40,879 as well as having operational 19 00:00:41,259 --> 00:00:41,759 responsibility 20 00:00:44,564 --> 00:00:46,104 for major product lines, 21 00:00:47,125 --> 00:00:49,364 not only at Mass General Brigham, but in 22 00:00:49,364 --> 00:00:51,364 a prior stop with a different carrier in 23 00:00:51,364 --> 00:00:53,144 my earlier career. 24 00:00:54,405 --> 00:00:56,804 I was asked in 2020 25 00:00:56,804 --> 00:00:57,864 to come in 26 00:00:58,390 --> 00:01:00,789 into build out a vision for Mass General 27 00:01:00,789 --> 00:01:02,010 Brigham's health plan, 28 00:01:02,390 --> 00:01:05,290 which included a full product line portfolio 29 00:01:06,549 --> 00:01:09,209 so that every member who is 30 00:01:10,484 --> 00:01:11,944 using a Mass General 31 00:01:12,325 --> 00:01:15,045 Brigham provider can find a Mass General Brigham 32 00:01:15,045 --> 00:01:16,185 health plan product 33 00:01:16,724 --> 00:01:17,704 that will support, 34 00:01:19,125 --> 00:01:22,004 their journey through the health care system. So 35 00:01:22,004 --> 00:01:23,384 we have taken that 36 00:01:23,939 --> 00:01:25,780 and our focus on the members sort of 37 00:01:25,780 --> 00:01:27,079 our North Star and 38 00:01:28,099 --> 00:01:30,200 have built out a full product portfolio, 39 00:01:31,140 --> 00:01:33,000 which includes commercial products, 40 00:01:33,619 --> 00:01:34,599 Medicare Advantage, 41 00:01:35,540 --> 00:01:36,040 a 42 00:01:36,534 --> 00:01:39,034 very large, in fact, the second largest Medicaid 43 00:01:39,415 --> 00:01:39,915 ACO, 44 00:01:40,855 --> 00:01:42,395 in the Commonwealth Of Massachusetts, 45 00:01:43,895 --> 00:01:44,855 and now, 46 00:01:45,255 --> 00:01:48,055 dual eligible products in both the 65 47 00:01:48,055 --> 00:01:49,334 and the 65 48 00:01:49,334 --> 00:01:51,599 market. So we have pretty much rounded out 49 00:01:52,400 --> 00:01:54,259 a full portfolio at the plan. 50 00:01:54,560 --> 00:01:56,159 Right. And let's stay on the topic of 51 00:01:56,159 --> 00:01:59,219 of the dual eligible special special needs plans. 52 00:01:59,599 --> 00:02:01,519 You announced earlier this year that you're planning 53 00:02:01,519 --> 00:02:04,420 to enter that space in in 2026. 54 00:02:04,875 --> 00:02:06,635 So talk to us a little bit about 55 00:02:06,635 --> 00:02:08,814 why the the health plan made this decision 56 00:02:08,875 --> 00:02:11,055 and, ultimately, how you're building on your existing 57 00:02:11,354 --> 00:02:14,335 Medicaid experience, serving that population to really ensure 58 00:02:14,555 --> 00:02:16,415 that there's meaningful engagement there, 59 00:02:16,794 --> 00:02:18,175 that you're providing support 60 00:02:18,569 --> 00:02:20,030 for this new population, 61 00:02:20,729 --> 00:02:22,509 particularly, Steve, when it comes to 62 00:02:22,810 --> 00:02:26,090 coordination of their care, addressing social determinants of 63 00:02:26,090 --> 00:02:26,590 health, 64 00:02:27,050 --> 00:02:28,729 ultimately, how you're how you're thinking about that 65 00:02:28,729 --> 00:02:30,110 as we head into next year. 66 00:02:31,305 --> 00:02:33,705 We've set out at the plan to really 67 00:02:33,705 --> 00:02:34,205 build 68 00:02:35,224 --> 00:02:37,004 a different kind of experience 69 00:02:38,105 --> 00:02:39,564 for our members 70 00:02:40,185 --> 00:02:41,405 by taking advantage 71 00:02:42,264 --> 00:02:45,159 of the services and our ability to to 72 00:02:45,159 --> 00:02:45,659 meaningfully 73 00:02:46,199 --> 00:02:48,219 integrate, not just be owned by 74 00:02:49,000 --> 00:02:50,539 one of the world's best 75 00:02:51,239 --> 00:02:51,739 known, 76 00:02:52,280 --> 00:02:53,180 delivery systems, 77 00:02:53,479 --> 00:02:54,699 Mass General Brigham. 78 00:02:55,639 --> 00:02:57,340 And it was extraordinarily 79 00:02:57,959 --> 00:02:59,180 important to us 80 00:02:59,905 --> 00:03:02,724 to build out the duals product, Jacob, because, 81 00:03:04,305 --> 00:03:06,405 we have over a 100 approximately 82 00:03:07,025 --> 00:03:08,224 a 150,000 83 00:03:08,224 --> 00:03:10,084 Medicaid members right now. 84 00:03:11,185 --> 00:03:12,805 We believe that we have 85 00:03:14,189 --> 00:03:16,689 maybe upwards of close to 20,000 86 00:03:17,069 --> 00:03:19,250 members in that Medicaid pool 87 00:03:20,110 --> 00:03:20,610 who, 88 00:03:21,150 --> 00:03:22,129 might be eligible 89 00:03:22,590 --> 00:03:23,409 for participation 90 00:03:24,430 --> 00:03:27,389 in our duals product, either one k, which 91 00:03:27,389 --> 00:03:28,509 is the 65 92 00:03:28,509 --> 00:03:29,009 product, 93 00:03:29,594 --> 00:03:32,715 or, senior care option, which is the 65 94 00:03:32,715 --> 00:03:33,215 product. 95 00:03:34,634 --> 00:03:35,935 That allows us, 96 00:03:36,715 --> 00:03:39,354 to answer your question directly, it it allows 97 00:03:39,354 --> 00:03:40,094 us to 98 00:03:40,715 --> 00:03:42,574 to provide those members 99 00:03:43,240 --> 00:03:46,060 with additional benefits as well as 100 00:03:46,840 --> 00:03:48,379 giving us the resources 101 00:03:49,240 --> 00:03:51,639 to build a model of care, which is 102 00:03:51,639 --> 00:03:54,620 essential to the actual licensing and filing 103 00:03:55,479 --> 00:03:58,085 of a dual product with both the state 104 00:03:58,085 --> 00:03:59,224 and the federal government 105 00:03:59,605 --> 00:04:01,705 and to use those clinical resources 106 00:04:02,245 --> 00:04:04,165 as well as a bunch of community based 107 00:04:04,165 --> 00:04:04,665 services 108 00:04:05,444 --> 00:04:06,665 to really improve 109 00:04:07,764 --> 00:04:08,585 the experience, 110 00:04:09,925 --> 00:04:11,305 the service package, 111 00:04:12,219 --> 00:04:12,719 and 112 00:04:13,259 --> 00:04:13,759 ultimately 113 00:04:14,699 --> 00:04:17,180 the, you know, not just the health care 114 00:04:17,180 --> 00:04:18,959 experience, but the entire 115 00:04:20,060 --> 00:04:20,560 lifestyle 116 00:04:21,259 --> 00:04:21,759 experience 117 00:04:22,540 --> 00:04:24,959 of those members who we believe are eligible 118 00:04:26,154 --> 00:04:27,454 for dual coverage. 119 00:04:27,915 --> 00:04:28,415 So 120 00:04:29,274 --> 00:04:30,954 this does a couple of things for us. 121 00:04:30,954 --> 00:04:32,794 One, it provides, as I said, a much, 122 00:04:32,794 --> 00:04:35,675 much better opportunity for those members who we 123 00:04:35,675 --> 00:04:36,654 believe are eligible. 124 00:04:37,435 --> 00:04:38,254 And two, 125 00:04:38,634 --> 00:04:40,970 it really is the the crucible. It's the 126 00:04:40,970 --> 00:04:41,870 pressure test 127 00:04:42,410 --> 00:04:44,889 for our ability to work closely with and 128 00:04:44,889 --> 00:04:46,750 integrate with the delivery system 129 00:04:47,129 --> 00:04:49,610 because they're gonna be essential to helping us 130 00:04:49,610 --> 00:04:50,110 support 131 00:04:50,810 --> 00:04:52,509 the care management model. 132 00:04:52,814 --> 00:04:55,235 The third and last leg of the stool 133 00:04:55,375 --> 00:04:56,115 to support, 134 00:04:56,735 --> 00:04:57,634 duals business 135 00:04:58,574 --> 00:05:00,675 is we have a long history 136 00:05:01,535 --> 00:05:05,475 at Mass General of collaborating both on care 137 00:05:06,180 --> 00:05:07,800 and and quite frankly, 138 00:05:08,899 --> 00:05:09,800 from a philanthropy 139 00:05:10,100 --> 00:05:11,080 perspective with 140 00:05:12,180 --> 00:05:13,560 community based providers. 141 00:05:15,139 --> 00:05:17,939 This allows us to build those community based 142 00:05:17,939 --> 00:05:18,439 providers 143 00:05:19,154 --> 00:05:21,735 directly and very intentionally into that, 144 00:05:22,435 --> 00:05:24,995 care model, as I said, to improve the 145 00:05:24,995 --> 00:05:25,495 entire 146 00:05:26,115 --> 00:05:27,654 experience for those members. 147 00:05:28,355 --> 00:05:29,735 This product was extraordinarily 148 00:05:30,435 --> 00:05:32,514 important to this team. We viewed it as 149 00:05:32,514 --> 00:05:33,175 sort of, 150 00:05:34,050 --> 00:05:36,389 you know, essential for us to really 151 00:05:36,930 --> 00:05:38,930 reach the highest levels of what we're trying 152 00:05:38,930 --> 00:05:40,389 to do from a mission perspective. 153 00:05:41,569 --> 00:05:43,430 I've spent twenty five years, 154 00:05:44,449 --> 00:05:46,290 on the board and as an officer of 155 00:05:46,290 --> 00:05:47,990 Boston Health Care for the homeless. 156 00:05:48,449 --> 00:05:49,669 In many ways, 157 00:05:50,185 --> 00:05:52,024 the members at Boston Health Care for the 158 00:05:52,024 --> 00:05:54,345 Homeless typify the kind of members that we'll 159 00:05:54,345 --> 00:05:55,004 be seeing 160 00:05:55,384 --> 00:05:56,764 in the duals product. 161 00:05:57,225 --> 00:05:59,225 In providing sort of that full range of 162 00:05:59,225 --> 00:05:59,725 services, 163 00:06:00,504 --> 00:06:03,084 acute care, community based care, 164 00:06:03,720 --> 00:06:06,459 and community support services to those members 165 00:06:07,000 --> 00:06:08,379 was what we viewed 166 00:06:08,839 --> 00:06:11,160 as an exciting opportunity as well as a 167 00:06:11,160 --> 00:06:11,660 challenge. 168 00:06:12,599 --> 00:06:15,579 Understood. So you're you're thinking that 20,000 169 00:06:16,004 --> 00:06:18,725 potential members could be enrolled in this new 170 00:06:18,725 --> 00:06:21,605 offering, Steve, and and you're really looking to, 171 00:06:21,925 --> 00:06:24,725 reach them with this more enhanced services and 172 00:06:24,725 --> 00:06:25,225 benefits, 173 00:06:25,925 --> 00:06:27,384 for this special population. 174 00:06:27,949 --> 00:06:30,829 You mentioned, earlier on, you know, just the 175 00:06:30,829 --> 00:06:32,990 the strength of Mass General Brigham as a 176 00:06:32,990 --> 00:06:35,310 as a leading integrated care system in this 177 00:06:35,310 --> 00:06:38,110 country, and and we're constantly hearing from from 178 00:06:38,110 --> 00:06:40,669 the system around investments in digital health, in 179 00:06:40,669 --> 00:06:43,125 community based initiatives. So So I'm wondering if 180 00:06:43,125 --> 00:06:44,425 you could share with our listeners, 181 00:06:44,805 --> 00:06:46,665 one or two recent notable examples 182 00:06:47,045 --> 00:06:49,285 from where you sit in terms of where 183 00:06:49,285 --> 00:06:52,004 the the system's investments, the health plans investments 184 00:06:52,004 --> 00:06:53,704 in these spaces have really improved, 185 00:06:54,324 --> 00:06:56,105 the outcomes of your members. 186 00:06:57,060 --> 00:06:58,279 Sure. Wow. 187 00:06:59,300 --> 00:07:00,120 One investment. 188 00:07:00,819 --> 00:07:03,300 In fact, one very key investment, which if 189 00:07:03,300 --> 00:07:06,040 we do it well, should be relatively transparent 190 00:07:06,100 --> 00:07:07,639 to the member, but extraordinarily 191 00:07:08,100 --> 00:07:08,600 important 192 00:07:09,225 --> 00:07:09,705 to, 193 00:07:10,904 --> 00:07:11,805 provider partners 194 00:07:12,504 --> 00:07:15,725 is we have built out and invested in 195 00:07:16,185 --> 00:07:16,925 a digital 196 00:07:18,264 --> 00:07:19,805 care management platform, 197 00:07:20,745 --> 00:07:24,285 which is fully synced up and coordinated with 198 00:07:24,730 --> 00:07:26,990 an identical care management platform 199 00:07:27,770 --> 00:07:31,550 that the delivery systems population health service organization 200 00:07:31,689 --> 00:07:32,430 has provided. 201 00:07:32,970 --> 00:07:34,110 So we essentially 202 00:07:35,129 --> 00:07:36,670 have a window 203 00:07:38,314 --> 00:07:40,235 into the clinical side and they have a 204 00:07:40,235 --> 00:07:41,134 window into 205 00:07:41,675 --> 00:07:44,254 our services, the benefits we can provide, 206 00:07:45,514 --> 00:07:47,294 who's enrolled, when they were enrolled, 207 00:07:47,595 --> 00:07:49,214 how we can look at those members 208 00:07:49,754 --> 00:07:52,894 in a way that a traditional insurance plan 209 00:07:53,490 --> 00:07:55,029 that doesn't have that linkage 210 00:07:56,529 --> 00:07:58,230 with delivery system 211 00:07:58,930 --> 00:07:59,430 cannot. 212 00:07:59,889 --> 00:08:01,569 So, you know, I mentioned that we have 213 00:08:01,569 --> 00:08:03,829 up to 20,000 people in our medicated 214 00:08:04,689 --> 00:08:06,470 right now in our Medicaid ACO 215 00:08:06,930 --> 00:08:08,949 who we think will ultimately be 216 00:08:09,384 --> 00:08:12,264 a qualify for enrollment. And I just wanna 217 00:08:12,264 --> 00:08:14,504 clarify, we don't believe we're gonna get 20,000 218 00:08:14,504 --> 00:08:17,245 members in our initial open enrollment, but 219 00:08:17,865 --> 00:08:19,865 that's the pool that we think we're gonna 220 00:08:19,865 --> 00:08:20,925 be drawing from. 221 00:08:21,649 --> 00:08:25,009 That investment in sort of that mirror care 222 00:08:25,009 --> 00:08:26,149 management system, 223 00:08:26,770 --> 00:08:27,910 we think is gonna 224 00:08:28,449 --> 00:08:29,430 really improve 225 00:08:30,449 --> 00:08:31,189 our ability 226 00:08:32,210 --> 00:08:32,950 to provide 227 00:08:33,490 --> 00:08:36,210 the right service at the right place at 228 00:08:36,210 --> 00:08:37,110 the right time 229 00:08:37,784 --> 00:08:38,684 for our members 230 00:08:39,225 --> 00:08:41,384 because of our ability to look at what's 231 00:08:41,384 --> 00:08:43,084 going on in a real time basis. 232 00:08:43,544 --> 00:08:44,125 That's, you know, 233 00:08:44,904 --> 00:08:46,204 that's a real time 234 00:08:46,584 --> 00:08:47,644 significant investment 235 00:08:48,345 --> 00:08:51,304 where we coordinated our investment with a similar 236 00:08:51,304 --> 00:08:53,519 investment on the delivery system that we think 237 00:08:53,519 --> 00:08:55,139 is gonna pay huge dividends. 238 00:08:56,320 --> 00:08:57,620 In addition to that, 239 00:08:58,000 --> 00:09:00,399 we're working with the delivery system to look 240 00:09:00,399 --> 00:09:02,100 at what we can do on the innovative 241 00:09:02,320 --> 00:09:02,820 side 242 00:09:03,519 --> 00:09:05,220 to develop specific clinically 243 00:09:05,679 --> 00:09:06,740 clinical programs 244 00:09:07,679 --> 00:09:08,419 to support 245 00:09:09,014 --> 00:09:10,475 the specific needs 246 00:09:11,174 --> 00:09:12,634 of the dual membership. 247 00:09:13,335 --> 00:09:15,274 These by and large are members 248 00:09:15,894 --> 00:09:17,835 with complicated health conditions, 249 00:09:18,695 --> 00:09:20,075 many of whom have 250 00:09:20,855 --> 00:09:23,355 behavioral health, you know, substance abuse 251 00:09:24,070 --> 00:09:26,649 diagnosis, as well as clinical programs. 252 00:09:27,750 --> 00:09:31,129 We're looking at, can we provide, an elevated 253 00:09:31,190 --> 00:09:32,169 level of services 254 00:09:33,110 --> 00:09:35,909 on sort of the diabetes obesity issue that 255 00:09:35,909 --> 00:09:38,570 goes well beyond looking at just GLP ones? 256 00:09:39,695 --> 00:09:42,195 Do we build in some specialty obesity 257 00:09:43,134 --> 00:09:44,115 medical services 258 00:09:44,815 --> 00:09:46,995 that, these members will be available, 259 00:09:47,615 --> 00:09:49,154 have available to them? 260 00:09:50,254 --> 00:09:52,415 Do we do the same thing with senior 261 00:09:52,415 --> 00:09:55,779 care on the behavioral health side? We're looking 262 00:09:55,779 --> 00:09:57,000 at building out 263 00:09:57,699 --> 00:10:00,600 a very new and very specific program 264 00:10:01,299 --> 00:10:03,779 which deals with some of the issues that 265 00:10:03,779 --> 00:10:05,720 seniors have in terms of isolation, 266 00:10:06,659 --> 00:10:07,159 loneliness, 267 00:10:07,695 --> 00:10:10,674 and how that impacts their health status, 268 00:10:11,375 --> 00:10:12,914 their mental health status, 269 00:10:13,535 --> 00:10:14,355 and their overall 270 00:10:15,054 --> 00:10:17,955 wellness. We believe that we can dramatically 271 00:10:18,414 --> 00:10:18,914 improve 272 00:10:20,379 --> 00:10:22,639 the health status of those senior members 273 00:10:22,940 --> 00:10:23,600 in our 274 00:10:24,220 --> 00:10:25,120 SCO product 275 00:10:25,980 --> 00:10:29,759 by directly addressing and by directly making services 276 00:10:29,820 --> 00:10:30,320 available 277 00:10:30,779 --> 00:10:31,519 that focus 278 00:10:32,139 --> 00:10:33,360 on those very 279 00:10:34,254 --> 00:10:37,054 prevalent problems related to isolation and loneliness that 280 00:10:37,054 --> 00:10:38,514 we see in the senior market. 281 00:10:38,975 --> 00:10:39,954 We're prioritizing 282 00:10:41,294 --> 00:10:43,695 a stack of services on the women's health 283 00:10:43,695 --> 00:10:44,195 marketplace 284 00:10:44,574 --> 00:10:45,315 to support, 285 00:10:46,420 --> 00:10:49,300 women in these products. And we're looking at 286 00:10:49,300 --> 00:10:50,679 things that we can do 287 00:10:51,300 --> 00:10:53,160 in home health writ large, 288 00:10:53,540 --> 00:10:56,120 which includes home hospital, home health care, 289 00:10:56,899 --> 00:10:59,860 where we can support these members outside of 290 00:10:59,860 --> 00:11:01,080 the hospital setting, 291 00:11:01,524 --> 00:11:02,345 whether it's 292 00:11:02,725 --> 00:11:05,684 doing infusions at home versus the hospital on 293 00:11:05,684 --> 00:11:07,705 sort of the high end of the service 294 00:11:08,245 --> 00:11:08,745 spectrum 295 00:11:09,365 --> 00:11:10,345 or just providing 296 00:11:10,644 --> 00:11:13,284 a series of home services to them, which 297 00:11:13,284 --> 00:11:14,904 can keep them out of the hospital. 298 00:11:15,365 --> 00:11:15,865 But 299 00:11:16,209 --> 00:11:19,110 we're intentionally building out this service package 300 00:11:20,049 --> 00:11:21,589 with the capabilities 301 00:11:21,889 --> 00:11:24,450 of the delivery system in mind to, we 302 00:11:24,450 --> 00:11:27,089 think, provide a higher level of service for 303 00:11:27,089 --> 00:11:27,750 our members. 304 00:11:28,675 --> 00:11:31,235 Absolutely. No. That's so so great in terms 305 00:11:31,235 --> 00:11:33,315 of making these investments now so that these 306 00:11:33,315 --> 00:11:35,235 members in the new year can really take 307 00:11:35,235 --> 00:11:37,715 advantage of your integrated care model. It's it's 308 00:11:37,715 --> 00:11:38,215 amazing. 309 00:11:38,675 --> 00:11:39,815 I wonder, Steve, 310 00:11:40,355 --> 00:11:41,715 I'd be remiss if I didn't ask you 311 00:11:41,715 --> 00:11:43,750 about, of course, it's been a really busy 312 00:11:43,750 --> 00:11:45,610 year when it comes to health care policy, 313 00:11:45,750 --> 00:11:47,269 both on the on the federal and and 314 00:11:47,269 --> 00:11:48,009 state levels. 315 00:11:48,710 --> 00:11:51,029 We, of course, had this this summer, and 316 00:11:51,029 --> 00:11:54,149 everything that happened there with with, HR one 317 00:11:54,149 --> 00:11:55,830 and then, of course, right now with everything 318 00:11:55,830 --> 00:11:57,914 that's going on in in Washington around, 319 00:11:58,315 --> 00:11:59,695 ACA talks. So 320 00:12:00,235 --> 00:12:02,894 just given the broader context of of continually 321 00:12:03,034 --> 00:12:03,534 evolving, 322 00:12:04,394 --> 00:12:07,434 state and federal regulations, I'm wondering how your 323 00:12:07,434 --> 00:12:09,929 participation across multiple insurance markets 324 00:12:10,409 --> 00:12:12,730 really positions you to anticipate this kind of 325 00:12:12,730 --> 00:12:13,230 disruption. 326 00:12:13,929 --> 00:12:15,529 Some of the advantages that you you would 327 00:12:15,529 --> 00:12:16,429 note for us, 328 00:12:16,970 --> 00:12:18,669 that your your product 329 00:12:19,129 --> 00:12:19,629 diversity, 330 00:12:20,409 --> 00:12:22,029 enables you to really stay, 331 00:12:24,035 --> 00:12:26,455 agile across your business model, your care strategies 332 00:12:26,595 --> 00:12:29,254 as you're bringing in new new care models, 333 00:12:30,195 --> 00:12:31,735 how that all works together. 334 00:12:32,595 --> 00:12:33,575 Sure. So 335 00:12:34,449 --> 00:12:36,789 that's where being part of an overall 336 00:12:37,490 --> 00:12:40,629 delivery system, an integrated delivery system and financing 337 00:12:40,769 --> 00:12:41,269 system, 338 00:12:41,809 --> 00:12:43,029 I think gives us 339 00:12:44,209 --> 00:12:46,070 some significant advantages, Jacob. 340 00:12:47,125 --> 00:12:49,445 I think as long as we stay focused 341 00:12:49,445 --> 00:12:51,045 and if I were gonna give any advice 342 00:12:51,045 --> 00:12:51,545 to, 343 00:12:52,245 --> 00:12:53,865 colleagues in similar situations, 344 00:12:54,725 --> 00:12:56,264 as long as we stay focused 345 00:12:56,644 --> 00:12:59,865 on what is ultimately best for our member, 346 00:13:00,459 --> 00:13:02,080 the delivery systems patients. 347 00:13:02,700 --> 00:13:04,399 And that's our North Star. 348 00:13:05,100 --> 00:13:05,759 If we 349 00:13:06,220 --> 00:13:08,799 test everything that we build out and support 350 00:13:08,940 --> 00:13:11,200 against that in our mission 351 00:13:11,580 --> 00:13:12,320 to improve 352 00:13:13,254 --> 00:13:14,794 the health and well-being 353 00:13:15,214 --> 00:13:15,714 of 354 00:13:16,134 --> 00:13:18,774 people in our communities across all of the 355 00:13:18,774 --> 00:13:20,314 product lines, as you've mentioned. 356 00:13:21,495 --> 00:13:23,674 That will continue to focus us 357 00:13:24,454 --> 00:13:25,595 on supporting 358 00:13:26,615 --> 00:13:28,714 a full portfolio of products 359 00:13:29,389 --> 00:13:31,710 where every single member who sees a Mass 360 00:13:31,710 --> 00:13:32,529 General physician 361 00:13:33,470 --> 00:13:35,090 should be able to see 362 00:13:36,029 --> 00:13:39,309 and buy a Mass General Brigham health plan 363 00:13:39,309 --> 00:13:39,809 product 364 00:13:40,350 --> 00:13:43,570 that will support them throughout their life cycle. 365 00:13:44,325 --> 00:13:44,825 So 366 00:13:45,445 --> 00:13:47,065 we're very much focused 367 00:13:47,524 --> 00:13:48,024 on 368 00:13:48,485 --> 00:13:50,884 having the health plan support the core mission 369 00:13:50,884 --> 00:13:52,264 of Mass General Brigham, 370 00:13:52,884 --> 00:13:54,884 which has been around for over two hundred 371 00:13:54,884 --> 00:13:55,384 years 372 00:13:56,004 --> 00:13:58,904 and takes their role as improving 373 00:14:00,039 --> 00:14:00,779 The health 374 00:14:01,160 --> 00:14:03,340 of not only communities in Massachusetts, 375 00:14:04,279 --> 00:14:05,660 but improving the health 376 00:14:06,279 --> 00:14:09,480 of the broader community across this country because 377 00:14:09,480 --> 00:14:11,179 of our research and training 378 00:14:12,445 --> 00:14:14,365 as in teaching as well as what we 379 00:14:14,365 --> 00:14:16,304 do on the direct clinical care side. 380 00:14:16,764 --> 00:14:19,024 So we stay very much focused on that. 381 00:14:20,044 --> 00:14:23,004 That allows us to to deal with the 382 00:14:23,004 --> 00:14:24,845 federal policy piece. And don't get me wrong, 383 00:14:24,845 --> 00:14:26,704 we're spending a huge amount of time 384 00:14:27,139 --> 00:14:29,539 trying to understand not only what's going on 385 00:14:29,539 --> 00:14:30,039 today, 386 00:14:30,340 --> 00:14:32,500 but what the implications of what's going on 387 00:14:32,500 --> 00:14:33,000 today 388 00:14:33,379 --> 00:14:34,120 may mean 389 00:14:34,820 --> 00:14:35,320 for 390 00:14:35,940 --> 00:14:37,860 our members a year from now. Some of 391 00:14:37,860 --> 00:14:39,240 them are gonna lose eligibility. 392 00:14:39,620 --> 00:14:41,894 Some of them going to have to change 393 00:14:41,894 --> 00:14:43,674 the way they access services? 394 00:14:44,295 --> 00:14:46,295 Is there gonna be more debt and free 395 00:14:46,295 --> 00:14:47,674 care in the system, etcetera? 396 00:14:48,535 --> 00:14:50,235 But everything we do 397 00:14:50,615 --> 00:14:53,254 is focused on maintaining as as broad a 398 00:14:53,254 --> 00:14:55,575 level of services and as broad a level 399 00:14:55,575 --> 00:14:57,210 of coverage as we can 400 00:14:57,750 --> 00:15:00,490 for all of those patients because those patients 401 00:15:01,670 --> 00:15:03,509 are in fact our members and we share 402 00:15:03,509 --> 00:15:04,809 sort of a dual responsibility 403 00:15:05,509 --> 00:15:07,670 to provide them with the best packages of 404 00:15:07,670 --> 00:15:09,529 services, both clinical and 405 00:15:10,774 --> 00:15:13,195 from a health insurance perspective that we can. 406 00:15:13,575 --> 00:15:14,075 So 407 00:15:15,335 --> 00:15:18,455 we we approach these policy challenges, and there 408 00:15:18,455 --> 00:15:20,855 are many right now, both on the fund 409 00:15:21,014 --> 00:15:22,634 on the actual funding level, 410 00:15:23,029 --> 00:15:25,429 but just in the level of complexity of 411 00:15:25,429 --> 00:15:27,509 some of the regulatory changes that are going 412 00:15:27,509 --> 00:15:28,009 on. 413 00:15:28,470 --> 00:15:31,129 We approach all of these challenges with 414 00:15:31,509 --> 00:15:33,110 how are we gonna deal with them? How 415 00:15:33,110 --> 00:15:33,929 do we anticipate 416 00:15:34,549 --> 00:15:36,975 maintaining the best support as we can for 417 00:15:36,975 --> 00:15:37,714 our members 418 00:15:38,174 --> 00:15:38,914 as possible? 419 00:15:39,694 --> 00:15:40,194 First, 420 00:15:40,654 --> 00:15:42,254 do we make a decision to stay in 421 00:15:42,254 --> 00:15:44,355 these markets or drop out of these markets? 422 00:15:44,894 --> 00:15:48,014 That's not a decision we're actively contemplating. Jacob, 423 00:15:48,014 --> 00:15:49,475 we're all in right now. 424 00:15:50,120 --> 00:15:51,639 So our goal on a day to day 425 00:15:51,639 --> 00:15:53,320 basis is trying to figure out how to 426 00:15:53,320 --> 00:15:55,580 best provide those services to our members. 427 00:15:56,360 --> 00:15:59,080 Absolutely. Well, in that vein, Steve, and before 428 00:15:59,080 --> 00:15:59,740 we go, 429 00:16:00,120 --> 00:16:01,480 you've got the ears of a lot of 430 00:16:01,480 --> 00:16:04,095 other health plan and industry leaders from all 431 00:16:04,095 --> 00:16:07,214 over the country right now facing the same 432 00:16:07,214 --> 00:16:10,595 or similar challenges that you are. I wonder 433 00:16:10,654 --> 00:16:13,134 what final thoughts or final bits of advice 434 00:16:13,134 --> 00:16:15,154 that you would share with them today. 435 00:16:16,254 --> 00:16:17,075 One is 436 00:16:17,980 --> 00:16:18,720 there's an 437 00:16:19,660 --> 00:16:22,960 what we've talked about puts an incredible demand 438 00:16:24,059 --> 00:16:25,039 on our workforce, 439 00:16:25,580 --> 00:16:27,419 both in the delivery system and at the 440 00:16:27,419 --> 00:16:28,160 health plan. 441 00:16:29,179 --> 00:16:30,940 I think one of the things that's most 442 00:16:30,940 --> 00:16:32,000 incumbent upon 443 00:16:32,620 --> 00:16:33,519 me personally 444 00:16:33,954 --> 00:16:35,414 and my leadership team 445 00:16:36,355 --> 00:16:39,014 is to up the level and the effectiveness 446 00:16:39,875 --> 00:16:40,774 of our communication 447 00:16:41,794 --> 00:16:42,934 with our teams. 448 00:16:43,554 --> 00:16:45,735 They need to understand why we're pivoting, 449 00:16:46,115 --> 00:16:47,334 why we need to 450 00:16:47,909 --> 00:16:50,709 adjust almost constantly to the challenges that are 451 00:16:50,709 --> 00:16:51,370 out there. 452 00:16:51,909 --> 00:16:54,409 So if you think you're doing enough communication 453 00:16:54,870 --> 00:16:56,409 with your teams right now, 454 00:16:56,789 --> 00:16:58,649 I'd say take that level of communication 455 00:16:59,350 --> 00:17:01,784 and multiply it by at least two, and 456 00:17:01,784 --> 00:17:03,304 that should be a goal for the next 457 00:17:03,304 --> 00:17:05,164 year. That you need to 458 00:17:05,625 --> 00:17:06,765 be extraordinarily 459 00:17:07,224 --> 00:17:08,365 focused and extraordinarily 460 00:17:09,065 --> 00:17:09,565 intentional 461 00:17:10,345 --> 00:17:12,365 in terms of providing them with information 462 00:17:12,984 --> 00:17:13,484 about 463 00:17:13,809 --> 00:17:15,410 where the health plan and the system are 464 00:17:15,410 --> 00:17:16,309 going strategically, 465 00:17:17,250 --> 00:17:18,150 what the implications 466 00:17:18,529 --> 00:17:21,269 are for that from an operational basis, 467 00:17:21,730 --> 00:17:23,970 and quite frankly, what the implications are for 468 00:17:23,970 --> 00:17:26,230 that workforce, which is working extraordinarily 469 00:17:26,769 --> 00:17:28,849 hard right now. I can't tell you, 470 00:17:30,184 --> 00:17:32,265 how proud I am of the of of 471 00:17:32,265 --> 00:17:33,884 the response that we've got 472 00:17:34,265 --> 00:17:36,825 from the team at Mass General Brigham health 473 00:17:36,825 --> 00:17:37,325 plan. 474 00:17:37,625 --> 00:17:38,125 In 475 00:17:38,505 --> 00:17:39,325 2020, 476 00:17:40,265 --> 00:17:42,204 we had a relatively small Medicaid 477 00:17:42,585 --> 00:17:44,744 ACO. We're the second largest in the state 478 00:17:44,744 --> 00:17:47,700 right now. We did not have a Medicare 479 00:17:47,700 --> 00:17:48,600 Advantage product. 480 00:17:49,460 --> 00:17:52,019 Our Medicare Advantage product is the fastest growing 481 00:17:52,019 --> 00:17:53,000 one in the state, 482 00:17:53,460 --> 00:17:55,539 and we weren't in the duals marketplace at 483 00:17:55,539 --> 00:17:56,039 all. 484 00:17:56,500 --> 00:17:57,000 They've 485 00:17:57,715 --> 00:18:00,674 dealt with all of the challenges that all 486 00:18:00,674 --> 00:18:02,855 insurers are dealing with as well as growing 487 00:18:03,555 --> 00:18:04,595 in all of those, 488 00:18:05,075 --> 00:18:07,255 market niches over the last few years. 489 00:18:07,555 --> 00:18:08,455 So communication 490 00:18:08,914 --> 00:18:10,615 is extraordinarily important. 491 00:18:12,299 --> 00:18:14,539 Two is just staying focused on mission, as 492 00:18:14,539 --> 00:18:15,200 I said. 493 00:18:15,660 --> 00:18:17,680 As long as we sort of pass 494 00:18:18,220 --> 00:18:20,700 all of our initiatives through the logic filter 495 00:18:20,700 --> 00:18:21,200 of, 496 00:18:21,580 --> 00:18:23,360 does it improve the experience 497 00:18:23,980 --> 00:18:25,920 clinically? Does it improve the 498 00:18:27,025 --> 00:18:28,484 the day to day experience 499 00:18:29,105 --> 00:18:31,045 of the member? Does it improve 500 00:18:31,585 --> 00:18:32,325 the member's 501 00:18:32,945 --> 00:18:33,924 overall well-being? 502 00:18:34,384 --> 00:18:36,705 And does it improve the the health status 503 00:18:36,705 --> 00:18:37,525 of our communities? 504 00:18:38,144 --> 00:18:40,085 If we stay focused on 505 00:18:40,779 --> 00:18:41,279 pushing 506 00:18:41,819 --> 00:18:42,480 sort of 507 00:18:43,180 --> 00:18:45,920 all of our initiatives up against those challenges, 508 00:18:47,099 --> 00:18:49,180 it pretty much tells us where we need 509 00:18:49,180 --> 00:18:50,640 to go right now. 510 00:18:51,180 --> 00:18:54,059 So we have, I I would like to 511 00:18:54,059 --> 00:18:54,559 think 512 00:18:54,994 --> 00:18:56,535 a little less ambivalence 513 00:18:57,795 --> 00:19:01,394 about continuing to grow and quite frankly, continuing 514 00:19:01,394 --> 00:19:02,375 to grow aggressively 515 00:19:03,075 --> 00:19:05,075 into our markets because we believe that's the 516 00:19:05,075 --> 00:19:07,154 only way we can continue to improve the 517 00:19:07,154 --> 00:19:07,975 service levels, 518 00:19:08,835 --> 00:19:10,055 for our members. 519 00:19:10,434 --> 00:19:12,210 So So if I was gonna translate that 520 00:19:12,210 --> 00:19:12,710 into 521 00:19:13,730 --> 00:19:16,869 advice for my colleagues and quite frankly, 522 00:19:17,809 --> 00:19:20,049 I when I meet with my colleagues, I'd 523 00:19:20,049 --> 00:19:21,910 like to try and listen more than 524 00:19:22,845 --> 00:19:24,845 talk because I I learn a lot from 525 00:19:24,845 --> 00:19:25,345 them. 526 00:19:25,884 --> 00:19:27,025 I would say that 527 00:19:27,724 --> 00:19:29,664 you need to be all in, and 528 00:19:31,484 --> 00:19:33,244 you need to be all in across all 529 00:19:33,244 --> 00:19:35,404 the product lines because your members are gonna 530 00:19:35,404 --> 00:19:37,325 be looking for very different things through their 531 00:19:37,325 --> 00:19:38,304 own life cycle. 532 00:19:38,720 --> 00:19:40,640 And I'd like to believe that we're building 533 00:19:40,640 --> 00:19:41,299 an extraordinarily 534 00:19:42,400 --> 00:19:43,380 strong brand 535 00:19:43,759 --> 00:19:44,900 and brand loyalty 536 00:19:45,680 --> 00:19:46,740 for our members 537 00:19:47,279 --> 00:19:49,039 who wanna stay with us over the long 538 00:19:49,039 --> 00:19:51,200 term. I do not believe that you can 539 00:19:51,200 --> 00:19:53,519 sort of have a strategy which shrinks yourself 540 00:19:53,519 --> 00:19:54,285 into success 541 00:19:55,244 --> 00:19:57,565 that we need to continue to adjust and 542 00:19:57,565 --> 00:20:00,045 grow with the market demands that are out 543 00:20:00,045 --> 00:20:02,525 there as complex and as daunting as they 544 00:20:02,525 --> 00:20:03,424 are right now. 545 00:20:04,125 --> 00:20:06,445 Fantastic. I think that's a great last place 546 00:20:06,445 --> 00:20:08,319 to leave things, Steve, so I want to 547 00:20:08,319 --> 00:20:10,240 thank you for taking the time to sit 548 00:20:10,240 --> 00:20:11,839 down with us on the podcast today and 549 00:20:11,839 --> 00:20:14,559 for sharing your insights with our listeners. We 550 00:20:14,559 --> 00:20:15,700 really appreciate it. 551 00:20:16,159 --> 00:20:17,839 Right. Thank you for the time, Jacob. I 552 00:20:17,839 --> 00:20:20,546 appreciate it. Absolutely. And to our listeners, if 553 00:20:20,546 --> 00:20:22,226 you'd like to listen to more podcasts from 554 00:20:22,226 --> 00:20:26,006 Becker's Healthcare, you can visit beckershospitalreview.com.