1 00:00:02,240 --> 00:00:05,059 This is where health insurance leadership comes together. 2 00:00:05,279 --> 00:00:09,039 Becker's fourth annual spring payer issues roundtable brings 3 00:00:09,039 --> 00:00:12,259 together over 400 payer and health plan executives 4 00:00:12,400 --> 00:00:16,524 and more than 100 speakers to Chicago April. 5 00:00:16,904 --> 00:00:19,785 This year's event includes keynote conversations with the 6 00:00:19,785 --> 00:00:23,064 industry's top leaders and former president George W. 7 00:00:23,064 --> 00:00:25,704 Bush. For the full agenda and event details, 8 00:00:25,704 --> 00:00:27,785 visit beckershospitalreview.com 9 00:00:27,785 --> 00:00:29,224 and click on the events tab in the 10 00:00:29,224 --> 00:00:31,519 upper right. We're looking forward to hosting you 11 00:00:31,519 --> 00:00:32,659 here in Chicago. 12 00:00:34,000 --> 00:00:36,239 Hello, everyone. This is Jacob Emerson with the 13 00:00:36,239 --> 00:00:38,179 Becker's Payer Issues podcast. 14 00:00:38,559 --> 00:00:41,039 Thrilled today to be joined by doctor Alice 15 00:00:41,039 --> 00:00:43,679 Chen, who is executive vice president and chief 16 00:00:43,679 --> 00:00:45,219 health officer at Centene. 17 00:00:45,645 --> 00:00:47,645 Doctor Chen, thank you so much for taking 18 00:00:47,645 --> 00:00:49,004 the time to be with me on the 19 00:00:49,004 --> 00:00:51,564 podcast today. Jacob, thanks for having me. I 20 00:00:51,564 --> 00:00:53,644 am delighted to be here. Absolutely. It's a 21 00:00:53,644 --> 00:00:55,004 pleasure to get to sit down with you, 22 00:00:55,004 --> 00:00:58,045 doctor Chen. And before we dive into everything 23 00:00:58,045 --> 00:00:59,484 we wanna talk with you about, a lot 24 00:00:59,484 --> 00:01:02,086 of the impactful work that's going on with 25 00:01:02,086 --> 00:01:05,026 you and your team at Centene. First, can 26 00:01:05,026 --> 00:01:07,639 you tell our listeners a little bit more 27 00:01:07,639 --> 00:01:10,252 about yourself, your background in health care, and 28 00:01:10,252 --> 00:01:12,865 what it is that you do today at 29 00:01:12,865 --> 00:01:15,204 Centene? Absolutely. So doctor Alice Chen, I'm the 30 00:01:15,204 --> 00:01:17,284 chief health officer at Centene. And just a 31 00:01:17,284 --> 00:01:19,064 little bit about Centene for those 32 00:01:19,605 --> 00:01:22,084 of your, listeners who may not know us. 33 00:01:22,484 --> 00:01:24,084 We are what I think of as a 34 00:01:24,084 --> 00:01:25,385 three m company, 35 00:01:26,325 --> 00:01:29,704 Medicare, Medicaid marketplace, so focused on government programs. 36 00:01:30,299 --> 00:01:33,099 Last year, we serve more than 20,000,000 people 37 00:01:33,099 --> 00:01:35,340 across all 50 states. That's about one in 38 00:01:35,340 --> 00:01:36,319 15 Americans. 39 00:01:36,939 --> 00:01:39,180 And when you look at our footprint, it's 40 00:01:39,180 --> 00:01:41,180 about the same across three all three lines 41 00:01:41,180 --> 00:01:44,159 of business. But in Medicare, 32 states, Medicaid, 42 00:01:44,584 --> 00:01:47,004 30 states, and in Ambetter, our marketplace 43 00:01:47,384 --> 00:01:48,765 product, 29 states. 44 00:01:49,144 --> 00:01:51,805 As for me, I would say my career 45 00:01:52,265 --> 00:01:53,545 could be described as, 46 00:01:53,944 --> 00:01:56,504 focused on ensuring access and quality of care 47 00:01:56,504 --> 00:01:57,724 for underserved Americans. 48 00:01:58,180 --> 00:01:59,879 And I come to the payer space, 49 00:02:00,340 --> 00:02:01,159 joined Centene 50 00:02:02,259 --> 00:02:05,640 almost exactly three years ago, 2023, 51 00:02:06,259 --> 00:02:09,459 with experience across multiple sectors. I think some 52 00:02:09,459 --> 00:02:11,159 people might call it a checkered history. 53 00:02:12,104 --> 00:02:14,504 I'm a primary care internist by training who's 54 00:02:14,504 --> 00:02:17,805 worked in community health centers, public hospitals now, 55 00:02:18,424 --> 00:02:19,724 at a free clinic volunteering, 56 00:02:20,745 --> 00:02:22,284 but I spent time in academia, 57 00:02:22,584 --> 00:02:25,620 philanthropy, public health, had leadership roles in delivery 58 00:02:25,620 --> 00:02:28,500 systems, government, purchaser, and out payer. And here 59 00:02:28,500 --> 00:02:29,159 at Centene, 60 00:02:29,860 --> 00:02:31,560 my role is tied directly 61 00:02:32,180 --> 00:02:34,099 to our mission, which is transforming the health 62 00:02:34,099 --> 00:02:36,340 of the communities we serve one person at 63 00:02:36,340 --> 00:02:38,354 a time. And by that, I mean, I 64 00:02:38,354 --> 00:02:41,634 oversee Centene's clinical policies and programs to improve 65 00:02:41,634 --> 00:02:43,175 population health for our members, 66 00:02:43,955 --> 00:02:44,935 specifically leading 67 00:02:45,235 --> 00:02:47,555 medical affairs, health equity, drivers of health, and 68 00:02:47,555 --> 00:02:50,390 clinical strategy. And just a word about how 69 00:02:50,390 --> 00:02:51,909 we do this because I think it'll inform 70 00:02:51,909 --> 00:02:53,129 our discussion, which is, 71 00:02:53,830 --> 00:02:54,330 given 72 00:02:54,790 --> 00:02:55,689 our footprint, 73 00:02:56,230 --> 00:02:58,730 the way we approach population health, and frankly, 74 00:02:59,590 --> 00:03:01,930 our, I think, unique identity is around 75 00:03:02,355 --> 00:03:04,534 leveraging national size and scale 76 00:03:04,915 --> 00:03:08,135 for local impact through our state health plans. 77 00:03:08,355 --> 00:03:08,855 So 78 00:03:09,395 --> 00:03:11,715 it comes in many flavors, but two two 79 00:03:11,715 --> 00:03:14,034 big buckets are, one, we're really big on 80 00:03:14,034 --> 00:03:16,729 data. How do we use data across in 81 00:03:16,729 --> 00:03:19,389 Medicaid, for example, 30 states to identify trends, 82 00:03:19,849 --> 00:03:22,889 guide evidence based interventions that address community specific 83 00:03:22,889 --> 00:03:23,949 needs? So it's both 84 00:03:24,250 --> 00:03:26,729 a bird's eye view across multiple markets, but 85 00:03:26,729 --> 00:03:29,575 then tailoring them to the specific nuances of 86 00:03:29,575 --> 00:03:30,555 any given community. 87 00:03:30,935 --> 00:03:33,014 And that second part ties to that nuance 88 00:03:33,014 --> 00:03:35,415 piece, which is we look to partner with 89 00:03:35,415 --> 00:03:37,655 local, regional, and national organizations to have a 90 00:03:37,655 --> 00:03:38,555 similar mission, 91 00:03:38,855 --> 00:03:41,495 a focus on low income Americans and improving 92 00:03:41,495 --> 00:03:42,235 their health. 93 00:03:43,000 --> 00:03:44,840 Understood. Well, I I really appreciate you taking 94 00:03:44,840 --> 00:03:47,020 us through that, Alice. You had a fascinating 95 00:03:47,240 --> 00:03:49,800 career before Centene, and and now you're you're 96 00:03:49,800 --> 00:03:51,400 with one of the largest insurers in the 97 00:03:51,400 --> 00:03:52,460 country. You mentioned, 98 00:03:52,920 --> 00:03:56,215 serving around one in 15 Americans. That's absolutely 99 00:03:56,215 --> 00:03:56,715 incredible 100 00:03:57,094 --> 00:03:59,414 across your different your different product lines all 101 00:03:59,414 --> 00:04:01,414 over the country. And I'm and I'm excited 102 00:04:01,414 --> 00:04:03,114 to get to talk with you today because 103 00:04:03,175 --> 00:04:04,854 I I really wanted to dive in first 104 00:04:04,854 --> 00:04:07,974 by talking about something really an exciting announcement 105 00:04:07,974 --> 00:04:09,675 from the company last year, 106 00:04:10,120 --> 00:04:13,000 that Centene helped launch the Maternal and Child 107 00:04:13,000 --> 00:04:15,879 Health Center for Policy and Practice as a 108 00:04:15,879 --> 00:04:16,860 founding member, 109 00:04:17,480 --> 00:04:19,560 which for our listeners who might not be 110 00:04:19,560 --> 00:04:20,060 familiar, 111 00:04:21,000 --> 00:04:23,720 it ultimately aims to improve maternal and child 112 00:04:23,720 --> 00:04:24,459 health outcomes 113 00:04:24,805 --> 00:04:26,964 in rural parts of the country in many 114 00:04:26,964 --> 00:04:28,904 states, but starting in Arkansas. 115 00:04:29,524 --> 00:04:31,285 So, Alice, can you can you fill us 116 00:04:31,285 --> 00:04:33,464 in on exactly how this all came about 117 00:04:33,524 --> 00:04:35,384 and why ultimately Centene 118 00:04:35,845 --> 00:04:37,865 wanted to be a part of it? Yeah. 119 00:04:38,230 --> 00:04:40,250 You know, it ties to what I was 120 00:04:40,550 --> 00:04:42,730 describing before about who we serve 121 00:04:43,189 --> 00:04:46,149 and how we approach our work. So as 122 00:04:46,149 --> 00:04:48,730 the largest Medicaid MCU in the country and 123 00:04:49,189 --> 00:04:51,670 by dint of that, the largest TANF payer, 124 00:04:51,670 --> 00:04:52,410 we have, 125 00:04:52,790 --> 00:04:53,610 very naturally 126 00:04:54,084 --> 00:04:56,985 a focus on pregnant women, new mothers, 127 00:04:57,604 --> 00:04:58,504 infants, children. 128 00:04:59,204 --> 00:05:00,425 In 2020, 129 00:05:01,444 --> 00:05:03,845 '4, I think was the last complete year 130 00:05:03,845 --> 00:05:06,724 of data, we were responsible for more than 131 00:05:06,724 --> 00:05:08,985 three hundred and thirty thousand births, 132 00:05:09,730 --> 00:05:11,649 a third percent of whom are high risk. 133 00:05:11,649 --> 00:05:13,170 So, again, when you look at who we 134 00:05:13,170 --> 00:05:14,529 care for and, 135 00:05:15,889 --> 00:05:18,050 where the vulnerabilities line, where we need to 136 00:05:18,050 --> 00:05:20,389 lean in, maternal childcare is clearly, 137 00:05:21,009 --> 00:05:23,009 a priority for us. So we have a 138 00:05:23,009 --> 00:05:24,230 multi pronged approach, 139 00:05:24,850 --> 00:05:25,350 to 140 00:05:25,694 --> 00:05:28,115 just call it perinatal care, maternal child health. 141 00:05:28,654 --> 00:05:31,694 We have internal care management programs. We have 142 00:05:31,694 --> 00:05:34,094 value based care programs to partner with our 143 00:05:34,094 --> 00:05:36,834 providers to incentivize pre and postnatal visits. 144 00:05:37,214 --> 00:05:38,435 We have, partnerships 145 00:05:38,830 --> 00:05:41,389 with a whole variety of entities, including what 146 00:05:41,389 --> 00:05:42,430 we'll be talking about, 147 00:05:43,230 --> 00:05:45,569 to to expand access to evidence based models. 148 00:05:45,949 --> 00:05:47,550 And then another piece, which I think is 149 00:05:47,550 --> 00:05:49,949 really relevant because it's really in the water 150 00:05:49,949 --> 00:05:51,810 right now when you look at CMS, MMI, 151 00:05:52,245 --> 00:05:55,464 We focus on introducing and scaling technology 152 00:05:55,764 --> 00:05:58,904 enabled interventions, so things like telehealth, virtual 153 00:05:59,845 --> 00:06:01,865 health tools, remote patient monitoring, 154 00:06:02,805 --> 00:06:04,964 with a real focus on how do you 155 00:06:04,964 --> 00:06:06,264 strike the right balance 156 00:06:06,660 --> 00:06:08,759 of high-tech, high touch care. 157 00:06:09,060 --> 00:06:10,900 And this is particularly relevant when you talk 158 00:06:10,900 --> 00:06:12,199 about the Heartland 159 00:06:13,540 --> 00:06:14,040 Forward. 160 00:06:14,340 --> 00:06:16,580 This is what the group that's sponsoring the 161 00:06:16,580 --> 00:06:19,480 Maternal Child Health Center for Policy and Practice. 162 00:06:20,764 --> 00:06:23,824 So just a little PSA about Heartland Forward. 163 00:06:24,764 --> 00:06:27,084 It they describe themselves as a do and 164 00:06:27,084 --> 00:06:27,904 think tank, 165 00:06:28,605 --> 00:06:32,125 focused advanced economic success for states in the 166 00:06:32,125 --> 00:06:35,290 primarily Midwest but also South. And so as 167 00:06:35,290 --> 00:06:36,730 part of that, the health land, 168 00:06:37,370 --> 00:06:38,750 Heartland Health Caucus, 169 00:06:39,689 --> 00:06:42,649 decided to focus on rural health. And when 170 00:06:42,649 --> 00:06:44,170 you look at rural health, a few things 171 00:06:44,170 --> 00:06:46,009 really rise to the forum. One is maternal 172 00:06:46,009 --> 00:06:46,830 child health, 173 00:06:47,449 --> 00:06:48,105 one is 174 00:06:48,504 --> 00:06:50,585 mental health, and a third is, 175 00:06:51,145 --> 00:06:52,444 workforce shortages. 176 00:06:52,824 --> 00:06:55,384 And so how this came about was, our 177 00:06:55,384 --> 00:06:57,785 CEO, Sarah London, was approached a few years 178 00:06:57,785 --> 00:06:59,785 ago given, again, who we serve, what our 179 00:06:59,785 --> 00:07:00,285 focus 180 00:07:00,585 --> 00:07:03,245 is about participating in how Heartland Health Caucus, 181 00:07:03,620 --> 00:07:05,480 which is in the process of establishing 182 00:07:06,180 --> 00:07:06,839 the center. 183 00:07:07,300 --> 00:07:09,080 And just when you look at the alignment 184 00:07:09,220 --> 00:07:11,560 in terms of priorities and focus areas, 185 00:07:12,020 --> 00:07:14,520 and members and people who are trying to, 186 00:07:15,220 --> 00:07:16,839 improve the health of it, made 187 00:07:17,574 --> 00:07:19,814 intuitive sense for us to join forces. And 188 00:07:19,814 --> 00:07:22,235 so we really welcome the opportunity, 189 00:07:23,814 --> 00:07:26,534 to bring in, an all one Centene, all 190 00:07:26,534 --> 00:07:28,935 of Centene approach. So it's our local health 191 00:07:28,935 --> 00:07:30,794 plan. It's our national team, 192 00:07:31,660 --> 00:07:34,139 both on the clinical side and the drivers 193 00:07:34,139 --> 00:07:35,740 of health and health equity side as well 194 00:07:35,740 --> 00:07:36,399 as our foundation. 195 00:07:37,259 --> 00:07:39,360 And the partnership itself focuses 196 00:07:40,220 --> 00:07:41,279 on midwifery 197 00:07:41,979 --> 00:07:44,639 as a proven high quality cost effective model 198 00:07:44,884 --> 00:07:47,524 to improve access and outcomes, particularly for women 199 00:07:47,524 --> 00:07:49,444 in rural areas. And our main goal is 200 00:07:49,444 --> 00:07:50,425 to expand education 201 00:07:51,204 --> 00:07:54,664 and improve the workforce pipeline there. So 202 00:07:54,964 --> 00:07:57,685 launched mid last year, already made some great 203 00:07:57,685 --> 00:07:58,185 progress. 204 00:07:59,290 --> 00:08:00,650 Wow. And and it does it makes a 205 00:08:00,650 --> 00:08:03,370 lot of sense approaching Centene specifically for this 206 00:08:03,370 --> 00:08:04,270 type of partnership. 207 00:08:04,970 --> 00:08:06,569 Like you said, Alice, given that you are 208 00:08:06,569 --> 00:08:09,689 the largest Medicaid MCO in the country, you 209 00:08:09,689 --> 00:08:10,189 you, 210 00:08:10,490 --> 00:08:13,710 provide coverage to hundreds of thousands of births, 211 00:08:14,514 --> 00:08:17,154 every year. And so you you mentioned the 212 00:08:17,154 --> 00:08:19,555 the senator is really focused on expanding access 213 00:08:19,555 --> 00:08:22,454 to community health workers, to doulas, 214 00:08:22,754 --> 00:08:24,055 to midwifery care, 215 00:08:24,915 --> 00:08:27,875 especially as in areas where labor and delivery 216 00:08:27,875 --> 00:08:30,100 units have closed. And I and I know 217 00:08:30,100 --> 00:08:31,779 when I when I speak from our perspective 218 00:08:31,779 --> 00:08:33,779 here at Becker's, that is something that we 219 00:08:33,779 --> 00:08:35,940 almost see, I'd say, every week at this 220 00:08:35,940 --> 00:08:36,440 point, 221 00:08:37,139 --> 00:08:40,259 across the country, a a maternity unit that 222 00:08:40,259 --> 00:08:42,340 is closed somewhere in the country. It's something 223 00:08:42,340 --> 00:08:44,500 that we track very closely, and it seems 224 00:08:44,500 --> 00:08:45,105 to be a very, 225 00:08:45,904 --> 00:08:47,684 a growing trend nationally. 226 00:08:48,784 --> 00:08:51,424 So I wonder from from a population health 227 00:08:51,424 --> 00:08:51,924 perspective, 228 00:08:52,384 --> 00:08:54,544 you were you were mentioning mentioning earlier about 229 00:08:54,544 --> 00:08:56,725 some of the interventions that are important here. 230 00:08:57,264 --> 00:08:59,345 What what is the evidence telling you right 231 00:08:59,345 --> 00:09:02,299 now about which interventions move the needle most 232 00:09:02,299 --> 00:09:02,960 in these 233 00:09:03,340 --> 00:09:03,840 rural, 234 00:09:04,379 --> 00:09:06,240 Medicaid dominant populations? 235 00:09:06,860 --> 00:09:07,360 Yeah. 236 00:09:07,740 --> 00:09:10,480 And to level set our listeners, 237 00:09:12,139 --> 00:09:14,559 you know, you may see the headlines around 238 00:09:15,495 --> 00:09:16,955 rural health crises 239 00:09:17,495 --> 00:09:17,995 or, 240 00:09:19,254 --> 00:09:21,894 maternity deserts. Like you said, every week, there 241 00:09:21,894 --> 00:09:22,794 seems to be, 242 00:09:23,414 --> 00:09:26,855 another facility closing. But right now, 35% 243 00:09:26,855 --> 00:09:29,434 of counties are considered maternity deserts. 244 00:09:29,809 --> 00:09:32,709 Wow. I mean, where they lack any obstetric 245 00:09:33,169 --> 00:09:33,669 clinician. 246 00:09:35,490 --> 00:09:38,129 And in over a thousand counties, there's not 247 00:09:38,129 --> 00:09:39,589 a single birthing facility 248 00:09:40,370 --> 00:09:40,870 available. 249 00:09:41,490 --> 00:09:43,190 So when you think about 250 00:09:43,964 --> 00:09:44,625 rural Medicaid 251 00:09:45,164 --> 00:09:47,164 populations, actually, so it's not just rural, but, 252 00:09:47,164 --> 00:09:51,004 like, within Medicaid populations, rural communities face unique 253 00:09:51,004 --> 00:09:53,565 barriers. And so when you put together the 254 00:09:53,565 --> 00:09:55,985 fact that the women themselves are oftentimes 255 00:09:57,590 --> 00:10:01,129 higher risk profiles in terms of medical, behavioral, 256 00:10:01,269 --> 00:10:03,450 social risk factors plus 257 00:10:04,149 --> 00:10:06,889 maternity deserts and care fragmentation, you 258 00:10:07,429 --> 00:10:10,250 pretty logically get poor outcomes. And so, 259 00:10:11,295 --> 00:10:13,075 love that you asked about the evidence, 260 00:10:13,455 --> 00:10:16,115 because, again, we're really focused on both 261 00:10:16,575 --> 00:10:19,315 using our data across 30 markets to identify 262 00:10:19,455 --> 00:10:22,575 themes and issues, but then implementing models that 263 00:10:22,575 --> 00:10:24,595 have evidence of impact. Because 264 00:10:25,080 --> 00:10:27,559 just as an aside, as a government payer, 265 00:10:27,559 --> 00:10:29,980 we really do take our fiduciary responsibility 266 00:10:30,440 --> 00:10:33,100 very seriously. And so if we're using, 267 00:10:33,800 --> 00:10:36,040 taxpayer dollars to fund government programs, we wanna 268 00:10:36,040 --> 00:10:38,815 make sure those dollars go to evidence based 269 00:10:38,815 --> 00:10:41,394 interventions and then also ensure that we're evaluating 270 00:10:41,454 --> 00:10:44,095 the impact of our intervention. So in terms 271 00:10:44,095 --> 00:10:46,495 of the top three care models that we're 272 00:10:46,495 --> 00:10:48,355 looking to invest in, 273 00:10:48,735 --> 00:10:50,914 one is, for average risk pregnancies, 274 00:10:51,454 --> 00:10:52,754 midwifery led models, 275 00:10:53,429 --> 00:10:55,509 because they're associated with lower rates of c 276 00:10:55,509 --> 00:10:59,350 section, preterm births, low birth weight infants. And 277 00:10:59,350 --> 00:11:02,149 again, that's why we, with Heartland Forward, are 278 00:11:02,149 --> 00:11:04,710 really focused on expanding the workforce for rural 279 00:11:04,710 --> 00:11:05,210 areas. 280 00:11:05,934 --> 00:11:08,434 Second would be community based doula care. 281 00:11:08,735 --> 00:11:12,175 Lots of observational studies and Medicaid demonstrations showing, 282 00:11:12,175 --> 00:11:15,134 again, reductions in low risk c sections and 283 00:11:15,134 --> 00:11:17,235 preterm birth along with improved, 284 00:11:18,095 --> 00:11:20,355 engagement in patient reported experience. 285 00:11:21,029 --> 00:11:23,529 What's interesting there is that the greatest benefits 286 00:11:24,070 --> 00:11:26,470 are reported in some of the most vulnerable 287 00:11:26,470 --> 00:11:28,490 populations, so Medicaid insured, rural, 288 00:11:28,870 --> 00:11:30,949 black, native population. So it really does seem 289 00:11:30,949 --> 00:11:33,269 to have a mitigating effect on some of 290 00:11:33,269 --> 00:11:36,100 the structural barriers. And then the third, what 291 00:11:36,605 --> 00:11:38,524 I'd say, strongly evidence based care model would 292 00:11:38,524 --> 00:11:40,865 be, group prenatal visits, 293 00:11:41,404 --> 00:11:45,805 which, again, particularly among Medicaid populations and communities 294 00:11:45,805 --> 00:11:47,425 with limited access to traditional 295 00:11:48,125 --> 00:11:50,625 prenatal care, have been shown to reduce, 296 00:11:51,404 --> 00:11:51,904 preterm 297 00:11:52,740 --> 00:11:53,240 births, 298 00:11:53,860 --> 00:11:54,840 as well as 299 00:11:55,220 --> 00:11:56,600 patient or member engagement, 300 00:11:57,620 --> 00:11:58,360 and satisfaction. 301 00:11:59,700 --> 00:12:01,460 Aside from those models, I just wanna make, 302 00:12:01,779 --> 00:12:04,100 another really key point, which is when you 303 00:12:04,100 --> 00:12:05,320 look at the moms, 304 00:12:06,264 --> 00:12:09,225 the majority of maternal deaths actually occur after 305 00:12:09,225 --> 00:12:11,084 delivery. Over half of them occur 306 00:12:11,464 --> 00:12:13,865 between, you know, seven days to a year 307 00:12:13,865 --> 00:12:15,964 postpartum, and it's largely driven 308 00:12:16,424 --> 00:12:17,245 by cardiovascular, 309 00:12:17,784 --> 00:12:18,284 maternal, 310 00:12:19,065 --> 00:12:20,284 cardiovascular conditions, 311 00:12:20,940 --> 00:12:23,259 mental health, and substance use disorder. So really 312 00:12:23,259 --> 00:12:26,540 CBD and behavioral health. And so that then 313 00:12:26,540 --> 00:12:29,100 leads to looking at, like, what are the 314 00:12:29,100 --> 00:12:30,240 evidence based interventions 315 00:12:30,540 --> 00:12:33,120 from a policy side? It's about continuous, 316 00:12:33,980 --> 00:12:34,480 coverage 317 00:12:34,835 --> 00:12:35,815 and proactive engagement 318 00:12:36,195 --> 00:12:37,575 through twelve months. What's 319 00:12:38,035 --> 00:12:40,434 the really good news is almost every single 320 00:12:40,434 --> 00:12:40,934 state 321 00:12:41,475 --> 00:12:42,375 has expanded, 322 00:12:42,995 --> 00:12:44,054 Medicaid eligibility 323 00:12:44,995 --> 00:12:47,174 for women, twelve months postpartum. 324 00:12:47,480 --> 00:12:49,879 So that enables us as a Medicare managed 325 00:12:49,879 --> 00:12:52,279 care plan to really lean in and engage 326 00:12:52,279 --> 00:12:53,100 them around 327 00:12:53,559 --> 00:12:55,660 blood pressure control, you know, 328 00:12:56,200 --> 00:12:59,879 diagnosing and addressing postpartum depression, addressing substance use 329 00:12:59,879 --> 00:13:01,639 disorders. And then that leads to the second 330 00:13:01,639 --> 00:13:04,294 piece, which is integrated care models 331 00:13:04,674 --> 00:13:07,315 where you actually integrate chronic care, physical health, 332 00:13:07,315 --> 00:13:08,375 behavioral health, 333 00:13:08,754 --> 00:13:09,735 substance use 334 00:13:10,274 --> 00:13:11,414 disorder services, 335 00:13:12,274 --> 00:13:14,754 are really strongly supported by the evidence in 336 00:13:14,754 --> 00:13:15,394 terms of not 337 00:13:16,299 --> 00:13:18,320 again, for these high risk women, 338 00:13:18,779 --> 00:13:21,500 creating more holistic whole person care models as 339 00:13:21,500 --> 00:13:22,720 opposed to kind of fragmented 340 00:13:23,660 --> 00:13:24,960 parallel interventions, 341 00:13:26,460 --> 00:13:26,960 is 342 00:13:27,420 --> 00:13:29,100 are the types of models that we're looking 343 00:13:29,100 --> 00:13:29,600 to. 344 00:13:30,514 --> 00:13:32,455 Understood. So more midwifery 345 00:13:32,915 --> 00:13:34,535 doula group prenatal 346 00:13:34,915 --> 00:13:35,735 care models, 347 00:13:36,115 --> 00:13:39,495 hopefully scaled across the country and across Centene's 348 00:13:39,554 --> 00:13:41,554 Medicaid markets. And I have to say, it's 349 00:13:41,554 --> 00:13:43,634 also been very interesting, Alice, over these last 350 00:13:43,634 --> 00:13:44,695 few years, seen 351 00:13:45,160 --> 00:13:47,100 state Medicaid programs incorporate 352 00:13:47,639 --> 00:13:49,179 things like doula coverage, 353 00:13:49,960 --> 00:13:51,980 into their into their clinical pathways. 354 00:13:52,279 --> 00:13:53,580 It really seems to be 355 00:13:54,040 --> 00:13:57,399 a government private industry effort here, to incorporate 356 00:13:57,399 --> 00:14:00,024 more of these interventions all over. I think 357 00:14:00,024 --> 00:14:02,924 that's a wonderful development because, again, I think 358 00:14:03,225 --> 00:14:04,365 following the evidence, 359 00:14:04,745 --> 00:14:06,285 figuring out what the, 360 00:14:07,065 --> 00:14:08,205 most cost effective 361 00:14:09,304 --> 00:14:12,125 member patient person centric interventions 362 00:14:12,904 --> 00:14:14,445 is a place where 363 00:14:15,100 --> 00:14:16,399 having a Medicaid agency 364 00:14:16,860 --> 00:14:20,299 incentivize it allows us as MCOs to step 365 00:14:20,299 --> 00:14:22,879 up and really be that partner. Yeah. Definitely. 366 00:14:22,940 --> 00:14:24,399 Definitely. And I wonder 367 00:14:25,019 --> 00:14:26,480 going back to you mentioned 368 00:14:26,779 --> 00:14:28,399 you have a fiduciary duty, 369 00:14:29,264 --> 00:14:30,964 to to get the best outcomes, 370 00:14:32,384 --> 00:14:35,264 on behalf of of providing this this government 371 00:14:35,264 --> 00:14:37,985 service all over the country. And so what 372 00:14:37,985 --> 00:14:40,225 are some of the the maternal and and 373 00:14:40,225 --> 00:14:41,909 child health metrics that, 374 00:14:42,470 --> 00:14:43,769 Centene is really prioritizing 375 00:14:44,230 --> 00:14:46,549 internally right now? And and how does this 376 00:14:46,549 --> 00:14:48,009 partnership with Heartland 377 00:14:48,549 --> 00:14:51,269 help you build a better data infrastructure so 378 00:14:51,269 --> 00:14:53,429 that you can track these outcomes that really 379 00:14:53,429 --> 00:14:54,329 matter beyond, 380 00:14:55,029 --> 00:14:56,089 just the care delivery? 381 00:14:56,549 --> 00:14:59,815 Yeah. Absolutely. So data has been a strong 382 00:14:59,815 --> 00:15:01,575 focus for us over the last few years 383 00:15:01,575 --> 00:15:02,235 writ large, 384 00:15:03,095 --> 00:15:04,955 focusing on a core set of 385 00:15:05,335 --> 00:15:06,795 outcome and quality metrics 386 00:15:07,254 --> 00:15:07,754 that 387 00:15:08,375 --> 00:15:09,514 we feel represent 388 00:15:09,990 --> 00:15:11,289 safety and effectiveness 389 00:15:11,590 --> 00:15:14,710 of maternity care across the perinatal continuum. And 390 00:15:14,710 --> 00:15:17,269 working with a group like Heartland enables us 391 00:15:17,269 --> 00:15:19,370 to really hone in on 392 00:15:20,230 --> 00:15:22,250 starting with a state but then a region, 393 00:15:22,870 --> 00:15:24,409 to then use that data 394 00:15:24,954 --> 00:15:25,695 in a, 395 00:15:26,475 --> 00:15:29,294 proactive way to kind of tailor our interventions, 396 00:15:29,595 --> 00:15:31,914 continuing to evolve the programs, and make sure 397 00:15:31,914 --> 00:15:35,214 that those outcomes continue to improve over time. 398 00:15:35,434 --> 00:15:36,654 So some of the key, 399 00:15:37,460 --> 00:15:39,160 so obviously, all health plans, 400 00:15:39,539 --> 00:15:40,440 look to HEDIS. 401 00:15:40,899 --> 00:15:43,460 And so we have the obstetrical specific HEDIS 402 00:15:43,460 --> 00:15:45,700 metrics. But in addition to that and this 403 00:15:45,700 --> 00:15:47,720 is where, again, partnering with other 404 00:15:48,259 --> 00:15:49,720 entities, whether it's providers 405 00:15:50,100 --> 00:15:50,600 or 406 00:15:51,225 --> 00:15:54,264 regional leaders like Heartland Forward who are potentially 407 00:15:54,264 --> 00:15:55,325 able to to 408 00:15:55,784 --> 00:15:56,284 aggregate 409 00:15:56,985 --> 00:15:57,485 more 410 00:15:57,865 --> 00:15:59,865 diverse types of data is very helpful because 411 00:15:59,865 --> 00:16:01,464 some of these aren't claims based. I mean, 412 00:16:01,464 --> 00:16:03,225 the ones I'm about to talk about. So 413 00:16:03,225 --> 00:16:04,799 we need to look at charts and we 414 00:16:04,799 --> 00:16:06,820 need to partner with providers, but things like 415 00:16:07,120 --> 00:16:09,120 low risk c section rates are a key 416 00:16:09,120 --> 00:16:12,080 measure of obstetric quality because we know that, 417 00:16:12,720 --> 00:16:15,840 c section bursts can be associated with increased 418 00:16:15,840 --> 00:16:19,039 maternal morbidity, higher risk in subsequent pregnancies, and, 419 00:16:19,039 --> 00:16:21,014 of course, increased costs. And so if we 420 00:16:21,014 --> 00:16:23,115 can avoid those, that is a good thing. 421 00:16:23,495 --> 00:16:25,975 We also track preterm birth and low birth 422 00:16:25,975 --> 00:16:27,034 weight rates, 423 00:16:27,495 --> 00:16:29,014 which we see as a measure of the 424 00:16:29,014 --> 00:16:31,754 efficacy of prenatal and perinatal care. 425 00:16:32,629 --> 00:16:35,450 We track severe maternal morbidity rates 426 00:16:35,830 --> 00:16:39,289 because that gives us a signal around how 427 00:16:39,509 --> 00:16:40,970 effective has the prenatal 428 00:16:41,350 --> 00:16:42,410 care been in terms 429 00:16:42,789 --> 00:16:43,529 of proactively 430 00:16:44,309 --> 00:16:48,144 and aggressively identifying gaps in diagnosis response care 431 00:16:48,144 --> 00:16:48,644 coordination. 432 00:16:49,664 --> 00:16:51,184 The ultimate metric, 433 00:16:51,504 --> 00:16:53,985 mortality rates, so maternal and infant mortality rates 434 00:16:53,985 --> 00:16:56,325 is something that we track as a sentinel, 435 00:16:57,504 --> 00:16:59,345 indicator of, you know, the most severe and 436 00:16:59,345 --> 00:16:59,845 preventable 437 00:17:00,360 --> 00:17:01,480 adverse outcomes as, 438 00:17:02,039 --> 00:17:04,599 when possible. Not all of them obviously are 439 00:17:04,599 --> 00:17:05,400 preventable, but, 440 00:17:06,039 --> 00:17:06,539 given 441 00:17:06,920 --> 00:17:09,799 our rates compared to other industrialized countries, clearly, 442 00:17:09,799 --> 00:17:10,859 we have a lot of 443 00:17:11,559 --> 00:17:12,539 room for improvement. 444 00:17:12,914 --> 00:17:13,815 And then lastly, 445 00:17:14,434 --> 00:17:16,914 neonatal intensive care, you know, or NICU admission 446 00:17:16,914 --> 00:17:17,394 rates, 447 00:17:18,035 --> 00:17:18,535 which, 448 00:17:19,075 --> 00:17:22,134 again, not all are preventable, but are also 449 00:17:22,275 --> 00:17:22,775 a 450 00:17:23,555 --> 00:17:25,414 indication for us of prenatal 451 00:17:26,269 --> 00:17:27,250 care comprehensiveness 452 00:17:27,630 --> 00:17:29,009 and quality. So 453 00:17:29,630 --> 00:17:30,130 taking 454 00:17:31,069 --> 00:17:34,429 a broader view than just HEDIS and making 455 00:17:34,429 --> 00:17:35,569 sure that we, 456 00:17:36,190 --> 00:17:36,690 have 457 00:17:36,990 --> 00:17:37,490 complete 458 00:17:38,109 --> 00:17:40,289 high integrity data and then 459 00:17:40,904 --> 00:17:43,465 sharing that data with our providers and our 460 00:17:43,465 --> 00:17:44,285 other partners 461 00:17:44,904 --> 00:17:46,984 is core to how we think we're gonna 462 00:17:46,984 --> 00:17:50,125 be able to create a shared accountability framework 463 00:17:50,664 --> 00:17:52,904 and truly move the dial in terms of 464 00:17:52,904 --> 00:17:53,404 outcomes. 465 00:17:54,559 --> 00:17:56,720 Well, clearly, a lot that goes into this 466 00:17:56,720 --> 00:17:59,839 beyond just the claims data, Alice. And and 467 00:17:59,839 --> 00:18:01,839 to your point, a lot of work still 468 00:18:01,839 --> 00:18:03,700 needs to be done, to improve 469 00:18:04,400 --> 00:18:07,359 improve these maternal health outcomes compared to, other 470 00:18:07,359 --> 00:18:07,859 industrialized 471 00:18:08,160 --> 00:18:10,375 countries. And so in that vein, 472 00:18:10,994 --> 00:18:12,615 this is such a massive topic. 473 00:18:12,994 --> 00:18:15,634 So are there other strategies or initiatives you 474 00:18:15,634 --> 00:18:17,794 could share with us that Centene has been 475 00:18:17,794 --> 00:18:18,774 pursuing recently, 476 00:18:19,315 --> 00:18:22,115 to really address the these maternal and and 477 00:18:22,115 --> 00:18:23,494 child health outcomes overall? 478 00:18:24,250 --> 00:18:26,009 Yeah. Thanks for asking that because this is 479 00:18:26,009 --> 00:18:27,529 a this is an area where I'm really 480 00:18:27,529 --> 00:18:28,589 proud of our teams, 481 00:18:29,369 --> 00:18:31,450 because we really have we're not where we 482 00:18:31,450 --> 00:18:33,049 need to be. I don't think any anyone 483 00:18:33,049 --> 00:18:34,669 is in The United States, but I think 484 00:18:34,730 --> 00:18:36,669 we really have stepped back and created, 485 00:18:37,289 --> 00:18:38,029 a comprehensive, 486 00:18:38,490 --> 00:18:39,549 holistic approach, 487 00:18:40,964 --> 00:18:41,785 that includes, 488 00:18:42,644 --> 00:18:43,785 focusing on access, 489 00:18:44,404 --> 00:18:45,944 on member engagement, 490 00:18:46,404 --> 00:18:47,865 education, self management, 491 00:18:48,565 --> 00:18:51,204 on our care management resources, as well as 492 00:18:51,204 --> 00:18:51,944 care coordination, 493 00:18:52,325 --> 00:18:53,305 provider partnerships, 494 00:18:53,924 --> 00:18:55,224 technology enabled. 495 00:18:55,809 --> 00:18:57,690 But I think it was pro vendors. Like, 496 00:18:57,690 --> 00:18:59,369 sometimes people will call them vendors, but they're 497 00:18:59,369 --> 00:19:02,170 really also providing care, and then community based 498 00:19:02,170 --> 00:19:04,269 organizations as well as, you know, 499 00:19:04,730 --> 00:19:06,109 think do tanks like, 500 00:19:07,529 --> 00:19:08,990 Heartland Forward. And so 501 00:19:09,525 --> 00:19:10,265 some specific 502 00:19:10,644 --> 00:19:11,144 examples, 503 00:19:11,605 --> 00:19:12,345 we have 504 00:19:14,085 --> 00:19:15,305 a very robust 505 00:19:15,684 --> 00:19:18,744 care management program called Start Smart for Baby 506 00:19:19,365 --> 00:19:20,184 where we, 507 00:19:21,205 --> 00:19:22,265 leverage data 508 00:19:23,759 --> 00:19:24,500 to identify 509 00:19:24,799 --> 00:19:25,299 pregnancy 510 00:19:25,680 --> 00:19:28,259 as early as possible, do risk stratification, 511 00:19:28,720 --> 00:19:30,400 and then reach out to members in a 512 00:19:30,400 --> 00:19:31,619 very tailored way 513 00:19:32,320 --> 00:19:34,740 driven by their needs and their assessments. 514 00:19:35,119 --> 00:19:38,075 And, again, and in a whole person integrated 515 00:19:38,295 --> 00:19:38,795 physical 516 00:19:39,494 --> 00:19:43,194 behavioral, meaning mental and substance use disorder, social 517 00:19:43,654 --> 00:19:44,554 care model 518 00:19:45,015 --> 00:19:47,194 that includes comprehensive education 519 00:19:48,054 --> 00:19:48,554 and 520 00:19:49,200 --> 00:19:49,700 also 521 00:19:50,000 --> 00:19:52,740 integrate some of our drivers of health initiatives 522 00:19:52,880 --> 00:19:54,259 like, food is medicine. 523 00:19:54,720 --> 00:19:56,960 So, for example, we're piloting a program as 524 00:19:56,960 --> 00:19:58,500 part of Start Smart for Baby 525 00:19:58,960 --> 00:20:01,059 to provide funding to high risk members 526 00:20:02,625 --> 00:20:05,265 so they can order healthy food, blood pressure 527 00:20:05,265 --> 00:20:07,265 cuffs for folks who have high blood pressure 528 00:20:07,265 --> 00:20:09,445 and prenatal vitamins. All the things we know 529 00:20:09,825 --> 00:20:10,325 are 530 00:20:11,424 --> 00:20:13,505 core to just having a healthy pregnancy, but, 531 00:20:13,505 --> 00:20:14,005 like, 532 00:20:14,305 --> 00:20:16,945 trying to reduce or eliminate the barriers to 533 00:20:16,945 --> 00:20:18,500 being able to take those actions. 534 00:20:19,440 --> 00:20:21,039 We also just rolled out a first years 535 00:20:21,039 --> 00:20:24,000 of life program to support kids, from birth 536 00:20:24,000 --> 00:20:26,580 to two years taking advantage of that continuous 537 00:20:26,640 --> 00:20:27,859 eligibility postpartum 538 00:20:28,320 --> 00:20:30,480 to engage the mom and then hopefully keep 539 00:20:30,480 --> 00:20:31,859 those kids, covered. 540 00:20:32,545 --> 00:20:33,765 I mentioned before, 541 00:20:34,625 --> 00:20:35,125 technology 542 00:20:35,585 --> 00:20:37,204 is a big piece of our strategy, 543 00:20:38,065 --> 00:20:39,924 particularly when you think about rural communities, 544 00:20:40,545 --> 00:20:43,765 and just how do you leverage scarce resources, 545 00:20:44,384 --> 00:20:46,005 in the community and then 546 00:20:46,429 --> 00:20:47,490 outside the community, 547 00:20:47,950 --> 00:20:49,309 so that they don't have to spend hours 548 00:20:49,309 --> 00:20:50,289 traveling. So 549 00:20:50,669 --> 00:20:51,329 we do, 550 00:20:52,269 --> 00:20:54,929 traditional virtual health and telehealth where we, 551 00:20:55,470 --> 00:20:56,690 use that to enable 552 00:20:57,150 --> 00:20:59,950 earlier prenatal care and access to specialty services 553 00:20:59,950 --> 00:21:02,210 like maternal funeral medicine or perinatal 554 00:21:02,724 --> 00:21:04,644 mental health or substance use treatment, which may 555 00:21:04,644 --> 00:21:06,644 not be available in your community. But then 556 00:21:06,644 --> 00:21:08,964 we also have been leaning heavily into, 557 00:21:09,524 --> 00:21:10,664 remote patient monitoring, 558 00:21:10,964 --> 00:21:12,724 and we have a great project in, 559 00:21:13,365 --> 00:21:15,304 with Silver Summit Health Plan in Nevada 560 00:21:16,259 --> 00:21:19,380 where members are monitoring their blood pressure at 561 00:21:19,380 --> 00:21:21,000 home with nursing support, 562 00:21:21,779 --> 00:21:24,099 so that, again, because you only have that 563 00:21:24,099 --> 00:21:26,259 nine month window, if you can have someone 564 00:21:26,259 --> 00:21:27,779 check their blood pressure at home because they're 565 00:21:27,907 --> 00:21:30,035 even if they're plugged into care, they're not 566 00:21:30,035 --> 00:21:30,775 in their 567 00:21:31,075 --> 00:21:33,875 doctor's office that much. So the remote patient 568 00:21:33,875 --> 00:21:35,715 monitoring allows us to kinda keep a finger 569 00:21:35,715 --> 00:21:36,914 on the pulse of how people are doing 570 00:21:36,914 --> 00:21:38,434 and then proactively reach out and get them 571 00:21:38,434 --> 00:21:39,815 in and make sure that we can, 572 00:21:40,515 --> 00:21:43,470 get their blood pressure and diabetes controlled. 573 00:21:43,930 --> 00:21:44,589 And then, 574 00:21:45,210 --> 00:21:46,990 you know, we talked about midwives, 575 00:21:48,089 --> 00:21:49,150 which are a big, 576 00:21:49,769 --> 00:21:52,190 area of focus. The doulas are another, 577 00:21:53,049 --> 00:21:54,990 that I also had mentioned before. We have 578 00:21:55,394 --> 00:21:57,494 partnerships with community based doulas 579 00:21:57,955 --> 00:22:01,715 where we actively work with, again, community based 580 00:22:01,715 --> 00:22:03,795 organizations to help them understand how do you 581 00:22:03,795 --> 00:22:05,394 even partner with an MCO. How do you 582 00:22:05,394 --> 00:22:06,994 bill an MCO? So we do a lot 583 00:22:06,994 --> 00:22:08,134 of technical assistance 584 00:22:08,515 --> 00:22:11,369 in order to enable CBOs and community 585 00:22:12,789 --> 00:22:15,349 organizations to effectively partner with us. And then 586 00:22:15,349 --> 00:22:17,609 the last thing I would mention is we, 587 00:22:18,789 --> 00:22:21,669 partner with community health centers. So we have 588 00:22:21,669 --> 00:22:22,569 a three year 589 00:22:23,605 --> 00:22:26,164 project with the National Association of Community Health 590 00:22:26,164 --> 00:22:26,664 Centers 591 00:22:27,125 --> 00:22:27,944 and together, 592 00:22:28,884 --> 00:22:30,424 launched the maternal child 593 00:22:31,204 --> 00:22:32,904 health innovation initiative 594 00:22:33,204 --> 00:22:33,865 to identify 595 00:22:34,964 --> 00:22:37,829 best practices and create a forum for exchange 596 00:22:37,829 --> 00:22:40,150 and adoption across community health centers, which are 597 00:22:40,150 --> 00:22:41,609 the single largest source 598 00:22:41,990 --> 00:22:43,990 of primary care for low income Americans and 599 00:22:43,990 --> 00:22:45,910 particularly Medicaid. I think they serve one in 600 00:22:45,910 --> 00:22:47,690 five Medicaid members right now. 601 00:22:47,990 --> 00:22:49,589 So the focus will be, leveraging 602 00:22:49,934 --> 00:22:52,495 again, or hear hear similar themes across all 603 00:22:52,495 --> 00:22:54,515 these initiative, a virtual care model 604 00:22:54,894 --> 00:22:56,595 to improve blood pressure control, 605 00:22:57,295 --> 00:23:00,195 during pregnancy for community health center members. 606 00:23:01,535 --> 00:23:04,029 Wow. I mean, just so much exciting and 607 00:23:04,029 --> 00:23:06,590 impactful things going on across the company, Alice. 608 00:23:06,590 --> 00:23:08,350 So I hope you will keep us updated 609 00:23:08,350 --> 00:23:10,369 on on what some of these, pediatric 610 00:23:10,750 --> 00:23:11,890 remote monitoring, 611 00:23:12,509 --> 00:23:13,009 maternal 612 00:23:13,390 --> 00:23:14,130 health initiatives, 613 00:23:14,509 --> 00:23:16,269 besides what we talked about with Heartland, what 614 00:23:16,269 --> 00:23:19,194 you ultimately achieve through all of these. Before 615 00:23:19,194 --> 00:23:20,875 we go I love that. What what else 616 00:23:20,875 --> 00:23:23,275 are we missing? Any other final thoughts you 617 00:23:23,275 --> 00:23:25,275 wanna share with us or final bits of 618 00:23:25,275 --> 00:23:27,515 advice you wanna share, while you have the 619 00:23:27,515 --> 00:23:29,194 ears of a lot of other health plan 620 00:23:29,194 --> 00:23:30,654 leaders from across the country? 621 00:23:31,410 --> 00:23:32,769 Not so much advice, but, 622 00:23:33,330 --> 00:23:35,269 probably a ask, which is 623 00:23:35,730 --> 00:23:37,190 I think of Medicaid 624 00:23:37,650 --> 00:23:39,730 as a canary in the coal mine for 625 00:23:39,730 --> 00:23:40,710 US health care. 626 00:23:41,250 --> 00:23:43,730 And within Medicaid, I think of rural health 627 00:23:43,730 --> 00:23:45,350 as a canary in the coal mine, 628 00:23:45,715 --> 00:23:47,015 you know, within Medicaid. 629 00:23:48,595 --> 00:23:49,414 The challenges 630 00:23:50,275 --> 00:23:52,914 to maternal child health and rural settings is 631 00:23:52,914 --> 00:23:54,855 not unique, but the interventions 632 00:23:56,115 --> 00:23:58,615 that are successful there can oftentimes 633 00:23:58,994 --> 00:24:00,295 be scaled to less 634 00:24:00,720 --> 00:24:01,220 vulnerable 635 00:24:01,679 --> 00:24:03,259 settings. And so, 636 00:24:03,839 --> 00:24:04,980 you know, the way we've 637 00:24:06,000 --> 00:24:09,779 leveraged national insights and resources for local impact, 638 00:24:10,480 --> 00:24:13,059 data technology provider, pro vendor partnerships, 639 00:24:13,919 --> 00:24:14,579 is something 640 00:24:15,585 --> 00:24:17,284 that I would love to see 641 00:24:17,904 --> 00:24:21,105 our peer organizations do as well. You know, 642 00:24:21,105 --> 00:24:22,704 there's not a lot of lot going on 643 00:24:22,704 --> 00:24:24,164 in health care these days. Right? 644 00:24:25,265 --> 00:24:26,005 Just kidding. 645 00:24:26,464 --> 00:24:28,304 There's so much going on in health care, 646 00:24:28,304 --> 00:24:29,284 but to me, 647 00:24:30,170 --> 00:24:32,509 in this time where a lot 648 00:24:33,210 --> 00:24:33,789 of payers 649 00:24:34,250 --> 00:24:37,769 and providers, particularly in the government space, but 650 00:24:37,769 --> 00:24:40,410 frankly across the ecosystem because we're all tied 651 00:24:40,410 --> 00:24:40,910 together, 652 00:24:41,529 --> 00:24:43,549 in times of pressure, I think 653 00:24:44,575 --> 00:24:46,595 this is a time to double down 654 00:24:47,455 --> 00:24:48,914 on maternal child health, 655 00:24:50,095 --> 00:24:51,555 because it is the future, 656 00:24:52,174 --> 00:24:54,335 of our country. And I think we'd love 657 00:24:54,335 --> 00:24:56,914 to see providers, payers, and policymakers 658 00:24:57,855 --> 00:24:59,075 converge around 659 00:24:59,500 --> 00:25:01,759 the right policies, the right practices, 660 00:25:02,299 --> 00:25:03,200 the right support, 661 00:25:04,380 --> 00:25:07,119 similar to how we're doing with Heartland Forward. 662 00:25:07,980 --> 00:25:10,299 It's a great call out for this current 663 00:25:10,299 --> 00:25:13,179 moment in time, doctor Chen. So I wanna 664 00:25:13,179 --> 00:25:15,335 thank you so much for taking the time 665 00:25:15,335 --> 00:25:17,414 to sit down with us, for sharing your 666 00:25:17,414 --> 00:25:20,535 insights with our listeners, and for telling us 667 00:25:20,535 --> 00:25:22,855 a little bit about all the impactful work 668 00:25:22,855 --> 00:25:25,575 going on under your team at Centene. We 669 00:25:25,575 --> 00:25:27,950 we really appreciate it. My pleasure. Thank you 670 00:25:27,950 --> 00:25:30,590 so much for having me. Absolutely. And to 671 00:25:30,590 --> 00:25:32,830 our listeners, if you'd like to listen to 672 00:25:32,830 --> 00:25:35,309 more podcasts from Becker's Healthcare, you can visit 673 00:25:35,309 --> 00:25:37,570 beckers hospital review dot com.