1 00:00:02,240 --> 00:00:05,059 This is where health insurance leadership comes together. 2 00:00:05,279 --> 00:00:08,960 Becker's fourth annual spring payer issues roundtable brings 3 00:00:08,960 --> 00:00:10,580 together over 400 4 00:00:10,639 --> 00:00:13,039 payer and health plan executives and more than 5 00:00:13,039 --> 00:00:16,574 100 speakers to Chicago April. 6 00:00:16,875 --> 00:00:19,754 This year's event includes keynote conversations with the 7 00:00:19,754 --> 00:00:23,035 industry's top leaders and former president George w 8 00:00:23,035 --> 00:00:25,675 Bush. For the full agenda and event details, 9 00:00:25,675 --> 00:00:27,754 visit beckershospitalreview.com 10 00:00:27,754 --> 00:00:29,274 and click on the events tab in the 11 00:00:29,274 --> 00:00:31,489 upper right. We're looking forward to hosting you 12 00:00:31,489 --> 00:00:32,629 here in Chicago. 13 00:00:33,969 --> 00:00:36,210 Hello, everyone. This is Jacob Emerson with the 14 00:00:36,210 --> 00:00:39,329 Becker's Pay Your Issues podcast. Thrilled today to 15 00:00:39,329 --> 00:00:42,049 be joined by Aaron Henderson Moore, who serves 16 00:00:42,049 --> 00:00:44,689 as the president and CEO of Fidelis Care 17 00:00:44,689 --> 00:00:45,509 of New Jersey. 18 00:00:45,914 --> 00:00:47,515 Erin, thank you so much for taking the 19 00:00:47,515 --> 00:00:49,114 time to be with me on the podcast 20 00:00:49,114 --> 00:00:49,614 today. 21 00:00:50,075 --> 00:00:52,314 Thank you so much for having me. Really 22 00:00:52,314 --> 00:00:55,054 excited to be here. Likewise, Erin. We're excited 23 00:00:55,195 --> 00:00:57,594 to dive into some important topics and hear 24 00:00:57,594 --> 00:00:59,114 a little bit about what's been going on, 25 00:00:59,354 --> 00:01:01,539 under your leadership at Fidelis of New Jersey. 26 00:01:01,539 --> 00:01:03,619 But before we dive into that, just want 27 00:01:03,619 --> 00:01:04,119 to, 28 00:01:04,659 --> 00:01:07,540 have you fill in our audience on, who 29 00:01:07,540 --> 00:01:10,340 you are, what your healthcare career background has 30 00:01:10,340 --> 00:01:12,359 looked like, and if you could give everybody 31 00:01:12,420 --> 00:01:14,899 a quick overview of what your current role 32 00:01:14,899 --> 00:01:15,399 entails. 33 00:01:16,555 --> 00:01:17,295 Yeah. Absolutely. 34 00:01:17,754 --> 00:01:19,754 So as you mentioned, I serve as the 35 00:01:19,754 --> 00:01:21,915 president and CEO of Fidelis Care of New 36 00:01:21,915 --> 00:01:22,415 Jersey. 37 00:01:22,954 --> 00:01:25,354 Fidelis Care is a Centene health plan, 38 00:01:25,754 --> 00:01:26,894 supporting Medicaid, 39 00:01:27,194 --> 00:01:30,810 Medicare, and marketplace. We also are really excited 40 00:01:30,810 --> 00:01:32,030 about our large 41 00:01:32,329 --> 00:01:35,290 long term services and supports population across the 42 00:01:35,290 --> 00:01:37,930 state. So you'll hear me refer to that 43 00:01:37,930 --> 00:01:39,310 that group as the LTSS 44 00:01:39,689 --> 00:01:40,189 population. 45 00:01:40,954 --> 00:01:42,715 So here in New Jersey, my role is 46 00:01:42,715 --> 00:01:46,094 really about aligning access, affordability, and accountability 47 00:01:47,034 --> 00:01:50,415 for our state, our members, our provider partners, 48 00:01:50,474 --> 00:01:52,015 and really building teams 49 00:01:52,314 --> 00:01:55,215 who can execute against that mission. So excited. 50 00:01:55,275 --> 00:01:57,539 I've been here at Fidelis Care of New 51 00:01:57,539 --> 00:02:01,140 Jersey almost three years, but not new to 52 00:02:01,140 --> 00:02:03,239 the health care space. So prior 53 00:02:04,099 --> 00:02:06,200 to Fidelis Care, I was at UnitedHealthcare 54 00:02:06,739 --> 00:02:08,840 for six years. I led their 55 00:02:09,300 --> 00:02:11,560 dual special needs plans in 56 00:02:12,204 --> 00:02:14,604 DC and in Maryland, and I was really 57 00:02:14,604 --> 00:02:15,745 excited to launch 58 00:02:16,284 --> 00:02:17,905 the dual choice program 59 00:02:19,324 --> 00:02:22,544 in DC, which is an integrated Medicare and 60 00:02:22,844 --> 00:02:24,384 Medicaid plan really 61 00:02:24,909 --> 00:02:27,789 aligned and designed to serve duals across the 62 00:02:27,789 --> 00:02:30,129 state, and that was a really innovative program. 63 00:02:31,310 --> 00:02:33,489 Prior to my time at UnitedHealthcare, 64 00:02:33,949 --> 00:02:35,090 I've been in consulting. 65 00:02:35,469 --> 00:02:36,370 I've worked, 66 00:02:36,989 --> 00:02:39,884 in government programs my entire career. So spent 67 00:02:39,884 --> 00:02:41,465 some time at DC Medicaid, 68 00:02:41,844 --> 00:02:44,004 spent some time in consulting, and spent some 69 00:02:44,004 --> 00:02:47,044 time in nonprofit management. But really excited, 70 00:02:47,364 --> 00:02:50,245 to continue to be in the government program 71 00:02:50,245 --> 00:02:51,784 space where I feel like 72 00:02:52,219 --> 00:02:55,739 innovation is really key, and you need people 73 00:02:55,739 --> 00:02:57,199 that are aligned to the mission, 74 00:02:57,579 --> 00:02:59,579 and to the goals of of those specific 75 00:02:59,579 --> 00:03:00,079 programs. 76 00:03:01,340 --> 00:03:03,259 Wonderful. Well, Erin, like I said, we're we're 77 00:03:03,259 --> 00:03:04,905 excited to get to talk with you today. 78 00:03:05,224 --> 00:03:07,965 And let's stay on the topic of Medicaid. 79 00:03:08,025 --> 00:03:09,705 Like you mentioned, you've been in this space 80 00:03:09,705 --> 00:03:11,245 for a bit. You you've served, 81 00:03:11,625 --> 00:03:14,025 this population for a long time, and you've 82 00:03:14,025 --> 00:03:14,525 seen, 83 00:03:14,905 --> 00:03:16,764 trends come and go in this space. 84 00:03:17,384 --> 00:03:19,030 And so I I wanted to ask you 85 00:03:19,030 --> 00:03:20,549 and get us started by talking a little 86 00:03:20,549 --> 00:03:21,189 bit about, 87 00:03:21,509 --> 00:03:24,150 what we've been hearing from Medicaid managed care 88 00:03:24,150 --> 00:03:25,530 plans all over the country 89 00:03:25,909 --> 00:03:27,289 these last few years. 90 00:03:27,909 --> 00:03:29,509 Of course, in the face of everything going 91 00:03:29,509 --> 00:03:30,810 on federally with Medicaid, 92 00:03:31,194 --> 00:03:33,935 we're we're hearing from plans about rate adequacy 93 00:03:34,155 --> 00:03:36,014 concerns on the state level, 94 00:03:36,794 --> 00:03:39,915 increasing state scrutiny of how these dollars are 95 00:03:39,915 --> 00:03:42,175 being managed by companies like yours. 96 00:03:42,555 --> 00:03:44,395 So I wonder, you know, just given all 97 00:03:44,395 --> 00:03:46,395 the context of what's going on policy wise 98 00:03:46,395 --> 00:03:47,540 right now for Medicaid, 99 00:03:48,159 --> 00:03:50,000 what's an issue that's that's keeping you up 100 00:03:50,000 --> 00:03:52,080 at night in this space that isn't talked 101 00:03:52,080 --> 00:03:54,159 about enough right now in the industry that 102 00:03:54,159 --> 00:03:55,060 you don't think, 103 00:03:55,840 --> 00:03:57,599 the the media is hitting on enough that 104 00:03:57,599 --> 00:04:00,240 your colleagues don't touch on enough? What do 105 00:04:00,240 --> 00:04:02,400 you wanna hear more about in Medicaid managed 106 00:04:02,400 --> 00:04:02,775 care? 107 00:04:03,414 --> 00:04:05,275 Yeah. Absolutely. I would say two, 108 00:04:05,894 --> 00:04:07,594 two things keep me up at night. 109 00:04:07,974 --> 00:04:10,375 The first is really integration. I think you're 110 00:04:10,375 --> 00:04:12,854 starting to see a lot of integration of 111 00:04:12,854 --> 00:04:15,435 programs that are not traditional clinical programs. 112 00:04:16,040 --> 00:04:18,120 Two that I'll I'll talk about here are 113 00:04:18,120 --> 00:04:19,580 behavioral health and housing. 114 00:04:20,600 --> 00:04:22,540 You really we're starting to see 115 00:04:23,000 --> 00:04:26,040 huge increases in spikes of behavioral health in 116 00:04:26,040 --> 00:04:28,839 particular, but there is a link between those 117 00:04:28,839 --> 00:04:31,180 two programs. And so you are seeing states 118 00:04:31,694 --> 00:04:33,555 really work with the federal government 119 00:04:34,014 --> 00:04:36,254 to move towards carbons of really making this 120 00:04:36,254 --> 00:04:38,894 such an integral part of the managed care 121 00:04:38,894 --> 00:04:39,394 experience. 122 00:04:40,095 --> 00:04:41,935 Because what we're starting to see is that 123 00:04:41,935 --> 00:04:43,475 we've so traditionally 124 00:04:44,014 --> 00:04:44,915 focused on 125 00:04:45,279 --> 00:04:48,000 physical health, but really where the the cost 126 00:04:48,000 --> 00:04:50,240 are spiking are in behavioral health and how 127 00:04:50,240 --> 00:04:52,319 do we make sure that people, especially if 128 00:04:52,319 --> 00:04:55,379 behavioral health needs, can remain housed and housed 129 00:04:55,439 --> 00:04:58,064 long term because that way we we know 130 00:04:58,205 --> 00:05:00,605 where people are located and how to then 131 00:05:00,605 --> 00:05:03,004 intervene with all the other parts of the 132 00:05:03,004 --> 00:05:04,145 managed care experience, 133 00:05:05,165 --> 00:05:06,925 to make sure that the people are receiving 134 00:05:06,925 --> 00:05:08,145 the care that you need. 135 00:05:08,845 --> 00:05:10,305 The second is really around 136 00:05:11,009 --> 00:05:14,389 support for older adults and individuals with disabilities. 137 00:05:14,529 --> 00:05:16,389 So you're seeing states do a lot, 138 00:05:17,250 --> 00:05:19,970 leveraging the flexibility between their Medicare and their 139 00:05:19,970 --> 00:05:21,889 Medicaid, but I you're gonna start to see 140 00:05:22,050 --> 00:05:24,204 and you're gonna continue to see a lot 141 00:05:24,204 --> 00:05:26,305 of focus on LTSS modernization 142 00:05:27,404 --> 00:05:29,964 and focus for care of those continuity of 143 00:05:29,964 --> 00:05:32,044 care and care for older adults and people 144 00:05:32,044 --> 00:05:33,664 with disabilities in their homes. 145 00:05:34,444 --> 00:05:36,365 You're gonna see that for a couple reasons. 146 00:05:36,365 --> 00:05:38,544 One, we're just having an aging population. 147 00:05:39,430 --> 00:05:39,930 Two, 148 00:05:41,029 --> 00:05:41,849 the infrastructure 149 00:05:42,550 --> 00:05:45,029 is not designed for people. We just don't 150 00:05:45,029 --> 00:05:45,930 have the capacity 151 00:05:46,389 --> 00:05:48,789 for people to be in facilities, and so 152 00:05:48,789 --> 00:05:50,889 you're going to see this move away from 153 00:05:51,110 --> 00:05:52,089 people meeting, 154 00:05:52,470 --> 00:05:56,185 different environments to age safely in place. And 155 00:05:56,185 --> 00:05:58,764 then thirdly, people just that's a better experience. 156 00:05:58,985 --> 00:05:59,485 So, 157 00:06:00,024 --> 00:06:02,584 I recently, you know, lost my parents, and 158 00:06:02,584 --> 00:06:04,904 it was really important that they were able 159 00:06:04,904 --> 00:06:06,204 to stay in their homes 160 00:06:06,584 --> 00:06:07,084 and, 161 00:06:08,040 --> 00:06:11,240 die with dignity and care in places that 162 00:06:11,240 --> 00:06:13,080 are comfortable for them. And a lot of 163 00:06:13,080 --> 00:06:16,139 times that means at home and putting services 164 00:06:16,279 --> 00:06:17,500 around them. And so, 165 00:06:17,879 --> 00:06:19,639 you're starting to see a lot of cost 166 00:06:19,639 --> 00:06:20,139 again 167 00:06:20,764 --> 00:06:23,345 at behavioral health services and nontraditional 168 00:06:23,725 --> 00:06:26,524 clinical services to allow people to age in 169 00:06:26,524 --> 00:06:27,425 place at home. 170 00:06:28,204 --> 00:06:29,805 Well, I I'm very sorry to hear that 171 00:06:29,805 --> 00:06:31,884 about about your parents, Erin, but thank you 172 00:06:31,884 --> 00:06:33,959 for for sharing that with us, for connecting 173 00:06:33,959 --> 00:06:36,199 that back to why it's so important to 174 00:06:36,199 --> 00:06:39,720 continue to expand support for older adults, for 175 00:06:39,720 --> 00:06:40,620 people with disabilities, 176 00:06:41,319 --> 00:06:42,539 enrolled in these programs. 177 00:06:43,000 --> 00:06:44,839 And and if we're sticking on this topic 178 00:06:44,839 --> 00:06:45,944 in terms of, 179 00:06:46,824 --> 00:06:48,904 everything going on right now in terms of, 180 00:06:49,145 --> 00:06:51,645 Medicaid policy, of course, as you know, 181 00:06:52,264 --> 00:06:53,805 a lot coming down the pipeline, 182 00:06:54,425 --> 00:06:56,904 at the federal level, work requirements next year 183 00:06:56,904 --> 00:06:57,884 across the country. 184 00:06:58,870 --> 00:07:01,029 Nearby in New York, you've got the essential 185 00:07:01,029 --> 00:07:01,849 plan rollback, 186 00:07:03,189 --> 00:07:06,069 expired ACA enhanced subsidies at the end of 187 00:07:06,069 --> 00:07:08,709 last year and, you know, stalling of any 188 00:07:08,709 --> 00:07:10,584 kind of solution there in Congress. So just 189 00:07:10,584 --> 00:07:12,745 a lot going on for for individuals like 190 00:07:12,745 --> 00:07:15,464 yourself to be tracking. So I wonder, given 191 00:07:15,464 --> 00:07:17,084 all of that, how are you navigating 192 00:07:17,625 --> 00:07:19,785 member retention right now when when so many 193 00:07:19,785 --> 00:07:20,685 coverage pathways 194 00:07:21,064 --> 00:07:22,365 are shifting at once? 195 00:07:23,490 --> 00:07:26,069 That's an amazing question, and the the answer 196 00:07:26,529 --> 00:07:28,689 is we're using a multi pronged approach. We 197 00:07:28,689 --> 00:07:29,509 have not 198 00:07:30,129 --> 00:07:32,930 figured this out at, Fidelis Care, but we 199 00:07:32,930 --> 00:07:35,169 are working you know, we haven't figured out 200 00:07:35,169 --> 00:07:37,324 the bullet. Like, what what is the thing 201 00:07:37,324 --> 00:07:40,305 that that keeps people connected to care, especially 202 00:07:40,604 --> 00:07:42,604 with all the different things coming at them 203 00:07:42,604 --> 00:07:44,685 in the news and social media and other 204 00:07:44,685 --> 00:07:46,444 ways? But one of the things that I 205 00:07:46,444 --> 00:07:48,444 would say is really working with the state 206 00:07:48,444 --> 00:07:50,785 partners to make sure that the 207 00:07:51,139 --> 00:07:53,160 information that we have is correct. 208 00:07:53,460 --> 00:07:55,060 So, you know, one of the things is 209 00:07:55,060 --> 00:07:58,740 we've traditionally relied on mailing addresses and mailing 210 00:07:58,740 --> 00:08:01,240 things to people, but we're finding increasingly 211 00:08:01,939 --> 00:08:04,520 across the entire span is that people get 212 00:08:04,660 --> 00:08:05,160 their 213 00:08:05,665 --> 00:08:08,465 information differently. So one thing that generally doesn't 214 00:08:08,465 --> 00:08:10,705 change is email addresses, and so making sure 215 00:08:10,705 --> 00:08:13,185 that we have up to date email addresses 216 00:08:13,185 --> 00:08:15,745 for for people. Right? Like, stores have gotten 217 00:08:15,745 --> 00:08:16,064 this, 218 00:08:16,785 --> 00:08:18,560 down packed, and so figuring out how can 219 00:08:18,560 --> 00:08:20,959 we leverage things that are that other part 220 00:08:20,959 --> 00:08:21,360 of, 221 00:08:21,920 --> 00:08:24,879 other retailers or other companies have really figured 222 00:08:24,879 --> 00:08:27,279 out, email addresses being one of them. How 223 00:08:27,279 --> 00:08:29,519 can we leverage text messages? It's one of 224 00:08:29,519 --> 00:08:31,585 the things that we found is across our 225 00:08:31,585 --> 00:08:32,085 population, 226 00:08:32,705 --> 00:08:35,105 regardless of income and regardless of ages, people 227 00:08:35,105 --> 00:08:37,184 have phones. And so how do we use 228 00:08:37,184 --> 00:08:39,504 text message? And then how do we then 229 00:08:39,504 --> 00:08:41,105 work with the data when we have the 230 00:08:41,105 --> 00:08:43,105 data that's better or more, 231 00:08:44,309 --> 00:08:45,990 more up to date than our state partners? 232 00:08:45,990 --> 00:08:47,750 How do we figure out a way to 233 00:08:47,750 --> 00:08:49,590 make sure that that data is being updated 234 00:08:49,590 --> 00:08:52,309 in their systems and not being replaced by 235 00:08:52,309 --> 00:08:55,190 daily eight thirty four eligibility files? So those 236 00:08:55,190 --> 00:08:57,524 are three things that are just really, really 237 00:08:57,524 --> 00:08:58,024 crucial 238 00:08:58,404 --> 00:09:00,664 to making sure people stay connected to care. 239 00:09:01,284 --> 00:09:03,304 The second is really making sure, 240 00:09:03,764 --> 00:09:06,644 and I say second, but another thing is 241 00:09:06,644 --> 00:09:09,205 really making sure that the state systems, because 242 00:09:09,205 --> 00:09:11,365 that's where we get or federal systems if 243 00:09:11,365 --> 00:09:13,750 we're talking about marketplace or, 244 00:09:14,610 --> 00:09:16,389 Medicare, is making sure 245 00:09:16,929 --> 00:09:19,429 our data has a redetermination 246 00:09:19,809 --> 00:09:21,570 date. So right now, one of the things 247 00:09:21,570 --> 00:09:24,210 that we don't have that date, right, so 248 00:09:24,210 --> 00:09:26,524 the state is kind of reengineering how do 249 00:09:26,524 --> 00:09:28,205 they give that date so that we're really 250 00:09:28,205 --> 00:09:29,884 always kind of keeping up to date with 251 00:09:29,884 --> 00:09:32,684 our members saying, don't forget to renew. Don't 252 00:09:32,684 --> 00:09:34,764 forget, here's how you do it. Here's how 253 00:09:34,764 --> 00:09:37,004 you can check the system. So really working 254 00:09:37,004 --> 00:09:39,004 with our state partners to figure out ways 255 00:09:39,004 --> 00:09:39,985 that we can 256 00:09:40,299 --> 00:09:42,059 also have that date and so that there's 257 00:09:42,059 --> 00:09:44,639 not this kind of I think it's around 258 00:09:44,860 --> 00:09:45,600 this time, 259 00:09:45,980 --> 00:09:47,420 and so that we can really, 260 00:09:47,820 --> 00:09:49,360 walk our members through the process. 261 00:09:49,740 --> 00:09:51,259 And finally, one of the things that we 262 00:09:51,259 --> 00:09:53,340 would say is we think it's probably a 263 00:09:53,340 --> 00:09:55,600 good idea for states to really be thinking 264 00:09:56,084 --> 00:09:58,184 much more creatively in how plans 265 00:09:58,725 --> 00:09:59,225 can, 266 00:10:00,485 --> 00:10:01,225 help members 267 00:10:01,605 --> 00:10:03,524 get connected to care. There's a lot of 268 00:10:03,524 --> 00:10:05,304 really interesting and innovative, 269 00:10:06,725 --> 00:10:07,225 partners, 270 00:10:07,764 --> 00:10:08,264 vendors 271 00:10:08,804 --> 00:10:10,024 that are doing really 272 00:10:10,329 --> 00:10:12,190 cool work and and to use 273 00:10:13,289 --> 00:10:15,450 a, you know, more colloquial term of doing 274 00:10:15,450 --> 00:10:18,490 really innovative work, leveraging AI, leveraging all the 275 00:10:18,490 --> 00:10:20,809 data that we have on our members. And 276 00:10:20,809 --> 00:10:23,049 I think we need more flexibility in how 277 00:10:23,049 --> 00:10:25,335 we work with those members to keep them 278 00:10:25,335 --> 00:10:27,815 connected to care because what we're finding is 279 00:10:27,815 --> 00:10:29,754 when there's gaps in care, it's more 280 00:10:30,774 --> 00:10:32,475 expensive for the entire system 281 00:10:33,014 --> 00:10:35,654 and it doesn't serve people well to be 282 00:10:35,654 --> 00:10:37,575 disconnected. Right? So then now you're getting them 283 00:10:37,575 --> 00:10:40,110 back to the system. There's more expense And 284 00:10:40,110 --> 00:10:41,089 just that muscle, 285 00:10:41,549 --> 00:10:42,909 it takes a while to get that kind 286 00:10:42,909 --> 00:10:45,809 of muscle back of making sure people are, 287 00:10:45,950 --> 00:10:47,870 you know, taking their medicine and going to 288 00:10:47,870 --> 00:10:50,190 their doctor, and it causes a lot of 289 00:10:50,190 --> 00:10:52,049 downstream impacts to the system. 290 00:10:53,184 --> 00:10:55,105 Certainly. And I think that's such an interesting 291 00:10:55,105 --> 00:10:56,625 point that you make there, Aaron, in terms 292 00:10:56,625 --> 00:10:58,884 of we're hearing similar all over the country 293 00:10:59,105 --> 00:11:01,664 from leaders like yourself in in terms of 294 00:11:01,664 --> 00:11:02,485 get creative 295 00:11:02,944 --> 00:11:05,184 in a time of of uncertainty for the 296 00:11:05,184 --> 00:11:07,490 industry and and for some of your members. 297 00:11:08,029 --> 00:11:09,629 Think outside the box and meet them where 298 00:11:09,629 --> 00:11:12,830 they are, and really, I think, communicate differently 299 00:11:12,830 --> 00:11:14,750 is what we're hearing around the country with 300 00:11:14,750 --> 00:11:16,669 the members, with the state. And like you 301 00:11:16,669 --> 00:11:18,830 said, get innovative with with how you're interacting 302 00:11:18,830 --> 00:11:20,735 with them. And I think in that vein, 303 00:11:20,735 --> 00:11:22,334 kinda going back to what you were saying 304 00:11:22,334 --> 00:11:23,235 earlier about, 305 00:11:23,695 --> 00:11:26,254 thinking outside the box outside the clinical box 306 00:11:26,254 --> 00:11:26,654 and, 307 00:11:27,294 --> 00:11:28,034 really going, 308 00:11:28,815 --> 00:11:30,434 to address social determinants. 309 00:11:30,975 --> 00:11:33,799 I know that Fidelis last year announced half 310 00:11:33,799 --> 00:11:34,679 $1,000,000 311 00:11:34,679 --> 00:11:36,059 in health equity grants 312 00:11:36,519 --> 00:11:39,100 through this year for things like food security, 313 00:11:39,240 --> 00:11:41,100 maternal health access, 314 00:11:41,559 --> 00:11:43,500 expanding rural care access. 315 00:11:44,200 --> 00:11:47,235 So, you know, those things are amazing. Talk 316 00:11:47,235 --> 00:11:49,394 to us about the the business case here 317 00:11:49,394 --> 00:11:52,995 for investing in social determinants work during what 318 00:11:52,995 --> 00:11:54,754 we just talked about, during this period of 319 00:11:54,754 --> 00:11:56,855 coverage instability for so many. 320 00:11:57,794 --> 00:11:58,879 Yeah. Absolutely. 321 00:11:59,340 --> 00:12:01,840 I think what it's really about getting upstream. 322 00:12:02,700 --> 00:12:04,480 You know, what we are seeing 323 00:12:05,500 --> 00:12:06,480 is that 324 00:12:07,340 --> 00:12:08,559 a lot of the factors 325 00:12:09,259 --> 00:12:09,759 driving 326 00:12:10,460 --> 00:12:10,960 cost 327 00:12:11,784 --> 00:12:12,605 in the system 328 00:12:12,904 --> 00:12:15,705 is not the clinical cost. Clinical is a 329 00:12:15,705 --> 00:12:16,684 is a reactionary. 330 00:12:18,424 --> 00:12:21,304 It's a lagging indicator of of how people 331 00:12:21,304 --> 00:12:23,144 are doing. And so one of the things 332 00:12:23,144 --> 00:12:24,985 that we're really trying to do is really 333 00:12:24,985 --> 00:12:25,804 get upstream 334 00:12:26,870 --> 00:12:28,409 and really address social, 335 00:12:29,029 --> 00:12:31,289 social determinants of health, housing instability, 336 00:12:31,669 --> 00:12:33,049 behavioral health fragmentation, 337 00:12:33,590 --> 00:12:35,750 and all the caregiving burden on families. So 338 00:12:35,750 --> 00:12:38,570 if we don't up address those upstream levers, 339 00:12:38,789 --> 00:12:40,809 the system will continue paying downstream 340 00:12:41,565 --> 00:12:44,285 in the emergency department and long term care 341 00:12:44,285 --> 00:12:46,365 institutional settings. So a lot of the grants 342 00:12:46,365 --> 00:12:48,945 that we put up there, both at Centene 343 00:12:49,004 --> 00:12:51,345 nationally and at Fidelis Care, is really 344 00:12:51,965 --> 00:12:54,684 shifting spend upstream and not just lowering rates. 345 00:12:54,684 --> 00:12:56,065 Right? Getting really creative, 346 00:12:56,679 --> 00:12:59,080 you know, and really getting creative and paying 347 00:12:59,080 --> 00:12:59,580 differently 348 00:13:00,440 --> 00:13:02,300 to drive affordability in the system. 349 00:13:03,399 --> 00:13:05,000 Well, it's great to hear. And I know 350 00:13:05,000 --> 00:13:07,720 from our perspective, Centene has certainly been one 351 00:13:07,720 --> 00:13:09,879 of the more innovative companies in terms of 352 00:13:09,879 --> 00:13:11,740 how and where you decide to, 353 00:13:12,705 --> 00:13:14,245 use social determinants, 354 00:13:14,625 --> 00:13:15,125 grants, 355 00:13:15,585 --> 00:13:18,105 equity grants. So wonderful to hear about that 356 00:13:18,105 --> 00:13:19,924 at the New Jersey level as well, Aaron. 357 00:13:20,544 --> 00:13:21,605 Before we go, 358 00:13:21,985 --> 00:13:24,544 what else are we missing today? You've got 359 00:13:24,544 --> 00:13:26,970 the ears of a lot of other Medicaid, 360 00:13:27,269 --> 00:13:27,769 Medicare, 361 00:13:28,709 --> 00:13:31,449 insurance leaders overall all over the country facing 362 00:13:31,829 --> 00:13:34,309 similar dynamics as you. So, 363 00:13:34,949 --> 00:13:36,789 final bits of advice that you'd share with 364 00:13:36,789 --> 00:13:37,289 them. 365 00:13:38,325 --> 00:13:40,904 Yeah. I would say two things. I think 366 00:13:41,205 --> 00:13:42,665 we really need to focus 367 00:13:44,165 --> 00:13:44,745 on integration. 368 00:13:45,764 --> 00:13:47,764 I would you're you're seeing it in in 369 00:13:47,764 --> 00:13:48,264 large 370 00:13:48,884 --> 00:13:49,384 fragmentations 371 00:13:49,845 --> 00:13:51,304 of the integration of 372 00:13:51,899 --> 00:13:52,399 systems, 373 00:13:53,019 --> 00:13:55,419 you know, large systems, Medicare and Medicaid, but 374 00:13:55,419 --> 00:13:59,500 also medical, behavioral, social services, how that we 375 00:13:59,500 --> 00:14:00,000 operationalize 376 00:14:00,379 --> 00:14:01,279 those together. 377 00:14:02,220 --> 00:14:03,919 And the second thing I would say, 378 00:14:04,539 --> 00:14:06,480 is states are being asked 379 00:14:07,245 --> 00:14:10,445 states are being asked for measurable outcomes, not 380 00:14:10,445 --> 00:14:13,725 just access metrics or metrics. And so what 381 00:14:13,725 --> 00:14:16,524 you're going to be seeing is that what 382 00:14:16,524 --> 00:14:18,524 what states are asking what the federal government 383 00:14:18,524 --> 00:14:20,605 is asking of states, what this federal government 384 00:14:20,605 --> 00:14:23,269 is asking for providers, what the federal and 385 00:14:23,269 --> 00:14:25,850 state governments are asking for their MCO partners. 386 00:14:26,230 --> 00:14:28,009 That is changing. And so, 387 00:14:28,389 --> 00:14:30,490 to me, you're gonna start to see 388 00:14:31,509 --> 00:14:35,154 more data share sharing, more out come based 389 00:14:35,154 --> 00:14:37,475 contracting both with our with the health plan 390 00:14:37,475 --> 00:14:40,035 partners but also with our downstream partners. And 391 00:14:40,035 --> 00:14:42,295 so I think you're going to see a 392 00:14:42,835 --> 00:14:45,735 confluence or a mix of integration plus accountability 393 00:14:46,639 --> 00:14:48,960 that will really define the next decade of 394 00:14:48,960 --> 00:14:51,759 Medicaid or and and much larger government sponsored 395 00:14:51,759 --> 00:14:53,519 programs. And I think you're starting to see 396 00:14:53,519 --> 00:14:55,139 that really in the signals 397 00:14:55,600 --> 00:14:57,679 at the federal level, but we're seeing it 398 00:14:57,679 --> 00:15:00,500 local across the country how states are asking 399 00:15:00,799 --> 00:15:01,299 more 400 00:15:02,065 --> 00:15:02,565 integration, 401 00:15:03,105 --> 00:15:05,204 person centered care, and how we think 402 00:15:05,664 --> 00:15:07,345 about how we think about that to be 403 00:15:07,345 --> 00:15:09,264 really differently. And that's not just how we 404 00:15:09,264 --> 00:15:12,164 pay providers, but really how we drive accountability 405 00:15:12,304 --> 00:15:14,559 in the system. So that's really what I 406 00:15:14,559 --> 00:15:16,240 would think about. And then the last thing 407 00:15:16,240 --> 00:15:18,320 I would just say, is really about this 408 00:15:18,320 --> 00:15:19,460 population aging. 409 00:15:19,839 --> 00:15:22,559 I think you're starting to see that across 410 00:15:22,559 --> 00:15:24,019 the book of business, nonclinical 411 00:15:24,399 --> 00:15:24,899 services 412 00:15:25,679 --> 00:15:27,940 are driving the cost to Medicaid. 413 00:15:28,894 --> 00:15:30,735 And so you'll really start to see that 414 00:15:30,735 --> 00:15:32,754 demand continue to outpace 415 00:15:33,294 --> 00:15:35,154 traditional physical health demands, 416 00:15:35,934 --> 00:15:38,894 and we're gonna see people continue and we're 417 00:15:38,894 --> 00:15:41,215 gonna need to continue to enable aging at 418 00:15:41,215 --> 00:15:43,409 home. So lot of focus on that in 419 00:15:43,409 --> 00:15:46,149 the next decade, and I'm really excited, 420 00:15:47,409 --> 00:15:48,850 to kind of be at the table to 421 00:15:48,850 --> 00:15:50,789 see how we continue to change, 422 00:15:51,809 --> 00:15:53,970 Medicaid and and what we expect of the 423 00:15:53,970 --> 00:15:54,470 program. 424 00:15:55,915 --> 00:15:58,554 Wonderful. Well, it's some really great advice for 425 00:15:58,554 --> 00:16:00,795 our audience, before we go. So, Erin, I 426 00:16:00,795 --> 00:16:03,115 wanna thank you for taking the time to 427 00:16:03,115 --> 00:16:05,355 sit down with me today and for sharing 428 00:16:05,355 --> 00:16:06,014 your insights, 429 00:16:06,634 --> 00:16:08,475 and everything about what's going on under your 430 00:16:08,475 --> 00:16:10,575 leadership at Fidelis Care of New Jersey. 431 00:16:10,919 --> 00:16:12,919 We really appreciate you taking the time. So 432 00:16:12,919 --> 00:16:15,000 thank you. Thanks so much for having me. 433 00:16:15,000 --> 00:16:17,080 Look forward to the next one. Absolutely. And 434 00:16:17,080 --> 00:16:18,839 and to our listeners, if you'd like to 435 00:16:18,839 --> 00:16:21,320 listen to more podcasts from Becker's Healthcare, you 436 00:16:21,320 --> 00:16:24,059 can visit beckershospitalreview.com.