1 00:00:00,080 --> 00:00:02,159 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,159 --> 00:00:05,200 Becker's Payer Issues podcast. Very thrilled today to 3 00:00:05,200 --> 00:00:07,919 be joined by doctor Rhonda Randall, who serves 4 00:00:07,919 --> 00:00:10,259 as the chief medical officer for UnitedHealthcare's 5 00:00:10,719 --> 00:00:14,074 employer and individual business. Doctor Randall, thank you 6 00:00:14,074 --> 00:00:15,595 so much for taking the time to be 7 00:00:15,595 --> 00:00:17,434 with me on the podcast today. Thank you 8 00:00:17,434 --> 00:00:20,074 for having me. Absolutely. It's it's a pleasure. 9 00:00:20,074 --> 00:00:21,595 And before we dive into everything we wanna 10 00:00:21,595 --> 00:00:23,675 talk with you about, a special announcement from 11 00:00:23,675 --> 00:00:25,515 United. I'm wondering if you could first tell 12 00:00:25,515 --> 00:00:27,295 us a little bit more about yourself 13 00:00:27,690 --> 00:00:29,449 and give us an overview of your role 14 00:00:29,449 --> 00:00:30,109 at UnitedHealthcare. 15 00:00:31,130 --> 00:00:33,210 Yeah. Thank you for asking that. I'm a 16 00:00:33,210 --> 00:00:36,570 primary care physician and have been working with 17 00:00:36,570 --> 00:00:40,215 UnitedHealthcare for over two decades, focused on helping 18 00:00:40,215 --> 00:00:42,454 people live healthier lives and helping the health 19 00:00:42,454 --> 00:00:44,155 system work better for everyone. 20 00:00:44,695 --> 00:00:45,755 That, includes 21 00:00:46,295 --> 00:00:46,795 our, 22 00:00:47,414 --> 00:00:49,195 members who are going through 23 00:00:49,815 --> 00:00:53,399 health care journeys, including those that are preventative 24 00:00:53,539 --> 00:00:54,440 care and, 25 00:00:54,980 --> 00:00:56,600 avoiding when we can 26 00:00:56,980 --> 00:00:59,940 the escalation of a chronic disease and supporting 27 00:00:59,940 --> 00:01:00,440 members 28 00:01:00,820 --> 00:01:03,219 when they do have a significant health care 29 00:01:03,219 --> 00:01:03,719 journey. 30 00:01:04,579 --> 00:01:06,579 Wonderful. Well, Rhonda, thank you so much for 31 00:01:06,579 --> 00:01:08,634 taking the time to sit down and chat 32 00:01:08,634 --> 00:01:10,795 with us today. We're here today to talk 33 00:01:10,795 --> 00:01:12,974 with you about some exciting news from UnitedHealthcare. 34 00:01:13,834 --> 00:01:17,034 The company has announced a national expansion of 35 00:01:17,034 --> 00:01:18,414 its doula offering. 36 00:01:18,795 --> 00:01:20,519 And so throughout 2026, 37 00:01:20,759 --> 00:01:23,000 availability is going to continue to expand to 38 00:01:23,000 --> 00:01:26,780 additional employer groups. And by 01/01/2027, 39 00:01:26,840 --> 00:01:28,200 about 7,200,000 40 00:01:28,200 --> 00:01:30,219 members may have access to, 41 00:01:30,519 --> 00:01:32,759 this expanded coverage if it's part of their 42 00:01:32,759 --> 00:01:33,979 employer's health plan. 43 00:01:34,280 --> 00:01:35,924 So, Rhonda, to start us off, for our 44 00:01:35,924 --> 00:01:37,545 listeners who might not be familiar, 45 00:01:37,844 --> 00:01:40,644 what exactly does a doula do, and what's 46 00:01:40,644 --> 00:01:43,305 the significance of a major insurer like UnitedHealthcare 47 00:01:43,924 --> 00:01:46,424 expanding commercial coverage around this? 48 00:01:47,219 --> 00:01:49,560 Well, a doula is a non licensed, 49 00:01:49,939 --> 00:01:51,799 non clinically trained advocate 50 00:01:52,180 --> 00:01:56,019 who provides emotional, physical, and educational support, which 51 00:01:56,019 --> 00:01:57,799 can be throughout your pregnancy, 52 00:01:58,259 --> 00:02:00,899 during childbirth, and labor, and also in the 53 00:02:00,899 --> 00:02:02,119 postpartum period. 54 00:02:02,775 --> 00:02:05,575 And they don't deliver babies or provide medical 55 00:02:05,575 --> 00:02:08,235 care like a physician or a midwife may. 56 00:02:08,534 --> 00:02:10,855 They don't replace your doctor, but they are 57 00:02:10,855 --> 00:02:13,655 a very valuable part of that broader care 58 00:02:13,655 --> 00:02:16,055 team. And we're we've learned more and more 59 00:02:16,055 --> 00:02:19,289 about that in medical literature over the last 60 00:02:19,289 --> 00:02:21,930 several years that when a doula is working 61 00:02:21,930 --> 00:02:22,430 alongside 62 00:02:22,810 --> 00:02:25,209 those other clinicians who are part of your 63 00:02:25,209 --> 00:02:27,449 care team, it can help you feel more 64 00:02:27,449 --> 00:02:29,709 informed. It can help you feel more supported, 65 00:02:29,770 --> 00:02:31,949 more heard throughout your care journey. 66 00:02:32,275 --> 00:02:35,094 And there's good evidence now that there is 67 00:02:35,474 --> 00:02:35,974 improvement 68 00:02:36,915 --> 00:02:40,115 in preterm births, c section rates going down 69 00:02:40,115 --> 00:02:41,974 by more than fifty two percent, 70 00:02:42,514 --> 00:02:44,835 less babies need to be admitted to the 71 00:02:44,835 --> 00:02:47,415 NICU when there's lower preterm births, 72 00:02:48,069 --> 00:02:49,930 decreases of postpartum 73 00:02:50,229 --> 00:02:51,370 depression and postpartum 74 00:02:51,669 --> 00:02:54,629 anxiety by fifty seven percent when a doula 75 00:02:54,629 --> 00:02:56,330 is part of the care team. So, 76 00:02:56,870 --> 00:02:59,830 we see this as very valuable part of 77 00:02:59,830 --> 00:03:02,254 that helping people live healthier lives. 78 00:03:02,715 --> 00:03:04,974 And this is something that UnitedHealthcare, 79 00:03:06,474 --> 00:03:08,955 is doing now and in 2027 80 00:03:08,955 --> 00:03:11,854 will be doing at a very significant scale. 81 00:03:12,810 --> 00:03:14,729 And I do wanna dive in a bit, 82 00:03:14,969 --> 00:03:16,409 in just a bit, in terms of some 83 00:03:16,409 --> 00:03:19,209 of the the clinical importance here, but I'm 84 00:03:19,209 --> 00:03:21,789 also wondering what you were hearing from employers 85 00:03:21,849 --> 00:03:24,969 themselves in regards to the demand for something 86 00:03:24,969 --> 00:03:25,629 like this. 87 00:03:26,925 --> 00:03:28,305 Employers are particularly 88 00:03:28,604 --> 00:03:31,745 interested in making sure that their 89 00:03:32,525 --> 00:03:34,144 employees and their beneficiaries 90 00:03:35,084 --> 00:03:36,944 have better health experiences, 91 00:03:37,245 --> 00:03:38,384 better health journeys. 92 00:03:39,040 --> 00:03:41,460 Childbirth is one of the most common, 93 00:03:43,120 --> 00:03:45,219 health care events that an employer 94 00:03:45,520 --> 00:03:46,020 will 95 00:03:46,480 --> 00:03:49,060 pay claims for their employee over the course 96 00:03:49,439 --> 00:03:50,419 of their employment. 97 00:03:50,800 --> 00:03:53,754 And employers are very focused on the same 98 00:03:53,754 --> 00:03:56,155 things that we see in our nation with 99 00:03:56,155 --> 00:03:58,735 high rates of maternal morbidity and mortality. 100 00:03:59,435 --> 00:04:01,375 And the fact that, unfortunately, 101 00:04:02,235 --> 00:04:04,395 that is get has been getting worse over 102 00:04:04,395 --> 00:04:05,055 the last 103 00:04:05,370 --> 00:04:07,689 decade or more in The United States. And 104 00:04:07,689 --> 00:04:09,389 we see when we compare 105 00:04:10,090 --> 00:04:13,310 US to other developed and high income nations, 106 00:04:13,689 --> 00:04:16,189 our rates of maternal morbidity and mortality 107 00:04:16,889 --> 00:04:18,764 are often some of the worst in the 108 00:04:19,064 --> 00:04:19,564 world. 109 00:04:19,944 --> 00:04:21,164 So that affects 110 00:04:21,785 --> 00:04:22,285 employers 111 00:04:22,985 --> 00:04:25,305 as well as it does government programs like 112 00:04:25,305 --> 00:04:26,685 Medicaid, for example. 113 00:04:27,384 --> 00:04:27,884 Absolutely. 114 00:04:28,185 --> 00:04:29,865 It makes sense. And and when we're thinking 115 00:04:29,865 --> 00:04:30,365 about 116 00:04:30,819 --> 00:04:33,080 tackling this this national issue, 117 00:04:33,779 --> 00:04:36,180 what does the latest clinical research say about 118 00:04:36,180 --> 00:04:38,520 the importance of expanding this kind of coverage? 119 00:04:39,460 --> 00:04:41,699 Yeah. So there has been, again, more and 120 00:04:41,699 --> 00:04:42,600 more published, 121 00:04:43,300 --> 00:04:45,560 literature in well respected 122 00:04:46,794 --> 00:04:47,694 medical journals, 123 00:04:48,235 --> 00:04:49,454 like Lancet publications, 124 00:04:49,834 --> 00:04:50,574 for example, 125 00:04:51,035 --> 00:04:52,254 that doulas 126 00:04:52,555 --> 00:04:55,675 do have a reduction in preterm births, a 127 00:04:55,675 --> 00:04:58,954 reduction in c section rates, a reduction in 128 00:04:58,954 --> 00:05:01,279 NICU admissions, a reduction in postpartum 129 00:05:01,980 --> 00:05:04,060 anxiety and depression. And all of these are 130 00:05:04,060 --> 00:05:05,040 very meaningful 131 00:05:05,740 --> 00:05:06,240 measures, 132 00:05:07,020 --> 00:05:10,560 in not only outcomes, but also for employers' 133 00:05:10,620 --> 00:05:11,600 health care costs. 134 00:05:12,735 --> 00:05:15,215 Certainly. So this is expected to improve health 135 00:05:15,215 --> 00:05:17,694 outcomes in this space. And I wonder beyond 136 00:05:17,694 --> 00:05:20,415 the clinical case, Rhonda, is there a business 137 00:05:20,415 --> 00:05:21,475 case here to, 138 00:05:22,254 --> 00:05:25,615 do doulas ultimately save the system and and 139 00:05:25,615 --> 00:05:26,754 employers money? 140 00:05:27,669 --> 00:05:30,229 Well, they take a whole person approach to 141 00:05:30,229 --> 00:05:30,729 care. 142 00:05:31,110 --> 00:05:33,529 And I'm an osteopathic physician, so 143 00:05:33,990 --> 00:05:36,709 team based care and whole person approach to 144 00:05:36,709 --> 00:05:39,930 care really does matter. There's very, very strong 145 00:05:40,229 --> 00:05:40,729 evidence, 146 00:05:41,245 --> 00:05:43,564 in in every area that you look that 147 00:05:43,564 --> 00:05:45,725 whole person approach to care and team based 148 00:05:45,725 --> 00:05:46,225 care 149 00:05:46,685 --> 00:05:50,204 provides that type of not only informational support, 150 00:05:50,204 --> 00:05:52,384 but physical and emotional support. 151 00:05:53,004 --> 00:05:54,464 And so we're seeing that 152 00:05:54,790 --> 00:05:57,449 that advocacy, that coaching component 153 00:05:57,910 --> 00:06:00,089 that comes with the doula, the support 154 00:06:00,470 --> 00:06:02,250 that you can get during the 155 00:06:02,870 --> 00:06:05,129 pregnancy, during that labor and delivery 156 00:06:05,990 --> 00:06:08,490 time frame and postpartum as well, 157 00:06:09,785 --> 00:06:10,764 which may include 158 00:06:11,305 --> 00:06:13,245 your recovery from 159 00:06:13,545 --> 00:06:15,324 labor and delivery and also 160 00:06:15,785 --> 00:06:17,785 the support you need to care for your 161 00:06:17,785 --> 00:06:18,285 newborn. 162 00:06:18,904 --> 00:06:19,384 So, 163 00:06:20,345 --> 00:06:23,165 this is a very important journey and evolution 164 00:06:23,705 --> 00:06:25,100 to take something that, 165 00:06:25,560 --> 00:06:28,600 we've been watching very carefully that we have 166 00:06:28,600 --> 00:06:31,479 been doing with select benefit plans and in 167 00:06:31,479 --> 00:06:32,300 select markets 168 00:06:32,680 --> 00:06:33,339 and now 169 00:06:33,800 --> 00:06:36,540 scaling it, in a way that only UnitedHealthcare 170 00:06:36,839 --> 00:06:37,339 can. 171 00:06:38,365 --> 00:06:40,845 No. Absolutely. And it's been fascinating to see 172 00:06:40,845 --> 00:06:41,985 the wider industry, 173 00:06:42,605 --> 00:06:44,524 really begin to to latch onto this idea 174 00:06:44,524 --> 00:06:46,384 and roll it out like we are seeing 175 00:06:46,524 --> 00:06:47,024 UnitedHealthcare 176 00:06:47,485 --> 00:06:48,785 do this year. 177 00:06:49,165 --> 00:06:50,704 Rhonda, how do you see doulas 178 00:06:51,050 --> 00:06:54,730 fitting into broader care teams alongside OBs, alongside 179 00:06:54,730 --> 00:06:57,069 midwives? How does this all fit together? 180 00:06:57,770 --> 00:06:59,550 Yeah. Let's start with this. You know, there's 181 00:06:59,610 --> 00:07:00,509 there's always, 182 00:07:01,370 --> 00:07:04,110 a concern when you enter a new profession 183 00:07:04,330 --> 00:07:05,710 into a care team. 184 00:07:06,625 --> 00:07:07,925 You know, is there variation? 185 00:07:08,305 --> 00:07:09,204 Right? Are 186 00:07:09,665 --> 00:07:10,725 is there consistency 187 00:07:11,104 --> 00:07:12,964 in the way that those 188 00:07:13,345 --> 00:07:13,845 paraprofessionals 189 00:07:14,384 --> 00:07:15,125 are trained? 190 00:07:16,064 --> 00:07:18,625 And is there clear role definition? And do 191 00:07:18,625 --> 00:07:19,524 we all understand 192 00:07:20,029 --> 00:07:22,129 what our role in that team is? And, 193 00:07:22,589 --> 00:07:24,829 over the last few years, there have been 194 00:07:24,829 --> 00:07:28,910 an increase in training and certificate programs for 195 00:07:28,910 --> 00:07:32,209 doulas, and that has improved their focus on 196 00:07:32,430 --> 00:07:33,410 medical ethics, 197 00:07:34,145 --> 00:07:34,645 boundaries, 198 00:07:35,025 --> 00:07:35,525 collaboration 199 00:07:35,985 --> 00:07:37,685 with physicians and midwives. 200 00:07:38,145 --> 00:07:39,985 And that has really improved the way that 201 00:07:39,985 --> 00:07:43,345 doulas are integrating now into maternity care instead 202 00:07:43,345 --> 00:07:45,764 of being a separate stand alone industry. 203 00:07:46,889 --> 00:07:48,810 Absolutely. And I know it's been interesting on 204 00:07:48,810 --> 00:07:50,089 our side of things. We've been seeing a 205 00:07:50,089 --> 00:07:52,649 lot of state Medicaid programs really roll out 206 00:07:52,649 --> 00:07:54,970 coverage in this space as well. But before 207 00:07:54,970 --> 00:07:57,129 we go, doctor Rendell, is there anything else 208 00:07:57,129 --> 00:07:59,769 that we're missing on this topic or any 209 00:07:59,769 --> 00:08:01,689 other final bits of advice that you would 210 00:08:01,689 --> 00:08:02,189 share 211 00:08:02,564 --> 00:08:05,365 with, other health plan colleagues around the country 212 00:08:05,365 --> 00:08:07,925 looking at similar policies, looking at rolling out, 213 00:08:08,165 --> 00:08:10,345 similar coverage in the doula space? 214 00:08:10,965 --> 00:08:12,425 Two things. So 215 00:08:12,965 --> 00:08:13,465 UnitedHealthcare, 216 00:08:13,925 --> 00:08:16,824 through our philanthropic arm, the UnitedHealth Foundation, 217 00:08:17,520 --> 00:08:19,460 has been also focused on 218 00:08:19,839 --> 00:08:22,000 the concerns that we have with rising rates 219 00:08:22,000 --> 00:08:24,480 of maternal morbidity and mortality in The United 220 00:08:24,480 --> 00:08:25,199 States. And we've 221 00:08:25,839 --> 00:08:28,080 our foundation has been very focused on building 222 00:08:28,080 --> 00:08:31,245 that stronger future for maternal and infant health, 223 00:08:31,644 --> 00:08:33,424 And, that has included, 224 00:08:34,445 --> 00:08:34,945 significant 225 00:08:35,565 --> 00:08:37,485 funding in grants, $7,000,000 226 00:08:37,485 --> 00:08:40,445 in maternal and infant grants, which of that 227 00:08:40,445 --> 00:08:44,205 includes 1,000,000 dedicated to strengthening and diversifying the 228 00:08:44,205 --> 00:08:45,024 dual workforce. 229 00:08:45,884 --> 00:08:46,559 So that 230 00:08:47,039 --> 00:08:50,419 research and philanthropic arm, very important for UnitedHealthcare 231 00:08:50,799 --> 00:08:53,279 and UnitedHealth Group of the UnitedHealth Foundation as 232 00:08:53,279 --> 00:08:53,779 well. 233 00:08:54,240 --> 00:08:55,620 And then from an employer 234 00:08:56,000 --> 00:08:56,500 perspective, 235 00:08:57,200 --> 00:08:57,700 UnitedHealthcare 236 00:08:58,320 --> 00:09:00,794 now will be the first to offer the 237 00:09:00,794 --> 00:09:04,095 dual support in employer sponsored and commercial members 238 00:09:04,475 --> 00:09:06,495 at this scale across 239 00:09:07,034 --> 00:09:08,095 plans nationwide. 240 00:09:08,394 --> 00:09:10,554 And so what differentiates us there is the 241 00:09:10,554 --> 00:09:11,054 flexibility. 242 00:09:11,674 --> 00:09:13,695 Depending on an employer's plan, 243 00:09:14,279 --> 00:09:15,959 men most members are going to have a 244 00:09:15,959 --> 00:09:18,839 choice of which doula they work with and 245 00:09:18,839 --> 00:09:21,320 when they decide to use that doula support. 246 00:09:21,320 --> 00:09:24,679 So they can choose any trained doula, whether 247 00:09:24,679 --> 00:09:26,519 they're in or out of network. They can 248 00:09:26,519 --> 00:09:28,919 choose when they're deciding to work with them, 249 00:09:28,919 --> 00:09:31,504 whether it's during pregnancy, during labor and delivery, 250 00:09:31,565 --> 00:09:32,384 or postpartum. 251 00:09:33,485 --> 00:09:36,524 Wonderful. It's very exciting news, for the industry, 252 00:09:36,524 --> 00:09:38,924 I think, overall and, of course, for for 253 00:09:38,924 --> 00:09:40,605 the members that you serve, doctor Randall. So 254 00:09:40,605 --> 00:09:43,129 I wanna thank you for taking the time 255 00:09:43,190 --> 00:09:45,430 to chat with us about this and for 256 00:09:45,430 --> 00:09:47,670 sharing your expertise with our audience. We really 257 00:09:47,670 --> 00:09:49,450 appreciate it. Thank you. 258 00:09:49,830 --> 00:09:51,110 And to our listeners, if you'd like to 259 00:09:51,110 --> 00:09:53,269 listen to more podcasts from Becker's HealthCare, you 260 00:09:53,269 --> 00:09:56,009 can visit beckers hospital review dot com.