Hi, everyone. This is Lucas Voss with Becker's
Healthcare. Thanks so much for tuning in to
the Becker's Healthcare podcast series. It's great to
have you. I'm excited to welcome Kendall Walcott
and Steve Provence to the podcast. Kendall is
the founder and CEO of Me plus You
Care and former worldwide product head of interactive
media at a small shop you might have
heard of, the Walt Disney Company. Kendall founded
Me plus You Care in 2015 after a
deeply personal experience supporting a loved one through
cancer care where he saw firsthand
the gaps, fragmentation, and challenges patients and families
face. What started as a personal mission, however,
to create a more human centered connected approach
to care has since scaled to impact more
than 30,000,000
members
and caregivers.
Steve, on the other hand, brings decades of
health care leadership experience with him with a
background spanning hospital operations, large scale health system
management, including leadership roles at Kaiser Permanente, Providence
Healthcare Network, and Amida Health. He has led
organizations through operational transformation, performance improvement, expanded access
to care. He's also the former CEO of
Buckeye Health Plan and oversaw one of the
state's largest Medicaid health plans focused on improving
outcomes for vulnerable populations and advancing innovative
community based care models. I'm so very excited
to have you both on the podcast. Kendall
and Steve, welcome.
Thank you. We really appreciate it. That's exciting
times in health care these days, and we're
hoping to try and help help folks, learn
how to navigate through some of the biggest
challenges, that everyone's facing right now.
Yeah. Thanks as well. Excited to have the
conversation
today.
Yeah.
Kendall, as you've outlined, there's plenty to talk
about right now. HR one specifically
introduces some major shifts to Medicaid,
including work requirements and and more frequent eligibility
redeterminations.
While many plants don't have final guidance yet
from CMS and certainly their states as well
here,
what should plants be doing now
in order to prevent the most significant consequences
specifically
for vulnerable populations if the system just isn't
isn't prepared at all? Kendall, we'll we'll start
off with you. Yeah. I'll I'll say a
bit, but I I think getting Steve's perspective
as the CEO of of one of those
plans, you know, big time, I think,
is it really speaks to the heart of
it. But I'll I'll just start it off
by saying
people plans think they can't do something right
now because they're saying, oh, we're waiting. And
the answer is there is something to be
done right now, and it's actually critical that
you do it now. I think a lot
of folks saw with the Obamacare
issues, the ACA issues that happened Christmas to
January.
The drop off was huge. Right? People have
lost billions of dollars. Millions of people have
lost lost their care. We don't want that
to happen again, I think, is the is
the rallying cry for the industry right this
second. So we believe we have a way
to address that, but I think Steve ought
to set the table on on how an
executive has to think about this today. Yeah.
Absolutely, Steve. Go ahead. Yeah. Kendall,
I would agree on that. In my opinion,
the biggest mistake, right now would be waiting
for the perfect guidance.
By the time you get it, it's gonna
be too late.
There's really probably a couple things plans,
should be doing or thinking about,
moving into this is first, be honest about
who's at risk. Not not medically, but administratively.
And this is something Kendall was,
able to help,
out in a big way.
Who's going to lose that coverage because they
missed the form? They didn't get a letter,
or they just didn't understand what was being
asked of them. And then probably the second
thing is fix your data. Do you have
the right, demographics?
Phone, text, email, language preferences.
I had terrible demographic information,
and Kendall actually was able to come in
and help improve,
the likelihood I would get a hold of
a member,
which is the starting point. Because if you
can't get a hold of him, everything else
breaks apart.
And as we're moving into this, you have
to assume confusion,
assume volume spikes, assume members are going to
be overwhelmed.
Build and test for that now because at
the end of the day, the biggest risk
isn't going to be policy.
It's eligible people losing coverage because the system's
frankly just too hard to navigate.
Now looking back, speaking of navigation or navigating,
looking back at some of those post public
health emergency redeterminations.
Right? Many health plans face to this unprecedented
operational and human challenge,
probably continue to face it. From a leadership
standpoint, Steve, what did that moment reveal and
show us about where Medicaid infrastructure is most
fragile and where it needs to evolve?
Well, so it's probably a little bit of
what I was just saying. The unwinding really
showed
us that Medicaid isn't fragile clinically,
it's fragile administratively.
We still rely way too much on the
ideal that someone gets a notice, understands it,
trust it, and responds correctly,
usually within a very tight window or time
frame. And it's just not how real life
works,
for a lot of our Medicaid members.
It also exposed how disconnected
everything was between state systems, plans, providers, vendors.
They're not always getting
the same picture across all these entities, and
it's just causing confusion.
My opinion, we're still running a system that
expects perfect behavior,
from people living very imperfect lives. And that's
a
we really have to have a big shift,
moving the system from a transactional
model
to a continuous engagement model,
where we build trust over time with our
members. And, frankly, the partnership with MeYou
really helped Buckeye Health Plan achieve that consistent
engagement with our members and our providers and
our community
members.
From a leadership standpoint,
visibility is everything.
If you can't see where people are falling
off early, you can't fix it. Kendall,
kinda like, maybe, where you could speak into
some of the things you were able to
do to help me here. Yeah. No. I
think it's really important
to to have a sort of a mind
change or shift, if you will,
to think that, well, I can't get to
everybody perfectly today, whatever. That doesn't mean you
still can't get to a heck of a
lot of people. And and given digital technology,
led by the right minds, there's actually a
tremendous amount that we've proven we can do,
but also, is just possible, frankly. SMS. Right?
You're talking about people. Everybody has a phone.
I don't care what economic strata, what cultural
strata, what, you know, whatever issue you're dealing
with. You've got access to a mobile phone
almost invariably across the country today. So so
that's number one. Number two is the ability,
to find those numbers. One thing we helped
Steve with and we've helped other plans with
is we actually have a an ability through
partnerships
to go and find a mobile phone number
for someone that they don't have a connectivity
with at all. And we literally turned out
66%
from zero. So we went and these were
difficult, what are called, duals populations. Right? Both
Medicare and Medicaid.
Very hard to find, very hard to manage.
And the other really important piece was we
reached people in 80 languages.
Right? And you're talk you I mean, I
live in California.
Southern California on a daily basis, over 26
languages are used by the health plans are
encountered by the health plans. This is by
the way, it's also true in Ohio. It's
also true we found it in Tennessee.
I mean, it really is across the country
now. You're dealing with enormous numbers of variability
in terms of language. So the fundamental premise
that I took from both Disney, but also
from my experience in Steve, you're talking about
the complexity of the ecosystem,
was to meet people where they are.
Don't expect them to come to you. Don't
expect them to go log in to something,
to come to your website. People have lots
of billions of dollars of websites. People don't
use them. We're down to 7%
less access to websites. You gotta go meet
them where they are, and that's how we
built the company. So the ability to actually
put education,
put thinking, put just an awareness of this
thing's gonna happen
in the hands of members through SMS,
through secure SMS, or PHI protected SMS.
That's fundamental.
The other real trick that everybody could do
right now is there are other things besides
employment
that count towards the HR one eighty hours
a month work eligibility.
Their training programs,
school,
even there's some volunteer programs that count towards
those eighty hours. So what we're working with
health plans on is to literally send an
SMS
and take them through a little click through,
just a simple click, directly to a local
work training program, somebody who's vetted, somebody who's
already gone through the system and being approved,
where they literally can sign up and actually
start to build that eighty hours. They can
do that today. You wait till December
way too late. So both the people need
to know about this.
Consumers need to know about this, but also
plans need to know about this and take
action today,
not in July.
Steve, how do we then actually do this?
Right? This requires a lot more than just
implementing,
certain measures. It it requires a lot of
trust. It requires communication. It requires engagement. There's
a lot of levers that need to be
pulled for this to work. Right? So what
does it then truly
take to build that trust, to be able
to say, okay, we are doing the best
we can to reach you specifically when it
comes to we don't have the data. We
we need better data, etcetera.
How do we do this?
Yeah. Well, to Kendall's point, trust does not
occur with a single campaign.
It's the result of consistent member experiences.
A promise made, a promise kept.
It's when the message is clear, it's in
your language, it matches
what your doctor's office told you. And when
you ask for help, you actually get help.
If you reach out, you need to get
a response.
And Medicaid trust often sits in the community,
not just with the plan. So you have
to work through the people, through the organizations
that members already trust.
Like Ken Kendall was talking about with some
of the work programs out there. This becomes
even more important with
work requirements that people trust the system,
they're more likely to respond, report, or stay
engaged with you. When trust goes up, compliance
goes up. When trust breaks down, coverage breaks
down.
And one of the fundamental things, again, this
comes out of the Disney experience is
you have to deliver something of value
each time.
I used to argue with folks who said,
well, I just wanna send out a message
from the chief medical officer. I said, because
listening to a rich white doctor in his
fifties who went to Harvard is gonna work
in Columbus, Ohio.
You know? Have we have we really thought
this through? You know? And instead,
you work through the no. No. Small messages
of value. You know, do you need to
know how to deal with diabetic foot pain
because your mom's got it? That's all the
member wants to know is what can I
do now to help mom not hurt so
much? You do that with me a couple
of times, I'll listen to the next communication.
I'll I'll trust you on the next one.
So we have to get out of the
marketing message world,
and into the actual value added world. And
I think that is a large part of
why Steve had success. We reached a 98%
redetermination
rate,
at Ohio. It's because they built up a
series of trusted communications
where they said, okay. Well, they gave me
good information about that. They gave me a
reward. It actually gave gave me 10% off
something I wanted. You know, you build a
you build a relationship.
Yeah. And so to Kendall's point there, people
don't want
macro messaging that are just to the the
masses. They want micro messaging
that is to their specific needs and their
specific moment.
Example, back in COVID,
we literally had geo fence through, Kendall system
that could geo fence the populations within an
area
around the pharmacy, their trusted community partner,
to help connect with and get them,
engaged in the care we needed, with a
lot of unknowns at the time with COVID.
And so,
having a partner that can do that is
a game changer.
And part of that was to what we
call mass personalized.
And that was,
how do you have,
care managers
or pharmacies or assistants to them start to
own a population, start to own a group
of folks and say, I'm Kendall. I'm here
for you. You're gonna consistently see my image
on the SMS message. You're gonna hear my
voice on something. And even we get around
using the other part of me plus you,
which is chat. Right? No app. Remember? Meet
where meet people where they are. No apps,
folks. No no portals. No apps. But you
can start to have actual conversations. Well, with
who? We'd like to have with the same
person.
You know, we all know what customer experience
looks like today. It's an AI bot thing
that you you have no relationship with. We
go the other way. We believe that including
a human,
in every piece, every comes changes the dynamic.
It changes the entire conversation, and we've proven
that. We continue to prove that. And that
matters a lot to your core point about
trust.
And I just wanted to come back to
Steve's point that he made earlier. This can
only happen if the data is good. Right?
You know, Steve mentioned the data just wasn't
there at the point in time. We we
need data to be able to feed this
beast, so to speak, to be able to
say, okay. We can reach out. We have
meaningful interaction with you because we know exactly
who you are and what you need, which
is so crucial.
As we look towards the future then now.
Right? And and, Kendall, I love that you
mentioned, like, you need to be doing this
now. This is don't don't start six months
from now. This is something that needs to
start now. Right?
How should organizations
define success
when they're doing this heading into the rest
of the year and beyond? And and and,
again, as they prepare for policy changes, what
does all of this mean when we're looking
in preparedness?
I think one of the easy so I
I believe you know, as an English major,
I believe strongly in analytics.
Why? Because I'm a mission based company. I
want to prove to myself as a owner,
but also to our customers that something actually
happened, that action was actually taken. I don't
care about just, oh, they touched, they clicked,
they this. That's nice. I wanna know they
actually did something that matters to their future.
Right? Otherwise, I haven't met my mission,
and our clients aren't as happy as so
what we really look for is what I
call response campaigns. Did you we we send
bidirectional,
multidirectional communications where we can prove that something
transpired.
So I would say an early win to
your question is, did they get something in
whatever language? Did they respond back that they
understood,
had these three questions? And then to Steve's
point, you can't leave them dangling. You gotta
go back around again as many times you
follow-up
to see if in fact you answered their
questions. Do they know what they're supposed to
do next? Are they gonna try and go
to that third party and get training or
whatever it is? So I think early thing
is, can we check our response rates?
What the questions are? Are we improving the
education, the information
dynamic, if you will? That can be done
instantly.
You know? That we're a SaaS company. We
can have you up and running in less
than thirty days. That's that's the easy part.
Technology is the easy part. It's about did
you build the messages
to get the right response so you can
continue to refine
what's going on next. Then you say, I'm
gonna send you an esign form, or I'm
gonna have you take a photo of your
driver's license or whatever it is you need
next. We can support that entire
virtual transaction period. Again, no apps
all the way. But there's
easy early success right now that we can
demonstrate. It comes back to the trust piece.
Right? Building that trust, being able to do
that. Steve, same question for you. Again, how
should organizations
define success in all of this? Yeah. Well,
honestly, preparedness,
isn't just about compliance. It's whether your system
actually works under stress,
under that member stress.
And so to me,
you really gotta have a couple test points.
Are your operations ready for the volume, the
complexity that's gonna come? Are your communications
easy to understand in a way that they
know how to act on it?
Your providers and community partners know, and are
you working with them in a way that
brings them into the mix that that really
help there? Because it really comes down to
simply this with me. Success
is not how many notices you send out.
Success is whether or not eligible people stay
covered. The organizations that are able to lead
through this next phase
won't just manage policy, they're gonna reduce the
friction caused by the confusion.
Yeah. The root cause. We come back to
the root cause being able to attack it
from there and not just sort of hitting
little points here and there as as as
Kendall mentioned earlier in our conversation.
Steve and Kendall, it's so great to have
you both. Thank you so much for spending,
some time with us and providing you, us
with these great insights. It's great to have
you. Thank you. Thank you. Really appreciate the
opportunity. It was a pleasure.
We also want to thank our podcast sponsor,
Repulse You Care. You can tune into more
podcasts from Becker's Health Care by visiting our
podcast page at beckershospitalreview.com.