Issue link: https://beckershealthcare.uberflip.com/i/1476979
43 THOUGHT LEADERSHIP Q: Payers across the board believe so- cial determinants of health account for around 80 percent of a patient's care outcomes, and 20 percent is from med- ical care. What are some recent SDOH investments your organization has made, and what's on the horizon? DE: We've invested in actually gathering the data. One of the things that has been a challenge is making sure we're incorporating race, ethnicity and language data, which is tough to get. We're looking at how to work together on making sure that we have access to data that can help us better identify those numbers and our population health data and analytics. Another area we're investing in is accessing the data and then utilizing it in our own internal systems to better identify pop- ulations that are at higher risk. Secondarily, you have to actually invest in programs and different ways to interact with members around social determinants of health. We recently invested in the state of Minnesota for providing doulas, who sup- port women during childbirth. We're specif- ically supporting people moving into the in- dustry that will help support predominantly women of color, as we know that group has poorer health outcomes than the broader maternal population. ese are things that we can actually do tangibly in the field to help support people who may otherwise have barriers to accessing the best health outcomes. Q: Your company launched a digital health equity pilot with three compa- nies in Brooklyn Center this month. How is BCBS Minnesota incorporating health equity initiatives into its business strat- egy? DE: COVID-19 illuminated the health in- equities that were already here. We were the first organization that came out to say that racism is a public health emergency and be- ing dedicated to that is a part of our strategic plan on equitable care. If it's not equitable, then we don't see it as meeting our mission of helping everyone achieve a healthy life. We have dedicated investments on an annual basis around what we call place-based part- nerships. Brooklyn Center is one of them, where we're at the table. We believe that the answers come predominantly from the com- munity, and we're there to support that. But we need to listen first, so those investments in organizations like TurnSignl and others are a part of that. We're also investing internally. Like I men- tioned before, access to data and the doula program is where we can invest in the actual healthcare system to help drive better out- comes and more culturally competent care. I'm a firm believer that we have to hold a mirror up to ourselves and look at what we are doing internally before we can be credi- ble in the market. We have a diversity, equity and inclusion focus, and one of the things that I'm most proud of being here at Blue Cross nearly eight years now is that this is not new to us. Our foundation, the Center for Prevention, and BCBS have been a pres- ence in the state for many, many years in supporting access to care and really reducing those inequities across the board. Q: You started your career in nursing and have experience in home-based care. What lessons have you taken with you starting on the provider side and how does that influence where you want to take BCBS in terms of deliver- ing care directly in the home and hos- pice settings? DE: It's something that I'm so grateful for now — those experiences both as a registered nurse and respiratory therapist and in public health nursing, which was an eye-opening area. It taught me a few things. One is that we do ultimately have a pretty fragmented system that oen misses those 80 percent of things that we experience as a person that impacts our health. at hugely impacts the way I've looked at our role within the larger healthcare ecosystem, and how we help con- tinue to drive care that's more personalized, which predominantly happens in the home. One of the big trends I see aer COVID-19 is the expectation of healthcare consumers to no longer be treated episodically. You're not a heart patient, or a cancer patient — you're a holistic patient that needs and wants care that sees you from all aspects of your life, and much of it happens in the home. As a clinician I would go into people's homes and see the empty refrigerators, I would see equipment that had been purchased that was literally sitting inside bathtubs and never being used, and I would see the rural places where people could never drive and get to a provider. We have to continue to look for solutions and continue partnering. I'm a big believer that there's not any one part of the healthcare system that can solve the issues we're facing, we must do it collectively. We have to help providers with different tools to identify those needs in the home and com- munity to lead to a better outcome. I try to remember some of those patients I worked with in the community on a day-to- day basis because it helps ground us in our mission at Blue Cross, and what we need to do to continue to build our capabilities and work collectively within the healthcare space to meet people where they are. Q: The industry is rapidly growing its offerings of Medicare Advantage plans. How do these plans fit into your organi- zation's growth strategy? DE: Medicare has been an area of growth for us and we have a very strong presence in Medicare generally, and specifically in Medicare Advantage. It is a part of our over- all growth strategy and it continues to be an area of focus for us. A huge part of the solution and strategy has to be looking at partnerships in the community and in the home. We're really seeking to identify and help members who are on a trajectory of chronic illness and even into palliative care and hospice. Q: Every week we see reports of a health system and a major payer sever- ing in-network ties, leaving patients un- fairly caught in the middle. Each case is different, but are there better strategies insurers can take to avoid these contract fallouts? DE: Value-based contracting is one of the best ways to really be thinking longer term. We have the privilege of being a part of a longer-term value-based contract with Al- lina Health, one of our local, large systems. We were really committed to making that a multiyear strategy, and part of it was to weather what can arise. Right now, that's in- flation and the cost of labor. It allows us to look at a longer-term partnership with our providers that seeks to reimburse them for outcomes and allows them to invest in some of the capabilities we talked about. It also gets us out of coming back every one to two years and potentially having this more con- tentious relationship. at is certainly not our desire because it leads to instability in the market, and most importantly, instability with patients and their outcomes. Our desire is to pay a fair price for healthcare, but we still believe that we need to continue to push toward different and innovative payment models that really seek to eliminate some of the instability that these year-over-year ne- gotiations can drive. Q: Several BCBS companies have cre- ated travel benefits for their members or employees to access reproductive care following the overturning of Roe v. Wade. Is your company considering the same? DE: First and foremost, access to abortion services and reproductive rights is actually a part of the Minnesota Constitution. We had questions from employers as you can imag-