Latest / Becker’s Payer Issues Podcast / Jane Brown, Head of Medicaid Operations at Aetna

Transcript

Jane Brown, Head of Medicaid Operations at Aetna · Becker’s Payer Issues Podcast

• 0:00
  This is Laura Dierda with the Becker's Healthcare
• 0:02
  podcast. I'm thrilled today to be joined by
• 0:04
  Jane Brown, head of Medicaid operations at Aetna.
• 0:07
  Jane, it's a pleasure to have you on
• 0:08
  the podcast today. Thank you, Laura. Very excited
• 0:11
  to be here today.
• 0:13
  Now I'm looking forward to our conversation because
• 0:15
  I know you're doing some really cool things
• 0:16
  at Aetna, and certainly,
• 0:18
  Medicaid is a huge topic of conversation nationally,
• 0:20
  and hospital and health systems as well as
• 0:23
  health plans in general are are really interested
• 0:25
  to see how things unfold over the next
• 0:26
  several months. And so I'm excited for this
• 0:28
  conversation. But before we dive in, can you
• 0:31
  tell us a little bit more about yourself
• 0:32
  and your background?
• 0:34
  Absolutely, Laura. I am a sort of Medicaid
• 0:37
  dork, self avowed.
• 0:39
  I'm, somebody who graduated law school, and right
• 0:42
  after law school right went right into the
• 0:44
  Medicaid program.
• 0:45
  I started working for managed care organizations over
• 0:48
  a decade ago.
• 0:50
  I've worked for a number of the larger
• 0:52
  payers in the country who all support Medicaid
• 0:55
  beneficiaries.
• 0:57
  And for me, the growth and the the
• 0:59
  trajectory, I suppose, through the business has been
• 1:02
  primarily through the compliance,
• 1:04
  legal, and operational channels.
• 1:07
  But as I started working,
• 1:09
  into more sort of the operational,
• 1:11
  pathways,
• 1:17
  Medicaid health plan in Kansas.
• 1:19
  So I think I've probably sat in a
• 1:21
  lot of the health plan chairs that one
• 1:24
  could sit
• 1:25
  in the Medicaid space. And I, I really
• 1:28
  love this area of the business, and I,
• 1:31
  plan to spend probably the greater majority of
• 1:33
  the rest of my career continuing to support
• 1:35
  Medicaid and Medicaid beneficiaries.
• 1:39
  That's fantastic to hear. And, you know, where
• 1:40
  does your passion for Medicaid come from?
• 1:44
  For me, I think it's just having a
• 1:46
  lived experience in the program.
• 1:48
  As a kid, my family immigrated actually from,
• 1:52
  Belarus in the early nineteen nineties.
• 1:55
  And when we first came to this country,
• 1:56
  the Medicaid program was how we, you know,
• 1:59
  gained access to health care services.
• 2:02
  It's how we got support with translation
• 2:05
  services.
• 2:06
  It was pretty much,
• 2:09
  you know, like a bedrock in our community
• 2:11
  and certainly the thing that my parents had
• 2:13
  to rely on while they got their feet
• 2:15
  under them in sort of pursuit of the
• 2:17
  American
• 2:18
  dream.
• 2:19
  So my Medicaid experience
• 2:21
  comes from, you know, being on Medicaid as
• 2:24
  a kid
• 2:25
  and really having a front row seat to
• 2:28
  what good that program could do and what
• 2:30
  some of the challenges of it, can also
• 2:33
  be.
• 2:34
  That's really, you know, great to hear. And
• 2:36
  certainly, I I can imagine,
• 2:39
  like you said, it's such a passion area
• 2:41
  for you as you can see where the
• 2:42
  program is headed and how it can be
• 2:44
  beneficial as well as the challenges that it
• 2:46
  faces. From your perspective, what are some of
• 2:49
  the biggest issues that you're following in health
• 2:51
  care
• 2:52
  headed into the next several months?
• 2:54
  You know, I think right now, I'm working
• 2:56
  a lot with understanding,
• 2:59
  how to best enable our provider community in
• 3:01
  terms of, for example, value based arrangements.
• 3:05
  What are the data and technology
• 3:07
  and information
• 3:08
  that they need in order to,
• 3:11
  get to members in a timely manner and
• 3:13
  help members make the right decisions around their
• 3:16
  health their their health care? It really it's
• 3:19
  about empowerment. And I think as the managed
• 3:21
  care organization
• 3:23
  at the table,
• 3:24
  the onus is on us to really bring
• 3:26
  some of that data together and really incentivize
• 3:29
  the right actions within the provider community to
• 3:32
  ensure that members in turn get the services
• 3:35
  and supports that they need at the right
• 3:37
  time.
• 3:38
  So I think that infrastructure
• 3:40
  in terms of how we share information
• 3:42
  is where I plan to spend the bulk
• 3:44
  of my year
• 3:45
  and making sure that the information is, you
• 3:48
  know, shared timely in a way that's understood
• 3:51
  in a clear way.
• 3:52
  All of that can't be taken for granted
• 3:54
  because when we think about health care information,
• 3:57
  you know, the pool of it is it's
• 3:59
  humongous. It's millions of records coming from millions
• 4:02
  of different places.
• 4:03
  And and trying to create harmony in that
• 4:06
  process and ensuring that the right information gets
• 4:08
  to the right place at the right time,
• 4:11
  it's almost like a full time job, you
• 4:12
  could say. So we're spending,
• 4:14
  quite a lot of time,
• 4:16
  on that work within Aetna and certainly within
• 4:18
  our Medicaid space this year.
• 4:21
  That's great to hear. You know? And, certainly,
• 4:23
  I know no small task to troubleshoot that
• 4:25
  type of connection, support the technology needed, and
• 4:28
  ability to communicate
• 4:30
  in in a meaningful way. And then, too,
• 4:32
  it's great to hear that you're looking at
• 4:34
  the, value based arrangements. I know that's something
• 4:37
  that certainly seems like it could be a
• 4:39
  great opportunity for,
• 4:41
  health care overall to make a meaningful transition
• 4:43
  in that direction.
• 4:45
  Yeah. Definitely. I think that if we can
• 4:47
  crack this piece of it,
• 4:49
  really get everybody on the same page, we
• 4:51
  have an opportunity to align
• 4:54
  goals and incentives. Right? And I think when
• 4:56
  you align goals and incentives across the health
• 4:59
  care industry,
• 5:00
  that's, you know, the opportunity for us to
• 5:03
  do the greatest good and have the greatest
• 5:04
  impact because we're all going in the same
• 5:06
  direction
• 5:08
  together and at the same time. Absolutely. That
• 5:10
  is a really great point. Now I'm curious
• 5:13
  in looking ahead, what are you most excited
• 5:15
  about or what makes you nervous?
• 5:18
  I'm really excited about some of the emerging
• 5:19
  technologies that are all,
• 5:21
  that are all,
• 5:22
  aimed at sort of member enablement. I think
• 5:25
  that in the Medicaid space, you know, historically,
• 5:28
  you know, there's some misconceptions,
• 5:30
  in the industry that, for example, maybe Medicaid
• 5:33
  beneficiaries
• 5:34
  don't have cell phones or they don't have
• 5:36
  the same, data access.
• 5:38
  And I think that, like, legacy historically, that
• 5:41
  that some of that was true, but I
• 5:42
  think it's also rapidly changing.
• 5:44
  And I think that we have to, really
• 5:47
  leverage the opportunity ahead of us and really
• 5:49
  figure out how to provide tools and resources
• 5:52
  directly to members, really,
• 5:54
  to empower them to make the right decisions
• 5:57
  for their health care, to really make sure
• 5:59
  that there's education and empowerment so that when
• 6:02
  they're thinking about how to interact with the
• 6:04
  health care system,
• 6:06
  you know, they're driving they're driving towards a
• 6:08
  healthier outcome into a healthier lifestyle.
• 6:11
  So I'm really excited about some of the
• 6:13
  technologies and opportunities and even partners that are
• 6:15
  emerging who are all spending time trying to
• 6:18
  crack, that piece of the puzzle.
• 6:20
  That's great to hear. And and, certainly,
• 6:23
  having that ability to connect with so many
• 6:25
  different people. And as you said, I love
• 6:26
  the idea of empowering the patients and bringing
• 6:29
  them into the fold for making decisions within
• 6:32
  their own care process and treatments and journeys.
• 6:34
  It seems,
• 6:36
  really, really, like, an amazing,
• 6:38
  way to think about health care and health
• 6:40
  care delivery.
• 6:41
  I'm curious too, when you look
• 6:44
  look at the, broader landscape overall, what challenges
• 6:47
  are you anticipating or is there anything that
• 6:49
  you're preparing for,
• 6:52
  that, you know, could make you a little
• 6:54
  bit nervous in the future?
• 6:56
  Well, I think that that the health care
• 6:58
  system is it's big, broad, and it's fraught
• 7:02
  with challenges, you know, in every step of
• 7:04
  the way. But I think, ultimately,
• 7:06
  connectivity is gonna be the thing
• 7:08
  that unites us and really helps us,
• 7:12
  sort of go forward in a consistent and
• 7:15
  unified
• 7:16
  manner. And so how do we create connectivity?
• 7:19
  How do we make sure we have even
• 7:21
  something as basic as the right phone numbers
• 7:23
  for members or the right email addresses?
• 7:26
  You know, it it it makes me nervous,
• 7:28
  right, because in Medicaid, so much of
• 7:31
  our work depends on, for example, enrollment files
• 7:34
  coming in from regulators.
• 7:36
  And if those enrollment files don't have the
• 7:38
  right information on them, then we're stymied with
• 7:41
  how to then reach out to the member.
• 7:43
  But I think we have an opportunity to
• 7:45
  work with all of the parties involved, including
• 7:48
  regulators, and say, hey. You know, here's the
• 7:50
  correct information we obtained from the members.
• 7:53
  Let's update your systems. Let's make sure that
• 7:55
  at the source of truth, the information upstream
• 7:58
  is correct, and that everything that flows downstream
• 8:01
  from that is also correct.
• 8:03
  And that connectivity
• 8:04
  is ultimately what's gonna, I think, set us
• 8:06
  up for some of the exciting stuff I
• 8:09
  mentioned earlier, which is, you know, member empowerment,
• 8:12
  members taking control of their journey, members having
• 8:15
  access
• 8:16
  to the information that they need in order
• 8:19
  to make really good decisions at the time
• 8:21
  that they're making them.
• 8:23
  That makes a lot of sense, you know,
• 8:24
  and and really,
• 8:26
  fascinating challenge, but also it sounds like, you
• 8:28
  know,
• 8:29
  very much a possibility to,
• 8:32
  gather this information and and put the systems
• 8:34
  in place,
• 8:36
  to make sure that those that type of
• 8:38
  information is flowed upstream and downstream as well.
• 8:41
  Before we wrap up here, I'm wondering what
• 8:43
  do you think the most effective health care
• 8:45
  leaders will need to be successful over the
• 8:47
  next two to three years, especially given some
• 8:49
  of the things we've talked about today
• 8:51
  around the communication,
• 8:53
  transition into value based arrangements, and really truly
• 8:56
  taking care of those in the Medicaid program?
• 8:59
  You know, leadership
• 9:01
  is
• 9:02
  such a, like, multifaceted
• 9:04
  thing. And it and I don't think it's
• 9:06
  just one type of skill or personality
• 9:09
  type that can,
• 9:12
  sort of deliver on that leadership that is
• 9:14
  needed.
• 9:15
  But I do think that resiliency
• 9:17
  is gonna be a key feature. You know,
• 9:19
  I think that that that Medicaid continues to
• 9:21
  be a very hard program
• 9:23
  to administer and manage,
• 9:25
  and I think to continue to evolve it
• 9:27
  into the future and really think about,
• 9:30
  you know, what best practices to bring in,
• 9:32
  how to change really
• 9:34
  older legacy systems that take a lot of
• 9:36
  investments and a lot of time. I think
• 9:38
  all of that is gonna take a lot
• 9:39
  of resiliency,
• 9:41
  is gonna take a lot of grit, quite
• 9:42
  frankly. I think we're all gonna have to,
• 9:46
  look at look at ourselves, you know, with
• 9:49
  our best critical thinking hats and really assess
• 9:52
  where we are and really figure out how
• 9:55
  to move forward.
• 9:56
  And I think, I think to do that
• 9:58
  well, you're gonna have to be sort of
• 10:00
  very honest with yourself, honest with your team,
• 10:03
  and then, again, bring in that resiliency
• 10:06
  and that grit to get you through the
• 10:07
  harder parts of change management
• 10:09
  so that, ultimately, we come out in a
• 10:12
  more nimble,
• 10:13
  model, in a more nimble environment where we
• 10:15
  can do, you know, hopefully,
• 10:18
  more and more with member empowerment, with provider
• 10:21
  empowerment, really putting the health care back into,
• 10:25
  the the the hands of the people who
• 10:27
  it impacts the most, the beneficiaries,
• 10:29
  right, of the program.
• 10:31
  I love that. Jane, thank you so much
• 10:33
  for joining us on the podcast today. This
• 10:34
  has been such a fantastic conversation, and I
• 10:36
  look forward to connecting with you again soon.
• 10:39
  Laura, thank you so much for having me.
• 10:40
  I look forward to coming back anytime you'd
• 10:43
  like. Have a wonderful day. Take care.