Latest / Becker’s Payer Issues Podcast / Harlon Pickett, President, Eagle Care Health Solutions

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Harlon Pickett, President, Eagle Care Health Solutions · Becker’s Payer Issues Podcast

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  Evernorth brings the power of wonder and relentless
• 0:02
  innovation to create world class pharmacy, care, and
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  benefit solutions.
• 0:07
  Barriers to care can lead to gaps in
• 0:08
  care, which can drive up the total cost
• 0:10
  of care. Our capabilities work seamlessly together to
• 0:13
  create innovative pharmacy care and benefit solutions for
• 0:17
  today and tomorrow.
• 0:18
  Our connected health services make the treatment, prediction,
• 0:21
  and prevention of health care's most complex conditions
• 0:24
  easier and more accessible as we drive organizations
• 0:27
  and people forward.
• 0:29
  This is Haley Recker with the Becker's Payer
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  Podcast, and we are recording live at the
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  Becker's third annual spring payer issues roundtable.
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  Today, I am joined by Harlan Pickett, president
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  of EqualCare Health Solutions.
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  Harlan, thank you so much for joining me
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  today. Can you go ahead and tell us
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  a little bit about yourself and your background?
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  Absolutely. It's my pleasure to be here. Great
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  event. I've really enjoyed it.
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  I have been in the insurance and
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  health care world for about eighteen years. Started
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  Eagle Care back in 2019.
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  We provide
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  alternative solutions
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  for employers
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  to help control their health care spend and
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  to provide better access to health care.
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  These are customized plans, nothing off the shelf.
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  It actually gives the employer control over what
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  their health plan looks like instead of once
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  in, you know, a one size fits all.
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  That that's that's not
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  effective in today's
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  environment. It doesn't allow you to control cost
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  in any way, shape, or form, and it
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  certainly doesn't provide
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  the access to health care that your employees
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  deserve.
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  Well, I'd like to start this conversation off
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  by asking you what you and your team
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  at Eagle Care Health Solutions
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  does to
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  ensure that the quality of care is kept
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  at the forefront.
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  Now that that is it's paramount.
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  First of all, if you don't know cost
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  and you don't know quality,
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  there's no way you can understand what value
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  is. There's a lot of talk about value
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  based care right now.
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  But in this health care system,
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  it's almost impossible to know what the cost
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  is first. Well, if you don't know the
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  cost and you don't know the quality, how
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  do you know it's valuable? How do you
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  put a value to it? So we work
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  diligently on that side of it. One of
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  the major ways we do it is we
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  do direct contracts with
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  physicians
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  that have shown
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  outstanding
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  outcomes and that actually care about their clients,
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  so much so that it is a membership
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  based model
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  that is a monthly
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  per member per month,
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  and then any additional cost that would be
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  incurred at
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  that facility
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  is zero.
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  So it's just a monthly membership. There's no
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  co pays. There's no out of pocket,
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  and, therefore, any cost that happened there
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  never are attributed to the plan. The plan
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  doesn't have to pay anything. The employer doesn't
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  have to pay anything. It's just that one
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  monthly fee. This aligns
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  the incentives
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  for the
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  patient
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  and the physician
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  and it rebuilds that relationship as well.
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  Therefore, the patient and the physician working together
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  with one goal and that is an improved
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  quality of life and improved health for the
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  patient.
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  That's where you get the quality.
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  Absolutely. You know, I'd like to keep that
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  conversation going about quality.
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  So improving quality and advancing health equity while
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  also reducing cost seems to be a big
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  priority for everyone in health care. So how
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  do you approach aligning these priorities in your
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  organization's strategic vision? Yeah. Imagine that the reason
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  that you can't see a doctor is because
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  I don't know how much it cost.
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  We removed that barrier.
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  So health equity in many cases is because
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  folks cannot
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  afford to go or they don't even know
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  if they can afford to go, and there
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  maybe isn't a location
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  close to them.
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  So doing these direct direct contracts, having a
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  direct contract with a physician
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  that's gonna give this individual
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  not five to seven minutes, which is the
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  national average, but is gonna provide them forty
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  five minutes to an hour to focus just
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  on them, have a conversation,
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  not just about their health but about their
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  lifestyle choices,
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  It changes their life for a positive way.
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  It brings them back into
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  a relationship with a physician that they heard
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  tell about, but it hasn't been available for
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  so many years. It levels the playing field.
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  This is a level of service that in
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  most folks say, oh, you're talking about an
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  executive concierge. No. No. We're not talking about
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  an executive concierge. We're talking about
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  a physician
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  who is really invested
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  in your health
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  and invested so much so they wanna have
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  a relationship.
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  Most of our members
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  don't just have an app that they work
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  through to talk to their physician. They actually
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  have their physician's phone number.
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  They can text their physician. They can call
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  their physician if something's going on. We've had
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  the physician come and meet people on New
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  Year's Eve
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  whenever the baby
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  was turning blue. What do I do? This
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  would normally be an ER visit.
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  It turned out it it although it sounds
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  really serious, it turns out it was a
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  very simple thing
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  that the doctor was able to take care
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  of.
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  Those folks felt so much better.
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  Obviously, the baby felt so much better,
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  but
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  they've never stopped talking about how important it
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  was to them to have that relationship and
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  have that opportunity to do that. Well, can
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  you imagine what it was like when they
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  went back to work
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  to talk about their experience?
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  All of a sudden,
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  in that particular employer group, we started seeing
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  even greater participation,
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  even greater engagement than there was before. Sometimes
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  all it takes is one
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  isolated incident
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  to make something just explode, and all of
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  a sudden the uptake on it is incredible.
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  Absolutely. That's amazing. And I'd like to keep
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  the conversation going with HealthEquity,
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  as you mentioned earlier.
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  Can you share an overview of a key
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  initiative here that you're involved in or particularly
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  excited about, and what are you hoping to
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  achieve? Yeah. There's
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  there's obviously certain communities.
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  And I won't just get into inner city.
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  I mean, that's that's pretty well known, but
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  we're talking about rural destinations right now. There's
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  been a lot of talk at this conference
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  about how do we affect change in rural
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  areas to provide them access to. We're actually
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  it it it's a pretty pretty new thing.
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  It it became an opportunity for us. We're
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  investing
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  in a couple of physicians' offices that are
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  in rural areas
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  to help them change away from a fee
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  for service to this membership
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  based model
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  because that then
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  that generates your income today. What many rural
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  positions
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  cannot do
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  is wait through the payment cycle.
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  That payment cycle eats them up.
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  Even if they are
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  seeing a decent number,
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  if you're spread across multiple health plans and
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  you're continually waiting for that money to come
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  in,
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  they're already understaffed a lot of times, especially
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  in rural areas.
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  All of a sudden, now they can't afford
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  to even keep the people on. It's hard
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  for them to keep their practice going.
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  A change in model then
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  is
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  an acceptable way to keep your practice going
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  to help grow that practice because that that's
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  what our our mission is going to be,
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  is to bring then local employers
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  even in those rural areas to show them,
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  hey. Here's a here's a model that will
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  work better, and now your folks can have
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  this relationship again. The other thing we're doing
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  is providing them technology so that they can
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  do televisits.
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  Many of them don't have that type of
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  infrastructure in their practice, but we're bringing that
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  technology to them so that they can provide
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  that too. That helps expand their practice within
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  their state.
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  Amazing. Well, this has been such a fascinating
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  conversation. Again, this is Haley Rucker with the
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  Becker's Payer Podcast
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  recorded live at the Becker's third annual spring
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  payer issues roundtable. Harlan, thank you so much
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  for joining me today. It's been my honor
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  and my pleasure. Thank you so much,