Latest / Becker’s Payer Issues Podcast / Edward Juhn, Chief Quality Officer at Inland Empire Health Plan

Transcript

Edward Juhn, Chief Quality Officer at Inland Empire Health Plan · Becker’s Payer Issues Podcast

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  and outcomes for the populations we serve.
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  Hello, and welcome to the Becker's Health Care
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  podcast. I'm joined today by Edward Jung, chief
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  quality officer at Inland Empire Health Plan. Edward,
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  can you take a brief moment to, tell
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  us a little bit about your background and
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  your organization? Sure. Happy to. Again, my name
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  is Ed Jung. I serve as chief quality
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  officer at Inland Empire Health Plan, often referred
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  to as IHP.
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  IHP is a large Medi Cal or Medicaid
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  organization serving about 1,500,000
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  members
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  in the Inland Empire, which is made up
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  of Riverside and San Bernardino counties. Just to
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  give it a little context,
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  the Inland Empire is very large. It's about
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  27,000
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  square miles, making us larger than 10 states.
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  And so we work really hard to ensure
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  that our members receive the highest quality of
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  care in our region.
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  So from improving member experience and expanding value
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  based care, to controlling fair costs,
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  care executives have ambitious growth goals for the
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  rest of the year and next year. In
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  your role, what would you say is your
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  top priority, and, how are you planning on
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  getting there? Well, I think for us, our
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  top priority is focusing on quality outcomes for
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  our members and ultimately doing the right thing
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  to ensure that these members get those quality
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  outcomes that they deserve.
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  For us, whether it's in focusing on how
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  to support our providers
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  to better enable them to provide these high
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  quality services or walking alongside our members to
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  provide them their needs, I think that's something
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  that our entire organization
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  is rallying and focusing on. For example, internally
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  within our organization, we have a quality starts
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  with me campaign
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  because we recognize that every interaction is an
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  opportunity for us as a health plan to
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  do what's right for our members.
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  At an industry level, how would you describe
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  the biggest barriers to effectively serving and engaging
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  members?
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  And, what opportunities are you currently seeing for
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  large scale improvements, and how are you implying
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  all this in your current strategies?
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  Well, I think
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  a barrier,
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  for example, in our region is our low
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  provider to patient's ratio.
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  For us,
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  our opportunity
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  is to find ways to bring more providers
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  into the region to care for the most
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  vulnerable.
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  So I think the provider to patient's,
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  ratio is one thing. Definitely, that's an opportunity.
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  We also recognize that access and access to
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  care is an opportunity. I think that stems
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  from,
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  the opportunity for us to bring on more
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  highly qualified providers
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  into our region,
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  to serve our members.
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  Keeping up to, with today's
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  dynamic health care landscape is challenging.
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  You know, with your experience, what would you
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  say are some of your top pieces of
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  advice for other peer leaders, in in your
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  in your industry right now? I think one
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  of the things that we always have to,
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  keep our minds focused on is the member.
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  At the end of the day, there's a
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  lot of data out there. There's a lot
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  of analytics out there. But for us at
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  IHP,
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  these numbers represent people, families, and communities. And
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  for us to always remember that
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  the work that we do is a privilege.
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  It's an honor in service to serving some
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  of the most vulnerable people.
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  And so for us to always keep that
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  in mind and not be distracted by some
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  of the other things that might come with
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  that. Mhmm. Mhmm.
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  In an ever evolving
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  regulatory
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  environment, you know, what are some of the
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  tools and strategies that have helped your organization
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  improve quality and clinical outcomes for members that
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  are staying compliant with this regulatory change?
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  Well, I think for us, it's,
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  as I shared before, finding ways
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  to walk alongside our providers to ensure that
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  that they're meeting,
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  some of the requirements that are
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  asked from us as health plans, whether it's
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  finding ways to support,
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  their clinical practice, whether it's billing, coding, or
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  workflow opportunities,
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  whether it's finding ways to improve the way
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  that we engage with our members and how
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  they experience care,
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  whether it's the way that we outreach to
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  them, whether it's the support services we provide.
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  I think, we really focus on all those
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  pieces and everything in between.
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  I also think it's important for us to,
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  never lose the sight of the fact that
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  we always have to evolve and get better
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  and do better and be better
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  for the people that we serve, whether it's
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  leveraging
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  new tools and technologies,
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  such as AI, machine learning, whether it's finding
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  ways to leverage things such as automation.
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  I think just finding the right tools at
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  the right place is really going to be
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  important for us as an industry to move
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  forward, again, to better serve the people that
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  we have an opportunity to serve and deliver
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  the high quality outcomes that we want for
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  them.
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  You talked about some of these emerging technologies
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  such as AI.
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  How are they playing a role in your
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  organization's growth strategies? And can you elaborate a
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  little more on maybe a couple examples?
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  Sure. So one of the things that we
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  actually did as an organization,
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  over the past couple years
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  was focused on how to be better stewards
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  of our data.
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  With all the big push for big data,
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  predictive analytics, AI, machine learning, we recognize that
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  there was an ethical stewardship of that piece.
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  So one of the things that we've done
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  is actually conducted
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  algorithmic bias audits
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  on our care management algorithms
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  to ensure that the outputs
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  were, being
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  appropriately,
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  assessed and evaluated
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  to minimize and mitigate to the extent possible
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  any biases
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  and unintended biases that might have been generated
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  by the algorithms themselves. It's a continual process
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  that our teams are, working on, but I
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  know that we were ahead,
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  of starting that process,
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  about a few years ago.
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  Ed, I really appreciate all your insights today.
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  But before I let you go, do you
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  have any final thoughts for our audience?
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  Again, I think for us, especially for us
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  at IHP,
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  you know, for us, our mission is to
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  heal and inspire the human spirit, and our
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  vision is to do the right thing for
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  our members.
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  And just to keep that
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  at the forefront of everything that we do,
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  I think, is gonna be critically important with
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  everything that's going on. Because at the end
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  of the day, it's about our members. It's
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  about their health, and it's about their quality
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  outcomes.
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  Perfect. Thank you again for joining us today
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  on the Beckers Healthcare Podcast. I really appreciate
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  it. Thanks so much for having me. I
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  think you have a lovely rest of your
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  day. You too.