Latest / Becker’s Payer Issues Podcast / Mark Grippi, AmeriHealth Caritas Ohio Market President

Transcript

Mark Grippi, AmeriHealth Caritas Ohio Market President · Becker’s Payer Issues Podcast

0:00
Hello, everyone. This is Jacob Emerson with the
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Becker's Pay Your Issues podcast. Thrilled today to
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be joined by AmeriHealth Caritas' Ohio market president,
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Mark Grippi. Mark, thanks so much for taking
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the time to be with me on the
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podcast today.
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Thanks, Jacob. I'm glad to be here, and
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I'm really looking forward to the conversation.
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Yeah. Likewise, Mark. And before we dive into
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everything, we wanna talk with you about a
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an exciting,
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new initiative happening at the company. Can you
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tell us a little bit more about yourself,
0:27
your background in health care, and what it
0:29
is that you do today at AmeriHealth Caritas?
0:33
Sure. So my name is Mark Grippi. I
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am the Ohio market president for AmeriHealth Caritas.
0:39
We are one of the Medicaid managed care
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plans that the state of Ohio has selected,
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to deliver benefits,
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to some point 2,600,000
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members across Ohio, and we have a subset
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of that membership with with, with our plan.
0:54
Delivering Medicaid as a managed care entity, you
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often
0:58
tend to lump us into the larger conversation
1:01
of health insurance, but Medicaid managed care is
1:04
nuanced. It's different.
1:06
I often consider the work that we do
1:08
to be more social services and we just
1:10
happen to pay claims for a living. So
1:13
our jobs are really to connect with the
1:16
community to really make investments and understand the
1:19
needs
1:20
of those living in poverty, both
1:22
in one state or our larger company where
1:25
we operate in close to 13 states.
1:28
And
1:29
that role
1:30
is pretty important to us. A lot of
1:32
us started our career
1:34
in healthcare
1:35
services. Like I started my career in hospitals
1:38
and nursing homes, actually being a provider. And
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it wasn't only after I really wanted to
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learn about how can I make an impact
1:45
to much broader populations
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that I decided to come over to to
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Medicaid managed care?
1:52
My role
1:53
at, at the plan is is pretty simple.
1:56
I work very closely,
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to develop strategy with our team
2:01
and
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bring great people that are extremely passionate about
2:05
making a difference in the lives of others
2:07
together. And I clear barriers and I let
2:10
them get to work and do their thing.
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But it's an amazing opportunity that we have
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to work with such a deserving population.
2:19
Absolutely. It sounds like such impactful work that's
2:22
going on under your leadership,
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Mark. And I wanted to
2:26
dive right in today and talk a little
2:28
bit about
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a really unique initiative,
2:33
something, I I've never heard of, happening within
2:34
the industry before. Yeah.
2:36
It's a mobile gaming platform that the company
2:38
launched earlier this year to address long standing
2:41
gaps in Medicaid member care and and engagement
2:44
with those members.
2:45
So for our audience that that isn't familiar
2:47
at all with this, can you can you
2:49
share some details with us? What is this
2:50
program?
2:51
Where did this all come about? And and,
2:53
ultimately, what is the company hoping to achieve
2:55
through it?
2:56
Sure. You know, I I think before I
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answer that, Jacob, I have to ask you
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a question. Sure.
3:01
So let's say,
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something amazing happens in your life.
3:06
You and your partner may be expecting a
3:08
child in your life or, you know, maybe
3:11
the opposite of amazing as you've been informed
3:13
that you have a medical condition that's serious.
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Are you gonna tell your family and your
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closest friends first after you digest that information,
3:22
or do you think you're gonna pick up
3:24
the phone and say, hey. Hey, insurance company.
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This just happened to me. I just wanted
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to tell you about it.
3:29
That's a good question, and I I think
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you know the answer, but, certainly, I can
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go towards,
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family and friends.
3:35
Well, I that's what we encounter every day.
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The irony of of our in biz business
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is that some of the most important things
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that we do are dependent on us engaging
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our membership
3:46
and keeping them engaged.
3:49
The irony is is that that's also one
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of our biggest challenges.
3:53
Mhmm. It is difficult with people living in
3:56
poverty
3:57
to always keep the most up to date
3:59
contact information.
4:01
You know, when you're you're living on a
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couple dollars a day and you have to
4:04
worry about how do I feed my children
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or how do I pay rent, the last
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thing you think about is, oh, I have
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to go update my insurance company because I
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moved last month, or I have to go
4:14
update the state because my my telephone number
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changed.
4:17
And we started to see this in our
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data.
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And, you know, one of the the key
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things is that we saw single digit engagement
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levels, within, like, our applications. You know? I'm
4:29
sure we all are familiar with the the
4:31
insurance company app that has a big overwhelming
4:33
directory or maybe some language in it that
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says, well, you could do this or you
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might have this benefit.
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So we realized that in order for us
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to really be successful, and let's be clear,
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success is improving outcomes for the people that
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we serve,
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we needed to reach a broader population.
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We started to think about
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what do we do?
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We asked our members. I mean, that we
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had this
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this simple thought of
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we have an audience with our members. Let's
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ask them how do they go about their
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day. And we we learned that almost 70%
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of adults
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are using mobile games, and about forty five
5:13
to 50%
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of those people are playing multiple times a
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week. And that's
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just how they've,
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how our culture has evolved and developed. And
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it's much easier to do minor course corrections
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versus to try to instill a brand new
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behavior in someone.
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So we developed this platform
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in cooperation
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with our partner Motive,
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and we put together the common everyday games
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that you play, Candy Crush, versions of Candy
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Crush, I should say,
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solitaire.
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And
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it's been a fantastic journey because what we're
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seeing is that
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people are already using this mode to communicate.
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So instead of talking at our members, we
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actually started opening a dialogue and speaking with
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our members.
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We developed and curated
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content that was specifically designed, you know, for
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the diabetic or someone suffering from chronic high
6:10
blood pressure. And in between levels of the
6:12
games, these these these, users went on missions.
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And they're instead of an advertisement,
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we supplement it with health care education.
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And that health care education turned into a
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conversation. They started answering valuable questions for us.
6:27
One of the requirements that most
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plans have
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is to do a health risk assessment.
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The assessment isn't isn't complicated, but it's the
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foundation for population health. It's the foundation for
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us to get to know our members.
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On average,
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maybe 30%,
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is our response rate because, again, you're getting
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something from your insurance company, maybe or maybe
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not, you fill it out. We started to
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see rates as high as eighty two percent,
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seventy five percent were completing the whole assessment.
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I mean, this this is world class type
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of of outcomes. And it really was because
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we
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took a minute. We learned how to communicate
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with our members
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and, started delivering information in a way that
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they could digest. So I'll stop stop there
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on that. I'm I'm sure you might have
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a follow-up.
7:16
Yeah. I mean, what a great idea, Mark,
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just listening to you explain this.
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Really just,
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seeing where your members or and what they
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were engaging with and then literally as as
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the health plan going to them. It's it's
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fantastic. And and like I said, I've never
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heard of, any anybody else in the industry
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doing something like this. So it's it's really
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innovative.
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And and I have to ask because, you
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know, I've seen some of the engagement metrics
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you've recorded so far with this initiative.
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Members have logged over logged in over 12,000
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times. They've said more than a 100 thousand
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minutes on the platform so far. So I
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I think, you know, drilling down to the
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to the core of this, Mark, how do
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you measure the impact of this engagement on
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actual health outcomes?
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And what are some of the long term
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benefits you're anticipating for both your members and
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and the health plan overall?
8:04
You know, Jacob, I think when you start
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to look at some of the data and
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those those early numbers that that you just
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referenced,
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it becomes clear to me
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that our members truly care about their health.
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I think they're maybe a little bit skeptical
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about their health care and the health care
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delivery system.
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And that that's telling us that the opportunity
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is there to really make that difference. So,
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you know, how are we gauging success?
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You know, that that health risk assessment that
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I mentioned just a minute ago,
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when you can start to,
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get numbers in that seventy five to eighty
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percent of your total,
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population,
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completing a health risk assessment,
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we get such valuable information and we're able
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to engage them in a conversation because we're
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starting to build trust now with each other.
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And care management becomes
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a more likely possibility, allowing us to help
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them,
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connect them with with a physician because we've
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already developed that trust. We've identified that there
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might be some sort of a chronic condition
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or something else out there that they really
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need the help. And we can remove social
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barriers,
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to getting them that help. Transportation,
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we can provide them with with extra benefits
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and housing assistance,
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all of which they never would have known
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before because they weren't at a place where
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they they couldn't engage.
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But from a healthcare executive standpoint,
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I think it's important to recognize that we're
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starting to see early signs in our data,
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especially around behavioral health, that
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members with a behavioral health condition or some
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sort of substance use comorbidity
9:39
that are engaged in this application,
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we're actually starting to see some early data
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that would suggest that there's a reduction in
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the total cost of care because they're adherence,
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because of the fact that they're communicating with
9:51
a health plan and we know,
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what those barriers are for them and we're
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able to help, resolve them. And it's a
9:58
clear correlation between engagement
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and the ultimate goal of improving outcomes for
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our members.
10:05
That's amazing. So you're you're really already seeing
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a real life impact, within your behavioral health
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space and in really quite a short amount
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of time.
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Correct. And and as I understand it, Mark,
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so the mobile gaming has replaced traditional ads
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and in in app purchases with more personalized
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health content
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reminders for your members.
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So can you share a little bit about
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how the the trivia and the health related
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contents that you're
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offering, how is that tailored to align with
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with the health plans population health strategy? And
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and how do you ensure this is really
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resonating,
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with with, a pretty diverse member base?
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Sure. So when we when we looked at
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doing this, you know, the way it works
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is that a member will download any one
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of the the dozen or so games that
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we have available, and then they have immediate
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twenty four seven access to the whole suite
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of games.
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And as they launch a game,
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it's already prepopulated
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with some information
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about the member. We we know some of
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their their chronic conditions,
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as well as some of their history. But
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as they start to answer those health risk
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questions,
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the games learn,
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and we provide that information to our partner
11:13
motive
11:14
on on what those chronic conditions are. So
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let's take a diabetic
11:17
member, for example. As they're going through levels
11:20
of candy crush,
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they come to
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a space between the level. It's going to
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ask them,
11:28
have you exercised today? Or
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do you understand the importance
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of
11:33
a diet
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on a daily basis for someone with a
11:37
diabetic health condition?
11:39
Are you exercising?
11:41
And the amazing part is since we've started
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this journey with our members,
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those questions or those missions that they go
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on, one, can earn them tokens to unlock
11:50
additional levels. And, you know, that definitely
11:53
caters to our competitive nature, but it also
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allows them to unlock real life incentives. The
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more education they take on, the more that
12:00
they connect
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to providers, they're actually able to earn some
12:04
additional incentives, which keeps people coming back.
12:07
I personally think the neatest thing is that
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as they answer questions,
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our system tracks their amount of right answers.
12:14
And we've seen close to a 31%
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increase in health literacy
12:20
with our targeted subpopulation
12:22
since the beginning of the app. That's 31%
12:24
people
12:25
that now know today that diet and exercise
12:30
and eating healthy overall is much more important
12:33
to managing their diabetes than they understood
12:36
when they first,
12:37
joined this application. And that, again,
12:40
improves outcomes for our members.
12:42
Certainly. So it's this gamification
12:45
of of health benefits, I think, is is
12:47
fair to say. It it literally is closing
12:49
care gaps, but it sounds like it's it's
12:51
improving health literacy rates. It's really amazing. Absolutely.
12:54
Absolutely. Let me let me circle back to
12:56
some some numbers you had mentioned at the
12:58
start of start of our conversation.
13:00
89 of members have provided you with their
13:03
email. Seventy five percent have completed health risk
13:06
assessments.
13:07
Yeah. So
13:08
given that, I mean, clearly, those numbers point
13:10
to real success here. How do you see
13:13
mobile gaming as a scalable solution,
13:16
that could be applied to other Medicaid populations
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across the country?
13:20
So I think, you know, I'm I'm a
13:21
big believer in the science of quality improvement.
13:24
And, you know, the first thing that anyone
13:26
really needs to do is understand their population
13:28
and understand their data. And could this be
13:31
an intervention
13:33
or or or something that,
13:34
could help improve outcomes,
13:36
elsewhere?
13:37
We're actually working to scale, this program now
13:40
across our entire state and across all
13:43
of our subpopulations.
13:45
But it starts with just that ask and
13:48
understanding of what are the needs of your
13:50
members and,
13:52
do you have the capability to even test
13:54
this in small populations? If you're getting positive
13:57
feedback, then you work to scale it.
14:00
An interesting,
14:01
side note that we're finding as we promote
14:04
this opportunity to our members
14:06
is even though this is a digital solution
14:08
that's finding a lot of success,
14:10
the promotion of it, we're finding,
14:13
that members have digital fatigue. Everybody's hitting people
14:16
with text messages, email campaigns.
14:18
We're actually finding that the good old fashioned
14:20
snail mail where we're we're mailing postcards and
14:23
we're meeting with people in the communities is
14:26
a much better way to gain scale on
14:28
on the product than just
14:30
a a a one size digital solution.
14:33
That's a really great call out there, Mark,
14:34
that you have to actually go into your
14:36
communities, meet with your members in person,
14:38
versus, yeah, continuing the digital fatigue we're all
14:41
very aware of.
14:43
I think before we go, Mark, I wanna
14:45
open the floor back up to you in
14:46
terms of you've got the ears right now
14:48
of a lot of other health plan leaders
14:50
from from all over the country, many operating
14:52
in Medicaid.
14:54
What else do you wanna share with them
14:55
on this topic or or final bits of
14:57
advice that you wanna offer?
15:00
You know, I I think when we look
15:02
at,
15:03
what our ultimate goal should be, and and
15:05
that is to,
15:08
really make investments into the people that we
15:10
serve and to improve their their health outcomes.
15:14
But it's not a one labor solution.
15:17
Improving the health and wellness, especially people,
15:20
who are living on Medicaid is is complicated.
15:23
I wanna go back to a statement I
15:25
made earlier, and and I have to attribute
15:26
it,
15:28
to Scott, the owner
15:30
of our partner Motive here, is that remember,
15:32
I think people do care about their health,
15:36
but conditions both inside and outside of their
15:39
home have really complicated their relationship with health
15:42
care and certainly complicated their relationships with with
15:45
health insurance, and it's made them skeptical.
15:48
Involve your members in the conversation about what's
15:51
best for them.
15:53
Don't speak at them. Speak with them.
15:57
Create programs and products that really fit into
15:59
their daily life,
16:01
and don't try to impose something that just
16:04
doesn't fit. Remember, people living in poverty are
16:07
living minute to minute, not week to week,
16:09
month to month, or year to year.
16:12
And we have to help guide people through
16:14
this complex system,
16:16
that we've created over long periods of time.
16:19
I think if we can improve the process
16:21
of health care delivery
16:23
in such a way that it goes with
16:25
the people that we're serving,
16:27
you know, ultimately, it it has to lead
16:29
to better outcomes, and and that will ultimately
16:32
create efficiencies for companies like ours that reduce
16:34
the total cost of care. There's winners all
16:37
around. I think that's the message I would
16:39
love for people to, take away from from
16:42
this
16:44
this program that we started, this journey that
16:46
we've been on, and and share with some
16:48
of the success that we've had.
16:50
Wonderful. Well, I think that's a great last
16:52
message to leave us with. So, Mark, I
16:55
wanna thank you for taking the time to
16:57
sit down with us today and and for
16:59
sharing about, what is clearly very unique and
17:02
impactful work going on under your leadership. We
17:05
we really appreciate it.
17:06
Thank you for the opportunity,
17:08
and I think that, you know, we're just
17:10
scratching the surface
17:12
of of changing the way that we're thinking
17:14
and and how that different thinking is going
17:16
to lead to innovation and better outcomes for
17:19
people. So appreciate the opportunity and and, I
17:22
I wish you to have a great weekend.
17:24
Yeah. You as well. It sounds like exciting
17:25
things to still come from AmeriHealth Caritas.
17:29
Thanks so much, Mark, for being with us.
17:30
And and to our listeners, if you'd like
17:32
to listen to more podcasts from Becker's Healthcare,
17:35
you can visit beckershospitalreview.com.