Latest / Becker’s Payer Issues Podcast / Improving kidney health with Joe Vattamattam, President of Healthmap Solutions

Transcript

Improving kidney health with Joe Vattamattam, President of Healthmap Solutions · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Jacob Emerson with the
• 0:02
  Becker's Pay Your Issues podcast. Thanks so much
• 0:04
  for tuning in today where we're going to
• 0:06
  be talking about leveraging data analytics and clinical
• 0:09
  expertise to improve kidney health management for health
• 0:12
  plans. So to dive into what is a
• 0:14
  big topic, I'm joined today by Joe Vadimatum,
• 0:17
  who is the founder and president of HealthMap
• 0:20
  Solutions. Joe, thanks so much for taking the
• 0:22
  time to be with us on the podcast
• 0:23
  today.
• 0:24
  Thanks for having me, Jacob. Excited to be
• 0:26
  here. Yeah. Likewise. And before we dive into
• 0:28
  everything we wanna talk with you about, can
• 0:30
  you tell us a little bit more about
• 0:32
  yourself, your background in health care, and what
• 0:34
  it is that you're doing today at HealthMap
• 0:36
  Solutions?
• 0:37
  Yeah. Absolutely. So,
• 0:41
  I'm a Tampa Bay native, so the company's
• 0:43
  headquartered in Tampa.
• 0:45
  I grew up in Saint Petersburg, Florida.
• 0:47
  My my background,
• 0:49
  I,
• 0:50
  coming out of school,
• 0:51
  started off on an actuarial consultant path,
• 0:55
  took a right turn after business school and
• 0:57
  went into investment banking, and then eventually found,
• 1:01
  found my place in health care.
• 1:03
  I started off working
• 1:05
  at WellCare Health Plans, and
• 1:09
  company was focused and is focused on,
• 1:12
  you know, now acquired by Centene, but focused
• 1:14
  on the government program space. So really zeroing
• 1:17
  in on Medicare and Medicaid populations,
• 1:20
  which I found to be very rewarding,
• 1:22
  and gave me a good sense of what
• 1:23
  it's like to work
• 1:25
  within those populations
• 1:26
  trying to improve their care. I did a
• 1:29
  little bit of
• 1:30
  everything there,
• 1:32
  worked in office of the CEO and network
• 1:36
  and quality and finance and strategy, and,
• 1:38
  strategy. And,
• 1:40
  and then eventually made my way over to
• 1:43
  a company called CareCentrix where,
• 1:45
  we were focused on a very specific niche
• 1:47
  of health care,
• 1:49
  leveraging a home health platform nationally to
• 1:52
  be able to,
• 1:53
  improve the care that people received in the
• 1:55
  home, but also
• 1:57
  built out a post acute care program while
• 2:00
  I was there with a with a group
• 2:02
  of people
• 2:03
  and, and eventually
• 2:04
  risk on that and then also,
• 2:07
  acquired a sleep management company that would
• 2:10
  redirect,
• 2:11
  the side service of sleep testing for obstructive
• 2:13
  sleep apnea
• 2:15
  over to the the home from an outpatient
• 2:17
  setting.
• 2:18
  And I'd say at CareCentrix,
• 2:20
  it was great learning ground for how to
• 2:23
  lead and manage,
• 2:24
  and be part of a part of a
• 2:25
  team really that led and manage
• 2:28
  a, a growth company in the health care
• 2:30
  space,
• 2:31
  especially serving payers. Right? So we
• 2:34
  figured out how to take an existing asset
• 2:37
  and and leverage it to be able to
• 2:38
  impact more of the health care dollar.
• 2:40
  We
• 2:42
  also
• 2:43
  learned how to drive value through side of
• 2:45
  service steerage
• 2:47
  and build brand new programs leveraging clinical expertise.
• 2:50
  And what I mean by that is that
• 2:52
  post acute care program I mentioned, you know,
• 2:54
  when I joined the company,
• 2:56
  there is a PowerPoint deck, and that was
• 2:59
  the full product at that
• 3:01
  time. And,
• 3:02
  and I was fortunate to be part of
• 3:04
  the group that
• 3:05
  built it into a real living, breathing,
• 3:08
  program that served and and helped,
• 3:11
  many, many people to avoid readmissions and optimize
• 3:14
  their post acute care
• 3:15
  services.
• 3:17
  So so in doing that, we worked with
• 3:18
  some of the leading clinicians in the in
• 3:20
  the country when it came
• 3:22
  to transitions of care
• 3:24
  and post acute care health.
• 3:26
  And I think I took all of those
• 3:27
  lessons learned
• 3:29
  from both WellCare and CareCentrix
• 3:31
  as I went, and started cofounded really, HealthMap
• 3:34
  Solutions with with some other folks to be
• 3:37
  able to
• 3:38
  apply those towards the kidney population.
• 3:41
  I appreciate the background there, Joe. And and
• 3:44
  did you wanna dive into a little bit
• 3:45
  about HealthMap Solutions and and why you wanted
• 3:49
  to take on the challenge of of kidney
• 3:51
  health management?
• 3:53
  Yeah.
• 3:54
  So, you know, I I'd say for HealthMap,
• 3:56
  we started the company in 02/2013.
• 3:59
  And,
• 4:00
  you know, at that time, we were really
• 4:02
  focused on building out
• 4:04
  a population health platform.
• 4:06
  I I wouldn't say that we called it
• 4:08
  that back in 02/2013,
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  but that's essentially what we're doing. When you
• 4:11
  look back in hindsight,
• 4:13
  we're really trying to build out a great
• 4:15
  platform that,
• 4:16
  could take the spare data,
• 4:19
  ingest it, analyze it, and then push it
• 4:21
  out to external stakeholders in a way where
• 4:25
  they could take it. And and it wasn't
• 4:27
  just data. It was insights for them.
• 4:29
  And those stakeholders could be providers or members.
• 4:33
  With kidney disease, you know, we really were
• 4:35
  looking at it and thought, this was around
• 4:37
  02/1516,
• 4:40
  right, when we really started to go into
• 4:42
  the space. And at that time, it was
• 4:44
  one of health care's best kept secrets.
• 4:47
  Not the case anymore. Right? But at the
• 4:49
  time,
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  it was a population,
• 4:52
  and this persists today, unfortunately,
• 4:56
  but it it's a population where there's significant
• 4:59
  costs.
• 5:00
  So,
• 5:01
  the predecessor towards end state from end stage
• 5:03
  renal disease, which means
• 5:05
  you're at kidney failure and you need dialysis
• 5:08
  or a transplant.
• 5:09
  Before that, you're in chronic kidney disease,
• 5:13
  CKD. There's five stages of that. One is
• 5:16
  the least severe and five is the most
• 5:17
  severe.
• 5:18
  And what we saw in the data was
• 5:20
  that
• 5:21
  every time an individual
• 5:23
  progressed
• 5:24
  from one stage to the next,
• 5:27
  their costs would increase. Their per member per
• 5:30
  month PMPM cost would increase, and it would
• 5:33
  have a step function increase. Right? So on
• 5:35
  average, there's a big jump each time.
• 5:37
  The biggest jump being going from stage five
• 5:40
  towards
• 5:41
  ESRD because you have to then be on
• 5:43
  dialysis.
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  So that was one problem statement that in
• 5:47
  itself
• 5:48
  just didn't seem to be,
• 5:50
  addressed by anyone.
• 5:52
  Then when you looked at just the fragmented
• 5:55
  health care delivery system, right, the nature of
• 5:57
  that creates a lot of clinical gaps for
• 5:59
  these patients.
• 6:01
  It's it's you got doctors doing their absolute
• 6:04
  best, very good doctors doing their best who
• 6:06
  are seeing these members. But because these members
• 6:08
  are seeing so many different doctors
• 6:11
  and,
• 6:12
  getting care from other places as well and
• 6:14
  getting scripts and, you know, guidance and advice,
• 6:18
  it can conflict or be overwhelming
• 6:20
  for the patient.
• 6:21
  And that creates challenges for, you know, the
• 6:24
  really the whole population.
• 6:26
  And if you do find yourself
• 6:29
  progressing towards that end stage, I mean, the
• 6:32
  the stark reality of it is,
• 6:34
  at that point, you're facing
• 6:37
  a much higher mortality rate, so higher chance
• 6:39
  of death. Or if you go into dialysis,
• 6:43
  that is a life altering
• 6:45
  and life sustaining therapy. Right? So life altering
• 6:48
  not for the better, but, really, it's a
• 6:50
  challenge. It's a physical and mental challenge. It's
• 6:53
  an exhausting process for someone. To give you
• 6:55
  a sense,
• 6:56
  if you're
• 6:57
  on in center hemodialysis,
• 7:00
  you're going three to four times a week
• 7:03
  for about four hours at a time,
• 7:06
  and you're hooked up to a dialysis machine,
• 7:08
  which is essentially doing
• 7:10
  the job that your kidneys are meant to
• 7:11
  do all day, doing it in in a
• 7:14
  compressed time in four hours.
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  That's,
• 7:16
  again, exhausting to the patient, but also what
• 7:19
  a what a consumption of your time.
• 7:22
  It that really does change,
• 7:24
  change your life.
• 7:25
  And I'd say, sadly, eighty percent or so
• 7:28
  of the people who start
• 7:30
  dialysis, quote, unquote, crash into dialysis,
• 7:33
  meaning it wasn't a planned entry,
• 7:35
  and oftentimes that's associated with the hospital admission.
• 7:38
  So you had some tragic event happen in
• 7:41
  your life, You got admitted to the hospital.
• 7:44
  Usually, it's a fairly complicated admission.
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  And at that point, you know, your kidney
• 7:49
  disease is getting its attention, but you're you're
• 7:51
  at the end. And so it's almost like
• 7:54
  a reactive level of dialysis, which can lead
• 7:56
  to a lot of complications. So just
• 7:59
  with all of those problem statements stacking up,
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  both the financial, the clinical, the patient experience,
• 8:04
  the providers
• 8:06
  feeling frustrated as well because they wanna be
• 8:08
  treating these members as best as they possibly
• 8:10
  can, but they don't always have all the
• 8:12
  information at their fingertips to do so.
• 8:15
  We just saw that there is this
• 8:17
  nexus, right, this opportunity
• 8:19
  for that, you know, quadruple aim, that that
• 8:22
  people strive for, but particularly for this population,
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  where if you could
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  drive
• 8:28
  information
• 8:29
  to
• 8:30
  the right
• 8:31
  provider
• 8:32
  and to the member
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  and help to guide and potentially close some
• 8:37
  care gaps, but also empower that member on
• 8:39
  their journey
• 8:41
  and put them in a position to really
• 8:43
  manage their care and be proactive about it,
• 8:46
  there was that opportunity for lower costs,
• 8:49
  better quality of care,
• 8:50
  a better patient experience, and a better provider
• 8:52
  experience.
• 8:53
  So I think we did a decent amount
• 8:56
  of research,
• 8:57
  before we really decided to go down this
• 8:59
  path to be able to really verify all
• 9:01
  those things and to also see if we
• 9:03
  thought we could make a difference in the
• 9:05
  space. And once we got to yes, there
• 9:07
  was no turning back.
• 9:09
  Mhmm. And and, Joe, you mentioned that the
• 9:11
  the per member per month cost keeps going
• 9:13
  up as members
• 9:14
  progress within their kidney disease.
• 9:17
  You're speaking to a lot of health plans
• 9:18
  right now. So what's your core message to
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  them in terms of why these plans should
• 9:23
  be focusing
• 9:24
  on their CKD and ESRD population?
• 9:28
  Yeah. I I think it's a great point.
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  I I think the core message is, yes,
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  there are escalating costs
• 9:35
  for this population.
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  And anything you can do
• 9:41
  to slow that progression
• 9:43
  and keep a member in a healthy state
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  is good for your members,
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  and it's financially going to be beneficial for
• 9:50
  them, for the health plan.
• 9:52
  And if you partner with someone like HealthMap
• 9:54
  for for the for HealthMap as well, because
• 9:58
  a good partner is going to take risk
• 10:00
  in their ability to deliver on that value.
• 10:03
  I think
• 10:05
  addressing this population
• 10:06
  who is,
• 10:08
  multi chronic,
• 10:09
  so multiple comorbidities
• 10:11
  and high cost,
• 10:13
  there's a great opportunity
• 10:15
  to
• 10:15
  improve their health. But also,
• 10:18
  if I'm sitting in a health plan shoes,
• 10:20
  if I bring myself back to those days
• 10:22
  that I worked at a health plan, I'd
• 10:24
  be looking at this group and saying, well,
• 10:28
  there's a revenue opportunity here as well. Right?
• 10:30
  There's a clinical opportunity, which
• 10:33
  is paramount,
• 10:34
  which translates into a cost savings opportunity.
• 10:37
  There's also a revenue, a top line opportunity.
• 10:39
  If you can drive better quality, that should
• 10:42
  impact star scores,
• 10:43
  if you're a Medicare plan or quality scores,
• 10:45
  you know, if you're in any other type
• 10:46
  of plan. And there's also the opportunity to
• 10:50
  make sure that
• 10:51
  chronic repeatable
• 10:53
  diagnosis codes are appropriately recaptured. People will think
• 10:53
  about
• 10:54
  HCC
• 11:04
  clinical,
• 11:05
  intervention, right? Because it's the way through which
• 11:09
  one provider can communicate to another provider asynchronously
• 11:13
  about what's going on with that patient. If
• 11:15
  you have the appropriate
• 11:16
  level of codes recaptured
• 11:18
  and shared and communicated across providers as you're
• 11:21
  coordinating care,
• 11:23
  then, the patient will get,
• 11:26
  better and more appropriate care. And and really,
• 11:29
  that's our goal. So I think
• 11:31
  for the health plans, this should
• 11:34
  scratch all of the itches that that that
• 11:36
  they're focused on.
• 11:38
  Again, it's how will this impact top line?
• 11:40
  How will this impact a reduction in cost?
• 11:42
  Will my members be happier as a result
• 11:44
  of us managing this holistically?
• 11:47
  Will my providers be happier? And and it
• 11:49
  checks all of those boxes.
• 11:51
  Boxes. Absolutely. And it sounds like it makes
• 11:53
  a lot of financial sense, especially for for
• 11:55
  health plans to really focus on this population
• 11:58
  specifically, Joe. I have to ask, how do
• 12:00
  data analytics and technology come into play here
• 12:03
  within HealthMap's program?
• 12:06
  Great question,
• 12:08
  in many different ways. So,
• 12:11
  you know, in the early days,
• 12:13
  and it continues through today, we really focused
• 12:16
  on being highly analytical in what we did.
• 12:20
  So, you know, there's there's that Pareto that
• 12:22
  everyone will reference where
• 12:24
  across the board, not just for kidney members,
• 12:27
  but across the board, about five percent
• 12:30
  of the population
• 12:31
  consumes 50% of healthcare expenditures.
• 12:34
  So it's highly concentrated.
• 12:37
  It's not as concentrated
• 12:38
  in kidney disease,
• 12:40
  but it there is a level of concentration.
• 12:41
  So
• 12:44
  for the populations we manage,
• 12:46
  we found that somewhere between 25 to 30%
• 12:50
  of the members are going to consume 80%
• 12:53
  of the healthcare costs.
• 12:55
  And being able to identify those members
• 12:59
  is really important. I think the
• 13:02
  the the mistake or or the misnomer is
• 13:04
  that all kidney members, because they're so, they
• 13:07
  have
• 13:08
  have a lot of comorbidities, they're all going
• 13:09
  to be very
• 13:11
  high cost. Not necessarily the case. It fluctuates.
• 13:13
  And so you have to be able to
• 13:14
  identify
• 13:15
  which members
• 13:16
  are going to represent
• 13:17
  significant costs in the future
• 13:19
  so that you can find them during that
• 13:22
  window of
• 13:23
  opportunity where you could prevent progression of disease
• 13:25
  states.
• 13:26
  That might be kidney disease, but we also
• 13:29
  are very focused on all of the comorbidities
• 13:32
  because the driver
• 13:33
  of advancing kidney disease tends to be
• 13:36
  unchecked diabetes or unchecked hypertension.
• 13:39
  So really, we've created a program that's holistic
• 13:42
  in nature because we're managing
• 13:45
  not only their kidney disease, but also the
• 13:47
  the patient's comorbidities.
• 13:48
  We're looking at other things that might impact
• 13:51
  their ability to manage that care. Right? So
• 13:54
  it it goes beyond the the clinical disease
• 13:58
  itself.
• 13:59
  Behavioral health is a clinical disease. We'll look
• 14:01
  at behavioral health. We will also look at
• 14:03
  social determinants of health. We're really motivated and
• 14:06
  focused on just improving,
• 14:08
  the access to care, the quality of care,
• 14:10
  and the coordination of care for, all of
• 14:13
  our patients.
• 14:14
  So I would say I'd put that into
• 14:17
  this sort of
• 14:18
  predictive analytics, advanced analytics bucket as bucket number
• 14:22
  one for tech and analytics.
• 14:25
  The second
• 14:26
  is really how do you engage with the
• 14:28
  population.
• 14:29
  So
• 14:31
  digital engagement
• 14:33
  is really critical.
• 14:34
  You know, we at HealthMap, we,
• 14:37
  we've always had a focus on this, but
• 14:40
  we recently acquired
• 14:41
  a company called Carium,
• 14:43
  which is really a
• 14:45
  phenomenal they built a phenomenal
• 14:47
  digital ecosystem
• 14:49
  for
• 14:50
  providers,
• 14:52
  members,
• 14:52
  and
• 14:53
  I use the word members and patients interchangeably,
• 14:56
  but providers, patients,
• 14:57
  and really health map to be coexisting and
• 15:00
  sharing information.
• 15:02
  And I think digital engagement is
• 15:04
  just so critical. I think titrating
• 15:07
  your level of engagement with
• 15:09
  patients is really important.
• 15:11
  What I mean by that is you could
• 15:13
  have,
• 15:15
  somebody who's CKD three
• 15:17
  has,
• 15:19
  you know, heart failure,
• 15:21
  has
• 15:22
  is diabetic,
• 15:23
  and is a smoker, and also can't really
• 15:26
  get around the house so well.
• 15:28
  Right? That person
• 15:29
  might need a home visit.
• 15:31
  So we might arrange for a home visit
• 15:33
  for that person.
• 15:35
  That doesn't mean everybody should get a home
• 15:37
  visit. Right? There's some people in our population.
• 15:40
  You could be a stage four member
• 15:42
  who is actually really well managed. You
• 15:45
  can be a stage four member who is
• 15:47
  really empowered. You have great control of your
• 15:49
  health. You know what kind of foods you
• 15:50
  should be eating. You know the medications you
• 15:52
  should be on. You've got a really great
• 15:55
  schedule of seeing your providers at the right
• 15:57
  time, you're getting your labs done so you're
• 15:59
  monitoring your
• 16:01
  health,
• 16:02
  that person
• 16:04
  would scoff at a home visit, right? We
• 16:07
  would say we wanna, we said we wanna
• 16:08
  put someone in your home, they'd say they
• 16:10
  might say, look. I'm really busy. No thanks.
• 16:13
  I'm good.
• 16:14
  But they could use
• 16:16
  something simple like digital engagement
• 16:18
  of medication reminders.
• 16:20
  They might still be on quite a lot
• 16:22
  of different drugs, and they could use a
• 16:24
  reminder for, don't forget to take this med
• 16:26
  today, or, hey, don't forget this script is
• 16:29
  running out. Just make sure that, you know,
• 16:31
  we get it refilled.
• 16:32
  So
• 16:34
  there's
• 16:35
  a a a wide array of
• 16:38
  intensity and types of modality of intervention
• 16:41
  that you have. And I think having the
• 16:43
  technology capabilities
• 16:45
  to modulate that well is really important, and
• 16:48
  that's another way it plays a role for
• 16:50
  us at HealthMap.
• 16:51
  And then, you know, I've kind of
• 16:53
  tiptoed around AI with predictive analytics,
• 16:56
  so far, but our third bucket would really
• 16:58
  be AI. Right?
• 17:01
  We're investing in this. We're leveraging it for
• 17:06
  your traditional
• 17:07
  machine learning predictive analytics, like I mentioned ear
• 17:10
  earlier,
• 17:11
  but we're also using it leveraging generative AI.
• 17:14
  Right? And so far, we're keeping that mostly
• 17:17
  inwardly focused,
• 17:19
  but we have an AI digital assistant that,
• 17:23
  supports our clinicians as they're speaking with
• 17:26
  providers and members. We have the capabilities that
• 17:29
  just makes our team way more efficient
• 17:32
  just as they're
• 17:33
  prepping for a call with a provider or
• 17:36
  with a patient, for instance.
• 17:38
  So that
• 17:39
  they're spending less and less time on administrative
• 17:42
  work and more and more time practicing at
• 17:45
  the top of their clinical license.
• 17:47
  It just puts the puts a clinician in
• 17:49
  a different mindset.
• 17:51
  We all hear about physician burnout, right, and
• 17:53
  being having to
• 17:55
  document and over document and review all the
• 17:57
  documentation.
• 17:58
  And it it ends up creating this unbalanced
• 18:02
  approach where so much of their time can
• 18:04
  be,
• 18:06
  a physician's time could be focused on administration
• 18:08
  as opposed to actually being in front of
• 18:10
  the patient or being present with that patient.
• 18:13
  We hear about that happening in the marketplace.
• 18:16
  We wanna make sure that does not happen
• 18:18
  here at HealthMap.
• 18:19
  So we're leveraging AI to do that so
• 18:21
  that when one of our care navigators,
• 18:24
  which is typically
• 18:25
  an RN,
• 18:26
  is in front of a a patient,
• 18:28
  they can spend the time really
• 18:31
  empathizing with that patient, doing motivational interviewing,
• 18:34
  and,
• 18:35
  you know, practicing at the top of their
• 18:37
  license. So
• 18:38
  I think those those are the ways that
• 18:40
  we're using it so far. And,
• 18:42
  you know, AI is a brave new world.
• 18:44
  We'll figure out the right ways to deploy
• 18:46
  it. We're cautious with it as at the
• 18:47
  same time,
• 18:49
  and making sure that, there's always a human
• 18:52
  being between the AI and the patient or
• 18:54
  the provider. We think that's important right now,
• 18:57
  especially when it's in its nascent phase.
• 19:00
  Absolutely. And let me hook on there to
• 19:01
  your last few points, Joe, about, your your
• 19:04
  clinical team and the work they do because
• 19:06
  you mentioned this is all about improving the
• 19:08
  quality and coordination of care for for members.
• 19:12
  As as you know, managing kidney disease requires
• 19:14
  very very specific clinical expertise.
• 19:16
  So how does HealthMap's clinical team support members
• 19:19
  and providers effectively throughout this journey?
• 19:22
  Yeah. I'm I'm glad you asked because I'm
• 19:24
  I'm so proud of our clinical teams. I
• 19:26
  really am.
• 19:28
  We so first, they're they're led by our
• 19:30
  chief medical officer, doctor Howard Chaps, who's,
• 19:33
  you know, practiced as
• 19:35
  a a phys ER physician, actually, and, and
• 19:38
  also was at
• 19:39
  Centene,
• 19:41
  previously WellCare.
• 19:43
  So
• 19:44
  I would I would say, you know, between
• 19:46
  him and we have, wonderful,
• 19:49
  nephrology medical directors, we have a scientific advisory
• 19:51
  board,
• 19:56
  of multiple specialties, nephrologists, internal medicine, cardiologists,
• 20:00
  you know, pharmacists, etcetera,
• 20:02
  and endocrinologists.
• 20:03
  That group,
• 20:04
  collectively, I think of as kind of the
• 20:07
  the clinical brain of the program, so to
• 20:09
  speak.
• 20:10
  And,
• 20:10
  what they're really doing is
• 20:12
  designing the right care pathways and protocols
• 20:16
  to be able to be shared with our
• 20:18
  our care navigators,
• 20:19
  our our clinicians who are care navigators. Those
• 20:21
  are
• 20:22
  RNs,
• 20:24
  sometimes nurse practitioners as well.
• 20:26
  They're a combination of people who are in
• 20:28
  the field, so they could be
• 20:31
  face to face with the provider as we're
• 20:33
  interacting with, you know, the the providers or
• 20:35
  they could be, you know,
• 20:37
  remote and they could be telephonically
• 20:39
  interacting.
• 20:41
  Our clinical model is structured so that
• 20:45
  we take an entire population
• 20:47
  and we identify,
• 20:49
  the physicians that they're currently seeing, right? So
• 20:52
  they see
• 20:53
  a lot of different types of physicians, but
• 20:55
  primarily they'll be seeing PCPs,
• 20:57
  nephrologists,
• 20:59
  endocrinologists,
• 21:00
  and cardiologists, just given their comorbidities.
• 21:03
  That's what we tend to find.
• 21:05
  And what we'll do is we go into
• 21:07
  the model our clinical model is one where
• 21:09
  we're not
• 21:10
  trying to compete with those providers.
• 21:13
  We are very much working
• 21:15
  alongside them. In fact, we're an extension of
• 21:17
  their
• 21:18
  practice. Right? So I think that really sets
• 21:21
  us apart because
• 21:22
  if you go in and you compete with
• 21:24
  a provider in a given market, all of
• 21:26
  a sudden,
• 21:27
  you know, the the lines of communication are
• 21:29
  a little bit harder and care coordination can
• 21:32
  become a little bit more challenging. Right? So
• 21:34
  we don't do that. We come in and
• 21:35
  we're an extension of their practice.
• 21:38
  There's as I said, there's some folks who
• 21:39
  will be feet on the street. We'll work
• 21:41
  with those providers to be able to share
• 21:43
  information with them that they were otherwise missing
• 21:45
  and highlight where there might be some care
• 21:47
  gaps they just didn't know about because they
• 21:49
  didn't have the data.
• 21:51
  At the same time,
• 21:52
  that group will be connecting to the member
• 21:55
  to be able to say, hey. Look. We're
• 21:57
  coordinating, working with your physician.
• 22:00
  So you have this sort of coordinated, aligned
• 22:03
  care team on your side supporting you.
• 22:06
  And let us walk you through,
• 22:08
  all of the challenges you're facing, and let's
• 22:11
  get to know you and let's help empower
• 22:13
  you in your journey to manage, those chronic
• 22:16
  conditions. And really the goal for us, our
• 22:18
  mission is to make it so that,
• 22:20
  you know, kidney disease is not the primary
• 22:22
  focus of their lives, that it's in the
• 22:24
  background because it's being so well managed.
• 22:27
  I'd say as those as those clinicians and
• 22:29
  that clinical team works together,
• 22:32
  they're supported as well by
• 22:34
  social workers and dietitians and pharmacists. So it
• 22:36
  really is that multidisciplinary
• 22:38
  team approach that we bring to our
• 22:41
  patients. And at the end of the day,
• 22:43
  they're really focused on outcomes.
• 22:45
  Right? So
• 22:47
  to give you an example,
• 22:49
  Jacob, that some of the outcomes that we
• 22:50
  have are
• 22:52
  slowing the progression.
• 22:53
  We we slow the progression by about thirty
• 22:56
  percent on average,
• 22:58
  reducing
• 22:59
  inpatient
• 23:00
  and ED visits,
• 23:01
  increasing plant starts to dialysis so that you
• 23:04
  don't have that crash that I mentioned earlier,
• 23:07
  and ultimately lowering cost. And I'd say
• 23:10
  that
• 23:11
  that's the crux of the whole program. I
• 23:13
  mentioned that quadruple aim. I mean, for us,
• 23:15
  we're focused, and our clinicians
• 23:18
  are using the the data and analytics we
• 23:20
  have to coordinate care, make sure that,
• 23:23
  the patient's on a path towards better health.
• 23:26
  And what we see when we do that,
• 23:28
  when you look at the sort of financial,
• 23:32
  ledger, so to speak, of that, you'll see
• 23:34
  physician costs go up. Right? So our health
• 23:37
  plan partners will see some increase in physician
• 23:39
  costs, but that's drastically offset by a reduction
• 23:42
  in hospital admission costs,
• 23:45
  reduction in ED visits, and other facility costs.
• 23:48
  And that's how you know,
• 23:50
  really I
• 23:51
  I was just talking to,
• 23:53
  a leadership group here at HealthMap.
• 23:55
  That's how you know that, we are mission
• 23:58
  oriented because
• 23:59
  the wallet matches the heart. Right? Like, it's
• 24:01
  tied together. If we don't do better on
• 24:04
  on outcomes for members, we're not gonna drive
• 24:07
  savings. If we don't drive savings, then, you
• 24:09
  know, in a value in our value based
• 24:11
  care models, we're not getting compensated. So,
• 24:14
  we are very much aligned on and focused
• 24:16
  on that mission, and it's a it's a
• 24:18
  pure mission, which is, a nice place to
• 24:20
  be.
• 24:22
  Fantastic. Well, I appreciate that overview and those
• 24:24
  examples you shared, Joe. Some really great ones
• 24:26
  for our audience.
• 24:27
  Before we go, can you detail for us
• 24:30
  how HealthMap's approach has evolved over the years
• 24:33
  and what the future looks like for HealthMap?
• 24:36
  Yeah. Absolutely. I mean so the the fun
• 24:39
  thing about being in health care is that
• 24:41
  it's never stagnant. Right? The the,
• 24:44
  the landscape is constantly evolving, and we have
• 24:47
  to keep evolving with it.
• 24:49
  And and I I'd say
• 24:51
  that's first and foremost for us. You know,
• 24:53
  we've learned how to some of the things
• 24:55
  that we've we've been we've done over time
• 24:58
  and continue to do and improve on.
• 25:01
  For instance, as we grew, we've been growing
• 25:03
  quite a bit,
• 25:05
  we've learned how to tailor our delivery to
• 25:07
  different types of providers based on their characteristics.
• 25:10
  Right? Some providers,
• 25:12
  you might be talking to a massive group,
• 25:14
  and you have to
• 25:16
  deliver information to them and even access them
• 25:19
  in their time in a certain way. That
• 25:21
  would be very different from a small group
• 25:23
  or a different type of specialty.
• 25:25
  Sometimes,
• 25:26
  you know, the the age of the physician
• 25:28
  matters. Right? Like,
• 25:30
  docs coming around in med school might interact
• 25:31
  with you very differently than docs who've been
• 25:34
  practicing for thirty years.
• 25:36
  So we we've learned how to tailor our
• 25:38
  approach to physicians, and we've also learned how
• 25:41
  to tailor our approach to members
• 25:43
  based on where they're at in in their
• 25:44
  lives.
• 25:45
  And we manage
• 25:47
  Medicare members, Medicaid members, commercial members, exchange members,
• 25:51
  all have very different needs.
• 25:53
  So I think tailoring our approach is one.
• 25:57
  The other way we've evolved
• 25:59
  over time
• 26:00
  you know, I think in the early days,
• 26:01
  and and
• 26:02
  this is true of many who kind of
• 26:04
  go into a newer space. You see all
• 26:07
  this opportunity
• 26:08
  when you connect
• 26:10
  with the external stakeholders, those providers and those
• 26:13
  those patients.
• 26:14
  You wanna be able to share all the
• 26:16
  information with them all at once. And there's
• 26:19
  a lot of evidence based guidelines and, you
• 26:22
  know, care gap opportunities
• 26:24
  that you could throw at these patients.
• 26:27
  It it just tends to be,
• 26:29
  overwhelming
• 26:30
  for them.
• 26:32
  And when you
• 26:33
  when you can, first of all, curate
• 26:36
  your interventions, we've we've leveraged a ton of
• 26:39
  clinical expertise and data analytics to figure out
• 26:41
  how to do that,
• 26:43
  because it's hard to prioritize them.
• 26:45
  But when you can curate those
• 26:47
  interventions
• 26:49
  and narrow them down and then deliver them,
• 26:52
  you know, in the right sequence,
• 26:54
  we find that you can get a lot
• 26:56
  more throughput
• 26:58
  of compliance and care gap closure as opposed
• 27:00
  to trying to give them everything at once.
• 27:02
  If you just thought about it, it'd be
• 27:03
  overwhelming if I I told you, hey. I
• 27:06
  want you to,
• 27:07
  change your diet. I want you to take,
• 27:09
  you know, these different drugs. I want you
• 27:10
  to stop taking other drugs. I want you
• 27:12
  to see your nephrologist
• 27:13
  more often. I want you to go see
• 27:15
  a cardiologist. And,
• 27:17
  you know, I've got a bunch of labs
• 27:18
  you have to take once a quarter. If
• 27:21
  I just gave it to you all at
• 27:22
  once, they would
• 27:23
  you might feel like you failed before you
• 27:25
  even started. But if all I said was,
• 27:28
  hey. We really think you should go see
• 27:29
  a nephrologist. Can we get you to a
• 27:31
  nephrologist?
• 27:32
  That's more manageable. Right? And so I think,
• 27:35
  we've we're along with tailoring the approach,
• 27:38
  being able to
• 27:39
  curate and focus,
• 27:41
  the the time and attention we have with
• 27:43
  members and providers,
• 27:45
  has been a really strong evolution in our
• 27:47
  program.
• 27:49
  Wonderful. Well, Joe, thank you so much for
• 27:51
  taking the time to sit down with us
• 27:53
  and for sharing your insights with our listeners.
• 27:55
  We really appreciate it. Thanks for having me.
• 27:57
  This is a lot of fun. I appreciate
• 27:59
  it. Yeah. Absolutely. And I'd also like to
• 28:01
  thank our podcast sponsor, HealthMap Solutions. You can
• 28:04
  tune in to more podcasts from Becker's HealthCare
• 28:07
  by visiting our podcast page at beckershospitalreview.com.