Latest / Becker’s Payer Issues Podcast / Wayne Pan, Medical Doctor at San Francisco Health Plan

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Wayne Pan, Medical Doctor at San Francisco Health Plan · Becker’s Payer Issues Podcast

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  and outcomes for the populations we serve.
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  This is Gracelyn Keller with the Becker's Healthcare
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  podcast, and we are live at the 2024
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  payer issues roundtable.
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  I am joined currently by doctor Wayne Pan,
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  who serves as the medical director for San
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  Francisco Health Plan. So, doctor Pan, thank you
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  for joining me today. We'd love to have
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  our conversation start with you briefly introducing yourself
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  and telling us a little bit more about
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  your current role. Morning, Grace. My name is
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  Wayne Pan. I'm a medical director at San
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  Francisco Health Plan, which is a Medi Cal
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  managed care plan, based in San Francisco.
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  We are serving the indigent population,
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  low income, and also age blind and disabled
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  populations.
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  And my current role is, medical director for
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  as well as for quality improvement appeals and
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  grievances.
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  Wonderful. Well, thank you for taking the time
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  to be here, and let's start our conversation
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  talking about member experience. So from improving member
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  experience and expanding value based care to controlling
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  costs, payer executives have ambitious growth goals for
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  the rest of the year and the new
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  year ahead. So in your role, what is
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  your top priority, and how are you planning
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  to get there?
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  Yeah. I think one of the things that
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  health plan executives
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  overlook is, grievance and appeals. It's an area
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  where it's regulatory defined and, you have to
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  maintain,
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  records and and follow-up on on cases. But
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  in fact, it's actually a great way to
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  understand how your providers are providing services to
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  your members.
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  And member satisfaction is, you know, paramount to,
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  growth in a in a health plan. So,
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  our top priority is really to make sure
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  that the grievance and appeals process is actually
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  working well, and we're taking those insights
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  and actually,
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  acting on them to, actively improve the patient
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  experience.
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  And going off of that, at an industry
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  level, how would you describe the biggest barriers
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  to effectively serving and engaging members? And what
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  opportunities do you see for large scale improvements,
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  and how are you applying this at your
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  current strategy?
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  I think the hardest part right now is,
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  care management, care coordination.
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  A lot of providers are saddled with that
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  responsibility, but they don't actually have the resources
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  within their
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  offices or clinics, to be able to carry
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  out effective care management and care coordination.
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  So that's where the health plans really need
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  to step up so that when they hear
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  about these issues, that they're actually able to
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  solve the problem so that members get the
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  access to the care that they need.
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  And shifting gears to speak to our up
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  and coming leaders out there,
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  keeping pace in today's dynamic health care landscape
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  is challenging.
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  And so what's one piece of advice you'd
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  share with peer leaders to grow their businesses
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  while keeping members top of mind?
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  Yeah. I think one of the things, that
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  health plans need to understand is that being
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  in silos really makes it difficult to solve
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  problems.
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  And so what we see is that making
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  sure that provider relations as well as, contracting,
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  grievance and appeals,
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  all work together to be able to address
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  issues that are typically across departments. And the
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  more that a health plan is able to
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  do that and keeping the patient at the
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  center, the easier it is to solve the
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  problems and and provide a better patient experience.
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  And as we wrap our conversation today, is
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  there anything else you'd like to share as
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  closing remarks on the podcast?
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  So I think in the health care space,
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  particularly for payers, value based care as well
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  as risk adjustment are gonna be tied together.
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  And to be able to have a process,
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  as patient centered would be the best way
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  to be able to adjust,
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  the internal processes as well as external processes
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  so that,
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  patients and payers and and providers can all
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  work together, to achieve the best results.
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  Wonderful. Well, doctor Pan, thank you for joining
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  me today on the Becker's healthcare podcast. Again,
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  we're live at the 2024
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  payer issues roundtable.
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  Alright. Thanks, Grace.