Latest / Becker’s Payer Issues Podcast / Inside MD Live: Improving Healthcare Access, Affordability & Outcomes

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Inside MD Live: Improving Healthcare Access, Affordability & Outcomes · Becker’s Payer Issues Podcast

0:00
This is Haley Recker with the Becker's Payer
0:02
podcast, and we are recording live at the
0:04
Becker's third annual spring Payer Issues roundtable.
0:07
I am thrilled today to be joined by
0:09
doctor Eric Weil, who is the chief medical
0:11
officer at MDLIVE by Evernorth.
0:14
Hi, Eric. Thank you so much for having
0:15
this discussion with me today. Can you go
0:17
ahead and introduce yourself and share a little
0:19
bit about your background?
0:20
Sure. Thanks for asking. My name is Eric
0:22
Weil. I'm the chief medical officer for MD
0:25
Live by Evernorth.
0:27
I am a practicing primary care physician
0:31
who has overseen the clinical infrastructure
0:35
and strategy for our virtual solution for the
0:37
past two plus years.
0:40
My career began
0:41
in general primary care and through a relatively
0:45
circuitous path. I found myself in medical leadership,
0:49
and then in home based care.
0:51
Interestingly, though, when I went into home based
0:53
care, it was right at the beginning of
0:55
the COVID pandemic,
0:56
and we rapidly
0:58
were forced to pivot into a strategy that
1:01
was primarily
1:02
telemedicine based.
1:04
And in that context, I really learned about
1:08
both the value and the opportunity of,
1:11
virtual care
1:12
and have been running in that
1:15
race ever since. I wanna make sure that
1:17
we have an opportunity to talk a little
1:19
bit about the company that I support, MD
1:21
Live.
1:22
MD Live is an Evernorth health services company
1:24
and one of the leading providers
1:26
of telemedicine and virtual care in The United
1:29
States.
1:30
We offer services in primary care, in urgent
1:33
care, in dermatology,
1:35
in behavioral health, and we have an employee
1:37
assistance program.
1:39
The MD live intervention, the MD live program
1:43
supports 62,000,000
1:44
individuals. They have access to MD live as
1:47
a covered benefit through their health plan. And
1:49
the way that we offer services is either
1:51
through video,
1:53
through telephonic care, or through asynchronous care, which
1:56
we call e treatment.
1:58
We have over 2,000 board certified physicians and
2:02
licensed therapists that are trained to deliver care
2:04
virtually,
2:05
and we are dedicated to delivering exceptional,
2:08
accessible, and personalized health care through a seamless,
2:11
smoothly connected virtual platform.
2:14
That's awesome. Thank you so much for that
2:16
brief introduction.
2:18
Now moving on, balancing affordability
2:21
and quality is a constant challenge for health
2:23
plans. How is your organization innovating to manage
2:26
the cost of care while maintaining or improving
2:29
member outcomes?
2:31
So I like to break down
2:33
our approach to
2:35
the balance of affordability and quality into three
2:37
different domains. We use
2:40
efficiency,
2:41
prevention, and access.
2:43
Efficiency allows us to deliver a high quality
2:45
care at,
2:47
at a better price point
2:49
through,
2:50
economy of scale, but also through technologies that
2:53
streamline the experience and improve communication for patients
2:56
and providers.
2:58
We also
2:59
leverage technology
3:00
to support our administrative
3:02
responsibilities.
3:03
So for example, when you deliver over
3:06
1,500,000
3:08
visits a year, you wanna be able to
3:09
deliver quality at scale. And the way that
3:11
you do that is by using an AI
3:14
intervention, for example, to help with quality chart
3:18
reviews. And that allows us to
3:20
manage our leadership workforce and at the same
3:23
time as that support
3:25
the oversight of quality and safety,
3:28
at a volume that's much higher than one
3:29
would ordinarily be able to support.
3:32
We focus very much on optimizing processes, and
3:35
and we have a
3:37
continuous process improvement philosophy that allows us to
3:41
take any existing
3:42
programs or interventions that we have and focus
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on making them even more impactful.
3:47
The second area that we focus on is
3:48
prevention.
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And the concept here, of course, is that
3:52
in order to
3:54
reduce the total cost of care, you have
3:55
to keep people healthy. You have to keep
3:57
people from
3:59
utilizing more expensive health care services, and you
4:01
have to prevent them quite frankly from, needing
4:04
to miss work.
4:05
And so our interventions
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not only
4:08
deal with care in the moment,
4:10
but are very strategically focused on thinking about
4:14
the future needs of an individual. So when
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a patient comes in for their virtual primary
4:19
care, for example, we're not just managing their
4:22
complaint in the moment. We're thinking about what
4:24
preventive screenings they need, what we can do
4:27
to ensure that their diabetes is well controlled,
4:29
and that is
4:30
a chunk of the work that we do
4:32
at any given time.
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And then the third area is access because
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you can't
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have good health care if you can't access
4:40
health care.
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So we have a twenty four seven
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strategy
4:45
that allows us to deliver primary care at
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10:00 at night or on a Saturday morning.
4:51
If you have an urgent care need, you're
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gonna see us within twenty minutes.
4:55
If you need routine care, even in primary
4:59
care, we have the ability to offer that
5:01
the same day. If you are in need
5:03
of behavioral health services, we can actually manage
5:06
those within
5:07
within a week. Our physicians can refer patients
5:10
to in network specialists,
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which means that we can help to,
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ensure access and connectivity to the health care
5:18
providers that are within an individual's network. And
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because we also show cost transparency, we actually
5:24
show the cost of the visit in advance.
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We allow individuals to make the decisions that
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they need to make with regards to how
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and when and where they wanna access care.
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And then the last point I would say
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is that the approach that we've chosen to
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use
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means that patients are not pursuing health care
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in other
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venues.
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About twenty percent of our MD live patients
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indicate that they would have delayed care if
5:47
we had not been available to them. MD
5:49
live had not been available to them as
5:50
a service.
5:51
Well, I'd love to go deeper into this
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conversation about quality of care. So in an
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ever evolving regulatory landscape, what best practices or
6:00
tools does your organization rely on to keep
6:02
quality of care at the forefront?
6:05
I appreciate you asking the question. It's important
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to recognize that in the DNA of MD
6:11
live,
6:12
quality and safety are the top focus.
6:15
When we have a business review, when we
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review
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performance,
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we don't start with financials. We don't start
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with utilization. We start with quality and safety.
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We we talk about whether or not there
6:27
have been safety events. We talk about how
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our physicians are performing
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from a quality point of view. That's where
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we always start, And that message is delivered
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to
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our entire team, whether that's marketing
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or strategy or product,
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quality and safety come first. When we develop
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clinical interventions,
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we are always using evidence based guidelines.
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When we develop interventions, we ensure that they
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are being reviewed, embedded, and produced by licensed
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health care professionals, physicians, therapists, and other.
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When we select physicians or therapists to be
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in our network,
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they are all board certified and are robustly
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vetted.
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And
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when we develop new clinical interventions,
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they're reviewed every single year.
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Nothing that we do becomes outdated because we
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are constantly looking at what we offer
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to ensure that it is up to date
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with the most recent literature.
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Finally,
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what I would say is that the platform
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that we've created
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is designed in such a way as to
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make it easier for physicians or therapists to
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do the right thing.
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The platform
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helps to facilitate
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thoughtful clinical decisions.
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It helps to facilitate
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ease of decision making in such a way
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that we worry less
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about whether or not a physician is going
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to make the right decision because we are
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confident that it's going to happen just because
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of the way we're structured.
7:56
Thank you so much for sharing. And looking
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ahead,
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what do you see as the biggest opportunity
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for payers to lead the charge in transforming
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care delivery and driving better outcomes for all
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stakeholders? How can leaders take a step in
8:09
this direction now?
8:11
You know,
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I would make the argument that
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we should be acknowledging and embracing the fact
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that change is happening and is going to
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continue to happen.
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For example, if you think about the length
8:25
of stay in the hospital for a heart
8:27
attack in 1990, it was between nine and
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ten days.
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When you think about the length of stay
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in the hospital today for a myocardial infarction,
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it's three days.
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A hip replacement in 1970, you were in
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the hospital for seventeen to twenty days, and
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now it's a same day procedure.
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Every
8:45
step of the way,
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care is being moved from being
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in a hospital to being in an ambulatory
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setting. And now health care is being moved
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in an ambulatory setting from a specialist to
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primary care, and then it moves into the
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virtual space.
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And our role is to recognize that that
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is the direction that health care is is
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moving in, and our role is to make
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sure that we are
9:10
well positioned to support the movement of
9:13
that care to the home, to a virtual
9:15
space. And so the way that we do
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this is
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we focus on
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enhancing and personalizing the patient experience.
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We
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work as much as we possibly can to
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broaden the number of clinical capabilities
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that we can offer even in a home
9:32
based environment through through a virtual platform, and
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that includes things that you historically would have
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gone into the office for. Some of those
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are around managing
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chronic disease,
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hypertension,
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diabetes,
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obesity.
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And some of those are focusing on other
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areas that are very much priorities
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for,
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men and women in the course of their
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daily health experience,
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women's health, menopause care, contraceptive management.
9:59
Our role is to ensure that our clinical
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capabilities and specialized care are expanding,
10:06
and that we're offering more optionality in terms
10:09
of referrals, for example. Absolutely. I would say
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that we're also
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redefining the referrals so that it's not just
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to,
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in person care,
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but also to other virtual services.
10:20
And now you mentioned
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diabetes care and weight loss
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medication. So I'd really like to hear your
10:26
thoughts on the recent explosion,
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in popularity of direct to consumer
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virtual care services
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that promote easy access to prescription medications
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to treat everything from weight loss to hair
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loss to ED.
10:39
Thank you for asking the question.
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The first point
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that is worth keeping in mind when we
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think about
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the trend towards direct to consumer care is
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that health care
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is a service industry. It's a service industry
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with consequences, however, because if you're not receiving
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the service you need, then you may not
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be receiving crucial health care or you may
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be delaying it in some fashion or another.
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So that's point number one. Point number two
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is that
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patients want more control over their health care.
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They want more control in the decisions that
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are being made. They wanna be more informed
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than perhaps in the past, and they're willing
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to pay for it. With that, however, there
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is a component of risk because
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if
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those decisions are not informed decisions
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and a patient is willing to pay, then
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they could go down a pathway of receiving
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care that is not in their best interest.
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So the direct to consumer
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journey
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is one that is going to become increasingly
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more prevalent in The United States,
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and our role within MD Live is going
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to be to
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to be a partner acknowledging
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the need and the desire for control, but
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to do so in a way that ensures
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high levels of quality and safety.
11:55
And if an individual's priorities may not entirely
11:59
align with
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what a physician might recognize
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as a priority in their health care. Our
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role
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is to help support a journey that both
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meets the patient's needs and at the same
12:11
time as that keeps them healthier, makes them
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healthier.
12:14
So our model, which is
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not just focused on direct to consumer, but
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it's a more comprehensive and more holistic approach,
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would focus on a patient's priorities
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and at the same time as that, their
12:27
clinical needs.
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Most of the time, that's also covered by
12:30
their insurance.
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And if necessary, we have the ability, and
12:34
if desired, to share that information
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with their
12:38
primary care provider or their specialist provider in
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the community.
12:42
Alright. Well, thank you. Again, this is Haley
12:44
Recker with the Becker Payer Podcast recording live
12:47
at the Becker's third annual spring payer issues
12:49
roundtable. Thank you so much for joining me
12:52
today. Thanks.