Latest / Becker’s Payer Issues Podcast / Brad Riley, VP of Clinical Delivery at Longevity Health Plan

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Brad Riley, VP of Clinical Delivery at Longevity Health Plan · Becker’s Payer Issues Podcast

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  Evernorth brings the power of wonder and relentless
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  innovation to create world class pharmacy care and
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  benefit solutions. Our connected health services make the
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  treatment, prediction, and prevention of health care's most
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  complex conditions
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  easier and more accessible as we drive organizations
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  and people forward. Ever North home based care
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  provides value based care that helps patients with
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  multiple chronic conditions
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  and social determinant of health barriers get the
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  care they need and the personalized experience they
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  deserve. We serve patients who struggle to navigate
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  the health care system by bringing high quality
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  primary
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  and preventative care services to the home. By
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  providing clinical care and support services that provide
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  whole person care, we improve health equity, access,
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  and outcomes for the populations we serve.
• 0:47
  This is Gracelyn Keller with the Becker's Healthcare
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  Podcast, and we are recording live at the
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  2024
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  payer issues roundtable.
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  I'm currently joined by Brad Riley, who is
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  the VP of clinical delivery at Longevity Health
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  Plans. So, Brad, thank you for joining me
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  today. We'd love to start our conversation by
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  having you introduce yourself and tell us a
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  little bit more about your role. Sure. Absolutely.
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  Well, first off, appreciate you having me. Thank
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  you. So like, Grace said, I'm the vice
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  president of clinical delivery at Longevity Health Plan.
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  We're the fastest growing iSNP in the nation
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  right now,
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  and we are both a, clinical services organization
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  and an institutionalized special needs plan. And what
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  that means is we place advanced practice
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  providers within skilled nursing facilities. We have 13
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  different markets,
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  and, ultimately,
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  they are there to help patient centered care
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  and drive, better health outcomes and goals of
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  care for our iSNP,
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  members.
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  Wonderful. Well, thank you for being here. And
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  let's start our conversation with growth goals. So
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  from improving member experience to expanding value based
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  care to controlling costs,
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  payer executives
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  have ambitious growth goals for the rest of
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  this year and looking into 2025.
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  So in your role, what is your top
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  priority, and how are you planning to get
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  there?
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  Absolutely. I I think
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  for me, specifically, in my role, one of
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  the big things that I do is
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  the, VP of clinical deliveries. I help liaison
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  between
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  our IT
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  department and our integrations with predictive modeling and
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  different things and our clinical teams.
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  And so for me, specifically, I think one
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  of the big things,
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  obviously, AI, Gen AI, predictive analytics is big
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  right now.
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  Figuring out how we can,
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  position ourselves to better leverage that as an
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  organization,
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  I think, is something a lot of organizations
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  are trying to find figure out right now.
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  One of the biggest obstacles
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  organizations are running into is you have these
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  legacy systems, but these legacy systems weren't built
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  with this kind of technology in mind all
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  the time. And so there's plenty of data,
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  but the data is not particularly available or
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  it's not organized in the right way or
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  it's not refreshed at the right cadence. And
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  so aggregating and setting up infrastructure
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  to support the ability of having a good
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  foundational
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  dataset that you could help drive some your
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  operations off of is something I'm definitely gonna
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  be pushing through 20 the end of 2024
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  and and 2025.
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  And shifting our conversation towards the digital realm,
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  how is technology supporting value based care for
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  member focused initiatives at your organization?
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  And what is exciting you most in this
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  space?
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  So,
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  you know, I think, first off,
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  longevity
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  our our entire business model is built off
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  of a value based care. Right?
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  We firmly believe that
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  driving
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  health outcomes and ensuring that our members meet
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  their care,
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  their goals of care and their better care
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  outcomes can to be driven both by clinical
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  intervention,
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  but also,
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  informed
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  through proper data driven decisions.
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  And I think right now,
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  you know, there's a really good opportunity, and
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  I'm I've referenced it a little bit in
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  our last, question. But there's a really good
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  opportunity right now to leverage available data
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  in helping
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  inform decision making without using the data to
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  make decisions. And what I mean by that
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  is,
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  you know, I think the big buzz right
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  now is generative AI, chat g p t,
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  you know, Copilot, whatever whatever people have access
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  to. And I think, you know, that that's
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  fun, but it's also
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  it's not controlled. It's not standardized.
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  There's a lot of exciting work that is
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  going to, be available to us in the
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  next few years. And I think, 1, building
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  a foundational data structure to help support that's
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  key. But in the interim, we can use
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  other types of analytics. Advanced analytics is what
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  I'd call it. Right? It's not technically AI,
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  but you could use advanced analytics like predictive
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  modeling and other things to really drive
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  clinical outcomes and to understand your patient population
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  a lot more. And I think the biggest
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  key here, right, is is building opportunities
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  for payers
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  to assess all the data that they have
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  available to them and then equip it,
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  put it in the hands of the clinicians
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  to operate at the top of their license.
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  And so if we're able to,
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  take data and take analytics
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  and use it to allow our clinicians to
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  do less administrative work or more informed
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  administrative work, every single day, I would opt
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  for a clinician to be able to spend
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  more time with the patient talking to them
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  rather than
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  spending time
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  going through files and trying to figure out
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  what information is where
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  through many different platforms. So that's, I think,
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  the big thing we're driving is is leveraging
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  data, making sure it's it's accurate, making sure
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  it's consistent, and giving it to clinicians to
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  allow them to operate at the top of
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  their license.
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  Absolutely.
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  And
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  when we look at leadership
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  growth,
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  keeping pace in today's dynamic health care landscape
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  is challenging. So what is a piece of
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  advice you'd like to share to peer leaders
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  to help grow their business and keep members
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  top of mind?
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  Sure. So sticking with the theme, I think
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  establishing
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  a
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  foundational
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  dataset, reassessing your legacy systems that you're using,
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  understanding
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  how potential current integrations or future integrations
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  could impact or drive
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  factors for technologies that may not be,
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  widely available right now, but might be in
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  the next few years, I think, is gonna
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  be key. We should be a couple years
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  ahead. Traditionally,
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  the the payer industry is is 3 years
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  behind the technology industry, right, at least.
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  I think some instances, maybe a little more.
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  But I think the big thing is
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  every I I think every leader needs to
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  be thinking about,
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  specifically,
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  all the work that they're doing now and
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  they're doing next year. They need to be
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  thinking about how that's gonna impact their foundational
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  data that they use at an enterprise level
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  in 3, 4 years to make sure that
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  there aren't any unintended consequences that could hinder
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  their ability to leverage technologies
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  that are, you know, not quite available yet,
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  but on their way.
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  And as we wrap our conversation today, are
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  there any parting words you'd like to share
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  for the podcast?
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  I think if you're not aware of longevity
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  health, I recommend you you take a minute
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  and check us out. Really great organization.
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  Like I said, it's the fastest growing I
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  SNP in the in the nation right now.
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  And as a clinical services organization,
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  institutionalized special needs plan.
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  We partner with both national insurers,
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  long term care facilities,
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  skilled nursing facilities,
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  and our goal is to meet the unique
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  medical, social, and emotional needs
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  of our nursing home residents. And there's no
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  other space or place I'd like to to
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  be in to be able to make that
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  impact. I think sometimes it's it's really hard
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  to when when you work in data and
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  when you work in, analytics to to understand
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  your impact to
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  members is a little hard. But I think
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  absolutely recommend, check out longevity health. There's a
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  lot of good things going on.
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  Wonderful. Well, Brad, thanks for being on the
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  Becker's Healthcare podcast today. Again, we are live
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  at the 2024 payer issues roundtable.
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  Appreciate it. Thanks.