Latest / Becker’s Payer Issues Podcast / Dr. Pooja Mittal, Vice President and Chief Health Equity Officer at Health Net

Transcript

Dr. Pooja Mittal, Vice President and Chief Health Equity Officer at Health Net · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Jacob Emerson with the
• 0:02
  Becker's Payer Issues Podcast.
• 0:04
  Thrilled today to be joined by a special
• 0:06
  guest. Doctor Puja Mittal is vice president and
• 0:09
  chief health equity officer at Health Net. Doctor
• 0:12
  Mittal, thank you so much for taking the
• 0:14
  time to be with me on the podcast
• 0:15
  today.
• 0:16
  Sure. Thanks for having me.
• 0:18
  And before we dive into everything we wanna
• 0:20
  talk with you about, can you tell us
• 0:21
  a little bit more about yourself, your background
• 0:23
  in health care in terms of your career,
• 0:25
  and what it is that you're doing today
• 0:27
  at HealthNet.
• 0:29
  Sure.
• 0:30
  So,
• 0:31
  I am a family doctor.
• 0:33
  I came to that through,
• 0:36
  my mom, who was also a family doctor.
• 0:38
  I grew up in Southern California, and,
• 0:40
  she was working at an FQHC there with
• 0:44
  primarily farm workers.
• 0:46
  And, through just watching her my entire childhood,
• 0:49
  that that became my goal as well. And
• 0:51
  so,
• 0:52
  I went to medical school, school, became a
• 0:53
  family doctor, did residency in Southern California working
• 0:56
  with farm workers,
• 0:58
  and,
• 0:59
  really since then have had a career that's
• 1:01
  focused on caring for the underserved. And so,
• 1:05
  I was an academic clinician working at Boston
• 1:08
  Medical and then after that, UCSF
• 1:11
  for many years before coming over to the
• 1:13
  plan side. And so
• 1:15
  I have been at Health Net for,
• 1:17
  eight and a half years.
• 1:19
  I've had a lot of different positions here,
• 1:22
  a lot of different
• 1:23
  roles, and have had the opportunity to learn
• 1:25
  a lot of different aspects of health care,
• 1:27
  I think, Medicaid, commercial,
• 1:30
  and Medicare. And for the last four years
• 1:34
  or so, have been the chief health equity
• 1:36
  officer.
• 1:38
  And so
• 1:39
  that means that,
• 1:41
  I have three essential areas of focus at
• 1:44
  Health Net. One is broad population health, so
• 1:47
  really looking at the health of the individual
• 1:49
  and the populations we serve and improving,
• 1:53
  disparities in health outcomes amongst those populations.
• 1:56
  The second is more broadly equity focused benefits,
• 2:00
  so things like ensuring that we are,
• 2:04
  have enough community health workers, enough doulas,
• 2:08
  and other
• 2:09
  sort of surround staff that we call nontraditional
• 2:13
  providers supporting our members and ensuring the quality
• 2:15
  of those benefits.
• 2:17
  And then the third is is more broadly
• 2:20
  health equity strategy. How do we ensure that
• 2:22
  everything that we're doing at the plan really
• 2:24
  takes an equity focus and an equity lens,
• 2:27
  to ensure that we're meeting the needs of
• 2:29
  those who are most vulnerable across the state?
• 2:32
  And so
• 2:33
  Health Net really has a pretty broad footprint.
• 2:35
  We're in 14 counties,
• 2:37
  everything from very urban counties such as Los
• 2:39
  Angeles County to very rural counties like Imperial,
• 2:43
  and,
• 2:45
  some of the northern
• 2:46
  rural counties. And so our
• 2:48
  populations are are quite diverse.
• 2:50
  And we have, in different regions of the
• 2:53
  state, different populations that we really hone in
• 2:55
  on, from my team's perspective to ensure that
• 2:58
  we're meeting the needs of those who are
• 2:59
  most vulnerable, those communities.
• 3:02
  Wonderful. Well, I I really appreciate that overview,
• 3:05
  Puja, and, and really appreciate you taking the
• 3:07
  time to sit down with us and share
• 3:09
  your insights with our listeners.
• 3:11
  I wanna get started by,
• 3:13
  asking you what are some of the biggest
• 3:15
  issues that you're following within health care right
• 3:17
  now. And I and I ask that question
• 3:19
  given that it's a time of transformative
• 3:21
  change, both for private organizations like yours, but,
• 3:25
  of course, also,
• 3:26
  policy wise, both the state and federal levels
• 3:28
  when it comes to Medicaid and things that
• 3:30
  will affect your members. So,
• 3:33
  what's top of mind for you? What are
• 3:34
  you keeping an eye out for in the
• 3:36
  media, in in the latest data?
• 3:38
  What are you keeping an eye out for
• 3:39
  in terms of what's gonna be impacting your
• 3:41
  your membership?
• 3:44
  Yeah. There there are a handful of things.
• 3:46
  One,
• 3:47
  big one, of course, is, federal funding for
• 3:50
  Medicaid,
• 3:51
  because that directly impacts what we're able to
• 3:53
  do,
• 3:55
  in our day to day work. And so,
• 3:57
  I'm keeping an eye on that broadly. What
• 3:58
  does that look like? Are we going to
• 4:00
  have to change within our state,
• 4:02
  who's covered with Medi Cal? And so that's
• 4:05
  a big one.
• 4:07
  Another is
• 4:08
  also looking at federal funding and federal funding
• 4:11
  subsidies for the Exchange population
• 4:15
  and where that might shift things.
• 4:17
  If there is less federal funding for,
• 4:20
  for,
• 4:22
  the members on the exchange,
• 4:23
  that will shift
• 4:25
  some of the things that I know Covered
• 4:27
  California has been really successful in doing in
• 4:29
  terms of
• 4:30
  supporting
• 4:31
  benefits and subsidies so that people are not
• 4:34
  having to pay as much out of pocket
• 4:36
  for their benefits.
• 4:37
  And so that's another thing that I'm keeping
• 4:39
  an eye on, just in terms of trying
• 4:40
  to understand
• 4:42
  what type of health care will be accessible
• 4:44
  to people and if we're going to see
• 4:46
  any shifts in
• 4:47
  who is able to access
• 4:49
  broader health care.
• 4:52
  Another thing that I'm keeping an eye on
• 4:54
  is
• 4:55
  telehealth solutions
• 4:57
  and,
• 4:58
  the shift and how those are permeating in
• 5:00
  different regions
• 5:01
  of the state and of the country. And
• 5:04
  so, I think there's been a bit of
• 5:05
  a push and pull in using telehealth as
• 5:08
  a way of extending access,
• 5:10
  particularly in rural areas,
• 5:13
  and then
• 5:14
  how that is affecting
• 5:16
  those who are practicing in those areas and
• 5:19
  what that does to the way that patients
• 5:21
  are shared. And so just trying to understand
• 5:24
  better and kind of keep an eye on,
• 5:26
  you know, how do we best use telehealth
• 5:30
  and what does it really mean for access,
• 5:32
  particularly for those who are
• 5:34
  underserved.
• 5:35
  And, you know, there's good data that shows
• 5:37
  that a lot of the
• 5:39
  changes in telehealth,
• 5:41
  availability of,
• 5:43
  therapy, for example behavioral health therapy, has not
• 5:47
  necessarily benefited those who are most vulnerable. It
• 5:49
  really does end up supporting,
• 5:52
  higher socioeconomic
• 5:53
  populations. And so really trying to see how
• 5:56
  that continues to change, if see that become
• 5:59
  more equitable over time or if there's something
• 6:01
  that we're gonna need to do from a
• 6:02
  policy perspective
• 6:04
  to support that.
• 6:05
  Absolutely. That's three major topics that I think
• 6:08
  most health care executives right now are keeping
• 6:10
  their eyes on. Medicaid reimbursement changes,
• 6:13
  ACA subsidies, and whether those will be allowed
• 6:16
  to expire, and then what you just mentioned,
• 6:18
  Puja, as well, the the telehealth shifts that
• 6:20
  we're seeing all over the country, especially when
• 6:22
  it comes to Medicare right now. Yeah.
• 6:25
  So
• 6:26
  when you think about your your member population
• 6:28
  and what you're in charge with in terms
• 6:30
  of serving them, what what gives you the
• 6:32
  most concern right now in terms of health
• 6:34
  equity trends that you are seeing,
• 6:37
  in the California counties that you serve?
• 6:40
  I'm gonna come back to the technology piece
• 6:42
  because I think equitable access to technology is
• 6:45
  a really important one.
• 6:47
  And,
• 6:48
  you know, I think there's real policy implications
• 6:50
  around
• 6:51
  the access of broadband,
• 6:53
  for example,
• 6:54
  and the inequitable access to broadband.
• 6:57
  You know, I I we used to talk
• 6:59
  about,
• 7:00
  Internet service or broadband access as being something
• 7:03
  that's a nice to have but not a
• 7:05
  need to have. And more and more in
• 7:07
  today's world, it's essential. It's an essential part
• 7:10
  of our,
• 7:11
  you know, social drivers of health. If we
• 7:13
  don't have access to broadband internet, we don't
• 7:15
  have access to being able to really function
• 7:18
  in the world, particularly when it comes to
• 7:20
  health care where so much of it requires
• 7:22
  that type of access. And so
• 7:24
  I'm, I'm looking at, you know, what does
• 7:27
  it look like to really make that
• 7:29
  broadband access accessible and
• 7:32
  affordable
• 7:33
  because we know that it's often more expensive
• 7:35
  in poorer communities.
• 7:37
  And then
• 7:38
  so the broadband access is one piece of
• 7:40
  it, but then the other piece of it
• 7:42
  is how are we taking all these innovations
• 7:44
  that are occurring in
• 7:47
  technology
• 7:48
  and being able to apply those to our
• 7:50
  communities that are most in need? And so
• 7:53
  looking at, you know,
• 7:56
  telehealth access to,
• 7:58
  behavioral health therapy and ensuring that those huge
• 8:02
  gains that we've made, right, there are many,
• 8:04
  many providers that are now,
• 8:06
  bringing in really diverse
• 8:09
  sets of therapists so that whatever
• 8:12
  whatever type of background you're seeking in your
• 8:14
  therapist, you can find. If you're a veteran
• 8:16
  and you're looking for a veteran therapist, you
• 8:19
  can find that. If you are,
• 8:21
  you know,
• 8:22
  a queer
• 8:23
  Asian woman, for example, you can go in
• 8:25
  and find a therapist that sort of understands
• 8:27
  your culture and reflects that. But how are
• 8:30
  we ensuring that those
• 8:32
  technologies, those advancements,
• 8:34
  are getting out to those, in the Medicaid
• 8:36
  community
• 8:37
  who may actually have less access to that
• 8:40
  type of care already.
• 8:41
  And so, that's something that continues to be
• 8:44
  top of mind for me because it's so
• 8:46
  important
• 8:48
  in terms of
• 8:49
  really being able to meet the needs of
• 8:51
  our communities in the most equitable way.
• 8:54
  Absolutely. And so you're you're focused on democratizing
• 8:57
  access to new technologies for for the underserved
• 9:00
  populations,
• 9:01
  that's that HealthNet serves.
• 9:03
  And and I imagine, that access to broadband
• 9:06
  Internet is a major challenge, especially in some
• 9:08
  of those far Northern California and
• 9:10
  coastal counties. So really interested to hear you
• 9:13
  talk about
• 9:14
  that. On the flip side of my my
• 9:15
  last question,
• 9:17
  what are some of the trends among your
• 9:18
  your member population that you're really seeing,
• 9:21
  improvements in terms of health outcomes or technology
• 9:24
  access,
• 9:25
  trends where you're you're excited about where things
• 9:28
  are moving for you and your Health Net
• 9:30
  members?
• 9:33
  You know,
• 9:35
  I've been really excited to see that people
• 9:38
  are in more and more engaged with care.
• 9:41
  I mean, really, one of the biggest struggles
• 9:43
  that,
• 9:44
  we as a plan have and and most
• 9:47
  plans have is driving engagement, sort of engaging
• 9:51
  those unengaged members.
• 9:53
  And so I think because
• 9:55
  of our
• 9:57
  flexibility
• 9:58
  in multimodal outreach
• 10:01
  and being able to leverage technology in a
• 10:03
  way that meets the needs of the people
• 10:05
  that we're serving,
• 10:06
  we've been able to drive engagement in new
• 10:09
  ways. And that's really exciting to me because
• 10:11
  the first step in improving any outcome
• 10:15
  is driving engagement.
• 10:16
  And then the second is making sure that
• 10:18
  when they are engaging with us that they're
• 10:20
  having a good experience.
• 10:21
  And I think we're making progress in both
• 10:23
  of those
• 10:24
  both of those, and so that to me
• 10:26
  is really encouraging.
• 10:28
  I am also particularly
• 10:30
  excited about, just from a systems perspective and,
• 10:34
  like, as a as an industry,
• 10:36
  the potential for
• 10:38
  AI to help
• 10:39
  improve and extend
• 10:41
  clinical
• 10:42
  care. And I think that's a really interesting,
• 10:45
  forefront that we're at now is how we're,
• 10:47
  how we're going to be able to use
• 10:49
  AI to
• 10:50
  extend our reach, right? Can we use it
• 10:52
  to,
• 10:53
  build large language models to pull
• 10:56
  unstructured data from an EMR
• 10:59
  and then use that to drive insights that
• 11:01
  we can use to better engage our members,
• 11:03
  right? So I think there's a we're on
• 11:05
  the precipice of a huge amount of potential
• 11:08
  to
• 11:09
  better use the data that already exists
• 11:12
  to to meet the needs of our members
• 11:14
  and give them a better experience.
• 11:17
  Yeah. And it's so exciting to hear leaders
• 11:19
  like yourself talking about the potential
• 11:21
  for AI and and, what it could do
• 11:23
  to improve
• 11:24
  health outcomes among your members. Because, you know,
• 11:27
  I know sometimes it can be very easy
• 11:29
  for for for media organizations like us to
• 11:32
  focus on some of the negative aspects, but
• 11:34
  it's you know, we're we're hearing from leaders
• 11:36
  constantly about, how this is going to continue
• 11:38
  to transform the industry and and health outcomes.
• 11:41
  So really exciting to to hear you talk
• 11:43
  about that as well, Puja.
• 11:45
  I I should ask, you know, you've been
• 11:46
  in this industry for a long time, and
• 11:48
  you've you've clearly been very successful to to
• 11:50
  the to where you've gotten.
• 11:53
  So for our audience of health plan leaders
• 11:56
  listening in for all all from all over
• 11:58
  the country, what would you tell them in
• 12:00
  terms of what, the most effective health care
• 12:03
  leaders need to be successful,
• 12:06
  especially moving forward over these next two to
• 12:08
  three,
• 12:09
  what are sure to be very transformative
• 12:12
  years for the industry?
• 12:14
  Yeah. Thank you for the question. I
• 12:18
  you know, I think in the equity space,
• 12:20
  generally, there's always this need to
• 12:24
  focus on an overall
• 12:25
  or overarching set of strategies,
• 12:28
  but be flexible
• 12:29
  in how you're getting there. Because as things
• 12:32
  shift, there's different resourcing available for certain things,
• 12:37
  and there's different interest in focusing on certain
• 12:40
  pieces.
• 12:41
  And so I would say a foundation of
• 12:44
  strength in terms of an understanding a clear
• 12:47
  understanding of strategic focus,
• 12:49
  but the ability to be flexible and pivot
• 12:52
  as needed to to achieve that focus. And
• 12:52
  I think for us,
• 13:02
  equity strategy. One is place based work. How
• 13:06
  are we able to
• 13:08
  look at a particular region or a particular
• 13:11
  population,
• 13:12
  understand what their
• 13:14
  what their assets are in that community, and
• 13:17
  then understand where the opportunities are, and then
• 13:20
  be able to come in as a plan
• 13:22
  and support
• 13:23
  to improve outcomes in that particular community. And
• 13:25
  that really requires
• 13:27
  being aligned to where the needs are in
• 13:29
  that community and responding.
• 13:31
  And so I think place based work is
• 13:33
  one thing that allows us to like hone
• 13:35
  in on a goal of improving outcomes, but
• 13:37
  be flexible about the path to get there.
• 13:40
  And then the second is really member experience
• 13:43
  and honing in on
• 13:46
  member experience being at the center of everything
• 13:48
  we do, because if we know that we're
• 13:51
  getting
• 13:52
  people engaged and they're having a good experience,
• 13:55
  their outcomes will improve.
• 13:57
  And so
• 13:58
  the other is keeping member experience at the
• 14:00
  center of everything we do and then being
• 14:02
  creative and flexible
• 14:04
  about how we
• 14:05
  influence that.
• 14:07
  And so,
• 14:08
  you know, we do have a clear overarching
• 14:10
  set of strategies, but I've had to be
• 14:12
  very flexible and pivot many times to be
• 14:15
  able to continue to drive the work forward,
• 14:18
  as the environment changes, as resourcing changes,
• 14:21
  and,
• 14:22
  and as our focus,
• 14:24
  continues to to move us forward.
• 14:28
  Wonderful. I some great advice for our audience
• 14:31
  and I think a great place to leave
• 14:33
  things. So, Doctor. Mittal, I wanna thank you
• 14:36
  for taking the time out of your day
• 14:37
  to sit down with us and and for
• 14:39
  sharing your insights with our listeners. We truly
• 14:41
  appreciate it.
• 14:42
  Thank you so much, Jacob, for the opportunity.
• 14:45
  If you'd like to listen to more podcasts
• 14:47
  from Becker's Healthcare, you can visit beckershospitalreview.com.