Latest / Becker’s Payer Issues Podcast / Supporting Families Beyond the NICU: How Harvard Pilgrim Is Extending Postnatal Care with Jake Biscoglio

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Supporting Families Beyond the NICU: How Harvard Pilgrim Is Extending Postnatal Care with Jake Biscoglio · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Jacob Emerson with the
• 0:02
  Becker's Pay Your Issues podcast. Thrilled today to
• 0:04
  be joined by Jake Pascaglio, who is the
• 0:07
  president of commercial business at Harvard Pilgrim Health
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  Care. Jake, thank you so much for taking
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  the time to be with me on the
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  podcast today.
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  Great to be with you, Jacob. Thank you.
• 0:16
  Yeah. Absolutely. And before we dive into everything
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  we wanna talk with you about, can you
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  tell us a little bit more about yourself,
• 0:21
  your background in health care, and what it
• 0:23
  is that you do today at Harvard Pilgrim?
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  Certainly.
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  Again, I'm Jacob Viscaglio. Currently serve as a
• 0:29
  president of commercial markets and specialty products for
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  Harvard Pilgrim Health Care, which is a subsidiary
• 0:37
  company of point thirty two Health. We're based
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  in Massachusetts
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  and serve
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  New England markets,
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  Massachusetts,
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  Maine, New Hampshire, and Rhode Island.
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  And through that and in my role, I'm
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  responsible for sales, sales operations, product strategy innovation,
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  strategic business development, and the overall financial performance
• 0:57
  of the commercial and specialty businesses.
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  I've been in health care the majority of
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  my career
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  with
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  other organizations
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  like Cigna, Anthem,
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  Blue Cross Blue Shield of Massachusetts. Been with
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  Irving Pilgrim Health Care for about seven months
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  now.
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  And,
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  I also have a stint in financial services
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  at Prudential Financial, and it's great to be
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  back in health care.
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  Fantastic. Well, we're glad to have you with
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  us. A long career in the industry,
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  Jake.
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  And we're and we're here specifically to talk
• 1:29
  with you a little bit about Harvard Pilgrim
• 1:31
  Health Care expanding its partnership with Progyny Health
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  to support your members for a full year
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  after NICU or special care nursery discharge. So
• 1:41
  let's dive into that a little bit because,
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  as you know, neonatal care, it's getting increasingly
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  complex
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  as the year goes on. Coverage of these
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  services is increasingly getting more complex. And and
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  the challenges,
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  that these families face after NICU discharge,
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  are daunting. So
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  how do you see programs like this, between
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  Harvard Pilgrim and Progyny Health shaping the future
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  of post acute care management and improving those
• 2:06
  long term outcomes for the families that you
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  serve?
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  It is complicated as you mentioned, and I
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  think you touched on a really important aspect
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  of this, which is the family aspect of
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  care. So certainly,
• 2:18
  the
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  the child, the newborn that's in receiving care
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  is the one who's receiving care, but really
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  it's impacting the family
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  across the board. So it's not only about
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  caring for the the infant,
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  but it's also really taking care of the
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  the family,
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  at large.
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  And I'll I'll share a little bit of
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  the perspective in terms of why we think
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  this expansion is so important, but I'll also
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  give my own, family story because it's, something
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  we've we experienced now. Yeah. It's been a
• 2:48
  while since my children are older, but, firsthand
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  experience
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  with,
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  twins,
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  that were
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  premature
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  and, spent some time in the NICU. So
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  for me and my family, it's very personal.
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  So what we're doing here is we're expanding
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  a program that we started,
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  with our great partner, Progyny.
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  Initially, we're sixty days after
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  birth,
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  to care for the newborn,
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  in the family.
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  I should say newborns or or more plural
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  there.
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  And,
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  really expanding that to the full year.
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  And just a little bit about the program
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  around Progyny. So their team includes board certified
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  physicians, nurses, social workers,
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  and to date, they've worked with more than
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  2,500
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  of our members.
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  And I think as most know,
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  there are specific life challenges that families face
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  following a NICU stay.
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  In addition to assistance with discharge planning, education,
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  screening for postpartum depression,
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  the Progyny Health team and their case managers
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  connect families to important resources they may
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  need,
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  things like transportation, healthy food, financial support for
• 3:58
  utilities and rent, and even help members find
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  access to free items they need
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  for their babies like cribs, car seats, diapers,
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  and baby formula. So certainly, the
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  the care in the hospital and the coordination
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  there,
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  for the newborn or newborns, the the mom,
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  the dad, etcetera,
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  but also really beyond that and the impacts
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  that,
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  someone, a family that's going through,
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  this is dealing within all aspects of what's
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  needed
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  to really
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  launch,
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  the the new family,
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  on a path, is really important. So as
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  I mentioned,
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  my wife and I are fortunate to have
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  a set of twins,
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  that spent time in the NICU and,
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  programs like this were not available to us
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  at that time. Fortunately, we had a great
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  support system of family members,
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  friends, great doctors, nurses, etcetera. But as I
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  reflect back on that time,
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  we were just
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  trying to survive day to day. We actually
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  had, a 20 old at the time, so
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  trying to juggle across all that,
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  and care for our newborns,
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  and just make sure we were on top
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  of everything.
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  Looking back, was a daunting challenge. So a
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  program like this, would have been something that
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  would have been very much appreciated,
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  for for my family at the time. So
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  that's why for me, it's personal and something
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  that I'm really proud that our organization
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  stands behind for our clients, for our members,
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  and making this more broadly available.
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  Certainly. So you really understand these issues firsthand,
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  these issues that are also facing your members.
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  In that vein, Jake, what are some of
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  the broader implications of expanding this kind of
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  care management from the sixty days to a
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  full year for neonatal cases?
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  And how do you think this shift, in
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  care strategy is reflecting the industry evolving the
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  industry's evolving approach towards more,
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  member centered health plans?
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  Yeah. Absolutely. It's, it's an important
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  aspect of
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  how we really want to surround our members
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  with
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  services that are going to be helpful
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  over time.
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  And it it just makes good sense to
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  support the the families
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  with a program like this.
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  Additionally, as we know, the first year of
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  an infant's life is crucial for their ongoing
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  health. No surprise there.
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  Then a NICU stay can further compound some
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  of the challenges that families face during
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  that baby's first year.
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  One of the things we saw in the
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  data is,
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  more than ninety percent of our Harvard Pilgrim
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  members who participate in the program have reported
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  high satisfaction.
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  We saw the opportunity to do even more
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  for this population.
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  And I'd love to share an example of
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  one of our members from New Hampshire,
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  was a mother of premature twins born at
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  33,
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  and
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  the daughters were in the NICU. They had
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  a toddler at home, sounds familiar,
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  and the the mom had just started a
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  new job and had no paid maternity time
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  off. So certainly a challenge there just to
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  start.
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  Add a complication
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  of
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  her grandmother passing away and that she had
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  contracted COVID and couldn't visit the twins in
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  a hospital for an extended period of time.
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  Progyny stepped in with gift cards to help
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  with travel expenses, connected the mom with resources,
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  helped manage the cost of formula to help
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  her fortify her breast milk due to the
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  twins' prematurity.
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  The Progyny team also worked closely with the
• 7:27
  hospital to clarify the twins milestones and provided
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  reassurances
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  to the mom and her husband when needed.
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  So the members are not just getting help
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  and support,
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  but advocacy.
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  And by expanding the program, we can assure
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  ensure that happens. Right? There is not a
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  timeframe of sixty days or ninety days.
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  Sometimes that's sufficient, but sometimes,
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  that first year is longer. So for us,
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  this isn't really a shift in strategy,
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  but rather it's an expansion of a program
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  that was
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  critically needed by this subset of our membership.
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  And for us, it was an easy decision
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  to expand the partnership to help our vulnerable
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  members and their families.
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  Absolutely. Well, that's a great real world example.
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  So appreciate you sharing that with us and
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  and some amazing satisfaction rates that you're you're
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  seeing through this.
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  Jake, we we hear from health plans,
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  all over the country about beyond Harvard Pilgrim
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  about,
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  NICU admissions and preterm births remaining a significant
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  concern for for their poll how they how
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  they cover things. And so I wonder if
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  you have advice for,
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  our our listeners in terms of, how to
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  integrate more comprehensive
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  maternity and infant care management
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  into into their health plans.
• 8:41
  Yeah. Absolutely. Let me start maybe with some
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  of the the data
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  in terms of what's happening industry wide around
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  the, you know, the specific need around
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  NICU admissions and the this topic that we've
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  been talking about. So the stats paint a
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  a pretty dire picture. In The United States,
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  we have one of the highest maternal mortality
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  rates in developed world and the rates are
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  on the rise.
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  According to the March of Dimes twenty twenty
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  four report card, preterm birth rate in The
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  US remains historically high at ten point four
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  percent
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  and NICU births require specialized attention to ensure
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  the best outcomes during an infant's first year.
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  And even a short stay in the NICU
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  can delay family bonding, impact breastfeeding adoption.
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  And once an infant is discharged from the
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  hospital, the risk of a readmission back to
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  the hospital is significant without case management support
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  for the infant and family. Additionally, perinatal depression,
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  which is a condition that can have devastating
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  consequences, affects up to one in seven women
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  in The US. And some studies suggest that
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  this number can be even higher.
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  So we've seen the first hand of positive
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  results
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  of this type of program with Progyny Health,
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  and the impact it has on babies and
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  the families, broadly.
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  So as it relates to other,
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  insurance
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  leaders that are thinking about these programs, I
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  really think about it in a couple of,
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  important manners. One is really understanding
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  the needs of
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  the
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  memberships
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  that a membership that is covered,
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  by the plans
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  and really understanding
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  with those needs, what's the best way to
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  deliver it,
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  that care, that coaching, that program, whatever the
• 10:22
  case may be,
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  in determining
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  what is the best approach to enable
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  that program
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  or the that those care pathways, etcetera.
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  And as we think about this, across all
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  aspects of our business, we really think about,
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  is this something that
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  we can do ourselves?
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  Is there a way to do it through
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  a partner relationship that has that specialized
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  expertise?
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  That's so critical.
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  And,
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  certainly with
• 10:52
  NICU,
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  we saw the opportunity to
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  work
• 10:56
  alongside Progyny Health, which is, you know, very
• 10:59
  focused across,
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  this dimension of enabling
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  support and care,
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  for the most vulnerable members. And, again, very,
• 11:07
  very pleased with the
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  results that we've delivered as our our members,
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  which is most important to us.
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  Certainly. And it's such a good call out
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  and a reminder for our listeners in terms
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  of the maternal and infant,
• 11:20
  issues and care that that the country still
• 11:22
  faces.
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  Before we go, Jake, what else are we
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  missing? Any final thoughts that you wanna share
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  with our listeners while you have the ears
• 11:30
  of a lot of health plan leaders,
• 11:32
  from all over the country right now? Yeah.
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  I appreciate the opportunity.
• 11:36
  Yeah. So first and foremost,
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  Progyny Health, as I mentioned, a significant impact
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  positively on our members, and we're very proud
• 11:43
  of this collaboration.
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  For us, this collaboration is not just a
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  one off program at Harvard Pilgrim Health Care.
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  We are always looking to sort support our
• 11:52
  members through their entire health care journey.
• 11:56
  Related,
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  obviously, is women's health, which is a large
• 11:59
  area of focus for us. We've
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  we had a number of partnerships with,
• 12:04
  organizations like Maven and Innovia Health that really
• 12:08
  helps us to provide women with 24 access
• 12:11
  to a variety of specialists,
• 12:13
  personalized resources,
• 12:14
  coaches,
• 12:16
  lactation experts, behavioral health experts, etcetera, etcetera,
• 12:19
  that really help us provide much needed information,
• 12:23
  access to providers, to the right providers,
• 12:26
  and care across the board,
• 12:29
  for
• 12:30
  our members,
• 12:32
  who are
• 12:33
  navigating
• 12:34
  challenging life transitions
• 12:36
  really end to end.
• 12:37
  Additionally, something that we're really proud of that
• 12:39
  connects in well here is
• 12:42
  a program that was launched, which we refer
• 12:45
  to as our behavioral health service navigation program.
• 12:48
  This program provides personalized one to one assistance
• 12:52
  that helps members find a behavioral health provider.
• 12:55
  And we know finding behavioral
• 12:57
  health providers, can be a challenge at times.
• 13:00
  Scheduling those appointments once you find
• 13:03
  that provider
• 13:04
  can be a challenge at times. So our
• 13:06
  navigators really take that burden off of the
• 13:09
  individual and work side by side with our
• 13:12
  members to
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  enable
• 13:15
  awareness,
• 13:16
  access to the right
• 13:18
  provider, and
• 13:19
  then scheduling,
• 13:20
  to make sure that they can get what
• 13:22
  they need. And then we follow-up to make
• 13:24
  sure they're satisfied with their care, and then
• 13:26
  we take those learnings and continue to iterate
• 13:28
  and improve upon our programs.
• 13:30
  Why that's really important,
• 13:32
  as we're talking about the topic of,
• 13:35
  NICU care,
• 13:36
  for for the birth mom, for the children,
• 13:39
  etcetera, is the connection certainly between,
• 13:42
  behavioral health needs,
• 13:44
  in this context,
• 13:46
  making sure that we're able to provide that
• 13:49
  access that's so important
• 13:51
  to remove any barriers,
• 13:52
  for for the moms and all the members,
• 13:55
  quite frankly, who are looking to access vital
• 13:57
  mental
• 13:59
  health services when they need them.
• 14:02
  Last thing I'll add is,
• 14:04
  women's health month will end soon.
• 14:07
  The yet the focus on the maternal health
• 14:09
  crisis needs our year round attention and action.
• 14:11
  And it's really my hope that we can
• 14:13
  work together, broadly across the system
• 14:16
  of health care to ensure every woman has
• 14:18
  the opportunity
• 14:19
  to experience a healthy pregnancy,
• 14:21
  safe delivery, and a thriving happy life with
• 14:24
  their baby or babies, for that matter. It's
• 14:27
  a really important topic, and we're very focused
• 14:29
  as I know many of,
• 14:31
  the other insurance leaders are as well.
• 14:34
  Absolutely. Well, I I think that's a great
• 14:36
  place to leave things. So, Jake, I wanna
• 14:38
  thank you for taking the time to sit
• 14:40
  down with us and for sharing
• 14:42
  about the impactful work going on under your
• 14:44
  leadership at Harvard Pilgrim. We really appreciate it.
• 14:48
  Thank you, Jake. Appreciate the opportunity to join
• 14:50
  you today.
• 14:51
  And to our listeners, if you'd like to
• 14:52
  listen to more podcasts from Becker's Healthcare, you
• 14:55
  can visit beckershospitalreview.com.