Latest / Becker’s Payer Issues Podcast / Krischa Winright, President of Medicare Advantage at Blue Cross Blue Shield of Michigan

Transcript

Krischa Winright, President of Medicare Advantage at Blue Cross Blue Shield of Michigan · Becker’s Payer Issues Podcast

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  This is Gracelyn Keller with the Becker's Health
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  Care podcast, and we are live at the
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  2024
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  payer issues roundtable.
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  I'm currently joined by Krisha Winwright, who is
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  the president of Medicare Advantage at Blue Cross
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  Blue Shield of Michigan. So, Krisha, thanks for
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  being here. We'd love to have you start
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  off by introducing yourself and explaining a little
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  bit more about your role. Thanks for having
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  me, Grace. It's so good to be here
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  and all the excitement. It's,
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  energetic just to walk through this this event.
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  Thanks for having me. As you mentioned, I'm
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  the president of Medicare Advantage for Blue Cross
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  Blue Shield of Michigan, and we are the
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  7th largest payer in the nation for Medicare
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  Advantage.
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  And we cover Michigan, several states that we
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  have partnerships with other Blues plans to really
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  drive performance in Medicare Advantage. So that's my
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  that's my role within the Blue System. I've
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  been in health care for
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  many, many years working in a variety of
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  roles across the health care continuum,
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  and this is a really great spot to
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  see the action in Medicare Advantage these days.
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  So glad to be here.
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  Wonderful. Well, thank you for taking the time.
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  And let's start our conversation today around growth
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  goals. So from improving member experience
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  and expanding value based care to controlling costs,
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  payer executives do have ambitious growth goals for
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  the rest of this year as well as
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  we're 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? You know, it's interesting that you mentioned
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  the focus on growth. We know that the
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  Medicare Advantage market is growing, and it's growing
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  nationally.
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  Millions of Medicare Advantage members will come into
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  the pipeline in the coming decades, and
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  that is,
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  causing a a market reality right now in
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  Medicare Advantage and a market shift overall. And
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  so it's interesting when you mentioned that payers
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  have high growth goals. I would probably rephrase
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  that a little bit that we are facing
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  growth,
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  but it's also a moment when Medicare Advantage
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  is going through an inflection point. And so
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  what we're doing right now and what is
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  top of mind is how do we create
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  a sustainable
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  solution for Medicare Advantage and for seniors that
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  is really true to our mission, that doubles
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  down on that which we care a lot
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  about, which is access to excellent quality affordable
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  health care for seniors and do that in
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  a way that
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  is taking advantage of the market context, understand
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  the market context, but really being true to
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  who we are. I imagine that payers nationally
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  are doing that right now. It is, a
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  market shift that's happening.
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  Increased utilization
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  coming out post pandemic is causing pressure on
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  payers nationally
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  that is well above anything that we would
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  have imagined pre COVID nor seen.
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  And at the same time, the,
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  CMS program is contracting funding to cope with
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  the increased surge of Medicare Advantage lives, and
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  that's causing quite a moment for Medicare Advantage.
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  And so as we look ahead to positive
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  growth, we also wanna do that in a
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  way that's sustainable,
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  that we can be counted on by seniors
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  to continue to serve them in the manner
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  that we have for many, many years. And
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  so it's a very exciting time for sure.
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  Absolutely. Well, thank you for those insights. And
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  kind of going off of that in the
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  industry level, how would you describe the biggest
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  barriers to effectively
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  serving and engaging members? And what opportunities do
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  you see for large scale improvements, and how
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  are these being applied to your current strategies?
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  It's so interesting that you asked me that
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  question on today of all days, which is
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  election day nationally.
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  And I would,
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  hearken to that when I think about seniors
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  that are navigating the health care environment. It
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  is an incredibly noisy environment. Much like our
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  election day and leading up to it, just
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  even cutting through the noise has been very
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  difficult. And we know that that's happening nationally
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  just as a result of this event today
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  with voting day being so critically important to
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  our nation today. Well, very similarly,
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  it's tough to cut through the noise for
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  seniors. And,
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  seniors are telling us that they want more
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  alignment. They want easier selection.
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  They have a lot of choices to make
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  in the market, and sometimes they're not fun
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  to make. They're hard to navigate.
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  The
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  health care landscape
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  continues to be complex
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  due to lots of factors, but innovation is
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  happening in the market. And that causes even
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  more fantastic solutions for health care. It's also
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  more confusing at times for seniors. And so
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  one of the things that we're doing to
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  get through those barriers of noise and concern
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  and, confusion
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  is to really get aligned with providers. We
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  have fantastic
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  partnerships with providers in our market.
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  And, that's true of Blue Cross companies nationally.
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  Health care is very, very local, and the
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  partnerships that we build with providers tend to
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  be critically important. They're important more than ever
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  now.
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  The seniors that we talk to want us
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  to be on the same page with their
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  provider. They don't want confusion. They don't want
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  different answers. They want alignment, and that's what
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  we're working very, very hard to do. We
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  have enjoyed
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  success in partnering with providers. Our blueprint for
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  affordability program is among the leading in the
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  nation where we are coming alongside
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  providers in our market, partnering together to make
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  things better, more affordable, sustainable
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  for everyone in the market, including seniors. And
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  we're so proud of that work. Over 22
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  physician organizations
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  have joined us in that quest.
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  And, so I would say that that's probably
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  the number one thing that we're doing right
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  now to overcome those barriers with consumers is
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  doubling down on our partnership with providers.
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  Absolutely.
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  And shifting our conversation
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  toward digital innovation,
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  what role is technology currently playing in your
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  organization's growth strategies?
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  And can you share any specific examples with
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  us? Sure can. The Medicare Advantage market
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  ends up serving members with a lot of
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  complex chronic disease, and that's the cause of,
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  as we mentioned, not only,
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  a lot of care being delivered in that
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  market, confusion, but also,
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  is fraught with
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  opportunities and challenges. Technology
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  helps us get precise in how we work
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  with seniors.
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  It also helps us get more precise in
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  how we work with providers so that we're
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  working in the context of someone's illness burden
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  and their unique situation.
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  It's not just about the the clinical challenges
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  that you have. It's about your social
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  environment, your context in which you journey through
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  that. And health care is so much more
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  than what we've given it, credit for in
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  the past, and we wanna do a really
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  good job and get more precise as we're
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  journeying with seniors in context.
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  Technology,
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  especially
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  artificial intelligence, generative AI, new solutions that are
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  hitting the market are table stakes to be
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  able to provide that type of care precision
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  and, be able to be there for members
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  in new ways and in new more meaningful
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  ways that are tailored specifically to where they're
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  at, meeting them where they're at. As it
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  turns out, the CMS program for Medicare Advantage
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  also rewards our doing that on a member
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  by member basis. It's very unique
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  in that way. And so it's a really
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  good fit. Technology innovation and contemporary technology that's
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  in market right now allows you to do
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  exactly what we need to do right now,
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  which is get more precise for members, align
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  better with the CMS Medicare Advantage Program, and
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  that's what we're doing.
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  And how is technology supporting value based care
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  or member focused initiatives at your organization, and
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  what is most exciting to you here?
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  I think the most exciting thing is the
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  conversations that we're able to have with providers
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  to
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  understand that we're really after many of the
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  same things, but we have different sources of
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  information.
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  Providers are working at the point of care,
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  and the insurer and the payer is seeing
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  the longitudinal care across every
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  provider and facility that that member might be
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  seeing. They they see all of the,
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  pharmaceuticals, the drugs that they might they might
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  be on and take. And we also see
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  the benefits
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  in the environment that the senior is working
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  in with their products. And so those perspectives
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  are very helpful when they're working together. And
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  so the most exciting work that we're doing
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  right now is in partnership again with providers
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  to see the whole person
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  and to be able to participate in that
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  positive conversation
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  with providers to make sure that we're moving
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  the ball down the field and that we're
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  getting where the senior wants to go and
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  helping them live their very best life.
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  And shifting toward quality, in an ever
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  evolving regulatory environment, what tools or key strategies
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  have helped your organization improve quality and clinical
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  outcomes for members while staying compliant?
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  Embrace the reality
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  of the program
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  and
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  look at the intent
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  of the regulatory
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  guidance
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  and still stay true to the mission that
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  your organization
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  is,
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  attempting to implement.
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  For us,
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  we want to be senior centric, and we
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  will always be senior centric. We're gonna be
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  local. We're gonna be, pro provider. Those things
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  are unchanged. They work very well in their
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  changing regulatory environment. But there are challenges.
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  Changing regulatory makes you more, need to be
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  more nimble. It makes you need to,
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  operate in a way that's very responsive. That's
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  been hard for health care organizations to do,
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  and we're continuing to chase that as well.
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  How do you get to be a more
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  responsive, nimble organization? We're working really hard at
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  that, making some fantastic strides in doing that.
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  And so I would say it's those few
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  handful of things. It's making sure that you're
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  embracing the intent, you are committed to be
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  compliant, but you're also on mission. And that
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  drives you to do incredibly inspiring things on
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  behalf of the members that you serve.
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  Absolutely. Well, Krisha, before we wrap up here,
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  are there any parting words you'd like to
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  share on the podcast today?
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  I'm just, inspired to be a part of
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  the conversation right now. The market in health
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  care is very, very,
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  challenging. But with that challenge also comes opportunity.
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  And, Blue Cross Blue Shield of Michigan is
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  a part of that right now, and we
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  couldn't be more thrilled
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  to be, creating solutions for members that we
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  believe are gonna last for a very, very
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  long time. And so I would just leave
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  the the,
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  the listeners with that. Be true to your
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  mission, double down on it, and be excited
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  about the impact that we can have in
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  this moment.
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  Wonderful. Well, thank you so much for taking
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  the time to be here today and join
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  me on the Becker's Healthcare podcast. Again, we
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  are live at the 2024 payer issues roundtable.