Latest / Becker’s Payer Issues Podcast / Paige Brogan, Principal CalAIM at Blue Shield of California

Transcript

Paige Brogan, Principal CalAIM at Blue Shield of California · Becker’s Payer Issues Podcast

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  Evernorth brings the power of wonder and relentless
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  providing clinical care and support services that provide
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  whole person care, we improve health equity,
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  access, 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're recording live at the 2024
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  fall payer issues roundtable.
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  I'm joined right now by Paige Brogan,
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  who is the principal CalAIM at Blue Shield
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  of California.
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  Paige, thanks for being here. We'd love to
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  have you briefly introduce yourself as we get
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  started.
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  Thank you, Grace.
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  Again, my name is Paige Brogan, and I
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  am from the Blue Shield California Promise Health
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  Plan, where I am responsible for implementing
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  our medical transformation work, which is really what
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  CalAIM, California Innovating and Advancing Medical is really
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  all about. It's a program designed to fundamentally
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  address the whole person needs of our medical
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  population,
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  as well as to streamline
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  the
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  bureaucratic process for payers, for providers, for community
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  based organizations,
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  and, ultimately the community.
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  Wonderful. Well, thanks for being here and let's
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  start our conversation with growth goals. So from
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  improving member experience and expanding value based care
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  to controlling costs, payer executives have ambitious growth
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  goals for the rest of this year and
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  looking ahead into 2025.
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  So in your role, what is your top
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  priority right now and how are you planning
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  to get there?
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  So it's interesting because when we think about
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  value based models from a Medi Cal perspective,
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  we really for us, this is something that's
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  so critical because we really wanna make sure
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  that our most vulnerable members are really getting
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  care that is based on value.
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  And I think for us, it's really
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  better engagement with our providers,
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  ensuring that they really understand what value based
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  models of payment look like, and really making
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  sure that we are aligned both from a
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  provider perspective
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  and a payer perspective,
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  what that means for both of us and
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  what it ultimately means for our members.
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  I think we will continue to
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  grow, and I think our contracting teams will
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  continue to evolve
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  as they work with our providers
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  to
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  really encompass a true value based model. But
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  we're not there yet. I think we're getting
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  there. And I'm excited to see kinda where
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  that takes us into 2025 and beyond.
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  Wonderful. And going off of that at an
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  industry level, how would you describe the biggest
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  barriers to effectively serving and engaging members? And
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  what opportunities do you see for larger scale
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  improvements? And then how are you applying all
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  of that to your strategy?
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  Well, Medi Cal traditionally has been a very
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  difficult population to engage. Part of it is
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  knowledge, just understanding that these benefits exist for
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  this vulnerable population.
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  And then another piece piece of it is
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  once they are enrolled in the program, making
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  sure that they're aware of the wide array
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  of benefits that are available to them. Medi
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  Cal is not just strictly clinical services. It
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  encompasses things like medically tailed meals,
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  housing
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  supports,
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  community supports, such as substance use
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  disorder support, behavioral health.
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  And I think that
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  at Blue Shield Promise,
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  we really are a leader and an innovator
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  in connecting with our communities.
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  And I think that's our strength in member
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  engagement, member retention,
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  and also member utilization because we are there
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  in the communities.
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  We are engaged with our members, and we're
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  helping them to understand
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  the wide array of opportunities that they have
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  to improve the health of them, their families.
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  And then beyond that, acting as peer advocates
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  for other Medi Cal members. You know, I
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  think about one of the sessions that I
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  heard at this year's conference
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  around substance use disorder. And one of the
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  things that the moderator brought up was how
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  powerful it is to have a peer who's
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  been through and has lived experience.
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  And that person can then act as a
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  conduit
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  to assist other members within the community that
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  are part of the Medi Cal population
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  to really inform
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  and create a successful recovery
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  outcome.
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  And shifting gears just slightly toward leadership,
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  keeping pace in today's health care
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  landscape is challenging. So what is a piece
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  of advice you'd share with peer leaders to
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  grow their businesses while keeping members top of
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  mind?
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  Well,
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  I don't like to think of Medi Cal
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  as a business. I like to think about
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  it as a program that's really designed to
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  capture the needs
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  and provide support and services for
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  our most vulnerable members.
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  I think from a provider perspective,
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  if you're thinking about growing your business, you
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  really need to think about how you're collaborating
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  with plans
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  to really prove and show that what you're
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  offering is both congruent with the needs of
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  the population,
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  but also
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  very respectful
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  of health equity outcomes, very respectful of consideration
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  of how they're thinking about health equity in
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  their delivery of their practice.
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  I think that is so important. I health
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  equity is not a buzzword that's gonna go
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  away. It is critical to how we think
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  about it and how we serve our members,
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  thinking about social determinants of health, and really
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  thinking about how are they utilizing
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  data,
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  both the ingestion of data and then the
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  sharing of data. I think that for any
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  provider, that is really key to success in
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  the health care landscape.
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  And as we round our conversation out here
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  today, are there any parting words you'd like
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  to share on the podcast?
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  I would like to say thank you for
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  this opportunity, not just to talk to you
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  for a bit, Grace, but also for the
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  opportunity
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  to speak to some incredibly
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  intelligent, well informed, and passionate leaders in health
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  care. I think Becker's is just a wonderful
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  forum for innovation, for conversation,
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  and to build ideas that we can use
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  moving going forward.
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  Wonderful. Well, Paige, thanks for joining me today
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  on the Becker's health Care Podcast. Again, we're
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  live at the fall 2024
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  payer issues round table.