Latest / Becker’s Payer Issues Podcast / Erin Henderson Moore, President and CEO of Fidelis Care

Transcript

Erin Henderson Moore, President and CEO of Fidelis Care · Becker’s Payer Issues Podcast

• 0:00
  Evernorth brings the power of wonder and relentless
• 0:02
  innovation to create world class pharmacy care and
• 0:05
  benefit solutions. Our connected health services make the
• 0:09
  treatment, prediction, and prevention of health care's most
• 0:12
  complex conditions
• 0:13
  easier and more accessible as we drive organizations
• 0:16
  and people forward. Ever North Home Based Care
• 0:19
  provides value based care that helps patients with
• 0:22
  multiple chronic conditions
• 0:23
  and social determinant of health barriers get the
• 0:26
  care they need and the personalized experience they
• 0:28
  deserve. We serve patients who struggle to navigate
• 0:31
  the health care system by bringing high quality
• 0:34
  primary
• 0:35
  and preventative care services to the home. By
• 0:37
  providing clinical care and support services that provide
• 0:40
  whole person care, we improve health equity, access,
• 0:44
  and outcomes for the populations we serve.
• 0:47
  Hello, and welcome to the Becker's Healthcare podcast.
• 0:50
  I'm joined today by Erin Henderson Moore, president
• 0:52
  and CEO of Fidelis Care. Erin, welcome to
• 0:55
  the show. And, can you please tell us
• 0:56
  a little bit about your background and what
• 0:58
  your role at your organization is? Yeah. Hey,
• 1:00
  everyone.
• 1:01
  Like he said, my name is Erin Henderson
• 1:03
  Moore, and I'm the president and CEO of
• 1:05
  Fidelis Care New Jersey.
• 1:07
  We serve a 150,000
• 1:09
  people across the state of New Jersey. That
• 1:11
  includes our Medicaid business, our Medicare business, and
• 1:13
  our marketplace business.
• 1:15
  And it is a wholly owned subsidiary of
• 1:17
  Centene Corporation.
• 1:19
  What's exciting about Centene Corporation and Fidelis Care
• 1:21
  is that we serve 1 in 15 individuals
• 1:23
  across the United States through our government services
• 1:26
  platform.
• 1:28
  From improving member experience and expanding value based
• 1:31
  care to controlling costs,
• 1:33
  Executives in the payer space have ambitious growth
• 1:35
  goals for the rest of the year and
• 1:36
  in next year.
• 1:38
  As president and CEO, what is your top
• 1:40
  priority,
• 1:41
  and, how are you planning to get there?
• 1:43
  Yes. I have 5 priorities that I'm really
• 1:45
  focused on. One of my top priorities is
• 1:47
  definitely growth.
• 1:49
  Besides growth, one of my top other priorities
• 1:52
  really focus on our external reputation,
• 1:55
  quality, and member experience.
• 1:57
  The reason these are really important is that
• 1:59
  without all of those, you're not gonna grow
• 2:00
  in a way that is meaningful and that
• 2:03
  drives down disparities and really focuses on health
• 2:06
  equity. So, you know,
• 2:08
  one of those things that we're seeing coming
• 2:10
  out of the pandemic is that people are
• 2:11
  sicker and that they are using health care
• 2:14
  services at a much higher rate. And so
• 2:17
  really focusing on making sure that we can
• 2:19
  do all that we can to connect people
• 2:21
  with both health care, but also social care
• 2:24
  to meet their needs.
• 2:25
  At the industry level, what would you say
• 2:27
  are the biggest barriers to effectively serving and
• 2:30
  engaging members?
• 2:31
  And what opportunities are there for large scale
• 2:34
  improvements? And and what are you doing in
• 2:36
  your organization to address these with your current
• 2:38
  strategies?
• 2:39
  Well, one is really the rates and understanding
• 2:42
  about how that we think about health care
• 2:44
  curve services in the Medicaid space. So what
• 2:46
  we're seeing in that is coming out of
• 2:47
  the pandemic
• 2:48
  that members are sicker. And so that we
• 2:51
  there's really working with our state partners to
• 2:53
  figure out how do you really pay us
• 2:55
  appropriately so that we can care for those
• 2:57
  people. So that's just an ongoing
• 2:59
  learning curve that we're really talking about. This
• 3:01
  is a never seen before situation that we're
• 3:03
  really looking at. So that's one. The second
• 3:05
  is really how do we think about doing
• 3:07
  more with less so that we can be
• 3:09
  more community oriented
• 3:11
  to continue to focus on how do we
• 3:13
  reach members where they are
• 3:15
  to drive health care literacy and to drive
• 3:17
  engagement with the health care system in a
• 3:19
  different way because traditional ways are not working.
• 3:22
  And so, you know, you'll see that across
• 3:24
  the industry are really how do we partner
• 3:25
  and work as a convener to drive,
• 3:28
  systemic change.
• 3:30
  So, you know, technology in the healthcare space
• 3:32
  is rapidly evolving.
• 3:34
  How is it kind of currently playing a
• 3:36
  role in your organization's growth strategies? And do
• 3:38
  you have any examples you can share?
• 3:40
  Yeah. One of the things that we're really
• 3:42
  proud of is leveraging AI in a different
• 3:44
  way to give us more information about our
• 3:46
  members. Because you know, one of the things
• 3:48
  that managed care organizations have are we have
• 3:51
  a lot of data. We don't always know
• 3:53
  how to what to do with all that
• 3:54
  data and how do we use that to
• 3:56
  help predict and help support our members across
• 3:58
  their journey.
• 4:00
  So, you know, we use we're leveraging AI
• 4:02
  as a tool in our toolbox to really
• 4:04
  spur and help growth. But, also, do we
• 4:06
  have the right providers in our network? Do
• 4:08
  we have the right point solutions?
• 4:10
  Are we thinking about, you know, making sure
• 4:12
  that all of the interactions with our health
• 4:15
  plan
• 4:17
  are appropriate and are used in the most
• 4:20
  efficient and effective way possible. So we're really
• 4:22
  excited about that. Typically, you know, AI has
• 4:25
  been a scary thing of, like, how do
• 4:27
  we prevent people? But we just think it's
• 4:29
  a really interesting way in our toolbox
• 4:32
  to drive innovation at the local level.
• 4:34
  One of the things I I am hearing
• 4:36
  pretty frequently is how excited people are about
• 4:39
  all the new technologies out there. Mhmm. Is
• 4:41
  there anything that really jumps out to you
• 4:42
  that you're particularly excited about when it comes
• 4:44
  to technology and how it can improve, your
• 4:47
  your member's experience?
• 4:49
  Yeah. I mean, I would say, again,
• 4:51
  I will techno there's a lot of them
• 4:52
  out there. And so I I lump them
• 4:55
  as, like, yes, technology is
• 4:57
  exciting, and it is a solution for some
• 5:00
  but not for all. I think health care
• 5:02
  is so local,
• 5:04
  and and I really think it's member to
• 5:05
  member, kind of like voting. Right? You gotta
• 5:07
  knock on doors and get people out and
• 5:10
  engage and talk to them in the community
• 5:12
  and leverage community health workers. So, yeah,
• 5:15
  I am excited about a lot of the
• 5:17
  point solutions that we're evaluating. And when I
• 5:19
  mean that, it's all the different vendors out
• 5:21
  there. But what I'm most excited about is
• 5:22
  how do we, as a healthcare organization,
• 5:25
  really tie all those together to really focus
• 5:27
  on member experience.
• 5:29
  I love that. I love that. And with
• 5:31
  your experience,
• 5:32
  you know, especially with as rapidly as the
• 5:35
  health care landscape is changing,
• 5:37
  what would you say are your, you know,
• 5:38
  maybe top one or two pieces of advice
• 5:40
  for other other leaders in the health care
• 5:42
  space?
• 5:44
  Yeah. That's a really good question. The first
• 5:46
  one is do not forget the member.
• 5:49
  You know, a lot of times we can
• 5:51
  focus on profits. We can focus on point
• 5:53
  solutions. We can focus on digital. There's a
• 5:56
  lot of there's a lot of things that
• 5:57
  we can focus on in the shiny things.
• 5:59
  But the end of the day, it's a
• 6:00
  person centered business. And so that when we
• 6:03
  move away from that, we've lost sight of
• 6:05
  really our most important customer.
• 6:08
  So one of the things that we do
• 6:09
  in in meetings and in town halls and
• 6:12
  different things in our local organization is we
• 6:14
  always start with a member story.
• 6:15
  We spend a lot of time tracing how
• 6:18
  the member journeys through our internal health plan
• 6:20
  and where that we can change operations to
• 6:22
  focus back to the member.
• 6:24
  And then the bells and whistles are just
• 6:26
  an an addition. You know, again, a tool
• 6:28
  in our toolbox with something shiny, and they
• 6:31
  add to the member experience. But sometimes it's
• 6:33
  just, does your call center work? Mhmm. Can
• 6:35
  are we speaking our does our team speak
• 6:37
  in the correct languages? Those simple things like
• 6:39
  that.
• 6:40
  So that that's one of the things that
• 6:42
  I've been really focused on and really changing
• 6:44
  my mindset and and encouraging my team to
• 6:47
  do the same to make sure that we
• 6:48
  have that we're grounded in the member experience.
• 6:51
  I really like that that that focus on
• 6:53
  the people as opposed to that overreliance on
• 6:55
  technology. I think I think that's important.
• 6:59
  Erica, I really appreciate you joining us today.
• 7:01
  But before I let you go, do you
• 7:02
  have any final thoughts you'd like to leave
• 7:03
  with our listeners?
• 7:04
  Yes. I would say that this is a
• 7:06
  really exciting time to be in health care
• 7:08
  and especially in government sponsored health care. I
• 7:10
  would encourage everybody to not forget that Medicaid
• 7:13
  is,
• 7:14
  you know, pays for more births across this
• 7:16
  country than any other payer. And that one
• 7:19
  in you know, more than 1 in 15
• 7:21
  individuals are on Medicaid. And that this is
• 7:24
  really the backbone
• 7:25
  of really a healthy society and a society
• 7:28
  that we really wanna can see continue to
• 7:30
  do transformative
• 7:32
  things across the country. So I would say
• 7:34
  that stay tuned. This is a super exciting
• 7:36
  time, and I'm excited to see how it
• 7:38
  continues to evolve. Right. Thank you again for
• 7:40
  joining us today on the Becker Self Care
• 7:41
  Podcast, and you have a lovely rest of
• 7:43
  your day. Thank you. My pleasure.