Latest / Becker’s Payer Issues Podcast / Dr. Rebekah Hughey, Medical Director at Highmark Wholecare

Transcript

Dr. Rebekah Hughey, Medical Director at Highmark Wholecare · Becker’s Payer Issues Podcast

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  Evernorth brings the power of wonder and relentless
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  innovation to create world class pharmacy, care, and
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  benefit solutions.
• 0:07
  Barriers to care can lead to gaps in
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  care, which can drive up the total cost
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  of care. Our capabilities work seamlessly together to
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  create innovative pharmacy care and benefit solutions for
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  today and tomorrow.
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  Our connected health services make the treatment, prediction,
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  and prevention of health care's most complex conditions
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  easier and more accessible as we drive organizations
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  and people forward.
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  This is Haley Recker with the Becker's Payer
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  Podcast, and we are recording live at the
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  Becker's third annual spring payer issues roundtable.
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  I am thrilled today to be joined by
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  doctor Rebecca Huie, medical director of Highmark Full
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  Care.
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  Doctor, thank you so much for joining us
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  today. Thank you for having me.
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  Alright. So before we get started, can I
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  just have you go ahead and introduce yourself
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  and share a little bit about your background?
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  Sure. I am doctor Rebecca Huey. I'm a
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  medical director with Highmark Whole Care. I've been
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  there for about five years.
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  I am an integrative family medicine physician by
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  background
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  and then have also worked, with multiple,
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  types of patients, including civilians
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  and military
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  inpatient and outpatient.
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  Oh, that's fascinating.
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  I'd like to start our conversation a little
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  bit off by talking about balancing affordability and
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  quality of care. So how is your organization
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  innovating to manage the cost of care while
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  maintaining or improving member outcomes?
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  So,
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  well, for me and and I always say
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  this. For leaders, the critical first step is
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  to see the health care journey
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  through the patient's eyes. So at Highmark Health,
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  we have a model called living health, and
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  Living Health is our strategy to redesign and
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  enhance the health care experience
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  by integrating insurance
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  and health care delivery. So we leverage the
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  technology we have
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  and
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  data analytics, and then we take that information
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  that we gain about member behavior to create
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  a system that is more proactive, is more
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  personalized,
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  and is more coordinated.
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  And so we're accomplishing this by basically removing
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  redundancies and making things more streamlined whenever we
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  can.
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  Living health aims to make interactions between members
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  and their care teams more productive, and that
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  makes things more timely.
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  It makes care
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  better and excuse me. Let me go back.
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  Yeah. So Living Health aims to make interactions
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  between members and their care teams more productive,
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  providing a timely and actionable information to improve
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  health outcomes and then ultimately make care more
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  affordable.
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  I'd like to pivot the conversation a little
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  bit more towards health equity now.
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  So can you share an overview of a
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  key initiative here that you're involved in or
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  particularly
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  excited about, and what are you hoping to
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  achieve?
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  Absolutely.
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  So health equity is fundamental to our mission
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  as an organization
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  at Highmark Healthcare. So we have several impactful
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  initiatives.
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  We're fighting food insecurity through community farmers markets.
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  We're distributing tens of thousands of pounds of
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  fresh produce annually. And there are a couple
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  of programs also that I want to highlight.
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  We're deeply invested in maternal health
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  through a couple of programs. One is called
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  mom matters,
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  and we have this is a special program
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  for pregnant women.
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  And we give education and support to moms
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  to help them navigate a healthy pregnancy.
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  We help them find a doctor, set up
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  their appointments.
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  They can call as soon as they find
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  out they're pregnant, and we can set them
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  up. And then we answer questions,
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  and we can direct them to community services.
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  And we arrange home visits by nurses.
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  We can provide transportation to appointments, and we
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  can even help them stop smoking, which is
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  very important for,
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  for great outcomes for their babies.
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  We also have what's called the pathway program.
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  And pathway is a comprehensive program, and this
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  supports pregnant women and new mothers managing substance
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  use disorder.
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  So it integrates
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  medical care, like medically assistant treatment for withdrawal,
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  but then also mental health counseling and social
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  services.
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  Again, transportation,
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  education.
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  We even help treat babies who are suffering
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  from neonatal abstinence syndrome
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  and any other postpartum care that the mom
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  or baby might need.
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  In addition, we support breast milk
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  banks and diaper banks and provide doulas.
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  So when very notably, just one last thing,
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  we've
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  scaled up
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  our training significantly so that we can help
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  members
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  reenroll
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  every year in Medicaid,
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  so that they keep their benefits and they're
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  not dropping benefits or losing their health care.
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  And so we're doing this by partnering with
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  pharmacies,
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  title one schools,
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  and also just through community events, letting people
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  know if
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  they have Medicaid that they do need to
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  continue to renew that in order to maintain
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  their services.
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  Well, that's so refreshing to hear, especially as
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  a woman. I feel like a lot of
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  women centered sources,
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  turn a blind eye to women's health care.
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  Definitely.
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  So so that kind of brings me to
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  my next question, which is about member satisfaction.
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  What experience or engagement strategies have proven effective
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  for your organization? How are you measuring success?
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  So overall, I will say, first of all,
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  that our our members tend to be very
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  satisfied.
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  We view member satisfaction
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  holistically.
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  So this is all encompassing experiences with the
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  health care plan and then also with providers.
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  So and we consistently score well on the
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  annual CAHPS surveys, which is consumer assessment of
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  health care providers and systems.
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  So we believe in continuous feedback and continuous
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  improvement,
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  and we're monitoring appeals and grievances.
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  We also conduct
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  immediate post call surveys in customer service so
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  we can know right away
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  if they had a good experience or a
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  bad experience, and then what about it was
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  good or bad.
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  And we're currently achieving a 4.9
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  out of five
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  satisfaction score. So that's excellent.
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  And we use these post appointment surveys for
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  provider feedback,
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  and we actively, again, strive to improve our
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  process.
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  And this is really, really important. We prioritize
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  this feedback because we found that a positive
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  member experience strongly correlates, of course, with better
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  health outcomes because they're more willing to engage
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  with us on a regular basis
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  when they know that they're gonna have a
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  pleasant, productive, and rewarding experience.
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  Absolutely. And just to wrap up our conversation
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  today, what do you see as the biggest
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  opportunity for payers to lead the charge in
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  transforming care delivery and driving better outcomes for
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  all stakeholders?
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  Well, so this is gonna resonate with a
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  lot of people, but everything seems so complicated
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  right now. Things are changing daily, and then
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  we're inundated with constant messaging from a ton
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  of different places.
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  Sometimes it's hard to tell signal from noise
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  just because of all the information we have,
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  and it's often conflicting.
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  Keeping that in mind, I believe the biggest
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  opportunity for us as a plan lies in
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  simplifying the health care experience for everyone.
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  So payers can lead by making benefits crystal
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  clear and easy to navigate,
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  and technology has been our friend in this
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  endeavor. So technology is a major lever here.
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  We can expand access through telehealth,
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  online programs, and then also using tools like
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  a like AI to stream
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  the processes.
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  I'm gonna mention again,
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  coming back to our living health model, which
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  is built on this principle of integration
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  and simplification.
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  So, again, for leaders, the critical first step
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  is to truly see the health care journey
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  through the patient's eyes and then understanding their
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  challenges and their needs. And this is essential
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  to building a simpler, more effective, and patient
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  centered system.
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  Well, doctor Huie, thank you so much for
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  joining me today. That was an amazing conversation.
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  Again, we are live at the Becker's third
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  annual spring payer issues roundtable.