Latest / Becker’s Payer Issues Podcast / Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health

Transcript

Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health · 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.
• 0:07
  Barriers to care can lead to gaps in
• 0:08
  care, which can drive up the total cost
• 0:10
  of care. Our capabilities work seamlessly together to
• 0:13
  create innovative pharmacy care and benefit solutions for
• 0:17
  today and tomorrow.
• 0:18
  Our connected health services make the treatment, prediction,
• 0:21
  and prevention of health care's most complex conditions
• 0:24
  easier and more accessible as we drive organizations
• 0:27
  and people forward.
• 0:29
  This is Haley Recker with the Becker's Payer
• 0:31
  Podcast, and we are recording live at the
• 0:33
  Becker's third annual spring payer issues roundtable.
• 0:36
  I am thrilled today to be joined by
• 0:37
  Don Maroney, president of Alignment Health and CEO
• 0:40
  of Alignment Health Plan.
• 0:42
  Dawn, thank you so much for joining me
• 0:44
  today. Can you go ahead and share a
• 0:46
  little bit about yourself and your background before
• 0:47
  we get started? Absolutely.
• 0:49
  Well, I've been with Alignment
• 0:51
  for about
• 0:53
  eleven years. Actually, it's eleven years going on
• 0:55
  in May, so very excited about that.
• 0:58
  Thank you.
• 0:59
  And,
• 1:00
  I have been
• 1:01
  representing or working with Medicare
• 1:05
  beneficiaries,
• 1:06
  seniors, individuals who are typically
• 1:08
  65
• 1:09
  and or disabled
• 1:11
  for about a little bit over thirty plus
• 1:13
  years.
• 1:14
  I always had the,
• 1:17
  dream to just work with seniors as grandparents
• 1:19
  because I had grandparents that died at a
• 1:21
  very, young age, or I was young age,
• 1:23
  and they died at a young age as
• 1:25
  well.
• 1:26
  And, it just was an opportunity to take
• 1:28
  on a job,
• 1:29
  over thirty years ago to just work with
• 1:31
  seniors, and it's been that ever since. So
• 1:34
  it's the only space I've been in. Well,
• 1:36
  that's such a great story. I love to
• 1:37
  hear that.
• 1:39
  Alright. To kick things off, I wanna talk
• 1:40
  about affordability
• 1:42
  and quality of care, which is a constant
• 1:45
  challenge for health plans. So how is your
• 1:47
  organization innovating to manage the cost of care
• 1:49
  while maintaining
• 1:50
  or improving member outcomes?
• 1:52
  Well, I think for affordability for all of
• 1:54
  us, right, has been, when it comes to
• 1:56
  health care, it just continues to rise. Medical
• 1:58
  expenses rise as well as,
• 2:00
  whether it's under the core
• 2:03
  catastrophic tech coverage or preventative coverage as well
• 2:06
  as a pharmacy cost.
• 2:09
  And our organization for quite some time,
• 2:12
  a lot of us started are working at
• 2:14
  another organization where we had to do a
• 2:16
  lot of
• 2:17
  hands on touch. And then in this digital
• 2:20
  age,
• 2:21
  we started in the very beginning with working
• 2:23
  with, our
• 2:26
  technology platform and how do you get to
• 2:28
  individuals
• 2:29
  sooner,
• 2:30
  quicker, faster, in real time from the standpoint
• 2:34
  of when they're taking prescriptions, how do you
• 2:36
  connect into data or into hospital systems,
• 2:40
  doctor's offices,
• 2:41
  and or directly with seniors? And we started,
• 2:44
  that
• 2:45
  actually literally
• 2:46
  when I started eleven years ago,
• 2:49
  and it's been growing ever since. So when
• 2:51
  we hear about AI today, you know, everybody
• 2:54
  talks about AI in different fashions. We're not
• 2:56
  in the robotic phase of AI for our
• 2:58
  company, but we do a lot of the
• 3:00
  machine learning as well as,
• 3:03
  many other aspects of AI,
• 3:05
  to
• 3:07
  prioritize
• 3:08
  seniors when it comes to the quality as
• 3:10
  well as the
• 3:12
  health care that's needed sooner than later.
• 3:14
  And we have the ability to predict things
• 3:17
  that may happen prior to them even knowing.
• 3:20
  Some cases, it's just quite as simple as
• 3:22
  they're taking their prescription drugs and mixing those
• 3:25
  drugs the wrong way or having occurrences where
• 3:28
  they land in an ER or in a
• 3:30
  hospital multiple times within a year.
• 3:33
  So we put clinical programs around that, and
• 3:36
  we've been doing that for quite some time.
• 3:37
  And it's been quite effective,
• 3:40
  from the standpoint of
• 3:41
  when you look at Medicare today, the average,
• 3:46
  admit per thousand is sitting at 220
• 3:49
  plus,
• 3:49
  and we're running about one fifty one for
• 3:52
  our organization. That means we're keeping seniors out
• 3:55
  of the hospital,
• 3:56
  which is probably the largest one of the
• 3:58
  largest areas of expense.
• 4:00
  There's also the preservice, but the postservice, when
• 4:02
  you get into a hospital,
• 4:04
  you're talking about hospitals in many of our
• 4:05
  markets that are 20,000
• 4:07
  plus per day.
• 4:09
  So how do you keep people out and
• 4:11
  or make sure that you're proactive in that
• 4:13
  approach? So it's what we push heavily on.
• 4:16
  Would you say that that integration of AI
• 4:18
  has improved member experience greatly?
• 4:21
  It has.
• 4:22
  We started it, and I call it AI
• 4:24
  assist because you I believe that in health
• 4:27
  care, it still requires a human touch, you
• 4:30
  know, a caring
• 4:31
  touch, especially with our audience.
• 4:34
  But it has been
• 4:36
  I don't think we've even seen how great
• 4:38
  the possibilities
• 4:39
  are in in this area,
• 4:42
  but we've been doing this for quite some
• 4:43
  time. And so it's helped us greatly by
• 4:45
  not having to have thousands of physicians to
• 4:47
  address the hundreds of thousands of popular seniors
• 4:50
  that we serve, but it,
• 4:52
  I think it's gonna even grow bigger. Yeah.
• 4:55
  I kinda wanna pivot the conversation just a
• 4:57
  little bit to health equity, which has become
• 4:59
  a critical focus for many health plans. Can
• 5:02
  you share an overview of a key initiative
• 5:03
  here that you're involved in or particularly excited
• 5:05
  about, and what are you hoping to achieve?
• 5:08
  Absolutely.
• 5:09
  I I think the biggest when I think
• 5:11
  of health equity, I think of so many
• 5:12
  different variations of health equity. But I look
• 5:15
  at
• 5:16
  individuals starting with income and then diversity, but
• 5:19
  primarily when I think of people that are
• 5:22
  less fortunate than,
• 5:24
  many individuals out there, like people that are
• 5:26
  the the most frail, the most I say
• 5:29
  poor, and I'm trying to think of another
• 5:30
  word, but low income beneficiaries or people that
• 5:33
  are sitting with Medicare and Medicaid.
• 5:35
  We've put that task force,
• 5:38
  many years ago, and it's one of the
• 5:40
  fastest growing populations for us. The other tie
• 5:43
  to that is health equity when it comes
• 5:45
  to people that have chronic conditions or multiple
• 5:47
  chronic conditions that are also frail and that
• 5:50
  have, need income assistance.
• 5:53
  And, we were probably one of the first
• 5:56
  with creating collaboration with different companies like Instacart
• 5:59
  and others, when it comes to
• 6:01
  giving food
• 6:02
  to people that, you know, instead of picking
• 6:04
  medications
• 6:05
  over food or vice versa, how do you
• 6:08
  get that? How do
• 6:10
  you give them unique benefits that help them
• 6:12
  with loneliness and other things
• 6:14
  or access to
• 6:16
  getting a ride, something as basic as getting
• 6:18
  a ride to your doctor or your pharmacy
• 6:20
  or even picking up, certain supplies
• 6:23
  and having,
• 6:25
  programs to outreach to individuals because they are
• 6:28
  living alone. And so there are things or
• 6:30
  questions that we do or sending clinicians to
• 6:32
  the home,
• 6:34
  to to address that. And they don't wanna
• 6:37
  feel like
• 6:38
  they're needy or being dependent on a child
• 6:41
  or a loved one. They're, you know so
• 6:44
  they will go without. And so it's like,
• 6:46
  how do you break that barrier?
• 6:48
  And it's been quite successful for us by
• 6:50
  addressing that in its entirety with from a
• 6:52
  clinical
• 6:53
  care as well as a service and then
• 6:55
  a benefit package that's designed around that,
• 6:58
  where we are sitting today with that audience
• 7:00
  with a net promoter score of 75 plus,
• 7:03
  which is very hard to do,
• 7:05
  and it's continuing to grow at a very
• 7:07
  fast pace for alignment. So we're super excited
• 7:09
  that it's working,
• 7:10
  but it starts with that senior, that consumer
• 7:12
  directly
• 7:13
  talking to them, finding out what are their
• 7:15
  needs and what are their fears about,
• 7:17
  you know, whether it's the government or it's
• 7:20
  the state or
• 7:21
  asking for help. It's critical.
• 7:24
  So it's big. Yeah. That's fascinating.
• 7:26
  We've, been talking about the imperative to reduce
• 7:29
  costs, improve quality, and advance health equity, and
• 7:32
  I'd like to keep going with that. So
• 7:33
  how do you approach aligning these priorities in
• 7:35
  your organization's strategic vision?
• 7:39
  Well, seniors in general, it's interesting because when
• 7:42
  you think about
• 7:44
  when I talk to people, and I actually
• 7:46
  have experienced this now that I'm say I'm
• 7:47
  50. Well, I'm going through my full age,
• 7:50
  but,
• 7:51
  just ageism
• 7:53
  and how people view seniors today and where
• 7:56
  they were twenty years ago. And I say
• 7:58
  that at every stage of life.
• 8:00
  When you're 30, and if you're not married
• 8:03
  or you don't have a child, why are
• 8:05
  you not married, and why don't you have
• 8:06
  children? It's like, well, why should I have
• 8:09
  to be married? Or if you're Exactly. There's
• 8:10
  no time left. Plus, or why don't you
• 8:12
  have grandchildren? Or, you know, there's just so
• 8:15
  many things. Or when you talk to people
• 8:16
  and interview them and survey them,
• 8:19
  their view of what somebody is at 60,
• 8:21
  60 five, 70
• 8:23
  is really interesting,
• 8:24
  so from that perspective. And so it's
• 8:27
  when you think about equity,
• 8:29
  even as it applies and where we kind
• 8:32
  of have judgment with that audience, and so
• 8:34
  then then tap on somebody who's got Medicare
• 8:37
  and Medicaid,
• 8:39
  why should they be treated any different? Because
• 8:41
  of their income level? Or if you start
• 8:43
  to put because of the color of my
• 8:45
  skin
• 8:46
  or because you there's so many different things.
• 8:49
  And so from the company perspective, we do
• 8:52
  senior sensitivity trainings.
• 8:54
  We you know, when we're interviewing, we want
• 8:57
  a heart of caring.
• 8:58
  So they have to have that passion to
• 9:00
  wanna work with this audience and not want
• 9:03
  to just
• 9:04
  do this because of a job. And it
• 9:06
  is hard to find talent that's out there,
• 9:08
  and so,
• 9:10
  we have a a phenomenal culture of caring
• 9:13
  within our organization. And as we're growing, because
• 9:15
  we are getting bigger and we're growing fast,
• 9:18
  we work really hard. How do you keep
• 9:20
  that culture of caring as we're growing? And
• 9:23
  that is something that we need to continue
• 9:25
  to pay attention,
• 9:26
  because at the end of the day,
• 9:28
  the number one person in our company is
• 9:31
  that senior, and how do we make sure
• 9:33
  that we're doing
• 9:34
  doing right by doing good. Yeah. Thank you
• 9:36
  so much for for, providing that perspective.
• 9:39
  Before we wrap up here, do you have
• 9:41
  any final thoughts you'd like to share with
• 9:43
  our listeners today?
• 9:44
  Well,
• 9:45
  first of all, thank you for listening.
• 9:47
  Secondly,
• 9:48
  you know, just when you see that
• 9:51
  individual that is older out there or if
• 9:54
  they they're walking in the door and they're
• 9:57
  whether they're
• 9:58
  frail or not frail, just have think about,
• 10:01
  like, their life and how far they've become
• 10:03
  and
• 10:04
  just make that extra step and helping them
• 10:06
  out. Open the door, something as simple, or
• 10:08
  help them out on lifting something for them.
• 10:10
  Just be there,
• 10:12
  as an audience to take care of this
• 10:14
  consumer, and, you know, they've been leading the
• 10:17
  pack, and now we've gotta follow with the
• 10:19
  next generation of just doing, you know, doing
• 10:21
  right by doing good. Yeah. I love that.
• 10:23
  I think we can all take that home
• 10:24
  with us today. Well, thank you so much
• 10:26
  for joining me today. Again, this is Haley
• 10:28
  Rucker with the Becker's Payer Podcast
• 10:30
  recorded live at the Becker's third annual spring
• 10:33
  pair issues roundtable.
• 10:34
  Dawn, thank you so much. You're welcome.