Latest / Becker’s Payer Issues Podcast / Dr. Shantanu Agrawal, Chief Health Officer at Elevance Health

Transcript

Dr. Shantanu Agrawal, Chief Health Officer at Elevance Health · Becker’s Payer Issues Podcast

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  Hello, everyone. This is Jacob Emerson with the
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  Becker's Pay Your Issues podcast.
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  Thrilled today to be joined by a special
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  guest. Doctor Shantanu Agrawal is the chief health
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  officer at Elevance Health. Doctor Agrawal, thanks so
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  much for taking the time to be with
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  me on the podcast today.
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  Happy to do so, Jacob. Thanks for having
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  me. Yeah. And before we dive into everything
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  we wanna talk with you about, can you
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  tell us a little bit more about yourself,
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  your background in health care, and what it
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  is that you're doing today at Elevance Health?
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  Sure.
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  So I've been fortunate to have kind of
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  an interesting journey in health care.
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  I'm an emergency medicine physician by training, so
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  I I sort of started my health care
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  journey as a practicing clinician.
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  From there, I went into healthcare consulting for
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  a few years and that really helped me
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  pivot out of sort of being a %
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  clinician,
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  learning some different skills that could be applied
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  to different companies and organizations.
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  I spent about six years at the Centers
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  for Medicare and Medicaid Services,
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  working on,
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  program integrity issues there.
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  From CMS,
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  I ultimately kind of ended my role there
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  in a political appointment.
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  And so at the end of the,
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  administration, I went over and became the chief,
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  executive officer of the National Quality Forum, which
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  is a nonprofit,
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  based in DC that focuses on quality measurement
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  and improvement.
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  And then from there, I came to Hellevance
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  Health, the role that I'm in now, as
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  chief health officer.
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  And here, I I get to work on
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  a lot of, I think, very interesting things.
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  I I focus on our whole health strategy,
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  across the enterprise.
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  I
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  work my team works on, quality improvement across
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  all of our,
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  member populations.
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  And then one of the things that I
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  oversee, which we'll get to talk about today,
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  is the Hellevance Health Foundation.
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  Fantastic. Yeah. So let's dive right in and
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  talk about that, doctor Agarwal, because we we
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  we wanna hear a little bit about Elavance
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  Health Foundation's impact investment in site services.
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  It's a great example for the rest of
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  the industry in terms of,
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  what we've been seeing as a growing trend
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  of health insurers taking a more active role
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  in supporting social determinants of health, such as
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  mental health services and access to care in
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  underserved communities.
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  So from your perspective,
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  how do you see the role of of
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  health insurers evolving in addressing
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  these broader social needs? And what are some
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  of the long term benefits for the industry
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  and for a company like Elevance Health when
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  when you invest in these community based initiatives?
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  Yeah. That is a a great question, a
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  big question. So just, taking a step back,
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  you know, I think we increasingly realize
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  that,
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  social health is just as important as mental
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  health and physical health. And in fact, those
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  three components are really the center of our
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  whole health strategy,
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  in our company.
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  So we believe if you address whole health,
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  you will address quite naturally health care value
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  and affordability
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  because it will allow,
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  us in this case to go beyond sort
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  of the traditional health care environment and address
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  the root causes of what often shows up
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  in traditional health care. And so, you know,
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  again, I think it's commonly known now in
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  the field that 80% of what affects a
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  person's health really isn't about what happens in
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  the doctor's office. And I say that, of
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  course, as a doctor, and I I think
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  doctors are are incredibly important for the work
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  that they do.
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  They can't be responsible for everything that happens
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  that ultimately affects a person's health.
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  But I think we as a company really
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  need to play our role in doing that.
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  So whole health is really central to what
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  we do. Why I think
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  social,
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  care matters is because
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  a a big chunk of that whole health
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  paradigm
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  is, the social resources that a person has.
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  That might be
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  their social supports and whether or not they're
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  socially isolated. It might be their access to
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  healthy food.
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  It it it might be their access to,
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  you know, clean air, clean water, a clean
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  environment, a place to work out, walk, exercise.
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  So there's, you know, like, sort of that
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  entire social ecosystem
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  that surrounds a person. I've often said, you
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  know, no one is really healthier than the
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  community that that they're in.
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  And so there's a lot that you can
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  do as a company like ours to address
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  some of these social context. I think it's
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  critical to do because, ultimately,
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  if you don't address root issues like the
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  quality of the food that a person is
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  eating, they will invariably develop chronic conditions like
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  diabetes or hypertension
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  that then show up in the ER or
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  show up at the doctor's office. And as
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  a payer, we're we'll certainly be responsible
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  for the entirety of that journey. So why
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  not put our, resources
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  earlier where we can really affect a person's
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  life, hopefully stem chronic diseases from developing or
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  worsening,
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  and ultimately, you know, provide value for that
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  member.
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  Certainly. And I know, from our coverage and
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  our readership,
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  Elavance Health is really on the forefront of
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  addressing social determinants of health among your members
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  and within the communities you serve.
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  Shanti, let's let's specifically talk about this most
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  recent $300,000
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  investment in mental health services for children and
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  families, which really underscores the increasing importance of
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  behavioral health within
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  overall health outcomes.
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  Given, as you know, the rising mental health
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  crisis all over the country, what are some
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  of the further steps you think insurers should
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  be taking right now to better integrate mental
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  health support into their broader health benefits offerings?
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  Yeah. So, again, let me just remind the
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  audience a little bit like,
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  this,
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  work is being conducted through the foundation. Now
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  I think addressing mental health,
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  behavioral health is incredibly important for our company
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  as a whole, even of course outside of
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  the foundation and for the industry.
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  And really integrating mental health with other kinds
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  of healthcare delivery, including social is really important
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  because oftentimes
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  these issues hang together.
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  What the foundation is doing very differently that
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  I I just want people to know about
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  is, you know, the foundation is has existed
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  for years and in the vast majority of
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  that time, it's been a grant making organization,
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  which means we invite nonprofit partners to come
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  in and apply for grants, and then we
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  we provide those grants for specific areas of
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  programmatic work. As a former CEO of a
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  nonprofit, I know exactly what that feels like
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  from the
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  applying and receiving side, and now I get
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  to sort of do it on the foundation
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  side.
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  What I wanted to do is to try
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  to open the aperture of the foundation a
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  little bit. We're we're never gonna move away
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  from being a grant making organization.
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  But, you know, grant grants are wonderful for
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  a variety of things. What it also unfortunately
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  does is it can limit the kinds of
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  organizations we can work with.
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  They have to be specifically programmatic in nature
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  and they have to be nonprofits in order
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  to really take advantage of a grant. So
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  we opened up a brand new program
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  putting initially a $10,000,000
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  kind of investment into that program
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  for the purposes of providing impact investment
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  to downstream recipients. You can basically think of
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  this as loans.
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  So one of the first loans that we
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  have,
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  made as part of this program is to
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  in the organization that you cited, Sykes Services
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  in California. We gave them an initial loan.
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  This is truly a loan. Now we made
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  sure that we construct these loans working really
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  closely with
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  a partner
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  to be to have a very low interest
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  rate. The goal is to be well below
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  the market so that we make sure we
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  are getting,
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  funds to organizations that can really use those
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  dollars to aid their communities and and drive
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  health improvement,
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  but not burden them with a high interest
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  rate. So Sykes services has gotten that. I'm
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  really excited about it.
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  And and to your point, they are in
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  the kind of behavioral health, mental health space.
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  And what's really exciting is that what they
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  really seek to do is provide services for
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  children,
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  for their caregivers,
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  and educators,
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  starting in California, but they're also now virtual
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  in, I think over 30 states around the
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  country.
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  They offer a lot of different therapeutic solutions,
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  including counseling and group therapy,
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  specialized programs for adolescents.
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  So it's it's just really interesting. They work
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  closely with schools. They work closely with kids
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  and caregivers,
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  and we thought they would just be a
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  fantastic organization to help grow and support through
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  this loan program.
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  Absolutely. That's amazing, and I'm sure it's going
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  to be a very impactful investment for for
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  those individuals.
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  As the Elavance Health Foundation continues to expand
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  its impact investing program to address health disparities
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  and and to promote economic development,
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  how do you think the wider insurance industry
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  can scale similar initiatives?
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  What are some of the lessons that
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  everyone should be taking from Ellevance
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  from the Ellevance model in terms of structuring
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  investments to create meaningful change?
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  That that's a that's a really kind way
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  of putting it, and thank you for that.
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  I look. I think
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  one of our main drivers for doing this
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  is,
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  again, working with a wider variety of organizations
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  and companies
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  that could be benefited by a loan program,
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  maybe even more so than a grant making
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  program. And to any of our nonprofit partners
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  who who may listen to this, again, I'll
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  reiterate grants are gonna be central to our
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  mission as well.
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  We just wanted to widen the the scope
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  of who we could work with and what
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  they could get funding from us to do.
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  You know, we are I think I believe
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  we're the first in our industry to do
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  this. I know there are other industries that
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  have taken this kind of approach.
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  I encourage it. I think if it makes
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  sense for the the strategic goals of of,
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  an organization, it makes sense to offer this.
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  I'm really excited to see businesses thrive based
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  on the loans that they're getting. So my
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  mental model is often, hey. Imagine we're in
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  a community.
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  We could help to give a grant to
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  the local food bank, which we do all
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  the time. And then in addition, we could
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  help to grow a community grocery store
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  through this loan program that is truly a
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  business that is thriving, you know, striving to
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  be a a self sustaining grocery store, perhaps
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  in a food desert. And it's sort of
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  the opportunity to bring those two together, these
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  these two different approaches
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  in in the same community,
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  encourage entrepreneurship
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  in one,
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  bolster the social safety net in the other.
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  I mean, I think this is the sort
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  of complete approach that we're trying to take.
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  And in all of the work that we
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  do, we really focus on socially disadvantaged populations
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  and, social areas that we know matter a
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  lot to community. So, again, I hope to
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  see we're really early in the loan program.
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  I hope to see many, many more of
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  these dollars go out the door, supporting small
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  businesses,
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  supporting,
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  organizations that then are doing great work in
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  their community,
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  and and fingers crossed, they will be sustainable
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  over time. So we'll really be improving those
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  communities for generations to come.
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  Certainly. Well, I hope you will keep us
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  updated as these investments continue and as as
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  you continue to see outcomes
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  through them.
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  But before we go, Shantanu, what else are
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  we missing? Any final tidbits of advice you
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  wanna offer, the health plan leaders listening in?
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  Yeah. I mean, you know, I think people
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  understand the the basic concept here. If there's
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  questions about it or if people wanna know
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  how to how to maybe get their own
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  companies involved, I'd be happy to serve as
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  a resource. I know my team would be,
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  I think as a big company ourselves,
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  we take our role in
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  in this area really seriously. We take our
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  role in improving health very seriously. We also
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  take our role as being an economic engine
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  for society really seriously. It's really bad thinking
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  that I wanted to bring to this, impact
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  investing program.
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  So we measure things, of course, like, hey.
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  How are we improving health? But we also
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  measure things that are employ important as an
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  employer. We want you to be sustainable. We
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  want you to grow the number of employees
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  that you are,
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  employing in your community.
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  So those kinds of KPIs matter as well.
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  I mean, this is this can be the
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  thing that I that I think can really
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  be a broad strategy
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  for putting more resources in communities
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  through sustainable enterprises that then actually aim to
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  improve the health of those communities. So if
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  that idea is interesting, I'd certainly love to
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  stay in touch, but invite anyone,
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  listening to this to also reach out, and
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  we're we're happy to be a a guide
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  wherever that's helpful.
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  Fantastic. Well, doctor Agrawal, thank you so much
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  for taking the time to sit down with
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  us and for sharing about the latest work
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  happening at Dilavance and and under your leadership.
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  We really appreciate it. Thank you. It's been
• 12:32
  it's been great. Thank you for the opportunity.
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  And if you'd like to listen to more
• 12:35
  podcasts from Becker's Healthcare, you can visit beckershospitalreview.com.