Latest / Becker’s Payer Issues Podcast / Innovating Home-Based Care: Insights from John Young

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Innovating Home-Based Care: Insights from John Young · 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. Our connected health services make the
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  treatment, prediction, and prevention of health care's most
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  complex conditions
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  easier and more accessible as we drive organizations
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  and people forward. Ever North Home Based Care
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  provides value based care that helps patients with
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  multiple chronic conditions
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  and social determinant of health barriers get the
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  care they need and the personalized experience they
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  deserve. We serve patients who struggle to navigate
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  the health care system by bringing high quality
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  primary
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  and preventative care services to the home. By
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  providing clinical care and support services that provide
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  whole person care, we improve health equity, access,
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  and outcomes for the populations we serve.
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  Hello, everyone, and welcome to the Becker's Health
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  Care podcast. We're thrilled today to be joined
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  by John Young, chief strategy and development officer
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  at Evernorth Health Services Home Based Care. John,
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  thank you so much for joining us today.
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  Yeah. Thank you. It's great to be here.
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  So let's jump into today's conversation.
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  Can you please tell us a little bit
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  about yourself and your background?
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  Yeah. So I'm with Evernorth Home Based Care,
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  and we are, in home primary care group
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  that does value based care work for health
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  plans focusing mainly on their,
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  critical and chronic care, patients
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  that need more attention in the home, need
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  clinical care and services in the home.
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  And so I've been in health care for
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  30 plus years now, and always have had
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  a passion for looking at how might we
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  deliver better care and better solutions
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  to solve the big challenges that we have
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  in health care. One of them is the
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  rising chronic condition patients,
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  and on top of that is just the
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  escalating cost of care.
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  Can you speak a little bit more about
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  the mission of Evernorth home based care, and
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  why is this mission important to both you
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  and your team? Yeah. So for me, it
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  goes way back.
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  You know, primary care is essential
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  to our health care system, and I think
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  really powerful
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  option for us to continue to double down
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  on
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  in order to decrease the the cost of
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  care, but also improve the outcomes. Because
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  a lot of the focus of our practice
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  is taking a brick and mortar primary care
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  group
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  and truly bringing that into the home such
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  that we can deliver as many visits, as
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  many services,
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  and as much care and other support that
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  that individual needs
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  so that they're not going to the urgent
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  care or going to the emergency room or
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  going up into the acute care
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  because they're not getting primary care. And a
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  lot of the members just have many issues,
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  social determinants that they're dealing with.
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  They also have,
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  you know, other challenges,
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  transportation,
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  medications.
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  Many of them are on 20 plus medications.
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  They don't know how to balance that. So
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  being in their home and helping in their
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  home is important.
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  For me, it goes way back. My dad
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  was a pediatrician.
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  Growing up in the seventies, I remember him
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  doing house calls.
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  And the way that he created trust
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  and the way that he was able to
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  individually serve each of his patients and our
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  neighbors really resonated with me, and I think
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  it's one of the biggest solutions that we
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  have to to really double down on to
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  improve health care. Right. Right. Yeah. Exactly. That
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  that trust is really key there. So what
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  what are some of the industry barriers and
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  opportunities that your team is currently focused on?
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  Yeah. I I think
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  one is really just the the continued rise
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  and complexity of the the patients and their
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  needs.
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  I think how do you how do you
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  build the right
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  care plan and clinical team
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  that truly can impact in a meaningful way
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  the the individuals that we serve. So just
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  getting a handle of everything that's going on.
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  How many chronic conditions can one person have?
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  They can have 5, 6 plus. You know?
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  And so how do you build that right
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  team,
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  ensure that the patient who can't get out
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  of their home or struggles to get to
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  any level of care, we can bring that
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  into the door. So that's 1.
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  2, really building the trust with the individuals
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  and the caregivers of those individuals
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  such that they let us into their home.
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  It's it's really critical.
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  You can't do this virtually. You can't
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  see everything that's going on in the home.
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  You can't build a relationship with the folks
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  that really know what's going on with the
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  individuals, their caregivers,
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  And so you have to build that trust.
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  So we spend a lot of time focusing
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  on, you know, gaining that trust, getting our
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  teams into the home, and then building that
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  relationship with them. You know, the third thing
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  is, obviously, we we face, like everybody else,
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  just supply chain issues with clinic clinical teams.
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  And so, you know, we have the rising
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  chronic conditions, building the trust so that we
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  can truly become
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  a partner in their home for their clinical
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  care, and then ensuring and protecting our clinicians
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  so they can practice at the top of
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  their
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  license. It sounds like there's a lot going
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  on in your space right now.
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  And,
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  with your years of experience, what are some
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  of the biggest pieces of advice you'd have
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  for,
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  your peers in the health care industry? Yeah.
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  I think, you know,
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  having been around the block for 30 years
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  and really focusing on how do we transform
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  our health system, how do we make it
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  more efficient,
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  effective, how do we get it to deliver
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  better outcomes,
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  mainly don't give up. We we will solve
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  this at some point, I hope. And I
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  hope we do it, you know, and I
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  hope the the angle that we're taking with
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  home based care
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  and true,
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  you know, MDs and MPs and pharmacists and
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  RNs getting into the home and delivering care
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  is one of the answers that's gonna help
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  us maybe truly bend
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  the cost curve, increase outcomes, and and bring
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  value based care. So don't give up.
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  I think the other thing is really think
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  creatively. You know? The brick and mortar,
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  the fee for service,
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  the other challenges that we faced. I I
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  mean, truly, they haven't changed for 30 years
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  even though the big promises that CMS has
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  made,
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  the big initiatives that many of the payers
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  have
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  put forward,
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  are are are slowly changing the dynamics of
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  our health care system. But I think we
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  really have to think a bit radical and
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  think differently and and not be bound by
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  the the biases that have held us, you
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  know, kind of, you know, stuck for so
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  long.
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  So how does Evernorth home based care differentiate
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  itself from other home based care providers in
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  the industry?
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  And, what what would you say are some
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  unique advantages that you bring to your patients
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  and health care partners?
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  Yeah. I think, first,
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  just being able to go into a true
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  full,
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  capitated global risk model
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  is a a a really big advantage.
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  We are truly putting,
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  our money where our mouth is, you know,
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  to say.
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  And we we believe that
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  providers
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  and our clinical team
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  should be allowed to make their decisions and
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  not be bound by the OMI billing the
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  right code, OMI,
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  you know, billing something that I'm gonna get
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  reimbursed for. So I think that's one of
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  our our big advantages. I think to,
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  being a part of Evernorth
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  and the full suite of solutions that exist
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  from the the benefits
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  management's
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  aspects in pharmacy and medical
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  to all of the things that we do
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  on our side of the house and the
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  air delivery
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  and pharmacy side.
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  We're able to leverage the knowledge, for 1,
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  the resources and support that give us a
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  no another layer of clinical
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  competencies and teams and skills that we can
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  surround that patient by,
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  as well as, you know, doing some of
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  the virtual 247
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  If it's critical and we need to get
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  in touch or get someone to that home,
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  we're able to do that. So, you know,
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  a lot of those things are are really
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  important. The other big thing is,
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  you know, truly getting into the home,
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  being a trusted part of the family caregiver
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  team,
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  and seeing all of the social determinants of
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  health, and then building a care plan that's
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  unique to each individual
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  based on their conditions,
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  based on their social determinants,
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  based on their caregiver and other support, and
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  becoming kind of that Sherpa of their ecosystem
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  for their health.
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  John, I wanna thank you again for joining
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  us today on the Becker's Healthcare podcast. But
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  before I let you go, do you have
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  any final thoughts you'd like to leave with
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  our listeners? Yeah. I think this is just
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  an exciting time for health care, and it's
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  an exciting time for leaders in health care
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  to really rethink
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  where should the clinical
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  models be delivered,
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  how is care shifting
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  and getting into the home, and how am
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  I as a a leader going to respond
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  to that and become a champion of it
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  versus protecting kind of the biases of the
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  past. And I I just applaud everybody who's
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  doing it, and, the energy's there. So let's
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  get on it. Awesome. I really appreciate those
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  insights today.
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  John, thank you again for joining us today.
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  To our listeners, thank you for joining us,
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  and be sure to check out other Becker's
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  Healthcare podcast. Thank you, and have a wonderful
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  rest of your day. Yeah. Thank you.