Latest / Becker’s Payer Issues Podcast / How EmblemHealth is Fighting Food Insecurity and Advancing Community Health

Transcript

How EmblemHealth is Fighting Food Insecurity and Advancing Community Health · Becker’s Payer Issues Podcast

0:00
Hello, everyone. This is Jacob Emerson with the
0:02
Becker's Payer Issues podcast.
0:04
Thrilled today to be joined by Heather Tamberino,
0:06
who is the chief financial officer at EmblemHealth.
0:09
Heather, thanks so much for taking the time
0:11
to be with me on the podcast today.
0:13
Thank you so much. I'm here and excited
0:15
to talk with you.
0:16
Likewise, Heather. And we appreciate you taking the
0:18
time to sit down with us.
0:21
Before we dive into everything we wanna talk
0:22
with you both with you about,
0:24
can you tell us a little bit more
0:26
about yourself,
0:27
your background in health care, and what it
0:29
is that you're doing today at EmblemHealth?
0:32
Sure. Absolutely.
0:34
I've been in health care for over twenty
0:36
two years now with the majority of that
0:39
being within
0:40
nonprofit health plans.
0:42
More specifically, over the last ten years, I've
0:44
been lucky enough to work in
0:46
integrated health plan provider groups so we can
0:49
bring more of a unique proposal to the
0:51
members and communities we serve. And I have
0:54
to say, I'm most proud to be part
0:57
of the team at Emblem where I do
0:59
truly feel it's a unique health plan.
1:01
You know, our social missions
1:03
at the heart of everything we do and
1:05
the fact that we bring both the health
1:07
plan and the physicians together to serve the
1:09
community
1:10
on their path to health is truly
1:13
what I believe is a model for the
1:14
future.
1:15
Here,
1:16
I have overall responsibility for the financial health
1:20
of the enterprise.
1:21
I work with the broader leadership team on
1:23
strategy,
1:24
both on the health plan and on the
1:27
physician side,
1:28
support resource allocation,
1:30
and, you know, the traditional financial functions that
1:33
you would expect, tax, treasury,
1:35
actuarial,
1:36
underwriting,
1:37
etcetera.
1:38
Fantastic. So, Heather, I wanted to get us
1:41
started today by talking a little bit about
1:43
some important
1:44
work, just recently announced by EmblemHealth.
1:47
The the company has pledged $2,000,000
1:50
to food security efforts across New York City.
1:54
So fill in our audience who who isn't
1:56
familiar with this initiative,
1:59
where did this money come from? Who is
2:01
it going to? And what were you hearing
2:03
or seeing on the ground in,
2:06
your neighborhood care centers that that made this
2:08
investment feel really urgent right now?
2:11
Absolutely.
2:12
And I'm glad you're asking this question because
2:14
it's an important initiative, but it's it's also
2:17
an important moment in time.
2:19
I know your listeners are hearing on their
2:21
news feeds and through their government affairs teams
2:24
about the recent federal rollbacks
2:26
and the reports on rising cases of food
2:29
insecurity.
2:30
Critical programs like SNAP
2:32
are being pressured.
2:34
We're even seeing that the USDA's
2:37
decision to stop tracking and releasing annual data
2:40
on food insecurity.
2:42
You know, their last report showed that over
2:45
18,000,000
2:46
Americans
2:47
were facing food insecurity and hunger.
2:49
And as these resources
2:51
dwindle and food pantries are strained,
2:53
more and more New Yorkers are struggling.
2:56
And in fact, the New York City mayor's
2:58
office of food policy last reported that
3:02
almost 1,200,000
3:03
city residents, that's almost 15% of New York
3:06
were New Yorkers were food insecure.
3:09
So
3:10
we're hearing that. Right? That's that's happening broadly,
3:14
on the on the
3:16
broader stage. And we at Emblem are uniquely
3:19
positioned
3:20
through what we have our neighborhood care centers,
3:24
and we're seeing this issue firsthand.
3:27
You know? So as you said, it's a
3:28
it's a different and unique model,
3:31
but Emblem has invested in 15 sites across
3:34
the five boroughs in what we call neighborhood
3:36
care centers. Think of them almost as, like,
3:39
community hubs.
3:41
Anybody in the community can come in for
3:43
assistance with social determinants of health. It could
3:46
be a housing issue,
3:48
food distribution,
3:49
cooking and fitness classes. How do they get
3:52
access to care?
3:53
Someone to help them in language,
3:56
understand
3:57
mailings, or even just for a cup of
4:00
coffee. And when we think about social determinants
4:02
of of
4:03
of health, two top issues facing,
4:06
Americans now and New Yorkers here specifically is
4:09
both loneliness and food security.
4:11
And so
4:12
we offer these free services to any member
4:15
of the community, not just EmblemHealth members.
4:18
The other thing about these sites is they're
4:21
collocated in many instances
4:23
with our AdvantageCare
4:26
physician,
4:27
PCP, and specialist groups. So if there's a
4:29
health issue,
4:30
we can get that individual
4:32
almost immediate access to care.
4:35
So that's the construct. That's what we have.
4:37
And in these neighborhood care sites today, we're
4:41
tracking.
4:42
And in comparison to just a year ago,
4:44
we have a 17%
4:46
increase
4:47
with individuals coming into the centers
4:50
struggling
4:51
with getting access to food.
4:54
And I'll give you an example. In early
4:56
February,
4:57
at our Chinatown location, we had announced a
4:59
food distribution event. This has been part of,
5:02
ongoing programming that we have. And we had
5:06
announced a food distribution event for 11AM where
5:08
we had hoped to hand out
5:10
200 bags of food, which feed about an
5:12
Edgards family of three people.
5:15
When we arrived, our our team members arrived
5:17
to open that day at 7AM. We already
5:19
have a line around the block.
5:21
So if you know New York in February,
5:23
this is not a pleasant time to be
5:25
out and about.
5:26
But we launched earlier and and basically handed
5:29
out our full complement to food in fifteen
5:31
minutes. So you hear the federal impacts. You
5:34
know that the
5:35
with reductions in food,
5:37
support with SNAP, etcetera,
5:40
you see the increases
5:42
of our members coming into our
5:45
community centers,
5:46
and we have the opportunity to say, well,
5:49
what can we do?
5:51
So what are we doing? And you identified
5:53
it, the community food security initiative.
5:57
We recognize that there's this profound connection
6:00
between health outcomes and access to food,
6:04
So we're expanding
6:05
our food security programming
6:07
and
6:09
adding $2,000,000
6:11
to our security initiative. And you said, well,
6:13
where's where's that going?
6:16
We're providing donations to critical partners
6:19
who deliver services and support families in need
6:22
already in existence,
6:23
trusted,
6:24
groups with the Campaign Against Hunger,
6:27
the New York Common Pantry, and City Harvest.
6:31
Additionally,
6:32
we are
6:34
supporting
6:35
dozens of food distribution events each month through
6:39
our EmblemHealth
6:40
neighborhood care centers
6:42
and also then hosting pop up food distributions
6:45
and farmers market with our community affairs teams.
6:49
Our our goal here is to ensure that
6:52
families have easier access to free,
6:55
nutritious food right in their neighborhoods,
6:58
whether that's coming to a brick and mortar
7:01
neighborhood care center that's close to them
7:04
or at these pop up events so that
7:06
we can meet the communities where they are
7:08
with our partners.
7:09
Well, this really sounds like it's gonna be
7:11
such an impactful
7:13
and as you, you know, explained, you're really
7:15
seeing that the demand is there across the
7:17
city, both anecdotally and and then through some
7:20
of the data,
7:21
you shared with us that 15% figure. So
7:24
clearly, very comprehensive
7:26
infrastructure is in place across your your 15
7:28
care centers, across all five boroughs to really
7:30
tackle this head on. I wonder if we're
7:32
if we're looking more broadly at this from
7:34
an industry perspective. You know? We hear from
7:36
health plans all the time about how they
7:38
are really starting to try to incorporate more
7:41
food as medicine based initiatives
7:44
as part of their health care efforts, as
7:46
part of as part of benefits,
7:48
programs,
7:49
not just as community outreach, efforts, but as,
7:52
tied in with with reimbursement and and social
7:55
determinants of health. So I wonder
7:57
how how do you think the industry's approach
7:59
to social needs like nutrition
8:02
is evolving from from where you sit, Heather?
8:04
When where do you think things are still
8:06
falling short?
8:08
It's an important question because you can look
8:10
at one initiative that we just talked about,
8:13
but
8:14
it it is absolutely broader than that.
8:17
We know hunger and health deeply intertwined,
8:21
and and can't just switch health outcomes
8:24
directly in the doctor's office. It has to
8:26
be addressed in the kitchens. It has to
8:28
be addressed in neighborhoods and communities.
8:31
So to your point at EmblemHealth,
8:34
we're seeing that our neighbors are having to
8:36
make these very difficult decisions.
8:39
Do I pay rent? Do I put food
8:41
on the table? Or do I buy medicine?
8:43
And in this environment,
8:45
food and housing
8:47
will become the priority.
8:48
Health and fitness, etcetera,
8:51
will fall by the wayside.
8:53
And our internal analytics show a very clear
8:56
pattern.
8:57
Members that are experiencing
8:59
food insecurity
9:00
have higher rates of chronic diseases, such as
9:03
diabetes,
9:04
hypertension,
9:05
or heart failure.
9:07
They also show
9:09
higher ER utilization
9:11
and avoidable admissions.
9:13
So this is a health issue. And to
9:15
your point, it's not a charitable giving issue
9:17
or or it's not just a community outreach
9:19
where you're seeking reimbursement.
9:21
And so
9:23
you asked, well, why does the industry need
9:25
to think or engage in a different way?
9:28
When members don't have reliable access to nutritious
9:31
food, no amount of benefit design where the
9:34
traditional care management
9:36
can close that health gap.
9:38
So we, you know, are mission driven, community
9:41
focused, nonprofit health plan. And so we believe
9:45
our role is as a steward
9:47
of community health. We go beyond, like, traditional
9:51
benefit management.
9:53
And we understand that we have to adapt.
9:55
Look. I'm the CFO.
9:57
People ask me,
9:59
why are you the leader of this initiative?
10:01
Right? That's unusual.
10:03
And one, I would say, one, I wholeheartedly
10:06
believe in our mission.
10:08
But two, it makes financial sense.
10:12
Investing in food security is an upstream
10:14
strategy.
10:15
You know, preventing avoidable hospitalizations,
10:18
lowering long term costs,
10:21
most importantly,
10:22
improving the dignity dignity and quality of the
10:25
life of our members. It's a win for
10:27
everyone.
10:28
And and
10:30
addressing
10:31
food insecurity
10:32
is more than just the right thing to
10:34
do.
10:35
It can support
10:36
medical cost management.
10:38
If we intervene early,
10:40
we address the root causes of poor health
10:43
rather than try and treat the more expensive
10:47
downstream consequences.
10:49
So EmblemHealth is leaning into these types of
10:52
community investments, not just the food initiative,
10:55
but by establishing
10:57
these co located neighborhood care centers that partnered
11:00
with physicians' offices,
11:02
delivering support in language,
11:05
providing unique tailored local programming.
11:09
If as health plans,
11:11
look at any one of our mission statements.
11:13
It could be a for profit. It could
11:15
be a not for profit.
11:17
But almost all of us will have a
11:19
focus on improving the health of our members
11:20
and our mission and vision statements.
11:22
But we cannot continue to lean on aged
11:26
practices.
11:27
We need to be in the community. We
11:29
need to be focused on specific concerns as
11:32
they are emerging. Like, we're seeing this pivotable
11:35
point
11:36
in time right now for New Yorkers and
11:39
the country.
11:40
And we need to think local, and we
11:42
need to serve local.
11:44
I think that's where
11:46
we have to see as you asked specifically,
11:49
I think that's where you have to see
11:51
health plans thinking about it as a broader
11:53
element,
11:54
not just the traditional.
11:56
It it really is if you want to
11:58
address the costs
12:00
of care. Right? If you think about it
12:03
from a for profit perspective,
12:05
let alone the social mission and
12:09
care of our members aspect of it. I
12:11
think that's why we have to see people
12:13
lean in differently
12:15
more through partnership, more through connectedness,
12:18
more through understanding
12:19
very specific local needs.
12:22
Absolutely. And I think it's such a great
12:23
point that you you made, Heather, that and
12:26
it sends such a great message of, why
12:28
the CFO is overseeing,
12:30
an initiative like this. It all ties back
12:33
together. It's all connected. And And I think
12:35
in the spirit of talking about, you know,
12:36
the connectedness
12:37
of the health care system,
12:39
looking forward on on something like this, and
12:42
we can take this just from the New
12:43
York City perspective.
12:44
What do you think it will take from
12:46
from payers like EmblemHealth,
12:48
from providers across the city, and then, of
12:50
course, from from local and and state policymakers
12:53
to make food security a a lasting part
12:56
of public health infrastructure and and as part
12:58
of the work that you do at Emblem?
13:02
I I think we have to be
13:04
specific.
13:05
Right? We can talk about it. But when
13:08
you have a multifactor,
13:12
difficult
13:12
sort of challenge in front of us,
13:15
and you use the word connections or connectedness,
13:18
we really do have to think about how
13:20
do we connect
13:22
our community affairs team
13:24
with our care providers.
13:26
How do we focus on consistency
13:28
of that application?
13:30
How do we
13:31
highlight partnership and collaboration
13:34
across all those groups you just noted? You
13:36
could be a payer. You could be a
13:38
provider. You could be elected official.
13:40
But how
13:41
do each of us think about that? I
13:44
do think in many ways right now, the
13:46
model
13:47
health that we're providing
13:49
and investing in at Emblem,
13:52
you know, we talk about neighborhood care as
13:54
being different.
13:55
Those care centers are focused on not just
13:59
the
14:00
not just food distribution, but it's on education
14:03
and empowerment.
14:05
So in addition to providing free and healthy
14:08
food,
14:08
we're hosting nutrition workshops,
14:11
culturally tailored cooking demonstrations.
14:14
We're helping families
14:16
take fresh ingredients, and how do you turn
14:19
those into healthy,
14:20
affordable meals
14:22
that align with their health goals. So so
14:24
when I talk about nutrition classes,
14:27
a couple of the nutrition classes we have
14:29
are like, how do you make healthier choices
14:31
when you're eating out? Some folks would say,
14:33
well, eating out, like, they can bear you
14:35
know, some
14:36
of our our constituents can barely put money
14:39
on their table. But what will happen is
14:41
they will go to
14:42
quick, easy, cheap, not necessarily always nutritious fast
14:46
food.
14:47
So how do you make a healthier choice
14:48
if you're in that option?
14:51
Having series on plant based foods, heart health
14:54
nutrition.
14:56
We even have like, you can go to
14:57
our website today.
14:59
There's cooking demonstrations.
15:01
So, again, with limited healthy food,
15:05
how do you make it you know, how
15:06
do you make it spread? How do you
15:08
make it
15:09
seem nutritious? And how do you link it
15:11
to your specific condition?
15:14
So
15:15
another thing we do is really design classes
15:19
around chronic conditions that are most prevalent in
15:22
the neighborhoods we serve.
15:24
So we we know
15:27
almost ZIP code by ZIP code, we track
15:30
what are the most prevalent chronic disease conditions.
15:33
Is it diabetes? Is it hypertension?
15:36
Is it heart disease?
15:38
And we focus
15:39
on some of our population health activities and
15:42
leveraging
15:43
these neighborhood care centers
15:46
to reflect
15:47
the people that we're serving and their needs
15:50
in those local spaces.
15:52
So so, really, you're connecting not just the
15:55
food access,
15:56
but you're connecting it to health literacy,
15:59
and you're connecting it
16:01
to community belonging.
16:03
Right? Because it's tied to the cultural
16:06
norms and cultural needs that are prevalent in
16:09
certain
16:10
microcosms
16:11
within our service area,
16:13
you know, that helps create more sustainable outcomes
16:17
that can improve health.
16:19
And so I I talk a lot about
16:20
neighborhood care, and so maybe other
16:23
plans don't have that same investment that we've
16:26
made. But they do have community affairs teams.
16:29
They do have partnerships
16:31
with large provider systems.
16:34
And we do. We couple our community affairs
16:36
teams. We partner with ACP and Y and
16:39
other provider groups.
16:41
Our events teams
16:42
are out there pointing members to resources available
16:45
to them through community based organizations
16:49
or through our neighborhood care sites.
16:51
Our neighborhood care team members can actually connect
16:54
people to PCP appointments right on the spot,
16:57
or they can connect them to SDOH resources.
17:01
In our PCP offices,
17:02
they can walk people down stairs to someone
17:05
who can help beyond just the health visit.
17:08
So we're doing this all as well. We
17:11
talked about that third leg of the stool,
17:14
in concert with elected leaders across the city,
17:18
reaching out and talking to them through our
17:20
community affairs and government affairs teams,
17:23
understanding
17:23
and learning what is most critical to their
17:26
constituents,
17:28
making sure that we're leaning in and standing
17:30
up to that specific need in partnership with
17:33
those on the bids. I think this level
17:37
of partnership, sort of consistency, connecting needs to
17:40
resources is what we're striving to achieve with
17:44
our investments at EmblemHealth. Any health plan, though,
17:47
or large provider system, they have those same
17:50
capabilities. They have community affairs and government affairs
17:53
functions.
17:54
They have population health teams. They have big
17:57
data.
17:58
This isn't unique. It doesn't have to be
18:01
unique to a nonprofit
18:02
mission based health plan like ours.
18:05
This connectedness
18:06
of data,
18:07
resources,
18:08
partnerships
18:09
to extend nutrition,
18:11
extend health and education
18:13
and empowerment.
18:15
I think that's where we have to see
18:16
people lean in to really get to something
18:19
that's more sustainable.
18:21
And, Heather, you're really you're speaking directly to
18:23
a lot of the other health plans listening
18:25
in right now. You mentioned some of the
18:26
smaller plans and where they may be at
18:28
in their journey, in the space that we're
18:31
talking about.
18:32
And before we go, is there any final
18:34
thoughts that you would offer them or or
18:35
final bits of advice,
18:38
as as they continue on, like I mentioned,
18:39
in in different stages of this food is
18:41
medicine and an access
18:43
journey.
18:44
Anything any parting words for them?
18:47
Yeah. I mean, I would say
18:49
I do believe we're unique in our mission
18:53
and where we are on our path
18:55
because we have continued to believe and still
18:58
believe that we are
18:59
envisioning a health plan model that addressing
19:03
social determinants of health and true community health
19:06
needs, it's not an add on.
19:08
We've already made it to that step that
19:10
we believe it's a core part
19:12
of our benefit design and our population health
19:15
strategy.
19:16
And we are seeing and believe that making
19:19
these types of investments
19:22
in whether it be food security initiatives
19:25
or
19:26
access to care in underserved
19:28
populations,
19:29
but leveraging
19:30
our resources where we can,
19:33
we believe we're sending the signal.
19:35
Health equity is not charity.
19:37
It's a strategic imperative,
19:39
and it's good business.
19:41
Right? If you wanna move the needle
19:43
on outcomes
19:44
for underserved
19:45
populations,
19:47
we have to reimagine
19:49
what it means to be a health plan.
19:51
That could mean,
19:52
depending on where you are in your journey,
19:54
it could mean leaning into food. It could
19:57
be leaning into connections,
20:00
leveraging your data.
20:02
I think those are all things where we
20:05
can be.
20:06
We, as an industry,
20:07
can identify
20:09
opportunities
20:11
to deliver a different health outcome.
20:15
I mean, we do believe that these types
20:17
of investments that we're making, whether it be
20:19
in food security or establishing
20:22
these community hub type neighborhood care centers
20:26
or not everybody's along that path yet. Investing
20:29
in primary care practices in underserved areas.
20:32
You know, we'd like this to serve almost
20:34
as a rallying cry to other insurers and
20:37
providers.
20:38
You know, we can lift our communities.
20:41
We can help
20:42
our members and the members of our community
20:45
on their path to health, but we need
20:48
to do it together, and we need to
20:49
be consistent about it.
20:52
Wonderful. Well, Heather, thank you so much for
20:55
taking the time to sit down with us
20:56
and for sharing
20:58
about the impactful work going on under your
21:00
leadership at EmblemHealth.
21:02
We really appreciate it. Thank you so much,
21:04
Jacob.
21:05
And to our listeners, if you'd like to
21:06
listen to more podcasts from Becker's Healthcare, you
21:09
can visit beckershospitalreview.com.