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