Latest / Becker’s Healthcare Podcast / Linda Hines, Virginia’s Medicaid Market President at Humana

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Linda Hines, Virginia’s Medicaid Market President at Humana · Becker’s Healthcare Podcast

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  This is where health insurance leadership comes together.
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  Becker's fourth annual spring payer issues roundtable brings
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  together over 400 payer and health plan executives
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  and more than 100 speakers to Chicago April.
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  This year's event includes keynote conversations with the
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  industry's top leaders and former president George W.
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  Bush. For the full agenda and event details,
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  visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right. We're looking forward to hosting you
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  here in Chicago.
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  Hello, everyone. This is Elizabeth Caslow with the
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  Becker's Payer Issues podcast.
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  I'm thrilled today to be joined by Linda
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  Hines, Virginia's Medicaid market president for Humana.
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  Linda, thank you so much for chatting with
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  us today.
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  Good morning, Liz. Thank you so much for
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  having me today. Of course.
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  So before we dive in, can you tell
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  us a bit more about yourself, your health
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  care career backgrounds, and your current role at
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  Humana?
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  Absolutely.
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  So I always like to start off by
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  saying I am a nurse by background.
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  I, I'm a registered nurse, and that's where
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  I started my career, mostly on the provider
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  side and, hospital space. I had an opportunity
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  to join,
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  Medicaid managed care specifically,
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  oh my goodness, back in 1996, so it's
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  been thirty years ago.
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  Joined a very small health plan that was
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  really just in the Central Virginia market at
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  that time. We had only had about 3,000
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  members.
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  And, I actually joined them managing their medical
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  management department,
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  continued to stay with them, progressed,
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  through the ranks to become the vice president
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  of clinical services, which encompassed
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  everything clinical,
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  pharmacy, quality,
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  care management, credentialing,
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  and and stayed in that role for about
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  sixteen years,
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  then moved into a chief operating role, then
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  to CEO of that health plan.
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  When I left that health plan, we actually
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  had grown from that 3,000 that we started
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  with to well over 380,000
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  members.
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  Went to another health plan, was the president
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  of, the Virginia Medicaid market,
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  the dual special needs.
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  And then now I am at Humana
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  as the plan president specifically
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  for the Health and Horizons, which is Medicaid
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  and
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  our integrated dual special needs plan.
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  So,
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  you know, that's quite a journey. I know
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  I often get asked, how did you move
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  from clinical, so to speak, into the more
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  administrative? But I do think that it all
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  fits together.
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  That clinical experience really shaped,
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  my experience to move more into the operations
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  piece, and I think having that I'm more
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  of an effective leader in this space at
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  this time.
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  Yeah. That makes a lot of sense. So
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  today, we're gonna chat a bit about your
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  market's youth behavioral health efforts.
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  And schools are a cornerstone of those efforts
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  from what I've been reading. Can you elaborate
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  a bit on your partnerships and initiatives taking
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  place in those settings?
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  Sure.
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  So we often see how distance and travel
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  can truly impact,
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  our members being able to specifically access those
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  services.
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  Many of our parents,
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  you know, contrary to popular belief, they are
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  working, and it is challenging for them to
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  get off,
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  during the day. And so we have formed
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  a partnership
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  with the Virginia Healthcare Foundation
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  to focus really on meeting the critical needs
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  of behavioral health services for our youth in
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  our communities
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  especially in those rural communities.
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  So we invested
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  $2,500,000
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  in the nurture NAM program. And specifically, that
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  program through the Virginia Healthcare Foundation
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  supports,
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  the delivery of school based therapy,
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  and
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  the pipeline to actually grow the behavioral health
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  provider workforce.
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  We truly believe if we can provide that
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  care in the schools while we have that
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  captured audience,
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  it's more effective. They don't have to worry
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  about transportation. Many times the parents do not
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  have to worry about taking off from work.
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  We are able to be more effective.
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  So in 2023,
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  Humana,
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  actually invested 500,000
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  in that, and we will continue to invest
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  each year as the program grows.
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  I can also imagine having these resources in
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  schools, you know, even parents aside and transportation
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  access there. It's also easier to keep kids
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  in schools and not have them physically leave
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  that space too.
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  You did mention growing the behavioral health workforce.
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  So those challenges are prevalent across the country.
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  Can you elaborate a bit more about what
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  Humana Healthy Horizons in Virginia is doing to
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  address this,
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  especially when it comes to specialists for the
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  population?
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  So yes. So this particular grant, actually, the
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  nurture now grant that we're working with, the
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  Virginia Healthcare
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  Foundation, not only is it providing the therapy
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  in the schools,
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  but then we are helping more practitioners to
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  become licensed
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  and
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  then be able to get their practicum done
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  while they are
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  providing the therapy in the school. So they're
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  working with,
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  people who are already licensed,
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  shadowing them, as well as starting to provide
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  some of the therapies so that they can
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  become licensed.
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  And to date,
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  they have been successful
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  in really treating a total of over 1,200
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  students at six schools
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  and, providing 2,900
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  behavioral health visits
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  as well as medical visits. So that that
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  has increased
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  our ability
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  to really reach more students with increasing the
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  number of practitioners in schools.
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  As a follow-up to that, I'm curious. What
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  are you seeing in the long term
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  with
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  working with these providers and being able to
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  build out a more robust base of providers?
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  How are you seeing that interplay with other
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  aspects of
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  health care outcomes for youth?
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  Is it changing utilization,
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  cost? What are you seeing there?
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  So, I mean, Liz, I think all of
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  the above. I think that, you know, the
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  metrics that we look at, yes, of course,
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  is utilization. And when we say utilization, I
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  know a lot of people think for managed
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  care that's keeping people from utilizing the services.
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  Quite the opposite. We really want people to
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  utilize these services because when they do,
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  we see the opportunity to identify other areas.
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  It's not just behavior health. It's also their
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  medical concerns, primary care concerns.
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  And so we're able to do that. Then
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  that has increased preventive care as well. We're
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  seeing children receive more of their immunizations,
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  their well child visits.
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  It decreases anxiety. We are able to get
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  people
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  really
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  off of medications if they don't need them
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  or to improve compliance
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  with their medication, which is also very important.
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  We also measure things like days absent from
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  school.
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  We've seen a decrease in that for our
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  children.
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  More compliant with their schoolwork,
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  being able to sit and listen and participate
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  in the classroom.
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  So it really has a very far reaching
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  effect that, you know, when we think about
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  sometimes
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  just the health care, you're thinking only about,
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  well, has it improved their mental status? Well,
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  mental status really, you know, touches a lot
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  of different points, improves the quality of life
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  for not only the student,
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  but the parents as well as the community.
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  That's great to hear. And thinking more broadly,
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  at least in the communities that you're serving,
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  so I know you mentioned rural Virginia,
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  what sorts of supports are most lacking for
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  youth in Medicaid,
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  and how is your team working to address
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  those gaps?
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  So, really, it is about the partnerships. You
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  know, we we don't deliver direct care.
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  It is through the support
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  that we can provide to our providers,
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  to our community partners that also touch the
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  social determinants
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  of health and social factors.
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  So, yes, we need to grow the behavioral
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  health pipeline of providers as well as our
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  medical pipeline providers.
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  But we also look at housing needs,
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  food and nutrition needs.
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  The transportation, again, is is very important.
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  And so
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  our initiatives focus,
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  yes, on all of the health care needs,
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  the benefits that we provide. We want to
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  make sure that people understand those benefits,
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  that they are availing themselves of those benefits.
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  But we also look what are the barriers
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  that are keeping people from utilizing those, from
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  getting the services, and we try to fill
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  in that gap. We have housing specialists
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  that are not only looking for the particular
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  partnerships,
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  but then if someone has an immediate need.
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  We work closely with the food pantries.
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  We we've worked with our, food banks to
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  look at the food as medicine initiatives.
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  We have lots of baby care programs, and
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  those baby care programs go beyond
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  making sure that, our members are getting
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  great prenatal care because that's really where it
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  starts. We need to make sure that they're
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  getting that care. But what's keeping them from
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  receiving that care so that they can have
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  a healthy birth outcome
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  and also get connected to those services so
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  that the children will continue to receive services
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  throughout,
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  their span of time?
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  So as we wrap up, I would love
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  to hear what advice you have for other
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  industry leaders, particularly those
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  in the Medicaid space,
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  when it comes to
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  handling
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  issues with youth behavioral health and establishing those
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  partnerships.
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  One, I would say, really listen to your
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  partners. Listen to the community,
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  and your members. And, you know, when I
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  say members,
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  yes, it's important that we talk to the
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  parents, but it's also important to talk to
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  our youth and to understand
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  what are the challenges. I mean, going to
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  school today is a lot different. You know?
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  I will say when we were in school,
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  just even, you know, all the AI challenges,
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  the social media, all the other things that
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  will impact it. So we like to listen
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  to, you know, what are they facing and
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  how can we help? Where are the gaps?
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  Start there, you know, whether you do focus
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  groups or it's just a listening session. And,
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  of course, our providers, what are they seeing
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  in in the community? How can we decrease
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  provider operation for them so that they can
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  treat and see more of our members?
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  So I would just say be really good
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  stewards
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  of what we've been entrusted, especially in the
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  Commonwealth of Virginia,
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  but also to be good partners,
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  with all of our stakeholders.
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  I absolutely love that point about making sure
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  the youth voice is included and heard.
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  Well, thank you so much, Linda, for chatting
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  with us today. We really appreciate having you
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  on. Thank you so much again for having
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  me.
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  And to our listeners, if you'd like to
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  listen to more podcasts from Becker's Healthcare, you
• 10:58
  can visit beckershospitalreview.com.
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  Thank you.