Latest / Becker’s Payer Issues Podcast / Dr. Edward Juhn, Chief Quality Officer at Inland Empire Health Plan

Transcript

Dr. Edward Juhn, Chief Quality Officer at Inland Empire Health Plan · Becker’s Payer Issues Podcast

• 0:00
  This is Laura Dierdo with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor Edward Judd, chief quality officer at Inland
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  Empire Health Plan. Edward, it is a pleasure
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  to have you on the podcast today. Thanks
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  so much for having me.
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  Now I'm excited for our conversation because I
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  know that you really have a lot of
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  fascinating things going on in the Empire and,
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  truly, you know, our our model for how
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  other organizations can
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  aim to troubleshoot the big challenges within the
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  Medicaid system, but also be able to care
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  for their communities in a meaningful way. So
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  I'm excited to talk a little bit more
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  about some of the things that, you've been
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  up to in the last year and what
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  your plans are for the future. But before
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  we do that, I'm wondering, could you tell
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  us a little bit more about yourself and
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  your background?
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  Sure. Well, again, my name is Edward Judd,
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  and I serve as the chief quality officer
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  at Inland Empire Health Plan, oftentimes
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  referred to as IEHP,
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  where I'm responsible for leading the advancement of
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  IHPs quality journey through transformative
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  incentives,
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  initiatives, and innovative solutions and partnerships.
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  In this role, I work to ensure that
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  our health plan's commitment in providing the highest
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  quality of care for the members
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  and the communities we serve alongside providers
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  is top tier.
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  As a little bit of background,
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  IHP is one of the top 10 largest
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  Medicaid health plans in the country and supports
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  about 1,500,000
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  Riverside and San Bernardino County residents
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  enrolled in Medicaid,
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  Covered California,
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  and decent for those with both Medicaid and
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  Medicare.
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  And we also have nearly 9,000 providers in
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  our network. And for those who might be
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  curious,
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  as to who I am with a little
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  bit more background,
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  I'm an internal medicine physician,
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  and I've been sitting at the intersection of
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  clinical care, data innovation and technology, and also
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  in public health.
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  That's great to hear it. And, you know,
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  what a perfect position to be in, in
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  this day and age as you're looking at,
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  you know, so many changes within public policy
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  and information and data really playing a meaningful
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  role in how health care and health care
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  delivery is moving forward.
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  From your perspective, what are some of the
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  biggest issues that you're following in health care
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  right now,
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  and especially headed into the new year?
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  Well, I'd say a new year is a
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  new opportunity
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  to learn how we can best meet patients
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  where they're at.
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  One of the issues I'm following this year
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  is how technology will continue to improve the
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  delivery of health care and the positive impact
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  it'll have on patients.
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  The great thing is consumers are driving this
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  demand and that's shifting the expectations of the
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  health care industry as a whole.
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  I anticipate seeing continued demand for both in
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  person and virtual doctors visits,
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  increased expectations
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  for digital communications like texts, emails, and web
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  chats,
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  and the desire to supplement a doctor's visits
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  with patient technology
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  and engagement,
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  all in service to improving our patients' health
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  and outcomes.
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  And I think this also impacts the health
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  care delivery system itself,
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  which means we'll continue to see increased access
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  points for patients.
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  And I believe these trends will evolve throughout
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  2025
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  and even to the next decade as health
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  plans catch up to all other industries where
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  consumer experience is king.
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  That makes a lot of sense. And, certainly,
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  thinking about that consumer experience, you know, is
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  top of mind for so many folks in
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  the health care space as it becomes more
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  competitive and and people really have more control
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  over
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  their choices and decisions for where they're receiving
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  their care or how they're, moving through the
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  their health care journeys.
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  From your perspective, when you're looking at the
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  technology, some of the things you've tried, whether
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  it's the virtual visits or
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  the text and and emails and different ways
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  for to connect with, members. What have you
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  seen really
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  been most successful, and how do you especially
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  troubleshoot some of the challenges with the Medicaid
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  patient population in integrating technology into,
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  your care delivery?
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  Yeah. I think for us, it's always putting
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  members at the center of everything that we
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  do. And at the end of the day,
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  it's finding
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  ways for us to improve the outcomes for
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  the people that we all have a privileged,
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  opportunity to serve.
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  So, for example, when it comes to things
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  such as artificial intelligence and machine learning,
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  we here at IHP have actually started to
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  think through
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  what it means to be responsible and thoughtful
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  when we leverage these types of techniques. And
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  one of the things that we introduced,
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  almost a
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  a a a year or 2 ago is
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  how we can address algorithmic bias in our
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  care algorithms
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  just to make sure that we're being good
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  stewards of the information and the data that
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  we have. We've also started to push on
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  transformative
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  initiatives around automation.
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  And I think it's important to note that
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  we must continually figure out how to make
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  our processes better and to learn from one
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  another as we step through some of these
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  new concepts and solutions and technology
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  because we need to ensure that everything that
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  we do, again, improves care and outcomes for
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  our members, providers, and community.
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  That's great to hear. And, you know, really
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  cool to have that ability as you're implementing
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  artificial intelligence
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  to think through the the ways that,
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  you know, the the potential biases that it
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  could have and and then being able to
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  avoid them as much as possible or at
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  least get ahead of some of those very
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  real challenges. I know so many organizations in
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  the health care space are really paying very
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  close attention
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  to what they need to do in order
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  to safely apply AI
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  and get the right algorithms,
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  in place. And so that's really cool to
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  hear. Now in looking ahead, what are you
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  most excited about, or what makes you nervous?
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  Well, I think what excites me the most
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  and also gives me the greatest pause, revolves
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  around our region's significant provider shortage. You know,
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  on one hand, I'm very excited about the
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  outcomes from IHP's health care scholarship fund.
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  This program is a program that IHP launched
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  in 2020,
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  that provided about $40,000,000
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  in full tuition scholarships for medical students,
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  and later grew to also include nurse practitioners
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  in psychiatry.
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  In the past 5
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  years, IHPS supported nearly 240 local students who
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  were able to begin their journeys as medical
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  professionals right here in the Inland Empire,
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  and continue serving where they were raised.
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  What's also exciting is that we're building relationships
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  with our health care scholars in addition to
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  funding their education.
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  For example, they attend our IHP events to
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  better understand
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  the nuances of our region,
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  and they have also gone to know our
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  IHP leaders on a personal level, adding more
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  meaning to what it means to serve our
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  community.
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  At the same time, what makes me most
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  nervous is knowing that our region remains at
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  the lowest provider to patient ratio in all
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  of California
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  with 39 providers per 100,000 residents,
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  far below the recommended 70 providers per 100000
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  people.
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  You know, this statistic,
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  is one that keeps me up at night
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  as we strive to care for our most
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  vulnerable residents.
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  Well, that's fascinating. I didn't realize, you know,
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  how big of a discrepancy there was between
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  that patient provider ratio within the Inland Empire.
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  So when you look out at and obviously
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  doing what you can to play the long
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  game in training additional,
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  clinicians to jump in and and really help
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  in the future. But how do
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  you troubleshoot the challenges that are right in
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  front of you today and manage and balance
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  being able to look into the future and
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  see where,
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  long term you can shore up some of
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  those,
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  shortages or or close that gap, while also
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  managing,
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  you know, what you have, in front of
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  you and the patients that really truly need
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  health care today.
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  Yeah. I think for me, I think, you
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  know, over the next 2 to 3 years,
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  the most effective health care leaders are going
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  to be able to increase their skills and
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  comfort,
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  with innovation and technology,
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  as well as building their resilience
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  and strategic mindset to face some of the
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  numerous challenges and opportunities in our industry.
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  And it's one thing to know about these
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  concepts that I just shared, but it's another
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  thing to practically,
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  ethically and effectively
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  implement them. So I do think that it's
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  going to be really important for all of
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  us,
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  in the industry to leverage our learnings, both
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  small and large, because at the end of
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  the day, we're all able to make a
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  positive impact on our communities.
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  You know, for example,
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  you know, IHP has also started to use
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  advanced data modeling
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  to better understand how to provide the right
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  care at the right time by the right
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  provider in the right setting. You know, whether
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  it's preventive or chronic care opportunities,
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  we wanna make sure that we're as proactive
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  as possible.
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  And it's about leveraging
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  the best of our internal capabilities,
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  our provider network capabilities,
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  and all available tools and technologies,
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  to help people get the care that they
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  need. And I guess I'll close with saying
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  that the most effective
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  health care leader
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  and health care, I would say,
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  partner
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  in the future will also be fearless in
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  learning new ways to serve our industry and
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  unlearning what no longer serves our industry
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  because both these concepts are crucial
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  to transforming our health care delivery system that
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  desperately needs our best efforts,
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  for the best cause of all, which is
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  our members.
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  I love that. What a way to, really
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  think through the future and
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  understand what's gonna be necessary
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  as you move forward.
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  Edward, thank you so much for joining us
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  on the podcast today. This has been such
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  a fascinating conversation, and I look forward to
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  connecting with you again soon.
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  Absolutely appreciate it. Thanks so much.