Latest / Becker’s Payer Issues Podcast / Anne Groves, Market President at Arkos Health

Transcript

Anne Groves, Market President at Arkos Health · Becker’s Payer Issues Podcast

• 0:00
  Evernorth brings the power of wonder and relentless
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  providing clinical care and support services that provide
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  whole person care, we improve health equity, access,
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  and outcomes for the populations we serve.
• 0:47
  This is Gracelyn Keller with the Becker's Healthcare
• 0:50
  podcast, and we are live at the 2024
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  payer issues roundtable.
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  I'm currently joined by Anne Groves who serves
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  as market president, Arcos
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  Health. Anne, thank you for being here. Would
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  love to have you start off by introducing
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  yourself and telling us about your current role
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  and organization.
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  Hi. My name's Anne Groves. I am the
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  market president for Illinois for Arcos Health. I'm
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  also the chief medical officer in the market.
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  We are a value based startup company.
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  We take full risk on
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  populations
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  contracting with insurance companies
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  to provide
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  wraparound services outside of the hospital
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  in order to drive down utilization
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  costs.
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  Our model is built on the idea that
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  most health care
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  is actually delivered at home
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  and not in the hospital or clinic.
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  And too many patients leave the doctor's office
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  and then don't follow-up on care plans for
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  whatever reason.
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  Wonderful. Well, thank you for being here. And
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  let's start our conversation
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  with growth goals. So from improving member experience
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  and expanding value based care to controlling costs,
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  payer executives have ambitious growth goals for the
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  rest of this year and looking ahead into
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  2025.
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  So in your role, what is your top
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  priority, and how are you planning to get
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  there?
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  So our top priority
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  is member engagement.
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  All of the challenges that you just described
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  have this similar route.
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  Patients don't understand
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  why it's important for them to
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  do all of the health care measures that
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  we're asking of them. They don't understand why
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  their annual exam matters.
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  We have a Medicare Advantage population.
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  Our members don't understand why they need to
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  do their blood pressure screening, get their hemoglobin
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  a one c checked, or any of the
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  other HEDIS measures that play into
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  the payers star ratings.
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  So we need to get out and talk
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  to our members 1 on 1
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  in order to
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  educate them and in order to get their
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  cooperation.
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  Absolutely.
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  And going off of that at an industry
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  level, how would you describe the biggest barriers
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  to effectively serving and engaging members? And what
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  opportunities do you see for large scale improvements
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  and how you're applying these to your current
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  strategies?
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  So by far, the biggest barrier is data.
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  This is a theme that I'm seeing over
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  and over again here at Becker's.
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  Data management is so very difficult.
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  It's
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  the root cause is the fact that data
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  is coming from multiple different sources.
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  These sources are not integrated.
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  It is difficult to
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  tell what is accurate
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  in the data. And so
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  the old maxim of garbage in garbage out
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  applies. We've got to make sure that our
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  data is
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  trustworthy
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  before we act on it.
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  So
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  we are
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  concentrating
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  on building out a platform where we can
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  compile data from multiple different payers and then
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  draw our own conclusions as to where we
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  need to focus our attention.
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  When we're looking at large scale improvements,
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  we have to remember that health care is
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  personal. So large scale improvements
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  only come from engaging individual members.
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  We are working on forms of outreach that
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  actually get patients
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  to communicate with us and where we can
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  educate
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  as to
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  our case management services.
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  And shifting gears slightly toward leadership growth. Keeping
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  pace in today's dynamic health care landscape
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  mission, and you have to remember your mission.
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  You've got to keep also a mission. And
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  you have to remember your mission. You've got
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  to keep it front and center with everything
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  you do. It is absolutely possible to make
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  money in health care, but you can't forget
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  why you're doing what you're doing.
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  Absolutely.
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  And is there anything else you'd like to
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  share as a closing remark while we finish
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  up the podcast here?
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  So I am a physician by training. I'm
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  a neonatologist.
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  And
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  one theme that I've seen over and over
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  again is how very siloed
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  health care is.
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  We have 3 primary groups
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  that needs to all interact with each other.
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  We have our patient,
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  our providers, and our payers.
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  And what I'm seeing at the moment is
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  that the silos don't interconnect
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  at all.
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  Even here at a big payer conference, the
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  number of physicians I've seen
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  who are
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  practicing
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  is so few. It's a little scary. We've
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  got to have all the voices sitting at
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  the same table.
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  Otherwise,
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  we're never gonna make the changes that we
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  need to.
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  Absolutely. Well, Anne, thank you for being here
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  today and sharing your insights on the Becker's
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  healthcare podcast. Again, we are recording live at
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  the 2024 payer issues roundtable. It was my
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  pleasure. Thank you.