Latest / Becker’s Payer Issues Podcast / Virtual Care Innovation and What’s Next with MD Live by Evernorth

Transcript

Virtual Care Innovation and What’s Next with MD Live by Evernorth · Becker’s Payer Issues Podcast

• 0:00
  Hi, everyone. This is Lucas Voss with Becker's
• 0:02
  Healthcare. Thanks so much for tuning in to
• 0:03
  the Becker's Healthcare podcast series. It's fantastic
• 0:06
  to have you. Very exciting topic today, virtual
• 0:10
  care, innovation, adoption,
• 0:12
  and what's next with MD Life, which we'll
• 0:15
  talk about in a second. And joining me
• 0:17
  for today's discussion is Tony Calistra, president MD
• 0:20
  Life by Evernorth. Tony, thanks so much for
• 0:22
  being here today. It's great to have you.
• 0:24
  Hi, Lucas. Thanks so much for having me.
• 0:26
  Yeah. It's great to have you. If you
• 0:28
  could introduce yourself to our audience and just
• 0:30
  share a little bit about your role, your
• 0:31
  the organization, and your background in health care.
• 0:34
  Yeah. I'd be happy to. So I have
• 0:36
  the pleasure of leading the team at Evity
• 0:38
  Live. We're a virtual care company. We provide
• 0:40
  access
• 0:41
  of our services to more than 62,000,000 members
• 0:44
  throughout our national network of board certified physicians
• 0:47
  and licensed therapists, and they are all specially
• 0:50
  trained to deliver care virtually. So we partner
• 0:52
  with health plans, health systems,
• 0:54
  and employers, and we provide urgent care, behavioral
• 0:57
  health, primary care, and dermatology.
• 0:59
  And we do so across
• 1:01
  a variety of different modalities on our platform.
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  So whether it's telephonic, video, or chat functionality.
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  And,
• 1:08
  our members and our customers, they rely on
• 1:10
  us to solve some of the the common
• 1:12
  barriers that they face in the industry today.
• 1:14
  So that's easily accessible health care, cost effective,
• 1:18
  high quality care, and and a compliment to
• 1:20
  their more traditional care care delivery models.
• 1:24
  Yeah. Tony, it's so great to have you
• 1:25
  because, again, it's this is such an interesting
• 1:28
  topic, and it certainly
• 1:29
  developed so much over the last couple of
• 1:31
  years. Again, if we think about the pandemic,
• 1:33
  right, completely different to what it is today.
• 1:35
  And and last year, we were hearing a
• 1:38
  lot of talk on on the consumer enthusiasm
• 1:40
  for virtual k waning a little bit with
• 1:43
  post pandemic.
• 1:44
  Now it's sort of changing. Right? More resurgent
• 1:47
  of interest, again, with direct to consumer offerings
• 1:50
  being more prevalent for for folks. Right? Weight
• 1:53
  loss, hair loss, sexual health,
• 1:55
  other conditions
• 1:56
  that impact overall health and lifestyles. There's a
• 1:58
  lot happening
• 2:00
  right now.
• 2:01
  Where does MD Live see consumers
• 2:03
  leaning into using virtual care as we head
• 2:06
  into 2026
• 2:08
  here?
• 2:09
  Yeah. Lucas, it's a it's a really important
• 2:10
  question, and we're we discuss this with many
• 2:14
  of our clients every day. I think it's
• 2:15
  important to start with a few statistics. First
• 2:17
  of all, virtual care utilization is almost 30%
• 2:20
  higher than it was pre pandemic. Yes. So
• 2:23
  while it's not as high as it was
• 2:24
  during the pandemic when there were literally no
• 2:27
  other options,
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  we still are significantly higher because of that
• 2:30
  acceleration
• 2:31
  and adoption
• 2:32
  during the pandemic. In fact, we just recently
• 2:35
  did a consumer research study that showed that
• 2:37
  forty three percent of all insured
• 2:39
  adults are open to receiving care virtually. But,
• 2:43
  actually, I think the more important statistic that
• 2:45
  we learned from that study was that thirty
• 2:47
  percent prefer it to be
• 2:49
  over in person care. Mhmm. So we know
• 2:51
  that there's demand out there, and you mentioned
• 2:52
  a couple of the reasons whether it's
• 2:54
  this increased demand for the popularity of the
• 2:57
  the weight loss medications or lifestyle conditions. But
• 3:00
  there are also opportunities to go well beyond
• 3:02
  just those conditions that we see on the
• 3:04
  on the television every day and every night.
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  There's a lot more demand that we're seeing
• 3:09
  for
• 3:09
  those conditions that are not low acuity, episodic,
• 3:12
  or those lifestyle conditions that that we we
• 3:15
  discussed. There's a tremendous demand for much more
• 3:17
  longitudinal products
• 3:19
  like our virtual primary care or behavioral health
• 3:22
  solutions that are ongoing and not episodic one
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  and done,
• 3:26
  or some of the things that we're seeing
• 3:27
  on the television.
• 3:28
  Couple of things we're we're trying to do,
• 3:30
  Lucas, to
• 3:31
  continue to drive that adoption. I think it's
• 3:33
  really important.
• 3:35
  We're focused on a lot of innovations that
• 3:37
  enhance that patient experience. So if you think
• 3:39
  about how do we increase the value that
• 3:41
  we deliver very specifically, we have to expand
• 3:44
  our clinical capabilities
• 3:45
  Mhmm. To meet some of the demands that
• 3:47
  that we've already alluded to. Primary care, behavioral
• 3:50
  care, chronic condition management, weight loss, the sexual
• 3:53
  health men's and women's health, etcetera. But there's
• 3:56
  also other things like preventive screenings and other
• 3:58
  specialized
• 3:59
  conditions that we see demand in the marketplace,
• 4:02
  not just through d two c channels, but
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  also through through our channels with our health
• 4:06
  plan and and health system partners.
• 4:09
  You've touched on what you're trying to do,
• 4:11
  right, to drive that adoption
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  or continuing to drive that adoption as it
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  as it again picks up.
• 4:18
  I'd be curious to know what you're hearing
• 4:20
  from
• 4:21
  payers too about sort of the current and
• 4:24
  future challenges
• 4:25
  with virtual care for virtual care providers.
• 4:30
  Yeah. This is probably not a novel answer.
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  I think I've heard this answer on a
• 4:33
  few of your your other podcasts in the
• 4:35
  past, but one thing that we hear all
• 4:37
  the time is there's way too many point
• 4:38
  solutions.
• 4:39
  Yeah. There's too many options. Members don't know
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  where to go. They don't know what to
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  do when they get overwhelmed. They just revert
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  back to what they know, which
• 4:47
  when you're relating it to virtual care, they
• 4:49
  go back to brick and mortar or they
• 4:50
  just delay care.
• 4:52
  So there's also
• 4:54
  a huge lack of coordination and data sharing
• 4:57
  amongst those providers, which puts that onus on
• 4:59
  the patient when there are too many different
• 5:01
  point solutions.
• 5:03
  Where we feel fortunate where we can help
• 5:05
  a lot of our our customers is our
• 5:07
  physicians can help unlock the value of all
• 5:09
  those different phone solutions and get them to
• 5:12
  the most appropriate clinically
• 5:14
  appropriate referral as opposed to just throwing them
• 5:17
  back into the to the ocean, and
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  those members often have options of 12 or
• 5:22
  or even more
• 5:24
  different point solutions to choose from. The clinical
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  provider guided care, we think, is a real
• 5:29
  differentiator.
• 5:31
  Yeah.
• 5:32
  Are there any other challenges that stick stick
• 5:34
  out for you in the market itself that
• 5:36
  that are important?
• 5:38
  Yeah. There's there's another that I mentioned because
• 5:40
  I think, again, this is prevalent across the
• 5:42
  entire industry is
• 5:44
  our payer partners specifically are asking for help
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  in educating the members to change the this
• 5:50
  evolving perception of what is virtual care and
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  what can virtual care do. Yes. So as
• 5:55
  we continue to educate them that the range
• 5:57
  of services is much more than just this
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  very low
• 6:01
  acute episodic care. It's
• 6:03
  so much more than we can provide in
• 6:04
  a convenient virtual setting. And knowing now that
• 6:07
  statistic I I alluded to earlier, that 30
• 6:10
  would prefer a virtual setting, We need to
• 6:12
  make sure that we help our our partners
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  communicate to their member bases
• 6:17
  about longitudinal
• 6:18
  services like behavioral health or virtual primary care,
• 6:21
  some of the wellness exams and laboratory referrals
• 6:24
  that we do for our members every day.
• 6:27
  Tony, we've talked a lot about challenges. Right?
• 6:29
  We wanna talk about the positive tool a
• 6:31
  little bit
• 6:32
  or at least the the the opportunities
• 6:35
  that we're seeing.
• 6:36
  What are some of those opportunities,
• 6:38
  that you're hearing from payers specifically for
• 6:42
  virtual care providers?
• 6:44
  Yeah. Again, probably not a novel answer, but
• 6:46
  it's something we're focused on every day is
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  how do we become more personalized with our
• 6:50
  members with every visit and every interaction that
• 6:53
  we have. So the members want that, and
• 6:55
  they expect that. They see that in every
• 6:57
  other facet of their lives today. So how
• 6:59
  do we make it
• 7:00
  more personalized at every turn, whether it be
• 7:03
  the initial intake to follow-up care,
• 7:05
  down the line after
• 7:07
  treatment is delivered?
• 7:08
  Our ability to offer several different modalities
• 7:12
  is the start of that. So whether it's
• 7:14
  telephonic or if a member prefers just to
• 7:16
  chat or prefers to be on video, the
• 7:18
  ability to meet them in a preferred modality
• 7:21
  is obviously one really important,
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  aspect of starting off on the right foot
• 7:27
  with the members. The second is
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  there is a huge opportunity for chronic condition
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  management and behavioral care. As all of us
• 7:35
  have heard many times in the industry, the
• 7:37
  shortages with with providers and also the the
• 7:40
  rising epidemic of
• 7:42
  these chronic conditions across the country. We have
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  to be there and and make sure that
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  our members that have access to us understand
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  that we can help take care of those
• 7:50
  those conditions as well as the sore throat
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  and the and the pink eye that typically
• 7:55
  people think of when they think of urgent
• 7:57
  telephonic care.
• 7:58
  Yeah. And lastly, the one other thing I
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  would mention that's coming up more and more
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  often is our ability to provide fast access
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  to care as that first point of contact.
• 8:08
  Mhmm. So when a member is not sure
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  of the severity of whatever their condition might
• 8:12
  be, we can either treat that or we
• 8:13
  can help triage the member to that, again,
• 8:16
  clinically appropriate, either full solution or site of
• 8:18
  care if necessary. And I think those are
• 8:21
  just three things that our our partners are
• 8:23
  asking us for help with as as opportunities
• 8:26
  for the future.
• 8:28
  Yeah. And I think, again,
• 8:30
  all three of them are in general are
• 8:32
  are very important. I think two of them
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  come back to what we started our conversation
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  with, right, is that consumer attention of, like,
• 8:38
  fast access, that consumer experience. But then the
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  other thing, the personalization
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  piece is so important as well that you've
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  mentioned. And and what plays a big role,
• 8:46
  I feel like, in that personalization piece is
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  the use
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  of AI right now, and and we'd be
• 8:52
  remiss not to talk about it. I think
• 8:53
  it's an important piece to to providing more
• 8:56
  personalized care in certain instances,
• 8:58
  and it can certainly play a transformative role
• 9:00
  in health care. We're seeing that right now.
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  I'd love to get your thoughts on this
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  and how you are
• 9:06
  applying GenAI to upper GenAI to operations with
• 9:10
  MD Life and and again, just your general
• 9:12
  thoughts on on how this is going.
• 9:15
  Of course. So AI is obviously it's unlocking
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  new levels of efficiency across every different industry.
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  Again, pick up the paper and not hear
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  about the latest in AI and and some
• 9:24
  of the new
• 9:25
  innovations that are occurring across across the world
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  today. So we use it to improve the
• 9:30
  patient and provider experience. We we have the
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  ability to process now enormous amounts of just
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  unstructured data Mhmm. In tasks that may have
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  taken hours or even days to complete can
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  now be done in seconds.
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  So the key is how do we make
• 9:42
  sure that we use AI responsibly and ethically,
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  and we have a whole center of excellence
• 9:46
  that's that's committed to making sure anything that
• 9:49
  we incorporate AI into is done in the
• 9:51
  right way as efficiently as possible, but also
• 9:54
  keeping in mind the the responsibility we have
• 9:56
  to our members and to our
• 9:58
  our customers.
• 10:00
  We use that to streamline those provider tasks.
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  In essence, it allows them to spend more
• 10:05
  time with the patient. Instead of doing administrative
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  duties or tasks that they would have otherwise
• 10:10
  had to do, we can
• 10:12
  solve a lot of those issues and give
• 10:14
  the patient more time with the doctor as
• 10:16
  opposed to getting them in and out real
• 10:17
  quickly. And and,
• 10:19
  we we know what that can turn into,
• 10:20
  a lesser lesser quality care.
• 10:23
  So I I absolutely see AI as an
• 10:25
  incredible opportunity.
• 10:26
  It's going to make
• 10:28
  providers' lives easier. It's gonna deliver better care
• 10:30
  to the member. And, ultimately,
• 10:33
  we all have the same goal of improving
• 10:34
  that member experience and improving the outcomes, and
• 10:37
  AI will absolutely,
• 10:39
  help us do so.
• 10:41
  Yeah. Tony, I feel like with all of
• 10:42
  these changes and all of these developments, we'll
• 10:44
  we'll just have to meet again in a
• 10:46
  couple months and talk again. Right? I would
• 10:48
  look forward to it. It's changing by the
• 10:50
  day. Yep. There'll be something new to talk
• 10:52
  about. Again, Tony, thank you so much for
• 10:53
  your time and insights today. It's fantastic to
• 10:55
  have you, and we also want to thank
• 10:57
  our podcast sponsor MD live by Evernorth. You
• 11:00
  can tune in to more podcasts from Becker's
• 11:01
  Health Care by visiting our podcast page at
• 11:03
  beckershospitalreview.com.