Why is Health Tech SLEEPING on Medicaid?

and what I see the most common is that people come to us and they vendors would come to us and want to do the more profitable side right they want to do ACA and they want to do Medicare but they don't want to do Medicaid and so that's been frustrating to me to to be able to offer services to some members but not others and and so I've worked really hard to teach companies that you can innovate inside of Medicaid and if they will engage in a dialogue with me in a whiteboard session we can figure out the ways to to start to work their way into to medicate along the way and so biggest that's probably the biggest myth that I see is that you can't innovate inside of Medicaid welcome to another Meeting of Minds with wot health I am your host Chris hill we are ready to dig in deep on mythbusting in Medicaid challenging existing assumptions that are holding organizations back from best serving their Medicaid members but before we get into it got to apologize have to apologize because the audio and V the audio and video didn't turn out the way that we would expect but we're posting this anyway because the conversation was so great Tracy Rico who is the director of virtual care services at cinen corporation's Superior Health Plan started her journey as a Medicaid member and she goes into that story and the frustrations how she felt lost in the system and how that's ultimately translated to the work that she's done is she's evolved her career into nursing into Care Management and ultimately into leading technological innovations for Medicaid members so really eager to get into this with you sorry about the audio video but the conversation makes up for it thank you I wanted to start by actually thanking uh the behavioral the going digital Behavioral Health Tech conference uh actually we were uh planning to do this as a uh a podcast there uh but we ended up uh we we weren't able to meet schedules didn't cross and uh tra Tracy fell ill so we had we had to do it here online which is also awesome so we we're not mad at that in the slightest but just wanted to thank uh Sol and uh team at uh Behavioral Health tech for uh helping us to facilitate this conversation and make it happen now uh getting into it with uh with with Tracy uh and going deeper on on this this this gap between what healthtech is doing and the needs of Medicaid members and our our populations out there just really excited to to to speak with her because like this isn't someone who's a talking head this is someone who look at her LinkedIn profile it says Fierce Patient Advocate uh so we're going to hear a lot of that passion come through and uh she shared also that she was a member of Medicaid herself so we getting like this this is leadership and uh passion that that is informed by experience and can't be excited enough to uh to to welcome you to to talk to this audience today Tracy thank you I appreciate it and thanks to salom too she threw a magical conference where I got exposed to all kinds of fun new programming and I can't wait to go again that really was a magical conference and honestly just to get the conversation started again overall well we're about to get into it the the the the main goals that we have here are to help break down some of those myths like identify what are these myths that are holding us back from uh developing and doing effective Outreach uh for our Medicaid populations what what actually is holding us back and what are some some of the practices what are some of the ways we can rethink the way uh the way that we're doing what can we look for in 24 uh in 2024 and 2025 to think about innovating for these these populations so breaking down those myths is is one aspect but uh again Tracy uh who who who's been in this role for over 10 years we we have her here to discuss and lead by example and and uh share maybe borrow a little bit from from her strategy and thinking so uh getting into it Tracy uh can can you start with your personal story and and What's led you to devote your career to that intersect of uh Health Tech and Medicaid for sure for sure so um hey everybody nice to see you again if I've seen you before um I obviously I'm Tracy um my background is um when I was first starting out a family I was still in college and and getting most of the way through it and um I decided in my inate wisdom as a as a 20-year-old that I should start a family at the same time um and so I actually had Medicaid um my first experience with Medicaid was through my pregnancy and then with my young children and so I've been on the receiving end of the sto of the side of the story um for a long time and so I knew what it was like to try and interact with an MCO to to look for programming that helped me to be a part of you know what gets paid for and what doesn't and so I really understand the patient perspective and then as things progress um my kids continued to have um some chronic things going on with asthma and I got frustrated with the health system and not knowing what to do like what the navigation behind you know getting through the Health Care system was and and finding the right people to really take care of my kids the way that I wanted them to take care of and so I went back to school and I decided to switch and become a nurse instead so that I could take care of my kids um and and and pick the right levels of care for them on my own um I did that for several years I did some labor and delivery I did some pediatric nursing um and then I got to see what it was like to help patients that had Medicaid and then from there um I cine called one day and said hey how would you like to try doing something on administrative life and I was like you know what maybe so and and it gave me the opportunity to go from helping one person at a time to helping millions of people at a time which was really freaking cool um and so I'm this is casual Tracy sorry if you're if you were expecting corporate Tracy I don't have one of them um yeah I I couldn't find a corporate Tracy um my first role was in um I served as a case manager and so I got to feel what it was like to be on the administrative side but actually like trying to get a hold of numbers on the phone and trying to work through the fact that demographics are wrong more often than they're right um coming from Medicaid agency and so I got to try to reach members and get frustrated by all I can do was make phone calls and and send postcards and hope that people call back and I didn't feel the like I was really really helping as much as I wanted to help and so one day they asked me if I would go speak to the marchs about what we did and I did and I was with a member of our um Ops Team or not yeah our Ops team and they were like and I was telling them I'm like doctors don't know that we do what we do right I mean I'm talking to pregnant members their Obstetricians would benefit from knowing the programs that we can offer their members we would benefit from knowing what's going on with their pregnancies so we really as nurses can understand what those numbers mean and help translate and and she mentioned hey like what were you thinking about putting a nurse on the off I was like huh I was like does is it like is it like a drug rep for case management and and she was like you know what it could be and so we had those conversations and we decided to move forward and so we built out the first clinical nursy aison program um and and that that was essentially what what started as a drug rep case management and for mcos became an education program for Physicians to teach them how to interact with us how to work with us best how to support your members what programs are available that kind of thing and then along the way um we started like taking out reporting that was about you know your ER your these are the members that were 120 days ago were in the ER can you like help them understand that there's other levels of care like you're available after hour or the urgent care or for things like strip right and so I would get Physicians the Physicians would tell me hey this data is really old how do we like act on this you want me to call Tracy who had R 90 days ago and see if you finished your meds like what do you want me to do with this and so I fell in love withal information exchanges and 24hour you know delays on data as opposed to 90 to 120 days to on data and so I had a great time doing that for a few years um um we built out some alert programming to let to let um to let providers know when their patients have been in ER or in an IP St they can do followup with them um we built out um automation for some prior offs based on ad data um we built the relationships with all of the health information exchanges in Texas um and then that kind of progressed and and suddenly tella Health became a thing and I'd been waiting for tell Health to be a thing for so long it wasn't payable um when it was finally payable I was like let's do this like all the things right um let's break all the barriers that everybody has to get to their appointments and really be able to help people where they're at in the moment that they're at without causing them to lose income because they have to stop and go to the doctor's office or they have to leave to pick up their child from school and so we I started building out that relationship um this is super public so I can say this um we have a relationship with t do and then I spent the the last four years um building out the programs that are more specialized and more High touch and and focused on specific disease States not necessarily an urgent care solution or an adult VH solution but beyond that and so I've had the best time um meeting with companies and and designing co-designing projects that that work for us as a payer that help members and that providers will tolerate I'm excited about that and and looking forward to what's coming next well thank you for sharing that detail because uh I I I think that it's really powerful to start from a position of being frustrated by the lack of options uh available and then moving into a uh caretaker uh and Care delivery role uh but it's so important to recognize that if you're distant from having a healthcare professional closer in the family then it really hurts your your your ability to navigate through through the Healthcare System uh so to hear from you who has has gone through this journey in terms of also like the next step when we talk about navigation uh case management all the way to to Leading the these technology initiatives in spirit of the theme of the webinar Medicaid MythBusters can you talk about some of the harmful assumptions that that you may have seen on the way uh and and what what some of the most important myths are to to bust sure sure so centine as a whole um has three major lines of business it's the ACA market and better um Medicare and Medicaid people come to us and they vendors would come to us and want to do the more profitable side right they want to do ACA and they want to do Medicare but they don't want to do Medicaid and so that's been frustrating to me to to be able to offer services to some members but not others and and so I've worked really hard to teach companies that you can innovate inside of Medicaid and there's no budget for Innovative programming and that's not true is there a ton of money no um but is there opportunities that if you create if you co-create a project and and that targets specific members that are on the higher spend level and you can design a service that works to lower that cost all we really need is I'm gonna get hurt for this comment but the thing we really need is that we need to be able to pay for it right if we if you can save enough money to pay for it then we can innovate with you I think that it's important that people start thinking about how like like how that fits into the ethos so it's not a matter of everything being completely static it's a matter of really seeking ways to enhance these patient experiences but at the same time uh help W uh help reduce the cost burden and uh uh and unnecessary burdens uh to to those same patients right yeah I mean we need to innovate right I mean you can't help people if you never change anything right right the progression of diseases is outrageous the volume of people showing up with comorbidities is just horrific especially in the mental health space in the last few years like if you don't continue to innovate you aren't helping enough people moving a little bit deeper into that thought uh just wanted to think about other myths that that you might have seen as holding Healthcare leaders back and holding innovators back and I wanted to to couch it kind of in terms of uh kind of a rapid fire like what's the myth and then what's the reality so a com another common myth is that people with low income or disabilities can't use Health Tech and they won't have access they won't be able to use it they won't have the devices to support it they don't have the aptitude for it like none of that's absolutely true and that's changed dramatically and and this is a strange comment but uh Co was the Silver Lining of covid was every grandchild taught their grandparent how to do this and now now they have devices and now they know how to use them and now they've been exposed and they're not intimidated by them so so many more people are engaging in technology that they wouldn't have engaged in before and trusting it that was that was the trick right they had to see a kid do it and that that helped expose them and then they were so motivated to continue to be able to see their babies you know and grandbabies during this time they they really got into technology and so we haven't you know everyone warned me when I started doing programs like this no one's going to use it your utilization is going to be like 1% that's not true at all you know the the the that's a myth that's pervasive with that with with the Medicare population as well is uh assuming that that people can't use this this technology I will actually accuse myself of of being guilty of that myth uh before I started looking at the data like when I'm uh not podcasting here at wobot uh help with Healthcare data science uh and looking at patterns uh like engagement patterns within the app our uh 65 plus users we we just saw tremendous usage and retention even higher than than lower age groups so uh definitely uh should be looking past that concept major major important myth is is really painful to hear just that that idea that people have this assumption that because of a certain Financial class and uh resources available people can't use Technologies uh did you have some other ideas too in that kind of myth versus reality framework so further out like people often say that not only can you not access them but they won't understand how to use them or won't want to have want to continue to develop them I think that the way that you roll things out in a program like that is what's really important so we what I do when we run programs like this is we don't just send out the devices we don't just send out programming we don't just advertise you know an app through a mailer right we teach uh I spend a lot of time internally teaching our case management staff Our member facing staff our community uh Our Community Resources staff um on what these programs are I give them like access so that they can see what it's like to experience them I try them myself um and anybody else who wants to try them as you know we get them an account we let them try the services so they fully understand it so that you can see one do want teach one when we send out programming we make sure that we're doing a whole bunch of Education along with it we're teaching health literacy we're teaching digital literacy we're asking important questions like hey do you have access to a device do you know where you can go what public places are available we actually surveyed um last year we commissioned a survey of five um remote counties and and trying to decide hey do people really not have Broadband access that's good enough like are there is can you do a quote quot KOC visit by video in random places most of those people could it wasn't it wasn't a concern about if they could it was more concerned about Comfort level with it and so we allow for Audio Only um with especially Behavioral Health visits so that members who aren't comfortable like with the with the you know I don't love being on video myself but but I do it um but on on when I'm meeting with a physician a lot of times like I'm in pajamas with my hair everywhere like you know when I do my so I don't particularly want to be on video so if people are nervous about being video worthy then they can do Audio Only and that takes away also some stigma by the way of Behavioral Health visits and so if you allow for lots of ways to connect you do this low Tech low bandwidth Solution that's really high touch and has humans backing it going hey as your case manager I can tell you I played with this thing it's pretty freaking cool you should do it it's really educational and and we have a lot of our programs involved coaching so that there's someone who when they make the phone call or they download the app there's someone who can say hey this is where you click within the app to get where you're going this is how you set up an account this is you know all the things and so we actually took the time last year to also do um we created videos for um our members and for our providers so that because one of the other things we learned in those surveys is we asked every provider in those counties what's up with tell Health like do you do you not like it will you continue to do it after covid was it only a necessity is it something that you know what is what are the barriers around it what are you afraid of things they're afraid of is that they won't get paid uh they don't know how to work it into their workflow they don't really understand tella Health bedside manner like all of those little things so we had um the university um of Texas has a uh a professor that teaches all things to heal and so we we had her create a series of videos there's four for providers and then there's four for members in English and four for members in Spanish but teach you all the basics it's we call it virtual care 101 so that people feel prepared hey like if a case manager is talking to them and they're like hey you can do a tele Health visit they can say hey I don't really the member will say hey I don't really know how to do that or I don't understand it or I don't trust it they can refer them to these videos and then after they go through the series of videos they're much more likely to have that higher digital literacy that allows them to participate programs that increase their healthare lit literacy the the the way that you frame this program uh just makes me think that we do ourselves a disservice if we put a wall around hey these are the the ways you just uh increase experience for Medicaid members because really everybody can benefit uh from that handholding and guidance when it comes to adoption on the clinical side on the yeah on the patient side so I I really love that frame up because uh the things that you're talking about don't just apply to one population they apply to everyone so I guess getting into it too uh we're we're we're exploring we're exploring these myths and we're exploring exploring these these Concepts but it makes me wonder about uh the experience and and what you drive at at as a result of addressing these so just thinking maybe borrowing from your experience maybe plagiar uh giving people something a little bit to plagiarize on can you talk about your strategy and and goals for 2024 and 20225 kind of in the context of hey we've explored some of these myths what are we going to be doing uh this year to to to address the needs for for our Medicaid populations um continuing in the vein of navigation um we are actually piloting a couple of things so we just went through and and by the way my biggest advice for digital Health people who want to start working in Medicaid and need to know where to find some funding follow RFP Cycles we we have to bid for every few years for each line of business that we have to the state right and they determine and that determines how many more people we get to serve or how many less people we get to serve and so in those moments we're looking actively looking for programming that's more updated than than we've had historically so that we can better take care of these members and prove to the state that's reading the RFP that this is the place to do that um and so following that that vein of of navigation um we are actually piloting a program that is called Cass the company's called Cass aai um it's the first time that I'm doing anything in an AI space so fingers [Music] crossed we're going slowly and carefully um we're doing a small pilot for members that have just left the hospital um that were had a mental health diagnosis and so they need to follow up right away but oftentimes they you know anyone who leaves a hospital one is completely overwhelmed and exhausted period no matter what you're there for it's not it's not a grand experience and you're not at your at your finest in that moment and so thinking through how hard Healthcare navigation is when you're healthy it's so much worse when you're just being returned from a hospital and so we are having them Outreach um casses um the AI chatbot mental health assistance um they reach out and they say Hey you know every single day they have a new list of members that left yesterday because of the data projects that I've done historically they say hey Tracy we you know we hear that you you were just Rel least from the hospital and we know we would like to help you with any follow-up here that you might need do you have a provider yes or no if you say yes great can that provider see you within the next seven days if they say no then they suggest um our finder provider they walk them through it they suggest our virtual care provider um Partners they walk them through it all the way down to they can help make an appointment directly and then once they find out that the member has that appointment made they do appointment reminders one day three days in advance um and then they follow up afterwards and they ask how the visit went and you know if they have any questions or concerns and and throughout the process not only did they teach them how to navigate and how to get them in front of a provider when they need to be in front of a provider so that they won't have to go back to the hospital because no one wants that they they also do screenings um BH screenings like for anxiety and for depression so that they can give us that data back and let us know how patients are doing and if their Acuity level has changed to a degree where they need a crisis counselor they can route directly to our crisis counselors and then they also can route back to our Behavioral Health case managers to let us know hey we need somebody to see them like today and so I'm really excited to Pilot that it it it's got a conversation behind it it's trained by BH clinicians it's peer-reviewed studied and all the things and so I'm really psyched um it's only been live today is two weeks um and and so far members are staying engaged with it like they have over 40 50 plus messages and so they haven't been bothered by the fact that it's a bot they're excited that someone wants to talk to them about what's going on and somebody's trying to help when they don't feel like maybe every anyone's trying to help and so I'm I'm really excited about that um but like I said just launched we we're going to see how that one goes and then um on the data side um we're about to launch a company um we just signed the contract yesterday um called Watershed health and this this gets to the nurse nurse nurse and me right so I remember as a Medicaid member trying to understand where do I go for help right like my kid just got released from the hospital and I don't know what all these medicines are I don't know where to go get them I don't have transportation to go get them I don't have you know and by the way I don't have enough food so I'm not super psyched about having to figure that out I'm figuring out what to feed right the what to feed people in my home so what this program does is it creates a healthcare ecosystem with the patient at the center which is one of my favorite words right now and so it's a it's a communication platform where the entire ecosystem around a patient can actually interact with each other and see who's doing the services they say they're going to do so Tracy's kid left the hospital yesterday um while they were there they filled out an seoh survey that said she had these four needs that need to be met right no one agency including us um Can can provide all of those needs for all of those needs that's why there's lots of versions of us right um so in the system as a case manager my case manager can go look in there and see hey while Tracy was there these are the things she needed and she needs a follow up with in in my case it was a pulmonologist right so we need to find her a pulmonologist so the whole like every provider is connected every PCP in the area every specialist in the area is connected like imagine it's San Antonio right so every provider in the area that we're they in our Network are connected in addition to all the community agencies so like the diaper Bank the food bank Transportation vendors things like that everybody else in that everybody who who handles an seoh need and everybody who handles a clinical need they can all see it they can all log in and find out where Tracy is and who's on first and then as they provide services say the Texas diaper Bank logs in they click the button that says hey I Tracy said she needed diapers I'll give her diapers so then Superior doesn't have to go hey let's also try to give her diapers we know someone else is doing it and we can spend that money on a different resource instead now now medical records are flowing in the between right so all the clinicians can see the Specialists can see what happened in the hospital the PCP can see what happened with The Specialist like everyone is able to communicate and this is the first time that we've had that much of an ecosystem around the member and we can really say hey we referred to these places and they had to reply back and tell us if they did anything about it so we can grade the network and say who should we not be sending things to because they aren't responsive who should we be sending things to you because they're very responsive so yeah those are those are my two like I'm launching immediately programs this year woohoo those are that so I I I anticipate a big year uh based on everything that you said and I don't know if you're looking but I was I was taking notes furiously during during this because uh it it just seemed to answer uh two major questions two major misses that a lot of organizations have when they're engaging their their patient popul populations which Cass correct me if I'm wrong but it it sounded like uh navigation tools for always knowing the next step that you need within your care Journey with within within the health system and and plan and uh Watershed seemed like it uh brought in the things that that the system uh might not offer but helped coordinate resources and identify Pathways uh for for patients to be able to take and assess Partnerships excellent excellent well well uh when also there there's another thing that that that happens when when you talk about something that that that has th that many connection points that many checkpoints like I know that it takes a lot of uh conversation across the board from a care navigation perspective from a clinical perspective and and also from an IT perspective and what do we have at every step along those ways are and are our myths and uh ideas that that might prevent people from opening up the the pur strings and opening up the resources to be able to make those things happen so when we think about like even before something even gets to RFP before uh like while we're still Coalition building and and trying to engage our peers and leaders and things like that how do how do you overcome obstacles or what what is and it doesn't necessarily have to be seninen I'm I'm just looking for what are what is your advice for uh people to to be able to start opening these doors among their peer leaders despite some of the pervasive myths uh about Medicaid members like my top advice points whenever because companies ask me these things all the time right because I meet with people frequently who are interested in doing something in the space and and what I start with is one you need to find a clinical human like obviously I'm a clinical human um and so I'm passionate about doing these things because it's been my experience and I want to make things better than what the experience that I had with my kids growing up um and so find if you can find somebody like I wish I could tell you there's a particular title of a person to go after right come agile like yes you have a service but is it necessarily the the most effective delivery method when you consider a Medicaid population trust us to tell you what's more effective and so you have to have that cheerleader within the company that's willing to to understand like when when the companies that I describe when they came to me and said hey we do a thing I went that's a very cool thing now can I do this thing instead like just little little tweaks so if you create a partnership with a clinical person that's your best step forward and really understanding and and going after the barriers that that you think are real and the ones that are real there there's another part that wonders too about uh perhaps that that clinical person who has identified a solution identified something that uh they they believe can help address the needs for these uh for for for a Medicaid population I'm talking kind of internal to a health plan or to to a health system and they might encounter uh barriers or blocks or or misconceived Notions from their peers and and other leaders I wonder if if you have ideas or stories about uh how like how as as someone who's identified an innovation uh uh within an organization like how how they can work with their peers who might have objections to what they're trying to do or the resources and and money spent to to make that Innovation happen with their Health Plan yeah so how do you do it if you're within a Health Plan like you're a case manager who wants to do something cool like how do you get past the all the barriers inside um yeah you you story tell like you you explain where that that like what your problem statement was right you go to like when I first did my first project right I started meeting it was a data project and so I went to my leadership to explain hey doctors are really mad at us when we tell them they aren't you know they aren't managing the ER utilization of their members well and they aren't following up and we're giving them a report that's 120 days old like how do you you know they it's reasonable that they would be frustrated with us to tell them to correct something that we can't provide data on and so that was the beginning of my first use case and I went to um I had a I had a clinical human as a boss um around that time and then also an operations person and so I went to I went to both of them and and the Ops person like stepped up and went okay this is how you write a business case like it sounds like you have a solution to a problem but you just don't know how to do that thing and so we started out figuring out um how much Roi right you have it's always money um money is my least favorite topic by the way um but you have to figure out what things we can save that will pay for the that right and so we figured out along the way how you know how many ER visits we might be able to prevent because people didn't go back to the ER because they forgot to continue their meds for their strip throat it after the three-day Mark right they didn't finish the course suddenly they're sick again they're back in the ER because they didn't no one reached out to them to tell them hey follow up with your own doctor your own doctor is better able to treat you and you won't have a 12-h hour ER wait wouldn't that be cool um and so we built out that business case together of the potential savings for investing in a health information exchange and that you know we went through approvals luckily I had a backing of someone that was credible in in the operation ation space um and and I was the clinical human um so we built out that business case and then that taught me along the way how to pay attention in the organization so have your listening ears on like what things is everybody saying oh my gosh we've gotten in trouble for these things or these scores aren't as good as they they can be like for heus um like heus and stars and and um caps are all really important metrics for health plans and so if you find a way to Target those problems and your solution works for those problems then figure out how to measure it and that will get you past so many boundaries that you think that you you can't get past like definitely it's it's about listening within the organization and like RFP is one of them right I know in an RFP it's it's the best time to suggest the innovations that I've been wanting to do for a while so when that comes up that's the first thing I do I go here's my list on day one here's the things I've been wanting to do forever tell me which ones you like I will get them in front of you instantly so that that's typically how I make things work is that what you're looking for 100% And I I hope that uh you you got innovators and uh people on the tech side to to take notes furiously on that that that part and you got people working internally in the organizations who want to drive these Innovations I hope they they took notes furiously too so yeah uh thanks for for helping with both angles there I know that that you're you're hitting hard right now with regards to to navigation both internal and external I'm wondering about what you're looking at in the market and and saying I wish there was a solution here just this is for people to uh for for innovators out there to maybe plagiarize some of these ideas but just curious about what would be your wish list for available Technologies for for helping to address Medicaid so I am completely obsessed with teen um and child pediatric Psychiatry In This Moment Like The Gap is so wide and we just don't have enough you know clinicians we don't have enough Partnerships we don't have like there isn't there's not enough steps in between right not everybody needs a therapist not everybody needs a psychiatrist right there's peer support groups there's digital Therapeutics there's like opportunities for education for in the middle so even if a member states that or even if a member like leaves the hospital and we want them to see you know follow up with a therapist or psychiatrist that's once a month once a week Max right we want stuff in the middle like they can work on coping skills they can learn ways to manage their mental health in in a nonclinical environment and so I'm looking for and i' I've found some I just haven't figured out the funding for some so I'm very open to hearing if you have a way to fund your support groups it is a payable service through Medicaid but the reimbursement unfortunately is so low you can barely afford the staff to do the thing and so I'm looking for a creative way to um form a partnership that allows us to maybe do both right like maybe they do the therapy and the Psychiatry but they also have peer support so that the cost gets spread across them I'm not quite sure what the solution is there but I want to do something for the middle right all the moments that you're you're feeling stressed out and you need some someone something somehow that isn't necessarily your assigned physician or um assign clinician we we went in with this this assumption that if a child has a behavioral health concern or mental health concern they are the only person that needs treatment and that's not true like how much time like I said you spend very little time with your actual clins in in comparison to the reality of how much time there is right you know what about everything else I mean do you think that you know the mental health problems weren't triggered by something else going on in that family and don't you think that if we treated the whole family everyone was learning the coping skills together they can support that child and continuing to work on the coping skills together they can all learn to communicate better there's so much you can learn as a family and we don't involve parents in treatment enough we don't teach them along the way so um I really like there's a program um that I really like that that treats and my favorite line about them they say they treat bir and up and I was like what how do you do be at Birth and and they do so they start by parent training and they teach parents along the way the things that as they come up um they can learn how to cope with learn how to support learn how to navigate and they're there for them so they can be stronger for their child who needs support for their actual diagnosis so I want sh families like help me figure out a way to pay for that it makes me think about things like Precision Behavioral Health which seeks to uh understand the like what program what inter intervention is going to be the best fit and uh perhaps that that might not be the uh in-person uh talk therapy there there might be other uh services or other things that that it's uh that that that's more applicable to so it it does make me wonder though that there there's there's another part to this which is uh like you you've identified some Innovations you've identified some some some Pathways that you'd like to see out there what do you use so so you are that clinical person that that people should be seeking out and asking questions to what does uh uh what tells you green light or red light uh when you're talking to someone who who's proposing a particular Innovation it's definitely a series of conversations like I'll meet someone at a conference we'll have like a conversation there and then we continue to talk several times and so as we're talking I'm figuring out one do you have a history with this like like me right are you doing this because you saw a problem or experience the problem and you want to help people because of it so you really relate to and understand the problem it's not just a product to you um I'm obsessed with Mission based companies the first one I ever met taught me that that's the way to go and I I that's what helped me Define the difference between a partner and a vendor is like if you're Mission based you're open to learning um that's another thing that I'm obsessed about if you absolutely just want to sell me the thing in the box and it only comes in the box and it only does these things like odds are if you don't customize there's not a whole lot we can do together um I also look for in the past few years um there have been some unfortunate experiences within um the whole ecosystem not me specifically um where companies have come in and said I really want to do Medicaid but really have no idea like how complicated it is and aren't able to manage their bottom line when they figured out that the no-show rate for Medicaid members is often in the 40 50% range if it's just a brick and mortar building and so people who are are who are open to doing like hybrid approaches or open to doing what like I described earlier like multimodal approaches to using the technology they'll do better and so I'm listening for one do you have any experience with payers I need like three to five years of other payers in most cases due to some Bad actors along the way um and then separately in Medicaid you have at least a year of experience in Medicaid or do you have leadership that came from a lot of experience with decade and they just happen to show up at your company at this time um so those two can can equate we have piloted historically companies like the first time like I we pilot so Texas tends to Pilot a whole lot of stuff for Olive centine and the other health plans kind of chime in I'm sort of obsessed with Pilots um because you know I got to make that money work right and I can't make that money work if I don't have any outcom so if you'll pilot with me at little or no cost no cost um then then we can prove out your value and in a short-term pilot so that I can justify getting you paid for um for a longer term project and so it it takes that agility that flexibility that willingness to listen and learn and actually be a partner those are the things I'm looking for the things that are required are some experience the the the question that we always like to finish with is uh we give you a superpower a magic wand that allows you to change any one thing just one I know there's many that we need to work on but just one thing within Healthcare so with that magic power what would that change be um I want more collaboration I want you to not do your do your work in a box I want you to like this goes for everyone right I want you to be willing to understand like from Pair to pair Medicaid members can change once a month right they can they can go from Etna to Superior once a month and then back and forth and back and forth and so I want everybody to start to realize that if we just help all Medicaid members across the board that that member is probably going to be our member at some point and then back and forth we're all we're only just helping each other and so I want I want us to start to see that and just make it the mission that we just help Medicaid members in general knowing that in the end the money will work out it's just little things well uh I I like the collaboration that we had today in in going into having this conversation um I come uh coming out of it very energized informed and excited and I I'm guessing that a lot of people who are watching or listening uh feel the same way so what's the best way for for them to keep track of what you're doing or follow you on social you can find me on LinkedIn um I don't do like Twitter or Facebook or any of the others but you can find me on LinkedIn and and we do I do a ton of press releases too so you can always see what I'm up to cool y'all yeah yeah please keep watch keep notice again like even look at your LinkedIn profile uh Fierce Patient Advocate I I think that that's just a reminder that uh like you're in a director level and Leadership role but like you're still thinking about the patient and I I I I think that everybody needs to be reminded to keep the patient at the center of everything that they do and not get too far away from that so uh with that I I'm I'm super thankful for for everyone who came onto this conversation thank you very much and uh we'll see you next time thank you

2024-02-20 14:22

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