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Becker’s Healthcare Podcast
Inside Clever Care Health Plan’s Growth: Blending Cultures, Community, and Value-Based Care
00:09:42
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- [00:00]
A
Hello everyone. This is Jacob Emerson with the Becker's Payer Issues podcast. Thrilled today to be joined by Richard Green, who is the president of CleverCare Health Plan. Richard, thank you so much for taking the time to be with me on the podcast today.
- [00:13]
B
Thank you, Jacob. It's my pleasure.
- [00:16]
A
Absolutely. Richard, before we dive into everything we want to talk with you about, can you tell us a little bit more about yourself, your background in healthcare and what it is that you do today at CleverCare?
- [00:25]
B
Happy to. I'm the president of Clever Care Health Plan. Clevarecare was founded to provide a culturally sensitive and competent Medicare Advantage health plan. We give members access to care that's delivered in their own language and with their own unique cultural traditions in mind. We have a value based care model that essentially blends Eastern and Western medicine. I joined the company in April of 2023 initially as our Chief Financial Officer and then March of 2024 I moved into the role of President where I oversee the day to day operations of the company as well as the financial Strategy. Before joining CleverCare, I really dedicated my career nearly 30 years to financial and operations roles across both payers as well as groups. And most recently I served as the COO and CFO of Apple AppleCare Medical Management, which was one of the first acquisitions within OptumCare.
- [01:30]
A
Wonderful. Well, like I said, we really appreciate you taking the time to join us today. Richard and I wanted to get started by talking about some recent news from CleverCare. The company just opened its new flagship community center, which is now the fourth CleverCare Community center in California as I understand it. So talk to us a little bit about this new center and what role your community centers play in the overall growth retention strategy at Clever Care and how you want to measure their impact on member experience on outcomes, engagement. Give our listeners a full picture of how you're thinking about this.
- [02:07]
B
Absolutely, you're right. The Rolling Heights Community center is our fourth location and our community centers are really at the heart of our mission. These centers are part of how we invest in our members and deliver on our commitment to of being a reliable partner. What makes the center special is that they blend Eastern and Western approaches to wellness. Our members can attend Tai Chi classes, participate in community classes on mental health and dental care, or come together for community building events that might include lessons on technology, book clubs, birthday celebrations, and we even have found some talent within both our associates and our members with live music. They like to do a lot of sing alongs. Everything is offered in languages primarily spoken by our members. Covering Mandarin, Cantonese, Vietnamese and Korean. The Rowland Heights center, as I mentioned, is our fourth center, joining our centers in Monterey Park, Westminster, Koreatown. In 2024, our three legacy centers generated nearly 18,000 visits, which tells us our members are actively engaging and we're seeing that engagement translate into better satisfaction, better retention, and really increase connectivity with our members. These centers position us to deliver an exceptional member experience and build deeper, more meaningful relationships with the communities we serve. And these centers are places of connection and belonging and that's a foundation of our growth.
- [03:56]
A
That's fantastic and it's amazing to continue to see to build out these community centers in the markets that you serve. Richard, I also wonder if, you know, I want to talk a little bit about the Medicare Advantage landscape more broadly and some of the news and trends we've been seeing this year with companies all over the country. As you know, we're seeing plans consolidate their offerings, tighten margins heading into 2026. So I wonder if you could explain for us how Clever Care specifically is navigating some of these industry headwinds while continuing to invest in what you just talked about, these culturally tailored care and community based services.
- [04:34]
B
Yes, we believe our combination of Eastern and Western medicine, along with features like the community centers resonate with our community. And we're focused on investing and expanding, much like our Roland Heights center which just opened as a perfect example. We're able to do this because we've proven our model which honors culture and tradition, delivers financial results. Since 23, we've more than doubled in size, growing to nearly 30,000 members. As you alluded to, it's no secret that national payers have found the transition to value based care challenging. Outcomes based models tend to take time to deliver on cost savings, but we feel as though we're leading the way with a sustainable model that works. Central to our success is the trusted relationship we've developed with providers in our network. We ensure seamless claims processing, timely and accurate claims payments, and unique to CleverCare, our network includes 700 directly contracted acupuncturists and other non traditional specialists. We've also maintained stable and reliable benefits over the last couple of years, giving both our members and our brokers confidence in our commitment to them. That stability combined with our financial performance is what has allowed us to continue to invest in things like our community center, while others may be pulling back.
- [06:14]
A
Sure, that makes a lot of sense and clearly clevercare is a very unique health plan in terms of its offerings and benefits and it's clearly working in terms of the growth you've seen in enrollment over the last few years. Richard, I wonder in that vein, where you see the biggest openings for innovation or differentiation in Medicare Advantage over the next few years, Whether that's in growth in your benefit design, care delivery, member engagement, how do you continue to see clevvercare innovate in the MA space?
- [06:44]
B
I think the biggest opportunity is exactly what we've been doing at clevvercare is just continuing to create a model that blends Eastern and Western medicine while focusing on removing barriers and improving outcomes. In benefit design, there's a real opportunity to reflect members actual health traditions. As I mentioned earlier, Our network includes 700 directly contracted acupuncturists and these aren't extras. In fact for many people they are core to how they approach health and wellness and help create a sense of real connection in care delivery. Being a reliable, transparent and trustworthy partner matters and creates the foundation for better care delivery. And in member engagement, physical presence in communities through our centers makes a difference. Engagement, especially when delivered in our members own language, is what drives better outcome. And the plans that will differentiate themselves are the ones that genuinely understand and serve their members unique needs while maintaining the financial stability to deliver on their commitments year after year.
- [08:01]
A
Absolutely. And for sticking on that as our last question, Richard, in terms of some of the advice or final thoughts you would offer all the other insurers listening in right now, navigating the same headwinds, what would you share with them?
- [08:16]
B
First I would say don't chase unsustainable growth. Build something that lasts through strong operational foundations, genuine relationships with the provider network and a clear understanding to the communities you serve. The industry is at such a critical moment, so it's crucial to understand that sustainable growth requires a different approach than the past. Our approach is to focus on maintaining the stability that allows us to invest for the long term. And to that point we're posed for continued growth and investing. Over the last few months we've brought on a new Chief Information Officer, Vice President of Operations and Vice President of Sales, all seasoned leaders that understand Medicare Advantage. And that's the kind of investment that positions ourselves as well as others for sustainable success and growth.
- [09:16]
A
Wonderful. Well Richard, I hope you keep us posted on the continued innovations and growth at CleverCare. But I want to thank thank you for taking the time to chat with us and for sharing your insights about all the new stuff going on at your company. We really appreciate it.
- [09:31]
B
Thank you very much Jacob. I appreciate the opportunity.
- [09:34]
A
Yeah. And to our listeners, if you'd like to listen to more podcasts from Becker's Healthcare, you can visit beckershospitalreview. Com.