← Becker’s Healthcare Podcast
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- [00:00]
A
Evernorth brings the power of wonder and relentless innovation to create world class pharmacy care and benefits solutions. Barriers to care can lead to gaps in care which can drive up the total cost of care. Our capabilities work seamlessly together to create innovative pharmacy care and benefit solutions for today and tomorrow. Our connected health services make the treatment, prediction and prevention of healthcare's most complex conditions easier and more accessible as we drive organizations and people forward.
- [00:29]
B
Hello and thank you for joining us on the Becker Pairs Issues Podcast recorded live at the third annual Spring Pear Issues Roundtable here in Chicago. I'm joined today by Lila Benioun, Chief Operating Officer at Metro plus Health. Lila, thank you so much for joining us today.
- [00:44]
C
Thank you for having me. I'm so excited to be here.
- [00:46]
B
Could you please take a moment to introduce yourself and tell us a little bit about your organization?
- [00:50]
C
Sure. I am the Chief operating officer at MetroPlus Health. We are a health plan that's located in New York City. We have approximately 700,000 members across the five boroughs. We are a fully owned subsidiary of New York City Health and Hospital Corporation, which is the largest municipality system in the nation. We have over 32,000 providers and we have our staff speaks over 40 different languages so that we can cater to those our members because it's a very diverse population. And so I oversee plan operations, making sure our members and providers have excellent service. And yeah, I'm very excited to be here and thank you for having me.
- [01:31]
B
It's my pleasure. Well, I guess my first question for you would be balancing affordability and quality is a constant challenge for health plans. How is your organization innovating to manage the cost of care while maintaining or improving member outcomes?
- [01:46]
C
So we continue to look at utilization drivers of our members and making sure that we are at the forefront of providing holistic care to our members, also addressing social determinants of health and then also not only looking at utilization drivers, but partnering with our provider community to see if there's better ways that we could service our members and being proactive about their care. We do provide various incentive programs so that we continue to ensure that our members are staying healthy or becoming healthy on both the provider aspect and member aspects.
- [02:24]
B
Well, member satisfaction is essential to thrive in today's competitive healthcare market. What experience or engagement strategies have proven effective for your organization and how are you measuring success?
- [02:34]
C
So we're coming out of the PHE Unwind and Medicaid redetermination calling you back. We're in the second year and so what we did to prepare for that was we create these concierge units, and we really entrenched ourselves into our membership in the communities within the five boroughs. And so, with that said, we are humanizing Measure plus Health and making sure that our members have a place to go if they have a question. They don't have to come to a corporate office. They could go to one of our community centers. Whether it's a service that they need help with, whether they need to make a PCB change or help with, you know, recertifying their enrollments, we're here to help them and serve them. Not only that, we are very sensitive to the various culture and the diverse population. We consider race and ethnicity because one culture may hear a message that might be a totally different message than another culture may hear. And so we really factor that in because we just want to make sure that our members have the best care and the best service possible.
- [03:36]
B
Net Promoter Score is a powerful indicator of member loyalty and satisfaction. How are you using NPS to drive meaningful improvements across your health plan?
- [03:44]
C
We use a Net Promoter Score every day whenever a member calls our call center, they do have an opportunity to provide feedback, and we have a survey that goes out. It's a very good indicator about how satisfied our members are. Right. Are they a net promoter or are they a net detractor? And we want to make sure that we allow our members to express themselves. And so whether it's dental coverage or a provider issue, we do our best to hone in on what those drivers are that are causing dissatisfaction. And so Net Promoter Score is a very good guide for us to understand and pivot our strategy so that we have continue to provide excellent care to our members.
- [04:28]
B
Looking ahead, what do you see as the biggest opportunity for payers to lead the charge in transforming healthcare delivery and driving better outcomes for all stakeholders? And how can leaders take the first step in this direction right now?
- [04:40]
C
So I think using data as a guiding post is very important. Doing predictive analytics and then also just honing in on the member from an individual standpoint. And holistic care is going to be key factors. Right. And so we want to be moving from a reactive to a proactive health insurance. Right. And so not just managing sick care, but making sure that our members are healthy and stay healthy. And, you know, based on data, we're looking to see whether it's medication, behavioral health, we will be able to predict whether a member needs additional support. I think that social determinants of health is another factor to our members that they can't get to their appointment because there's no transportation, they will miss that appointment. And so Metroplus continues to really look at our members from a social factor, making sure they have housing, food insecurity, behavioral health. And so I think that's so important to making sure that our members continue to live their best life.
- [05:42]
B
Well, Lila, thank you so much for joining us today on the show. I really appreciate your thoughts and insights today. Thank you so much.
- [05:47]
C
Sure. Thank you for having me.
- [05:48]
B
My pleasure. You have a lovely rest of your day.