← Becker’s Healthcare Podcast
Loading summary
Transcript23 lines
- [00:01]
A
Hello, everyone. This is Jacob Emerson with the Becker's Payer Issues podcast. Thrilled today to be joined by AmeriHealth Caritas Ohio Market President Mark Grippy. Mark, thanks so much for taking the time to be with me on the podcast today.
- [00:14]
B
Thanks, Jacob. I'm glad to be here and I'm really looking forward to the conversation.
- [00:18]
A
Yeah, likewise, Mark. And before we dive into everything, we want to talk with you about an exciting new initiative happening at the company. Can you tell us a little bit more about yourself, your background in healthcare, and what it is that you do today at AmeriHealth Caritas?
- [00:33]
B
Sure. So my name is Mark Grippy. I am the Ohio market president for AmeriHealth Caritas. We are one of the Medicaid managed care plans that the state of Ohio has selected to deliver benefits to some 2.6 million members across Ohio. And we have a subset of that membership with our plan. You know, delivering Medicaid as a managed care entity, you often tend to lump us into the larger conversation of health insurance. But Medicaid managed there is nuanced. It's different. I often consider the work that we do to be more social services, and we just happen to pay claims for a living. So, you know, our jobs are really to connect with the community, to really make investments and understand the needs of those living in poverty, both, you know, at one state or our larger company where we operate in close to 13 states. And that role is pretty important to us. A lot of us started our career in healthcare services like I started my career in hospitals and nursing homes, actually being a provider. And it wasn't only after I really wanted to learn about how can I make an impact to much broader populations that I decided to come over to Medicaid managed care. My role at the plan is pretty simple. I work very closely to develop strategy with our team and bring great people that are extremely passionate about making a difference in the lives of others together. And I clear barriers and I let them get to work and do their thing. But it's an amazing opportunity that we have to work with such a deserving population.
- [02:19]
A
Absolutely. It sounds like such impactful work that's going on under your leadership. Mark and I wanted to dive right in today and talk a little bit about a really unique initiative, something I've never heard of happening within the industry before. It's a mobile gaming platform that the company launched earlier this year to address long standing gaps in Medicaid member care and engagement with those members. So for our audience that isn't familiar at all with this. Can you, can you share some details with us? What is this program? Where did this all come about? And ultimately what is the company hoping to achieve through it?
- [02:57]
B
Sure. You know, I think before I answer that, Jacob, I have to ask you a question.
- [03:01]
A
Sure.
- [03:01]
B
So let's say something amazing happens in your life. You and your partner may be expecting a child in your life, or you know, maybe the opposite of amazing. As you've been informed that you have a medical condition that's serious. Are you gonna tell your family and your closest friends first after you digest that information, or do you think you're gonna pick up the phone and say, hey, hey, insurance company, this just happened to me, I just wanted to tell you about it.
- [03:29]
A
That's a good question. And I, I think you know the answer, but certainly I go towards family and friends.
- [03:35]
B
Well, that's what we encounter every day. The irony of, of our business, business is that some of the most important things that we do are dependent on us engaging our membership and keeping them engaged. The irony is, is that that's also one of our biggest challenges. It is difficult with people living in poverty to always keep the most up. You know, when you're, you're living on a couple dollars a day and you have to worry about how do I feed my children or how do I pay rent, the last thing you think about is, oh, I have to go update my insurance company because I moved last month, or I have to go update the state because my telephone number changed. And we started to see this in our data and you know, one of the key things is that we saw single digit engagement levels within, like our applications. You know, I'm sure we all are familiar with the insurance company app that has big overwhelming directory or maybe some language in it that says, well, you could do this or you might have this benefit. So we realized that in order for us to really be successful, and let's be clear, success is improving outcomes for the people that we serve, we needed to reach a broader population. We started to think about what do we do. We asked our members. I mean that we had this simple thought of, we have an audience with our members, let's ask them how do they go about their day? And we learned that almost 70% of adults are using mobile games and about 45 to 50% of those people are playing multiple times a week. And that's just how they've, how our culture has evolved and developed. And it's much easier to do minor course corrections versus to try to instill a brand new behavior in someone. So we developed this platform in cooperation with our partner Motive and we put together the common everyday games that you play. Candy Crush, versions of Candy Crush, I should say Solitaire. And it's been a fantastic journey because what we're seeing is that people are already using this mode to communicate. So instead of talking at our members, we actually started opening a dialoguing, speaking with our members. We developed and curated content that was specifically designed, you know, for the diabetic or someone suffering from chronic high blood pressure. And in between levels of the games. These, these, these users went on missions and they're instead of an advertisement, we supplement it with healthcare education. And that healthcare education turned into a conversation. They started answering valuable questions for us. One of the requ that most plans have is to do a health risk assessment. The assessment isn't complicated, but it's the foundation for population health. It's the foundation for us to get to know our members. On average, maybe 20, 30% is our response rate because again, you're getting something from your insurance company maybe or maybe not. You fill it out. We started to see rates as high as 82%, 75% were completing the whole assessment. I mean this is world class time type of, of outcomes. And it really was because we took a minute, we learned how to communicate with our members and started delivering information in a way that they could digest. So I'll stop, stop there on that. I'm sure you might have a follow up.
- [07:16]
A
Yeah, I mean what a great idea, Mark, Just listening to you explain this, really just seeing where your members and what they were engaging with and then literally as, as the health plan going to them, it's fantastic. And, and like I said, I've never heard of any, anybody else in the industry doing something like this. So it's, it's really innovative. And I have to ask because you know, I've seen some of the engagement metrics you've recorded so far with this initiative. Members have logged over, logged in over 12000 times. They spent more than a hundred thousand minutes on the platform so far. So I, I think you know, drilling down to the, to the core of this Mark, how do you measure the impact of this engagement on actual health outcomes and what are some of the long participating for both your members and the health plan overall?
- [08:04]
B
You know, Jacob, I think when you start to look at some of the data and those, those early numbers that, that you just referenced, it becomes clear to me that our members truly care about their health. I think they're maybe a little bit skeptical about their health care and the healthcare delivery system and that that's telling us that the opportunity is there to really make that difference. So you know, how are we gauging success? You know that, that health risk assessment that I mentioned just a minute ago, when you can start to get numbers in that 75 to 80% of your total population completing a health risk assessment, we get such valuable information and we're able to engage them in a conversation because we're starting to build trust now with each other and care management becomes a more likely possibility, allowing us to help them connect them with a physician because we've already developed that trust. We've identified that there might be some sort of a chronic condition or something else out there that they really need the help. And we can remove social barriers to getting them that help. Transportation, we can provide them with extra benefits and housing assistance, all of which they never would have known before because they weren't at a place where they couldn't engage. But from a healthcare executive standpoint, I think it's important to recognize that we're starting to see early signs in our data, especially around behavioral health, that members with a behavioral health condition or some sort of substance use comorbidity that are engaged in this application, we're actually starting to see some early data that would suggest that there's a reduction in the total cost of care because they're adherence, because of the fact that they're communicating with the health plan and we know what those barriers are for them and we're able to help resolve them. And it's a clear correlation between engagement and the ultimate goal of improving outcomes for our members.
- [10:05]
A
That's amazing. So you're, you're really already seeing a real life impact within your behavioral health space and in really quite a short amount of time. And as I understand it, Mark, so the mobile gaming has replaced traditional ads and in app purchases with more personalized health content reminders for your members. So can you share a little bit about how the trivia and the health related contents that you're offering, how is that tailored to align with, with the health plan's population health strategy and how do you ensure this is really resonating with, with a pretty diverse member base?
- [10:41]
B
Sure. So when we, when we looked at doing this, you know, the way it works is that a member will download any one of the, the dozen or so games that we have available and then they have immediate 24. 7 access to the whole suite of games. And as they launch a game it's already pre populated with some information about the member. We know some of their chronic conditions as well as some of their history. But as they start to answer those health risk questions, the games learn and we provide that information to our partner motive on what those chronic conditions are. So let's take a diabetic member, for example. As they're going through levels of Candy Crush, they come to a space between the level. It's going to ask them, you know, have you exercised today? Or you know, do you understand the importance of a diet on a daily basis for someone with, with a diabetic health condition, are you exercising? And you know, the amazing part is since we've started this journey with our members, those questions or those missions that they go on, one can earn them tokens to unlock additional levels. And you know, that definitely caters to our competitive nature, but it also allows them to unlock real life incentives. The more education they take on, the more that they connect to providers, they're actually able to earn some additional incentives which keeps people coming back. I personally think the neatest thing is that as they answer questions, our system tracks their amount of right answers. And we've seen close to a 31% increase in health literacy with our targeted subpopulation since the beginning of the app. That's 31% people that now know today that diet and exercise and, and eating healthy overall is, is much more important to managing their diabetes than they understood, you know, when they first joined this application. And that again improves outcomes for our members certainly.
- [12:43]
A
So it's this gamification of, of health benefits, I think is fair to say it, it literally is closing care gaps. But it sounds like it's, it's improving health literacy rates. It's really amazing. Absolutely. Let me, let me circle back to some, some numbers you had mentioned at the start of, start of our conversation. 89% of members have provided you with their email, 75% have completed health risk assessments. So given that, I mean, clearly those numbers point to real success here. How do you see mobile gaming as a scalable solution that could be applied to other Medicaid populations across the country?
- [13:20]
B
So I think, you know, I'm a big believer in the science of quality improvement. And you know, the first thing that anyone really to do is understand their population, understand their data, and could this be an intervention or something that could help improve outcomes elsewhere? We're actually working to scale this program now across our entire state and across all of our, all of our subpopulations. But it starts with just that, ask an understanding of what are the needs of your members and do you have the capability to even test this in small populations? If you're getting positive feedback, then you work to scale it. You know, an interesting side note that we're finding as we promote this opportunity to our members is even though this is a digital solution that's finding a lot of success, the promotion of it, we're finding that members have digital fatigue. Everybody's hitting people with text messages, email campaigns. We're actually finding that the good old fashioned snail mail where we're mailing postcards and we're meeting with people in the community is a much better way to gain scale on the product than just a one size digital solution.
- [14:33]
A
That's a really great call out there, Mark, that you have to actually go into your communities, meet with your members in person versus continuing the digital fatigue. We're all very aware of.
- [14:43]
B
I think.
- [14:44]
A
Before we go, Mark, I want to open the floor back up to you in terms of, you've got the ears right now of a lot of other health plan leaders from all over the country, many operating in Medicaid. What else do you want to share with them on this topic or final bits of advice that you want to offer?
- [15:00]
B
You know, I think when we look at what our ultimate goal should be, and that is to really make investments into the people that we serve and to improve their health outcomes, but it's not a one lever solution. Improving the health and wellness, especially people, people who are living on Medicaid, is complicated. I want to go back to a statement I made earlier and I have to attribute it to Scott, the owner of our partner. Motive here is that, remember, I think people do care about their health, but conditions both inside and outside of their home have really complicated their relationship with health care and certainly complicated their relationships with health insurance. And it's made them skeptical. Involve your members in the conversation about what's best for them. Don't speak at them, speak with them. Create programs and products that really fit into their daily life and don't try to impose something that just doesn't fit. Remember, people living in poverty are living minute to minute, not week to week, month to month or year to year. And, and we have to help guide people through this complex system that we've created over long periods of time. I think if we can improve the process of healthcare delivery in such a way that it goes with the people that we're serving, you know, ultimately it has to lead to better outcomes and that will ultimately create efficiencies for companies like ours that reduce the total cost of care. There's winners all around. I think that's the message I would love for people to take away from, from this, this program that we started, this journey that we've been on and, and share with some of the success that we've had.
- [16:51]
A
Wonderful. Well, I think that's a great last message to leave us with. So, Mark, I want to thank you for taking the time to sit down with us today and, and for sharing about what is clearly very unique and impactful work going on under your leadership. We really appreciate it.
- [17:07]
B
Thank you for the opportunity. And I think that, you know, we're just scratching the surface of, of changing the way that we're thinking and, and how that different thinking is going to lead to innovation and better outcomes for people. So appreciate the opportunity and, and I wish you to have a great weekend.
- [17:24]
A
Yeah, you as well. It sounds like exciting things to still come from AmerHealth Caritas. Thanks so much, Mark, for being with us and, and to our listeners. If you'd like to listen to more podcasts from Becker's Healthcare, you can visit Beckershospitalreview.com.