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%20so%20much%2C%20Sam.%20This%20has%20been%20insightful%20and%20I'm%20really%20looking%20forward%20to%20Episode%20Three%20of%20the%20health%20plan%20series%20next%20month.%3C%2FP%3E%0A%3CP%3E%26nbsp%3B%3C%2FP%3E%0A%3CP%3E%3CSTRONG%3ESam%20Robinson%26nbsp%3B%20%3C%2FSTRONG%3E%3C%2FP%3E%0A%3CP%3EThank%20you%2C%20Claire.%20Good%20speaking%20to%20you%20again.%3C%2FP%3E%0A%3CP%3E%26nbsp%3B%3C%2FP%3E%0A%3CP%3E%3CSTRONG%3EClaire%20Bonaci%26nbsp%3B%20%3C%2FSTRONG%3E%3C%2FP%3E%0A%3CP%3EThank%20you%20all%20for%20watching.%20We%20look%20forward%20to%20having%20Sam%20back%20next%20month.%20Please%20feel%20free%20to%20leave%20us%20questions%20or%20comments%20below.%20And%20check%20back%20soon%20for%20more%20content%20from%20the%20HLS%20industry%20team.%3C%2FP%3E%3C%2FLINGO-BODY%3E%3CLINGO-TEASER%20id%3D%22lingo-teaser-1953003%22%20slang%3D%22en-US%22%3E%3CP%3E%3CSPAN%20class%3D%22lia-inline-image-display-wrapper%20lia-image-align-center%22%20image-alt%3D%22COHG%20logo.jpg%22%20style%3D%22width%3A%20999px%3B%22%3E%3CIMG%20src%3D%22https%3A%2F%2Ftechcommunity.microsoft.com%2Ft5%2Fimage%2Fserverpage%2Fimage-id%2F237532iC394DC06055D6F84%2Fimage-size%2Flarge%3Fv%3D1.0%26amp%3Bpx%3D999%22%20role%3D%22button%22%20title%3D%22COHG%20logo.jpg%22%20alt%3D%22COHG%20logo.jpg%22%20%2F%3E%3C%2FSPAN%3E%3C%2FP%3E%0A%3CDIV%3ESam%20Robinson%20describes%20the%20proactive%20changes%20health%20plans%20are%20making%20to%20transform%20healthcare%3C%2FDIV%3E%3C%2FLINGO-TEASER%3E%3CLINGO-LABS%20id%3D%22lingo-labs-1953003%22%20slang%3D%22en-US%22%3E%3CLINGO-LABEL%3ECovid-19%3C%2FLINGO-LABEL%3E%3CLINGO-LABEL%3Edigital%20health%3C%2FLINGO-LABEL%3E%3CLINGO-LABEL%3Ehealth%3C%2FLINGO-LABEL%3E%3CLINGO-LABEL%3Ehealth%20plans%3C%2FLINGO-LABEL%3E%3CLINGO-LABEL%3EHealthcare%3C%2FLINGO-LABEL%3E%3C%2FLINGO-LABS%3E
Microsoft

Claire Bonaci 

You're watching the Microsoft US health and life sciences, confessions of health geeks podcast, a show that offers Industry Insight from the health geeks and data freaks of the US health and life sciences industry team. I'm your host Claire Bonaci.  Today we continue our health plan series with Sam Robinson, our national director for  US health plans. Sam recently spoke at the International Federation of health plans COVID-19 series, and on this episode, we discuss how health plans can be more proactive in adapting to this new normal. Hi, Sam, welcome to Episode Two of the health plan series.

 

Sam Robinson 

Claire, thanks for having me back.

 

Claire Bonaci 

Yeah, of course. So two weeks ago, you spoke at the International Federation of health plans COVID-19 series. And I'd love to learn a little bit more about that. Can you tell us what your key message was and what the attendees were most interested in?

 

Sam Robinson 

Sure. It was a fantastic conference, obviously held virtually over  Teams. So I was very pleased by that. And we had a to z, I can't think of who the A health plan was. But all the way through Zimbabwe so Chile, a Zimbabwe, South Africa, New Zealand, and what the common theme was across all of these health plans are, what are we going to do? How do we stay in business? Are we gonna stay in business? So if you're a CEO of a health plan, right now, your board is saying, What are you doing? And what are you doing? The right answer is not nothing, or the same, or hoping things turn out? So the major theme and question for most of them is, what should we be focused on from a digitization standpoint, to lead us into the future and frankly, to survive the current. That really brought us down to the framework that I think you've heard a lot from Satya on down about responding to the crisis is the first stage, we are now in a recover phase, if you will, with some and some are still in respond. But then you will move into a reimagined phase, which won't be optional, you'll need to reimagine your business or you won't have a business. And as we talked to the health plans, what they were really focused on or what we focused my message on was, you need to respond. But that response should have at its heart, a reimagine. And so start with the end in mind. And the end is a reimagined. So there was a lot of efforts that are going on right now and health plans before COVID, if you remember back that far, that really led to where they are now. And those same efforts, especially the digitization efforts, are if anything accelerated because of the crisis. And that's a good thing. And it will allow them to move to where they had to be anyway, is a reimagined state of business, where virtual is not a part of what they do is not an alternative to an in person, it is a core part of every business line that they need to recover from.

 

Claire Bonaci 

So really great answer, I love that you bring up that a lot of these health plans were already doing efforts with virtual health and health, they were already kind of doing that to begin with. But now it's really reimagining that new normal. So can you give us some examples of how virtual health would be affected by the changes that these health plans are making?

 

Sam Robinson 

Sure. For years, we've heard about it focused on the member. Member first member 360 total health of the member moving from a payment to a care navigator. All these things are the same general theme is we care about our members, and we want to service our members in a new and unique way. All of those efforts started pre COVID and virtual health being one of them. What was virtual health, really just a different service they were paying for. In COVID, we're now paying the same so in person we call that parody or paying parody. That's a real respond reaction. It will still pay for it. Do it your way. What the health plans are looking to the future saying is how do we make virtual health a real part of our care management plans? How do we use virtual health as part of how we go to market? So imagine oncology case, you might have 20 visits in a given treatment cycle to the oncologist not to treatment, points of treatment, but to the oncologist. Can some of those be virtual? Absolutely. But does that virtual mean the same as a in person visit? Absolutely not. It has to be optimized for the virtual experience, maybe a pre survey, a post survey whether it happened. Maybe the pre survey asks, How are you feeling how are you dealing with the therapies? Are there anything we could do for you? Do you have any major questions you want us to answer that's reviewed by the doctor while you're in the waiting room, the electronic waiting room, and when you go in, it's a much more meaningful conversation.  Much like we're having right now. And that's part of your overall plan. And guess what the parody will go away, I'm not going to pay the same for that five minute conversation that it would for an inpatient visit, where I'm using resources and office time, etc. There's a lot of negotiation. And what we're seeing is, when you bake virtual care into a value based plan, it can be very powerful, most, most importantly, as an effective treatment plan, but secondarily, for the consumer who can sit here in our homes, just like we are now to do that appointment. And lastly, whether they like it or not, for the providers, right now, fee for services left them high and dry. There's a lot of providers going out of business waiting for patients to walk in their door, or trying to supplement with the virtual health that they can. A Value Based Payment Program, paying, for example, a bundled payment for an oncology treatment, will keep them in business longer, and is frankly, a much more sustainable model for our economy, and to keep the providers there that we need when we need them.

 

Claire Bonaci 

So one area I'm interested in as well is behavioral health. So how is that really being affected right now?

 

Sam Robinson 

Very great question. We've always suffered from are having a decent, you know, Behavioral Health Network. While there's Magellan and other others out there that are, you know, outsourcing that the individual health plans have always wanted to get more control over a Mental Health Network, run a Mental Health Network, and frankly, bake it into, like the oncology care plan we just talked about, we all know the evidence is there. If we add behavioral health screening, if we have behavioral health visits into a care plan, we're going to get better outcomes. It's just that simple. And it's a very cost effective way to get best outcomes. The issue is, if you're sick, if you're going through treatment, you don't really feel like dragging yourself into an office. If we can move that to a tele mental health visit, we really can expand not only what's happening out there in the world mental health, which is underserved. But we can also get better outcomes and better member satisfaction. The trick is very state specific right now. And so you have to build up those networks. But I think this is the time that now that you have this behavioral health possibility in front of you, you're going to see plans invest a lot in building up their own mental health networks, working with the mental health plan providers, and building that into those virtual health visits into many, many more. And of course, we don't have to legislate to get that mental health cross state, just like we did with the relaxed rules on regular visits and primary visits, we need to do the same thing on telehealth.

 

Claire Bonaci 

That's great. I'm really looking forward to that change, actually. So if you had to choose one other area health plan to focus on right now to be more proactive, what would it be?

 

Sam Robinson 

Sure, the general area that it would say you should focus on is everything, anywhere, you're dropping the paper, anything that's not digitized. But specifically, you know, think about what's coming up, we have open enrollment coming up my my open enrollment is around the corner, if you don't have a way to do that virtually, you're really going to drop your memberships think let's take one population, the Medicare Advantage population, typically, I will do phone trees, I will do lots of ways to get to those folks. They also probably drive an RV up and just park it and say come on in, that's not going to happen. Or go to a local community center and have a mass meeting. That's not going to happen on many fronts, right? So how do you take that meeting concept? bring people in and make the virtual experience, not only as good as an in person experience, but better? How do you deal with the technology limitations of that population, and still allow them to have a differentiated experience. If you focus there, like everything we've talked about within the member, then you're gonna have a much better outcome and you'll get to that reimagined stage much faster.

 

Claire Bonaci 

So really just being proactive reimagining the new normal from every stage of virtual on every stage of the patient engagement. So that's great. Thanks so much, Sam. This has been insightful and I'm really looking forward to Episode Three of the health plan series next month.

 

Sam Robinson 

Thank you, Claire. Good speaking to you again.

 

Claire Bonaci 

Thank you all for watching. We look forward to having Sam back next month. Please feel free to leave us questions or comments below. And check back soon for more content from the HLS industry team.