Evernorth brings the power of wonder and relentless innovation to create world class pharmacy care and benefit solutions. Our connected health services make the treatment, prediction, and prevention of health care's most complex conditions easier and more accessible as we drive organizations
and people forward. Ever North Home Based Care provides value based care that helps patients with multiple chronic conditions and social determinant of health barriers get the care they need and the personalized experience they deserve. We serve patients who struggle to navigate the health care system by bringing high quality primary
and preventative care services to the home. By providing clinical care and support services that provide whole person care, we improve health equity, access, and outcomes for the populations we serve. Hello, and welcome to the Becker's Healthcare podcast. My name is Chanel Bunger. And right now, I'm thrilled to be joined by doctor Yvette Lefebvre, the chief medical officer, home based care, Ever North Health Services. Thank you so much for joining me today.
Thank you. Thanks for having me. Perfect. Well, to get us started, could you please tell us a little bit about your background? Sure. So I'm an emergency medicine physician by background. And as you said, I'm I'm currently the chief medical officer for home based care at EverNorth. And so kind of an interesting, I'd say circuitous route to get here. Started off my career in emergency medicine and have
now transitioned into home based care. And it's kind of a a great full circle experience, if you will, because I feel like now so at EverNorth home based care, we provide in home care in a few different programs. We have an in home primary care program. We have a health risk solutions program, and we have a post acute care and transitions
of care program. And so if I think back to my days in the emergency room where I struggled with giving the time and attention to patients with a lot of chronic conditions who would come into the emergency room for care, usually in the middle of the night when there was a lot going on because they weren't getting the primary care that they needed,
That was a stressful time for me. And so now I feel like working at EverNorth home based care, I'm actually starting to address the root causes of the problems that those patients were having. And so it's it's a great program and happy to talk more about that offline at some time. Perfect. And speaking of problems, from a clinical perspective, how would you describe the biggest barriers to effectively serving and engaging members? And what opportunities do you have for large scale improvements?
And how are you applying this in your current strategies? That's a lot, and probably more than we can cover in a 15 minute podcast. But so high level, I think some of the biggest challenges that we're facing together when we're looking at health care across the country right now, we're looking at an aging population. The population reference bureau is telling us that by the year 2050, we're going to have 85,000,000 people who are aged 65 or over. That's a 47%
increase over what we saw in 2022. Wow. Yeah. So that's a lot of aging patients that we need to be prepared to take care of. And then coupled with that, we're actually seeing a sicker younger generation, if you will. So when you look at patients who are under 45, we're seeing an increase in obesity. We're seeing an increase in cancers. We're seeing an increased risk of death from heart failure, and that's patients under 45. So we've got sicker patients, and we've got patients who are aging.
So we've got a lot of challenges in how we're going to deliver the care that those patients need. And then coupled with that, there's 2 other things that I think it's worth addressing or trying to address. We're not gonna fix it again in 15 minutes, but we need to acknowledge that there's been an erosion of trust of the health care system.
I think it's been happening gradually over time, but I think over the last 5 to 10 years, we've really seen a lot of erosion of trust in the traditional health care relationships with our patients. And then last but not least, I would call out the fact that we've got a a provider shortage in our country, and that's only going to get worse. First of all, providers are not immune to aging. Right? So we're gonna see more and more providers getting
ready to retire in the coming years. And we've also got providers who are burning out. Right? Probably as a result of all those other challenges that we've been facing. So those are what I would highlight as kind of my my hit list, my top five challenges. And then as far as opportunities and how we're addressing that from home based care, I would say, flip those on their head. Right? So if we look at those challenges as as opportunities, at Evernorth home based care, we're doubling down
on population health. And so if you think about population health as the health outcomes for a group of individuals, including the spectrum of outcomes for those patients across the group. Okay? By identifying the patients who are at highest risk or rising risk, like the ones I
just outlined. Right? The patients who are aging, the patients who are younger and sicker, patients who are disenfranchised for one reason or another from the health care system, patients who don't have access to providers because they're leaving health care,
standing up population health. First of all, identifying where they are, who they are, and having the data to show us where we need to focus our efforts, and then working to stand up programs to help specifically assist those patient populations. That's how we're starting to tackle some of those challenges, and I think it's a great opportunity for us to meet those patients where they are and to start addressing kind of the challenges that they're facing. Got it. Thank you so much for walking
us through that. Now kind of switching gears here. In an ever evolving regulatory environment, what tools or key strategies have helped your organization improve quality and clinical outcomes for members while staying compliant? Yeah. So, that's another big one to tackle in few minutes. But, at Evernorth, I would say actually that home based care is a live living, breathing example of one way that that larger organizations are starting to address that challenge.
By leaning into care delivery, and that's what home based care is, we are we are actually providing care to these patients. We're sending our in home primary care providers and our nurses and our social workers into the home to take care of patients, to touch them, and to help them through their care journey. That's a great way that a lot of larger organizations are really leaning in to drive quality outcomes for their membership as a whole.
I would also say that for our health plan clients, taking advantage of the of the drive towards value based care is is a great opportunity. And, actually, it's a great opportunity for both providers and the health plan clients. Right? Because the health plan clients have the opportunity to support providers in those value based care arrangements. The value based care arrangements enable these providers to provide the care that they always wanna
deliver in order to drive great outcomes. And so I think, obviously, we've been talking about value based care for, what, at least a decade? Probably more now. And so it's definitely going to happen. We're definitely going in that direction. And then so I see that as another great opportunity for organizations to drive quality outcomes even though we're seeing more and more regulation around how health plans can interact with providers and with patients.
That makes sense. Absolutely. And you spoke on a panel focused on fostering health equity. How do you define what health equity truly means in practice? And how would how should health plans redefine strategies to ensure equitable outcomes across diverse patient populations? That's another good one. So if we think about health equity as a state in which everyone has a fair and just opportunity to be as healthy as possible, And then we recognize that
equity and equality are 2 different things. Right? So health care equality is, unfortunately, what we've seen in the past in this country, right, where we build a care model, we build a health care system delivery, and we try to spread it peanut butter across the country. And then we wonder why wait. These patients are doing well with that, but these patients aren't. Right?
Equity says, you know what? We need to look at those patients who aren't doing as well and figure out what additional resources, what different care models they need because they're starting from an uneven starting point. Right? They're it's not even playing ground, so to speak. So they're starting from a different place. And so there are populations who need different programs. There are populations who need additional resources in order
to attain the same outcomes. Right? So we can't just say, here's how we treat CHF across the country. We need to figure out what each population needs. Equity, not equality. Exactly. Exactly. And so how do we do that and how do health plans do that? I would I would come back to where I started,
which is with population health. Right? So coming back to the idea that population health is looking at the outcomes of a group of patients, but also looking at the individuals across that continuum to see how they're responding to programs. Another way to think about population health is how do we treat individuals at scale? And so population health, I started earlier saying that we
need data. Right? So we can identify the populations who need different programs that need additional resources to obtain health care equity. But I would also submit that once we have that data, we also need to spend time with the individuals. And we need to spend time with the caregivers, and we need to spend time in the communities because I can't I shouldn't. Sitting in my office, look at data and say, okay. Here's a population that
needs a a different program. I'm gonna design it in my program and and send it in my office and send it out to be, you know, implemented. Right? We need to spend time with those communities so that we can hear from them what they need. Because I don't know what they need. They know what they need. So so getting back to the root of where health care started. Right? Spending time with our patients, hearing from them, hearing from what they need, and then taking that back and saying, okay.
This is how now we can operationalize that at scale. I think that's how we're going to start to really address health equity within our care models, and then that can spread right across the country as far as our health care system goes. Got it. Got it. Well, Yvette, I wanna thank you for sharing your insights today on the Becker's healthcare podcast. And to our listeners, thank you for joining us, and please be sure to check out other Becker's podcast. Have a wonderful rest
of your day. Thanks so much for having me.