Hello, everyone, this is Jacob Emerson with the Becker health care podcast. Thanks so much for tuning in today where we're thrilled to be joined by a very special guest. Doctor Sac and Jai is the President and Ceo of Scan Group. Doctor Jane, thanks so much for taking the time to be with us on the podcast today. Thank you, Jacob. It's great to deal
with you. Yeah. Likewise. And before we dive in, hoping you can tell us a little bit more about scan group for those that may not be familiar and what it is that you all do there. Scan group was founded in 19 77 by a group of community activists that we affectionately called 12 angry seniors. This was a group of individuals who believed that there had to be a better way to age in Long Beach, California.
And they built a network of services, called the senior care action network that was aimed to better address the needs of older adults in the Long Beach community and adjacent areas. The the scene of imagination that they had in 19 77 has grown into a movement we now are, diversified healthcare care entity that serves over 300000 people, in California, Arizona, Nevada, New Mexico, Texas and Pennsylvania. We operate a large not for profit, Medicare
advantage plan. We operate medical groups, including welcome health, My place health, health care and action, and Home based Medical. It is incredibly gratifying to be scans leader at a time of a lot of change in health care, where where there's is greater focus on health equity, greater focus on the sustainability of not for profit health care, greater focus on segmentation to serve distinct populations, and it's it's really excited to be representing scan on your podcast today.
Yeah. And you mentioned such a that the that the root of the organization is addressing the needs of seniors. And this month's scan released its first environmental social and governance report, showcasing your impact on seniors and the un house population. Can you share key takeaways or notable statistics from that report that resonated with you most. Look, I'm I'm very proud of this report. But I will tell you we initially resisted putting it together in the first place.
You know, that... It's become, you know, I I think a pro form a activity in a lot of organizations to write an es report and know, when 1 of our board members, Rosemary Turner asked us to do 1? We said, well, everything we do is Es. Why are we... Why do we need to do this report. We, of course, didn't tell her that, but we went ahead and, you and did the report. And we've had to thank her since then because it allowed us to really think about everything that we're doing
and in the collective. And everything that we're doing to serve the populations that matter most to us. And when you take a big step it's it's something that we're all really, really proud of. The deep investments we made in the homeless services. The investments we made in health plans that focus on populations that others have forgotten, like, our affirm product, which is focused on Lgbt lgbtq plus seniors.
The efforts that we're really making to enhance our employee experience and be a health plan that actually provides good health benefits to its employees. Imagine that. So, you know, I think when we when we start to think about all of the pieces that come together. It really helps us feel like we're an exe in organization to the industry. We're... By no means
perfect. We have lots of things we can do better, But I think when you put it all together, what it really represents is a blueprint for an ethical company that's trying to do the right things. Us for data, And what I can tell you is we we now provide medical services to about 2000 unique individuals every month. Through our health care and action medical group that's focused on providing clinical services and housing support services to people experiencing homelessness.
So we're we're in a pretty exciting place of impact. You know, we have a... The affirm product has now grown to sort of, you know, over a thousand Lgbtq plus seniors or or people who are attracted to that that plan. We're helping people who are unseen, feel seen. And that is, you know, honestly, just very gratifying. 2000 unique services provided per month to those...
Experiencing homelessness. That's an amazing statistic. And it's so fascinating in hear that you were hesitant to even do this report at first, I do wanna talk about your care delivery models, though. And as I understand that they're designed to care for some of the most vulnerable seniors that you serve. From from your perspective such, and I know you just touched on this a bit, But why is it so important for scan group
to to serve these populations? And what inroads have you made with tackling the homeless crisis in the states that you serve. Look, you know, so I think that the the you know, health care and action was really inspired by, you know, some early career work that I did with, Cambridge Health alliance, which, offered a a program called Cambridge healthcare for the homeless.
And, you know, what you quickly saw when, you know, you're providing homeless health services to people who are experiencing homelessness is that their homelessness is either caused by health care problems or exacerbated by health care problems. And, you know, in when we think about the scourge that is homelessness. And when you think about the embarrassment that we all feel or should feel about homelessness.
You realize that we have just an incredible opportunity, to address the needs of of homeless older adults through you know, a medical group that's actually focused on their needs Now we started out with the intent of serving homeless older adults, you know, a list consistent with our mission. But something happened along the way, which is, you know, in search of older adults, you know, who are the fastest growing portion of the homeless population, you know, we couldn't ignore everyone else in
the community. And you know, now health action has contracts with, the city of C City, the city of West Hollywood, you know, various other health plans, you know, various private for profit health plans various public, not for profit health plans, we even received a a very generous donation from, Ben post to 2 of a million dollars to actually bring, you know, our our services to the County of San Mateo. And, you know, the we talk a lot
about product markets fit in health care. There's unfortunately fantastic product market fit for health care and action where People are looking for a solution that's gonna address some of the root causes of homelessness, and that's really what we're what we're delivering. Yeah. It's amazing. And it's clearly very impactful work and it's it's good to know that a group like scan is is on the ground doing this work. In these communities.
Let's talk about, the health plan side of the business for a second, such and your tier 6 formula offers 13 commonly prescribed brand name drugs at 0 dollars to 11 dollars per month 4 seniors, 10 of which are on the Biden administration's negotiation list. What went into being able to offer this to your members and and what are you hearing in terms of the affordability that you're offering for these drugs? Look, every every whole
plan can... You know, decide where it's gonna put its dollars, and we truly believe that we wanna make sure that the drugs that we would want for ourselves or for our family members are available you know, in an affordable way for our our members. And, you know, the truth is is that we know that high c pays are a huge barrier to members actually, you know, receiving the drugs
that are prescribed by their doctors. So many people, for go filling their prescriptions or taking their medicines because their prescriptions cost too much money, and these are people on fixed incomes. And you know, the ultimate long term impact of not taking your
medicine is poor health outcomes. And so when we think about benefit design it's, when we think about what we wanna do for the people we serve, we do everything we possibly can to try to reduce dan barriers to the things that we think are gonna move the needle the
most. It's why we have the generous, you know, tier 6, 0 dollar copay for those expensive drugs, but it's also why we have 0 dollar c pay for primary care, 0 dollar c pay for specialty, 0 dollar c pay for hospitalizations, in in some of our most popular products because we really wanna make sure that, you know, people don't have, a sense of a barrier. And which brings me to a really important point, which is there's a lot of criticism of Medicare Advantage today.
And I I just wanna make sure that people recognize that 1 of the things that Medicare Advantage is doing is really increasing affordability of care to a population of seniors who really need their affordability to to be improved because traditional Medicare if if you haven't looked at it recently, actually covers very little And so I think there's a lot of misplaced nostalgia for traditional Medicare, you know, when plans like scan are using instruments like tier 6.
To really make, you know, drugs affordable and drive improvements in health outcomes. Yeah. And your point is... Heard loud and clear as well as the fact that you mentioned in the past to me directly of the amount of low income people that are on Medicare Advantage plans, and and they receive care, through these services. But in that vein such and, we've also previously discussed scans population specific Medicare advantage plans designed to meet the unique needs of women of Lgbtq plus,
older adults. You have your partnership with Apollo Med to provide care, to Asian and Hispanic adults, you know, you don't hear initiatives like this from health plans often. So anything new to share here on these on these plans, how has enrollment been so far? Yeah. We're we're in early innings. I would say, you know, the most popular of these products so far has really been our firm product which
you know, is our Lgbtq plus product. When we started it, we we thought we were doing something, you know, symbolically, which you know, supportive of Lgbtq plus seniors thinking we might get a hundred members, maybe 200 members. And when we got 500 in our first year and now thousand. We realized we might be beyond to something, which really I think spurred us to think about other groups of people who are not necessarily well represented in the Medicare Advantage product portfolios.
1 of which is women which is probably shocking to people because, you know, more than 50 percent of seniors are women, But how many of those products actually speak to their needs? How many of their... Those products actually specifically have interventions and programs to design to support the health needs of women.
Very few. How many have actually you know, I'd identify a bunch of services that could actually improve the health of, you know, hispanic patients or Asian patients know, I think clover clever care in our market has been an example of a really successful Asian focused health plan. But, you you know, I I throw a lot of inspiration. III see competition there, but I also see inspiration, which is
opportunities for us. To do better for specific populations who probably don't necessarily be, you know, feel seen or heard by traditional, you know, health plan marketing and traditional health plan products. So you know, I think the future of all health care is really segmentation. Segmented approaches to interacting with patients, providers, communities, vendors, And and so, you know, I I would say it's a core foundational principle of how we organize and manage
the company. Is to really think in terms of of populations. Some people say, well, you know, how does that align with health equity, you know, if you're slicing and d the population that way, And I would say, it... We're aligning with health equity by really, you know, allowing people to feel seen in ways that they aren't necessarily seen. You know, in traditional products where they don't necessarily feel like their distinctive attributes and qualities aren't necessarily reflected.
Absolutely. And then let's say on the topic of of the future of health care specifically, Medicare Advantage. As you know, the the industry is facing big reimbursement and audit changes from Cms. You mentioned there's increasing segmentation and market competition. So beyond these population specific health plans, how is scan navigating these industry changes over the next few years. Look, I I frequently stated the the Golden days.
Of Medicare advantage are over. And I kinda I kinda like that in a lot of ways. Because I think, you know, this business was probably too easy for to for a long time. You know, if if if reimbursement were cut, it forces you to do more with less, forces you to be sharper from forces to forces you to refine your thinking. And so, you know, we're taking a hard look at our products and trying to understand what's really needed and what's not really needed.
We're taking a hard look at our administrative cost structure and asking hard questions about you know, whether, you know, some of our vendor relationships, make the most sense for us for, you know, whether there's opportunities to disrupt them you know, obtain lower prices, and then frankly, you know, better serve our members or maintain benefits. So I I think,
you know, pressure is a privilege. I think there's an ability to ultimately, use that pressure to try to drive, you know, sharper approach to things, and and that's the kind of muscle that we're building its skin. I like that That pressure is a privilege. That's a really, fantastic perspective. I didn't come up with it. That's that's philly bill billie Jean King. So... But but I believe it. Right? So Yeah. Good hit a star billie jean king pressure is a privilege.
And as a tennis player myself, you know, I I feel that. It's... You know, when your standing in the baseline and and, you know, you're getting a ball hit at you at a hundred miles an hour. Mh. That's that's fun. But you'll also... You'll also need to have an approach to really really manage it.
And I think that's what's going on in our industry right now is is the pace of play is increasing, the intensity of play is increasing, And I think we all have to get a little bit more competitive a little bit tougher and, have our heads a little bit more fully in the game. Yeah. Yeah. No. It's great advice. And in that vein, any any final thoughts or final pieces of advice you would offer all the health plan, health system leaders listening to us today.
Look, I, you know, 1 of the things I'm reflecting on increasingly these days is is why it's so hard to change in health care. And I... Have to say that we're... I'm I'm now almost 2 decades into a career trying to make health care better, and I feel like it's it's you know, mostly getting worse. I think it's getting better in terms of there's silos scientific innovations, you know, lots of ideas are maturing and so we have better therapies for diseases that were previously death sentences.
But we're delivering, you know, 20 first century science you know, through nineteenth century delivery systems. And we're patti ourselves on the back for it. And so, you know, I think we need a leadership revolution in health care. I think we need to get out of the toxic positivity that you know, kinda traps us and start seeing things clearly, which is things can be better. Things should be better.
And we have to stop, you celebrating great top line, you know, and bottom line financial results, what do we know that patient care could be better. And that the experience of being a clinician could be better and the experience of being a a patient could be so much better. And so that, that's the mission that I'm on. That's the mission I'm inviting everyone else to be on with me, because I think, we need to stop... Normalizing
abnormal things in health care. So I will leave this podcast on that note. Your candidate perspective is very much appreciated, Doctor Jane, and I also just wanna thank you for taking the time to sit down with us. And for sharing more about the very impactful work that you, your team and at scan group are are clearly doing. So thank you. It's it's an honor. Thank you so much. If you'd like to listen to more podcasts from Becker healthcare, you can visit Becker hospital review dot com slash.