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, everyone, and welcome to the Becker's Health Care podcast. We're thrilled today to be joined by John Young, chief strategy and development officer at Evernorth Health Services Home Based Care. John, thank you so much for joining us today. Yeah. Thank you. It's great to be here.
So let's jump into today's conversation. Can you please tell us a little bit about yourself and your background? Yeah. So I'm with Evernorth Home Based Care, and we are, in home primary care group that does value based care work for health plans focusing mainly on their, critical and chronic care, patients that need more attention in the home, need clinical care and services in the home.
And so I've been in health care for 30 plus years now, and always have had a passion for looking at how might we deliver better care and better solutions to solve the big challenges that we have in health care. One of them is the rising chronic condition patients, and on top of that is just the escalating cost of care. Can you speak a little bit more about the mission of Evernorth home based care, and why is this mission important to both you and your team? Yeah. So for me, it goes way back.
You know, primary care is essential to our health care system, and I think really powerful option for us to continue to double down on in order to decrease the the cost of
care, but also improve the outcomes. Because a lot of the focus of our practice is taking a brick and mortar primary care group and truly bringing that into the home such that we can deliver as many visits, as many services, and as much care and other support that that individual needs so that they're not going to the urgent care or going to the emergency room or going up into the acute care
because they're not getting primary care. And a lot of the members just have many issues, social determinants that they're dealing with. They also have, you know, other challenges, transportation, medications. Many of them are on 20 plus medications. They don't know how to balance that. So being in their home and helping in their home is important. For me, it goes way back. My dad was a pediatrician. Growing up in the seventies, I remember him doing house calls.
And the way that he created trust and the way that he was able to individually serve each of his patients and our neighbors really resonated with me, and I think it's one of the biggest solutions that we have to to really double down on to improve health care. Right. Right. Yeah. Exactly. That that trust is really key there. So what what are some of the industry barriers and opportunities that your team is currently focused on?
Yeah. I I think one is really just the the continued rise and complexity of the the patients and their needs. I think how do you how do you build the right care plan and clinical team that truly can impact in a meaningful way the the individuals that we serve. So just getting a handle of everything that's going on. How many chronic conditions can one person have? They can have 5, 6 plus. You know?
And so how do you build that right team, ensure that the patient who can't get out of their home or struggles to get to any level of care, we can bring that into the door. So that's 1. 2, really building the trust with the individuals and the caregivers of those individuals such that they let us into their home. It's it's really critical. You can't do this virtually. You can't see everything that's going on in the home.
You can't build a relationship with the folks that really know what's going on with the individuals, their caregivers, And so you have to build that trust. So we spend a lot of time focusing on, you know, gaining that trust, getting our teams into the home, and then building that relationship with them. You know, the third thing is, obviously, we we face, like everybody else, just supply chain issues with clinic clinical teams.
And so, you know, we have the rising chronic conditions, building the trust so that we can truly become a partner in their home for their clinical care, and then ensuring and protecting our clinicians so they can practice at the top of their license. It sounds like there's a lot going on in your space right now. And, with your years of experience, what are some of the biggest pieces of advice you'd have for, your peers in the health care industry? Yeah.
I think, you know, having been around the block for 30 years and really focusing on how do we transform our health system, how do we make it more efficient, effective, how do we get it to deliver better outcomes, mainly don't give up. We we will solve
this at some point, I hope. And I hope we do it, you know, and I hope the the angle that we're taking with home based care and true, you know, MDs and MPs and pharmacists and RNs getting into the home and delivering care is one of the answers that's gonna help us maybe truly bend the cost curve, increase outcomes, and and bring value based care. So don't give up. I think the other thing is really think creatively. You know? The brick and mortar, the fee for service,
the other challenges that we faced. I I mean, truly, they haven't changed for 30 years even though the big promises that CMS has made, the big initiatives that many of the payers have put forward, are are are slowly changing the dynamics of our health care system. But I think we really have to think a bit radical and think differently and and not be bound by the the biases that have held us, you know, kind of, you know, stuck for so long.
So how does Evernorth home based care differentiate itself from other home based care providers in the industry? And, what what would you say are some unique advantages that you bring to your patients and health care partners? Yeah. I think, first, just being able to go into a true full, capitated global risk model is a a a really big advantage. We are truly putting, our money where our mouth is, you know, to say.
And we we believe that providers and our clinical team should be allowed to make their decisions and not be bound by the OMI billing the right code, OMI, you know, billing something that I'm gonna get reimbursed for. So I think that's one of
our our big advantages. I think to, being a part of Evernorth and the full suite of solutions that exist from the the benefits management's aspects in pharmacy and medical to all of the things that we do on our side of the house and the air delivery and pharmacy side.
We're able to leverage the knowledge, for 1, the resources and support that give us a no another layer of clinical competencies and teams and skills that we can surround that patient by, as well as, you know, doing some of the virtual 247 If it's critical and we need to get in touch or get someone to that home, we're able to do that. So, you know, a lot of those things are are really
important. The other big thing is, you know, truly getting into the home, being a trusted part of the family caregiver team, and seeing all of the social determinants of health, and then building a care plan that's unique to each individual based on their conditions, based on their social determinants, based on their caregiver and other support, and becoming kind of that Sherpa of their ecosystem for their health. John, I wanna thank you again for joining
us today on the Becker's Healthcare podcast. But before I let you go, do you have any final thoughts you'd like to leave with our listeners? Yeah. I think this is just an exciting time for health care, and it's an exciting time for leaders in health care to really rethink where should the clinical models be delivered, how is care shifting and getting into the home, and how am I as a a leader going to respond to that and become a champion of it versus protecting kind of the biases of the
past. And I I just applaud everybody who's doing it, and, the energy's there. So let's get on it. Awesome. I really appreciate those insights today. John, thank you again for joining us today. To our listeners, thank you for joining us, and be sure to check out other Becker's Healthcare podcast. Thank you, and have a wonderful rest of your day. Yeah. Thank you.