This is Laura Dierda with the Becker's Healthcare podcast. I'm thrilled today to be joined by Jane Brown, head of Medicaid operations at Aetna. Jane, it's a pleasure to have you on the podcast today. Thank you, Laura. Very excited to be here today.
Now I'm looking forward to our conversation because I know you're doing some really cool things at Aetna, and certainly, Medicaid is a huge topic of conversation nationally, and hospital and health systems as well as health plans in general are are really interested to see how things unfold over the next several months. And so I'm excited for this conversation. But before we dive in, can you tell us a little bit more about yourself and your background?
Absolutely, Laura. I am a sort of Medicaid dork, self avowed. I'm, somebody who graduated law school, and right after law school right went right into the Medicaid program. I started working for managed care organizations over a decade ago. I've worked for a number of the larger payers in the country who all support Medicaid beneficiaries. And for me, the growth and the the trajectory, I suppose, through the business has been primarily through the compliance, legal, and operational channels.
But as I started working, into more sort of the operational, pathways, Medicaid health plan in Kansas. So I think I've probably sat in a lot of the health plan chairs that one could sit in the Medicaid space. And I, I really love this area of the business, and I, plan to spend probably the greater majority of the rest of my career continuing to support Medicaid and Medicaid beneficiaries. That's fantastic to hear. And, you know, where does your passion for Medicaid come from?
For me, I think it's just having a lived experience in the program. As a kid, my family immigrated actually from, Belarus in the early nineteen nineties. And when we first came to this country, the Medicaid program was how we, you know, gained access to health care services. It's how we got support with translation services.
It was pretty much, you know, like a bedrock in our community and certainly the thing that my parents had to rely on while they got their feet under them in sort of pursuit of the American dream. So my Medicaid experience comes from, you know, being on Medicaid as a kid and really having a front row seat to what good that program could do and what some of the challenges of it, can also be.
That's really, you know, great to hear. And certainly, I I can imagine, like you said, it's such a passion area for you as you can see where the program is headed and how it can be beneficial as well as the challenges that it faces. From your perspective, what are some of the biggest issues that you're following in health care headed into the next several months?
You know, I think right now, I'm working a lot with understanding, how to best enable our provider community in terms of, for example, value based arrangements. What are the data and technology and information that they need in order to, get to members in a timely manner and help members make the right decisions around their health their their health care? It really it's
about empowerment. And I think as the managed care organization at the table, the onus is on us to really bring some of that data together and really incentivize the right actions within the provider community to ensure that members in turn get the services and supports that they need at the right time.
So I think that infrastructure in terms of how we share information is where I plan to spend the bulk of my year and making sure that the information is, you know, shared timely in a way that's understood in a clear way. All of that can't be taken for granted because when we think about health care information, you know, the pool of it is it's humongous. It's millions of records coming from millions of different places.
And and trying to create harmony in that process and ensuring that the right information gets to the right place at the right time, it's almost like a full time job, you could say. So we're spending, quite a lot of time, on that work within Aetna and certainly within our Medicaid space this year. That's great to hear. You know? And, certainly, I know no small task to troubleshoot that type of connection, support the technology needed, and ability to communicate
in in a meaningful way. And then, too, it's great to hear that you're looking at the, value based arrangements. I know that's something that certainly seems like it could be a great opportunity for, health care overall to make a meaningful transition in that direction. Yeah. Definitely. I think that if we can crack this piece of it, really get everybody on the same page, we have an opportunity to align
goals and incentives. Right? And I think when you align goals and incentives across the health care industry, that's, you know, the opportunity for us to do the greatest good and have the greatest impact because we're all going in the same direction together and at the same time. Absolutely. That is a really great point. Now I'm curious in looking ahead, what are you most excited about or what makes you nervous?
I'm really excited about some of the emerging technologies that are all, that are all, aimed at sort of member enablement. I think that in the Medicaid space, you know, historically, you know, there's some misconceptions, in the industry that, for example, maybe Medicaid beneficiaries don't have cell phones or they don't have the same, data access. And I think that, like, legacy historically, that that some of that was true, but I think it's also rapidly changing.
And I think that we have to, really leverage the opportunity ahead of us and really figure out how to provide tools and resources directly to members, really, to empower them to make the right decisions for their health care, to really make sure that there's education and empowerment so that when they're thinking about how to interact with the health care system, you know, they're driving they're driving towards a healthier outcome into a healthier lifestyle.
So I'm really excited about some of the technologies and opportunities and even partners that are emerging who are all spending time trying to crack, that piece of the puzzle. That's great to hear. And and, certainly, having that ability to connect with so many different people. And as you said, I love the idea of empowering the patients and bringing them into the fold for making decisions within their own care process and treatments and journeys.
It seems, really, really, like, an amazing, way to think about health care and health care delivery. I'm curious too, when you look look at the, broader landscape overall, what challenges are you anticipating or is there anything that you're preparing for, that, you know, could make you a little bit nervous in the future? Well, I think that that the health care system is it's big, broad, and it's fraught with challenges, you know, in every step of
the way. But I think, ultimately, connectivity is gonna be the thing that unites us and really helps us, sort of go forward in a consistent and unified manner. And so how do we create connectivity? How do we make sure we have even something as basic as the right phone numbers for members or the right email addresses? You know, it it it makes me nervous, right, because in Medicaid, so much of our work depends on, for example, enrollment files coming in from regulators.
And if those enrollment files don't have the right information on them, then we're stymied with how to then reach out to the member. But I think we have an opportunity to work with all of the parties involved, including regulators, and say, hey. You know, here's the correct information we obtained from the members. Let's update your systems. Let's make sure that at the source of truth, the information upstream is correct, and that everything that flows downstream from that is also correct.
And that connectivity is ultimately what's gonna, I think, set us up for some of the exciting stuff I mentioned earlier, which is, you know, member empowerment, members taking control of their journey, members having access to the information that they need in order to make really good decisions at the time that they're making them.
That makes a lot of sense, you know, and and really, fascinating challenge, but also it sounds like, you know, very much a possibility to, gather this information and and put the systems in place, to make sure that those that type of information is flowed upstream and downstream as well.
Before we wrap up here, I'm wondering what do you think the most effective health care leaders will need to be successful over the next two to three years, especially given some of the things we've talked about today around the communication, transition into value based arrangements, and really truly taking care of those in the Medicaid program? You know, leadership is such a, like, multifaceted
thing. And it and I don't think it's just one type of skill or personality type that can, sort of deliver on that leadership that is needed. But I do think that resiliency is gonna be a key feature. You know, I think that that that Medicaid continues to be a very hard program to administer and manage, and I think to continue to evolve it into the future and really think about, you know, what best practices to bring in, how to change really older legacy systems that take a lot of
investments and a lot of time. I think all of that is gonna take a lot of resiliency, is gonna take a lot of grit, quite frankly. I think we're all gonna have to, look at look at ourselves, you know, with our best critical thinking hats and really assess where we are and really figure out how to move forward.
And I think, I think to do that well, you're gonna have to be sort of very honest with yourself, honest with your team, and then, again, bring in that resiliency and that grit to get you through the harder parts of change management so that, ultimately, we come out in a more nimble, model, in a more nimble environment where we can do, you know, hopefully, more and more with member empowerment, with provider empowerment, really putting the health care back into,
the the the hands of the people who it impacts the most, the beneficiaries, right, of the program. I love that. Jane, thank you so much for joining us on the podcast today. This has been such a fantastic conversation, and I look forward to connecting with you again soon. Laura, thank you so much for having me. I look forward to coming back anytime you'd like. Have a wonderful day. Take care.