Hello, everyone. This is Jacob Emerson with the Becker's Pay Your Issues podcast. Thrilled today to be joined by Jake Pascaglio, who is the president of commercial business at Harvard Pilgrim Health Care. Jake, thank you so much for taking the time to be with me on the podcast today. Great to be with you, Jacob. Thank you.
Yeah. Absolutely. And before we dive into everything we wanna talk with you about, can you tell us a little bit more about yourself, your background in health care, and what it is that you do today at Harvard Pilgrim? Certainly. Again, I'm Jacob Viscaglio. Currently serve as a president of commercial markets and specialty products for Harvard Pilgrim Health Care, which is a subsidiary
company of point thirty two Health. We're based in Massachusetts and serve New England markets, Massachusetts, Maine, New Hampshire, and Rhode Island. And through that and in my role, I'm responsible for sales, sales operations, product strategy innovation, strategic business development, and the overall financial performance of the commercial and specialty businesses. I've been in health care the majority of my career with other organizations like Cigna, Anthem,
Blue Cross Blue Shield of Massachusetts. Been with Irving Pilgrim Health Care for about seven months now. And, I also have a stint in financial services at Prudential Financial, and it's great to be back in health care. Fantastic. Well, we're glad to have you with us. A long career in the industry, Jake. And we're and we're here specifically to talk with you a little bit about Harvard Pilgrim Health Care expanding its partnership with Progyny Health to support your members for a full year
after NICU or special care nursery discharge. So let's dive into that a little bit because, as you know, neonatal care, it's getting increasingly complex as the year goes on. Coverage of these services is increasingly getting more complex. And and the challenges, that these families face after NICU discharge,
are daunting. So how do you see programs like this, between Harvard Pilgrim and Progyny Health shaping the future of post acute care management and improving those long term outcomes for the families that you serve? It is complicated as you mentioned, and I think you touched on a really important aspect of this, which is the family aspect of care. So certainly, the the child, the newborn that's in receiving care is the one who's receiving care, but really it's impacting the family
across the board. So it's not only about caring for the the infant, but it's also really taking care of the the family, at large. And I'll I'll share a little bit of the perspective in terms of why we think this expansion is so important, but I'll also give my own, family story because it's, something we've we experienced now. Yeah. It's been a while since my children are older, but, firsthand experience with, twins, that were premature
and, spent some time in the NICU. So for me and my family, it's very personal. So what we're doing here is we're expanding a program that we started, with our great partner, Progyny. Initially, we're sixty days after birth, to care for the newborn, in the family. I should say newborns or or more plural there. And, really expanding that to the full year. And just a little bit about the program
around Progyny. So their team includes board certified physicians, nurses, social workers, and to date, they've worked with more than 2,500 of our members. And I think as most know, there are specific life challenges that families face following a NICU stay.
In addition to assistance with discharge planning, education, screening for postpartum depression, the Progyny Health team and their case managers connect families to important resources they may need, things like transportation, healthy food, financial support for utilities and rent, and even help members find access to free items they need for their babies like cribs, car seats, diapers,
and baby formula. So certainly, the the care in the hospital and the coordination there, for the newborn or newborns, the the mom, the dad, etcetera, but also really beyond that and the impacts that, someone, a family that's going through, this is dealing within all aspects of what's needed to really launch, the the new family,
on a path, is really important. So as I mentioned, my wife and I are fortunate to have a set of twins, that spent time in the NICU and, programs like this were not available to us at that time. Fortunately, we had a great support system of family members, friends, great doctors, nurses, etcetera. But as I reflect back on that time, we were just
trying to survive day to day. We actually had, a 20 old at the time, so trying to juggle across all that, and care for our newborns, and just make sure we were on top of everything. Looking back, was a daunting challenge. So a program like this, would have been something that would have been very much appreciated,
for for my family at the time. So that's why for me, it's personal and something that I'm really proud that our organization stands behind for our clients, for our members, and making this more broadly available. Certainly. So you really understand these issues firsthand, these issues that are also facing your members. In that vein, Jake, what are some of the broader implications of expanding this kind of care management from the sixty days to a full year for neonatal cases?
And how do you think this shift, in care strategy is reflecting the industry evolving the industry's evolving approach towards more, member centered health plans? Yeah. Absolutely. It's, it's an important aspect of how we really want to surround our members with services that are going to be helpful over time. And it it just makes good sense to support the the families with a program like this. Additionally, as we know, the first year of an infant's life is crucial for their ongoing
health. No surprise there. Then a NICU stay can further compound some of the challenges that families face during that baby's first year. One of the things we saw in the data is, more than ninety percent of our Harvard Pilgrim members who participate in the program have reported high satisfaction. We saw the opportunity to do even more for this population. And I'd love to share an example of one of our members from New Hampshire, was a mother of premature twins born at 33, and
the daughters were in the NICU. They had a toddler at home, sounds familiar, and the the mom had just started a new job and had no paid maternity time off. So certainly a challenge there just to start. Add a complication of her grandmother passing away and that she had contracted COVID and couldn't visit the twins in a hospital for an extended period of time.
Progyny stepped in with gift cards to help with travel expenses, connected the mom with resources, helped manage the cost of formula to help her fortify her breast milk due to the twins' prematurity. The Progyny team also worked closely with the hospital to clarify the twins milestones and provided reassurances to the mom and her husband when needed. So the members are not just getting help and support, but advocacy. And by expanding the program, we can assure
ensure that happens. Right? There is not a timeframe of sixty days or ninety days. Sometimes that's sufficient, but sometimes, that first year is longer. So for us, this isn't really a shift in strategy, but rather it's an expansion of a program that was critically needed by this subset of our membership. And for us, it was an easy decision to expand the partnership to help our vulnerable members and their families. Absolutely. Well, that's a great real world example.
So appreciate you sharing that with us and and some amazing satisfaction rates that you're you're seeing through this. Jake, we we hear from health plans, all over the country about beyond Harvard Pilgrim about, NICU admissions and preterm births remaining a significant concern for for their poll how they how
they cover things. And so I wonder if you have advice for, our our listeners in terms of, how to integrate more comprehensive maternity and infant care management into into their health plans. Yeah. Absolutely. Let me start maybe with some of the the data in terms of what's happening industry wide around the, you know, the specific need around NICU admissions and the this topic that we've been talking about. So the stats paint a
a pretty dire picture. In The United States, we have one of the highest maternal mortality rates in developed world and the rates are on the rise. According to the March of Dimes twenty twenty four report card, preterm birth rate in The US remains historically high at ten point four percent and NICU births require specialized attention to ensure the best outcomes during an infant's first year. And even a short stay in the NICU can delay family bonding, impact breastfeeding adoption.
And once an infant is discharged from the hospital, the risk of a readmission back to the hospital is significant without case management support for the infant and family. Additionally, perinatal depression, which is a condition that can have devastating consequences, affects up to one in seven women in The US. And some studies suggest that this number can be even higher.
So we've seen the first hand of positive results of this type of program with Progyny Health, and the impact it has on babies and the families, broadly. So as it relates to other, insurance leaders that are thinking about these programs, I really think about it in a couple of,
important manners. One is really understanding the needs of the memberships that a membership that is covered, by the plans and really understanding with those needs, what's the best way to deliver it, that care, that coaching, that program, whatever the case may be, in determining what is the best approach to enable that program or the that those care pathways, etcetera.
And as we think about this, across all aspects of our business, we really think about, is this something that we can do ourselves? Is there a way to do it through a partner relationship that has that specialized expertise? That's so critical. And, certainly with NICU, we saw the opportunity to work alongside Progyny Health, which is, you know, very focused across, this dimension of enabling support and care,
for the most vulnerable members. And, again, very, very pleased with the results that we've delivered as our our members, which is most important to us. Certainly. And it's such a good call out and a reminder for our listeners in terms of the maternal and infant, issues and care that that the country still faces. Before we go, Jake, what else are we missing? Any final thoughts that you wanna share with our listeners while you have the ears of a lot of health plan leaders,
from all over the country right now? Yeah. I appreciate the opportunity. Yeah. So first and foremost, Progyny Health, as I mentioned, a significant impact positively on our members, and we're very proud of this collaboration. For us, this collaboration is not just a one off program at Harvard Pilgrim Health Care. We are always looking to sort support our members through their entire health care journey. Related, obviously, is women's health, which is a large
area of focus for us. We've we had a number of partnerships with, organizations like Maven and Innovia Health that really helps us to provide women with 24 access to a variety of specialists, personalized resources, coaches, lactation experts, behavioral health experts, etcetera, etcetera, that really help us provide much needed information, access to providers, to the right providers, and care across the board, for our members, who are navigating challenging life transitions really end to end.
Additionally, something that we're really proud of that connects in well here is a program that was launched, which we refer to as our behavioral health service navigation program. This program provides personalized one to one assistance that helps members find a behavioral health provider. And we know finding behavioral health providers, can be a challenge at times. Scheduling those appointments once you find that provider
can be a challenge at times. So our navigators really take that burden off of the individual and work side by side with our members to enable awareness, access to the right provider, and then scheduling, to make sure that they can get what they need. And then we follow-up to make sure they're satisfied with their care, and then we take those learnings and continue to iterate and improve upon our programs.
Why that's really important, as we're talking about the topic of, NICU care, for for the birth mom, for the children, etcetera, is the connection certainly between, behavioral health needs, in this context, making sure that we're able to provide that access that's so important to remove any barriers, for for the moms and all the members, quite frankly, who are looking to access vital mental health services when they need them. Last thing I'll add is, women's health month will end soon.
The yet the focus on the maternal health crisis needs our year round attention and action. And it's really my hope that we can work together, broadly across the system of health care to ensure every woman has the opportunity to experience a healthy pregnancy, safe delivery, and a thriving happy life with their baby or babies, for that matter. It's a really important topic, and we're very focused as I know many of, the other insurance leaders are as well.
Absolutely. Well, I I think that's a great place to leave things. So, Jake, I wanna thank you for taking the time to sit down with us and for sharing about the impactful work going on under your leadership at Harvard Pilgrim. We really appreciate it. Thank you, Jake. Appreciate the opportunity to join you today. And to our listeners, if you'd like to listen to more podcasts from Becker's Healthcare, you can visit beckershospitalreview.com.