This interview has been edited for length and clarity.
Q1: Looking back on the last 90 days, what issues have you been focused on the most? Do you think your peers (leaders in other MCOs) have been focused on similar issues?
The hot topic in Tennessee, particularly over the last few weeks, has been the state’s block grant proposal, which will be submitted to CMS sometime in November. In addition to the policy review and analysis we have been doing, our phones have been ringing off the hook from health plans in other markets, industry and policy experts, and associated health care media inquiries. The industry and key stakeholders locally and nationally have demonstrated a lot of interest in what the block grant means to Tennessee, Medicaid, and the future of the program. We have engaged with TennCare to support them in this effort and have been working internally with our policy experts to provide meaningful feedback.
We have also been focused on executing on our social determinants of health (SDOH) strategy. We have spent a lot of time nailing down and fine tuning our 2020 strategy so we can execute well. Our particular SDOH impact areas we are focused on are transportation and food, and we have identified strong partners for each of these. Overall, we prefer to support organizations that are already working in the community, and that are closer to our members across the state of Tennessee. We have made investments in mobile and brick and mortar food markets and pantries. We have a great grant from the Anthem/Amerigroup Foundation that is going to Second Harvest and Nashville General to create a food pharmacy in the hospital. Also related to food insecurity, we made some investments in Nashville with The Store, which included some seed funding to get The Store up and going. Other partners include the Chattanooga YMCA, which has been solving for food deserts in urban areas for many years and has done a fantastic job.
We are expanding our use of assessments, with Aunt Bertha, to ID community resources for our members facing SDOH barriers. We have spent a lot of time weaving that solution into all of our teams that do member assessments and make referrals to the community resources. We have partnered with Aunt Bertha for some time, but recently have spent time on optimizing internal training and integration with team member workflows and day to day operations.
We have also recently established a community relations team. Historically we have not had that type of team in Tennessee and we have invested a lot in its success. We have hired bilingual staff, and now have folks across the state of Tennessee working to establish community relationships with organizations large and small. This is all part of our strategy where we are seeking really deep partnerships with Community Based Organizations (CBOs) that include exchanging data, establishing communications and connectivity, and making the right referrals for support; Not just writing checks. Sometimes you see grants go out, photo-ops happen and there’s no meaningful collaboration long-term. Money is always good, but we find that our partners need our time and energy even more than just financial support. Along those lines, we have aligned our associate volunteerism strategy with SDOH and went from one of the least engaged health plans across Anthem to the most engaged over the past year. We plan to further tailor our associates’ support to help address the “health” side of the health care landscape in the communities we serve across Tennessee.
Q2: Looking ahead for the next 90 days, what do you think the most pressing issues will be?
The TennCare program is always evolving, improving, and staying on the cutting edge. We typically receive a new contract amendment that takes effect on 1/1 of each year, so our focus over the next 90 days will be to ensure that we are fully prepared to meet and exceed the new requirements or program changes that will take effect.
Additionally, we have annual cost of care and quality strategic goals and the end of the year always presents opportunities for an additional push to ensure those goals are met or exceeded. And as I previously mentioned, the block grant will be submitted sometime in November, so we will be staying close to our state customer throughout the process on next steps and how we can continue to be a resource.
We also have a new RFP cycle that will kick off next year, with an expected release in July or August. We’ve been working on it for some time, but there will be significant work to stay on track to meet those deadlines. We’ve enjoyed a highly collaborative partnership with the state of Tennessee in service to our members for twelve years, but we must stay on top of our game and continuous improvement is our modus operandi.
Q3: What advice would you give to your peers about managing vendor partner relationships?
We just completed a partnership with Lyft and they are now serving as a subcontractor to the current non-emergency medical transportation (NEMT) vendor, Tennessee Carriers. Right now, it’s a pilot program for 1-year in Shelby County (Memphis). Lyft will be providing integrated trips for missed pick-ups, rides where a 72-hour notice is challenging or not possible, and other similar situations. Think of this addition as a targeted NEMT supplement instead of a full replacement, completely integrated for our members so there is no change needed on their part to access the NEMT benefit as they did before we kicked off the pilot. I find this very exciting because it is truly a unique collaboration with TennCare, Tennessee Carriers, and Amerigroup Tennessee, all centered around improving member satisfaction and reducing transportation as a barrier to care. We are thankful to have a state partner and regulatory agency that aren’t afraid to get innovative and creative in an effort to continuously improve the health of the Medicaid population.
My advice to my MCO peers is to look for ways to get vendors to collaborate with each other and be clear with your state customer about the why and the problem the vendor relationship aims to solve. Having their support and ensuring they are a stakeholder and champion early in the process is critical. Public/private partnerships have a wealth of opportunity when the engagement is aligned to a common issue or problem, of which there are many left to solve.