Healthcare Innovation: A Conversation with Rebekah Swain || EP. 171

[00:01:02] Rebekah Swain, Debva Studios Producers sideùng He is the Wellington Chief Executive Manager in West Virginia, West Virginia. for being on Inspiring Women. Thank you so much for having me. So here you go, you were just telling

[00:01:29] me your travel schedule and it sounds like you know you came here from Raleigh and now you're here in Chicago and I think you're going to six different cities. Well after this conference

[00:01:38] right back and forth a little bit we're doing you know Advocate Health is from Wisconsin to Georgia. So spending some time this week in Wisconsin as well. Okay so you've been at

[00:01:48] Advocate now for a year and a half is that correct? Yeah just over a year I joined last April. Okay and you've got a long career in the area of managed care, managed health as well as

[00:01:59] employee engagement so give us a little bit of your background if you wouldn't mind. Sure yeah I started my career in a hospital system in Raleigh and was there for about 10 years and we worked in business development looking at what new services we should have

[00:02:16] where they should be placed what physicians to work with new equipment things like that. So we did a lot of connecting with patients understanding where they wanted care to be delivered. The area has experienced just tremendous growth over the last 20 years and

[00:02:33] and figuring out where people were going to be living and working and where they wanted to access that care was really important. For you Rebecca in terms of like choosing this career

[00:02:44] and moving up the leadership ladder and being an executive you know now sort of like for a large population that you're dealing with what's kept you interested across the way? My healthcare

[00:02:57] career started when I was 14. Oh my gosh my mom was a nurse in a hospital on the surgical floor and for a variety of reasons you know I was doing sort of community service hours that you

[00:03:10] do when you need to in school and she had me start as a volunteer in the hospital. Okay. A real life candy striper with the striped uniform and everything. Thank you sir for gosh I haven't heard

[00:03:21] that for a while probably they don't call it that these days but I worked in the hospital two afternoons a week and the things that I got to see and experience there and the sort of

[00:03:34] you know life or death and dramatic situations and the impact that a community hospital has on the lives of the people in the community is really what drew me to it and and that continues today

[00:03:46] you know that you know the things that you're doing have real impact on people's lives. Yeah well healthcare is a special place and it's very personal in terms of why people stay in it

[00:03:56] so if you can you just tell us like what is your job today? What are you responsible for what is the strategy of advocate you know in terms of how you contribute to that? Yeah absolutely

[00:04:07] advocate health is a large healthcare system now as I said we're in six states over a thousand care delivery sites 69 hospitals and 155,000 employees and so in my role most of the time I spend working through what managed health payers what contracts we should be sort of running

[00:04:30] towards what we might want to be running away from where should we engage the most and how we can make the most out of every situation that we're in in terms of payer contracts. The membership performance? Are these a payer contract for your team members or are these

[00:04:46] payer contracts for people who come to advocate? With advocate as a provider so they and of course that does include a lot of our teammates but with advocate as a provider we have over 600 managed care contracts with various payers across all those states. 600? 600 okay and you know that

[00:05:03] seems like a lot it is a lot and and that happens as a result of the mergers and acquisitions and changes that our system has gone through but we we need to understand where should

[00:05:13] we be spending our time yeah we can't just spread it equally across all 600 and so that's really a lot of the analytical work that my team does is to figure out where should we be focusing where should

[00:05:25] we be working hardest to engage the members of certain plans and and that's where our membership performance team is engaged in turning members into patients okay so when we enter a relationship

[00:05:38] with either an employer or a payer the most important first step we can make is get those members to engage in the healthcare system yeah and so we do that through a variety of efforts everything from traditional letter writing to messaging to getting in their electronic health portal

[00:05:58] and messaging them there emailing them events on site we have on-site clinics with employers different people need different you know ways to get engaged and so we try to offer all of those to get them connected into primary care whether that's in-person primary care or virtual primary

[00:06:14] care we get them connected with someone they can trust and build a relationship with and see for all their healthcare needs. Rebecca you're talking about a couple things in healthcare that sound um I've been in health here a long time you've been in

[00:06:28] healthcare a long time and it's only become more complicated we're doing this conversation together you know we've got trans-carent in the background of one place for health and care the systems become more complicated so if you think about the trust that you're trying to achieve with your members

[00:06:46] turning them into patients plus 600 contracts across a large-scale health system how are you making things more simple how are you actually achieving that engagement that trust that you're trying to do at advocate? Yeah I don't know if we're making it more simple but I think on a

[00:07:05] on a single member basis we're trying to make it easier like you said to get connected and you asked about our mission um we have a mission around improving health and elevating hope advancing healing for all and that for all a lot of times I think it's

[00:07:22] interpreted as meaning people who need financial assistance who need charity care but it's not just that um if you think about a working mom who has a couple of kids and and I remember what it's like

[00:07:34] it's it's all you can do to deal with the emails from school and the pick up and drop off from daycare you don't really have time as a mom to take care of yourself right and you know

[00:07:45] connecting with that mom might mean engaging her in virtual primary care that she can have an appointment at 11 o'clock at night from home and have that relationship with a primary care provider that way so we try to create those approaches that make it simpler for an individual

[00:08:01] person because healthcare is so personal and let them make decisions about how and where and when they receive that care instead of having you know sort of a single office or a single location

[00:08:13] and everyone has to come to us. Well what do you think then in terms of does I mean we've seen so much adoption of whether it's you know digital health solutions telehealth and things

[00:08:23] like that and people do expect access you know 24-7 these days so how are you achieving that at Advocates? So like what do you what do you think that you are doing that you is special

[00:08:34] so that you really can engage those members? Yeah I'm really excited about our virtual programs we have everything from full virtual primary care practices not just when I'm sick and need an antibiotic but permanent relationships with a virtual primary care provider we have a

[00:08:50] thriving hospital at home program that was born out of some CMS waiver work that was done during COVID but is still thriving today where we take care of inpatients in their homes using

[00:09:04] remote patient monitoring so that they can stay in the comfort of their home they have caregivers around them if they have family at home that family doesn't have to worry about transportation

[00:09:15] back and forth to a hospital and they can stay in that familiar environment you know people like that obviously have to be clinically appropriate for that kind of care but they have the remote

[00:09:26] monitoring and they have the in-person visits when they need them. Yep so thriving hospital at home program a lot of virtual consults you know a lot of our territory is quite rural and being able

[00:09:41] to have the top experts from our urban center hospitals do consults with their care providers out in their rural communities in the smaller hospitals brings that top-notch care to their region and to their home which it is really exciting that they don't have to travel hours

[00:09:59] and hours to get to that tertiary center. I agree I mean look you know I think you know any person expects that when they are receiving care from a physician that it should be a certain level of

[00:10:10] quality but as you know there is a lot of variety for all kinds of different factors you know that are out there so the access to you know the top physicians to get the best

[00:10:21] level care regardless of where you are that's exceptional and that you know and complicated right in terms of actually being able to provide it so with Transcarent you know you know that Transcarent provides a lot of solutions to organizations to employers and employers are becoming harder and

[00:10:41] harder to reach in terms of how you interact with them so I'd love your thoughts in terms of what kinds of solutions when you know how do you engage large employers because people go where

[00:10:52] they can get the highest quality of care but it has to be affordable too. Well and it's hard to know what is highest quality what is the highest quality to me may not be highest quality to you

[00:11:03] there's a lot of there's just a ton of information out there and I think the reason we partnered with Transcarent to be a site of care a destination site of care in their network was

[00:11:14] because they they cut through that they help make it simple for an employee when they're in that time of crisis needing a particular type of care or surgery what whatever it may be to help guide them

[00:11:26] and to walk that path with them and deliver them to a place like Advocate where they can get that care that they need and be confident that they're receiving it like you said at the highest quality

[00:11:38] but also affordable right and whenever whenever they need to because health care and issues don't wait for a certain time of day no matter what wait for research right in the last thing you

[00:11:48] want to be doing in that time of need is starting your own research project to try to determine where you should go and so I think having that trusted source is really appealing to employers too. Yep

[00:11:58] yep so Rebecca you were at this at this conference that you came to Chicago to actually speak at you were talking about innovation and health care you were talking about you know sort of

[00:12:08] like where is the future in terms of engaging members and stuff so I'd love to get your comments and thoughts on that yeah you know we had some good conversations around that lately and the workforce is more diverse I think than ever before and we're celebrating that diversity

[00:12:25] and celebrating that individual needs and wants more than ever and that bleeds over into how they want to receive their health care and I think being able to have a variety of models is fantastic

[00:12:38] because then you can engage with people on their own terms wherever they're at but along with that comes complexity right the more different models that you have it's it's harder for people to

[00:12:51] understand where to go what they should be doing and so having some trusted source whether it be transparent or or or some other program that their employer or that their provider has to get

[00:13:04] that engage to get that engagement and that direction to where they want to go I think that just gets more important because there's more options than ever and it's harder to know who to trust

[00:13:15] yep yep so in terms of that future state okay so like if we think about what it what is in in terms of you know you're any person at your employer you're trying to figure out where to get

[00:13:28] care you often turn to whatever app they have made available for you you're trying to get some simplicity around that what do you think is the difference between sort of like where the

[00:13:39] confusing state of today is to what might be optimal in terms of where you would want your members your people who are coming to advocate to have available if you were to wave your magic

[00:13:51] wand and paint the future state for all of us what would that look like you know the hot topic obviously is AI for everyone these days and the beauty of AI is the ability to take huge

[00:14:02] quantities of data and sift through it sort through it make the connections and the inferences faster than a human can and we have some great examples of how AI is serving as a decision support

[00:14:16] tool yet to our clinicians especially in emergency situations we have an ED program around stroke detection and identification and you know rapidity is really essential when you're dealing with stroke but if you take that same AI model of sifting through tons of data and being able to get

[00:14:33] inferences and and conclusions it's a great use case for things like finding care yep and understanding the quality of care and where I should go what's my next best action and I think there's a lot of applications for it there yep and we you know certainly at

[00:14:52] Transcarent we're talking a lot about this in front in the sense of you know we're calling it wayfinding and really trying to find that navigation to what is the appropriate care

[00:15:02] that I need so something as simple as my shoulder hurts where do I go for it that should be a simple use case for AI to solve for yet it's so it can be so very complicated unless you can actually apply

[00:15:17] some tools to do that yeah absolutely and and you know I think having a primary care point of connection is really important and certainly there's always going to be times when you're

[00:15:27] going to want to talk to your personal physician about what the next best course of action may be but all of the administrative steps that are included in that you know checking if a doctor's

[00:15:38] in your network making sure you've got benefit coverage for it whatever those things may be getting decision support tools in place whether for the provider or for the consumer to make that decision better and sort of come out with an optimal decision sooner

[00:15:55] I think is the future yep and hopefully the future is now and happening happening sooner Rebecca I want to go back to on inspiring women I love to showcase women leaders like yourself and particularly in the area of healthcare because we make 80 percent of the decisions for our

[00:16:12] families our parents our children our extended families and when we're in the space of healthcare even though we know how complex it is you know other people friends and family come to us so

[00:16:24] as you think about your role not just as you know a woman making healthcare decisions but also as a leader in the healthcare space how do you see sort of like you know for women who are

[00:16:36] leaders how do you see us making further impact in the years ahead oh gosh that's a big question it's a big question I think it's important for for women to get involved in all of those places and certainly women have historically played a really important role in healthcare

[00:16:56] whether it be traditional caregiver roles within the family or as nurses and now as leaders in the healthcare system I there's room at the table there for expansion of that and and I think that women at the table will help to make those decisions better

[00:17:14] and help us to advance advance the ball right in in making sure that we're delivering care to all the people that need it yep and Rebecca as we were talking about earlier I certainly believe that more women around the leadership table make for better business decisions make for

[00:17:33] more equitable decisions for the people that we're actually serving if you can go back into those times of you know starting out as a candy striper now being the leader that you are today

[00:17:46] and just think of the next generation of women leaders who want to be like Rebecca Swain what advice would you be giving them oh gosh I think the biggest thing would be to work in different parts of the healthcare sector you know whether that be for a healthcare

[00:18:07] provider you know in a hospital in a health insurance plan in in a solutions provider I think that getting different perspectives on the same issues is really important as you're building your career early on and I would say embrace the difficult assignments

[00:18:27] you know that we've all had assignments when we were when we were younger and today that we you know maybe saw as more challenging or uncomfortable and those are typically the ones

[00:18:37] you just learned so much from can you point to one that you know that you took on that maybe was sort of like that assignment you didn't want but you took it anyway that was really

[00:18:46] important to you you know in my first role in a hospital organization we did business development and one of the things we did was dig into we had a data set that we had available to us

[00:18:58] that had never really been used very much and we were able to dig into it and start to analyze physician practice patterns sort of what kinds of cases they took to which facilities and how

[00:19:11] much of their business they did with our hospital versus a competing hospital and dig into the why of that and it led to some interesting conversations with those physician leaders who very often were men and well established physicians in their fields and we would

[00:19:28] sit and have conversations with them about you know we understand you only do 20% of your business with us why is that how can we encourage you to bring more of your business to us and

[00:19:38] that sort of confrontational exposing the data and and sort of sales relationship that we were having with them at that time was completely out of my normal scope and approach to anything

[00:19:55] and sounds like comfort zone too in terms of like being out my comfort zone yeah yeah and it wasn't really you know a confrontation with them right it wasn't a lot of disagreement but it was it

[00:20:06] something that had not been done for us data they had not been exposed to before they didn't know we were aware of it and it led to some really amazing conversations around what

[00:20:16] they were looking for how did you handle that so you know sometimes when you are sort of like the early you know the earlier stage of your professional self and you're going into one of those conversations and it's like there's somebody who is much more senior that you're

[00:20:29] presenting to and it's not necessarily you know the the best news or something like that I mean that's gonna be a little bit frightening so how did you handle yourself in that moment

[00:20:40] there's a couple of things you know I had I had a lot of good mentors men and women who I copied right I saw their style I appreciated how they handled themselves

[00:20:50] in moments like that and I said just do what they would do and and go through it and I think there's a fair bit of fake it till you make it and off there that

[00:21:01] you just carry through and get through it and then I think the biggest thing is admit that you're uncomfortable and inexperienced and and that you don't have the answers and that you're there on a fact-finding mission I have this data I want to talk to you about it

[00:21:17] I'd like to understand I'm looking to get knowledge from you and you know most of them were great about explaining why they had certain things locations they wished we had equipment they wish we had it led to so many great business development opportunities for our organization

[00:21:35] it was absolutely worth it wow and it also sounds like you know just the approach that you showed up with in terms of just being you know self-aware and also making it sort of your uneasiness comfortable for everyone and then really showing what you were capable

[00:21:49] that's really impressive um this has been a fantastic inspiring women conversation really thankful that you were able to be here today Rebecca Rebecca thank you so much I appreciate it this has been an episode of inspiring women with Laurie McGraw please subscribe rate and review

[00:22:06] we are produced at executive podcast solutions more episodes can be found on inspiring women dot show I am Laurie McGraw and thank you for listening