Inside MD Live: Improving healthcare access, affordability, and outcomes.

Transcript

Haley Wrecker: This is Haley Wrecker with the Becker's Payer Podcast, and we are recording live at the Becker's third annual Spring Payer Issues Roundtable. I am thrilled today to be joined by Dr. Eric Weil, who is the Chief Medical Officer at MD Live by Evernorth. Hi Eric. Thank you so much for having this discussion with me today. Can you go ahead and introduce yourself and share a little bit about your background?

Dr. Eric Weil: Sure. Thanks for asking. My name's Eric Weil. I'm the Chief Medical Officer for MD Live by Evernorth. I am a practicing primary care physician who has overseen the clinical infrastructure and strategy for our virtual solution for the past two+ years. My career began in general primary care, and through a relatively circuitous path, I found myself in medical leadership and then in home-based care. Interestingly though, when I went into home-based care, it was right at the beginning of the COVID-19 pandemic, and we rapidly were forced to pivot into a strategy that was primarily telemedicine-based. And in that context, I really learned about both the value and the opportunity of virtual care and have been running in that race ever since. I want to make sure that we have an opportunity to talk a little bit about the company that I support, MD Live.

MD Live is an Evernorth Health Services company and one of the leading providers of telemedicine and virtual care in the United States. We offer services in primary care, urgent care, dermatology, and behavioral health, and we have an employee assistance program. The MD Live program supports 62 million individuals. They have access to MD Live as a covered benefit through their health plan. And the way that we offer services is either through video, through telephonic care, or through asynchronous care, which we call e-treatment. We have over 2,000 board-certified physicians and licensed therapists who are trained to deliver care virtually, and we are dedicated to delivering exceptional, accessible, and personalized healthcare through a seamless, smoothly connected virtual platform.

Haley Wrecker: That's awesome. Thank you so much for that brief introduction. Now, moving on, balancing affordability and quality is a constant challenge for health plans. How is your organization innovating to manage the cost of care while maintaining or improving member outcomes?

Dr. Eric Weil: So, I like to break down our approach to the balance of affordability and quality into three different domains. We use efficiency, prevention, and access. Efficiency allows us to deliver a high quality of care at a better price point through economy of scale, but also through technologies that streamline the experience and improve communication for patients and providers. We also leverage technology to support our administrative responsibilities. So, for example, when you deliver over 1.5 million visits a year, you want to be able to deliver quality at scale. And the way that you do that is by using an AI intervention, for example, to help with quality chart reviews. And that allows us to manage our leadership workforce and, at the same time, support the oversight of quality and safety at a volume that's much higher than one would ordinarily be able to support. We focus very much on optimizing processes and we have a continuous process improvement philosophy that allows us to take any existing programs or interventions that we have and focus on making them even more impactful.

The second area that we focus on is prevention. And the concept here of course is that in order to reduce the total cost of care, you have to keep people healthy. You have to keep people from utilizing more expensive healthcare services and you have to prevent them, quite frankly, from needing to miss work. And so our interventions not only deal with care in the moment, but are very strategically focused on thinking about the future needs of an individual. So, when a patient comes in for their virtual primary care, for example, we're not just managing their complaint in the moment—we're thinking about what preventive screenings they need, what we can do to ensure that their diabetes is well controlled, and that is a chunk of the work that we do at any given time.

And then the third area is access, because you can't have good healthcare if you can't access healthcare.

So, we have a 24/7 strategy that allows us to deliver primary care at 10 o'clock at night or on a Saturday morning. If you have an urgent care need, you're going to see us within 20 minutes. If you need routine care, even in primary care, we have the ability to offer that the same day. If you are in need of behavioral health services, we can actually manage those within a week. Our physicians can refer patients to in-network specialists, which means that we can help to ensure access and connectivity to the healthcare providers that are within an individual's network. And because we also show cost transparency, we actually show the cost of the visit in advance. We allow individuals to make the decisions that they need to make with regards to how and when and where they want to access care. And then the last point I would say is that the approach that we've chosen to use means that patients are not pursuing healthcare in other venues. About 20% of our MD Live patients indicate that they would've delayed care if MD Live had not been available to them as a service.

Haley Wrecker: Well, I'd love to go deeper into this conversation about quality of care. So in an ever-evolving regulatory landscape, what best practices or tools does your organization rely on to keep quality of care at the forefront?

Dr. Eric Weil: I appreciate you asking the question. It's important to recognize that in the DNA of MD Live, quality and safety are the top focus. When we have a business review, when we review performance, we don't start with financials, we don't start with utilization, we start with quality and safety. We talk about whether or not there have been safety events. We talk about how our physicians are performing from a quality point of view. That's where we always start and that message is delivered to our entire team. Whether that's marketing or strategy or product, quality and safety come first. When we develop clinical interventions, we are always using evidence-based guidelines. When we develop interventions, we ensure that they are being reviewed, vetted, and produced by licensed healthcare professionals, physicians, therapists, and others. When we select physicians or therapists to be in our network, they are all
board-certified and are robustly vetted.

And when we develop new clinical interventions, they're reviewed every single year. Nothing that we do becomes outdated because we are constantly looking at what we offer to ensure that it is up to date with the most recent literature. Finally, what I would say is that the platform that we've created is designed in such a way as to make it easier for physicians or therapists to do the right thing. The platform helps to facilitate thoughtful clinical decisions. It helps to facilitate ease of decision-making in such a way that we worry less about whether or not a physician is going to make the right decision because we are confident that it's going to happen just because of the way we're structured.

Haley Wrecker: Thank you so much for sharing. And looking ahead, what do you see as the biggest opportunity for payers to lead the charge in transforming care delivery and driving better outcomes for all stakeholders? How can leaders take a step in this direction now?

Dr. Eric Weil: I would make the argument that we should be acknowledging and embracing the fact that change is happening and is going to continue to happen. For example, if you think about the length of stay in the hospital for a heart attack in 1990, it was between nine and ten days. When you think about the length of stay in the hospital today for a myocardial infarction, it's three days. A hip replacement, in 1970, you were in the hospital for 17 to 20 days, and now it's a same-day procedure. Every step of the way, care is being moved from being in a hospital to being in an ambulatory setting. And now healthcare is being moved in an ambulatory setting from a specialist to primary care. And then it moves into the virtual space. And our role is to recognize that that is the direction that healthcare is moving in. And our role is to make sure that we are well positioned to support the movement of that care to the home, to a virtual space.

And so, the way that we do this is we focus on enhancing and personalizing the patient experience. We work as much as we possibly can to broaden the number of clinical capabilities that we can offer, even in a home-based environment through a virtual platform. And that includes things that you historically would've gone into the office for. Some of those are around managing chronic disease, hypertension, diabetes, and obesity, and some of those are focusing on other areas that are very much priorities for men and women in the course of their daily health experience: women's health, menopause care, contraceptive management. Our role is to ensure that our clinical capabilities and specialized care are expanding and that we're offering more optionality in terms of referrals, for example. I would say that we're also redefining the referral so that it's not just to in-person care, but also to other virtual services.

Haley Wrecker: I know you mentioned diabetes care and weight loss medication. So, I'd really like to hear your thoughts on the recent explosion in popularity of direct-to-consumer virtual care services that promote easy access to prescription medications to treat everything from weight loss to hair loss to ED.

Dr. Eric Weil: Thank you for asking the question. The first point that is worth keeping in mind when we think about the trend toward direct-to-consumer care is that healthcare is a service industry. It's a service industry with consequences, however, because if you're not receiving the service you need, then you may not be receiving crucial healthcare, or you may be delaying it in some fashion or another. So that's point number one. Point number two is that patients want more control over their healthcare. They want more control in the decisions that are being made. They want to be more informed than perhaps in the past, and they're willing to pay for it. With that, however, there is a component of risk because if those decisions are not informed decisions and a patient is willing to pay, then they could go down a pathway of receiving care that is not in their best interest.

So, the direct-to-consumer journey is one that is going to become increasingly more prevalent in the United States. And our role within MD Live is going to be being a partner, acknowledging the need and the desire for control, but to do so in a way that ensures high levels of quality and safety. And if an individual's priorities may not entirely align with what a physician might recognize as a priority in their healthcare, our role is to help support a journey that both meets the patient's needs and, at the same time, keeps them healthier, makes them healthier. So, our model, which is not just focused on direct-to-consumer, but it's a more comprehensive, holistic approach, would focus on a patient's priorities and, at the same time as that, their clinical needs. Most of the time, that's also covered by their insurance. And if necessary, we have the ability, if desired, to share that information with their primary care provider or their specialist provider in the community.

Haley Wrecker: Alright, well thank you again. This is Haley Wrecker with the Becker's Payer Podcast recording live at the Becker's third annual Spring Payer Issues Round Table. Thank you so much for joining me today.