Meritain Health® - In the Booth

TCOC: Access to Care

February 22, 2021 Meritain Health Season 2 Episode 3
Meritain Health® - In the Booth
TCOC: Access to Care
Show Notes Transcript

The value that Meritain Health helps provide through Access to Care

Gaining access to strong networks and pharmacy brings savings right to you. We’ll give you the pathway to: 

  • National value-based networks (Aetna and CVS). 
  • Accountable Care Organizations (ACOs), and similar groups. 
  • Multiple network configurations. 
  • Centers of excellence and institutes of quality 
  • Integrated pharmacy solutions. 
  • Innovative point solutions. 
  • Walk-in services (Minute Clinic® and HealthHub™).

Welcome. My name is Bridgette Cassety and I am in the Broker engagement department here at Meritain health. I am pleased to be joined today by Dan Day, and Dave Parker. Dan is our middle market head of sales nationally, and Dave is our national account head of sales here at Meritain. I am thrilled to have both of them here with me today. The topic that we are going to be discussing is the value that Meritain helps provide through access, which is one of our core components of our total cost of care approach in the marketplace. Dave, I thought you could kick us off in our conversation and just share with our listeners when you think about access what that really means to you and what that really means to our customers.


Thanks Bridgette. When we look at access, it really should not just be about having every provider across the whole country. Access really should be highest quality providers. In specific geographies throughout the country, obviously we need to have a very comprehensive network, but looking at providing the high-quality providers, at good economical prices valued to the members is important from an access perspective.


That is a good point Dave. Dan, when you think about what Dave just shared can you talk a little bit more about what our overall network strategy is here at Meritain?


Yes, really to accentuate the point that David made, it is not just about the broadness of the access or availability everywhere, but it is really the value that we are getting from our provider partners. Aetna has deployed some of the most advanced contracting methodologies in the marketplace. That really underscores the value based contracting methods with both hospitals and large health care providers. So that we are striving to manage the overall population health that they are managing. But it's also a much more advanced version of the old reduced fee for service that we still can offer if clients want that. But this advanced methodology really optimizes the network and points our members towards those who are providing the best value.


Value is certainly a word that we hear a lot about. A lot of times when we talk about value, the word flexibility also gets woven into the conversation. Dave, when you think about Meritain being a TPA, how does that play into how we can create custom solutions for our clients?


So this is a great point and great question. Most of the time when people think about flexibility and network, they immediately think about carving it up. That is not the best solution for the network, the best solution in terms of flexibility with a network, is to create steerage and the ability to help plans drive the membership to the network. Looking at various solutions that we can tie to it that will help with steerage such as, a healthcare blue book type product. Additionally looking at putting in, practices such as I mentioned earlier, that the tiering where benefits are more driven to the high quality low cost providers really can result in better benefits for the members and better results for the clients.


Dan, when you think about Meritain now being part of not just Aetna, but also part of CVS, how has that furthered the access that Meritain can provide to our customers?


This really gets us to the point where we are integrating a lot of the care that is being delivered to our members. That care comes in the form of health hubs or minute clinics that are in many CVS store locations. In addition to the pharmacist is one of the most sought-after consultative healthcare figures that people have within their lives. We essentially have married those together to form a healthcare experience that has both broad access, but also delivers a lot of point access and value to our members. The health hub and minute clinics are expanding and attendant rapid rate across the country. This year, there were 1200 new ones built within the pharmacy location. Next year, 1200 to 1500 more are going to be built across the country. So we're increasing access and during the recent pandemic, this became evermore important because they remain open and available for our members.


The access is something certainly that you are right, Dan in our current environment is becoming increasingly important.  I guess as I think about, our time here today and getting to the end of our time. I If I were to ask each of you, what you think about Meritain and you think about access, our current health environment, and being part of a broad enterprise like CVS. What do you think is the number one thing that folks should take away from the conversation as unique advantages of Meritain? Dave, I'll let you go first on that.


Sure. So I think what people typically think about access, you get pigeonholed to having a network solution  with having the ability to have different network configurations, not just a broad network, but to get to a high performance network or to an ACO. We have options for our clients that most TPA is never even fathom having. I think access has a different meaning when you look at it from that perspective.


Dan how would you answer that?


We could leverage both that access, but we also leveraged different point solutions because our members are starting to consume healthcare in a very different way. Meritain along with CVS and Aetna are really leading that change into what health care is going to be looking like in the future. So whether it be the access points of health hubs, or minute clinics, it can also be through alternate providers, such as telemedicine, et cetera, that really gives us different both points of access with different ways to consume healthcare.


I agree with both of you, those are two key things. I think something else that you both mentioned in different ways in the conversation, is really that care integration. That care integration comes from a whole host of things that you talked about, be it steerage, or advanced methodology, or the value of high quality providers in the network and how that all plays together into creating an integrated care solution that really manages total cost of care. I want to thank you both for taking some time and talking about that with our customers. I appreciate you joining us. I look forward to some time in the future.