Meritain Health Point Solution Optimization

Join our host, Bridgette Cassety, as she speaks with Jenny Shanks, head of Market Intelligence and Stacey Meade, head of our National Sales and Account Management team to discuss the value that point solutions offer, and the many purposes they serve. 

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Speaker 1 (00:05):

Well, welcome to another edition of in the booth. My name is Bridgette Cassety and I am head of our broker and consultant engagement here at Meritain health. And I'm pleased to be joined today by Jenny shanks, who oversees our market intelligence work here at Meritain as well. Stacey Meade, who's been with us before and Stacey is head of our national sales and account management. You know, it's a pleasure to be with both of you today. And I'm so excited to talk about our topic, which the market is all of us about today. And of course that's around point solutions. So there's so much to talk about on this topic. I think the best thing we can do is just to go ahead and dive in. So Jenny, I was gonna start our conversation with you and, and ask what might seem like the obvious, but you know, how does Meritain define point solutions?

Speaker 2 (00:49):

Great question. So Mercer has a popular definition. One that we've referenced in the past, and that is a specific solution that a vendor provides within your benefits program. Typically it's offered by a new innovative company. That's looking to fill some kind of gap in healthcare and the solution might address a specific condition like diabetes, or it might support a lifestyle change. It could also be a technology play to drive engagement, or maybe even a specialized network to provide easy access to expert medical opinions. So it's a pretty long definition that they use, but it really shows the, the breadth of coverage that point solutions can have within the industry. And I think, you know, we've all seen how much medical costs have increased. And we recognize that the traditional means of managing costs like network and medical management, while those are critical, they simply aren't enough anymore. So we see the value that point solutions offer and the many purposes that they serve. So not just the cost containment, but also how they can improve on the member experience and especially more recently how employers can use them as a recruitment and retention tool.

Speaker 1 (02:05):

Yeah. And, and Jenny, thanks for that definition. Cause I think it's always good to level set when we talk about point solutions. It's a term that gets thrown around a lot, but I, I appreciate sort of the broad explanation of what it means and, and thanks for defining that for our listeners. And I think the next question I would, I, Jenny, I'd also like to throw your way, which is how does Meritain look at point solutions these days? Because like you said, it, it can mean a lot of different things to different people. So what's the Meritain perspective on point solutions.

Speaker 2 (02:31):

It can, and there are actually a few different ways that we look at the solutions and how we deliver them to our customers. So I'll start with targeted point solutions and those really address individual conditions. Are they solved for a specific problem, like a condition specific. You may have heard that term. And I think we'd all acknowledge that the proliferation of options in the market is almost unbelievable. It certainly can be overwhelming. So we at Meritain do our part to those options. And while we can and do work with a very broad range of solutions, some that are brought to a fire customers, we also have our market intelligence team that assesses the market based on industry trends and also what's happening across our own book of business, which is nearly on 4 million members right now. And we use that insight to identify the solutions that are most relevant for our plan sponsors and our members.

Speaker 2 (03:28):

And then also address the needs that they have at the moment. Another means of delivery for point solutions is through a navigation partnerships and those solutions that require a, a deep level of integration. And we have a very unique approach to those types of relationships. One that's even worthy of its own pro podcast. So we have planned one another podcast for later this year. So stay tuned for that. And then finally we have our Meritain connected solutions and these are unique, a offerings that we can coordinate through our partnership and ownership with Aetna CVS, it's meriting connecting our customers to an ecosystem of solutions, many of them from CVS and bringing them together to improve the members' health and reduce the total cost of care. And we actually recorded a podcast all of the out Meritain connect connected solutions in February. So if anyone wants to learn more detail about that, I encourage them to give it a listen.

Speaker 1 (04:29):

Jenny, thanks so much for explaining how we approach these in the, in the word that came to mind as you were speaking was, you know, strategy solutions, strategy. And I think that that's what the point solutions are meant to do. So what would you say is our motivation then for evaluating these types of strategic solutions and point solutions for the market?

Speaker 2 (04:48):

Well, first and foremost, I would say meeting the needs of our customers, really selecting point solutions that address the challenges that our customers are facing. But we also are looking at creativity throughout, and that means from the partner election where we're vetting the solutions and the options through the end to end plan design process. And, you know, we work with some of the best in class point solutions. And in some cases we're not the only TPA or carrier that these point solution companies work with, but we're able to create custom offerings that uniquely meet the needs of those customers. And I think that allows us to stand out in the field. Another item that we look at when we're selecting these partners is health equity, and that's the concept that everyone should have access to care and the opportunity to be as healthy as possible, regardless of their zip code, their raise, their age, their financial status, et cetera. We know that members' needs. Aren't all the same populations are very diverse and they vary greatly. But the point solutions can be a way for each plan to meet members where they are and in increase equity within their health plans. They really, I look at 'em as almost the puzzle pieces that enable employers to provide a holistic health plan for their employees and their families.

Speaker 1 (06:09):

Jenny, I think you're right, you know, it's that holistic approach because all members needs are not the same and customers and consultants wanna make good choices and just decisions around solutions. And so I think safety would be a great opportunity to bring you into our conversation, cuz I've heard you use a term that I think our, our listeners would love to learn more about and that's around point solutions, COE and exactly what does that mean? So I thought you could spend some time and, and give us some perspective around point solutions center of excellence.

Speaker 3 (06:36):

Yeah. Thanks bridge. Appreciate you having me here to talk about our point solution center of excellence and you know, it, it's not real in our world unless we have an acronym for it. So you might hear us refer to as a point solution COE. You know, I'm sure it's gonna end up with PS C OE or something crazy, but what this really is, is our way of bringing together all the ways, which we optimize point solutions for our customers. We think about point solutions, every single one of them is an investment for the plan sponsor. And so if we think about Maritime's role with that, when investments are made, we see it as our job, not just to allow those investments, but rather to help maximize them. And so we took a series of activities that mostly were already in existence, but we're tying them all together through our point solution center of excellence to make sure we're optimizing the experience for our members, for our plan sponsors and that folks are getting the, the most out of their point solution.

Speaker 3 (07:40):

So when we think about that, so getting into some specifics, there's a few ways we do it. So first is the, the team general leads the market intelligence team, super helpful for us because they are constantly scanning the market for, you know, what's the latest and greatest what's emerging, you know, who are the emerging players, things like that at, but one of the things that they also do is help us vet who's likely to stick around with the, the way point solutions have been receiving venture capital investments and things of that nature. You know, what we don't want is we don't want our employers to, to start working with point solution that's here today and tomorrow leaving a gap in the health plan. And so we help with identifying, you know, are these people really sustainable? Are they doing the things they say they're doing?

Speaker 3 (08:29):

Do they have data behind it? And our market intelligence team help us evaluate that when they find the coolest things, they turn it over to our product team. So when we move something from our market intelligence team to our product team, we've identified it as a best in class solution for our customers. While certainly we can work with a very wide variety of point solutions. We also think that, you know, many of our customers are relying on us to narrow down the options out there. Think about telemedicine or virtual care. There are approximately one zillion options available and we actually have products with more than one provider. What we've done is we can clearly identify our product team has helped us say, Hey, you know, what if texting capabilities are important to you, this is the type of point solution you want. Or if you want the broadest access to the most people across the country. And you've got a large population in Alaska, this is actually the partner you want. So those are some unique things we've done between the market intelligence and the product team.

Speaker 1 (09:42):

And, and I think Stacey, when I hear you talk about what comes to mind is creating that easy button, right? The easy button opportunity that gives you that strategic solution, that maximize results that people can rely on is best in class. And, and I think that maybe a, a good question for you would be then is to say, you know, how what's different from an operational perspective. So when you talk about that, how is that operationalized here at Meritain that works differently from how it's working in the rest of the marketplace? What would your perspective be on that?

Speaker 3 (10:11):

Yeah, there's some really cool things we do through our center of excellence to ensure that the easy button is hit and, you know, it does start with operational you know, ease. So, you know, what we see in the marketplace is that very often other administrators will say, Hey, we can send eligibility to whoever you want, you know, sign off on and a Phi form. And here you go, we'll just send it off. I mean, that's okay. That's the minimum required. However, what we do is we actually have an entire team of folks whose job it is to evaluate point solution operations. So they've got a very standard process that they start by understanding what is this point solution looking to accomplish? Why does this customer in interested in it? And then they've got a list of ways in which we can interact with the point solution.

Speaker 3 (11:03):

So think about things from custom claims processing. Maybe you want certain claims to be covered under your point solution, but not under your medical plan. Sometimes you need to reference these benefits and plan, document language. Sometimes you need to help demonstrate to a reentry provider that these point solutions are being effective and there should be a reduction in premiums for that. Those are the types of things we do from minute one, the, either a client comes to us or we identify a point solution that we think is a good option for the market. So that's a starting point when we think about hitting the easy button, one of the other things we do is we have been working diligently with our partners on data to confirm the impact, right? So if you think about the point of point solutions is to ensure that we're reducing the total cost of care.

Speaker 3 (11:58):

Well, you need data to do that. Now, of course, the data you can provide varies dramatically, depending on the solution and the level of partnership, but for every product that we have partnered with to offer where everybody solution we are offering as a product, we know we have data to justify the investments that are being made. In addition, we're running some pilot projects right now through our COE where we're incorporating health plan data with point solution data to show a holistic picture. So the example I would give you is, you know, your telemedicine vendor can tell you how many times somebody called their service, but then you put that alongside a comparison of whether or not more or less people use the emergency room in urgent care. And suddenly you have a more holistic picture of the impact. That point solution is making so very excited to see that, you know, that is a big big undertaking and quite the challenge.

Speaker 3 (13:02):

But we do believe that over the course of time, those types of analyses will help make a determination about what can be effective. And then the final thing we do for our easy button is the head of our COE, which is Ryan Brookes. His whole job is to pull together all of these capabilities, make sure we keep the focus on impacting the total cost of care and being advocates for healthier livings for our members. He's looking for ways he, we can bring quality, simplicity and savings to our customers for through these point solutions. And by having a single individual who's responsible for the big picture of point solution strategy that makes things easy. We've got one resource and he can say, okay, great. Now if this is what you're looking for, let me pull in market intelligence or let me pull in product, or let me get my data to folks together, to help understand your goals and figure out how we can help you accomplish them. So very excited as this rolls out, I think it's gonna be a, a game changer for point solution strategies,

Speaker 1 (14:09):

Stacey, thanks so much for sharing that perspective. And, and when I hear you talk a few things come to mind as we sort of wrap up our time together is that, you know, a lot of these things that we've been doing for a long time or a TPA, it's part of our DNA to bring in, you know, a variety of solutions. But I think what we've really learned in the discussion today is that it's how we, how we approach it, how we track it, how we measure it. And we're doing that all in this, as you call it center of excellence related to point solutions so that we, people can tangibly rely on the results around the point solutions that they choose. So with that, I'd like to thank you Stacy and Jenny for joining me again today for our series of in booth. And I look forward to our listeners joining us next time. Thank you.