Episode Transcript:
Dawn Maroney
There's a lot of loneliness that goes on. Because there's that judgment that happens because of one's age or, you know, who they are, etc. And we see that across the board, you know, just with just humans, unfortunately, not being humans. So, from the perspective with seniors, how do you outreach? How do you get them more involved?
Robert Traynham
Hello, welcome. It's so good to see you. I love starting these conversations first and foremost, with an icebreaker. Favorite movie? A movie that has some profound interest for you, something that, you know, you still remember to this day. It could be something from 30 years ago, or maybe three days ago. I'll start with you, Dawn.
Maroney
Well, my favorite movie is Gone with the Wind.
Traynham
Of course, that's a classic.
Maroney
Yeah, so much that I just named my car Scarlett O'Hara, because I got a red car. And so, I鈥檝e decided to name the car Scarlett.
Traynham
Something else tells me you're not the only one! Something tells me in that Scarlett, your car, is probably not the only car out there named Scarlett. It's got a little personality a little something. I got it.
Hakan Kardes
Yeah, for me, it's one of the movies that 鈥� actually it's a show on Netflix recently, it's The Club.
Traynham
Club?
Kardes
Yeah. It talks about 40-50 years ago in Turkey, some of the things that have been going there.
Traynham
I want to go back for a second. Hakan, I'll start with you. Why does that speak to you, that series or that movie?
Kardes
I like real life stories. Just what people have gone through, how they dealt with it. So, there have been a lot of really good personal stories, there.
Traynham
Something you can relate to?
Kardes
Yes.
Traynham
Yeah. Dawn, I'm going to go back to Scarlett. Why is that movie so profound for you?
Maroney
So, the movie brings a lot of memories. So, as a child, we used to watch it every year. And it's just a lot of history. And it's just one of my mother's favorite movies and just became mine as well.
Traynham
The reason why I bring up the icebreaker is because it's a very nice鈥� I look at life, almost like an onion, where there's different layers. And usually, a book, or a movie, or a childhood experience really does inspire you for the work that you do when you grow up, if you will. So fast forward to now, you both are coworkers, you both are doing some impactful work. Walk me through your roles.
Dawn, let me start with you.
Maroney
So, I run our markets for our organization as the president for the company. And I also am the CEO of the health plan, and primarily responsible for just a number of things within the company. But anything that represents the health plan is my accountability. I鈥檝e been doing this for quite some time, love the senior market. It's just a passion that I have. My grandparents died at a young age. So, I always wanted that opportunity to work with older adults. And now I'm getting to that point myself, so I'll be working with myself!
Traynham
Hakan?
Kardes
I'm Chief Technology and Experience Officer. I'm mainly responsible for data technology, AI teams, as well as our customer service. Medicare STARS quality teams.
Traynham
You know, I'm gonna be a little bit of a鈥� make a controversial statement, although I don't believe the statement that I'm going to make. And that is: that seniors and technology are like oil and vinegar. I think that used to be the case, I think that used to be kind of the stigma, if you will. But if you fast forward to today, you know, most seniors, first of all, they're younger seniors, if you will, because they're obviously living longer. But they've kind of grown up with technology in many ways, very proficient with a smart device, or what have you, on Instagram and other social media. But why is this still a stigma, assuming that I'm right with this with this prejudicial statement that I just made?
Maroney
You know, it's interesting, because it you know, I think it's the fastest growing population in the segment. You know, I mean, a lot of seniors have iPads, a lot of people you text. I mean, there are, of course, courses that we will do as an organization to educate on how do you, you know, communicate with your grandchild, among other things. And it is, the continuous feedback is, 鈥渨ell, seniors are probably not on text,鈥� or 鈥渢hey're not on a computer,鈥� 鈥� it really is. Seniors today are very different than they were 20 years ago. And so we've got to grow up into that phase.
Traynham
Is it fair to say that the grandparents of yesterday are not the grandparents of today? I mean, that's how I would phrase it in many ways. To your point and my earlier point. Seniors are pretty with it. I mean, they understand technology. Now having said that, technology is changing so quickly. I think the question is, how quickly seniors are catching up?
Kardes
Yeah, I think for that it's mainly us changing as well. And our perceptions. At the end of day for me, it is just, we cannot just force somebody to use a technology, they should get some value out of it. Just, there should be a win-win situation, especially when we look at senior care.
Okay, we would like them to use technology. But what are they going to get out of it? Just how are we going to make it much easier for them? Many times, okay, we are thinking 鈥渟eniors are difficult鈥� but when we spend the time, when we show them鈥� for example, during COVID time, we sent many seniors cell phones or iPads to be able to do virtual visits. Maybe for the first couple visits, they required some assistance, they needed some help. But after a while, yeah, they know how to do it. They love it. I think mainly there are things we can do as well, to make it easier for them.
And that is what we are trying to do at Alignment.
Traynham
Let's expand on that a little bit Hakan. Would you make the argument that that was impactful for you to see 鈥� my words not yours 鈥� the transformational change that seniors made during COVID with technology?
Kardes
Absolutely. It forced everybody. I think it forced seniors to seek different ways. But it forced us, as well, to do something for seniors just to go above and beyond to push our boundaries. I think it forced everybody.
Traynham
And how did that make you feel?
Kardes
It's made me feel great.
Maroney
I love the question. And I love the conversation. It's just interesting. So COVID actually changed more of, I think, the industry than it did the consumer directly. You know, we would institute town hall meetings because we were prioritizing, you know, the highest risk member that we can identify through our technology, on how we can get food to them, how we can get even something as simple as a mask. I mean, at that point in time, a mask really wasn't simple, it was very hard to get, so we had masks made.
But we would conduct virtual town hall meetings to talk and ask and have question and answer sessions with clinicians, etc. And we would have 11,000 seniors participate. And they were really ahead on what they believe could help than even some of the clinicians we鈥檙e inviting to that conversation. But you know, that technology became very 鈥� it was more for us than it was for them. And the other piece too, is, you know, when you think about technology, it's really kind of behind the scenes. It's like, 鈥済et to know me better. How do you know me as an individual?鈥� We can be more proactive, and those conversations with our consumers, just in general, whether senior or non-senior. And so, the technology is pretty powerful, when you think about utilizing it in the right way.
Traynham
What are some of the biggest misconceptions that you think we all have about seniors? And how do you think we should address that?
Kardes
Yeah, great question. I think sometimes, for example, we feel like 鈥淚 hear this a lot,鈥� or it might be a 鈥渦ser error.鈥� Some have misconceptions about seniors, that they are not really able to use the technology well. But in reality, when we look at, 鈥淒id we design the technology for them? Did we make it easy to use for them? Did we create, adjust user guides? Or did we train them?鈥� I think we have some gaps there. But really, at the end, we show them we are there to try to help them. And if we are able to get their feedback in a constructive manner. I think it will make it better for everybody. It helps us to make our products better. And it helps seniors to get what they need from us.
Traynham
Dawn, your point of view on this?
Maroney
Well, I think when you think of somebody that's older, they've been through life. And they actually have the, you know, so much to teach all of us. That's, although I'm getting close again, to that senior stage.
Traynham
Let's be clear, let's be clear, you're probably maybe pushing 40, okay? You鈥檙e pushing 40.
Maroney
Thank you. Thank you. So, I'm trying, I'm trying to reverse that age. But it really is, you know, I've learned so much from people that are older, even when I was in my early 20s. And the wisdom and the experiences in life and the lessons learned and some of that I've wished there was opportunity that I would have even listened more at that point in time, because of that. So, it's not that, you know, people are, less experienced or talented. In fact, they're more! And so, because they have, they've made it. If you think about it, a lot of people don't even make it to certain age groups, right? And they've made it, you know, they're living life.
Traynham
Yeah. And they're just learning a different way.
Maroney
Right, now the pieces that I see, where we want to do a lot more, it鈥檚, there's a lot of loneliness that goes on. Because there's that judgment that happens because of one's age or, you know, who they are, etc. And we see that across the board, you know, just with just humans, unfortunately, not being humans.
So, from the perspective with seniors, it's like, how do you outreach? How do you get them more involved? And so, we do a lot of work through our technology to say, you know, are they living alone? Have you been outside? What do you do for your activities? How can we help? Or how do you create these clubs to get them more involved? And then teach our folks that are answering the phones, getting them more鈥� We're forming a lot of different committees, and we're inviting them. And it's just such a great experience to see, you know, former CIOs of banking industries or, you know, getting involved in committees. Now, they're negotiating dollars at this point. But they want to get involved and they want to, you know, help the younger generation, which is great.
Traynham
What I'm hearing Dawn say, Hakan, it鈥檚 like building community and that connectivity, in many ways. Is that what you're hearing as well?
Kardes
Yes, exactly.
Traynham
So, there's some really, really impactful things that are happening. Dawn, let me turn to you to see if there was like a specific example that really does warm your heart.
Maroney
Well, most recently鈥� so my mother has been in a skilled nursing facility because she had a fall and she actually loves the facility that she's in. However, every time I go and visit, you just, you see an environment that just needs so much improvement, and so much work. So most recently I asked the facility, 鈥淐an I bring my dog?鈥� I have a Sheepadoodle, and I have a Westie and a Mini Pin.
And so I brought the Sheepadoodle and the Westie and I decided to go visit patients inside each of the rooms. And it just was such a beautiful experience to see the happy, like the smiles, you know, because people don't, you know, they didn't have visitors. But with that dog, you know, our dog coming in and just, 鈥淐an I touch your dog?鈥� Like, 鈥淧lease, please?鈥� Almost even to a point of begging and just the smile, and just 鈥淭hank you so much,鈥� including the staff! It was just such a beautiful experience.
And looking at that I was thinking, 鈥淕osh, we need to do more of that! How do we write letters, specifically to all the patients that are sitting in our skilled nursing facilities that may not have a loved one that's visiting them, or do a visiting program.鈥� And you know, because we know that the value of what we're seeing and what's happening and these skilled nursing facilities are not at the level that anyone would expect it should be for, you know, what's happening in that environment.
Traynham
I remember a few years ago, Medicare Advantage was the small little baby that was a project for the federal government, and it really was just kind of like this extra little thing. Fast forward to today, that baby is now a grown adult that is mature and really popular with seniors in terms of the choices, in terms of the flexibility, in terms of the cost. From your perspective, first of all, am I right? And also, from your perspective, how are you seeing it on the ground?
Maroney
Well, since you said, I'm 40, I think I started at seven. I鈥檝e done this about 33 years. And, you know, it's just evolved. But you know, it's interesting, the likes and wants and needs of that consumer, there's a lot of similarities. However, it's evolved. And the more that we can talk about it and get the message out that it really is a fantastic program, the more you'll see that growth and that growth rate is exceptional. It's continuing to grow.
I think a lot of us when we think about the cost of health care today, you know, prior to that 65th birthday when you get Medicare, it is really a challenge when you look at the rates, and you look at what the coverage is. So coverage 鈥� even though there's coverage that is available for the uninsured 鈥� that cost of health care is crazy, when you think about it. And I talk to people. Too often they'll say that they don't have that coverage, as a result of it. And they're waiting till that 65th birthday. So, a lot of people can't wait. We, of course, are a growing industry and so we're all trying to be as creative as possible in that journey. But seniors like it and they're growing.
Traynham
Why do you think they like it my earlier point around flexibility and choice, is it that or something else?
Maroney
You know, a lot of delivery systems are participating as a part of it. So, the choice of the doctor, choice of benefit options, the competitiveness related to the premium and the cost of care. Coinsurances. It鈥檚鈥� the value is great. You know, there still is a supplemental market but MA is definitely outgrowing.
Traynham
Hakan. We've reached 30 million people, and it's still growing, seniors that have signed up for the program. From your perspective, what do you think is the sweet sauce or the secret sauce, if you will, about Medicare Advantage?
Kardes
I think being more consumer centric and really taking care of seniors. Just the health insurance industry is evolving. Maybe, you gave the example, maybe 2030 years ago, it was more like business transactions or an administrative function to administer the claim, manage the membership. But today, when we look at it, Dawn mentioned about supplemental benefits, or really just doing the full-court care coordination for the member.
Just from a couple weeks ago is story. A new member who recently joined to Alignment. Prior to joining Alignment, she was having transportation issues to her dialysis appointment. Then she joined us. I realized, okay, first couple of appointments with us, as well, the driver was canceling the appointment. Just then we reached out, we figured out it's a rural area, just not much transportation companies. We found, actually, a local company we contracted with, and we took care of her. And after a couple of weeks, she called me crying. She said, for the first time, she was able to sleep with peace of mind thinking that the next morning, she will be able to make her appointment.
Traynham
Oh, wow.
Kardes
So as a health insurer, our only obligation is not keep paying the claim for a dialysis appointment. But making sure that it really happens, really make it happen for different, diverse populations. I think that is where the real power comes down with the innovation around all these benefits: make it more personal, really making sure every senior gets the care that they deserve. Not only from payment side, but make sure it happens. I think that is the real part.
Traynham
You know, that's interesting, it kind of warms my heart in many ways, because it's a real story around a real person. And you know, folks that work with me, I've heard you say this a million times now. And that is, it's a real deep relationship, a meaningful relationship. It's not just about, to your point, account around just paying the bill. It's about making sure that person is okay about getting to their dialysis appointment. And she was able to sleep that night, you know that. So that's, that's a really powerful story. So, thanks for sharing.
Dawn, I want to talk for a few moments about the next chapter at Alignment Health. What does that look like from your perspective?
Maroney
You know, it's our goal to make sure that we grow beyond certain markets. So, we're in six states today, we'd like to go across the country, if you know, or enable other payers to do what we do. So, you know, as Hakan said it so eloquently, we do more than just pay that claim, we actually have a full clinical model, we actually have clinicians that go to the home for home care for patients that are homebound or need more, you know, special attention. So, you know, the journey is to just spread the news to get the message about what we do to more seniors across the country. I think when people hear about it, and they enroll and their experience, you know, it's very rewarding, but it's getting that message out.
Traynham
Hakan, would you like to share anything on that note?
Kardes
Yeah, I think just our mission is to Dawn's point, right. We have built, I think, a unique high-touch, high-tech experience. And yeah, we would love to bring it to every senior in the country.
Traynham
Yeah. I love to end on this question. And that is the next big thing in health is.
Kardes
Yeah, I think leveraging more and more AI, I think it's going to really help reduce the burden on clinicians. They are still unfortunately, spending a lot of time on documentations on different things, just pulling data. We really would like them to focus on the patient. And I think AI is going to help us a lot. And even some other technologies with the telehealth, with other things. Unfortunately, for many specialists today, you might need to wait two months, three months just to get an appointment. So, definitely, I think there are so many things that we can see, just to make that access to care much better through technology.
Traynham
Yeah, thanks for sure. Dawn?
Maroney
Of course, I love all these questions. You know, I think that the next big thing in healthcare 鈥� oh, there鈥檚 so many things that I think about 鈥� but I'm trying to鈥�
Traynham
Give us two or three!
Maroney
So the one would be I really do believe that we're going to get to a place where we're going to pay claims via through a credit card. So, I think that to get real time immediate payment as well as connection鈥�
Traynham
And also flexibility perhaps for the patient. There's a there's a lot of reasons why they put it on their credit card. It could be for their points it could be whatever reason.
Maroney
Correct, and you know, us even honoring or organizations honoring that card specifically so that you can pay, get the tracking and the documentation around that can be 鈥� can't get any better than that.
You know, the other pieces, I think it's going to be around Part D. So, for pharma. There's a lot of discussions about, you know, you hear about it Ozempic庐, Mounjaro庐, and others, you know, when you see the demand in that space, or you see the demand in areas like whether it's drugs and or ChatGPT it's like, how do you embrace that and make that a part of what your journey is.
So, we're already doing that with technology we've been, we've been ahead of it, real time. So, it's not a year old. It's like here and now for the technology piece. But the piece specifically around the drugs, like how do you embrace that, but make sure that you have a true care or coordinated health program journey to support if people want to embrace those types of drugs for, you know, weight management, etc? Because we have a lot of diabetics that are in our company and our plan. And so, and separate of that, but how do you embrace that to, to offer that to your seniors.
Traynham
To be determined.
I look forward to having you back on sooner rather than later, where we can unpack this a little bit more, especially around AI. And then the question becomes the privacy guardrails around that and how do we, as a society, feel about some type of algorithm, maybe making some decisions for us that a human use to make, but flipside to that, to your point around the human being free, to make much more informed decisions that is more patient centric. To be determined.
Hakan and Dawn, thank you very much for joining us. Really appreciate it.
Maroney
Thank you.
Kardes
Thank you. Thanks.
