Transcript 0:02 [upbeat music] Hey everyone, thanks so much for joining me on the Slice of Healthcare podcast. 0:20 I'm your host, Jared Taylor. Today I'm speaking with Donna Dooley, the president and chief operating officer at MediTeleCare. Donna, how are you today? I'm great. Thanks for having me on. Absolutely. I'm, I'm excited. 0:31 We've had a couple members of the MediTeleCare family on the podcast, uh, so far, and I've heard a lot of great things about you, and super excited to do this podcast with you today. Thank you. Me too. 0:45 Let's, let's kick things off. If you could tell the audience a little bit about your background and your role- Sure... uh, that would be much appreciated. Sure. 0:51 So I, I've been in, uh, the healthcare arena, um, mostly in long-term care for, uh, longer than I care to, to admit. Um, I, I, I spent time in a, um, in a startup nursing home, um, company in, in the '90s. 1:07 Uh, I spent some time on the payer side running, uh, benefit plans as well, um, and came back to the provider side about 10 years ago and worked in a, in a, in a company that was doing kind of the same thing that MediTeleCare is doing, but we were doing it in person. 1:24 Uh, so today we use telehe- the telehealth environment to provide services to the senior population in a variety of senior housing settings, in- including skilled nursing facilities and assisted living. 1:41 Thanks for that quick, uh, that quick intro. Much appreciated. 1:45 I, I want to just let our, our listeners know today, the, the topic of really discussion, the overall topic for this episode today is basically becoming the employer of choice for clinicians and provider of choice for payers. 1:57 So to kickstart that conversation, I'd love to hear, one of the things that, uh, you and I were talking about ahead of the call is, why is getting, uh, URAC certified, why does that confirm the credibility of a robust credentialing process in, in your, in your eyes? 2:13 So yeah, so URAC is a, is a, um, an organization that's been around for a long time. They've been accrediting healthcare organizations in, in a variety of fields for, for quite a while. 2:24 Um, they began their telehealth accreditation about two years ago. Um, and, and we entered that process, which is a pretty robust, uh, review of a lot of, uh, clinical processes, um, delivery systems, and technology. 2:39 Um, so we, we took about nine or 10 months to get through that process and, and earlier this year became the first telehealth company that they had certified. 2:49 Uh, we feel like that's helped us, uh, with the payers to understand kinda what we do and that it's, it's a, it's a, a, a completely appropriate modality for delivering care to the senior population. 3:02 Um, you know, CMS, you know, uh, Medicare, Medicaid had been on board for quite some time with telehealth, but not all of the, um, the, the MCOs, the, the carve-out plans, not a lot of the commercial plans were necessarily as on board. 3:17 So we feel like contracting with those payers and being able to serve their beneficiaries i- is really helped by having this URAC accreditation. It's almost like the Good Housekeeping Seal of Approval for healthcare. 3:31 Yeah. [laughs] And, and how soon did you, uh, how recent did you get that certification? So we got certified in the first quarter of this year. 3:39 We, we started the process in the second quarter of last year, so it's pretty in-depth process with, with lots of reviews by, by their clinical team and their business teams to really dig into our organization, um, and, and really truly understand what it is that we do. 3:55 So we, we feel really, really proud of our team that worked on this and, and very happy that, uh, that the organization accepted us and, and gave us their seal of approval. Well, congratulations. 4:06 That's a huge accomplishment for, for you, obviously, and the organization as well. 4:11 I'd like to shift focus a little bit, and I know this is something you, that you do at MediTeleCare, but I'm also curious why maybe other companies should be looking to deploy a similar strategy, right? 4:22 And that's, uh, why, why is employing all of the cl- all of your clinicians and providing full caseloads, um, why do you feel that is the best pathway? 4:33 Um, you know, obviously that, that allows them to make, make the most money, right? Mm-hmm. 4:38 But is there, is there any other reasons behind that, and how soon did you decide that this was the best pathway for MediTeleCare to move forward with? 4:46 So we really feel like we wanna employ all of the clinicians that are servicing the patients within our practice. Uh, we feel that that increases that clinician's dedication to our organization and to our customers. 5:00 So when we're, when we're contracting with a skilled nursing facility, we can give them continuity of care. 5:06 It's the same clinician week after week seeing those same patients, and we feel like from a clinical perspective that that is absolutely the, the best kind of care that we can give. 5:17 Um, and, and we have plenty of work, so it's, it's, we're, it's very easy for us to give a clinician five days worth of work, um, in, in a variety of facilities, um, and, and, and see all of their patients ac- in accordance with the clinical protocols that I know some of our clinical team have probably talked to you about on, on their podcasts. 5:37 Um, so I won't delve into that because I am not a clinician, and I'm not qualified to speak to that. 5:42 Uh, but we really feel like we can build a, a much more cohesive clinical team by having all of those clinicians as part of our practice as employees. 5:52 Uh, we feel that it increases the, our dedication to them as well as their dedication to us and, and to the patients. 6:01 I'm assuming for, like, the newer, the newer startups that maybe try to dive into that place, is that not so much financially feasible, would you say, in the early days, or is it something every company should be trying from day one if, if possible? 6:14 Yeah, I think different telehealth organizations view, view things differently. 6:18 Um, I, and I know that there are some out there that, um, they have a practice where they, they, they engage a clinician, and then, then a clinician sits at a, at their home office waiting for the patients to come to them. 6:30 Our model's a little bit different. We're not, we're not a consumer to provider, so we're not waiting for that patient to call us. 6:38 We've already engaged with the referring, um, source at a skilled nursing facility, so we've built that caseload already, and we give that caseload to the clinician. 6:49 So we're going clinician to patient, not the other way around. So that's how we're able to build those robust, robust caseloads. It's not a, a model for everybody. 7:00 Um, you know, for, for, for, um, the adult population, you know, you know, somebody who's, who's, like, our age, they're gonna... you're gonna call your, your telehealth provider when you need them. 7:11 Um, we have a different kind of schedule with different kind of, of clinical protocols that allow us to build that caseload. Um, and, and I think that people just... 7:20 some companies just have different philosophies about how much they wanna take the risk. 7:24 We're willing to take the compensation risk and, and make sure that that clinician gets the appropriate caseload and our patients get seen on a regular basis. 7:34 Yeah, I really like that approach, and it's clear that it's working given Meditelicare's, you know, immense growth, uh, you know, over the last several months alone, right? It... 7:43 which, uh, I know when Ed was on last he was talking about that. And it just seems like every time someone comes on, you just keep growing. So, uh, congrats on, on all the success so far. Thank you. 7:53 I wanna shift our focus a little bit because part of this conversation was talking about becoming the provider of choice for payers as well. 8:00 So let, let's talk about some of the things that, that you've suggested and also that Meditelicare's doing in the space, and one of the things is outcomes-based analytics. 8:09 How does that instill payer confidence, and why is that something that you made a priority, uh, early on? Yeah, so it's, uh, led in large part by Medicare. Uh, lots of payers are, are looking for outcomes-based care. 8:22 Um, at some point, uh, and, and there's been experiments with this i- in... from a variety of payers. 8:28 There's gonna be value-based, value-based payment system, so we're not gonna get paid so much because we do a clinical intervention with a, with a patient today and then next week and then the week after that. 8:40 We're gonna get paid because we're improving the quality of life and the health of that resident. 8:46 Um, so we are able to, um, pull empirical evidence from the time we start seeing a patient through th- their, their, um, continuum of care and show that we're, we're making that, those, those lives better and, and more meaningful. 9:04 Um, as an example, we are part of... um, the, the, the drive for Medicare is to reduce the use of anti- antipsychotic drugs, as an example, in the, in the geriatric population in their nursing homes. 9:19 That was a really hard thing to do. You know, 20 years ago, everybody in a nursing home was on many, many kind of medications. 9:28 So, so CMS put together a program called Gradual Dose Reduction, and we are able to collect data that, that shows when we enter a facility where that usage was, 'cause it's all public information, and then where it is after three months, six months, nine months of our interventions. 9:46 Those are the kind of things that the payers are really looking for, is really to have us reporting. Us and, and not just telehealth companies. 9:53 All medical practices, all behavioral practices at some point are gonna have to point to the outcomes in order to be, be a sustainable practice and be, and be paid appropriately for, you know, the quality of their clinicians. 10:08 Well, I'm... by the way, I'm glad you mentioned CMS- Mm-hmm... because that was my next question, was about CMS. So can we, can we quickly cover, before we end up wrapping up here- Mm-hmm... 10:18 um, CMS's direction for telehealth expansion? Mm-hmm. Um, can you... do you, do you feel that the other payers will follow a similar path? 10:28 Oh, absolutely, and we- we're already seeing moves in that direction, um, in, in many areas. So CMS, um, well, I, I should probably say the VA was the first one to recognize the value of telehealth. 10:40 CMS followed fairly quickly. Up until, up until the beginning of the pandemic, you know, we were only providing services in rural markets. 10:48 CMS recognized that there was a shortage of providers in those rural markets and patients were not getting the appropriate treatments. 10:55 So i- in, in certain areas where there weren't enough providers, we were able to give service. During the pandemic, those restrictions were lifted, so we are now able to see patients in, in a broad spectrum of geography. 11:09 Um, we happen to believe that that genie's not going back in the bottle. 11:12 S- we've, we've got a lot of indications out of CMS and the professional organizations that the, the restrictions that were lifted w- will not be put back into place. 11:22 Um, and it helps us even in urban areas where it might be difficult to find a provider. Um, you know, if, if... 11:29 Massachusetts as an example can be, can be, you know, difficult to find the providers that we need because there's so many great, um, medical practices and, and hospital systems there. 11:41 But I can hire a clinician maybe out of Texas who has a Massachusetts license who can see a cl- and who can see patients by telehealth. They're not in Massachusetts, but they have that, that ability to see that patient. 11:53 Um, so that's, that is really helpful. Um, and I do see that many of the other payers are following. 12:00 Not all of them as quickly as we would like, um, but, but certainly I think they'll come along as they always do when, you know, when CMS sets the standard. 12:11 Well, Donna, I wanna thank you so much for, for coming on the podcast today and sharing your background and going through some, some detailed, I guess, strategies that Meditelicare has, is been deploying, but also maybe why other organizations should take a look at similar strategies. 12:27 So thank you so much for coming on today. Thank you. It was great spending time with you. 12:31 [outro music] Thank you to everyone that listened to this week's episode of the Slice of Healthcare podcast. 12:48 If you'd like to check out more of our podcasts, we're available on all the major podcast channels, and you can check us out on our website, www.sliceofhealthcare.com, and that'll have all of our past guests on there. 13:05 Uh, you can see our sponsors, and you can learn more about actually becoming a guest. Thanks, and look forward to another episode next week. 13:18 [outro music]
