There are vast opportunities to equalize the health care system and enable meaningful change for the future, Eric Palmer, president and CEO of Evernorth, said during a fireside chat at Reuters Total Health. He was joined in conversation by Eva Borden, president of behavioral health at Evernorth.
“In health care, there is variability in everything we measure,” Palmer said. “Technology and value-based care can move the needle to create more consistency and improve access to care, outcomes, affordability, and experience.”
Read on for some of the highlights from their conversation.
Eric Palmer, president and CEO of Evernorth, at Reuters Total Health
Harnessing the power of connectivity: Access, cost, and outcomes
Fragmentation in the health care ecosystem is a significant barrier, causing gaps in care and making the system difficult for patients and their families to navigate.
Regardless of their condition or disease state, patients typically lack a consistent point of care or individual who helps coordinate treatment, often causing delays in care. Many patients end up seeing different providers for different conditions.
On average, people with behavioral health issues have a gap of 11 years between the onset of their symptoms and when they receive initial treatment, Borden said. She added that a lack of coordination among providers can lead to more frequent hospitalizations and higher costs from the duplication of diagnostic tests, multiple prescriptions, and overlapping care.
Variability in health care compounds this fragmentation, Palmer said, citing significant differences and inconsistencies across technology, access to care, outcomes, affordability, and experiences. In the face of these challenges, however, both see significant opportunities for the health care industry to improve connectivity within the system.
In fact, Palmer said, Evernorth was born out of the recognition that health services are valuable, but they’re more valuable when brought together to make the health care system work more effectively.
Eva Borden and Eric Palmer discuss fragmentation and variability in health care
Encouraging a paradigm shift to value-based care at scale and expanding sites of care
A core theme of Palmer and Borden’s conversation was the need for the United States to shift toward a value-based health care system that uses metrics to reward providers based on improved outcomes, affordability, and enhanced experiences – not just the number of services they provide. This focus on measurement incentivizes providers to keep people healthy, intervene early, and ensure quality, connected, and personalized care. Palmer explored some of the ways that Evernorth is scaling value-based care and assembling high-performing care delivery through sites of care that optimize outcomes and cost.
As an example, he pointed to Evernorth’s multiyear partnership with VillageMD, one of the largest independent primary care groups with expertise in value-based care in the U.S. The partnership helps extend Evernorth’s suite of health services across hundreds of VillageMD primary care practices and connects patients with better access to virtual, digital, or in-person care. The contracts with providers in this collaboration are value-based arrangements, moving the needle on value-based care in a significant way.
Relatedly, Palmer sees an opportunity to enable more pharmacies and pharmacists to be points of care for their communities and expand their role as part of a patient’s care team. He cited some of the work Express Scripts has embarked on this year to empower and leverage the independent pharmacists who are the front lines of providing health care in their communities, many in rural locations.
Enabling the future of health care
Looking ahead, Palmer and Borden outlined some of the changes they hope to see in the health care industry, along with the role Evernorth can play in driving that change. “We're spending $4.2 trillion as a country on health care today, so it's not for a lack of resources – it’s about precision in tackling these challenges we’ve outlined,” Palmer said.
Preventive care and treatment will see meaningful change enabled by technology over the next five years, he said. They also see a sizable opportunity in harnessing the power of real-time data and advanced analytics to identify gaps in care, offer more coordinated care and experiences, and proactively empower and encourage patients to get the care and support they need. New technology won’t completely replace the existing systems, they said, but it will enable individuals to easily access the right care and help act as an equalizer.
(Note: Some of the quotes in this article were edited for clarity.)
