Dr Steve Evans on the Differences in Providing Care in Medicaid vs Medicare

In Medicaid, delivering care needs to address the lack of resources and other socioeconomic factors that impact patients, said Steve Evans, MD, chief medical officer of SilverSummit at Centene.

Transcript

You recently changed jobs from Intermountain Healthcare to Centene's SilverSummit. What prompted this move to the managed Medicaid space?

Centene’s relatively new to the [Medicaid managed care] market. Their goal’s on serving all of the health care needs of the community, but they have a special focus in caring for the underserved populations, such as Medicaid. And in the past 6 or 7 years, my work with remote patient monitoring and other aspects of population health has brought me to the understanding that a lack of resources and other socioeconomic factors really affect the ability for us to help care for our patients.

And so, when I was offered the opportunity to work for an organization which puts a big focus on these types of issues, I thought it was a great opportunity.

What have been key areas of focus for you throughout your career?

I've mostly focused in my career on quality improvement and utilization management. I'm a physician first and foremost. I still am a practicing anesthesiologist, I never stopped doing that. But I've been given the opportunity to help patients not only by continuing my anesthesia practice at Centene, but by using my unique perspective as a practicing doctor to try and improve the health care system in which I'm working.

I see the frustrations that doctors go through, and I have a good chance to try and fix part of those frustrations and in turn help our patients.

For the last several years, I focused primarily on population health, especially trying to make sure that patients with chronic conditions are monitored and receive the care that they need in an expedited fashion. I've also been working on making sure that the process of managed care doesn't actually impede care. By that I mean, I've been working with several groups to try and reduce the paperwork and delays involved in the insurance process for both doctors and patients. I'm definitely going to continue that work at Centene.

What actions has SilverSummit taken to improve uptake for the COVID-19 vaccine and other vaccines?

So, SilverSummit has developed a number of patient-facing programs to improve vaccine uptake. We've gone into the community. We've gone to various community organizations to offer the ability to get the vaccines. But what they found to be most helpful has been to work with the provider offices. Most the time patients have a much stronger relationship with their provider office, with their doctor, than with their insurance company. And so, we've tried to give all the possible resources to our doctor offices to help with the vaccine uptake—for COVID and for flu.

In the Medicare population, where I was before, the members were fighting to get the vaccines. In the Medicaid population, it's a little bit more of a challenge. People are a little bit more critical of the newness of the vaccines, and it's just harder to get hold of them and tell them about the benefits of the vaccine. And so, our uptake in the Medicaid space has been much lower than when I was working primarily with Medicare patients.

What is SilverSummit's focus for 2022?

Their focus in 2022 is trying to reach out to the most vulnerable patients in the community. I've been really amazed at how difficult it is to even contact some patients. Las Vegas has an area of extreme poverty in some areas and extreme wealth in other areas. And it's shocking to see the difference in the health care that these 2 groups receive.

And so SilverSummit’s focus is to go into the community—we have multiple teams that go into the community—trying to reach out to our patients and provide care not only by bringing them to our contracted facilities but by bringing the care to them through mobile teams and fairs and things like that.

In addition, Silver Summit invested quite a bit of money in community programs that help with preventive medicine and nutrition and things like that throughout the community.