With Diversification Advisory Council, SCAN Group Plans for Growth in Care for Older Adults

These are busy times for SCAN Group. Since February, the holding company for SCAN Health Plan, the not-for-profit Medicare Advantage plan, has made a string of targeted investments in companies that align with its mission of bringing high quality, high-value care to older adults along with “independence at home.”

There’s MedArrive, a platform that lets payers tap into a network of skilled nurses and emergency medical technicians to bring care into the home. There’s Monogram Health, which offers at-home care for chronic kidney disease. More recently, SCAN Group invested in Arine, a technology platform that combines social, clinical, and behavioral data to boost medication management and adherence.

And this week, the Long Beach, California-based group launched Welcome Health, a primary care network built with a focus on geriatrics, to be run by a leaders with experiences from Cedar-Sinai, medical schools at both UCLA and USC, DaVita Kidney Care, McKinsey & Company, as well as CareMore, the Anthem division that SCAN Group CEO Sachin H. Jain, MD, MBA ran for 5 years before arriving at SCAN in July 2020.

To guide its growth and its forays into home-based care, SCAN Group recently announced a Diversification Advisory Council, a group of 6 leaders from inside and outside health care with expertise in health care technology, reimbursement, and consumer engagement. Binoy Bhansali, who leads Corporate Development for SCAN Group, said in an interview with The American Journal of Managed Care® that the council is a “diverse group of seasoned experts” whose combined experiences touch on all the areas where SCAN seeks to innovate.

Forming the Council “was like putting together a mosaic or a puzzle, in that all the pieces needed to fit together really well,” Bhansali said. “We were looking for different viewpoints—people who knew a certain area really well or came from a set of experiences that would contribute to us collectively making better decisions about how to allocate our time.”

The initial members of SCAN’s Diversification Advisory Council are:

• David Brailer, MD, PhD, who is executive chairman of Health Evolution and a former managing partner at an investment fund focused on health care delivery. Brailer was the first National Coordinator for Health Information Technology.
• Aneesh Chopra, president of CareJourney, an open data and analytics platform that backs a ratings system to guide the shift in reimbursement from volume to value. Chopra was the first US Chief Technology Officer.
• Ana Gupte, PhD, a long-time strategy, finance, and innovation leader who most recently served as senior vice president (SVP), chief strategy and innovation officer for FloridaBlue/Guidewell.
• Abby Miller Levy, MBA, the managing partner and co-founder of Primetime Partners, which invests in early-stage companies focused on older adults. Levy has deep experience in the consumer sector, having served as SVP for Strategy & Growth at SoulCycle and president, Thrive Global.
• J. Mario Molina, MD, who spent 20 years as chairman and CEO of Molina Healthcare.
• Eric Topol, MD, is the founder and director of the Scripps Research Translational Institute. Topol is a recognized expert in health technology and AI; he is a member of the National Academy of Medicine and was the principal investigator for a $35 million National Institutes of Health grant to promote innovation in medicine.

Leaders at SCAN will work with council members both individually and collectively, Bhansali said, as SCAN Group focuses its diversification efforts “on building companies that can amplify our impact as an organization, direct investment in emerging companies that can solve our needs, and then thirdly, running mergers and acquisitions and partnerships for the organization.”

“SCAN’s overall diversification strategy is rooted in building and partnering with the next generation of innovative organizations that share our mission to improve healthcare for older adults and keep them healthy and independent,” Jain said in a statement when the Council was announced. “The expert advisory council we’ve built will bring decades of experience to bear in support of that agenda.”

Bhansali said SCAN Group will look to the council not for governance, but for shared experiences—on why things did or did not work—that will lead to better decision making as SCAN grows. “It’s people and knowledge and experience and wisdom that we thought it made sense to have around this new work at SCAN,” he said.

The council will advise on both diversification and expansion. SCAN, which covers more than 220,000 people in California, will offer plans in Arizona and Nevada next year.

Expansion comes as CMS’ “refresh” of alternative payment models (APMs) offered through the Center for Medicare and Medicaid Innovation appears likely to align with SCAN Health priorities. CMS officials said in October that both new and updated APMs would take health equity into account.

“We loved reading about and hearing about the focus on health equity,” Bhansali said. “Certainly, a focus for us as an organization is closing gaps related to different populations, adhering to certain protocols, or taking their medications.”

He pointed to investments SCAN Health Plan has made in improving medication adherence among Black and Latino enrollees, who have lower adherence rates than the overall plan population. “We want to close that gap. We want to close it so badly that we are not only investing a lot of our time and resources and efforts into closing that gap, but we're also tying a portion of our bonus, specifically, to closing this gap,” Bhansali said.

Care delivery innovations that address these goals include an initiative to treat the homeless population in the Los Angeles area. There are more plans to come, including efforts in the dual eligible space and a partnership with Virta Health to address how diet drives outcomes. Having a Diversification Advisory Council with some expertise in reaching consumers is essential for this, Bhansali said.

The shift, he said, is about thinking of health plan members as consumers, rather than patients. Decisions to invest in a company or partner with a vendor come from this starting point.

“We are thinking about, where does it make sense to build out a capability or service line to serve SCAN members? And then where does it make sense to build a payer agnostic organization that can amplify our impact and solve a market problem and a societal problem?” he said. “That is kind of the exercise that we're going through—we’ve got a whole list of themes and societal issues that we want to focus on."