"When you develop solutions for the most vulnerable, you make it work for everyone."

Q. Anika, tell us a bit about your background. What does your role at Centene entail?

Anika: I’m a clinician by training—a registered nurse. I transitioned into Clinical Informatics several years ago and then moved into roles that are progressively more at the intersection of business and technology. I work in that function of being an intermediator, translator, and facilitator, and bring it together. I’ve been really fortunate to join Centene as the Chief Digital Officer responsible for our digital solutions and products, and really driving us toward an even more data-driven organization.

I’ve enjoyed working with the senior leadership team and helped them align around objectives and key results, and how to support the organization holistically by putting our collective efforts toward making the business more efficient and providing ongoing consistent value to our customers. It’s a fun job. It’s different every day and absolutely fulfilling and humbling to serve the membership that we serve.

Q. Centene is the largest managed Medicaid provider in the country. How does being a predominantly Medicaid-focused organization drive digital priorities?

Anika: There are a couple of things. One is really thinking about how we identify our customer segments as a large managed Medicaid organization. Also, we’re thinking about the fact that while we’re so positioned, we better product—a Medicare product—so, how are we supporting our customers?

Holistically, we serve the most vulnerable populations and typically, they have very specific needs from a digital perspective. We think about how to look at digital literacy given the endpoint devices that our applications might be on which might look different. How do we support and close the digital divide? What are the specific ways to support our membership and how can we provide digital tools and technologies from a rural health perspective?

A couple of things for us as we develop our personas to build digital tools which those of you in this space will know, concerns how much time you spend doing that. We think specifically about our Medicaid population and try to ensure that there are situations where they’re represented. Our representation really shows up in the personas that we’re building.

We also think differently about how we undertake customer research. We know that our membership, specifically, isn’t always those that you find responding to surveys. So, how do you build out competency around ethnography among other ways to really understand that membership becomes really important in the work that we’re doing?

One of the things that is really our team’s responsibility, and the responsibility specifically for Centene, is to ensure that our membership including, our very vulnerable populations, show up in digitally transformed health care. Often, we’re developing tools to be very transparent for middle America. It’s not that we shouldn’t necessarily do that, but this ensures that for all of us who really need those tools, we are thinking very specifically about how to also provide access to them in ways that meet people where they are.

Q. Can you give us a couple of examples of programs that you’ve launched based on all the research and the background of your populations?

Anika: A couple of things would be the work that we’ve done to support, for example, digital care management. When we think about digital care management and how we really support our population specifically, question arises of how do we think about what’s the minimum necessary to qualify for digital care management? How do you onboard that membership specifically? How do you, assess the level of digital literacy to ensure that you’re able to provide those services in a way that’s specific and unique to that population? How do you support vendors who might not have really thought about this membership first, and help adapt their products and solutions to provide the best, highest possible value to this membership, uniquely? That’s one of the things that we think about.

Then, you start thinking about – What are some of the things actually regulatory wise that we are doing, in order to really support our membership, that might look different? How does an organization like ours respond to the “no surprises, exit and transparency rules?” When we think about trying to specifically explain benefits or other types of tools and services to a membership that’s not been catered to historically, what does that need to look like?

When I talk about endpoint devices, it comes down to—How do I need to think about how heavy that application is to ensure that it will be valuable across all the endpoint devices that it might show up on for our membership?

These are two of the programs that I think we are laser focused on and that are really helping us ensure that we are accounting for the work we’re doing specifically for our membership. I also want to be honest that it’s part of the reason that I love what I get to do at Centene. Very specifically, the reality is that when you develop for the most vulnerable, you make it work for everyone. You really have the opportunity to devise simplicity and create consistency in the experience that will work for the whole because you’ve actually thought about those who have the most needs. It really creates opportunities for us to make an impact in a truly exponential way because we’ve designed solutions for those who have really specific needs or for the ways that they’re going to use them.

Q. When it comes to care management, you’re partnering with healthcare providers to deliver the care that these vulnerable populations need. What does that collaboration look like? Can you share some examples?

Anika: One of the things that if you’ve heard Sarah London our CEO talk, is that she’s been very specific about how we will partner with provider groups—FQHCs. How do you wrap services and support around the places that our members very specifically are going to receive care? There are a couple of things.

One, we think about those who are providing community services and how we can support them from a data and data integration perspective. How do we support our federal federally qualified health centers from a data perspective? How do we think about the future of risk? How do we support those value-based care models for our most vulnerable provider groups separately from FQs? How do we also support those who are really thinking about how to be comfortable taking risks? How do we support them in understanding contract arrangements?

We know that, when it comes to social determinants and the risks that we see in differences in care around race and ethnicity, if we can keep those providers providing care and support them in the communities that they serve to offer better outcomes for those populations, then, we must think in very specific ways about how to provide such a partnership.

It’s not only about how to provide digital solutions and products to them, but also how to support them in thinking about managing panels and taking on risk. Are we supporting them to supply the right data and digital tools at the point of care to help them continue to really impact outcomes for that membership?

The organization is doing a really good job of that. We are laser focused on continuing to build our capabilities that will explicitly support the very close relationship between the provider and the member/patient/consumer, however you want to title them moving forward.

Q. These populations have a bundle of needs, but they may be living in areas which are bandwidth deserts or transportation deserts or food deserts. How do you successfully wrap all of that?

Anika: We have an incredible number of value-added benefits around transportation and food services. I would call out, for example, programs in our North Carolina Health Plan where we have forums where we encourage members to offer input into what some of the most important things are and how we provide differentiated services to the community.

It’s also crucial that when we think about those types of services, we understand the member’s perspective about what’s really most important to them. This is so that they can really get it and leverage the opportunity to provide that type of input. So, there are a couple of things.

One, it’s really about understanding what’s available from a community services perspective. Is it something that we need to provide directly? Is there an opportunity to support a community-based service that’s already in existence but may actually just need some lift?

When it comes to how we provide some of those additional benefits around transportation, food, and/or partnerships with companies like Lyft, then, that’s a part of our entire benefit model. It may span, for instance, supporting transportation partnerships with being able to provide healthy food services or, being able to send out a food truck to a community event to provide for more gatherings and/or quite frankly, just combat loneliness. That’s really the value that we bring as a managed care organization where the care component is really the most important.

The work that we do and the relationships that we build with our members revolves around really understanding how we engage them and involve them in their care. That is the crux of what we’re trying to do. Our medical director team, our population health and clinical operations teams, and the role that we play from a digital perspective not only support our members and providers but all those that are involved in providing that care.

Our members are really important and that’s why when we think about our customer/consumer/provider, we also think of ensuring that we understand the care manager, the utilization management nurse, the pharmacist, and others that are supporting them. We work at how we are supporting those customers who surround them as well.

Q. The third leg of the stool concerns the technology vendor community that’s coming up with the innovation and the solutions. Can you elaborate on the innovation targeted specifically at your population that you’d like to see from the technology vendor community?

Anika: When we look at how we think about consumer research, innovating, and how we’re developing our tools and services, we try to ensure that we have a representative population. We also try to ensure that you are testing those solutions across the spectrum of healthcare and thinking about it from a wellness and care delivery perspective. It’s equally important that you test it in a rural setting, with an ethnically representative population for understanding youth and language changes among others. That’s incredibly important.

One of the greatest opportunities we have from a digital perspective, is to start to self-govern, for lack of a better term, and really think about the impact that we have on people. This is especially for those of us who are blessed to work in the health care space. When I think about the impact that we have on people, that’s as significant as perhaps big pharma and so, I think about the amount of rigor that it really takes to ensure that we are doing no harm.

We have a very specific responsibility to ensure that we are thinking about digital ethics, research, rigor, and the representative populations in the solutions that we’re developing. This ensures we’re able to provide access to care for digital health and to everyone who needs and should have it.

Q. What about data and analytics? Apixio is one of your portfolio companies now, so, how are you deploying all those capabilities to serve your populations?

Anika: When we think about data, Big Data, contextual data, Artificial Intelligence, and Machine Learning, it’s such an important part of the work that we do, today. It’s an incredible part of what we’ll continue to do. It will help us ensure that we’re doing our best to supply things like a next best action to a care manager and undertake interventions that are most highly aligned with the most important benefits to provide to a particular population. Now, that maybe by geography or perhaps a group which has another type of similarity. That’s where data helps our understanding.

I think there is a “know me” component around data that is so important. But when we think about consistency and how we supply the entirety of the team that is going to surround the individual at the center, we must make sure that they know the things that they need to know at the time that they need to know it. When I think about the data story, it’s really the ability of being able to provide the right data at the right time for the right appropriate action for the individual. The action component for the individual is most important whether we’re asking the consumer or a member to do it themselves or asking a member of their “care team” to provide. It’s understanding that action and the outcome that that action had for the member and then, being able to supply the right next suggestion, that’s really the most critical component of what we have to do.

Q. Do you agree that working under constraints makes you more innovative? What are the challenges you face in your role as CDO when meeting your objectives?

Anika: I am a genuine believer that innovation is born out of friction. So, necessity without question breeds innovation. There is absolute necessity to innovate in the face of scarcity for when you have scarce resources, you are always thinking about how to do more with less. How do you do your best with what you have? That is a constant focus. It creates what is a great responsibility not just around fiscal responsibilities but also in ensuring that we are helping get the right resources to those most in need. That is absolutely one of the wonderful opportunities that we have. To your point, one of the pretty significant challenges is really an opportunity to rise to the occasion. It’s an opportunity again to serve the entirety of our patient populations using those innovative solutions.

When I think about sort of what constraints it might put on me specifically, or the team that I have the great privilege of serving, it’s really about prioritization and focus. When you think about trying to innovate, there is often so much that you want to do and so many things that you could do.

I often say most Chief Digital Officers want to build flying cars. I want to build flying cars too. It’s a natural thing for many of us, but, even more importantly, I want to ensure that we have a tarmac to take-off from. We have solid footing, rules, and an understanding so that when we get to the air, everybody is safe and comfortable. It does the thing that that flying car is supposed to do—get us there faster, safer, and better.

Making sure that those foundational things are in place is important. It gives me an opportunity to really think about what those foundational things are and how important they are to have solidified in concrete. Then, we can think about the additional things we really want to provide and the impact and value they’re going to have on the health care continuum for that membership. Finally, we can create laser focus on executing in the best possible way for those very specific things and deliver that value.

Q. If there’s one thing that you’d like to leave behind for your peers in the industry who are on similar journeys or operating in a resource constrained environment, what’s your advice going to be?

Anika: I think my advice will be—make sure that your digital transformation strategy, your digital strategy, and your technology strategy are centered around people, especially for those of you in healthcare. This is a very, very human industry so, I think of digital transformation very specifically. We are doing something tomorrow that’s different than what we did today because we created a thing. It’s having real, fundamental, important impact and delivering real significant value to people. We are driving through the change that we need humans to make to take best advantage of it. So, again, staying laser focused on ensuring that you are bringing people along your journey is the piece of advice that I will give.

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Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity