Health Care Reinvented Pittsburgh Technology Council

For Allegheny Health Network (AHN) and Highmark, the goal isn’t just to reinvent health care, but to also provide a seamless and supportive patient experience right down to the details of patient billing.
After all, patients can get overwhelmed by the disconnected bills and explanations of benefits piling up in their mailboxes. Not only can it compound stress patients already have about their health, but it can also lead to missed payments and costly customer service inquiries.
In this episode of Health Care Reinvented, we explore how ANH and Highmark leveraged technology and a leading-edge health care IT company, Cedar, to deploy a solution that not only increases payments but reduces patient stress around the billing process.
Listen in to Neil Kulkarni, Vice President of Customer and Clinician Experience Solutions at Highmark Health; Kimberly Wilkinson, Director, Central Business Office, AHN; and Shanti Krishnan, Vice President of Sales at Cedar, detail their journey to radically simplify their customer financial experience by implementing Cedar Pay. With the Payer Intelligence Layer, Highmark members who receive care at AHN have access to uniquely integrated billing information and insurance data.
In less than one year with Cedar Pay, AHN added $17 million in patient payments, thanks in part to the integration with Highmark. But the clearest signal that payer-provider partnership was working came from patients themselves, who gave the integrated experience a 90% satisfaction rating.
Listen and learn how embracing technology can create so much positive impact and how more projects are in store for the future.
Transcription:
You're listening to the healthcare reinvented podcast series. And I'm your host, Jonathan Kersting. With the Pittsburgh Technology Council. This podcast is all about the intersection of technology and healthcare. And we talk about it at every single level, whether it's in the operating room, whether it's about virtual visits, and everything in between. It's where technology is making a positive impact. And today, it's all about how technology is simplifying the payer provider system. Simplifying just makes it sound, dare I say too simple, because it is super complex. But you want a streamlined system, you want a sensible system, you want an easy system and understandable system, so the customers don't have to be stressed out when it comes to paying and understanding their bills. And joining us on the podcast today is Neil Kulkarni, who's the vice president of customer and coalition experience solutions at Highmark Health. We have Kimberly Wilkinson, who is Director of Central Business Office at Allegheny Health Network. And we have Shanti Krishnan, who is vice president of sales at Cedar. Thank you so much for hanging out with me today. I'm excited to explore this conversation. And I always love starting with introduction.
So our listener knows who is who. So why don't we just start down the list and I went through Neil, let's start with you your background real fast, and what you do, how you do it off the ball, Jonathan, thank you so much for having us and really excited to be able to kind of talk about this with the group today. I've been at Highmark, for a little under five years. And really what my role is all about is how do we transform our delivery system? And how do we make things easier for our customers? How do we make it easier for our clinicians? How do we think about simplification experiences being more practice personalized, and then working with our provider partners to really deliver a seamless and blended experience for people and so we say customer because it doesn't really matter if it's a insurance member or a provider system patient than today, it's a person. And healthcare is really complicated. And so I'm excited and unfortunate that I get to spend kind of my day thinking about how we think make things easier from a system perspective.
And you make it sound easy. And

On this episode of Highmark’s Health Care Reinvented, learn how Highmark uses massive data sets to improve patient experience and outcomes while simultaneously managing data bias and the utmost security.
We welcome Ian Blunt, VP of Advanced Analytics at Highmark Health, where his group form a center of expertise for all things data science and sophisticated analytical techniques.
Leading a team of 100-plus data scientists, researchers and engineers, Blunt and his team are at the forefront of developing new capabilities for novel use cases, building predictive analytics and machine learning models, next best action selection, behavioral engineering, evaluation of interventions, analytics enablement, natural language processing, coordinating Highmark’s analytic product portfolio and transitioning analytics to the cloud.
At the end of the day, Blunt says all of the work comes down to directly improving the patient experience and proving health outcomes. Listen and learn how the human experience is expressed through the data!
Transcription:
All right, Audrey, we're gonna get just a little geeky today on healthcare reinvented because we have someone who is no stranger to the healthcare reinvented podcast rodeo, we have Ian Blunt hanging out with us today. Very excited because this guy, when it comes to all things, analytics, we want to talk to you. Because he always I think last time we talked to moderate our brains were like, ooh, like this.
And now it's great to do a deep dive. So we're really excited. So do you want to? So Ian, why don't you just tell people a little bit about your background, and why you're such an expert on the topic that we're going to be talking about?
Sure. I'm very excited to be here talking to you guys about it. So my name is Ian Blunt. I'm Vice President of advanced analytics for Highmark Health. So we form a center of expertise for all things data science and sophisticated analytic techniques within the organization, Highmark Health integrated health care organization. So we've got a health insurance arm, we've got a provider arm in the form of Allegheny Health Network, and we've got a few diversified businesses as well and my team kind of sit at the parent company and help each of the business units with the various use cases they've got to apply. And that's that I think techniques that every now and again, we did get to this really interesting thing, or blended health, where we're using information from both sides in a regulated way to improve the experience for all of our members and patients make it sound so simple, but healthcare is really complicated. That's one of the things that I think makes it such a rich territory for analytics. It's also been an industry that's kind of slow to adopt some of the analytic techniques, often for good reason, because of the magnitude of the decisions being made and security concerns around the data privacy, and what have you. But I think when you look at how high marks really trying to transform healthcare, it all comes down to I live in health strategy, which really is about making healthcare simple, making it personalized, and making it more proactive. And there's advanced analytics applications throughout that kind of mission statement.
So what are the big things that you're working on? So like, what keeps you up at night, so that, you know, sort of set the table for us so we can understand because sometimes people are listening to this? And they're like, huh, how does that, you know, how does that really translate into meaningful experience and meaningful outcomes?
There's so much going on. It's really exciting, again, kind of a factor of healthcare having been traditionally slow to adopt these techniques, and also the huge range of use cases that Highmark Health covers. So some really good examples, I think about how we can improve the efficiency but certain services work with so got a really nice technique that's operational within chemother

Did you know that connecting to your doctor is literally just a text away?
On this episode of the Highmark Health Care Reinvented Podcast Series, Benjamin Edelshain, MD , Vice President, Clinical Engagement & Digital Innovation at Highmark Health, gives us the whole story on how a secure mobile text messaging platform is building better patient-doctor connections for healthier outcomes. 
The platform was deployed at the height of COVID-19, immediately proving its effectiveness in a world where people could not easily meet with health care providers. Ben shares some encouraging and surprising stats on how many patients are using the platform and how text messaging has improved customer engagement.
Discover how a simple text message is part of an ever-growing ecosystem of engagement tools to ensure access to care. 
Transcription:
Welcome to Healthcare reinvented, exploring the intersection of healthcare and technology brought to you by Highmark, here are your hosts, the Pittsburgh technology Council's Audrey Russo and Jonathan Kersting. This is Jonathan Kersting. With the Pittsburgh Technology Council. This is the next episode of healthcare Reinvented, where we explore the intersections of technology and healthcare. Today's interview will be a lot of fun. It's a follow up from our previous season and today we are going to be talking to Dr. Ben Edelshain, and he's with Highmark Health. And I love the fact that that Highmark is finding ways for its patients and doctors to better connect and using technology where it makes sense. And in our first interview that we had was, I can't believe it's, I think, more than 18 months ago, and I'm so excited to follow up on this. It's all about just using the simple concept of using texting to talk back and forth with your doctor. And it sounds easier than you think, especially in the medical setting.  So I'm excited to learn a the progress of it and some new things they might be working on and get some numbers around this as well, too, just to see how effective it's been. So Ben, welcome to the show today. We're so glad to have you. And it's great to reconnect.
 
Yeah, Jonathan, thank you very much for having me. I'm honestly super excited to share some updates. And it's always great talking to you. And just coming back again, is a privilege and an honor. very humbled. Yeah. Looking forward to sharing some exciting stuff. And you know, following up from where we left off,. A year and a half ago, just flown by and you had a child. Congratulations.
  
Thank you so much. Yes, we we had our second little Clara, and she's turning one soon. So very cool. Very cool. You got to be stoked about that. Absolutely. Very cool. So before we get things kids, I'm just refreshing our listeners, maybe are they forgotten or there's the first time listening, could you give us your background and what you do with Highmark Health.

Very happy to do so. So I am Ben Edelshain. I've been with Highmark, for about four years now, I'm a vice president in our enterprise clinical organization. I'm originally from the UK, hence the accent and used to be a national health service doctor back in London, but been stateside for about 10 years. And so my responsibilities at Highmark Health include kind of trying to push us to be more tech driven, more consumer focused. And then operationally I run a department to telephonic nurses who support our customers, as well as care navigate navigation as well, helping members find the best possible care.
That is interesting, that's gonna be a very rewarding job, because you're actually seeing the work that you do improves the quality of patients lives. It just, I think that's going to be so much fun.

I say this without any sort of sarcasm, and I love working. And I see a lot of similar missions to, you know, socialized care where I came from our country, slightly different by country and in the US. And but I think in Pennsylvania and Pittsburgh, we're doing som

With the My Highmark app, Highmark is building a “digital front door” to a holistic customer experience.  
The new season of Health Care Reinvented kicks off featuring the key team members that brought My Highmark to life. Hear from: 
Mick Malec, CEO, enGen and Enterprise Technology and Operations Officer at Highmark Health;   Tracy Saula, Senior Vice President of Product & Health Experience for Highmark Health; and   Naomi Adams, SVP Customer Strategy & Solution Engineering at League Inc.  With one username and password, My Highmark provides seamless care navigation, shared care plans, virtual/digital health and cost transparency. 
Learn how Highmark is being very intentional integrating solutions to achieve a simpler, smarter, more seamless system of health, coverage and care. Plus, get more insight on how Highmark worked hand-in-hand with League to build and deploy the app with future functions and capabilities planned. 

Can home-centered care be the catalyst for health care transformation?
Listen to the next episode of the Allegheny Health Network/Highmark Health Care Reinvented Podcast Series, to see how Highmark Health subsidiary Helion is addressing that question.
We welcome Nick Stupakis, Helion Vice President, to explore how with the right information, guidance and tools, provider organizations can deliver better care; payer organizations can reduce upstream and downstream costs; and patients have the opportunity to receive better care and an improved experience.
It’s the proverbial win-win-win in health care. Learn how Nick plays an integral part in the development and execution of Helion’s “Healing at Home” strategy to transform quality, service and value in the post-acute space through an innovative payor-provider network management model. 
Listen today and find yourself at the intersection of health care and leading-edge technology.
 

Big Data Analytics is creating new and exciting insights for health care that positively impact a patient’s health, care experience and overall cost.
In the next episode of the Allegheny Health Network/Highmark Health Care Reinvented Podcast Series, we talk to Ian Blunt, VP of Analytics at Highmark, about his team’s work crunching and analyzing data to provide powerful and actionable insights.
Ian details some of Highmark’s current projects and addresses how it ensures patient privacy and roots out unnecessary bias. Even more exciting are some the potential future uses of data analytics to drive the best health care outcomes possible.
Listen to learn more about this fascinating intersection of technology and health care.