[00:00:00] Stacey Richter: Episode 471. "High Cost Claimants in 2025 and Beyond—What Is Really Expensive Not to Know?" I'm gonna call this part one. Today I speak with Dr. Christine Hale.
Recently on Relentless Health Value, we've been tinkering around with a few recurring themes recurring through lines that are just true about American healthcare these days.
One of the things Matt McQuide and I talked about from a few weeks ago that if a plan sponsor isn't navigating or steering members, someone else is. Furthermore and wrapped up in all of this is the vital importance of trust and patients trusting who they are talking to.
If you would like to listen to this episode or read the full show notes with mentioned links, visit the episode page.
The Encore with Kenny Cole coming up is gonna hammer on this point even more than Matt McQuide did, and Dr. Scott Conard did in those earlier episodes. If you want to steer or navigate a member, they need to have an existing, trusted relationship with somebody, a case manager, a primary care team, maybe even an onsite clinic.
You know, they all know Monica, and when she calls, they pick up the call because they already know her. And that is a huge part of the conversation today with Dr. Christine Hale when it comes to high cost claimants. Because it's often not some random accident when a patient/member winds up in whatever care setting they find themselves, and that is especially true when that patient, again, is a high cost claimant.
Let's never forget that one person's cost is someone else's profit and high cost claimants are not always but often exceptionally profitable. So your members are getting steered, all right. And if it's not you doing the steering, it's someone else who has a huge financial incentive to figure out where that high cost claimant is gonna wind up.
This is part of the story I discuss in great depth, by the way, next week with Dr. Eric Bricker. So as you listen to this show, keep who is steering my members/the patients in the back of your mind. Also, keep in mind the undeniable, almost biblical level commandment that comes up in almost every Relentless Health Value episode.
The importance of not only having data, timely data, but also having the wherewithal to analyze it.
But what I also realized during this conversation is the absolute growing importance of recognizing a point that Dr. Scott Conard made in his show about Whole Person Health and recognizing that we are all one whole person, not a bunch of little parts.
So yeah, we really need to have pharmacy and medical claims, data comingled altogether and at the member level. People in the know have been saying to get one data set, not two or 12 for years, but at this point, given scientific advancements that are really expensive such as cell and gene therapy and infusions that may or may not be billed under the medical benefit or the pharmacy benefit.
Not having one data set to rule them all is going to have increasingly expensive consequences, which Dr. Christine Hale quantifies during the show that follows. So I am not gonna get into it here.
One other recurring theme that comes up in the show today is the importance, the vital importance as Dr. Steve Schutzer underscored about the Betsy Seal's episode recently of keeping track of the value that is accruing to the patient or member, not forgetting the human being while we are looking at the spreadsheets.
Turns out in this high cost claimant zone, you forget about the human being at your own financial peril, while possibly also subjecting the member to potentially avoidable clinical suboptimalness or even harm at the same time. These are a few humans that first of all, desperately need help, but also failing to align with their actual needs is going to wind up as a real world fail.
Dr. Christine Hale says quite crisply actually that high cost claimants don't get cheaper a lot of times if our approach is mostly some kind of across the board trying to take things away from these high cost claimants, is definitely one of those sounds good on paper, doesn't actually work out great kinds of approaches.
Dr. Christine Hale, my guest today is a pediatrician by training. She got an MBA because she wanted to work on changing the healthcare system and spend a bunch of years as a consultant and also working at primarily academic medical centers and children's hospitals. Past eight years, she has worked for an employee benefits consultant.
And as I mentioned earlier, do tune in next week for the show with Dr. Eric Bricker, where we go hard on how provider organizations can very strategically and profitably take advantage of everything you learned on this show when plan sponsors and probably payers and definitely consultants are unaware or maybe getting paid to look the other way.
Not everything is gonna show up in a 5500 disclosure form by the way. Don't forget that plan sponsors. But that is a conversation for another day.
My name is Stacey Richter. This podcast is sponsored by Aventria Health Group.
And here's my conversation with Dr. Christine Hale.
Dr. Christine Hale, welcome to Relentless Health Value.
[00:05:21] Dr. Christine Hale: Thanks so much, Stacey. Glad to be here.
[00:05:22] Stacey Richter: Jumping right in. What is a high cost claimant?
[00:05:25] Dr. Christine Hale: That definition we are seeing is changing over time. Historically and classically, it was $50,000 for one individual in a 12 month period. Increasingly, as costs continue to rise, especially in the upper echelon of these cases, more and more employers are saying, honestly, we can't deep dive into every $50,000, we're starting to set the bar at a hundred thousand dollars or even higher than that.
Generally, that a hundred thousand dollars and up in the employer sponsored world represents half to 1%, so 0.5 to 1% of all of the claimants on an employer sponsored plan.
[00:06:05] Stacey Richter: Interestingly, the definition of a high cost claimant has now doubled. Who do these individuals tend to be?
[00:06:11] Dr. Christine Hale: There is so much diversity in this population. We're gonna see, particularly in an employer that has an older population, we'll see things you might expect, chronic heart disease, chronic kidney disease, cancer, but also there's a very large proportion of these individuals, particularly the higher the cost that are under the age of 20 or even under the age of two.
So it ends up being a really diverse set of diagnoses. Everything from chronic illness but also big hospital stays, babies, sepsis, really intensive outpatient procedures like ABA therapy, dialysis, specialty pharmacy.
This is something that is really impacting plans because when we set up our insurance model in this country decades ago, it was designed for those unknown risks.
Those out of the blue, didn't see it coming, big claims. Now so much of what we do, even in conditions like cancer, are ongoing large claims. And that presents a really unique challenge for plans.
[00:07:11] Stacey Richter: Yeah, because they get lasered.
[00:07:13] Dr. Christine Hale: That's right.
[00:07:14] Stacey Richter: You were talking about the obvious pharmacy claims. And I'm assuming you're talking about not only pharmacy claims that come through the pharmacy, I'm assuming also you're talking about infusions and things which turn up on the medical side of the house.
[00:07:26] Dr. Christine Hale: That's correct. And in fact, especially the, we call it medical pharmacy, right? So these tend to be IV infusions. They're administered in a healthcare setting, hospital-based clinic, a provider office, particularly when those infusions are happening in a hospital-based setting.
What a lot of employers don't realize is that there's three components to that bill. There's the cost of the drug itself, which of course can be quite costly. The second piece, which tends to be pretty modest and reasonable, is the cost to give the drug. But then because the drug was procured through the hospital pharmacy, hospitals are allowed to mark up the cost of the drug as much as they want.
We call that buy and bill. And that multiple can be two times the cost of the drug, five times, even 10 times the cost of the drug. And when you're talking a drug that's a hundred, 200, $300,000 a year, and they mark it up 10x, you start to do the math, and that's really impactful for a single member.
[00:08:21] Stacey Richter: I'm gonna assume that was a little foreshadowing that just happened there. Call me, Nancy Drew, girl, detective, but like I'm thinking that last part there.
So we were just talking about medical pharmacy and the three costs of that bill. One of them was the cost of the drug. The second one is the administration fee to infuse the drug or you know, some kind of service level fee. And then the third one is the markup because the hospital is in fact procuring the drug and then reselling it. I mean, there's a resell operation that's going on there.
But let me ask you one more question before we dig in on that. Given who these people are, their 0.5% up to 1% maybe of, total claimants, does this have, I guess this is a two part question. First part is, what's the impact on total plan costs here?
[00:09:08] Dr. Christine Hale: It is so dramatic, much more dramatic than I expected when I came from the provider side. We see consistently across our employer groups, regardless of geography by its size industry and a multitude of factors, that half a percent to 1% makes up anywhere from a third to 40% of overall plan costs.
[00:09:28] Stacey Richter: Whoa. Hold up there. So we've got less than 1% to 1% by number of plan members who are, what'd you say up to 40%
[00:09:39] Dr. Christine Hale: That's correct.
[00:09:39] Stacey Richter: You also said that you didn't realize this before you got over on the plan side. Do most plan sponsors realize this, or is it somehow or another vague?
[00:09:49] Dr. Christine Hale: It's so funny. You should ask. It really depends on how much they're looking at their data.
The employers that are demanding their data and really diving into it, they're seeing this. They know there's a handful of people that are disproportionately driving their expense.
Unfortunately, many of our employer groups, either had problems getting their data or they don't themselves, or have a partner that can analyze that data. Or they're just being told, sorry for your luck, there's nothing you can do about this.
[00:10:18] Stacey Richter: Yeah. Sorry for your luck. My next question was gonna be what do plan sponsors tend to get wrong about this?
And it sounds like we've got one of them right out of the gate, which is, unless there's data to be had. And there's analytics. You're gonna get plan sponsors, sorry for your luck, but your plan costs are gonna go up whatever next year. And they're not quite understanding that that was a result of somebody's in the 0.5 to 1%.
Like they might just think across the board plans costs are going up or something like that. So it sounds like that's kind of like number one thing that can go wrong.
[00:10:52] Dr. Christine Hale: That's right. And the level of specificity to build on that, of that data is so critical. In so many cases, employers are getting maybe an annual report from their administrator and their PBM, and that report might say something like chemotherapy for $500,000.
It doesn't even say what body part the cancer's in. So there's really no way in that situation to know, is this appropriate? Is it clinically supported with evidence base? Is the member getting good care and is it being billed properly? Because you don't even know what drugs we're given. You don't know what the diagnosis is.
[00:11:28] Stacey Richter: It sounds like the data has to include the member level, but then also the DRGs. Like, what, if I'm a plan, what do I need to get there?
[00:11:38] Dr. Christine Hale: You need your medical and your pharmacy at a line item, detail level, and you need them integrated by member. This is particularly important if you have a carved out pharmacy plan or you have two separate partners, one that's administering medical and one pharmacy.
That's important because we see things, for example, where someone goes in and gets a gene therapy, which might cost $2 million, $3 million, where the clinician never slowed down or stopped the maintenance therapy to see if the gene therapy worked.
Gene therapy isn't intended to be a cure, at least for a period of time, but there's no way to know if you've got a cure if you don't actually slow down or stop the maintenance therapy.
And if you have two separate plans and one's getting one piece of that and the other's getting the other, and you're not integrating at a member level, then you're never gonna know that.
[00:12:28] Stacey Richter: Okay, so I'm, I'm picking up a couple of things. So, one has to be at the member level, but number two, it has to be aggregated at the member level, both medical as well as pharmacy.
As more of these therapies come into existence because go science, the more it becomes a really false dichotomy. You know what I mean?
Like we're just very artificially splitting things into categories to our own detriment.
[00:12:57] Dr. Christine Hale: That's right. Especially human beings are all one human being. And a lot of the nuance in how you manage these things is the interplay between multiple factors and thinking about why is it, for example, that someone can't be successful, they're not improving on this therapy.
Do they have something else going on? Do they have the wrong diagnosis? Do they have some genetic thing that prevents them from responding to that therapy? It's very nuanced and trying to force fit people and populations into buckets, while certainly that helps when you're doing broader population initiatives, this half to 1%, I call purple zebra unicorns because each member needs a look at them specifically rather than trying to force fit them into some generic bucket.
[00:13:41] Stacey Richter: We just did a pod with Dr. Scott Conard, who talked about whole person health and the dangers of splitting people into pharmacy and medical. We're splitting people into mental health. There's just so many ways that the human body can be sectioned into parts and so many stories about how that goes horribly wrong.
Not only from a clinical perspective, things can go horribly wrong, but if we're talking about hundreds of thousands, maybe millions of dollars, I mean, if the floor here is a hundred thousand dollars, there's lots of zeros here and lots of problems.
And you just brought up one of them, which is, okay, so you're paying however many zeros here for a gene therapy, while at the same time continuing to subject the patient to the baseline maintenance therapy, which also most people would agree is expensive. I mean, first of all, the poor patient, like their body's getting pounded by two treatments at the exact same time.
And it's maybe not twice as it's really expensive.
[00:14:42] Dr. Christine Hale: And I think you hit a really important point here, which is we have to keep in mind the impact on the member. The impact of their clinical outcomes. Their convenience of receiving their care, access to care.
The good news is you don't have to diminish those things to get savings. And in fact, in this population, many times, we're improving the clinical outcome by getting them to the right care by making sure that they have innovative therapies if they need them, but that they're not on therapies that aren't delivering clinical value.
So this can be a win-win situation for employers because they can deliver amazing service to their members and save a lot of money at the same time.
[00:15:23] Stacey Richter: I'm liking where this conversation is headed because it definitely sounds like there are things that can be done here. Obviously, like the prices are what the prices are and the, the member demand is what the member demand is. And for good reasons and maybe not so good reasons, right?
If there is science behind, this is a curative, you know, if you're a parent. And your kid is dying and your kid could potentially have access to a lifesaving pick something, you know, calling that member demand in kind of an insulting way. And I hear that, which is kind of why I'm saying that, right? Like I think we have to be really careful here.
And the, these prices are really high, but there's definitely things it sounds like that can be done to mitigate. The worst thing would be to pay a whole lot of money for something that actually doesn't work. What we should be striving for is let's try to get the best possible price and the best possible outcome if we're gonna be spending the money to do this.
[00:16:19] Dr. Christine Hale: And again, another insight coming over to the employer side that I was very pleased about was that the overwhelming majority of our clients really genuinely care about their employees and their families. And they want to be able to provide these life changing, life altering quality of life, improving therapeutics.
But they also have to be a planned fiduciary, and we're hearing more and more about that in the press, and that balance can be very tricky when you have people that are marking up the cost of their drugs, for example, 10 times what they're actually acquired at.
[00:16:52] Stacey Richter: There's that foreshadowing again.
What we should do right now is specify what plan sponsors need to be doing here at a foundational level.
And there's a lot that sounds data heavy, getting the data at the member level both the pharmacy side of the house as well as the medical.
Like find these individuals, the 0.5 to 1%, which is a very small number. So figure out for that limited number of individuals exactly and specifically what's going on. Like that sounds like just right outta the gate, number one thing. So let's just say, now we know who these people are, what's wrong with them, and where they are.
So maybe let me just ask you this question in a backwards kind of way. What should plan sponsors not be doing that maybe they tend to wind up doing accidentally or Ill advisedly.
[00:17:43] Dr. Christine Hale: Couple of things to keep in mind. The first and foremost is a big mistake folks make is trying to boil the ocean. Thinking they have to address all the cases or even address a much larger population outside of this half to 1%. There's certainly a place for that, but if you're trying to get ahead of your high cost claims, starting small is an option.
The next piece is, of course, we mentioned this. We alluded to this, is looking at options that take things away from members. Sometimes a plan is in such dire need of immediate cost savings, that that is the option, but overwhelmingly, this can be done in a quality can convenience, cost neutral or better fashion?
And then I think the last thing would be not tying your data to your strategy. So falling victim to, oh, the latest vendor that walked in my office and said, I need a certain solution. That must be right when you haven't actually verified that that's relevant for your population specifically.
[00:18:47] Stacey Richter: This is what I'm hearing, do not boil the ocean. There's no need. There's 20 individuals. So this is definitely something that your average human brain and plan sponsors tend to be very smart people, right? So like we can look through that list of individuals and pick somebody and these are patients that are costing hundreds of thousands of dollars.
So just impacting something probably relatively minor here, and we're gonna get to this in a sec so, we can have a huge financial impact. And just drawing on the thread that you brought up before about convenience, I'm looking forward to asking you how we can both save money as well as make it better for the patient.
Which leads me to the second thing that you said is kind of a, don't do this. Taking things away from patients might not actually result in the cost savings that one might expect. You remove something and that might be the thing that's keeping the lid on a whole lot of other things. That's number two.
And then number three is to make sure that we're looking at our data and keeping our eye on our own strategy.
What should we be doing instead?
[00:19:50] Dr. Christine Hale: I'll try to go in the order related to the, don'ts that you just outlined. I'll start with starting small. That's very helpful. It's almost like a SWOT approach where you're literally going case by case by case to develop an individual member level strategy.
Now over time, as you start to see patterns emerge amongst these individuals, and you start to see. Oh, I intervened in this manner. In this situation, you can then look and say, this is a more pervasive issue, and either I need to be taking that same approach across multiple individuals, or the things that I tried didn't work and I need a broader solution.
A third party vendor solution or a plan design change, but start first with that SWOT approach. It's also really helpful to do that, to build organizational support. So a lot of times I'm hearing from employers, I'd love to tackle this, but we have way too many competing priorities, or I have to get approval through 15 committees to do something big.
The nice thing about starting with a handful of cases is most time you don't have to go through 15 layers of approval. And you can garner savings that can then be reinvested in bigger initiatives and you can build the case that this is an appropriate and effective area to focus your time.
[00:21:10] Stacey Richter: Start small.
Probably already in any given HR and I'm gonna get laughed at, 'cause this is what HR does all day is help individual members and you don't have to go ask for permission to be doing that. That's the day job here. Right?
So this is basically an extension of what somebody's doing all day anyway. So a follow on to that, which may be your next point anyway, is alright, so is the HR person then engaging with these people, because we've all heard how difficult it is to engage and da da da. So how does that work?
[00:21:39] Dr. Christine Hale: That's a very important topic, and again, a concern I hear about addressing these cases for many employers. The first point I'll make on this is, the good news by starting small, taking a SWOT approach, is you don't have to engage a huge number of individuals.
You need to engage a small population, and frankly, first off, many of the things you'll do, particularly looking for claim errors, looking for fraud, the member doesn't even know are happening. These are all happening behind the scenes.
But certainly on the clinical front, getting people to better care, changing where that care is rendered so it's more convenient, lower cost, that does require member engagement, but on a handful of people, and these members very often are desperate. They're looking for help. They're swirling in the healthcare system. They're frustrated because they feel like their doctors aren't coordinating or nobody knows what's going on, or it's really inconvenient and burdensome to have to go in and get an infusion in the hospital.
So they are much more open than your average employee to engagement.
[00:22:43] Stacey Richter: Yeah, and just pausing on this engagement thing for one sec, because I think sometimes when the employees members, they don't engage, and we say that as a broad stroke.
We're talking about everybody all at once. Making a very sweeping judgment there and a couple of things and we did have a show with Matt McQuide where we dug into that, but it kind of goes back to the whole solution looking around for a problem, right?
Like if you have somebody who's largely healthy. They don't think they have an issue. This is adult learning 101 by the way. If anyone took any of those classes, everybody is super busy. Everybody has a lot of priorities. So if you're running around with a solution and somebody doesn't think they have a problem, then the level of engagement, it's just like you don't have anything that they're gonna prioritize in their life.
This is not that situation. They have a problem. They recognize they have a problem, if they are in the middle of a crisis and there is help proffered, it will be accepted mostly, most of the time.
[00:23:45] Dr. Christine Hale: And to take that one step further, frankly, a lot of these members are already engaging because they're at a point where they're asking about FMLA or short-term disability.
I'm constantly educating our employers, that is a trigger to say: Hey, is there something we might be able to intervene on this member's behalf even before their high cost? They're about to become high cost, and so let's actually get ahead of that.
The other piece is in the situation where imagine an employer, their HR benefits team is looking at the data and they see something going on with a member, but they haven't had interactions with that member, relying on a trusted partner, one who would be a familiar name to the member is a great strategy.
So often that's case management or a navigator, but we've even engaged groups like onsite clinic providers if they're treating the member for other things. Or the member's, primary care or specialist to say, the member will receive the offer for care from you, well, because they trust you, they respect your opinion, and so engaging those members or those sources that can actually be that trusted voice to deliver the offer for help.
[00:24:58] Stacey Richter: Definitely go back and listen to the show with Matt McQuide from a couple of weeks ago, a huge part of that conversation is wildly relevant here.
[00:25:06] Dr. Christine Hale: Another piece that's important is particularly again, when we require member engagement for something like moving the site of administration for a drug that should not be mandated. It's an offer of help, as you said. Now, a lot of members will be really excited about that because most people would rather sit at home and watch Netflix in their jammies than go to a hospital.
But not everyone will. Sometimes people have a reason that they prefer to stick with their current plan, and that's their choice. That's their purview, but at least you have done everything you can to help them.
[00:25:37] Stacey Richter: If I'm putting this kind of into a stepwise here, the first step obviously is to be able to identify these individuals with enough time to impact what's happening.
Like it's one thing to be able to do this retrospectively, I guess, but it's quite another thing and this is why you said at the very beginning, like, if you're only getting your data once a year, like that's probably not helpful. So now I'm kind of putting the pieces together, why that mattered.
So step one is identify individuals. And that might happen through, I guess, regular data feeds, but the other bit, you said there may be other ways that are kind of leading indicators. Like if somebody's calling in with an FMLA asking lots of questions about that, probably we should answer with one question of our own, which is what's going on.
And that kills two birds with one stone because if they all of a sudden bring up some major medical issue, then consider them engaged, which is kind of our second step here. Figure out how we're gonna reach out in a way that is going to be deemed as helpful, not invasive. And that could be, it could be HR themselves, depending on many factors.
But it also could be engaging the onsite clinic or engaging in navigator, like if those individuals already have a relationship with these particular patients, then enabling those patients to continue to work with their trusted partners.
And then the third thing is this should be an offer to help. Not anything mandated, because again, this is a very small number of people, so appealing to their particular sort of what they want, that there's two things. Number one, they're gonna be more receptive to what you're offering if you try to figure out what they actually want.
You have alluded several times, and don't forget, we started out talking about how some sites of care are really more expensive than other sites of care. I am inferring that that is part of trying to figure out what the win-win is.
Do you wanna just dig in on that for a moment?
[00:27:37] Dr. Christine Hale: I like to think of this in a couple of big buckets. The first is making sure, first and foremost, as you just stated, that the member is getting the appropriate evidence-based and effective for them care. Because we know that not every member's gonna respond to every therapy the same way.
Unfortunately, as was my own case for my 15 months of disability. Many of these members are going around with incomplete or incorrect diagnoses, and it's very hard to impact that if you are, for example, as we had a case giving a $300,000 a year medication for the wrong diagnosis, that not only is not fixing the member's problem, it's exposing them to potential complications and bad outcomes, and prohibiting them from actually getting the lifesaving or life altering care they need.
The second bucket is exactly what you say, which is, okay. Now we've identified what the diagnoses are. What care is likely to work for this member? How do we deliver that care in the most convenient and cost effective manner possible? And certainly site of care on infused drugs is a huge opportunity for that.
But also we're seeing some innovations, and again, yay for medical advancement uh, for things like doing dialysis in a member's home, this is great because members have to, traditionally, if they're on hemodialysis, they have to leave work three times a week to go sit in a center.
Now it can be set up to be run in their home overnight, and they're avoiding that missed work and disruption to their life. And then don't forget on the backend, it's not a win-win. It's more of a neutral win. But all of those things you can do on the backend by just simply making sure that there aren't fat finger errors on a bill.
We had a $400,000 error on an inpatient bill for a COVID claim. That just somebody fat fingered the dose of steroids that they billed for. And you know, sadly, like every industry medicine has its share or bad actors that are gaming the system at best or at worst, actually committing fraud.
Uncovering those things and going to that to write that situation is hugely important.
[00:29:50] Stacey Richter: You said three things there. Once we have identified these individuals and engaged them. Number one, ensure the treatment is appropriate evidence-based care.
And earlier we talked about someone getting double treated. You know, they're getting gene therapy while they're still getting the same. Like, that is obviously not evidence-based nor appropriate. And then you just brought up another example where the patient may be misdiagnosed. There's just that inflammatory news article the other day about a patient who didn't actually have cancer who was getting cancer therapy for nine years.
So let's hope that is an outlier. But it is definitely true that if somebody goes for a second opinion, 70% of the time the treatment changes. So, you know, like this is certainly a thing to make sure that the treatment is appropriate and evidence-based.
Then the second thing is, okay, once we've determined that, then let's make sure that this treatment is being delivered in the most cost effective way possible.
That could involve doing something, and you've said this also several times that might actually be more convenient for the patient, right? So like this is not send them to the place nobody agrees is the right place. Like the patient could be happy about this. But that site of care is not only more convenient, but it also could be wildly less expensive.
And by the way, Autumn Yongchu and Eric Davis really dig in on this in a pod from, I don't know, maybe it was a year ago. And they also touched on the third thing, which is just the number of errors here. Our system is obviously rife with errors and fat fingered, or just all kinds of stuff going on.
But because the numbers are so high here, really looking, scrutinizing these things incredibly carefully is also something that we should not forget to put on our list.
We've talked a lot about a lot of things today, Dr. Christine Hale.
Is there anything I neglected to ask you that you wanna talk about?
[00:31:36] Dr. Christine Hale: There's one more point just to build on everything else we've talked about. Don't be afraid to get creative. A lot of times these situations, by definition are complex and there are member factors involved, and you have to try to figure it out.
Don't stop with the surface solution. A great example, we talked a lot about the impact of redirecting site of care. In fact, our largest win we've ever had was $3 million for one person simply by moving their infusion out of a hospital and into their home.
But we also had a case where a case manager reached out on our behalf to ask a member if they wanted to do this, we're accustomed to members loving this. This person literally would not answer the phone after they called. And our team said, you know, that just doesn't make sense. And so we did some research all above board, I promise you, but publicly available.
But we found a blog that the member is a hoarder. She was writing about that experience and we said, ah, she likely doesn't want someone coming to her home.
So we sent her to a hotel and sent home healthcare there and saved the company $800,000 a year. So don't be afraid to think outside the box. Get a little creative within the bounds, of course, of reasonableness, but it's not a one size fits all.
[00:32:47] Stacey Richter: It sounds like something which is eminently possible given the very small numbers of patients that we're talking about here.
And this is also, dare I say, right up HR. Most the, let's just say the good ones are listening to this podcast, so those who are listening to this. There's so much creativity to be had with HR and I've seen just relative to all kinds of crazy situations with employees in the workplace, and it just sounds like this is another area where those muscles can be flexed.
[00:33:17] Dr. Christine Hale: And the other nice thing about focusing on the member first and meeting them when they are is those members can become your absolute best champions with respect to communicating the value you're delivering. We've had members that have sent thank you letters to their employers who've written newsletter articles to their entire company saying how much this changed their life.
So you can really make a difference for individuals, and then they will help you build enthusiasm around what you're trying to do in your plan.
[00:33:46] Stacey Richter: And let me just remind everybody, there was a solo show that I did several weeks ago where I rant, I'm just gonna say it out loud, why it's so important to be focusing on the member.
And had I done this recording before that show, I would've added this, that by focusing on the member, this is just another place where actually doing the right thing, turns out not only to be the right thing clinically, but it also will wind up saving money.
Dr. Christine Hale, if someone is interested in learning more about your work, where would you direct them?
[00:34:20] Dr. Christine Hale: Stacey, everyone can look for me on LinkedIn, follow my feed and see what we're up to there.
[00:34:26] Stacey Richter: Dr. Christine Hale, thank you so much for being on Relentless Health Value today.
[00:34:29] Dr. Christine Hale: Thanks Stacey.
[00:34:30] Dr. Marty Makary: Hey guys, it's Marty Makary. I wanna let you know that I love Relentless Health Value. I follow it and get the newsletter and it's great stuff.