LAS VEGAS—Health and social determinants data will be a "critical part of the transformation” of Centene as it looks to streamline its operations and drive better outcomes among its underserved populations, CEO Sarah London told HLTH attendees Sunday evening.
Rapid growth within the last several years has seen the payer swell to more than 26 million managed care members. It’s become the top participant in Medicaid market exchanges and a major player in Medicare Advantage.
That scale and the company’s current operating structure led to segmentation across each of its 30 states, London said, “and I sometimes joke that it’s 30 $1 billion startups.”
As Centene looks to “simplify and harmonize” its sprawling business, the CEO said the company will be better served extracting, codifying and acting upon its various troves of member data as opposed to merging its “extraordinarily complex technology ecosystem” into a single unified platform.
“If we can actually rely on the data, get the data out of the systems and think about actually operating on a data layer, it will simplify our business and make us even better at honoring our commitments and being good at the fundamentals,” she told conference attendees. “And then behind that, creating a culture of the organization that craves data to help us understand what’s going on, to help make us better and then to help us make decisions and prioritizations and trade-offs going forward.”
London, who was tapped to serve as CEO earlier this year after longtime leader Michael Neidorff stepped down due to health concerns, noted that Centene’s position as a leading insurer of lower-income Americans brings insights into populations that are uniformly underrepresented across clinical data sets.
Through a combination of disparate spreadsheets and employee-level knowledge, she said Centene already has information on key social determinants of health information—for instance, the best community-based organization to connect members to food pantries, job training or low-income housing within a specific county. Formally codifying that information could ensure those insights become future interventions.
“That’s where I think we sort of have a mandate to create that data,” she said. “To me, data is like the high-tech, low-cost intervention, which is really what we need more of in healthcare and particularly in the Medicaid [and] complex populations. The [other] high-tech stuff is exciting, but we can’t afford it, right? Data is the lowest cost way to have a huge impact.”
In the meantime, London said Centene has been working to remove barriers to care among underserved populations by “intentionally crafting” provider networks comprised of culturally diverse practitioners, care coordinators, call center representatives and other employees who might interact with a member. The payer has also invested in educational programs to train providers who commit to practicing in rural areas where there are “huge gaps” in provider networks.
Data, provider diversity and other health equity initiatives are long-term by nature, a potential pain point for a public company with financial commitments to its investors.
London, however, stressed that “there is no moral hazard” in Centene’s pursuit of health equity as better value for members directly translates to better value for a managed care company’s shareholders.
"It’s not just the nice thing to do, or the right thing to do, to invest in closing the gap of health inequities—the math actually works,” she said. “It is fundamentally how you change health outcomes, particularly in our populations … and what’s exciting is that I think it’s starting to be recognized more broadly in the industry.”