Sachin Jain, M.D., on July 1 took the helm of SCAN Health Plan, a nonprofit Medicare Advantage plan, as the company’s president and CEO. Jain in April stepped down as CEO of Aspire Health and CareMore Health, both subsidiaries of Anthem (NYSE: ANTM).
At SCAN, Jain leads a $2.4 billion organization that covers more than 215,000 members. The company is a part of the SCAN Group, a nonprofit dedicated to helping senior citizens stay healthy and independent.
Jain spoke with Hospice News on his priorities for SCAN’s future, the involvement of hospice in Medicare Advantage, and the importance of social justice in health care.
As you come into this new role at SCAN, what do you see as your top priorities?
SCAN was founded in 1977 by a group of 12 seniors who believe in social justice and believe that society can and should do more, to keep seniors aging healthily as well as aging in place. I think our objective is timeless in that regard, because we’re always going to have a need for innovation in the space of serving and supporting seniors.
SCAN has an extraordinary history of actually accomplishing that mission. We were originally what was called a social HMO, and it subsequently evolved into a Medicare Advantage plan that’s really differentiated in the marketplace by its focus on the social determinants of health. We also have what’s called our Independence at Home program, which is a set of programs that help to ensure that seniors are aging safely at home. We’re actually meeting a lot of unmet needs in the community.
We’re on the cusp of a revolution where I think seniors’ expectations are changing. Their digital savviness is changing. More and more people are accepting of care being delivered in the home, which I think gives us an extra pair of eyes and ears in terms of what patients have as unmet needs. I think that there’s opportunities for us to leverage technology to engage with patients, both in scheduled interactions, but as well as asynchronously through things like remote patient monitoring. SCAN has an incredible opportunity to continue its leadership in the industry around helping seniors live independently.
What attracted you to this endeavor at SCAN? What made you say “This is the organization that I want to lead”?
We need more health care with heart in the United States. I think over the last several decades we’ve seen a corporatization of American health care. I’ve known SCAN for several years now, and this is an organization that’s truly heart-first, and you can’t have enough of that. It’s the durability of the mission, the passion of the associates, and then frankly, the ambition of the board and the people of SCAN to really make a difference, and extend what we consider our “special sauce” to new geographies and to new service models. This is not an organization that wants to stand still. It’s always been a leader, and I think there’s an opportunity to really kind of grow the organization as well as expand and extend the ways in which it reaches people who need services.
What did you learn during your tenure at Aspire and CareMore that will most significantly impact your approach to leadership at SCAN?
I was really fortunate to spend my first year at CareMore working under the tutelage of Leeba Lessin, who had been the president of CareMore for over 10 years, as well as Dr. Sheldon Zinberg, the founder of CareMore. From them, I learned important lessons about how to fundamentally redesign health care delivery.
I think Leeba was a master at putting ourselves in the shoes of the patient and designing around the patient. Then Dr. Zinberg created this incredible culture of challenging the status quo. Those are important lessons I’m going to carry with me throughout my career. They’re very different from a lot of people who say that they do those things. There was an authenticity in the culture that changed me and made me a better leader. I’m excited to bring to SCAN a lot of what I learned from them and the incredible colleagues that I had the privilege of working with.
During your career you have overseen some tremendous growth at the companies you have led. Can you speak to some of the strategies you might employ to promote growth at SCAN?
Some of what we’re going to do at SCAN is expand to new geographies, but I think there’s also opportunities for us to enter into new areas of work. SCAN has a long history of partnering with provider groups, across the areas where it works. I think there’s opportunities for SCAN to build some of its own provider capabilities in geographies where seniors don’t have access to great health care.
I think we have opportunities to build senior-focused digital solutions and technologies.A lot of what comes out of Silicon Valley is not made for aging seniors. We have opportunities to partner with technology companies, as well as to build our own kind of native capabilities in this space.
We have a number of programs that I think have the potential to serve, you know, people who are not just SCAN members.
This is an organization with almost unlimited potential and a history of doing amazing work on behalf of people who need it. Now the opportunity is to do more on behalf of an even greater population.
What do you think needs to change in the larger health care system to better support seniors aging in place?
We need to stop thinking about people as “consumers.” I think it leads us down a particular path, which is we turn them into shoppers in health care instead of serving them as patients. We have to change our mindset in terms of how we think about what health care means in the lives of the people that we serve.
I think as a society we have to better embrace the fact that not everyone lives forever and that we have opportunities to help people live the last third of their lives gracefully and healthily. We sometimes build systems and clinical programs and clinical protocols with a view to keeping people alive for an unrealistic notion. I think we have an obligation to help people live the last years of their lives gracefully.
During your career, you’ve had a significant impact on palliative care in the United States. Can you say a little bit about where palliative care fits in at SCAN?
We have a partnership with a home-based palliative care company, and ultimately we believe very strongly in the power of palliative care to improve the quality of life and patient outcomes. I think this is something we’re going to continue to take a hard look at in terms of opportunities for us to broaden the reach of palliative care, as well as improve the quality of services delivered. I think we have incredible opportunities as a nation to improve symptom management for patients who need it, and this will definitely be an area that we look at closely at SCAN.
The Centers for Medicare & Medicaid Innovation (CMMI) in 2021 will begin a test of hospice coverage through Medicare Advantage. What impact do you think the demonstration project will have on the hospice and palliative care communities?
One of the experiences of seniors who transitioned from traditional Medicare to hospice is that they experienced a significant disjointedness in their care. We’re hoping to see through this new demonstration project at CMMI greater seamlessness in the transition of service and a better experience for patients and family members. I think it’s going to be up to the hospice and palliative care community to execute on this in partnership with traditional providers. I think that’s the opportunity of going forward.
Value-based payment models are designed to reduce costs, improve quality and care coordination. Do you think that payment models are the solution we need to achieve those goals?
I think payment models are a definite solution, because they create the foundation for how we deliver organized care. That said, I think there’s been inadequate focus on the human element of care delivery and ensuring that we have a health care workforce that’s passionate, committed, and concerned about delivering great care to people who need it.
One of the things that’s happened during the last 20 years that we often lament is that we’ve industrialized and corporatized health care to the point where many organizations are more focused on the profit motive than they are the caring motive. I think we have an opportunity over the next several decades to recenter around the caring motive.
We treat the two, sometimes, like they’re in opposition, or as though one motive is kind of superior to the other, with the profit motive oftentimes coming out ahead of the caring motive. We have to kind of redefine the rules for companies who are operating this in this space. We have to ensure that everyone who’s delivering patient care is motivated equally by doing right financially and also doing right by patients. I think that’s a place where we’ve kind of gotten a little bit lost.
You mentioned you would like to speak about social justice in health care. What message do you have for your colleagues in the health care space?
I think health care organizations have a special obligation, given their role in society, to promote social justice and racial equity and equality. We all have to take a hard look at ourselves and evaluate how we’re doing, whether or not disparities exist, both in terms of the quality of the outcomes but also in terms of our reach of service.
We have to look at whether we truly are fulfilling our mission to serve the communities in which we work. I think there’s another layer of it, which is ensuring that we’re creating a socially just and equitable workplace. These are huge priorities for me for SCAN at this moment in time when we do have a renewed dialogue around social justice and racial equality in this country, It’s really important for anyone who’s in a position of leadership in health care to take that on as an important mandate. It’s ensuring that we are treating people equally and that we are giving everyone an opportunity to live their very best lives.
Dr. Jain will be participating in a Fireside Chat at Hospice News upcoming Virtual Summit on Value-Based Care.