CEO Pooja Ika launched eternalHealth at just 24 years old in 2020, focusing on Medicare Advantage. But, a few years in, she says some health plans and their leaders are distracted — and she was, too.
“When you ask me all about the [social determinants of health] or other types of initiatives, we as health plans have gotten so distracted with all these initiatives, in my opinion, because I think they’re the shiny bells and whistles,” Ms. Ika told Becker’s.
While eternalHealth still participates in some of these initiatives, like a nutrition-focused partnership with Kroger, Ms. Ika emphasized that members need to take advantage of these perks for them to be worthwhile.
“Oftentimes, plans have really great benefits, but being able to actually leverage them ends up being very challenging,” Ms. Ika said. “It kind of deters anyone from actually using them. For us, we’ve tried to work really hard in having really thoughtful partnerships and relationships.”
When it comes to supplemental and other health benefits, Ms. Ika said she has learned that healthcare leaders and payers may “confuse the difference between want and need,” and placing more trust in provider partners can help guide decisions.
Keeping care simple is Ms. Ika’s latest priority, and she shared a few of eternalHealth’s strategies for doing so.
“Health insurance isn’t sexy. It’s not meant to be sexy. It’s all operational. It’s all about delivering care properly, effectively, efficiently,” Ms. Ika said. “We are, in a way, trying to just go back to the basics and focus on what a health insurer is truly supposed to do. We believe that if we can do that right, we can rebuild that trust that a lot of consumers have unfortunately lost.”
One way: Getting to know members better by gathering comprehensive data. Ms. Ika said even something as simple as claims data can be immensely valuable for analysis.
“The longer a member stays with me, the more I can actually take the claims data, the patterns, and anticipate what types of preventative care services they may need,” she said. “We find that it helps us not just invest in blanket preventative care strategies and all these areas that really tend to be buzzwords, unfortunately for our space. It gives us a lot more insight into the areas we need to invest in for a specific membership to actually see some ROI.”
Technology can be another cornerstone to keep things easy, even for Medicare members who may not be digital natives.
“When we’re thinking about any solutions we’re putting into place, we’re thinking about all cohorts within that population because each one is going to want to interact with the health plan a little bit differently,” she said.
