Darren Wethers, MD, is the chief medical officer of Salem, Ore.-based ATRIO Health Plans.
Dr. Wethers will serve on the panel "The Next Iteration of Behavioral Health, Pharmacy, Virtual Care and More: Insurers Weigh In" at Becker's Payer Issues Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference on Nov. 7-8 in Chicago.
To learn more and register, click here.
Becker's Healthcare aims to foster peer-to-peer conversation between healthcare's brightest leaders and thinkers. In that vein, responses to our Speaker Series are published straight from interviewees. Here is what our speaker had to say.
Question: What is the smartest thing you've done in the last year to set your system up for success?
Dr. Darren Wethers: The smartest thing I have done in the past year to set Atrio Health Plans up for success is to tighten our high-dollar case review process. The previous process was cursory and did not lead to any recoveries or changes in medical practices or billing schemes. We are now better stewards of the health care premium and, working with the fraud, waste, and abuse (FWA) team, can recognize and interrupt schemes.
Q: What are you most excited about right now and what makes you nervous?
DW: We are establishing closer relationships with our providers, as we are partners in growth and medical management; I am excited to see where this will lead! What makes me nervous is built on those same relationships: will we be able to leverage the provider relationships sufficiently to move the needle on CAHPS, HOS and Stars? The providers must deliver the goods: appointment times when members prefer, adequate follow-up after a medical incident, knowledge of test results — none of which the plan controls, but all of which impact our results.
Q: How are you thinking about growth and investments for the next year or two?
DW: We have a presence in the Pacific Northwest (Oregon, Nevada), so we are definitely interested in additional growth opportunities in that area. Beyond that, we look for providers who understand the mutual benefit which can come from effective payer relationships and are willing to work with us to create value.
Q: What will healthcare executives need to be effective leaders for the next five years?
DW: A phrase I heard a few months ago seems tailor-made for healthcare executives: pause and pivot. So many obstacles and occurrences arise that interrupt well-established projects and processes that it pays to be able to regroup and chart new directions quickly but thoughtfully.
Q: How are you building resilient and diverse teams?
DW: Atrio is still a small company; we are recruiting in areas of strategic need but don't have deep bench strength in many areas. Our managers must be very sensitive to their employees' well-being and make sure they take time off as needed; our HR team encourages the employees to share aspects of their lives in the employee newsletter (pets, children, partners, vacations, etc.) to build a culture where our personal traits are welcomed and encouraged. We allow paid time for volunteer work and match charitable donations. We hope these efforts will help create a resilient workforce. As to diversity, we have a good gender balance and welcome and support LGBTQIA+ employees. However, we don't have many underrepresented minorities (URM), largely due to their paucity in the areas where the plans developed. Telework has allowed the plan to expand the URM employee population by employing persons outside our core market.