Abner Mason 00:07
I don’t think that healthcare stakeholders like health plans and health systems, they don’t have a choice. People in health care consumers are going to gravitate toward solutions that treat them like who they are matters and they’re demanding to be treated better in health care. And what we’re trying to do at ConsejoSano is to deliver on that and to give them a personalized, customized experience that comes from understanding who people are through data and experience and then treating them like really who they are matters.
Gregg Masters 00:36
This episode of PopHealth Week is brought to you by Health Innovation Media. Health Innovation Media creates thought leadership content that supports your value proposition via original or curated digital assets for omnichannel distribution and engagement. Connect with us at www.popupstudio.productions. And welcome everyone. I’m Gregg Masters, the managing director of Health Innovation Media and the producer co-host of PopHealth Week. Joining me in the virtual studio is my partner co-founder and principal co-host Fred Goldstein, president of Accountable Health, LLC PopHealth Week engages top industry talent spanning health systems health plans, physician enterprises, joint ventures employer purchasing coalition’s or alliances including the regulatory community in population health best practices and strategies. On today’s episode, our guest is Abner Mason, the founder and CEO at ConsejoSano Health, a digitally empowered patient engagement solution focused on promoting health equity, and reducing healthcare outcome disparities.
Fred Goldstein 01:47
Thanks so much, Gregg and Abner, welcome to PopHealth Week.
Abner Mason 01:50
Thanks. Thanks for inviting me to join.
Fred Goldstein 01:53
It’s really a pleasure to have you on I heard you obviously at HIMSS. Fantastic panel, I listened to your discussion. And really looking forward to this. I think it’s a critically important area for population health. So why don’t we start, Abner, give us a little sense of your background and the work you’ve done before you formed Consejo Sano?
Abner Mason 02:08
Sure. So in terms of background, originally from North Carolina, you know, came from lower income family, I didn’t realize at the time, but we were and I got a scholarship to go to boarding school in Massachusetts, which was mind blowing from for kid from North Carolina, and then went to Harvard, and then worked at Bain and my first job as a consulting firm strategy consulting, and then got into state government, Massachusetts, and that really, you know, put me on this trajectory that that ended up with me getting more into healthcare and starting ConsejoSano. I was ended up being chief policy advisor for a couple of governors in Massachusetts. And that led me to do a lot of work around HIV AIDS, I was appointed to the President’s Advisory Council on HIV and AIDS, by George W. Bush. And that really transformed my my view of health and also my expectations about what we could we could achieve here in America.
Fred Goldstein 03:00
That’s great. And as you work through, obviously, all of those areas in HIV/AIDS, critical, really unique introduction to populations that are oftentimes disadvantaged. And so I assume that sort of set the foundation for what you then went on to do next. Yeah, I really
Abner Mason 03:15
learned with the HIV/AIDS challenges that that healthcare system and this is actually true for other health care systems around the world, too. They don’t, they don’t do a good job of meeting the needs of everyone. And sometimes, stigma and discrimination gets in the way. And that’s what happened with with HIV/AIDS. So I did a lot of work, instead of the, the, the, the conjunction of, of healthcare, and public health, and, and also sort of societal issues like biases. And so I learned a lot with the HIV/AIDS epidemic, and a lot of those lessons, we’ve, I’ve been able to apply in this current epidemic, which is, which is COVID. So it’s interesting, you know, having having been through one, and being able to draw on some of those lessons for the challenges that we face now.
Fred Goldstein 04:08
And so what did you see as the opportunity or the areas that really were in need to then go and form a company and and how does it address those areas?
Abner Mason 04:17
Sure. So that, you know, the, the need I saw was that our health care system in the US just doesn’t do a very good job of meeting the needs of and engaging with what is an increasingly multicultural company country. You know, the US healthcare system was kind of founded to serve English speakers and, and as the country has become dramatically more multicultural over the last four or five decades, one of the clear needs I saw was, how do we make our healthcare system work for what is becoming the majority of Americans we are now a very diverse country, we’re on the way to becoming a majority minority country and so the healthcare system is still kind of stuck in the 70s in the way that it engages. It’s usually, you know, engagement content created by English speakers for English speakers, and then they’ll translate it. But that approach, which is to it really is a one size fits all approach. If you take a message, and you translate it, it’s still the same message just translated. And what what I learned through my work internationally, and certainly in the early days of ConsejoSano is that we need to build a more personalized, customized engagement strategy, if we’re going to build trust with patients, and I’m going to not use the word patient, I’m going to call them healthcare consumers, because ideally, you want to get engaged with people when they’re not patients and actually prevent them from being patients, right. So let’s call them healthcare consumers. At some point in everyone’s life, they’re going to be a healthcare consumer, we need to build more personalized, customized approaches and treat people like who they are matters. Your life journey, Fred is different than mine. And if the health plan treats us the same, they’re not going to build trust with us, they’re not going to get deep engagement. And so what we’re saying at ConsejoSano, and I created the company to do this, let’s use technology, and experience, combine those to build more customized personalized engagement strategies that can build trust with with healthcare consumers.
Fred Goldstein 06:25
And when you talk about more customized and personalized, I think back to the day, and I know you saw this, you would get a contract with Medicaid or something. And they would say, Okay, we’re gonna have you produce materials in any language that more than 5% of the population speaks or something like that. And obviously, that was a start. But where’s that gotten to? Now? What sort of things you doing? And how do you go beyond that, hey, we created a pamphlet, like you said, that was just a translation.
Abner Mason 06:51
Right? So maybe maybe a good way to answer that question is to say, Give an example of where we’re trying to go. I was just, you know, like, a lot of Americans over the last year and a half, spent a lot of time on Netflix, because we were trapped at home. And and Netflix like other parts of our of our culture. And Amazon is the same way. When I go to Netflix, and I have a partner, we live in the same house, they recommend different things for him than they do for me. They treat me differently, they don’t assume were the same person, they they’ve pretty quickly get a sense of what I want to watch. And they start to cater to my needs. I Amazon is the same way, if you buy a pair of shoes on Amazon, I guarantee you, they’re going to recommend different things for you than for me. And after a while they get very good at this. What I’m saying is that the rest of our culture has figured out how to use data and technology in a way that can create a more personalized experience that can treat me like I am a unique person different from you, Fred, it takes into account my interests and my desires, in my experience, the things I hope for and, and the things I don’t want to see they don’t show me. They they’re treating me like who I am matters. And so what we’re trying to do at Consejo Sano is something very similar, we’re trying to say that health care, and here’s the point, healthcare has got to get out of the 1970s and move into 2022 and try and start to treat healthcare consumers. Give them the same respect and and and the same kind of customization that the rest of our culture and society has started to do. And frankly, healthcare, consumers have come to expect this. So I don’t think that healthcare stakeholders like health plans and health systems, they don’t have a choice. People in health care consumers are going to gravitate toward solutions that that that treat them like who they are matters. And they’ve gotten accustomed to being treated better in the in other parts of the society in the culture, and they’re demanding to be treated better in health care. And what we’re trying to do with ConsejoSano is use is to is to deliver on that and to give them a personalized, customized experience that comes from understanding who people are through data and experience and then treating them like really who they are matters.
Fred Goldstein 09:14
And so what sort of data elements are you grabbing to do that?
Abner Mason 09:18
It’s it’s very similar to other you know, to what some other folks in the culture are doing, we, we call one aspect of what we do cultural detailing. So we try to understand who if it’s a patient or health plan member, we try to understand who that person is and what their life is like. And there’s lots of data available to us public data that’s available, but we can start to understand for example, if it’s a low-income person, do they have public transit where they live? If we’re trying to get a Medicaid members, this is a low-income person by definition because they’re in Medicaid. We’re trying to get them to go in for a well child visit. If we know ahead of time that they are they live in area, but there’s no public transportation. And we know that there’s low car ownership. And we know that the clinic is far from where they live, it’s kind of foolish for us to engage in the effort to get them to come in for a well-child visit without asking them about do you have transportation? Can you get to the clinics, and if you can’t get to the clinic, maybe there’s a benefit that the plan has that we can talk to you about, or we can figure out something. But to treat that person that member like, we don’t know that transportation is likely an issue for them is not the way to build trust. And let me flip that around. One of the ways to build trust, is to not wait till that person misses the appointment because they didn’t have a ride. It’s instead to engage on the front end and ask the simple question, Is transportation the problem for you? And people really, when you do that you build trust that that’s what I mean by connecting with people and understanding who they are connected with them based on who they are, and not waiting for someone to kind of miss the appointment. And then we’ve we’ve and then we say, well, you don’t really, you know, not you, not you, but some people would, you know, draw from the missing the appointment, but they don’t really care about getting their child in for well-child visit. That’s not true, they care, but they never ride and we, we didn’t take the time to even ask them about that. So that’s, you know, there’s a lot that we can do to build trust with people. But a big part of that is understanding who people are at that deeper level.
Fred Goldstein 11:25
And how much of that sort of a relationship is built upon a care coordinator or a coach or promotora versus technology that you may be using in terms of your programmatics.
Abner Mason 11:36
So we we have in the as we’ve grown, the company we started with, with a very sort of hands on approach using what we would call care coordinators, and we call them now. I think community health guides, and they still are a great important part of our business. These are real people who come from different backgrounds, they cover about 25 Different cultures and languages. And they are very important, and they’ve helped us, you know, as we’ve grown the company, they’ve helped us to build that more of a trusted relationship. But as we grow as a company, we can’t. The truth is if you’re going to engage not just millions, but 10s of millions of people, and if we’re going to give them this kind of personalized, more customized, engagement approach that we’re talking about, we as a company have had to figure out and it’s not easy to do, but had to figure out how do you build into the technology, that human feel that our Community Health Guides naturally give, they naturally give it right. And they exude it, and they and it’s wonderful that we have them, but we can’t scale and serve 10s of millions with them. So we’ve got to we’ve had to figure out how do we build into our technology, that that experience that they’re offering. And I’m really proud to say that we are getting better and better and better at that at balancing, you know, the human touch with technology.
Fred Goldstein 13:03
And is that an app you built or a website or a portal? Or what do people do?
Abner Mason 13:08
Yeah, so you know, our experience, and others may have a different experience, but our experience, at ConsejoSano and we serve now I think we’re in 15 states, we’re about almost 3 million folks we engage. And and and we have learned that native text messaging is the best way to engage with healthcare consumers today, regardless of income. So this is true in Medicaid and Medicare Advantage and exchange and commercial. We found that two way text messaging native is the best way to engage asking people to download an app is a heavier lift, you know, you’ve got people, I don’t know how many apps on your phone. But I suspect if you count it up, it’s a lot of people, you know that there’s a bit of people are jaded a bit. So you’ve got to build a really trusted relationship nowadays, to get people to download an app, what we found is that we can be very successful with native text messaging. And we supplement that with calls from our Community Health Guides. So I really want to want to push folks in healthcare to to take a close look at text messaging. That is the way America communicates in 2022. And if you’re doing anything else, if you’re mailing people you think US mail, email, I’m just telling you, it’s not the way to engage engauge folks nowadays.
Gregg Masters 14:34
And if you’re just tuning in, you’re listening to PopHealth Week our guest is Abner Mason founder and CEO at ConsejoSano health a digitally empowered patient engagement solution focusing on promoting health equity and reducing health care outcome disparities.
Fred Goldstein 14:51
Well, I think you nailed it. You know, it’s absolutely true on the text messaging, and we we experienced that years ago and some of our programs as well, that that was definitely the way to reach the population. And also, just to point out, as I may have said, earlier shows at one time I was doing a health literacy program with the CDC, director of health literacy. And they made the comment. We’ve known for 30 years that handing out brochures or mailing them to people’s homes don’t work, but we still do it. You know, and here you are, you know, this this pathway. And so I would assume you get permission from the individuals to then text message it to them back and forth. And is that with a more centralized center? Are you using a primary care primary coach or primary nurse model, or using while the text came in? We’ve got somebody in our system. And today, it could be Fred tomorrow, it’s Abner that responds.
Abner Mason 15:44
So let me answer that in two ways. So first, I just want to double down on this text messaging issue as because it is a big challenge for us. And you know, we were now in January 2022. And the truth is that most health plans in the country and I focus on health plans, but this is true for a lot of health systems, they’re still not using text messaging as a way to engage with their, with their members. And the reason is that there’s an old law that the Telephone Consumer Protection Act from 1992, that basically says you can’t send a text message if you don’t have permission in advance to send that text message. Now that law from 1992, was written when like the first text messages were sent out, it does not reflect the reality of 2022, when this is the only way to engage with people. So we have a problem that we have got to as a healthcare community solve, it’s not solved today, but we need to solve it. Texting is a health equity issue. It is the only way that that particularly low income underserved populations are going to engage. And if we don’t figure out a way to solve this problem, we’re never going to achieve the goals we have for reducing, you know, healthcare disparities and making our healthcare system work better for everyone. So we have we’ve got to work with with the relevant stakeholders that plans are involved here, because they need to be more aggressive. And, and, and figure out a strategy to use texting to engage their members, we need regulators at the federal and state level to step up, they’ve got to fit, you know, I would, I’d like to say that we need the Congress to pass a new law. But that’s so that’s, that’s such a heavy lift, and I’m going to not even go there.
Fred Goldstein 17:22
Well I am going to go there Abner, Go there. I was going there directly. And I’m thinking, you know what we should do I mean, this is just straight-up smart. But you know, and you’ve got the data etc. to show this is we should create an exemption for healthcare with an opt-out model instead of an opt-in model for text messaging.
Abner Mason 17:40
Agree 100% Agree 100%. That is exactly what we should do. But you know, this is a federal law. And you know, these I respect the the folks that we send to Washington, but but they are struggling to get anything done. So I don’t want the the needs of health care consumers and patients and health equity put on hold while we wait for the Congress to act, they need to act and you are exactly right. And I 100% support that. But between now and the time that the US Congress enacts there, we need to do things we can’t wait. And I just want to emphasize texting is a health equity issue. And so if we believe we really are serious about health equity, we need to get the plans to step up. And we need to get regulators at the state and federal level to step up because there are things they can do. I’ll give you an example. A quick example, we could simply have the state’s could under Medicaid form, that if you’re approved for Medicaid, if you’re approved, you are giving permission to be communicated with by your Medicaid managed care plan. Simple it would be I mean, it’s that would solve that because we wouldn’t have to change the law, they we would have given consent already. So these that’s just one example the kinds of things that we could we can be smart about and that we could do that we really start to address this well, we could have you know, and I am encouraging this the the administrator over at CMS could give guidance to plans and and to regulators to say health equity is important. And this is a texting because health equity issue. So you need to use every tool available to you. So that we can engage with with all healthcare consumers, but particularly low-income Medicaid people are, that’s our focus, I can say we are not going to solve our health equity challenges and the health disparities if we can’t, can’t engage the people in the way that they not only prefer but in many instances, the only way they’re going to engage.
Fred Goldstein 19:33
And when you think about this, obviously you’re doing something you’re in the space, you’re seeking to address these issues, social determinants of health and this whole health equity issue has become the hot button. Topic. How much are you seeing is words and speech versus actions at this point, as we look at that on a larger scale.
Abner Mason 19:56
It’s a it’s a that’s a really good question. Yeah, that’s a really good, I think I think that is, you know, the, I think that is the most important question for us to have in mind as we sort of move into 2022. My, my view has been that, you know, because of the pandemic, we’ve had to focus so much on the pandemic, that a lot of the health equity work hasn’t gotten the kind of attention that it should get. So what I’m hopeful for is that, you know, we’ve got an administration President, Biden administration, they have said very clearly, health equity is a number one priority for them. But I understand when you when the house is on fire, and that’s what we had with COVID, they had to focus on putting the fire out.
Fred Goldstein 20:42
But I’m just gonna push back a little bit on that and point out something, the pandemic showed just how bad we are at it, we could have at least tried to address it within the pandemic itself.
Abner Mason 20:53
Yeah, it’s I mean, I, there’s, I agree with you, 100%. I think that even, I’ll give you an example that proves your point, which is that even as we did testing for COVID, and, and, and started to distribute the vaccine, we haven’t been collecting race, ethnicity and language data. This is a, this has been a problem for our healthcare system for decades. And you would think that we would have used the pandemic as a time to say, we’re gonna get it right this time, because we know there’s a correlation between being underserved and low income and, and even communities of color, and higher rates of infection and death for the pandemic. So you would think we would have said, let’s make sure that we’re collecting race, ethnicity and language data across the the responses to the pandemic, first, it was testing, and now it’s getting vaccines and even boosters. We still aren’t collecting that data the way we should. So I agree with you 100%, that we could have done better. But here’s my point. I want to be fair. And as I said, when the house is burning, you don’t say which fire department came? Or is that is that good? Is that clean water or dirty water? You say put the fire out, right. So I do think we’ve been in a crisis situation. But we are I feel we are starting to, you know, fingers crossed, move out of it. And there’s an opportunity for us going forward to learn from what what the pandemic has taught us, but also to draw the lessons that we knew before the pandemic, and start to really create a healthcare system that works better for everyone,
Fred Goldstein 22:21
given what we saw with with the pandemic. Where do you see the next areas we need to focus on? You’ve talked about getting some of this individual data on race, ethnicity, things like that? What are the next kinds of things we need to be thinking about working on?
Abner Mason 22:36
Yes, I think there’s a couple of things that come to mind immediately. So because it’s so important that texting issue we need to solve, it’s just that it’s almost like table stakes. If we don’t get that solved, in my view, we ought to stop talking about health equity and trying to say we’re serious about it, and we can’t even solve the table stakes issue. So we need to, you know, solve that. And then I think and this goes to your earlier question, too, we’ve got to figure out how do we move more quickly to to implement strategies that that address this reality that we all know, which is that a person’s health is not determined by what happens in a clinic visit when they’re with the doctor, maybe two, three, even four times a year. And the other factors that you know, as you know, Social Determinants of Health have a much more profound impact on on a person’s health. And so I think one of the key things we need to do is to figure out quickly, how do we, you know, allow the health care system to do a better job of addressing the whole person. And by that, I mean, investing in those social determinant health issues and addressing those. So there is good news here, the Medicare Advantage Program, which is the program for seniors, it has, they’ve come up with a new program, they call it supplemental benefits, and it’s new, and it allows the Medicare Advantage plan to spend some of the premium dollar for a member on non clinical issues. An example is if you’ve got a senior and she’s living in, in in South Texas, in in San Antonio, and it’s July, if she doesn’t have a and she’s got some some respiratory issues in general, if she doesn’t have an air conditioner, she’s going to have a respiratory event that’s going to cause her serious illness and have and be a big expense for that for her health plan that the Medicare Advantage plan. Now that plan can buy her an air conditioner, they can with premium dollars, they can actually install it in her window and even give her a little bit of money to address any kind of increases in the in her in her electric bill in the summer months. That’s what the supplemental benefits program is about. It gives you a little bit of flexibility, and it’s new and they’re going to develop it. I think that is really encouraging and I want to just commend the folks that at CMS and others for establishing a program like this for Medicare Advantage. But shouldn’t we have a program like that for Medicaid, Medicaid is a program for low income people, if anybody needs to have their social determinants of health issues addressed its folks on Medicaid, I think we need to see a similar kind of flexibility for Medicaid managed care plans to spend premium dollars on the social determinants of health issues. And we should not require every state to do what North Carolina has done to get a what’s called a 1115 waiver, so they can do it. Congratulations in North Carolina. I’m from there, by the way. So it’s a proud moment that North Carolina was the first state to get a waiver. But we shouldn’t require the other 49 states that go through a process like that, when we know that the Medicare managed care plans are capable of I’m in the best position to know how to use some of that premium dollar to address those social of the social terminal health issues in a way that will improve health.
Fred Goldstein 25:57
So just quickly on that issue of using the dollars, a lot of that I see is everyone saying let me add another CPT code for but if we put the dollars you’re in the system, because if you do those things, you’re going to save on something else. So shouldn’t we just move to some of these advanced payment models to do that?
Abner Mason 26:12
I think we should. And I think we should, we should, you know, have more flexibility and let people try things. I mean, I’m not smart enough to know what’s going to work everywhere. So my view is, let’s let 1000 Flowers bloom. Let’s let’s try some things and see what works. And then double down on what works. So I agree with you 100%. The money there’s money in the system to do a lot of this. It’s just not being deployed in the way it should.
Fred Goldstein 26:38
Absolutely. Well, it’s really been fantastic to get you on Abner. Thanks so much for joining us on PopHealth Week.
Abner Mason 26:43
Sure. Happy to be here. Thanks for all the work you’re doing.
Fred Goldstein 26:46
Oh, it’s certainly our pleasure. And back to you Gregg.
Gregg Masters 26:49
And that is the last word on today’s broadcast. I want to thank Abner Mason founder and CEO of ConsejoSano. Health a digitally empowered patient engagement solution focused on promoting health equity and reducing healthcare outcome disparities. For his time and insights today do follow his work on Twitter via @AbnerMason and @consejosano_us, that’s c o n s e j o s a n o underscore us respectively, and on the web at WWW.consejosanous.com. And finally, if you’re enjoying our work here at pop healthily, please like the show on the podcast platform of your choice. Share with your colleagues and do consider subscribing to keep up with new episodes as they’re posted. For PopHealth Week. My co-host Fred Goldstein. This is Gregg Masters saying bye now