Sachin Jain, MD, reveals new insights on the Anthem subsidiary's national expansion plans via the continuous adjustments needed to make care more efficient and effective for high-cost, high-need patients.
Sachin Jain became a fan of CareMore while he was at the Centers for Medicare & Medicaid Services during the first Obama administration. A little more than a year after being recruited from a lofty position at Merck, he's been named to lead CareMore.
A strategically and operationally independent subsidiary of Anthem, CareMore started out 25 years ago as an elder-focused physician practice in Southern California. Over time, the company morphed into a health plan serving seniors based on care protocols initially piloted at the physician practice.
Now its care management system has been integrated into pilot programs at Emory Healthcare in Atlanta, and in Medicaid-based partnerships in Memphis and Iowa.
Jain discovered CareMore while he helped launch the Center for Medicare and Medicaid Innovation at CMS. Jain served as a senior advisor to the CMS administrator. He also was a special assistant at the Office of the National Coordinator for Health Information Technology. At Merck, he was chief medical information and innovation officer before joining CareMore as CMO and COO in January 2015. Named president and CEO a week ago, Jain is succeeding longtime mentor Leeba Lessin, who will retire.
During an interview with HealthLeaders, Jain shared his mixed feelings about succeeding his mentor, the imminent release of a peer-reviewed study showing the effectiveness of CareMore's interventions, and his plans for the expansion of partnerships with acute care hospital partners pioneered by a program at Emory in Atlanta. He cautions: Nothing less than transformation of care delivery is required, and transformation requires full commitment.
HealthLeaders: Congratulations on the promotion. Were you expecting it so soon?
Jain: It's exciting. It's like following Michael Jordan. Leeba is an innovative thinker and I learned a lot working with her and it shaped me as a leader. You never expect anything like this. You just do your job and try to make a difference. Things worked out.
She had been here for nine years when she recruited me, and she was a huge part of why I came here, so I had very mixed feelings that she was handing the reins over to me. But I do get to take over what I think of as the marquee organization focused on high-cost, high-need patients in the country. What we have is simply a better way to manage those who are responsible for disproportionate amount of healthcare spending in this country.
HealthLeaders: When we last spoke, you were excited that CareMore could "model the future for healthcare." We talked about some projects with local hospitals and health systems that CareMore was doing outside California—in Memphis and Atlanta, specifically. What are some of the highlights so far of those programs?
Jain: Anthem is committed to leading in this space. That's why they acquired CareMore. It's been an engine to serve the Medicaid population through the partnerships with Amerigroup entities (health plans in states where Anthem does not have a Blue Cross license) as well as the partnership with Emory, which has been a positive demonstration on how our principles can be applied to settings other than traditional Medicare Advantage plans.
Philip Betbeze is the senior leadership editor at HealthLeaders.