Clover Health: A Health Plan's Digital Transformation Story

Ciji Adams: Hello everyone, and welcome to the Payor Principle, a Salesforce healthcare podcast created exclusively for payors. I'm your host, Ciji Adams. On the show you'll hear insights from healthcare industry experts and trailblazer organizations on all things payors, such as trends, business challenges, and the latest technological solutions. Today's episode focuses on the digital transformation of a Salesforce trailblazing organization, Clover Health, and the impact using a single integrated platform has made for the business and its members. I'm joined today by William Masson, manager of product management from Clover Health, who is responsible for building solutions on the platform. William, welcome to the podcast. It's great to have you.

William Masson: Thank you. It's great to be here.

Ciji Adams: So tell us a little bit about who Clover Health is and the members that you serve, who is Clover as an organization?

William Masson: Yeah, Clover is a Medicare advantage health plan in seven states. And in 2021, we're expanding to eight. We have over 350 employees. Our headquarters is in San Francisco, and Clover's goal is to improve the quality of life of our members and physicians. And we do that by using data analytics and a preventative care approach. We've been Salesforce customers for about five years, if I'm not mistaken.

Ciji Adams: Thanks, William. How would you describe Clover's evolution as a digital healthcare company?

William Masson: Clover, early on, like many digital healthcare companies, we build many of our applications and our technologies internally. And naturally our data kind of siloed or our work siloed into two major categories, marketing and sales, and then the standard insurance plan related data. The result is that finding answers to certain questions or digging into our data was more time- consuming than we expected. And we had to find the commonality amongst those two separate data sets to find answers to those problems or questions. By consolidating our work onto one single platform, it's become a lot easier to mine the data, find patterns, or dig into questions that might come up and learn more, and ultimately serve our members better.

Ciji Adams: Well being a digital first company, as you shared, couldn't have always been easy. What were some of the challenges Clover Health experienced prior to implementing the Salesforce platform, and as you said, being able to streamline everything on one platform.

William Masson: Like I mentioned, first of all, our data was siloed and it took a lot of effort and a lot of work and energy to find patterns in that data and merge that data together to make sense of it all. I think another challenge in this space is... Healthcare is highly regulated, and building software in this space can be a challenge because we have to meet those regulations. And with Salesforce, Clover, we found a way to rapidly iterate or come up with ideas or plan solutions while being in compliance and meeting the regulatory needs of our industry.

Ciji Adams: So prior to being on Salesforce, Clover struggled with silo data and being able to rapidly integrate to ensure compliance, as you said, in a highly regulated industry. What are some of the benefits Clover is able to realize now by being on a single integrated platform?

William Masson: Predominantly they fall into two major categories. It's observability and standardization. From the observability perspective, all of our information is on a single pane of glass. And what this gives us is the ability to show our teams all the relevant information about our members in one single place. And that helps them offer the best possible support. From the standardization and coordination perspective, by centralizing on one platform, that means all of our data is tracked in the same way across the entire organization. This makes, again, providing support and service to our members easy, but it also allows for easier reporting and dashboards. And it gives us the ability to study our data in one standard way and get to the bottom of a problem quickly. For the geeks out there, the data geeks, this decreases our need for reconciling our data or two data sets deduplication. And it definitely simplifies the ETL process, if there's one at all. This is really exciting to us on the product side, because a lot of our work is predominantly a function of people, process and technology. And with standardization, it helps us identify whether a problem or an issue that we're confronted with is related to training, or perhaps there's a missing step in the process, or if the tool itself is broken and we need to dig into it. A lot of times, this means that because we can identify the source of a problem, we solve many of our issues without writing more code or without trying to re- fix or fix a problem in technology that isn't actually a technology problem.

Ciji Adams: Thanks, William. It's amazing to hear Clover has been able to see such great improvements when it comes to observability, standardization, and coordination internally by using the Salesforce platform. I want to pivot for a moment and discuss how Clover has been navigating the COVID- 19 crisis. What are some of the challenges the organization has faced during the pandemic?

William Masson: Our approach to COVID falls into three categories. We focus predominantly on mail- order prescriptions and getting our members to sign up to receive their medications through the mail. We stood up an NP or a nurse practitioner hotline, and we quickly stood up telemedicine and support through those channels. The background toll of this is, we have to remember at the beginning of COVID and shelter in place, information was really dynamic and we were getting updates from a variety of sources every hour. And after a few cycles of trying to process the information, we really landed on one core value or core approach, is how do we help our members shelter in place efficiently, effectively? And the clarity of this direction unlocked our ability to come to these strategies that I just mentioned. And then we'd learned pretty quickly that up to 30% of our practices in our major markets were closed down because of COVID and shelter in place requirements. And we launched a communities page to provide easy and quick answers to our members, but that's where we also spun up our nurse practitioner line to take it one step further and answer those questions that we couldn't easily answer through that website. By leaning on field services, Lightning, and what we'd learned from our nurse practitioner hotline, we were able to establish a telemedicine and scheduling approach that our members could use to get answers to more deeper, more complicated clinical questions. And so it all kind of builds on each other, right? First it's mail order, then it was the NP hotline in the communities, and then we turned to telemedicine to support our members, and that all comes back to a lean approach to supporting our members in their health journey.

Ciji Adams: That's incredible to hear that Clover was able to deploy a mail order solution, nurse practitioner hotline, and telemedicine service since the onset of the pandemic to help support its members. There's been a huge surge in virtual care during COVID- 19, especially when it comes to telemedicine. Can you tell us a little more about how Clover rolled that service out?

William Masson: Leading up to COVID in the beginning half of the year, Clover was already thinking about and planning- through a telemedicine and scheduling solution. When COVID hit, we were able to take the pieces of that plan, or the ideas that we had come up with, and apply them to the COVID problem, and ultimately use Salesforce to rapidly iterate two solutions that would help us reach out to members, coordinate that outreach, coordinate scheduling, and then launch a telemedicine solution, and ultimately to keep our members healthy and safe during the pandemic.

Ciji Adams: William, you mentioned various solutions Clover has deployed to engage members during the pandemic and keep them safe and healthy. To wrap the episode, what advice would you offer to other health plans who are struggling with how best to engage members during the COVID- 19 crisis?

William Masson: One of the exciting things about the platform, about Salesforce, is those solutions that I mentioned... We stood those up, some within 48 hours, we were standing up new channels and the telemedicine solution was stood up within a week. And part of the reason we were able to do that is one, we took a members first approach. And as I mentioned, in our conversations with a member, in reaching out to them, we learned about their needs. So my advice to others is talk to your members, interact with them, engage with them. And there's a saying that we think a lot about, that" The people closest to the problem are those closest to the solution." Additionally, we talk often about the concept that small systems create small bugs and big systems create big bugs. And keeping this in mind is one of the core ways that we were able to build rapidly very point solutions, and then use that to kind of layer on top of each other, to have a more holistic approach. Again, I referenced back to how we approached COVID and it kind of took this cascading effect of solutions that we built on top of each other. And that leads me to my last recommendation. My last point is use the product to figure out what the product should be. So we use Salesforce to engage and track our interactions with our members, and then we studied that data to understand what they were asking for. And we were able to provide more support based on the feedback that we were getting. Part of that offers powerful prototyping abilities that lets us stand up these ideas very quickly, sometimes within hours, put it in front of our business partners, get feedback, and then quickly move towards launching a new solution.

Ciji Adams: William, thank you so much for joining us today on the Payor Principle podcast and for lending your perspective and sharing Clover Health's story. Listeners, if you want to learn more about our solutions for health plans, visit salesforce. com/ healthcare. I'm your host, Ciji Adams. Thank you for listening.