Episode 58: Our New CMO Kendra Emery DO

Heather: This is BACON, brief ACO news from the Maine Health Accountable Care Organization. A monthly podcast for health care providers. I'm Heather Ward.

Mike: And I'm Mike Clark. Heather and I are practicing physicians and participants in the MaineHealth ACO. This month we are very pleased to have the ACO's new, well, newish Chief Medical Officer join us.

Heather: That's right Mike, I am looking forward to this conversation. So let's get to it.

Mike: All right. Let's go.

Heather: Today we are pleased to welcome Doctor Kendra Emery to the show. She is the ACO Chief Medical Officer and started that role in July. Kendra is a board-certified family physician who I have had the pleasure of working with for many years at Coastal Healthcare Alliance. She has had the role of many medical directorships at Pen Bay. Our working relationship started way back when she was heading the quality committee there and we would get into some great conversations about quality and value-based care. But when I really got to know Kendra was when we were setting up our ambulatory COVID response in our respective institutions and spent many, many hours working together and getting through some very hard things. That was when I learned, like, what a force of nature Kendra is. She is incredible, kind, passionate, compassionate, and super hard working. It is with gratitude and really a warm heart that we welcome you to the show today, Kendra.

Kendra: Thank you. That was such an incredible introduction.

Heather: Doesn't even begin to compare to the real person. So we're super happy to have you.

Mike: We are. You know, Kendra, it's been such a joy to get to know you better in your new role. You've been at the helm now, a few months, you've kind of found your way around the different corners of the ACO and around the larger network. You've brought a fresh set of eyes and ears and a fresh perspective to some of the priorities of the ACO. And I'm curious what things have come up for you. What ways do you see the newer and expanded responsibilities you have now in the ACO? How those mesh with your own ideas and your own passions. What's come up for you in these first few months?

Kendra: That's a great question. I think I should start by answering the question with acknowledging that I've had the opportunity to be involved with the ACO on the Value Oversight Committee for the past several years, where I know we've interacted as well as the MHACO Board more recently. And it was really clear to me, even through those committee opportunities, how engaged and inspired the ACO staff are with the work that they do. And since starting that new role, I've really observed many examples that align with my values, including and Heather can relate to this, a consistent practice of listening to understand. The team provides truly compassionate support for members of the network and there's a dedication from the MHACO team members to support providers on a day-to-day basis, and how they integrate value-based care in their work. I think what really ties into the core of why I'm in medicine is MHACO's commitment to delivering high quality, affordable health care to our patients, which are literally our neighbors, my family, they deserve access to high quality care at the right place and at the right time, and that is at the center of the mission and vision for MHACO.

Mike: Yeah. Well stated.

Heather: Now that you've had a little bit of time to kind of get your feet wet and get used to how things are going, I'm really super curious to figure out, like, what has your understanding of the ACO changed at all? And, you know, were there things you were expecting, and you didn't get experience or anything that really surprised you?

Kendra: Yeah. The more obvious things I have gleaned in my first several months are an appreciation for the structure and function and scope, and the expansive job description for myself and the team. But something I wasn't expecting was, their secret sauce. So they are an organization of high functioning givers, and they've created a culture where givers are set up to succeed. Adam Grant is one of my favorite authors, and he's a professor of organizational psychology, and he describes the concept of givers and takers in a workplace. And at MHACO, it was very clear to me within the first few weeks that I was in the company of givers. What can I do to help? How can I help you with this problem? I can try, I can try to tackle that today. It's a phrase like this is consistent response. Anytime I approach the member of a team member with a question, a challenge, a new ask, a problem, a collaborative opportunity, and it's a really inspired environment to work in. And that's just a secret sauce I wasn't expecting. Adam Grant has said that cultures can be built where givers are set up to succeed, and the leadership has really done that, and I'm excited to be a part of that now.

Heather: That sounds exciting. Wow. We'll have to figure out how to spread that even further.

Mike: Yeah. That's great. That's really been, you know, as a, as a like a non MaineHealth employee. Right. As a private practice provider supported by the ACO, I have to say that's been my experience too, as I've gotten to know the ACO team. And that's just beautifully, beautifully stated, Kendra. I appreciate that. And a question I had for you is, you know, I imagine your first few weeks or months or a lot of it is just, you know, kind of feeling out the contours, right, of the organization, figuring out the details of the role of CMO and then pretty quickly, I've noticed that you're pivoting towards some specifics, some projects, some deliverables. And I really feel like you've had pretty quickly the opportunity to begin to leave your fingerprint on the organization's priorities. And so, I'm curious if there's some specific projects that you're thinking about or you're excited about that you're getting ready to work on or started to work on. Do you want to tell us about?

Kendra: I definitely smile when I think about the various seeds that are planted. But I think one that I want to highlight is in the space of value-based care education. I've been working with a team at MHACO on a value-based care basics level curriculum. So, an educational opportunity where, where myself or another member of MHACO could come to a specific audience and included in that education experience, we would provide data that's relevant and specific and focused for the audience, connected to value-based care. We hope that the fundamental understanding will inspire connections and understanding and potentially even action and value-based care performance. Something that I've learned and, you know, I continue to be a learner in the space of value-based care is that we're hoping to partner with leaders to improve, you know, the range of understanding in the network. And in addition to the basics, we're in the early stages of an advanced education curriculum that will serve as a follow up resource or a standalone opportunity for those who have a really great foundation and value-based care.

Mike: That's exciting. That makes so much sense. I feel like that reminds me how, you know, the opportunities I've had to learn about value-based care, about the how that affects our day-to-day work. Right? As providers in the trenches, I think that helps lift some of the burden of like, you know, these things are being done to us right by the payers or these different people who ask whether it's the government payers or private payers or other organizations, feels like a lot of things are being asked of us and having an understanding of how these tasks fit into the delivery of care and ultimately to the improved delivery of care for our patients. I think it can be a real game changer for providers to have that pull back the curtain and understand the why behind some of these asks. So that makes so much sense. I'm really excited about that, Kendra.

Kendra: Absolutely.

Heather: Kendra, these value based care educational sessions, they sound really kind of interesting. Are they like for doctors or what? Who are you teaching and what are you getting into with these?

Kendra: The audience is intended to be anyone who would like to receive the education. I recently did a session in January for a over 200 people, I think, in the IT department at MaineHealth they reached out and the questions and the engagement of the group were incredible. They asked so many questions related to how this impacts the care they receive, to try and understand how it impacts our work as providers. And I think it could be for a group of subspecialists who are looking to learn more about how the work they do ties into value-based care, and what opportunities they might have to impact contract performance. It could be for a group of new hires, residents, fellows. You know, really the spectrum is really broad, and I think the materials are going to be living and breathing and we will develop them and enhance them as the various audiences contribute their insights through their questions.

Heather: Yeah, I totally agree with that. Shifting a little bit, I'm kind of curious about some of the inner workings of the ACO. What I was really curious about was, how is it that the ACO learns about the priorities of the participants in the ACO, what kind of structure or how does that happen?

Kendra: What I have learned and have begun contributing to is there is a range within that structure, and it's also very organic at the same time. More recently have had some really exciting conversations with a group of providers near and dear to Mike Clark's heart, the private practice primary care providers, and this past fall, we hosted a dinner for these providers. And they came from all over the state. And we talked through initiatives that are currently in play with value-based care and what's on the horizon. Most importantly, we were able to learn about what they're struggling with, what they're worried about tomorrow, and how we can, as MHACO, can better support the work of this group. It was so well attended. We decided to host a couple of town halls this last month, and plan to host another series of town halls later this year to a broader scope of providers and have had great attendance to these conversations. I think in addition to that, I have been so impressed with the outreach over email, the one on ones where people just send me a note and say, I really want to talk about this and understand how I can contribute to or questioning what's happening in value-based care.

Kendra: When I think about providers that come to mind, Doctor Stout and Linda Durst, Doctor Durst from Maine Behavioral Health, Doug Smith from St. Mary's. One of my more memorable outreaches since I've been in this position was with Doctor Rughani, a neurosurgeon who reached out after my first MHACO newsletter article, to talk about a recent project. And this project, it was incredible. He had a question: How does patient experience, as measured by the Net Promoter Score, relate to quality? And he used the Heat Map as the quality part of that question. And he looked at one year of Net Promoter Score results by practice and Heat Map measure results by practice. And he found that there was a positive correlation with Net Promoter score and Heat Map results. And that literally was just a provider reaching out to share thoughts he had about value-based care after he read the MHACO newsletter. And it was just a very rewarding interaction. And I look forward to that type of stuff on a daily basis.

Heather: That is awesome. And I think that's the kind of thing to where you can see the engagement of the provider and like truly an understanding of how high-quality care also has a positive response from patients. That's fantastic.

Mike: That's great. It feels like, or seems to me that, these opportunities to look behind the curtain a little bit or to tinker with the machine and improve the quality of the care that that we deliver to our patients is a great antidote to burnout or to some of the challenges I think a lot of us are facing. So to have a platform or a person to speak with, like yourself, about observations or ideas or trying to make a difference in your organization, I think that's an important part of the role of the ACO as a convener, right, is to bring groups together. So that's exciting. Also speaking of convening exciting opportunities, I understand MHACO is planning an exciting event in May. Could you tell us a little bit about that, Kendra.

Kendra: Yes, and it's another example of just incredible contribution from the network. We're hosting a symposium in May on the 22nd, and the event is going to include a keynote address by Don Berwick followed by a panel discussion with Don Berwick, Jeanne Lambrew, Al Suelo and Chris Thompson.

Mike: Wow.

Kendra: We're then going to transition after lunch to afternoon sessions that will have just a wonderfully engaging set of workshops to choose from, and I have had the opportunity to partner with network participants in the development of these workshops. The topics, I'm just going to share a few like high level overviews of these topics, are care variation Shark Tank, where panelists are going to pitch their ideas for impacting cost of care and utilization in the acute care setting, a focus on how we can do better for people living with serious illness, led by Rebecca Hutchinson. I should mention Gina Quinn Skillings is leading the topic I referenced before. The third workshop will look at how data and analytics are being utilized to drive success in bundled payments. And this will be led by Jay Powers and Sue Seekins. And finally, we will have a workshop that will look at how. Early life events impact the trajectory of lifelong health and disease, and how research is being done by the pediatric leaders to better understand how to serve and provide access to care, led by doctor Tom Miller. So, a really diverse and fun set of workshops to choose from in the afternoon. So we're looking forward to the event.

Heather: That sounds like a blast. It's almost as something you could do entire days on each of those topics, but so true. I'm super curious about the Shark Tank thing, and that alone might get me to be there because that would be fun.

Mike: Yeah. Terrific.

Heather: So, Kendra, thank you so much for joining us today and taking time out of your busy schedule. It's been fantastic to talk to you and hear all of the exciting things that you're involved with and what the ACO is doing.

Kendra: Thank you for having me. It was wonderful to spend time with you both. Thank you.

Mike: Thanks for listening to BACON this month. You can find all our episodes on your podcast app and at our web page MaineHealthACO.org/BACON. And if you have questions, comments or suggestions, we'd love to hear from you. Also, if you are interested in the value based care trainings that Kendra spoke about, please also reach out to us. You could email us at bacon@mainehealth.org. 

Heather: Bacon is produced by the MaineHealth Accountable Care Organization. Thanks for joining us. See you next time.

Mike: See you next time.

Visit MHACO’s Understanding Value-Based Care website.