Jared S Taylor (00:01.474)
Hey everyone. Thanks so much for joining me on the Bring Care Home podcast. I'm your host Jared Taylor. Joining me today we have a very special guest, the Senior Director of lifestyle medicine at Blue Shield of California, Angie Kalousek Ebrahimi.
Angie Kalousek Ebrahimi (00:05.59)
Thank you.
Angie Kalousek Ebrahimi (00:16.39)
Hi there. Hey Jared, how are you? And you said my name perfectly, so great job.
Jared S Taylor (00:16.556)
Angie.
Jared S Taylor (00:21.102)
It's almost like I didn't just say it five times in a row. Right? That's wild. No, you have a, that's a really cool name, by the way. It's a pleasure to have you on right now. Been following you for probably the last couple of months. I saw some of your talks and some of the posts that you put up online. And I'm like, we need to have Angie on the show. It's called Bring Care Home, but it really just encompasses, you know.
Angie Kalousek Ebrahimi (00:23.255)
Hahaha!
Angie Kalousek Ebrahimi (00:29.245)
Thank you.
Jared S Taylor (00:49.498)
how we view care is a big part of it is in the home and then you go to the various places that you need to, but it's about building the right habits, right? And promoting a healthy lifestyle. So we are so excited. You're the right person to have on. Let's kick things off. Tell us about yourself.
Angie Kalousek Ebrahimi (01:01.347)
Thank you.
Angie Kalousek Ebrahimi (01:06.018)
Absolutely. Well, first of all, thanks for having me, Jared. Excited to be here. OK, well, so Angie Kalousek Ebrahimi, Senior Director of Lifestyle Medicine. What does that mean? I'm at Blue Shield of California. I've been there for about 13 years. My role leading the lifestyle medicine work at Blue Shield of California is to primarily oversee.
all of the lifestyle-based solutions that we offer to our population, kind of cross-line of business. And in the most, I said probably the biggest scaled way that we do that is through the platform that we offer, which is called WellVolution. So WellVolution has kind of a whole host of digital and some in-person solutions as well to help people prevent, treat, and reverse.
chronic conditions and other conditions. So right now we have a full diabetes prevention network. We have a weight management network, diabetes treatment and reversal and hypertension. So all of kind of the cardio metabolic chronic conditions that are so prevalent in our nation. We also have a mental health network and really kind of focusing more on the lower acuity mental health.
issues that people have stress, sleep, need for meditation, and then kind of that lower level like depression and anxiety that can be treated through digital means. We are also just about to launch a musculoskeletal network, which I'm really, really excited about. We have a tobacco cessation set of solutions for people to help.
kick that habit and we are continually growing, right? We are always looking for new solutions to add to the platform and kind of round out and make sure that we have something for everyone. I also oversee health education for our Medi-Cal line of business. So we have a team of health educators that
Angie Kalousek Ebrahimi (03:12.821)
do one-on-one coaching as well as classes for our Medi-Cal population. And they sort of need a little bit more of a high touch approach. And so it's really, really awesome to see them in action with our members.
Jared S Taylor (03:30.318)
That's a lot of hats.
Angie Kalousek Ebrahimi (03:32.569)
It's a few. It's a few hats. But none of them say slice of healthcare. So I you know, I feel robbed by that.
Jared S Taylor (03:38.038)
Oh, I like what you did that. Yeah, it's, I probably wear this hat way too much. I was telling someone today, I've done a couple of these. So there's an imprint where the little, you know, ball at the top is. It's like stuck in my head right now. That's funny. You talk about always looking for, you know, new solutions.
Angie Kalousek Ebrahimi (03:44.995)
Hehehehe
Angie Kalousek Ebrahimi (03:49.397)
Hehehehe
Angie Kalousek Ebrahimi (03:55.646)
I love that.
Jared S Taylor (04:01.566)
Are those primarily only internal or what does it look like in terms of also collaborating with external company? This is I always hear it from the other side, right? Everyone wants to work with you know, the blue shield of California's of the world, right? What does it look like? So obviously you do have your own internal solutions, but what does it take for? Organizations that also you know, you decide to partner with what does that look like?
Angie Kalousek Ebrahimi (04:15.623)
Yeah.
Angie Kalousek Ebrahimi (04:27.025)
Yeah, actually Jared, we have the WellVolution platform is made up of external solutions. So it is all digital apps that we have worked with. So we partner with Solera Health and Solera Health helps us kind of aggregate all of those different point solutions and we can bring them to our members in one kind of cohesive platform, which is called WellVolution. So we have lots of different.
apps and point solutions that we're working with. We're always looking for new ones. And generally, we do that through Solera Health. So come to us, come to Solera, that's how you get to work with us. And how we choose you is that you have clinical outcomes that are a result of the interventions that you're doing, you being the app, right? So yeah, always looking for new and fresh energy to bring to the platform.
Jared S Taylor (05:24.374)
does it get exhausting sometimes of hearing from so many? Because what I see is a lot of companies, before they're ready to work with you, also want to work with you, right? So at what stage, because I was just on a panel with, at Tampa General Hospital, with a few of the folks there, and we were talking about, when it comes to outside solutions and partnering, security being at the forefront, right? But at what stage, like,
Angie Kalousek Ebrahimi (05:29.01)
I don't know.
Angie Kalousek Ebrahimi (05:32.649)
Yeah. Yes.
Jared S Taylor (05:52.403)
Is there openness to work with early stage companies? Or you like, you have to be more established if we're gonna work with you.
Angie Kalousek Ebrahimi (05:58.995)
I think we love the energy of early stage solutions, but I think it would be very difficult for us to, for lack of a better word, sell it upstream to our leaders if there is no proven clinical solutions or cost of healthcare savings. And I...
I think that this is actually one of the things, you know, I know you and I, when you and I chatted before this, we talked about challenges that we have in this arena. And I think one of the biggest challenges that we face in prevention and in lifestyle and in the treatments that we are serving up to our members is that a lot of times the ROI is delayed.
So you are avoiding a future chronic condition, or maybe you are mitigating a disease that will over time reduce your cost of healthcare. So I think this is one of the biggest challenges of lifestyle and prevention programs is figuring out a way in the industry where we have a way to quantify what the benefit is without it being like,
the traditional straight up ROI calculation. And then I think the other thing that we need to think about is we partner all of the providers in our network are on a pay for performance model. So to some degree that gives us a little bit more of an ability to partner with early stage solutions because we can say, look, we're only paying you if you actually deliver outcomes. So if you wanna put your money where your mouth is, then.
we have the ability to say we can give you a try, you know, provided we're on the same page with what the offering is.
Jared S Taylor (07:54.146)
Super interesting. And thank you so much for sharing those insights. I wanna shift back to you a little bit now, because when we were putting together some questions, I found this really interesting. So you come from a family of health practitioners. I love these type of stories too, because it seems like in healthcare, like just because like you had family members in other industries doesn't mean that like inspired you to stay in that industry. In healthcare, I feel like that's been the case more often than not. How...
Angie Kalousek Ebrahimi (07:57.908)
Yeah.
Angie Kalousek Ebrahimi (08:11.401)
Okay.
Jared S Taylor (08:23.842)
How did you coming from a family of health practitioners, how did this influence your perspective on health and wellness moving forward?
Angie Kalousek Ebrahimi (08:33.597)
Yeah, so my father was a doctor, my mom was a nurse, my sister is still a practicing physical therapist. And when I actually started my career journey, you know, graduated from college and everything, I was like, I am not getting anywhere near healthcare, I'm going to do something totally different. And then I won't give you the whole, you know, long version of the story. But like, many years later, business landed me in.
healthcare and healthcare administration. And it felt like home, which was really, really interesting for me, just from an emotional standpoint. I think growing up in a family like that, you see the good, the bad, and the ugly. And I think that that's a really interesting perspective because what I learned was, there are a lot of things in healthcare that are not working, and there are a lot of things that are working. There's a lot of...
wonderful practitioners out there that, you know, their whole heart is about healing and helping people. And yet I know, you know, my father would always say, like, I don't have time to see people for the length of time that I need to give them the care that I want to give them. So and he felt very burnt out by that, by sort of the system and the churn. I think the other thing that became very clear to me living in that environment is that
The healthcare system that we have, and this is not a new concept, it is sick care. It is not healthcare. It is absolutely waiting until the problem happens and then trying to do the best we can to like salvage the situation. We need to get much farther upstream. And I think that's one of the reasons I developed such a passion for the lifestyle space. And that being the, you know, I think...
often the most clinically effective, definitely the most cost effective and sort of least risky solution out there.
Jared S Taylor (10:36.878)
We're gonna stay on the topic of you because I found this, and I think Blue Shield's so lucky to have you as part of the team because of these past experiences and your outlook. When doing research before this episode, I noticed that you were the wellness director at Visa, which is super interesting, right? Like people, credit card company, but I mean, it makes sense. I wanna know, cause obviously that was another large company, right? How did that?
Angie Kalousek Ebrahimi (10:40.265)
Yeah.
Angie Kalousek Ebrahimi (10:59.187)
Yeah.
Jared S Taylor (11:06.546)
experience kind of shape your perspective on corporate wellness and its impact on the employees health.
Angie Kalousek Ebrahimi (11:14.921)
Yeah, well, I think one of the things that was kind of notable about working with Visa is that it was, is the timing of when I was there, which was like 2008, nine, like kind of right around that time. And that was the era in which workplace wellness was becoming a thing, right? Like people were starting to do it. Um, but one of the things that I learned.
partly by being at Visa is that the way that people were doing workplace wellness back in that timeframe was entirely the wrong approach. It was health risk assessments, it was biometric screening, so it was getting a lot of data, a lot of information about your own biometrics, but there was no behavior change. There was no interventions available to people.
Once they learned, okay, I just did my blood work. I found out I'm pre-diabetic. What do I do about that? And then there was nothing available. I just sort of fell into this black hole. So that's one of the things that I learned about being at Visa. And that in large part led to how Blue Shield of California, once I started and among many others on the team working on it.
really evolved how we were looking at wellness, behavior change, and eventually what we now call lifestyle medicine, which is really using lifestyle as a first line therapeutic intervention. I think the other thing that I learned is that we spend a lot of time at work, and it was especially true then, we were going into the office on a daily basis that
corporations and workplace and the culture of work place that you come from can have a pretty big influence on, um, how you think about healthcare, self care, well care, whatever you want to call it. So, so there is a definitely an opportunity particularly for large employers, but really small employers as well, um, to help and, and move the needle in the space.
Jared S Taylor (13:38.014)
So it's so interesting how past experience continue to shape our my favorite I used to I mean you being in California We'll pull a Steve Jobs quote out though, right? Like you can't connect the dots looking forward You can only connect them looking backwards and when you look at your journey, right and you kind of connect those dots It's it's really cool how that shapes your experience today
Angie Kalousek Ebrahimi (13:42.313)
Yeah.
Angie Kalousek Ebrahimi (13:52.437)
True.
Angie Kalousek Ebrahimi (13:56.837)
It's funny, I hadn't ever thought of it that way, but it is very, very true. And it creates this really beautiful picture and this continuum. And it makes me excited to think about, like, where we're going, like what comes next. So I love that.
Jared S Taylor (14:12.086)
I looked back the other day, just with like being more in media now and doing these podcasts interviews. And I was like, what really like stem that interest? And I used to go out my first job in college during my lunch break, I used to call up startups and do interviews over the phone in my car. And I started looking back. And it's just funny how it like it comes back because I didn't do this for a number of years and then came back to it. But I just I really enjoy first and foremost learning about the person.
Angie Kalousek Ebrahimi (14:30.645)
I'm not gonna lie.
Jared S Taylor (14:42.098)
and kind of what motivates them, why are they in this field? And then secondary, the company they're at, what they're building, why they're building it, and then really the big opportunities that exist. So that's my next question for you leading into that. I know a big focus for you is food is medicine. It seems like that term, it's been something for a while, it seems like that term has been used not quite as much as AI over the last.
two years, but I hear it all the time now. And I mean, you look back at the health conference this year, they actually had a whole food is medicine section. Yeah, yeah, like a whole section, like wild. So let's talk about that. Biggest opportunities in food is medicine through your perspective.
Angie Kalousek Ebrahimi (15:14.521)
Yeah.
Angie Kalousek Ebrahimi (15:20.508)
Summit. Yeah.
Angie Kalousek Ebrahimi (15:30.317)
Yeah, well, I think as you say, everyone is using this term, food is medicine, food is medicine. Let's implement food as medicine. So I think we first need to become very clear on what food as medicine is, what is the definition. And so as we say it, we should also say it with the definition to make sure when we're talking to one another that we're talking about the same thing. Food as medicine can be a number of different things.
It can be incorporating healthy food into post discharge instructions or post discharge benefits. It can also be including food in interventions that are available, already available for all members. It can also be including food.
for within protocols for people who are food insecure. And I think that there is definitely applicability in all situations. Like I think we should do them all. And if I had a magic wand, I would make that happen. So your question is, what are the biggest opportunities in food is medicine? And from my perspective, I think one of the biggest challenges and therefore one of the biggest opportunities is that no one has figured out a way to pay for this.
right now food is not a claim, right? We can't bill a claim, there's no claims code that says food. And so that I think more at a global level, at a policy level really does need to change that food associated with some kind of chronic care intervention should, and you know, can and should be covered. It's something that we are working on at Blue Shield of California, very, very
tenaciously trying to get to this point. But I think that's the biggest hurdle that we've had. And actually, you know, we sit on like a symposium of food as medicine folks across the blues organizations. And this is exactly what they're saying is we run out of money. So we have this budget that we assign to food for a food as medicine effort. But as soon as that budget runs out,
Angie Kalousek Ebrahimi (17:58.101)
we're done, right? Like the effort is over. It needs to be tied to a claim where it can be utilized and scaled in that manner.
Jared S Taylor (18:09.662)
Yeah, I think there's so many things in healthcare that maybe we wanna see changed, but then you think through it at a level that you're talking about. Like there's not even a code for it, right? Like so there's steps that need to happen before we start to do other things in healthcare. It's just, and it's complex, right? It's not an easy thing to solve. Angie, I would love to, as we wrap up here, talk about what you can.
Angie Kalousek Ebrahimi (18:29.205)
It is.
Jared S Taylor (18:38.155)
some of the exciting initiatives that you're working on as it relates to Blue Shield of California.
Angie Kalousek Ebrahimi (18:44.005)
Yeah, absolutely. I think one that I always put as like as a goal for myself every year is just growth. So we need more people to be utilizing the programs that we offer. We have a lot of really, I think, great and exciting marketing efforts that we're going to be launching this year. I think that's really, really exciting.
I'd love to see a million of our members using WellVolution programs. Like that to me would just be, that is kind of like a goal that I have out there for me and my team. I think the other thing that I really am excited about is, well, excited about and not excited about is, is GLP-1s and what we do with them. So I think GLP-1s is a really scary concept for,
health plans because right now, some health plans are covering, some are not. There's not really a generalized accepted approach to how to deal with GLP-1s, but the one thing that we all know is that they are extremely, extremely expensive. And I think we can also all agree based on the clinical studies that there are a plethora of side effects that...
come from the drugs and the side effects have a very, very high impact on medication adherence. And GLP-1s are drugs that once you start taking them, the efficacy is going to go away if you stop taking them. So I think that the takeaway is GLP-1s will cause side effects more than likely, and if you stop taking them, the effects will be gone. So you have to either.
take them and deal with the side effects forever and pay the price or go off of them. We are doing a pretty big push this year to inform everyone that has applied for a weight loss medication through Blue Shield of California to steer them instead to our weight management programs in Well Volition. The idea is that if we can get them to try to do this through lifestyle,
Angie Kalousek Ebrahimi (21:10.697)
that they will have success and they will decide that they can do this without that potentially unpleasant side effects that they're going to get from the GLP-1. So I'm really, really excited that we're going to take this approach and direct our members to Wellvolution for GLP-1s.
We have some other stuff we're doing in 2024, but I can't talk about it yet. So you're just going to have to follow our journey. And as soon as soon as we have them ready and available, I will let you guys know. I will also say there's one other program that we just very recently launched, which I'm excited about. And this is the Ornish Lifestyle Medicine program. So Dr. Dean Ornish has created an intensive
lifestyle change program, behavioral, cardiac rehabilitation programs. I was like, what's the real term, cardiac rehabilitation? And he's been doing this in hospitals for many, many years. And he has now launched a virtual program, which we at Blue Shield of California made available to our members this month. So we just announced that, we're really excited about it.
It means that people don't have to be near a hospital to participate in the program. They can participate from the comfort of their own home.
Jared S Taylor (22:42.59)
Love it. I love it. Angie, love your energy. I'm so glad we were able to have you on. And let's continue the conversation in the future. We'd love to have you back on, and we can kind of talk about some of these things. The part you gave us actually quite a bit, so we appreciate that, but the stuff that you couldn't talk about today, I look forward to being able to be updated on that in the future.
Angie Kalousek Ebrahimi (22:48.253)
Thank you. So fun to be here.
Angie Kalousek Ebrahimi (23:05.705)
Let's do it. Thanks, Jared.