The Other 80

There’s a lot of hand wringing right now about healthcare affordability, but not enough action. Paul Markovich, the CEO of Blue Shield of California, is on a mission to bring down health costs by reducing administrative overhead and negotiating lower drug prices. In this episode we dive deep into Paul’s call to action for healthcare leaders to tackle the affordability crisis head-on. Paul and I discuss:How Blue Shield slashed the cost of arthritis drug Humira, by offering a biosimilar at 25% of the costWhy reducing healthcare  costs is critical to averting a national economic crisisWhether we need a new national mandate for health data sharingPaul’s advice on tackling fear and being a brave leaderPaul says healthcare affordability isn't just a pocketbook issues for patients, it’s also a huge economic issue for the nation:“The reality is we are facing a huge affordability crisis, a fiscal crisis right now. Even though our economy is running pretty much at or near full employment, we have record fiscal deficits… We cannot keep spending on this program the way that we are. We need to bring the spending down... Even our dysfunctional political system is going to have to deal with that.”Relevant LinksCalifornia’s new data sharing law Announcement of new Humira biosimilar Investment in nonprodit Civica for lower cost genericsNew prior authorization platform with SalesforceAbout Our GuestPaul Markovich is Chief Executive Officer of Blue Shield of California, a nonprofit health plan with $25 billion in annual revenue serving 4.8 million members in the state's commercial, individual, and government markets. Markovich has launched and led numerous initiatives to drive innovation and help reimagine healthcare, including funding support for a statewide provider directory to make it easier for Californians to find physicians and facilities in their plan; supporting development of a statewide health information network for patients’ records, enabling more seamless and holistic care; and investing in a partnership with the California Medical Association to help physicians pilot new care delivery models and leverage technology.Markovich is a North Dakota native and Rhodes Scholar with a master’s in Philosophy, Politics and Economics from Oxford University. He is a graduate of Colorado College, where he earned a Bachelor of Arts in International Political Economy and played Division I hockey.Source: https://www.blueshieldca.com/en/home/about-blue-shield/corporate-information/leadership/paul-markovichStay InformedSign up for The Other 80 Newsletter to receive a monthly update with reflections, news, events, jobs and funding curated for you by Claudia. Click here to sign up.

On so many issues, Congress has not been willing or able to act. But when faced with horrifying stories of death and mismanagement, Congress finally passed legislation to reform the US organ transplant system. They did so because people like Donna Cryer, a transplant recipient and patient advocate, demanded a better system for Americans who need lifesaving organ transplants. Now, as the new law moves into implementation, the work continues. In this episode, Donna and I discuss:The new legislation that is breaking up the deadly organ transplant monopolyHow ignoring the expertise and insights of patients dooms us to slow progress making healthcare safer and better Her advice for young people: “take your shot”Donna says we all need to start listening more closely to patients with lived experience:“I often think if you... had many people with great deals of experience and intelligence who were highly motivated to help you achieve your goal. Why would you not want to use them? Why would you not want to partner with them? Why would you work really, really hard to keep them away from solving the problem? And that's how people treat patients and patient advocates.”Relevant LinksDonna Cryer’s testimony to the Senate Finance Committee on organ transplant system failures (just past the 48:00 mark)Summary of the new law to break up the organ transplantation monopolyMore about the Global Liver InstituteSee more details about the Advanced Advocacy Academy Donna's organization launchedVisit UNOS’ websiteAbout Our GuestDonna R. Cryer, JD is the Founder and former Chief Executive Officer of Global Liver Institute, the only patient-driven liver health nonprofit operating across the US, EU, and UK. GLI convenes the NASH, Liver Cancer and Pediatric and Rare Liver Disease Councils, as well as the Liver Action Network, collectively more than 200 organizations.Mrs. Cryer has channeled her personal experience as a patient with inflammatory bowel disease and a 29-year liver transplant recipient into professional advocacy across a career in law, policy, consulting, public relations, clinical trial recruitment, and nonprofit management. At GLI, Mrs. Cryer has raised more than $10 million for liver health initiatives. She is a frequent speaker on the topic of patient-centeredness and patient engagement in healthcare transformation and created a unique model for advocacy that mobilizes patients, influences policy, and coalesces clinicians to improve patient outcomes.Mrs. Cryer serves on the Boards of Directors for the Council of Medical Specialty Societies, Sibley Memorial Hospital/Johns Hopkins Medicine, the Innovation and Value Initiative (IVI), and the Clinical Trials Transformation Initiative. She was the first patient to serve on the ABIM Gastroenterology Specialty Board, was one of the founding members of the AASLD Patient Advisory Committee and is the Community Representative on the AASLD NASH Task Force. She has been named one of the Top Blacks in Healthcare by the Milken Institute at GW School of Public Health and BlackDoctors.org, one of the Top 10 Patients Who Make An Impact by Health 2.0 and one of PharmaVoice’s 100 Most...

Dr. Theresa “Terry” Cullen is on a mission to make Pima County, Arizona one of the healthiest counties in the nation. It’s a challenging goal, and one that will take dedication and a willingness to fight for what’s right. But, Terry is a self-described, life-long pugilist – with an approach to healthcare that goes beyond policies and programs. Everything she does is rooted in her deep belief in accompaniment; that her role is to walk alongside her patients and community offering empathy, dignity and respect. We discuss:Her work as a rural doctor with the Indian Health Service Deploying to West Africa in 2014 for the Ebola crisisWhy the VA and DOD could not agree on electronic health recordsHer commitment to make Pima county one of the healthiest in the nationTerry reminds us that sometimes we need to step back and look at the work we do through a new lens:“My husband's an artist, and he challenges me all the time to look at something and look at the light. Look at the composition. Look at where it is. What's the pattern there? You know, and a lot of medicine is based on pattern, but think of a disruptive pattern. Think of a puzzle where the piece doesn't fit and what do you need to do to make that piece fit? Because if it falls into place, maybe the whole thing will heal.”Relevant LinksDefinition of pugilistResolve to save lives - 717 allianceHealthy Pima Indicators About Our GuestTheresa Cullen is currently the Public Health Director of Pima County, Arizona. She has developed a strategic approach to transformational health status change with a goal of health equity through supporting a learning public health system model based on data and action. She continues to work closely with Tribal, federal, state and local partners to ensure that community needs are integrated into planning with a goal of health justice. Dr. Cullen, RADM (retired) USPHS, began her family medicine clinical career with Indian Health Service (IHS) and worked in leadership positions for 25 years with American Indian/Alaska Native communities with a goal of improving health status through innovation and data informatics. Dr. Cullen worked as the Chief Medical Information Officer for the Veterans Health Administration from 2012-2015 and Associate Director of Global Health Informatics at the Regenstrief Institute. She has been honored with multiple local, state and national awards including the USPHS Distinguished Service Medal, the University of Arizona Medical College Alumni Award, and the AMIA Don Detmer Award for informatics health policy contributions.Source: https://academyhealth.org/about/people/theresa-cullen-md-msStay InformedSign up for The Other 80 Newsletter to receive a monthly update with reflections, news, events, jobs and funding curated for you by Claudia. Click here to sign up.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and

With the election just days away, Larry Levitt joins me to discuss where Harris and Trump stand on key health issues: reproductive health, affordability and Medicaid. While health has not taken center stage (as  it has in the past), the outcome of this election will have profound impacts on every aspect of health in the years ahead. We discuss:What's at stake in the electionWhy medical debt and drug prices are key affordability issues to watchThat single issue abortion voters are now Democrats, not RepublicansWhether we could see bipartisan progress on AI governance, long term care or PBM reform over the next four yearsLarry reminds us that health IS an economic issue:“People think of the economy and health care being separate issues, but they're In fact, not separate issues at all. I mean, we spend an enormous amount on health care. A lot of people's household budgets go to health care. So, you know, when you talk about an economic issue, health is an economic issue, issue for people.”Relevant LinksKFF panel: What the 2024 election could mean for health coverage, affordability and the budgetKFF election 2024 pageHow medical debt is the canary in the coal mine for health affordability [article]Project 2025Abortion-related state ballot measuresAbout Our GuestLarry Levitt is the executive vice president for health policy, overseeing KFF’s policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women’s health, and global health. He previously was editor-in-chief of kaisernetwork.org, which was KFF’s online health policy news and information service and directed KFF’s communications. Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, working on the development of the Clinton Administration’s Health Security Act and other health policy initiatives. Earlier, he was the special assistant for health policy with California Insurance Commissioner John Garamendi, a medical economist with Kaiser Permanente, and served in a number of positions in the Massachusetts state government.Levitt holds a bachelor’s degree in economics from the University of California, Berkeley, and a master’s degree in public policy from the Kennedy School of Government at Harvard University.Source: https://www.kff.org/person/larry-levitt/ Stay InformedSign up for The Other 80 Newsletter to receive a monthly update with reflections, news, events, jobs and funding curated for you by Claudia. Click here to sign up.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and...

How do you create a healthier city? As the climate shifts, screens dominate our lives and cities continue to grow - urban areas are grappling with how to put themselves on a better track to health. New York City Health Commissioner Dr. Ashwin Vasan joins The Other 80 to talk about his ambitious plan to increase health in the Big Apple, with the goal of increasing life expectancy from 78 to 83 years. We discuss:What Paul Farmer taught him about rejecting a scarcity mindset and reaching for bold goalsThe three cross-cutting challenges addressed in the Healthy NYC agenda: access to primary care, mental health and climate changeWhy NY issued a public health advisory on teen social media use and is suing Meta, Tik Tok YouTube and SnapChatAshwin shares why youth social media use is such a major public health priority:“ Our kids are hurting … Fifty percent of teens are saying that they are either moderately or severely depressed …It's hard to ignore the role that digital media and social media is playing … And what we found was pretty troubling …The more time you're spending on social media, the worse your self -reported mental health is. Whether it's symptoms of depression, anxiety, hopelessness, fear for the future.”Relevant LinksArticle: “Using Law to Advance Population Health Management”The City of New York’s Advisory on Social MediaMore information on Healthy NYCViral Video of “Dancing Guy”About Our GuestDr. Ashwin Vasan is the 44th Health Commissioner of New York City. He is a practicing primary care physician, epidemiologist and public health expert with nearly 20 years of experience working to improve physical and mental health, social welfare and public policy outcomes for marginalized populations in New York City, nationally and globally. Throughout his career, he has brought in a unique, unparalleled focus to combating the mental health crisis, releasing a comprehensive citywide mental health plan addressing the second pandemic – a crisis of mental health plaguing youth, vulnerable New Yorkers with severe mental illness, and those impacted by the overdose epidemic. Having begun his career in global health working at Partners in Health and the HIV Department of the World Health Organization, he most recently served as the President and CEO of Fountain House, a US-based mental health nonprofit. He currently serves as faculty at the Columbia University Mailman School of Public Health and Vagelos College of Physicians and Surgeons.Stay InformedSign up for The Other 80 Newsletter to receive a monthly update with reflections, news, events, jobs and funding curated for you by Claudia. Click here to sign up.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and

In July, US Surgeon General Dr. Vivek Murthy issued a landmark advisory declaring firearm violence a national public health crisis. The advisory builds on decades of work from Dr. Megan Ranney and other researchers who advocate taking a public health approach to reducing firearm violence. She joined us at Aspen Ideas: Health to discuss what this means: namely moving from a focus on law and order to centering harm reduction and prevention. Now, as the Dean of the Yale School of Public Health, Megan is applying the same systems thinking approach to focus on the big changes we need to drive health in the US.We discuss:What it means to be a great public health communicatorHow public health approaches were used to dramatically reduce automobile deaths over the last 50 years, and how the same strategies should be used now to tackle firearm deathsHer take on bridging the gap between medical care and public healthMegan says this is the moment for public health reinvention:“This is a moment where we get to reinvent how we study, teach, and most of all, practice public health, not just locally, but also globally, as we come out of the COVID pandemic, and I think there's a real moral clarity, but also a moral imperative for us, as public health professionals, to seize this moment, to take this kind of pivot point that we're at as a field, and to move it forward in a direction that we will be proud of.”Relevant LinksMegan Ranney testimony on gun violence as a public health issueGun violence panel at Aspen Ideas: HealthSurgeon General advisory on firearm violenceYale Q&A with Dean Megan RanneyCommon health coalitionBipartisan Safer Communities Act UC Berkeley School of Public Health course on urban gun violence preventionMore on Rahimi caseAbout Our GuestDr. Megan L. Ranney is an emergency physician, researcher, and national advocate for innovative approaches to public health. In July 2023, she joined Yale University as Dean of the Yale School of Public Health, where she is also the C.-E. A. Winslow Professor of Public Health. Her research focuses on developing, testing, and disseminating digital health interventions to prevent violence and related behavioral health problems, and on COVID-related risk reduction. She has held multiple national leadership roles, including as co-founder of...

Deena Shakir is an investor who is obsessed with expanding access to the basic health services people need and often can’t access: pediatric care, community health and women’s services. Her journey to investing passed through policymaking, journalism and big tech and her early techno optimism has given way to a much more nuanced and pragmatic view. She is able to see the big opportunities for impact hiding in plain sight.We discuss:The two obvious megatrends hitting healthcare: GLP1s and AIAnd the not so obvious opportunity: doing basic things betterHow Dobbs was an accelerant, not a deterrent, for investments in women’s healthWhy Public Health is great training for healthcare foundersDeena is excited about “asset light” investments that combine new care models – like community health workers – and technology:“There are some things that won't change. And there are things that hopefully tech can help to navigate. And so these asset light models, these models that are leveraging under leveraged care workers – like community health workers that are providing culturally competent care – and at the end of the day, that are improving metrics and outcomes, are the ones that get me excited.”Relevant LinksLux CapitalJonathan Haidt article in The Atlantic titled “Why the past 10 years of American Life have been uniquely stupid”President Obama’s Cairo speechARPA-H Sprint for Women’s HealthHealth companies Deena mentions that she invests in:WaymarkSummer healthMaven Clinic About Our GuestDeena's investments span stages and sectors, and include women's health, digital health infrastructure, health equity, foodtech, and fintech. Above all, she seeks out extraordinary, often underdog, founders on a mission. Prior to Lux, Deena was a Partner at GV (formerly Google Ventures), led product partnerships at Google for health, search, and AI/ML, and directed social impact investments at Google.org. Deena also served as a Presidential Management Fellow at The U.S. Department of State under Secretary Clinton, where she helped launch President Obama’s first Global Entrepreneurship...

Government systems often take a lot of flack for their (sometimes) built-in inability to take risks and make big bets. So, what would it take to encourage the government to take those big, risky moonshots? For Health, that’s the role of ARPA-H – to fund new ways of improving health by investing in people with big ideas. We sat down with ARPA-H Director Renee Wegrzyn at Aspen Ideas Health to talk about how it’s going and what comes next. We discuss:Why ARPA-H is personal for President Biden.How ARPA-H’s special authorities – from flexible hiring to novel contracting – are its secret weapons for speed and scale.The critical role of Program Managers – single decision maker driving the vision and execution of each $50-$200 million initiative.Renee says ARPA-H gives her the ability to direct funds into areas that are sometimes left off the list of “must haves” for innovation:“...one of the only top down things I've done as a director is said, ‘Why aren't we funding more in women's health? We don't have any program managers in the pipeline that want to exclusively focus on this’. But I think we all inherently understand that women are underrepresented in almost every aspect of health. So I asked our [Program Managers].. who wants to raise [a] hand and pick a topic that is really either unique to women, or is disproportionately affecting women that we can do a sprint and invest around. And so I got six Program Managers to come up with topics, everything from Women's Health at home, to brain health, to understanding and quantifying pain – and through the Investor Catalyst Hub we have worked with investors to understand what kind of convincing scale do we need to get to for you to be the second investor. And we competed this across the country.”Relevant LinksAbout ARPA-H ARPA-H Health Equity Factsheet The Minor Consult Podcast EpisodeARPA - H TimelineYoutube Conversation with New Yorker writerWhite House FAQ Sheet on ARPA-HAbout Our GuestDr. Renee Wegrzyn is the first director of the Advanced Research Projects Agency for Health (ARPA-H), appointed by President Biden on October 11, 2022. Previously, she was the Vice President of Business Development at Ginkgo Bioworks and Head of Innovation at Concentric by Ginkgo, where she focused on synthetic biology for combating infectious diseases like COVID-19.Wegrzyn has experience with DARPA and IARPA, the models for ARPA-H. At DARPA, she used synthetic biology and gene editing to enhance biosecurity and the bioeconomy, managing programs like Living Foundries, Safe Genes, PREPARE, and DIGET. She received the Superior Public Service Medal for her DARPA work. Her career includes leading biosecurity and gene therapy teams in private industry, developing immunoassays and diagnostics. Wegrzyn has served on various scientific advisory boards, including those for the National Academies and the Air Force Research Labs. She holds a Ph.D. and a bachelor's degree in applied biology from the Georgia Institute of Technology and completed...

The US is living through an affordable housing crisis - in fact, we are short millions and millions of affordable housing units. During the pandemic, homelessness flattened with an influx of resources to help keep people housed. But, those resources have long expired and now we are seeing an uptick in homelessness across the country. Jeff Olivet, the director of USICH (United States Interagency Council on Homelessness), says the problem is complex – but the math isn’t. We need more affordable housing. We discuss:Biden’s proposed budget, which includes guaranteed vouchers for every low income veteran and person aging out of foster careThe new frontier; pairing emergency response such as shelters with robust prevention strategiesHow prevention starts with helping families through periods of financial crisisWhat happens when heat crises turn deadly for people who are homelessJeff reminds us that the people affected most by the affordable housing crisis are those who have experienced trauma and domestic violence:“50 years ago, we still had domestic violence, we still had addiction, we still had mental illness, and we didn't have perfect systems to address that – but we had enough housing for everybody, and we did not see homelessness on the scale we see it today. So when we're responding to homelessness, it's critical to individualize support for people to make sure they have access to the care they need in terms of health and mental health and recovery and all of those important things. But if we don't solve the underlying structural stuff, the lack of affordable housing, the ongoing discrimination that people of color and LGBTQ people face in jobs and trying to buy a home or rent a home in the criminal legal system, in education, if we don't solve that underlying stuff, we're gonna keep seeing homelessness for a very long time to come.”Relevant LinksJeff Olivet testimony to Congress on strategies to reduce Veteran homelessnessFederal actions to increase housing supply and lower housing costs HUD-VASH vouchers to support homeless veterans USICH guidance document for healthcareArticle about the SCOTUS ruling About Our GuestJeff Olivet is the executive director of USICH. He has worked to prevent and end homelessness for more than 25 years as a street outreach worker, case manager, coalition builder, researcher, and trainer. He is the founder of jo consulting, co-founder of Racial Equity Partners, and from 2010 to 2018, he served as CEO of C4 Innovations. He has worked extensively in the areas of homelessness and housing, health and behavioral health, HIV, education, and organizational development. Jeff has been principal investigator on multiple research studies funded by private foundations and the National Institutes of Health. Jeff is deeply committed to...

California is the latest state to address healthcare affordability through cost growth targets. Elizabeth Mitchell – President and CEO of Purchaser Business Group on Health  – Joins us to discuss the nuts and bolts of the 3% cost growth target recently adopted by the state. Healthcare affordability is a big issue across the country. More than half of us skip or postpone care due to cost and medical bills are a leading cause of bankruptcy. Reining in medical costs is also how we’ll  free up resources for what we know works to build health in America: prevention, addressing the social drivers and fostering health in communities.We discuss:Two proven strategies to reduce healthcare costs: advanced primary care and effective specialty referralsWhy better consumer “shopping” is not the path to healthcare affordability How price transparency gives employers new tools to negotiate, and reveals troubling facts about purchasing intermediariesElizabeth reminds us how troubling it is that we don’t have clear prices in a sector that makes up 20% of the economy:“The idea that you can't find out what something is going to cost before you agree to it is outrageous. Name any other industry that refuses to show you a price. It is incredible to me that we are still fighting about transparency when it is 20 % of the US economy. I mean, this is a multi-trillion-dollar industry who feels no accountability to show pricing. So, I just think it is incredible that we do not have meaningful transparency yet.”Relevant LinksCalifornia’s Office of Health Care Affordability sets cost growth targetFederal hospital price transparency requirementsPurchaser Business Group on Health (PBGH) websitePBGH white paper on advanced primary careUS Department of Labor clarifies the fiduciary responsibilities of self-insured employers purchasing healthcareAbout Our GuestAs President and CEO, Elizabeth Mitchell advances Purchaser Business Group on Health’s (PBGH’s) strategic focus areas of advanced primary care, functional markets and purchasing value. Mitchell leads PBGH in mobilizing health care purchasers, elevating the role and impact of primary care, and creating functional health care markets to support high-quality affordable care, achieving measurable impacts on outcomes and affordability.At PBGH, Elizabeth leverages her extensive experience in working with health care purchasers, providers, policymakers and payers to improve health care quality and cost. She previously served as Senior Vice President for Healthcare and Community Health Transformation at Blue Shield of California, during which time she designed Blue Shield’s strategy for transforming practice, payment and community health. Mitchell also served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), a network...

The scope, scale and timeline of what California is trying to do with CalAIM is truly breathtaking. Two years after the launch of the ambitious program, which offers integrated medical and social care for California's 15 million Medicaid members, Dr. Palav Babaria joins us to discuss how it’s going and what comes next. Dr. Babaria is a primary care physician who leads quality and population health management for California’s Medicaid program, Medi-Cal. We discuss:Which community supports are used most, or least? One of the big learnings from CalAIM: the enhanced care management models that work for adults dont work for childrenHow Medi-Cal is leveraging health plans as the organizers of social care because that’s where the members areThe soon-to-be-released population health management service will address two big issues: standardized and equitable approaches to identifying high risk members and integrating state level benefits data, like for WIC Palav reminds us that CalAIM was built through listening:“Not everyone may know this, but CalAIM was generated from a statewide listening tour. Our previous state Medicaid director went around the state and literally asked communities… rooms full of plans, members, providers, what do you need from Medi-Cal that isn't working today? [The]  smorgasbord of recommendations is what turned into CalAIM … Listening to the community and responding to the community's needs is in the core DNA of this program.”Relevant LinksListen to our related episode “Reflecting on Year One of CalAIM with Jacey Cooper”CalAIM dashboard Population health management policy guide California and other states require managed care plans to reinvest in local communitiesNY waiver summaryAbout Our GuestDr. Palav Babaria was appointed Chief Quality Officer and Deputy Director of Quality and Population Health Management of the California Department of Health Care Services beginning in March 2021. She was formerly the Chief Administrative Officer of Ambulatory Services at Alameda Health System. In that capacity, she operationally and clinically oversaw 26 specialty clinics, four large primary care FQHCs, specialty and integrated behavioral health, and is responsible for all outpatient value-based payment programs. Prior to that role, she served as Medical Director of K6 Adult Medicine Clinic. She also has over a decade of global health experience and her work has been published in the New England Journal of Medicine, Academic Medicine, Social Science & Medicine, L.A. Times, and New York Times. Her areas of interest include ambulatory transformation in resource-limited settings, shifting to value-based care, and issues of gender in medicine. Babaria received her bachelor’s from Harvard College, as well as her MD and Masters in Health Science from Yale...

To achieve whole person care, we can try layering new social services on top of medical care. But Dr. Rishi Manchanda believes we should move further upstream and ask, what will it take to actually improve health in communities? From founding Rx the Vote to HealthBegins, Rishi is committed to building community social capital in America. We discuss:Why he created HealthBegins, which is now halfway to its goal of transforming equity in 250 communities by 2025How California is making practice transformation a foundation of whole person careRx the Vote and the important role of health organizations in voter engagementKaiser Permanente's health, housing and justice initiativeRishi thinks all public health students should study and know how to shift the political determinants of health:“I think we can recognize there's ways to… get the dollars out the door, get the services out the door, get the access that we need while [also building] local governance. And I think that's what I see as a really interesting opportunity for us in California… There are opportunities here for public health schools, including Berkeley, to [help] public health students… understand the political determinants of health and then understand their role [to]... address them and improve them.”Relevant LinksHealthBegins websiteRishi’s book The Upstream DoctorsRishi's TEDx Talk: "What Makes Us Get Sick? Look Upstream."New collaborative community health planning model in CaliforniaPolicy requiring California Medicaid health plans to invest 5-7.5% of profits into local communities California Medicaid investments in practice transformationKaiser Permanente's health, housing and justice initiativeOregon CCO modelAn interview with Rishi ManchandaAbout Our GuestDr. Manchanda is Founder and President of HealthBegins, a social enterprise that provides training, clinic redesign, and technology to transform health care and the social determinants of health. Dr. Manchanda is a dual board-certified internist and pediatrician, a board member of the National Physicians Alliance, and a fellow in the California Health Care Foundation’s Healthcare Leadership Program. He is the lead physician for homeless primary care at the VA in Los Angeles, where he has built clinics for...

June 18th is “Maya Petersen” day in San Francisco, in honor of her work building disease models that guided the region through the early days of COVID and saved countless lives. With projects spanning from developing HIV prevention strategies in East Africa to shaping new Medicaid models in California, the UC Berkeley epidemiologist is building a future where local public health leaders have the tools and data to ask and answer complex policy decisions in real time. Now that’s a world I want to live in.We discuss:How much better our pandemic response would have been if Public Health had access to integrated and linked dataHer work to bring sophisticated data tools to the point of decision in East AfricaHow California is building population management infrastructureSan Francisco’s Director of Health, Grant Colfax, taught her an important lesson about showing up and helping:“I remember… saying, ‘You know what? You really need to find somebody who's an expert in this, I'm not an expert in this.’ And he said, ‘Okay, Maya, but if you're gonna find me someone it needs to be in the next 24 hours, because I need help.’ And it was just a reminder that, you know, you're not always going to be an expert, sometimes you just need to show up, do your best… be clear about your uncertainty and communicate well, and that can be… a big service”Relevant LinksLocal Epidemic Modeling for the San Francisco Department of Public HealthSan Francisco’s COVID strategyMulti-sectorial Approach to HIV in East AfricaMaya Petersen Day in San FranciscoMaya’s UC Berkeley pageAbout Our GuestDr. Maya L. Petersen is Professor of Biostatistics and Epidemiology at the University of California, Berkeley. Dr. Petersen’s methodological research focuses on the development and application of novel causal inference methods to problems in health, with an emphasis on longitudinal data and adaptive treatment strategies (dynamic regimes), machine learning methods, adaptive designs, and study design and analytic strategies for cluster randomized trials. She is a Founding Editor of the Journal of Causal Inference and serves on the editorial board of Epidemiology. Her applied work focuses on developing and evaluating improved HIV prevention and care strategies. She currently serves as co-PI (with Dr. Diane Havlir and Dr. Moses Kamya) for the Sustainable East Africa Research in Community Health consortium, and as co-PI (with Dr. Elvin Geng) for the ADAPT-R study (a sequential multiple assignment randomized trial of behavioral interventions to optimize retention in HIV care).Source: https://publichealth.berkeley.edu/people/maya-petersenConnect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email

If there’s one thing politicians do little of these days it’s change their minds. But, that’s exactly what North Carolina’s General Assembly did in 2023. Ten years after the ACA was passed, and in a historic bipartisan move, they changed their minds and voted to expand Medicaid. NC Secretary of Health & Human Services Kody Kinsley joined us to talk about what it took to get this done and how it’s been going so far. We discuss:How to get stuff done in a politically divided stateOne move that would dramatically increase access to healthy food in America - automatically enroll all Medicaid beneficiaries in SNAP Why NC Medicaid has gone deep on peer to peer support for prenatal care and mental healthThe importance of building a better narrative about the role and value of public healthKody points out NC’s strategy of investing in community organizations is creating  both health and economic opportunities:“75% of our community based organizations are minority or women owned throughout those 33 counties. So, this isn't just about getting good access to what drives health in the long run. This is also about building that infrastructure and having a financing model that sustains it that is in the balance, a good value for the taxpayer.”Relevant LinksNC enrollment dashboardCrisis warmlineHealthy Opportunities pilots“NC Launches Additional Phone Support for People Experiencing Mental Illness or Substance Use Disorfer” [RELEASE]About Our GuestKody Kinsley serves as North Carolina’s Secretary of Health & Human Services, overseeing a department with over 18,000 staff and a $38 billion budget. With experience centered on health policy and operations, Kinsley worked on digital healthcare transformation, national education and labor policies, and served as COO and CFO of the U.S. Treasury. Secretary Kinsley’s three priorities for the department include: Investing in behavioral health and resilience, improving child and family well-being, and building a strong and inclusive workforce. Under his leadership, North Carolina expanded Medicaid and received the largest investment to bolster the mental health system in over a decade. Kinsley grew up in Wilmington, earning his bachelor’s degree from Brevard College and his master’s in Public Policy from the University of California at Berkeley. Source: https://www.ncdhhs.gov/about/leadership/kody-kinsleyConnect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams...

One thing is clear from the last four years: public health leaders need to seriously upgrade their skills in communication and partnering. In this episode Anne Zink, who is stepping down as Alaska’s Chief Medical Officer, brings us a master class in both topics.  Guiding the state through COVID she inspired both a Facebook fan group and the hashtag #ThinkLikeZink. Take a listen and you will see why.We discuss:How we might have avoided the politicization of COVID Partnering with Alaska’s tribes to get vaccines to every corner of the stateThe ways her background as a fine art major, mountaineer and emergency medicine doctor shapes her leadership approachAnne is committed to breaking the silos between medical care and public health: “Public health is population health and if you want to make a difference  … public health and health care have to be braided together. We need to not think about this in terms of separate systems, but we need to think in terms of patients and to get there, public health is that key chief strategist for population health and needs to be at the table.”Relevant LinksNPR Story on #ThinkLikeZinkArticle on the Five Reasons Dr. Zink is crushing it as a crisis communicatorAn interview with Alaska’s top doctorArticle on the rural Alaskan towns leading the country in vaccinationCase study on the partnership between public health and tribes for vaccine distribution in AlaskaInformation on the Watson FellowshipAbout Our GuestAnne Zink grew up in Colorado and moved through her training from College in Philadelphia to Medical School at Stanford and then Residency at the University of Utah. As a mountaineering guide she had fallen in love with Alaska and after residency in Emergency Medicine became lucky enough to call Alaska home. Not only does she love the people and the place, but also the medicine. She quickly became involved in helping improve systems of care as the medical director of her group, then in her hospital and with state and federal legislation, including state legislation to improve care coordination, opioid addiction treatment options, and integration between private systems and the VA, DOD, and IHS facilities and more.Dr. Zink became Alaska’s Chief Medical Officer in July 2019. In all the work she does, she strives to create work environments, policies and practices that are data-driven, foster collaboration and build system efficiencies that put patients first. Zink was a visible public presence in the early months of the pandemic,...

Today’s guest is Susannah Fox, author of Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care. The book is a deep dive into the expert network of patients, survivors and caregivers who are charting a new path of innovation and research. It is for anyone who feels alone, forgotten or lost in the shadows of suffering as they navigate a new diagnosis. But, it’s also for anyone working inside healthcare who is fed up with the status quo. We discuss:How patients – like those first affected by long COVID - accelerate solutions by making invisible problems visible That data liberation is often the foundation for patient rebel movementsThe pop up peer groups forming in Amazon reviewsA framework for understanding, and embracing patient expertise: seekers, networkers, solvers and championsSusannah reminds all innovators to talk with people living with rare and life-changing diagnoses: “If you are going to try to understand the intersection of healthcare and technology, you need to put down your clipboard – which is the classic status symbol of a survey researcher – and get out there and just talk to people. Talk to people especially who are dealing with rare and life-changing diagnoses, because those are the people who are going to use technology in ways that we can't even imagine.”Relevant LinksSusannah’s book Rebel HealthSusannah’s blog: Wow! How? HealthPatient-Led Research ScorecardsAn article about how patient-led research could speed up medical innovationA story about Tidepool Loop receiving FDA clearanceOpenAPS and #WeAreNotWaitingHugo Campos’s TedX talk about not being able to access his cardiac device dataGraphic used by Sarah Riggare to show the time spent in self-care for Parkinson’s diseaseAbout Our GuestSusannah Fox is a health and technology strategist. Her book, Rebel Health: A Field Guide to the Patient-Led Revolution in Medical Care, was recently published by MIT Press. She is a former Chief Technology Officer for the U.S. Department of Health and Human Services during the Obama Administration, where she led an open data and innovation lab. Prior to federal service, she was the entrepreneur-in-residence at the  Robert Wood Johnson Foundation. For 14 years she directed the health portfolio at the Pew Research Center’s Internet Project where she helped define a new market at the intersection of health, social media, and patient engagement.  Fox currently serves on the board of directors of Cambia Health Solutions of Portland, OR, and Hive Networks of Cincinnati, OH. She is an advisor to Alladapt Immunotherapeutics, Archangels, Article 27, Atlas of Caregiving, Before Brands, Citizen, Equip Health, Faster Cures, and the Lemelson Center for the Study of Invention and Innovation at Smithsonian Institution. Fox is a...

We'll be unpacking lessons from the COVID 19 pandemic for many years to come. Dr. Tomás Aragón, who leads public health for the State of California, joins us to discuss what he learned guiding America's most populous state through this challenging and disruptive period. We discuss:That public health’s deepest power lies in the ability to help diverse groups reach consensus under great uncertaintyHow California redeployed an army of census workers to support the COVID responseThe biggest opportunities to use AI for public healthThree great book recommendations: “How Emotions Are Made” by Lisa Feldman Barrett, “High Conflict” by Amanda Ripley and “Fifth Discipline” by Peter M. SengeDr. Aragón shared insights about leadership: “The other thing is to really appreciate the importance of human psychology. It is so incredibly important … You're going to come up against people who are going to “resist”. I don't think of it as resistance. I just think they're being human. That's just all it is. People have variability in how they process information … And so rather than seeing things as resistance, you really just see it as part of the diversity of ingenuity that exists in an organizational culture.” Relevant LinksDr. Tomás Aragón’s UC Berkeley Public Health profileDr. Tomás Aragón’s GitHub blogArticle on Bay Area pandemic response: The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area“How Emotions Are Made” by Lisa Feldman Barrett“High Conflict” by Amanda Ripley “Fifth Discipline” by Peter M. SengeAbout Our GuestDr. Tomás Aragón, MD, DrPH, has served as the director of the California Department of Public Health and the State Public Health Officer, since January 4, 2021. Prior to coming to CDPH, he was the health officer for the City and County of San Francisco and director of the public health division. Dr. Aragón has served in public health leadership roles for more than 20 years (communicable disease controller, deputy health officer, health officer, community health and chronic disease epidemiologist), including directing a public health emergency preparedness and response research and training center at the University of California, Berkeley School of Public Health.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn.

Using AI in healthcare comes with a lot of promise - but access to data, lack of clarity about who will pay for these tools and the challenge of creating algorithms without bias are holding us back. In 2023, TIME named Dr. Ziad Obermeyer one of the 100 most influential people working in AI. As a professor at UC Berkeley School of Public Health, and the co-founder of a non-profit and a startup in the AI healthcare space, his work centers on how to leverage AI to improve health and avoid racial bias. We discuss:The idea of a safe harbor for companies to discuss and resolve AI challengesHow his company Dandelion Health is helping solve the data log jam for AI product testingWhy academics need to spend time “on the shop floor”The simple framework for avoiding AI bias he shared in his recent testimony to the Senate Finance Committee Ziad says without access to the right data, AI systems can’t offer equitable solutions: “I think data is the biggest bottleneck to these things, and that bottleneck is even more binding in less well-resourced hospitals… When we look around and we see, ‘well, there are all these health algorithms that are in medical journals and people are publishing about them’. The majority of those things come from Palo Alto, Rochester, Minnesota [and] Boston. And, those patients are wonderful and they deserve to have algorithms trained on them and learning about them, but they are not representative of the rest of the country – let alone the rest of the world. And so, we have these huge disparities in the data from which algorithms are learning. And then those mirror the disparities and where algorithms can be applied.”Relevant LinksDr. Obermeyer’s profile at UC Berkeley School of Public HealthZiad Obermeyer’s testimony to the Senate Finance Committee on how AI can help healthcareMore about Nightingale Open ScienceMore about Dandelion HealthArticle on dissecting racial bias in algorithmsArticle On the Inequity of Predicting A While Hoping for B. AER: P&P 2021 (with Sendhil Mullainathan)About Our GuestDr. Ziad Obermeyer is the Blue Cross of California Distinguished Associate Professor of Health Policy and Management at UC Berkeley School of Public Health. His research uses machine learning to help doctors make better decisions, and help researchers make new discoveries—by ‘seeing’ the world the way algorithms do. His work on algorithmic racial bias has impacted how many organizations build and use algorithms, and how lawmakers and regulators hold AI accountable. He is a cofounder of Nightingale Open Science and Dandelion Health, a Chan Zuckerberg Biohub Investigator, a Faculty Research Fellow at the National Bureau of Economic Research, and was named one of the 100 most influential people in AI by TIME. Previously, he was...

Black women in the US are 3-4 times more likely to die than white women from a pregnancy-related cause and overall the US has the highest rate of maternal mortality in the industrialized world. These deaths are preventable.Dr. Monica McLemore, a Professor at the University of Washington School of Nursing, says we should stop blaming women for their own deaths and instead address the underlying social and healthcare drivers that impact pregnancy outcomes. In other words, we need to focus on the other 80.We discuss:The Momnibus, a comprehensive legislative package to improve maternal health in the US which has still not been passed into lawHow disruptive periods, such as the COVID-19 pandemic and Dobbs, provide opportunities to re-imagine maternal and child health in the USWhy community-centered research is essential for improving health equityMonica says we need to change our views on scientific evidence: “There is no way we're going to get … changes in health outcomes at a population level if you don't bring the social and the clinical together, it's just not happening. And so that requires a change in mindset of the scientific community about what is evidence, who generates evidence, who can contribute to evidence, what evidence is needed and what methods are we going to use to obtain said evidence? Because community is over extraction. They are over participating in studies and not getting anything back. They are over funding science as taxpayers and not being able to access it.”Relevant LinksCDC’s Report on Maternal Mortality JAMA Articles on trends in maternal mortality:https://edhub.ama-assn.org/jn-learning/audio-player/18796651https://jamanetwork.com/journals/jama/fullarticle/2806661?utm_source=podcast_platforms&utm_medium=referral&utm_campaign=related_article_linksSummary of JAMA webinar on maternal mortalityOp-Ed: How We Can Reimagine Black Maternal Health in the Changed Landscape of DobbsCentering the health of mothersTo Prevent Women from Dying in Childbirth First Stop Blaming ThemAbout Our GuestMonica McLemore is a preeminent scholar of antiracist birth equity research, community-informed methods, and policy translation. Dr. McLemore is a Professor in the Department of Child, Family, and Population Health Nursing at the University of Washington School of Nursing. She earned a bachelor’s degree in Nursing from The College of New Jersey in 1993 after declaring at eight years old that she would become a nurse. She has a Master’s in Public Health from San Francisco State University and a PhD in Oncology Genomics at the University of California, San Francisco. She’s worked her entire career in reproductive health, rights, and justice. Monica retired from active...

What is your just cause? Karen Dale is DC Market President for Amerihealth Caritas. She is a bold and fearless leader whose “Why” is to be a catalyst for change to promote equity and deeply support people encountering difficulties. In this episode she shares the leadership practices that support this work from sharing power, to community co-design and embracing disagreement on teams. We discuss:A powerful partnership with the Children’s Law CenterThe path to value-based payment for community organizationsThe future of public health education: providing the system, structure and culture that encourages every student to be a catalyst for positive changeHow DC is starting to address decades of under-investment in Wards 7 and 8 through its equity budget reviewKaren discusses the just cause for a school of public health in today’s world: “It would be to create … a system, structure and culture that infuses what every student needs to be a catalyst for positive change for human beings … [A] school that creates that culture, gives people the tools, gives them the encouragement, gives them the freedom to try and fail, but learn and apply – that would be amazing. Because … we need a whole generation of people who are in the fight.”Relevant LinksKaren’s commencement address to George Mason gradsNPR piece on partnership with Children’s Law CenterNew payment approaches for EPSDTGuidance for Health Care Entities Partnering with Community-Based Organizations: Addressing Health-Related Social Needs in Alternative Payment Models. [hcp-lan.org]About Our GuestKaren M. Dale is Market President for AmeriHealth Caritas District of Columbia, a mission-based Medicaid Managed Care Organization in Washington, D.C., and the Chief Diversity, Equity, and Inclusion Officer for the AmeriHealth Caritas Family of Companies. Her focus includes applying a health equity lens to impact all levels of policies, processes, decisions, laws, and outcomes for the communities AmeriHealth Caritas serves.She also leads a decidedly metric-driven business approach to mobilize leaders and accelerate strategies to advance diversity, equity, and inclusion inside and outside the walls of AmeriHealth Caritas. As a result, opportunities for people to experience health, wholeness, and belonging are enhanced by addressing the social, economic, and environmental conditions that are drivers of poor health.Her hobbies include gardening, creating healthy Caribbean recipes, traveling, and watching her son’s soccer games.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter...

We may be politically divided, but when it comes to healthcare there is actually a lot we agree on as a nation. We want healthcare that is affordable. We want a healthcare system that is easy to understand and navigate. We want to know we will receive good care when we need it most. These insights are something our guest Natalie Davis takes to heart in her work at United States of Care. She and her team are fighting hard to help create a more dependable healthcare system for diverse and underserved Americans. We discuss:Why we should never use the term “value-based care” ever again.Braidwood vs. Becerra: The court case that may eliminate free preventive services for half of all Americans.The double whammy of US healthcare: system failures and personal shame.How to nurture listening and belonging on a team.Natalie says before you start listening, you need to consider who is being failed by the healthcare system and prioritize hearing their stories:“If we look at something like maternal health – which is a work that we're doing right now – if you look at the data, it is women of color, especially Black women who are left behind and facing a real failure of our system, which is causing morbidity and mortality. And so, for our organization, we are listening loudly to Black women and we are talking to people in communit[ies], we are talking in focus groups to really make sure we understand those issues. Because, if the people who are not served by this healthcare system are listened to and then served it will make the healthcare system function better for all of us.”Relevant LinksUnited States of Care's websiteUnited Solutions for CarePatient-First Care (a.k.a. Value-Based Care) Messaging FindingsUnited States of Care Preventive Services Resource HubInsight Report from November 2023 The amicus brief United States of Care submitted on Braidwood vs. BecerraAbout Our GuestNatalie Davis has worked for nearly two decades shaping and implementing American health care policies to improve the lives of all people. In 2018, she and fellow national health care leader Andy Slavitt launched United States of Care to ensure that everyone in the country has access to quality, affordable health care regardless of health status, social need, or income. She is relentless in her person-centered approach to building health care solutions and has a history of building partnerships – with organizations, patient advocacy groups and everyday people – that work to create positive change in our country’s health care system. From 2010-2016, Natalie served at the Centers for Medicare and Medicaid Services, with the final two years as Senior Advisor to former CMS Administrator, Andy Slavitt. In 2017, Natalie served as the Director of Strategic Engagement at the Bipartisan Policy Center. A social entrepreneur, Natalie also helped found Town Hall Ventures and The Medicaid Transformation Project, both of which focus on bringing the best of innovation and care

The modern world, and the products we use everyday, are making us sick. But what if we could shift this trend and start to build health into everyday life? That’s exactly what Steve Downs and Thomas Goetz, co-founders of Building H, are working on. Steve, the former CTO of the Robert Wood Johnson Foundation, joins us to discuss how Building H is helping companies and designers re-engineer products and “product environments” so they improve rather than harm health.  We discuss:Shocking trends in American health: 48% of Americans are lonely, 35% dont get six hours a night of sleep and 60% of adult calories come from ultra-processed food.The mistake of thinking of our daily choices as “individual” decisions, when these decisions are profoundly shaped by our environments and the products we use.The Building H Index, which evaluates everyday products against five metrics of health: eating, physical activity, sleep, social connection, and spending time outdoors.Culdesac - A real-estate developer that is building “cities for people without cars”.Steve asks how we could broaden consumer product regulation to focus on broad health impacts, not just safety: "McDonald's is not responsible for all the food related chronic illnesses in America. But you might argue that they are, I don't know, 1.7%, responsible or 3.8% responsible …  I think we ultimately need to get to a place where if your product is leading to unhealthy behaviors, which is leading to illness and disease and cost, there may need to be some accountability for that." Relevant LinksBuilding H websiteBuilding H IndexAJHP paper on the product environmentDaniel Lieberman’s book on the history of the human body (no affiliate fee taken)Culdesac websiteHBS Impact-weighted accountsInternational Foundation for Valuing ImpactANNOUNCEMENT: Building H is seeking volunteers with a background in public health, healthcare or health policy to help build the Building H Index by rating products and services on their health impacts. If you’re interested in participating in a short scoring exercise, please go to this site for details and sign up https://www.buildingh.org/index/volunteer-signup About Our GuestSteve Downs works at Building H as a co-founder. Prior to his role at Building H, Steve was the chief technology and strategy officer at Robert Wood Johnson Foundation (RWJF) where he led a transformation of the Foundation’s practice of program strategy, putting in place an approach that is highly flexible and adaptive. Over his career at RWJF, Steve held a variety of management roles — including chief technology and...

Rural America is facing a healthcare crisis. Home to 60 million people, rural areas face a 23% higher mortality rate compared to urban locations due to lack of infrastructure, lower socio-economic status and provider shortages. Indeed, rural areas have half as many primary care providers and an eighth as many specialists as urban locales.In this episode, Homeward’s CEO, Jennifer Schneider discusses how her company uses remote monitoring, telehealth and a novel staffing model to re-architect care delivery in rural America with the goals of improving access and health outcomes.We discuss:Why Jennifer and her co-founder decided to make Homeward a B Corp.How Homeward uses technology and non-physician providers to expand access to care in rural America.Lessons from Homeward’s early rollout in Minnesota.Jennifer says we often underestimate how large the  rural healthcare market is:“I jokingly say [to] people when we started Livongo... we initially started in diabetes care. And people said, “That's amazing, it's going to be a huge business. There's 30 million people living with diabetes, so great that you did this nice little niche company for your next company”. And so well, how many people do you think live in a rural health care markets? [I] kind of get a blank stare. And the answer is – double the size [of] the population of people with diabetes… 60 million people live in… [a] rural market.“Relevant LinksHomeward websiteLack Of Access To Specialists Associated With Mortality And Preventable Hospitalizations Of Rural Medicare Beneficiaries [Article]U.S. Government Accountability Office: “ACCESSING HEALTH CARE IN RURAL AMERICA” [PDF]Forbes: “Healthcare In Rural America Isn’t A Little Broken, It’s A Lot Broken: A Conversation With Dr. Jennifer Schneider, Founder And CEO, Homeward Health”About Our GuestDr. Jennifer Schneider is the co-founder and chief executive officer of Homeward, a company focused on rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Previously, Dr. Schneider served as the chief medical officer and president of Livongo. She also served as chief medical officer of Castlight Health. Dr. Schneider has been honored by Modern Healthcare as one of the “100 Most Influential People in Healthcare” and by Fierce Healthcare as a “Woman of Influence” for her work empowering women and modeling diversity and inclusion in the workplace. Dr. Schneider is also on the boards of Maven and Jasper. Dr. Schneider completed her bachelor's degree in biology at the College of the Holy Cross. She went on to get her MD at The Johns Hopkins University School of Medicine and her master’s degree in Health Services Research at Stanford University.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and

Before the phrase “social drivers of health” was commonly used, Community Health Centers had already developed a model of care that was holistic, grounded in social change and embedded in the community. At this year’s HLTH Conference in Las Vegas, I sat down with Dr. Kyu Rhee, the new CEO of the National Association of Community Health Centers. Dr. Rhee brings a fresh perspective to NACHC as a clinician and an immigrant with broad experience in policy, clinical practice and technology.We discuss:What medicine would look like if every doctor was trained in a community health center, not just in fancy hospitals.How CHCs knock quality metrics out of the park while improving equity.One secret to community embeddedness: Every CHC must name patients to at least half of the governing board seats.The new prescriptions to improve health: food and iPads.Kyu reminds us that changing an entire system can’t happen overnight, we need patience and passion:“Earlier in my career as a medical director, I was like, “We got to fix this!” And I think I had to learn that there's so many angles on how you see a problem … so that passion of advocating for health equity and the injustices, you have to be thoughtful about allowing that passion to be part of your purpose, but also being patient in the process.”Relevant LinksWebsite for the National Association of Community Health CentersEconomic Impact of Community Health Centre in the United States [PDF]America’s Health Centers by the Numbers [PDF]"How the Civil Rights Movement Gave Rise to Community Health Centers" [BLOG]About Our GuestDr. Kyu (“Q”) Rhee, MD, MPP, joined the National Association of Community Health Centers as CEO in 2023. He leads efforts to advance health equity and support the mission of community health centers, which provide high-quality, affordable, transdisciplinary primary care services to more than 31.5 million people at over 14,000 sites across the nation. He has held leadership roles as the Senior Vice President and Aetna Chief Medical Officer at CVS Health, as the Chief Health Officer at IBM, and as Chief Public Health Officer at the Health Resources and Services Administration. Dr. Rhee has a medical degree from the University of Southern California and a masters degree from Harvard University’s John F. Kennedy School of Government.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn 

Is whole health here to stay, or is it a shiny new object? Our guest today is Dr. Shantanu Agrawal, Chief Health Officer at Elevance Health. He falls soundly on the “here to stay” side of the ledger. He shares that whole health is not a side business for Elevance Health and its 47.5 million members. It is the core strategy for how the company will achieve value and affordability. And it’s also what patients want.We dive into:Whether the US could get better outcomes at the same cost by redirecting resources from medical to social care.Why and how Elevance developed its Whole Health Index.The Elevance foundation’s three-part focus: maternal health, food as medicine and substance use disorders.The need for a new quality paradigm that measures whole health, not clinical care for individual body parts.Shantanu calls for a deeper look at US health spending and outcomes compared to other countries:“People often make this comparison, ‘well, our health outcomes are generally worse, we spend a lot of money in health care’. However, when you actually look at the total expense on health and social care across all these countries, it actually looks pretty similar. We are more on par with our peers, or they're more on par with us from a cost standpoint. But it is true - our health outcomes are worse. Well, why is that? Well, maybe it's because we've emphasized health care, and not care of a person's health, which means being inclusive of social and being upstream and working earlier in their life. Perhaps if we do this, we will right size the equation for our country.”Relevant LinksMore information on Elevance’s Whole Health Index [PDF]Health Affairs article on “A Whole Health Population-Based Payment Approach”Committing to Whole Health: A Conversation with Felicia Norwood & Dr. Shantanu Agrawal [VIDEO]Distinguishing Health Equity and Health Care Equity: A Framework for Measurement About Our GuestShantanu Agrawal, MD, MPhil is chief health officer at Elevance Health, where he oversees the enterprise whole health strategy, including medical policy and clinical quality, as well as the company’s industry-leading work to address health-related social needs and health equity. Passionate about improving health outcomes and reducing disparities, Agrawal draws on his clinical and business expertise to push for a more equitable health space for the people Elevance Health serves. He also leads Elevance Health’s community health strategy and the Elevance Health Foundation. Previously, Dr. Agrawal served as president and CEO of the National Quality Forum, deputy administrator for the Centers for Medicare and Medicaid Services, and director of one of its largest centers, the Center for Program Integrity.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter

For Dr. Tony Iton, we have to understand the past before we can shape the future. Our history of racism and exclusion laid the foundation for poor health in America. The way out is not simply delivering more and better services – it is building the voice and power of communities. Tony led The California Endowment’s nearly $2 billion and decade-long investment to test this approach.He shares his journey from Canada to the US to attend medical school and his eye-opening awakening to the stark disparities in Baltimore that led him to coin the phrase “your zip code is more important than your genetic code in determining health.”We discuss:The ABC’s of health equity in California: agency, belonging and fundamental conditionsThe power of narrative to shape policy choices towards either belonging or exclusionHow California communities applied this framework to dramatically change school climate and reduce suspensionsTony calls on public health to move away from medicine and towards its community-oriented roots:“[Public health has] essentially tried to mimic the healthcare delivery system. And it doesn't belong on that stage, it's a very different kind of entity. Where  public health actually proves itself to be authentic, is when it's in direct partnership with community. And it's about bringing the people who are closest to the pain into these decision making processes, so that we get true equity, we get solutions that are grounded in an understanding of how these things play out in people's lives. That's where public health is operating at its best and highest purpose.“Relevant LinksBuilding community power to dismantle policy-based structural inequity in healthBuilding healthy communities: Five drivers of changeShifting from technocratic to democratic solutions: A radical vision for health and racial equalityUnnatural Causes documentaryAbout Our GuestDr. Tony Iton is a Senior Vice President for Healthy Communities at The California Endowment. In the fall of 2009, he began to oversee the organization’s 10-Year, multimillion-dollar statewide commitment to advance policies and forge partnerships to build healthy communities and a healthy California. Iton serves on the board of directors of the Public Health Institute, the Public Health Trust, the Prevention Institute and Jobs For The Future. He is also an Advisor to the Dean and Lecturer at UC Berkeley’s School of Public Health.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn 

If we want people to experience whole person health – states will have to do a lot of silo-busting to integrate, streamline and coordinate disparate medical, social and economic programs. Data will be the axis of the strategy, but who owns that data and what guardrails are needed? How do we encourage not just data but also technology sharing across state programs?Jess Kahn joins me to discuss state efforts to integrate programs, technology and data to support whole person health. She’s a partner at McKinsey specializing in state Medicaid and social service programs, public-sector data and technology. Before joining McKinsey she led Medicaid data and systems at CMS. We discuss:Dual lessons from COVID: the danger of public health data silos and the possibility of rapid innovationThe technology and data infrastructure states are building for whole person healthHow states are partnering with nonprofit health data utilities The big miss from the national EHR rollout: user-centered design Jess highlights the dangerous gap in federal authority and accountability around the sensitive social data:"So the risks are really clear… this is data that tells you a lot more about the vulnerabilities people have … There isn't a federal agency that asserts that they have some kind of legal authority to set boundaries … Who's going to write that regulation? Who's going to tell state Medicaid agencies – or any entity for that matter – what the guardrails are around collection, around sharing, around ownership?”#healthcare #investments #housing #medicaid #health #socialdeterminantsofhealth #managedcare Relevant LinksHealth Data Utility Framework - a Guide to Implementation [PDF]Hubert Humphrey Quote in HHS Building Websites of Health Data Utilities Mentioned in Episode:CRISP HealthContextureCyncHealth IHIE

In this episode, recorded live at the Civitas Networks for Health conference in DC, I sit down with Jennifer Pahlka, author of "Recoding America", to discuss how to improve implementation and impact of big new policy initiatives. The book and episode are essential reading and listening for anyone trying to make government – or any ambitious project - work for people.We discuss: The dangers of treating the bureaucracy – not citizens – as the clientClosing the gap between intellectuals (policymakers) and mechanicals (implementers)What policymakers can learn from agile Using data as a compass not a gradeJen points out that a waterfall approach to policy implementation is a pledge not to learn:“... When you see us trying to implement law and policy by always having information flow from the top to the bottom, and never letting it return back, that's the problem. There can be no software development involved in this at all. And we can still be in a waterfall. The reason waterfall is a metaphor is that water only flows one way.”#healthcare #investments #housing #medicaid #health #socialdeterminantsofhealth #managedcare Relevant LinksJennifer Pahlka’s book Recoding America United States Digital Service Code for America Civitas Networks for Health  Clay Shirky’s book, “Here Comes Everybody: the Power of Organizing without Organizations”Clay Shirky’s book, “Cognitive Surplus: Creativity and Generosity in a Connected Age”About Our GuestJennifer Pahlka is the author of Recoding America, and a pioneer in making government work for people in the...

As Chief Health Equity Officer, Dr. Pooja Mittal is charged with improving equity and care for Health Net’s 3 million California members. She brings a strong data focus, skills in community organizing and a passion for social justice to this work – continuing her mother’s path as a family practice doctor working with farmworkers in California. We discuss: Co-designing more equitable outcomes with communities and membersHow member grievance and appeal data provides a roadmap to missed opportunities, discrimination and road blocksHealth Net’s experience implementing a doula benefit which laid the groundwork for statewide rollout of doula services in Medicaid The importance of reducing complexity and administrative barriers for new community partnersDr. Mittal tell us how she combats fatigue on the road to health equity:“How do I continue the work? … I try and think about the power of radical incremental change … How every little thing that we do actually has the power to have ripple effects that improve health for people, broadly. And so that's one way I sort of combat that. And then the other is really coming back to my why … Why am I in this work? Why does it matter to me, and what am I trying to accomplish?”Relevant LinksStreet Medicine - MLKCH and Expanding Access to Care (Page 5)Street Medicine - $1.5M USC Grant Unhoused - $114M with LA Care Health Plan COVID Support - Initiatives COVID Support - RV Program About Our GuestDr. Pooja Mittal is Medical Director of Health Equity at HealthNet, a Medicaid managed care organization. She is a family physician and uses this lens to design strategic initiatives to improve care for the most vulnerable. She is a member of the leadership team that works to further equitable care through a population health model for all HealthNet members. She has an expertise in digital health through her work in the HealthNet Digital Platforms Workgroup devising a defined digital strategy to support quality and member engagement.Dr. Mittal also works at the National Clinicians Consultation Center at UCSF, a national HIV/AIDS warmline, where she is recognized as a national expert on Perinatal HIV care. She is an Adjunct Associate Professor at University of California, San Francisco and Stanford University School of Medicine. In addition to her clinical work, she has published in the areas of well-child care, group visits, preconception care, health equity and perinatal HIV.

In Season 2 we’ll be drilling down on questions about what works and how to scale. Alan Weil is a great person to kick off this conversation. He is the editor of the premiere health policy journal Health Affairs, previously directed Medicaid in Colorado and led an ambitious health study at the Urban Institute. We discuss:How states use Medicaid to create entirely new delivery systemsThat we should not bank on savings from whole person careThe keys to successful implementation: focus on customer experience, implement iteratively and have strong feedback loops The missed opportunities to understand and solve for the underlying roots of inequityThe conversation ended in an unexpected place - a discussion of governance and power:“If a pot of funds being used to improve the health of a population is governed by a nonprofit health system, a state or a state authority, a county or a local authority or government or a community based organization, each of those enterprises will begin the process differently, which leads me to believe that they will almost certainly end the process differently … And we don't have a lot of examples in this country have the kind of community governance of resources that I think would be most valuable,"Relevant LinksAlan Weil’s podcast “A Health Podyssey”A Conversation on Health Equity with Alan WeilCommonwealth Fund ROI Calculator for Partnerships to Address the Social Determinants of HealthBuilding Community Power To Dismantle Policy-Based Structural Inequity In Population HealthMedicaid Transformation: Past, Present and Future with Alan Weil of Health AffairsThe Results of the CMMI Accountable Health Communities Model 1The Results of the CMMI Accountable Health Communities Model 2About Our GuestAlan Weil is the Editor-in-Chief of Health Affairs, the nation's leading journal at the intersection of health, health care, and policy. For the previous decade he was the executive director of the National Academy for State Health Policy (NASHP), an independent, non-partisan, non-profit research and policy organization. Before that, he directed the Urban Institute's Assessing the New Federalism project, one of the largest privately funded social policy research projects ever undertaken in the United States; held a cabinet position as executive director of the Colorado Department of Health Care Policy and Financing; and was assistant general counsel in the Massachusetts Department of Medical Security. He earned his bachelor's degree from the University of California at Berkeley, a master's degree from Harvard's Kennedy School of Government, and a J.D. from Harvard Law School. Follow Alan Weil @alanrweil on Twitter for the latest developments in health policy and Health Affairs.

When Claudia Williams started The Other 80 she was searching for evidence that whole person care – meaning the integration of social and medical care – is a viable model to bring more equity and health to all Americans. We started with some big questions. Can we flip the US healthcare system, making it more compassionate, more effective and more focused on health? Can we better address poverty's impact on health by integrating the often siloed worlds of medical and social care?In this episode Claudia sits down with her producer Avery Moore Kloss to discuss lessons learned and highlights from Season One and share what’s on deck for Season Two. We discuss what we learned in Season One: Data is the foundation of whole person health, but can also create new harmsOrganizations expert in sick care will not also be expert in community health We need new organizations and leaders combining these traits: health not sickness focused, the ability to scale, community-embeddedness and deep use of technology and dataSuccess requires ecosystem thinking, effective partnering and purposely balancing power differentials Addressing equity takes time and trustLearning in public – like we are doing on this podcast – is critically important to speed the national learning curve on health beyond medical careClaudia also shares her biggest takeaway:“Underneath a lot of this is just poverty and how hard it is to live in the United States if one is poor. And so I think the question that I'm still grappling with is how far should we go in putting on people who are working in health the responsibility of the impact of poverty? And one one way to answer that is to say, well look at all the resources that are in healthcare, yes, of course, this is what's making people not healthy. Of course, we should spend these resources on housing, on food on other things. Other people, though, are saying, but wait a minute, those people are delivering health services, they're not even delivering health services well, why should there be this expanded mandate for them?”About Our GuestClaudia Williams is a healthcare executive and entrepreneur who is passionate about creating the conditions, policies, systems and learning to enable health for all. Claudia was the founder and Chief Executive Officer of Manifest MedEx – one of the nation’s largest health data sharing initiatives. She served as Senior Advisor for Health Innovation and Technology at the White House under President Obama, building policies and programs for care transformation, data sharing, and precision health. Claudia is a graduate of Harvard’s Chan School of Public Health, where she earned her MS degree in Health Policy and Management. Claudia served as a Peace Corps volunteer in Botswana.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn.

For Dr. Clemens Hong, health is social justice work, rooted in the community-oriented primary care movement of the 1960s. He joins us for a powerful interview about on-the-ground implementation of whole person care in a county bigger than many countries. Dr. Hong leads community programs for LA County including housing supports, reentry and diversion programs, street-based outreach, and benefits navigation. We talk about the “mountain of challenges” people face when they return to the community from jail and prison, and the need to build the capacity and agency of community organizations and peer experts.We discuss: The impact of Intergenerational trauma, systemic racism and mass incarceration on healthDeep dives on reentry and housing for healthHis suggestions for CalAIM: broader eligibility, improved access to services, and making community supports an actual benefitCreating sustainable work and impactClemens shares the striking results from introducing community health workers with lived experience:"There's a study that's been done by the Transitions Clinic, and one of our partner sites, Santa Clara, where they showed that arrival to the first appointment after incarceration increased from 30% to 70%, with their hiring …  a community health worker with lived experience… Engagement is the foundation to anything we can do in delivering health to communities: engagement of the individual and the survivors of trauma, but also the communities organizations are really critical”Relevant Links Housing for Health - Housing For Health (lacounty.gov) Office of Diversion and Reentry - OFFICE OF DIVERSION AND REENTRY (lacounty.gov)Knitting Together Health and Social Services in Los AngelesImpact Report from Whole Person Care Pilots in Los Angeles [PDF]Community-Oriented Primary Care: A Path to Community DevelopmentAbout Our GuestDr Clemens Hong, MD, MPH, is Director of Community Programs for Los Angeles County Department of Health Services where he oversees multiple County programs including Housing for Health, the Office of Diversion and Reentry, Whole Person Care, My Health LA, CalAIM, and COVID-19 Testing. In 2006 he co-founded the Transitions Clinic with Dr. Emily Wang in San Francisco. He taught for several years at Harvard Medical School, and joined Massachusetts General Hospital as a primary care general internist and health services researcher.  Dr. Hong received his Bachelor’s Degree from the University of Washington and his Master’s Degree from Tufts University School of Medicine. He completed internal medicine training in the San Francisco General Hospital Primary Care Program at UCSF, as well as a general medicine fellowship at Harvard Medical School.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and...

Nearly half of Americans have a family member or close friend who’s been addicted to drugs. And most are not getting the help they need. The US has a 94 percent treatment gap for substance use disorders. Treatments are expensive, ineffective, or they’re simply not available. Corbin Petro is on a mission to close this gap. She is the CEO and Co-Founder of Eleanor Health, providing evidence-based whole person care for people with substance use disorders and mental health needs. We discuss: That addiction is a treatable chronic disorder just like DiabetesThe negative consequences of separating the brain and the body in healthcare delivery and policyWhy she’s fired up about closing health equity gapsHow Medicaid founders can get paid for outcomes and pick the right marketsCorbin reminds us that we need to lean more on community health workers and other non-licensed experts:"One of the challenges with workforce is the belief that care needs to be delivered at all times by … a very expensive specialty clinician. And I think we need as a society to more embrace non-licensed people ... [such as] community health workers, peers, others who can really support and deliver great outcomes."Relevant LinksEleanor Health websiteIn Recovery with Eleanor Health (podcast with co-founder Dr. Nzinga Harrison) Highlights from the 2021 National Survey on Drug Use and Health from SAMSHA [PDF]About Our GuestCorbin Petro is an experienced CEO, industry leader, and entrepreneur with a mission-driven, analytic approach to innovation. She is the CEO and co-founder of Eleanor Health, providing evidence-based, whole person care specializing in addressing the unique complexities of individuals and populations with substance use disorders and mental health needs. Eleanor Health leverages proprietary technology and data-driven insights, compassionate teams, and value-based payment to deliver superior clinical and financial outcomes. Prior to Eleanor Health, Corbin was the founding CEO of Benevera Health, a payer-provider JV and population health company. Corbin has an extensive background in healthcare including working on state Medicaid, advising a US Senator and in management consulting. She was honored as one of fifteen healthcare executives under 40 named a 2018 Up and Comer by Modern Healthcare. She received a BA from Yale University and an MBA from the Wharton School at the University of Pennsylvania. Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn.

Jacey Cooper, California’s Medicaid Director,  gives us an on-the-ground look at California’s pathbreaking CalAIM initiative that pairs intensive care management with access to a broad range of social services. It’s been a year since the program launched and Jacey reflects on how much communication, coordination, planning and agility was needed to implement a program of this size and breadth. Claudia and Jacey talk about opportunities and challenges as plans and providers navigate new benefits and participate in local housing, food, and community development conversations. We discuss: Lessons learned from the first year of CalAIM including the need for more standardization of social care benefits across health plans More details about the first-of-its-kind Justice Initiative which provides pre-release Medicaid services to people in jail and prisonBehavioral health redesign, payment reform, transitions of care, and administrative integration of mental health and substance use disorder servicesJacey says whole person care is truly a community effort:"As a collective force, we're making sure that plans are adapted to work with community-based organizations that have been championing these efforts for years. This is why we're focusing on embedding ourselves in the different aspects of care continuums - like housing and homelessness - within our local groups. We have to be present to have a voice in the decision-making, planning, and connection of individuals to vital services. It's not just about navigating people to housing, but ensuring they're connected to voucher programs too."#healthcare #investments #housing #medicaid #health #socialdeterminantsofhealth #managedcare Relevant LinksCalAIM Primer [PDF]Final Evaluation of California’s Whole Person Care Pilots [PDF]Fact Sheet on CalAIM Justice-Involved Initiative [PDF]Fact Sheet on CalAIM Population Health Management [PDF]Fact Sheets on CalAIM Community Supports

Sachin Jain is setting out to build a very different kind of company—a nationally scaled nonprofit health plan, grounded in Scan’s founding story of 1970s community activists seeking a new future of health for vulnerable communities. In the last two years the 4.5 star Medicare plan has announced a merger with Care Oregon, launched verticals focused on delivering health services to people experiencing homelessness and LGBTQ elders, and expanded to new markets. We discuss: What’s possible with a longer time horizonHow equity and social drivers are becoming the new hustleWhy healthcare should borrow less from other industriesHow “no margin, no mission” is creating ethical laxityUnfinished business from our time together at ONCSachin calls for a new era of accountable leadership:“We need more ethical leadership in health care. And what I mean by that is we need to make sure that the words on the wall of every healthcare organization, the ethical compass, the values, the mission statements, the vision statements, actually mean something, and that the behaviors of leaders actually align to things. I think we've gotten lost in this glib “no margin, no mission” chatter, that creates this ethical laxity in organizations to begin doing things like aggressively billing their patients, or, you know, going so far as to repossess their assets when they can't pay their bills.”Relevant LinksDr Sachin Jain on Combining SCAN Group and CareOregon: “We’re Trying to Build a Very Different Kind of Company”L.A.'s state of emergency on homelessness: How a street medicine team is treating patients in a unique waySCAN launches new Medicare Advantage plan for LGBTQ+ seniorsHow One Health Plan Reduced Disparities in Medication AdherenceAbout Our GuestDr. Sachin Jain has worked in clinical medicine, academia, government, big pharma, and the health insurance industry. His passion is in accelerating the pace of change in health care and building a sustainable health care system that addresses the needs of patients. Dr. Jain President and CEO of SCAN Group and Health Plan, a $3.4B non-profit entity that serves over 220,000 patients.  He also serves as a physician at the US Department of Veterans Affairs.  Dr. Jain was previously president and chief executive officer of the CareMore and Aspire Health, the care delivery divisions of Anthem. He is an Adjunct Professor of Medicine at Stanford University School of Medicine and Co-Editor-in-Chief, Healthcare: the Journal of Delivery Science and Innovation and trained in internal medicine at Boston's Brigham and Women's Hospital. He received his undergraduate (AB), medical (MD), and business degrees (MBA) from Harvard. He has worked in leadership roles at Merck and Company and the US Department of Health and Human Services and has held faculty appointments at Harvard Medical School and Harvard Business School. Follow Sachin Jain on Twitter @sacjai. Connect With Us

Former NIMH director and renowned neuroscientist Dr. Tom Insel joins Claudia to talk about the state of mental health in America today. The conversation dives into the challenges and opportunities for improvement, the potential of technology, and what it will take to scale integrated treatment approaches across the nation. Get a behind-the-scenes look at the Bipartisan Safer Communities Act and learn about Tom's new company, Vanna Health, which is delivering new care and payment models for people with serious mental illness.We discuss: Why he thinks the criminalization of mental illness is a fixable problemThat people, place and purpose are the foundation of recoveryThe big engagement issue in mental health treatmentWhy Medicaid patients don’t have access to psych hospitalsThat effective crisis response is more than a new phone numberTom talks about how mental health is the biggest health disparity in the US today: “Someone with a serious mental illness in the United States today is probably going to die 20 to 23 years before someone without… [that’s] the greatest health disparity that we have in the United States [and] far exceeds health disparities due to race or ethnicity. But beyond that, other forms of mortality like suicide and drug overdoses, what we call the deaths of despair, have become a massive public health issue… Suicide rates are up about 30 to 35% from the turn of the century, the mortality from drug overdoses is up about five to six fold from that time. So these are huge increases… That's a crisis we need to start talking about.”Relevant LinksTom’s book “Healing: Our Path from Mental Illness to Mental Health”More about Vanna Health Mental health provisions in the Bipartisan Safer Communities ActExplanation of Medicaid IMD (institutions for mental diseases) Exclusion [PDF]About Our GuestTom lnsel, M.D., a psychiatrist and neuroscientist, has been a national leader in mental health research, policy, and technology. From 2002-2015, Dr. Insel served as Director of the National Institute of Mental Health (NIMH). More recently (2015 – 2017), he led the Mental Health Team at Verily (formerly Google Life Sciences) in South San Francisco, CA. In 2017, he co-founded Mindstrong Health, a Silicon Valley start-up building tools for people with serious mental illness. Dr. Insel co-founded Vanna Health in 2022 and currently serves as Executive Chair. Vanna Health is focused on the needs of people with serious mental illness and works with community partners to provide the 3 Ps (people, place, and purpose) for recovery. In 2020, he co-founded Humanest Care, a therapeutic online community for recovery. Since May of 2019, Dr. Insel has been a special advisor to California Governor Gavin Newsom and Chair of the Board of the Steinberg Institute in Sacramento, California. He is the author of the book Healing: Our Path from Mental Illness to Mental Health, published by Penguin Random House. With journalist co-founders, he recently launched MindSite News, a non-profit digital publication focused on mental health issues. Dr. Insel is a member of the National Academy of Medicine and has...

Two things push Medicaid to the front of every equity conversation. First, its scale and focus. Second, its bold moves to improve equity through coverage expansions and addressing social drivers of health. Claudia chats with Dr. Aditi Mallick about Medicaid’s three-part agenda to improve equity, implement whole person care and expand coverage. Dr. Mallick — the Chief Medical Officer for Medicaid & CHIP at CMS — shares the deeply personal experience that fuels her push for health equity and access to care for all Americans. We discuss: Why addressing social needs is key to achieving Medicaid’s agendaThinking in new ways about maternal and infant healthTwo perennial challenges: workforce and data sharing Where to draw the line on what Medicaid should fundAditi reminds us that pure technology plays will never work in this space:“I think there is a tremendous role for technology here and tech enablement here when done thoughtfully. I think a pure technology business in this space that doesn't have humans or service layered on top of it will not work, frankly, because so much of the implementation success around health related social needs will be predicated on being able to bring together people from a community setting and trusted voices… as opposed to building and throwing something at the community.”Relevant LinksCMS guidance on covering in Lieu of Services through Medicaid managed care [PDF]CMS framework for covering health-related social needs through Section 1115 demonstrations [PDF]CMS “unwinding” websiteMACStats: Medicaid and CHIP data book [PDF]About Our GuestDr. Aditi Mallick is a physician, strategic policy advisor, and former management consultant, who is driven to serve and create a more inclusive, innovative, and responsible healthcare system. She is the Chief Medical Officer for Medicaid and the Child Health Insurance Program at the Centers for Medicare and Medicaid Services. Before joining CMS, she was Director of the COVID-19 Response Command Center at the North Carolina Department of Health and Human Services. A board-certified internist, Dr. Mallick has previously held clinical faculty positions at George Washington University and Johns Hopkins University. Dr. Mallick earned her BA with honors from Harvard College, including a Certificate in Healthcare Policy; her Medical Degree from Stanford University with a concentration in Health Services Research and Policy; and completed Internal Medicine Residency training at Massachusetts General Hospital and Harvard Medical School.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on Twitter @claudiawilliams and

Abner Mason has spent decades working to reduce barriers to care faced by underserved people, who often experience harm and misunderstanding in their health encounters.  He joins us to talk about how to build trust in healthcare. It means slowing down to really understand and meet each person’s unique needs. That’s the work Abner leads as Founder and CEO of SameSky Health. We discuss: That our work is not to judge other people’s choices, it’s to expand the opportunity set they see in front of themselvesHow health plans are learning to have patienceAdvice for entrepreneurs: don’t be too enamored of your own ideasUsing our voices to oppose hateWhat’s at stake with Medicaid redeterminationsAbner reminds us that people are not quality measures:“We focus on understanding people's priorities first, which helps us develop and maintain their trust. One of the things we've learned is that people are not quality measures; we need to prioritize them first. By figuring out what's important in their lives, we can truly make them feel heard and understood.”Relevant LinksSameSky Health websiteNCQA stratification of quality measures by race and ethnicity FCC declaratory on texting for Medicaid redeterminations [PDF]Results of vaccine outreach and equity campaign [PowerPoint] Effective Strategies for Collecting Health-Equity-Related Member Data to Identify and Address Health Disparities [Webinar]About Our GuestAbner Mason has spent decades working to reduce barriers to care faced by underserved people nationally and internationally, from the federal to the local level. He is founder and CEO of SameSky Health, a cultural experience company that forms meaningful relationships to bring people to health. He has served on President Bush’s Advisory Council on HIV/AIDS, as Chief Policy Advisor to the Governor of Massachusetts, and as part of the Biden-Harris Campaign Policy Committee. He currently sits on the Boards of Manifest MedEx and the California Black Health Network, is a member of United States of Care’s Founders Council, and the American Medical Association’s External Equity and Innovation Advisory Group. He is also the founder of Health Tech 4 Medicaid.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams and LinkedIn.

Many investors and founders shy away from building Medicaid-focused companies. Andy Slavitt – policymaker, investor and ‘In the Bubble’ host – joins us to discuss why this is a huge mistake. Medicaid now covers 85 million Americans and is where the opportunities to build meaningful and high impact companies are the greatest. We talk about Andy’s work at Town Hall Ventures and his takeaways from leading CMS in the Obama administration and COVID strategy in the early days of the Biden administration.We dive into: Why Medicaid-focused founders should think of states as 50 potential customers, not as governmentsA few of his portfolio companies: Eleanor Health, Cityblock Health, Plume and Spark PediatricsHow states can get better results from Medicaid managed careThe wide range of impacts from Medicaid expansion: lower medical debt and bankruptcy, increase in home ownership, and improvements in maternal, child health, cancer and cardiac outcomesAndy talks about the deep impact on people’s lives from having Medicaid coverage:“In every single study, all of those outcomes – every single one of them that are quality of life and health related – are better under Medicaid expansion. And it makes sense. If you put a little bit more money in people's pockets, put a little more security underneath them, they're going to live their lives, they are going to take that risk and take a better job, they are going to not worry as much … the kids are going to be healthier and more stable.”Relevant LinksTown Hall Ventures websiteHealth Affairs post showing far higher investments in Medicare- than Medicaid-focused companies Medicaid facts and figuresASPE study estimating that 15 million people will lose Medicaid coverage with the end of continuous enrollment  RWJF study showing that almost two thirds of Medicaid enrollees don’t know about upcoming redeterminationsAbout Our GuestAndy Slavitt has led many of the nation’s most important health care initiatives, serving as President Biden’s White House Senior Advisor for the COVID response, President Obama’s head of Medicare and Medicaid and overseeing the turnaround, implementation and defense of the Affordable Care Act. Slavitt is the “outsider’s insider,” serving in leading private and non-profit roles in addition to his government services. He is founder and Board Chair Emeritus of United States of Care, a national non-profit health advocacy organization as well as a founding partner of Town Hall Ventures, a healthcare firm that invests in underrepresented communities. He co-chaired a national initiative on the future of health care at the Bipartisan Policy Center. He chronicles what goes on inside the government and across the nation at town halls, in USA Today, on his award-winning podcast In the Bubble, and on twitter. He is the author of Preventable, a best-selling account of the U.S.’s coronavirus response, released in 2021. A...

Investing in housing for Medicaid enrollees is one of the ways Dr. Bradley Gilbert has pioneered Whole Person Health in California. He’s an original population health thinker, from his start as a county public health officer to decades of service as CEO of one of the nation’s largest Medicaid managed care plans and his most recent role as Director of Health Care Services in California. Dr. Gilbert chats with Claudia about lessons learned along the way and why we need to focus on what’s good for people, not just saving money. Relevant LinksEvaluation of IEHPs housing investmentOverview of CalAIMRecent CMS guidance for states offering social supports through Medicaid managed careAbout Our GuestDr. Bradley Gilbert, MD, MPP was Director of California’s Department of Health Care Services in 2020 and helped lead the state through its first response to the COVID-19 pandemic and initial implementation of CalAIM. Before that Dr. Gilbert headed the Inland Empire Health Plan, one of the largest Medicaid Managed Care plans in the nation. IEHP serves more than a million Members in Riverside and San Bernardino Counties in California. Previously Dr. Gilbert was the Public Health Officer for San Mateo and Riverside Counties. While he was CEO at IEHP Brad was board chair of the organization Claudia led, Manifest MedExConnect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams or on LinkedIn.

A move to whole person health in America is going to take a shift of the entire health ecosystem. In this episode, Claudia chats with Dr. Mini Kahlon, the founding Vice Dean of Health Ecosystem at Dell Medical School, about health beyond the clinic, the role of “traditional medical care” and medical schools in moving towards whole person health, and why we need big, visionary goals for the health of people and communities. Relevant LinksDell Medicine “health beyond the clinic” website Results of loneliness study conducted by Factor HealthFor more on health impact of loneliness, see this reportAbout Our GuestDr. Maninder “Mini” Kahlon is a founding vice dean of Dell Medical School, where she develops innovations that advance health beyond the clinic. Kahlon is an associate professor in the Department of Population Health and the founder of Factor Health. The Factor Health laboratory develops programs that rapidly improve health in people’s lives, testing them through community-based trials. Kahlon was previously the executive director and chief information officer at the University of California San Francisco’s Clinical & Translational Science Institute. She is an award-winning technology leader with experience in industry and academic medicine, building consumer-facing and research-enabling tools. Kahlon is a behavioral and systems neuroscientist. She received her Ph.D. from UCSF and is a graduate of Bryn Mawr College in Pennsylvania.Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow us on twitter @claudiawilliams or on LinkedIn.

Why is whole-person care so important? And, is it even possible to shift our current model in that direction? Former North Carolina Secretary of Health Dr. Mandy Cohen joins us to talk about why a shift to whole-person care is the right approach and how she generated bi-partisan support for North Carolina’s groundbreaking Healthy Opportunities Pilots which are providing food, housing and other services to Medicaid enrollees. She shares leadership lessons from COVID and perspectives on the data infrastructure states will need to support whole person health. Relevant LinksHealth Affairs article: “Buying Health for North Carolinians”https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01583Federal approval of Healthy Opportunities Pilotshttps://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/nc-medicaid-reform-demo-cms-approval-attachment-g-healthy-opport-pilots-eligib-services.pdfKaiser issue brief on North Carolina Pilotshttps://www.kff.org/report-section/a-first-look-at-north-carolinas-section-1115-medicaid-waivers-healthy-opportunities-pilots-issue-brief/About Our GuestDr. Mandy Cohen served as the Secretary of Health in North Carolina from 2017 to 2022, where she led the State’s COVID response and the transformation of the Medicaid Program - focusing on whole-person care and the social drivers of health. Dr. Cohen also served as the COO and Chief of Staff at CMS, helping implement the Affordable Care Act. She was recently named the EVP of Aledade Inc and the CEO of Aldade Care Solutions - scaling value-based care with doctors in charge. Dr. Cohen received her MD from Yale University School of Medicine and her Masters in Public Health from Harvard Chan School of Public Health. Dr. Cohen has been elected to the National Academy of Medicine and is an adjunct professor at the UNC Gillings School of Global Public Health. She trained in internal medicine at Massachusetts General Hospital. Connect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email [email protected] and follow Claudia on twitter @claudiawilliams and LinkedIn https://www.linkedin.com/in/claudiawilliamshealthdata/

Welcome to The Other 80 with former senior White House advisor and entrepreneur Claudia Williams. Claudia is opening a new conversation about the move to whole person health in America. Stay tuned for more. About our showThe Other 80 brings you real, honest dialogue about the things that help keep people healthy beyond traditional medical care – like housing, social connections and food – and the cutting edge policies and programs supporting whole person health. Join former White House advisor, entrepreneur and host Claudia Williams for deep conversations with the innovators, implementers and policymakers bringing these new models to life. We’ll talk about what’s working, what’s not and how to move towards whole person health rapidly and equitably across the US. About our hostClaudia Williams is a healthcare executive and entrepreneur who is passionate about creating the conditions, policies, systems and learning to enable health for all. Claudia was the founder and Chief Executive Officer of Manifest MedEx – one of the nation’s largest health data sharing initiatives. She served as Senior Advisor for Health Innovation and Technology at the White House under President Obama, building policies and programs for care transformation, data sharing, and precision health. Claudia is a graduate of Harvard’s Chan School of Public Health, where she earned her MS degree in Health Policy and Management. Claudia served as a Peace Corps volunteer in Botswana.Connect with usTo connect with our team, please email [email protected].