Gregory A. White, CPA, CEO of Lamprey Health Care

Today's guest is Gregory A. White, CPA. the CEO of Lamprey Health Care. Lamprey Health Care is a federally qualified health clinic (FQHC) with locations in New Hampshire: Nashua, Raymond, and Newmarket. Federally qualified health clinics are community-based healthcare providers that provide primary care and a range of other services to clients regardless of ability to pay. As a result they are often safety net care providers in a community.

In this podcast Greg tells us about his journey from being an auditor in a public accounting firm to a career in healthcare, coming up through the finance and accounting side of healthcare delivery organizations. One of the unique aspects of Lamprey Health Care is each of its locations are in very different communities.

This podcast was guest-hosted by University of New Hampshire students Regan Judge and Caroline Sweny.

Links to the Podcast

Soundcloud: https://soundcloud.com/healthleaderforge/gregory-a-white-cpa-ceo-of-lamprey-health-care

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

YouTube: https://youtu.be/aoetUX55Io8

Transcript

Podcast Outline

Time                Topic

0:01:15 studying accounting at Babson College
0:02:02 becoming a CPA, entering the non-profit sector though auditing
0:04:12 Greater Lawrence Family Health Center
0:06:49 building a Family Medicine residency program within an FQHC
0:10:32 Manchester Community Health Center - benefits of being in a small organization
0:11:57 making the jump to executive ranks
0:13:38 financing growth at a FQHC
0:16:11 Lowell Community Health Center
0:18:17 Lamprey Health Care
0:19:18 mission of Lamprey
0:20:06 making the transition to the CEO role
0:21:51 how did previous roles prepare for CEO role
0:22:28 Lamprey senior leadership team
0:23:02 what is the workplace culture like at Lamprey
0:24:07 metrics used to evaluate the health of the organization
0:26:11 what external issues does he track
0:30:16 moving toward population health and the opioid crisis
0:32:05 what is the role of the board of Lamprey Health Care
0:32:53 strategic planning
0:34:27 motivating employees
0:35:40 most important thing learned from role of CEO
0:36:31 what was most surprising about the role of CEO
0:37:36 what keeps him up at night
0:38:13 what is the thing people outside of healthcare least understand about FQHCs
0:39:03 making the transition from a large town like Lowell to a small town like Newmarket
0:39:45 how did the community served change
0:40:55 how has healthcare changed
0:41:35 leadership philosophy
0:42:57 characteristics of a good leader
0:44:08 leadership role models
0:45:29 difficult leadership lesson
0:47:03 what does he look for when hiring leaders
0:48:04 what is organizational culture
0:49:43 how do leaders shape organizational culture
0:50:29 mentors
0:52:30 what does a good mentor do
0:53:54 how important is the mentor relationship
0:54:43 the importamce of professional organizations
0:55:29 get experience by watching senior leaders
0:56:50 why work at an FQHC
0:58:03 what to study to get into leadership at an FQHC

Topics Discussed:

Lamprey Health Care

Lowell Community Health Center

Manchester Community Health Center

Greater Lawrence Family Health Center

AAFPCPA

Babson College

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Nirav Shah, MD, MPH, Senior VP and COO for Clinical Operations, Kaiser Permanente Southern California

Today's guest is Dr. Nirav Shah, the Senior Vice President and Chief Operating Officer for Clinical Operations for Southern California in the Kaiser Foundation Health Plan and Hospitals, in Pasadena, California. Nirav oversees the health plan and hospital quality, service, accreditation, regulatory compliance, and licensure, as well as nursing, the continuum of care, and the effective use of technology, data, and analytics to produce better patient health outcomes for $24B region serving 4.2M members.

Prior to coming to Kaiser, Nirav served as the Commissioner of Health for the State of New York, administering a $60B budget and was responsible for public health insurance programs covering 5 million New Yorkers as well as regulating the state's hospitals and nursing homes among other responsibilities.

Nirav completed an internal medicine residency at Yale, followed by a fellowship in epidemiology at Stanford. Before moving into leadership roles, he worked as a physician researcher at Bellevue Hospital in New York City and at the Geisinger Clinic in Pennsylvania.

I really enjoyed listening to Nirav's journey from physician researcher to large organization leader. Perhaps more than any other guest, Nirav talks about the importance mentors have played in his career, and how he seeks out support and guidance to help him solve his problems, while at the same time reaching out to return the favor.

Links to the Podcast:

Anchor: https://anchor.fm/healthleaderforge/episodes/Nirav-Shah--MD--MPH--Senior-VP-and-COO--Kaiser-Permanente-Southern-California-egra6j 

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://podcasts.apple.com/us/podcast/nirav-shah-md-mph-senior-vp-coo-kaiser-permanente-southern/id981989377?i=1000372542503

Transcript: A transcript of the podcast is available here.



Podcast Outline

Time Topic
0:02:22 Upbringing in India
0:03:41 College experiences, deciding to go into medicine
0:05:06 Completing a dual M.D./M.P.H. program in chronic disease
0:06:15 Being in a Pass/Fail environment at Yale Medical School
0:07:47 Residency in Internal Medicine
0:08:30 Fellowship in Epidemiology
0:10:20 The “Physician Identity”
0:11:31 Early career at NYU Medical Center/Geisinger Health System
0:14:34 Balancing the demands of a clinical vs. research career
0:15:24 Early career mentors, privilege, and grit
0:19:00 Early interests in administrative and leadership work
0:21:13 Work as the Commissioner of the NY Department of Health (DOH)
0:25:00 The importance of having a political appointee as a Commissioner
0:27:27 The importance of building networks for future leaders
0:29:12 Role of the Commissioner of the NY DOH
0:31:30 Reforms to Medicaid at the NY DOH
0:33:30 Dealing with conflicts as the Commissioner
0:35:25 Difficulties of implementing reform
0:37:48 Relationship with Kaiser Permanente prior to and as Commissioner
0:39:25 Leadership lessons learned as the Commissioner of the NY DOH
0:40:33 Shift to working at Kaiser Permanente
0:42:55 Advantages of the Payer/Provider alignment at Kaiser
0:48:38 Size and scope of Kaiser Permanente and KP Southern California (KPSC)
0:50:22 Day-to-day life and responsibilities
0:51:36 Use of data and analytics to improve patient outcomes
0:54:43 Benefits of KPSC and hospital association
0:56:03 Relationship between corporate and regional KP organizations
0:58:15 Regional leadership team organization
0:59:15 What keeps you up at night?
1:00:40 How did prior experiences prepare you for Kaiser?
1:02:48 Common misconceptions of Kaiser
1:04:11 Are you currently practicing medicine?
1:05:23 Questions regarding leadership, personal mentors, and leadership experiences, hiring and evaluating leaders
1:10:25 Working with “inexperienced” leaders, evaluating performance
1:13:20 Importance of organizational culture
1:15:30 Advice for students in developing good mentor relationships
1:19:54 Importance of professional associations in career development

1:20:54 Advice for clinicians/students going into healthcare 

Links Discussed

Kaiser Permanente Southern California
NY Department of Health

Geisinger Health System

Bellevue Hospital

Don Berwick

Robert Wood Johnson Foundation Clinical Scholars at UCLA

Yale Medical School

Thanks to Sameer Panesar for production support.

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Dr. Michael Sherman, MD, MBA, Chief Medical Officer, Harvard Pilgrim Health Care

Today's guest is Dr. Michael Sherman, the Chief Medical Officer and Senior Vice President for Health Services at Harvard Pilgrim Health Care. Harvard Pilgrim is a New England-based regional health plan with 1.25 million members. It has been ranked #1 by NCQA for the past ten years. Michael holds Bachelor’s and Master’s degrees from the University of Pennsylvania in Medical Anthropology, he attended Yale Medical School, and is a board certified anesthesiologist. In the mid-1990's he made the decision to pursue an MBA at Harvard Business School with the thought that he would seek to blend together his clinical expertise with a business education, but he was sure of one thing: that he would never work for an insurance plan. In this podcast he tells the story of his career, about becoming a physician, making the transition to executive leadership, and how he ultimately worked for three health insurers (ironically, the payers he said he would not work for). Michael's career involves a great deal of serendipity, but it also shows his deliberateness as he worked to develop the skills he knew he needed to progress as an executive by gaining exposure and experience in a wide array of organizations. He is also quite candid about his successes and challenges, which shows that the road to senior leadership is never smooth sailing.

His discussion of the work he is doing with value-based payment and bundling at Harvard Pilgrim is particularly useful and timely. It is very popular to demonize health insurers, but Michael’s efforts to create win-win arrangements between Harvard Pilgrim and its partners in the provider community shows what is actually possible. It is interesting to see how his passion for developing these agreements meshes with a recurring theme of negotiations from different points in his career leading up to his current role. The podcast concludes with a discussion about Michael's leadership style, and his recommendations for physicians who are looking to make the transition from clinical leadership to executive leadership.

The interview is available in its entirety at the unabridged link below. The podcast outline corresponds with the unabridged version. There is also an abridged version of the interview that focuses primarily on Michael's work immediately leading up to his current role. 

Links to the Podcast:

Anchor:

   Unabridged: https://anchor.fm/healthleaderforge/episodes/Dr--Michael-Sherman--Chief-Medical-Officer--Harvard-Pilgrim-Health-Care-egra8g

             Abridged: https://anchor.fm/healthleaderforge/episodes/Abridged-Dr--Michael-Sherman--Chief-Medical-Officer--Harvard-Pilgrim-Health-Care-egra7r

Stitcher: https://listen.stitcher.com/yvap/?af_dp=stitcher://episode/41445563&af_web_dp=https://www.stitcher.com/episode/41445563

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

YouTube: https://youtu.be/nxkYEFZWuKU

Podcast Outline (these times apply to the full length version)

Time	Topic
0:02:56	background education, becoming a physician
0:13:11	decision to go to business school
0:23:06	the importance of establishing self as a physician before going into business/leadership role
0:25:21	DaVita, Inc.: Director of Corporate Development, DaVita, Inc.
0:30:57	HealthAllies: Vice President, Provider Business Development and Product Management
0:36:37	IMMUSOL: Vice President, Medical Affairs
0:43:08	Thomson Reuters: Vice President & General Manager, Health Plan Solutions
0:54:27	Transition to the payer world: United Health Group
1:00:38	Humana: Corporate Medical Director, Physician Strategies
1:12:43	about Harvard Pilgrim Health Care
1:17:09	Harvard Pilgrim Institute/Harvard Medical School Department of Population Health
1:18:55	Chief Medical Officer and Senior Vice President, Health Services
1:21:52	Paying for value, one size doesn't fit all
1:34:45	Consolidation of Health Insurers
1:36:27	Thoughts on leadership, hiring the right talent, and being an executive
1:51:02	Mentorship
1:52:51	Professional Organizaitons
1:54:26	Advice to clinicians who want to make the transition to clinician executives

Topics Discussed:

Harvard Pilgrim Health Care

Harvard Business School

DaVita

HealthAllies (Optum HealthAllies)

Thomson Reuters

UnitedHealth Group

Humana

America’s Health Insurance Plans (AHIP)



Articles by Dr. Sherman:

              Paying for Value: What's Next?

              How to Design a Bundled Payment Around Value

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Jill Gravink, Founder and Executive Director of Northeast Passage

Today’s guest is Jill Gravink, the Founder and Executive Director of Northeast Passage. Jill founded Northeast Passage in 1990 as a means of bringing Recreational Therapy out of the inpatient setting and into the community. Northeast Passage works with people who have physical and mental disabilities, using sport and leisure activities to improve the quality of the client’s life and to, as they say at Northeast Passage, “Live beyond disability.” Northeast Passage works with everyone from children to combat veterans, treating more than 3,000 clients last year. In this podcast Jill tells the story of how Northeast Passage came to be, and what it took to grow the organization from just her operating out of the trunk of her car to where it is today. We also discuss how organizations like Northeast Passage are well poised to contribute to the future of health care as the industry shifts to outcomes and value-based reimbursement, and conclude with a discussion about leadership.

Links to the Podcast:

Anchor: https://anchor.fm/healthleaderforge/episodes/Jill-Gravink--Founder-and-Executive-Director-of-Northeast-Passage-egraam

Stitcher: https://listen.stitcher.com/yvap/?af_dp=stitcher://episode/41078139&af_web_dp=https://www.stitcher.com/episode/41078139

iTunes: https://podcasts.apple.com/us/podcast/jill-gravink-founder-and-executive-director-of/id981989377?i=1000356065522

Podcast Outline

Time	Topic
0:01:34	Educational background
0:02:47	Defining recreational therapy
0:05:16	Art of recreational therapy, about NEP
0:06:36	History of recreational therapy
0:08:03	Getting certified in recreational therapy
0:08:40	First job after graduation
0:10:45	Use of aquatics in physical therapy
0:11:40	Starting NEP and initial vision
0:14:46	NEP’s first clients
0:17:11	NEP initial funding and sponsors
0:18:00	Coming back to UNH to teach
0:19:57	NEP’s early days, lessons learned, partnerships
0:23:24	Defining “universal design”
0:24:44	Growth of NEP in clients and funding, future NEP sustainability
0:27:52	Beginning to charge clients fees for service, NEP financial difficulties
0:29:58	Development of recreational therapy at NEP, associated grants
0:33:21	Learning to manage an organization
0:36:21	Merging NEP with UNH
0:38:13	Defining and using “strength-based” in therapy
0:39:31	Importance of integrating therapy within the community
0:44:04	Role group dynamics play in therapy
0:45:00	Receiving veterans’ adaptive sports grant, addressing veterans’ therapy needs
0:50:00	Long term relationship with Veterans’ Affairs after grant, current work with VA
0:52:10	Broader healthcare reimbursement trends away from FFS towards outcome and value-based payments
0:54:58	Change in role as executive director with UNH merger
0:56:38	The future of NEP
0:58:55	Changes in strategy and vision of NEP over time
1:00:41	NEP’s current organizational structure, working with UNH students
1:02:27	Changes in personal leadership style over time, lessons learned
1:05:46	How to find the right people for leadership positions
1:06:57	Philosophy on leadership and its challenges and opportunities
1:11:35	Importance of organizational culture
1:13:47	Early career mentors, importance of mentorship
1:16:47	Advice for people who want to address social needs
1:19:05	Advice for people interested in a career in recreational therapy

Topics Discussed:

Northeast Passage

American Thereapeutic Recreation Association

Adaptive Sports

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Thanks to Sameer Panesar for production support.

Greg Townsend, Vice President of Business Intelligence and Analytics, Commonwealth Care Alliance

Today’s guest is Greg Townsend, the Vice President of Business Intelligence and Analytics at Commonwealth Care Alliance in Boston. Greg’s path to leadership in health analytics traces the coming of age of analytics in health care. Greg’s educational background began in public health working with disease management and health promotion, which led him to roles in risk management and quality improvement, two fields that rely heavily on data. These early roles helped him develop the skill set that he uses today to support the Commonwealth Care Alliance’s mission of providing health care to some of Massachusetts’ most needy citizens. The podcast concludes with Greg’s thoughts on leadership and his advice to people who are interested in entering the field of health analytics. An abridged version of the interview that focuses only on Greg’s work at Commonwealth Care Alliance is also available.

Links to the Podcast:

Anchor: 

Unabridged: https://anchor.fm/healthleaderforge/episodes/Greg-Townsend--VP-of-Business-Intelligence-and-Analytics--Commonwealth-Care-Alliance-egra63               

Abridged: https://anchor.fm/healthleaderforge/episodes/abridged-Greg-Townsend--VP-of-Business-Intelligence-and-Analytics--Commonwealth-Care-Alliance-egra8e

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://podcasts.apple.com/us/podcast/greg-townsend-vp-of-business-intelligence-and/id981989377?i=1000354725112

Podcast Outline:

Time	Topic
0:01:31	Educational background, college internships
0:03:11	Moving to North Carolina after college, initial jobs
0:05:12	Preventive health work at Blue Cross Blue Shield of North Carolina
0:07:00	Defining “disease management” and its history
0:08:28	Lessons learned from first jobs
0:10:22	Quality Improvement work at Harvard Pilgrim
0:13:37	Performance Improvement work at Elliot Health System
0:15:20	The role of the Joint Commission in accreditation
0:17:25	Other responsibilities at Elliot Health System
0:20:26	Leadership lessons learned at Elliot
0:24:52	Performance Improvement/Evaluation work at Tufts New England Medical Center
0:29:49	The importance and process of prioritizing
0:31:19	Quality Management work at Health Dialogue Analytics Solutions
0:34:30	“Unwarranted variation” in health care
0:36:07	Work in health analytics prior to HDAS
0:37:55	Tools used in health analytics
0:38:56	How prior work experiences contributed to knowledge in health analytics
0:39:52	Clinical partnerships work at Accretive Health and work on reimbursable codes with providers and CMS
0:45:04	Business Intelligence work at Commonwealth Care Alliance
0:47:28	Working with dually eligible patients (Medicare & Medicaid) and the importance of primary care
0:50:48	Assembling a primary care team through CCA
0:52:08	Work with capitated payments in healthcare
0:54:15	Lack of access to care for Medicare and Medicaid patients, the importance of home health care
0:56:06	Integration of specialty and inpatient care into capitated payments
0:56:41	Teamwork in healthcare and home health evaluations
0:59:17	Greg’s role, responsibilities at CCA
1:00:43	Problems solved using health analytics
1:02:28	Products created using health analytics
1:04:40	Difference between and use of “predictive” and “prescriptive” analytics
1:06:52	Evolution of analytics and its integration into health decision making
1:08:15	Challenges faced in the implementation of health analytics
1:10:11	The future of health analytics and its integration into health care
1:11:40	Personal leadership philosophy
1:13:28	Personal mentors in leadership
1:15:21	What to look for when hiring leaders
1:16:36	The role of a good mentor
1:18:17	Who looks to you as a mentor?
1:19:36	Advice for those interested in health analytics

Links to Topics Discussed:

Commonwealth Care Alliance

Masshealth

Plymouth State Health Promotion Program

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Thanks to Sameer Panasar for production assistance.