Living the Mission in Health and Business to Achieve Health Equity

Brian Urban (00:22):

Yes, this is the Healthcare Rethink podcast. I'm your host, Brian Urban. And today, we got ourselves a high level guest. Joining our podcast is Vice President and chief of staff to the CEO, Sameer Kohan, leading a lot of great strategy for Point32Health.

(00:43):

Sameer, welcome to our show.

Sameer Kohan (00:45):

Thanks for having me, Brian. It's great to be here.

Brian Urban (00:47):

This is going to be a lot of fun. We've gotten to know each other a little bit before the recording here, and we actually have an interesting connection. You were previous to the Pittsburgh area working with Highmark Health, and now safe to say you're a New Englander. So you changed some geographies on us.

Sameer Kohan (01:07):

I live in New England. I'm always going to be a Pittsburgher at heart, but yeah, I love it here. It's a great place to live.

Brian Urban (01:13):

I was hoping to hear that. That's perfect. Excellent, Sameer. With every episode, we'd love to get our audience familiar with our guests, and we got to start with your story. You have this amazing visibility across Point32Health and an amazing touch to deploying strategic initiatives. But before you got to this level, where did you come from? Where did this all start? What was your path to success and touching a lot of great strategy at Point32Health?

Sameer Kohan (01:47):

Well, I'll start at the way beginning, Brian. Actually, my whole life growing up, I knew with 100% confidence that I wanted to be a physician. There were no questions. That's what I was going to do. My mom was a physician. She also was a professor, and that was really... I saw what she was able to do and that's what I wanted. And so marched down that path and I was very happy to do so.

(02:16):

I went to Penn State and started my degree in biology, which again, leading me on that path. About halfway through, I thought maybe not. And so it was time for me to recalibrate. My parents, who have always been extremely supportive of me, I went and spoke to them about it. And my father, who was really successful, really in the business world with both Westinghouse and Eaton Cutler Hammer, he always thought that I would be good more on the business side. And so what he did was steered me towards doing a Master's in health administration from the University of Pittsburgh. And that really combines the business side of things, but still maintaining my healthcare passion and background.

(02:59):

And that really is what has put me on this really, what I like to call non-linear career path. So I have done pharmaceutical sales, which I did for two years, which taught me a lot, including that I did not want to do sales as a career. I did... From there, I went to IT. Actually for a small health system based out of Pittsburgh. After that, I was a construction project manager for 175,000 square foot medical facility, an outpatient facility, which was an extremely cool project. Actually, the Health and Wellness Pavilion in Wexford, if you're familiar with it.

Brian Urban (03:37):

Oh wow, okay.

Sameer Kohan (03:38):

Yeah.

Brian Urban (03:39):

That's one thing about your background I did not know. So that's a nice little surprise there.

Sameer Kohan (03:43):

And it's very cool. A lot of times the work that we do, there's not a tangible result. That's a tangible result that I can really point to, and it was an amazing project to work on. After that, I moved to the patient experience department where I worked with our chief nursing officers to really understand what drives the patient experience. And truly, that's nursing, and I got to see really the challenges that our nurses face and it just gave me an incredible appreciation for the work that they do.

(04:13):

From there, I switched to consulting, started at a small healthcare consulting firm called ProspHire. When I say small, I was employee number five, but by the time I left, and that's not just me, it was a great team there, by the time I left, we were at over 50 employees, and they've continued on an incredible trajectory. And now I'm on the health plan side of the equation. And as you know, it's a really complex equation when we talk about healthcare. And so I think I really have a unique view because of really the varied experience that I've had in my career.

Brian Urban (04:48):

Yeah. What a mixed bag that you come to the table with now at Point32Health. And a lot of nuggets in there I was not aware of. I think ProspHire is a great boutique consulting firm. Dan Crogan, one of the growing leaders there-

Sameer Kohan (05:05):

Absolutely

Brian Urban (05:05):

Big admiration or him and his work specifically there. But you've come to a really cool arc in your career now. And when I think about Point32Health, it's this growing name. I think the brand is maybe a year and a half, close to-

Sameer Kohan (05:22):

Two and a half. Yeah, a little over two and a half years old.

Brian Urban (05:24):

So it's still in its infancy in terms of brand, but the combination of Harvard Pilgrim Healthcare and Tufts Health Plan is your foundation. Totally makes sense under one roof across looking at the consolidation and mergers within the healthcare industry, but coming together must've been really challenging. There's a lot to work through and puzzle fitting, any big M&A project. So what has this meant to you personally and really I guess New Englanders beyond that, those that are actually going and getting their health services on the healthcare side and also the health plan side?

Sameer Kohan (06:03):

Yeah. I've been here for about four months now, I've been at Point32Health. And even in my four months here, while I wasn't part of that initial combination, I've seen what it's meant organization. I like to take a step back here. Like we talked about, we're basically about two and a half years old as Point32Health, as an organization, but we combined two incredible legacy organizations that have over 100 combined years of service to our members in our communities.

(06:39):

Now, add to that this happened during the pandemic, so you're trying to bring two cultures together when you can't physically be together. So that was, on top of the normal challenges you would face, that was that additional hurdle, I would say, to overcome. And what I've seen is just an incredible willingness, first of all, leadership from Cain, our CEO, down through the rest of the organization, willingness to really embrace that change, not without its difficulties, and create this path forward to really where we are now, which is we are truly unified as one organization. There's still work to be done, but as far as what that means to the industry, it really helps New England as a whole because we get to maintain our position as an anchor organization that's local to New England that really focuses on the communities where we live, the people that we serve. So it's been an amazing ride and it's going to continue. And I just think I'm excited to be part of something that's going to continue to grow and continue to do really impactful things for our communities.

Brian Urban (07:56):

And I love that because I think it says a lot about Point32's health strategy. You're new blood. You're not organically grown. And I think that's a very intelligent way to think about attracting talent and positioning them in the best place to be able to make the best impact. So I think a lot about those companies that take that approach because that's a risky approach, but it usually pays off in the end when you have well-rounded experiences coming into a new organization. So it's clearly a good fit and working out well. And kudos to Cain as well. I think he has an amazing background in touching so many different types of plans and projects around the healthcare ecosystem.

(08:48):

And for yourself, Sameer, you've been around the block and you've seen a lot of projects. In particular to health equity, what strategies have you started to see evolve over the last five years? Because you've been in health plans and consulting and healthcare it and even physical construction of centers. So what have you seen really start to take tangible meaning with health equity programs?

Sameer Kohan (09:18):

Well, first of all, I feel like been around the block is a nice way of saying you're kind of old, but I'll take it. It's okay. I would say if we look back, say five years, right? We're specifically talking about health equity. I think health equity was just getting on the radar as a concept, but I don't think that, broadly speaking, we were thinking about health equity in a really tangible or strategic way. You've seen a steady increase in awareness both across various organizations publicly with public policy and even at the individual level. I think part of that, quite frankly, is that we as a society have been forced to recognize a lot of the systemic inequalities that we have just broadly speaking in society, not just with regards to health.

(10:14):

Specific to health, one of the things that I've noticed over the years is there are a lot of individual initiatives that are happening, and what ends up happening with that is we get a boil the ocean approach. There are so many issues that we're faced with regards to health equity that it's a lot of shotgun approach to, hey, let's see how many things we can do and see where we can get with those individual things. Where we're evolving to, specifically at Point32Health, but I think more broadly is really trying to be data-driven as far as what can we measure because we know without being able to measure something, we can't really measure how we're performing and how we're improving.

(11:06):

And that's something that we've keyed in on here at Point32Health, is we're really focused. And so we've taken that boil the ocean approach and we've narrowed our focus down to really... We've actually focused on six separate initiatives and I could get more into that, but we're trying to be very focused on those initiatives so that we can move the needle. And we can use those as examples and to be able to start to spread how we did that organizationally and then hopefully to the broader community at large.

Brian Urban (11:40):

I like one thing in particular that you said, Sameer. It's getting away from the shotgun approach, the just blasting it out approach and being more thoughtful and precise and developing a strategy and an execution plan subsequent to that. So I think that goes beyond just throwing it on a website, throwing it into a marketing initiative. It's an actual plan. It's an actual part of your organization's culture. And speaking of that, definitely want to get into the six initiatives that you'd mentioned there. But I'm interested in particular, with health equity becoming more centric to the mission and the objectives of Point32Health, have you started to feel in your short time there, but have you started to feel the culture rally around health equity and have more of an understanding and begin to have more desire to have cultural health, competency education, things like that? Has that start to bubble up within the Point32's organization?

Sameer Kohan (12:50):

Absolutely. One of the things that we've talked about, I think, a lot in the past... Actually, not even in the past. We are one of the first plans in New England to achieve the health equity accreditation from the NCQA, and we're extremely proud of that. It's foundational to who we are and what we do, but we're not just about collecting metals, it's really about adopting a health equity mindset within the organization.

(13:27):

What I mean by that is we do have an extremely talented and motivated health equity team. Got to give a shout-out to Wendy Williams and her team. They do an amazing job here. Having said that, we need to adopt this health equity mindset, and that means making sure that all of our colleagues understand how the work that they do impacts health equity and how they need to have health equity as a focus in the work that they do.

(13:58):

So what I've seen is we are well on our way as part of that journey. We really are committed to that health equity mindset, but we're not there yet. We have work to do. And I think that's something that it's truly a culture change. And what's amazing is that all of our colleagues are here for a reason. And that's something that I've learned really in healthcare throughout my career.

(14:26):

Usually, people don't stumble into working in healthcare. Some people do, but by and large, people are really mission-driven and there's a reason why they want to be here, whether they're directly working with patients or members or they're more behind the scenes, but there's that mission, there's that desire to really help people just at its most basic. It's, how do we help people? And we have colleagues here that are absolutely focused on helping people. And that health equity just expands on that, is how do we change these outcomes that we have that are... I mean, when you look at the statistics, they're stark, they're disheartening, they seem like they're just too big to address, but that can't be the case. We know that there are solutions. We just have to be very focused on making sure that we drive towards positive outcomes and really making tangible change.

Brian Urban (15:23):

The one thing that you said in particular is having your organization. As a whole and individually know that their work touches health equity in some fashion. That's a very loving, intelligent, curious approach to have to work. And I don't think you would've ever felt that eight years, 10 years plus being in this health plan, integrated delivery network ecosystem. It wasn't really front and center as it is today. So that statement right there that you shared is very impactful. Love hearing that.

(16:06):

Sameer, the initiatives that you had mentioned just a little bit ago, curious on those and the progress that's been made. Can you give us a little bit more insight there?

Sameer Kohan (16:17):

Yeah. We've identified six areas that we want to focus on, and that's maternal health, so pregnancy and maternal health, vaccine equity, rural health, so access to healthcare in our more rural settings, substance use disorder, and most broadly, I would say SDOH. That's one of our focus areas. I know you've had discussions with guests on SDOAs just on its own. Right? It is such a pervasive and just massive challenge, but the way that we're focusing on it is, what are the tangible activities that we can do?

(16:59):

So when we talk about these six areas of focus, we've been able to narrow it down. Now, we have various initiatives within each of those, so we have our six verticals within health equity. And then, what are the programs, what are the areas where we can really measure progress and then really be accountable?

(17:19):

We actually recently released our first annual DEIA and health equity report. And the purpose for that is, number one, to really let the world know what Point32Health is doing in those specific areas, but also to hold ourselves publicly accountable. We're open and honest about what we're doing and also where we want to go, what are our goals. And I think that's really important. It's something that I know Cain has talked about a lot. When you hold yourself publicly accountable, it really moves the needle and people are going to ask you about it. So where are you with that? It's 2023, 2024, and we're excited about that. We're excited about the challenge. We think we can really move the needle on those initiatives and then start to expand that.

(18:12):

And the other thing I want to say is it can't just be individual organizations that are working on their own in silos. That's one of, I think, the issues that we've had with tackling health equity as a whole. And I'm really excited to see that it's not just health systems, it's payers, it's government organizations, organizations. It's all of these advocacy groups that are coming together to tackle this huge problem and work collaboratively. And to me, the biggest challenge is we just don't have clean data on a lot of the things that we're trying to impact. And I think that's a really area of opportunity for us as a whole, is to get clean data that we can all trust and share, and then we're all making that impact together rather than in our own separate silos.

Brian Urban (19:17):

You hit on so many important things. It's almost tough for me to pick on what's the next thing that I want to ask you about there, but I really appreciate you breaking down those six areas of interest that your focus is going to be on with your health equity initiatives going forward. So that is extremely helpful, I think is a good picture for everyone listening here to pick up and translating into their own organization's health equity initiatives.

(19:45):

And the point you made about data... We talk a lot about socioeconomic data on this podcast. Life happens outside physicians offices, things that aren't captured traditionally in electronic health records that are really important. If people are on the edge of bankruptcy, they've lost a loved one, they've lost an asset, a home or a car or job, those things are difficult to talk about, patient to physician, and difficult to integrate as it's not common data a lot of analytic teams have not played with in healthcare organizations and health plans, but it's definitely the next leap.

(20:26):

And you bring up such an interesting point. It's a village. It's a huge massive village approach that we all need to have to be able to start to break down a lot of these SDOH barriers that have been put up for generations in front of a lot of families across this country. And Cain, that you mentioned here, I'll go off of this, what a great leader to be able to act as a coach. I want to get an understanding of this guy's brain. So he comes off as a coach to me when I see a lot of publications and news regarding him, does he lead as a coach or is it a different type of mentality that he has with leading Point32Health?

Sameer Kohan (21:10):

He absolutely does lead as a coach. And I would even take a step back and say leads by example. He truly believes. For example, I just mentioned that the DEIA and health equity report that we published, that was something that Cain actually wanted to start two years ago when he got here. He was laser focused on that from day one, and has helped execute on it and has supported it and has championed it.

(21:45):

So when we talk about health equity, when we talk about the way that Cain leads, again, I've been here for four months, but in my four months I've seen just how real this is. It's not lip service. And unfortunately, there are places where it is. It's tangible, it's meaningful. And he really leads by example. He's out in the community. He speaks on health equity. I think, over the summer, he participated in three separate panels on health equity. And so, again, it's a topic that's pervasive in the ecosystem right now, but it's been pervasive at Point32Health since day one, really. So yeah, it's really just for me personally, I've had a lot of great mentors in my career and I've been very fortunate. And Cain, it's the next level. It's been great.

Brian Urban (22:47):

Yeah, I love hearing that. Top down, bottom up, a very authentic organization that is being continually transformed, Point32Health.

(22:58):

And I will tell you, in terms of who we talk to on our little podcast here, we talk to the doers and the impact makers. We've actually not wanted to talk to a lot of thought leaders, if you will, because they have not put in the work of the grit in terms of maybe their life experience or their career experience. But those that are truly invested into it and held accountable publicly is the voices we love to hear from. So I think, Sameer, you represent that so very well for your organization and everything that Cain is leading as well. So thank you for those comments.

(23:38):

We covered a good bit of ground here. One thing I want to go back to actually is the NCQA Health Equity Accreditation. I completely forgot to hit this because you mentioned this a few comments ago. You have two plans underneath Point32Health that got full accreditation. That's not just like taking a quick quiz. That is a lot of work. That is a lot of resource investment and it's a great consultative package in terms of value that the NCQA is offering to help health plans in particular hit a lot of measures that will be coming out in future years as CMS is really adopting a lot of NCQA's measures, guidelines and other strategic suggestions. So what has it meant to maybe the health plan side of Point32Health to achieve these full accreditations and start to put it in action? I mean, it's more than just a medal as you said, but what has it meant? It's have a great sense of achievement and motivation for your future health equity initiative. So I just want to get a sense of how that's been for the team.

Sameer Kohan (24:51):

I think it's been extremely impactful for us organizationally. One of our values is own outcomes. And this is very much something that we've accomplished where you see this tangible outcome, that accreditation. And like I said, it's not just lip service. This was an entire organization coming together to really coalesce around this is something that's important to us and it's foundational to who we are as an organization. So it's really helped us in that regard. And it is really been caused for celebration, right? It's something we're very proud of. But like I said, it is, I think, helping to prove and even just solidify our commitment, but it's really now just the foundation and a stepping stone for everything else that we want to do.

(25:48):

So it's something that's very important to us. And we're glad to see the NCQA, as you said, take such a leading role in bringing health equity up as an area of focus nationally. And I just think, together, we're going to be able to move the needle in a much more impactful way than we are separately.

Brian Urban (26:13):

You wrap that around so well, Sameer, because it's those that are leading not only strategy in terms of gap closures, measures that can be shown to why we need to address social health needs, but it's the whole village approach. So you wrap that up so nicely. And for Point32Health, I got to look in our crystal ball. I want to think two, three years down the road, what are the biggest contributions to the lives that Point32Health serves in greater New England and maybe the ecosystem abroad? What's the biggest contribution that you are seeing that will come to life over the next few years?

Sameer Kohan (26:59):

Sure. Well, I am going to make a pretty broad statement here, but I know that it's important to who we are, and that is we want to be the leader in health equity, not just regionally, but nationally.

(27:16):

To unpack that a little, I'll just give you a little personal anecdote here. My brother-in-law and my father-in-law both passed away from cancer. And the reason I bring that up, I saw what that did to not just them, families, loved ones, and the lasting impact that it's had, especially on my wife's family, quite frankly. Now, these were people that had great access to care. They had significant resources. They knew where to go to get help. They didn't have to struggle with transportation, getting to appointments, things like that. And when I think about the contrast to people that don't have that access, that don't have even, quite frankly, the trust in the healthcare system that's supposed to be supporting them in those moments, that's what really drives me personally.

(28:23):

But I think broadly as an organization, that's where we want to get to, where we want to help to create a system where those inequities... I mean, aspirationally, where they don't exist, but we've got to take steps to get there, right? It's not going to happen overnight. So we want to lead the way, and we are a regional plan, right? We are focused on New England, we live here, this is who we are. But when I say we want to be the leader nationally, we want to be that shining example of look at what Point32Health was able to do as an organization, working with other organizations, community-based organizations, government, everyone, bringing everyone together as really this convener and taking that to the next level and being an example for how we do this nationally.

(29:16):

And we're committed and we're headed in that direction. But I've said it before, I'll keep saying it again, there is a lot of work to do. And we're excited for the challenge, but we're... We're excited for the challenge and we know that we have the capability and we have the leadership and we have the people to make this happen. Our colleagues are so dedicated that we know we can do it. It's just not going to be easy.

Brian Urban (29:47):

And a bold statement, but you all can back it up, especially in terms of who you have leading the helm across Point32Health. And I'm excited to see the progress. I feel a follow-up conversation coming on here, Sameer, and would love to check back in with you and the team because I think those that show they're putting in the work, they want to be held accountable. They want to be a model for others to follow and to work with. So it's going to be exciting to see all of this work come to fruition over the next year plus.

(30:25):

I want to thank you again so much for your time joining our little show, Sameer. This has meant a lot to me, so thank you very much. And for more excerpts and insights, please visit us at finthrive.com. Thank you, Sameer.

Sameer Kohan (30:42):

Brian, thank you so much for having me. It was awesome, and look forward to checking back in soon.

Brian Urban (30:46):

Thank you.