by Mandy Cohen MD, MPH
I grew up watching our health care system through the eyes of my mom.
She was a nurse practitioner for her entire career – nearly all of it spent taking care of patients who came to the emergency room. She’s one of the most incredible clinicians I’ve ever known. Through her eyes, I first saw the impact that health care professionals make every day in the lives of their community. And that positive impact is why I charted my own career path into medicine.
But, through my mom’s eyes, I also saw the cracks in our health care system, which are often amplified in an emergency room. I saw how the system could erode trust between doctors and patients. I saw the misaligned incentives throughout the system that led to emphasizing reactive interventions rather than preventing bad outcomes in the first place. I saw how much the system, even with the best clinicians and the most attentive patients, all too often left certain patients behind – often the patients who needed help the most.
I realized we need a health care system that properly aligns incentives, so clinicians are rewarded for keeping patients healthy– - not just paid when their patients get sick. We need a system that is equitable and delivers on health for families and communities alike. Most of all, we need a health care system that isn’t just about caring for certain conditions or certain parts of ourselves – we need a system built around the idea of whole-person care.
I’ve been fortunate to be a part of teams at the federal and state levels committed to building towards that system. At the Centers for Medicare and Medicaid Services (CMS), I had a front row seat to the launch of new innovative payment models at the CMS Innovation Center and helped propel a massive expansion of health coverage through the health insurance exchanges and Medicaid.
As Secretary of North Carolina's Department of Health and Human Services for the last 5 years, I led the largest change to the state’s Medicaid program in its history – layering in investments in advanced primary care and integrated whole-person care, including mental health and the non-medical drivers of health. I also led the implementation of the first-in-the-nation, statewide coordinated care network, NCCARE360, to electronically connect people with identified needs to community resources. This private-public partnership was a key feature of North Carolina’s COVID response and the backbone to the innovative Healthy Opportunities pilot authorized under North Carolina’s 1115 Medicaid waiver. And for the past two years, I led North Carolina’s response to the COVID crisis, embedding health equity, transparent communication, and data-driven decision-making at the core of the response effort.
After nearly 15 years in public service at both the federal and state level, I am excited to keep growing and learning as a leader and health care executive, now in the private sector. When I looked for the next opportunity where I could continue to work on the mission to build a more equitable, health-focused, proactive, and trusted system, Aledade quickly rose to the top of the list.
The team at Aledade has built a nationwide network of more than 1,000 independent primary care practices delivering care to more than 1.7 million patients under value-based contracts across all payers – traditional Medicare, Medicare Advantage, commercial, and Medicaid. Aledade supports practices in delivering high quality care, targeting patients’ care needs with data and trust, and they have a financial model that aligns the incentives in the system – so primary care practices succeed when they're able to keep their patients healthy. I saw the strengths of the Aledade model firsthand in North Carolina, where they are supporting over 200 practices and 300,000 patients.
I chose Aledade because it is a company that aligns with my core values and vision for the future of health care. It is a mission-driven organization that is also evidence-based and pragmatic in how it supports primary care practices. I was also drawn to Aledade’s team of smart, driven, thoughtful, and kind people who I wanted to work with everyday. And lastly, I chose to join Aledade because of what I see over the horizon for this company and the practices and patients it serves.
Thus, today, I’m thrilled to officially announce that I’m joining Aledade as Executive Vice President and the CEO of its new health services unit, Aledade Care Solutions. Aledade Care Solutions, or ACS, will implement targeted wraparound care solutions to provide enhanced support to primary care practices and patients in Aledade’s nationwide network of Accountable Care Organizations.
It is intentional and important that I will be both embedded in the core work of Aledade – making sure Aledade continues to strengthen its support to practices and reach across all payers and populations – as well as building the new care delivery work for the company. One of my initial priorities will be to lead Aledade’s work to support the large and growing number of patients enrolled in Medicaid programs that are served by Aledade practices and health centers. This work will further Aledade’s goal of bringing the benefits of value-based care to patients across all-payers, and help Medicaid enrollees benefit from value-based care.
As we grow ACS, the team will find new ways to complement the care that the dedicated professionals in these practices provide every day. We’ll identify and test new ways to extend the reach and impact of primary care practices in targeted and technology-enabled ways. We will look to build new solutions within Aledade and collaborate with other companies that can integrate seamlessly into the workflow of primary care practices. And for solutions that can deliver better patient outcomes, save money, and support practices, we’ll work with the strong Aledade network to bring those innovative new care solutions to scale in practices across the country – touching millions of patients’ lives.
The team has already gotten to work. Just a couple of weeks ago, Aledade announced the acquisition of Iris Healthcare, a company that offers Comprehensive Advance Care Planning to patients across the country. This launch is the result of a pilot program, which proved that this service offered by Iris Healthcare greatly increased satisfaction among patients and doctors, while saving costs throughout the system.
Our future work will follow a similar model. We’ll explore new ideas and new innovations alongside the practices in the Aledade network. Together, we’ll integrate services that are most likely to improve health and increase savings. And by working across payers, we’ll reach patients more equitably. We’ll show how keeping the focus on integrated, whole-person care isn’t just good for patients, but it’s good for practices, good for payers, good for communities and good for society. It’s the kind of care system my mom would have loved to work in and the kind of care I want my family to receive.
I’m excited to get to work.