The Other 80

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 state
• One 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 health
• The importance of building a better narrative about the role and value of public health

Kody 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 Links

NC enrollment dashboard

Crisis warmline

Healthy Opportunities pilots

“NC Launches Additional Phone Support for People Experiencing Mental Illness or Substance Use Disorfer” [RELEASE]

About Our Guest

Kody 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-kinsley

Connect With Us

For 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.

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 state
• The ways her background as a fine art major, mountaineer and emergency medicine doctor shapes her leadership approach

Anne 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 Links

NPR Story on #ThinkLikeZink

Article on the Five Reasons Dr. Zink is crushing it as a crisis communicator

An interview with Alaska’s top doctor

Article on the rural Alaskan towns leading the country in vaccination

Case study on the partnership between public health and tribes for vaccine distribution in Alaska

Information on the Watson Fellowship

About Our Guest

Anne 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, providing medical information and guidance during frequent news conferences held by Gov. Mike Dunleavy and state health officials.

Connect With Us

For 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.

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 movements
• The pop up peer groups forming in Amazon reviews
• A framework for understanding, and embracing patient expertise: seekers, networkers, solvers and champions

Susannah 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 Links

Susannah’s book Rebel Health

Susannah’s blog: Wow! How? Health

Patient-Led Research Scorecards

An article about how patient-led research could speed up medical innovation

A story about Tidepool Loop receiving FDA clearance

OpenAPS and #WeAreNotWaiting

Hugo Campos’s TedX talk about not being able to access his cardiac device data

Graphic used by Sarah Riggare to show the time spent in self-care for Parkinson’s disease

About Our Guest

Susannah 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 graduate of Wesleyan University with a degree in anthropology. She is the mother of two children, a caregiver for elders, and lives in Washington, DC, with her husband, Eric Halperin.

Source: https://susannahfox.com/bio/

Connect With Us

For 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.

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 uncertainty
• How California redeployed an army of census workers to support the COVID response
• The biggest opportunities to use AI for public health
• Three great book recommendations: “How Emotions Are Made” by Lisa Feldman Barrett, “High Conflict” by Amanda Ripley and “Fifth Discipline” by Peter M. Senge

Dr. 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 Links

Dr. Tomás Aragón’s UC Berkeley Public Health profile

Dr. Tomás Aragón’s GitHub blog

Article 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. Senge

About Our Guest

Dr. 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 Us

For 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 challenges
• How his company Dandelion Health is helping solve the data log jam for AI product testing
• Why 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 Links

Dr. Obermeyer’s profile at UC Berkeley School of Public Health

Ziad Obermeyer’s testimony to the Senate Finance Committee on how AI can help healthcare

More about Nightingale Open Science

More about Dandelion Health

Article on dissecting racial bias in algorithms

Article On the Inequity of Predicting A While Hoping for B. AER: P&P 2021 (with Sendhil Mullainathan)

About Our Guest

Dr. 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 Assistant Professor at Harvard Medical School, and he continues to practice emergency medicine in underserved communities.

Connect With Us

For 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.

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 law
• How disruptive periods, such as the COVID-19 pandemic and Dobbs, provide opportunities to re-imagine maternal and child health in the US
• Why community-centered research is essential for improving health equity

Monica 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 Links

CDC’s Report on Maternal Mortality 

JAMA Articles on trends in maternal mortality:

• https://edhub.ama-assn.org/jn-learning/audio-player/18796651
• https://jamanetwork.com/journals/jama/fullarticle/2806661?utm_source=podcast_platforms&utm_medium=referral&utm_campaign=related_article_links

Summary of JAMA webinar on maternal mortality

Op-Ed: How We Can Reimagine Black Maternal Health in the Changed Landscape of Dobbs

Centering the health of mothers

To Prevent Women from Dying in Childbirth First Stop Blaming Them

About Our Guest

Monica 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 clinical practice after a 28-year career and was awarded tenure in 2019. Monica’s  research findings have been widely cited and her writings work synergistically to allow her thoughts, ideas, and strategies to design and test interventions to advance reproductive justice for all.

Connect With Us

For 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.

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 Center
• The path to value-based payment for community organizations
• The future of public health education: providing the system, structure and culture that encourages every student to be a catalyst for positive change
• How DC is starting to address decades of under-investment in Wards 7 and 8 through its equity budget review

Karen 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 Links

Karen’s commencement address to George Mason grads

NPR piece on partnership with Children’s Law Center

New payment approaches for EPSDT

Guidance for Health Care Entities Partnering with Community-Based Organizations: Addressing Health-Related Social Needs in Alternative Payment Models. [hcp-lan.org]

About Our Guest

Karen 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 Us

For 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.

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 Links

United States of Care's website

United Solutions for Care

Patient-First Care (a.k.a. Value-Based Care) Messaging Findings

United States of Care Preventive Services Resource Hub

Insight Report from November 2023

The amicus brief United States of Care submitted on Braidwood vs. Becerra

About Our Guest

Natalie 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 delivery to diverse communities. An advocate and a mother, Natalie currently serves on the board of directors of the Preeclampsia Foundation.

Natalie holds an M.A. in Social Policy from George Washington University and is an alumna of Salisbury University schools of Sociology and Art History. Natalie lives in Washington, DC with her amazing husband and four children.

Connect With Us

For 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.

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 Links

Building H website

Building H Index

AJHP paper on the product environment

Daniel Lieberman’s book on the history of the human body (no affiliate fee taken)

Culdesac website

HBS Impact-weighted accounts

International Foundation for Valuing Impact

ANNOUNCEMENT: 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 Guest

Steve 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 information officer, assistant vice president of the health group, and founding leader of the foundation’s innovation portfolio — while also funding and working directly with a broad portfolio of innovators at the intersection of tech and health. Downs is a lecturer at the Hasso Plattner Institute of Design (d.school) at Stanford University and adjunct faculty at the Interactive Telecommunications Program at NYU.

Connect With Us

For 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.

Summary

Steve Downs discusses his work as CTO and Chief Strategy Officer at the Robert Wood Johnson Foundation. (02:00)

• Claudia Williams and Steve talk about his work at the Robert Wood Johnson Foundation where he helped develop their strategy and grantmaking approach around building a “culture of health”..

Trying to be healthy in the modern world is like swimming upstream against strong currents. (05:58)

• Humans, who evolved as hunter-gatherers, are not well-suited for modern and sedentary life, leading to the rapid recent uptick in chronic diseases.
• We highlight the gradual erosion of healthy behaviors (diet, physical activity, sleep, social interaction) in parallel with the rise of chronic conditions.

The Building H Index measures the health impact of everyday products and services. (10:36)

• Steve and a team of experts developed a project – the Building H index – to assess the health impact of everyday products and services, starting with 37 major products and services and expanding to 75 in a new iteration.
• The team aims to use a Health Impact Assessment framework to evaluate the potential health effects of the products and services we use everyday.

Products can have negative (or positive) impact on a surprisingly broad range of health behaviors. (12:40)

• For instance, consuming fast food has a negative impact on nutrition but also on sleep, social interaction, physical activity and time spent outdoors.
• The Building H team aims to get companies to recognize their influence on health behaviors and work towards creating healthier products and experiences.

Laying the groundwork for different approaches to product regulation. (14:08)

• Steve discusses how consumer product regulation could consider the aggregate of product influences, rather than just safety.
• He argues that companies should be held accountable for the externalities of their products on people's health, such as obesity and related illnesses.
• Steve suggests that measuring and internalizing these externalities could lead to different forms of regulation.
• Researchers at Harvard Business School are developing a framework for corporate financial statements that quantify a company's social impact in dollars and cents.

How have companies reacted to the Building H index? (19:55)

• Some companies are eager to engage in conversations about product changes they could make to make them healthier. But that reaction is not universal.
• Some companies are curious, engaged, and want to improve, while others are indifferent or unresponsive.
• Steve highlights the constructive nature of the assessment, which is akin to a free product consultancy with actionable suggestions for product changes that could lead to a more positive impact on health.

Could this lead to voluntary agreements across companies? (23:34)

• Companies could work collaboratively to avoid harmful practices like autoplay in video streaming services.

Culdesac – a company building a car-free community in Arizona – won the top score on the 2022 Building H index. (25:41)

• Culdesac is building a car-free community in Tempe, Arizona, with shared bikes and scooters, lots of social spaces, and a grocery store. Many people want to live in an environment that supports and promotes healthier and more green choices.

Moving beyond a model of behavior change based on individual choice. (27:38)

• We discuss how individual agency and choice is not always a useful way to think about health behaviors given the enormous influence from how the products we use and the environments we live in are designed.
• Steve: "If you tilt the playing field in a certain direction, the balls are gonna roll to one side."
• Steve suggests reimagining entertainment beyond screens and couches, envisioning a future where it's more physical, social, and outdoors.
• Building H is collaborating with the University of Washington's Department of Human Centered Design and Engineering to explore speculative design projects.

How can universities and schools of public health be more impactful in creating the conditions of health in America? (33:30)

• Steve urges schools of public health to jump on this issue of the "product environment" since it is an underexplored topic for research and action. We need more research and measurement around the impact of product features on health behaviors. We also need more people to do research that is an input for an action, application or policy change that will influence health.

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 Links

Homeward website

Lack 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 Guest

Dr. 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 Us

For 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