Senior Implementations Manager, Interwell Health
Interwell Health is a value based care (VBC) organization that is focused specifically on patients in various stages of kidney failure. The VBC proposition includes patient support through a multidisciplinary care model that utilizes clinicians, dieticians, social workers, transportation networks, and more, to ensure that patients are receiving the highest quality care while reducing health care system inefficiencies and costs. Our goals are to reduce patient hospitalizations, increase pre-dialysis vascular placements, provide support in end stage renal disease options such as dialysis and/or transplant. Interwell Health utilize insurance payor and physician data to proactively identify patients at highest risk for immediate hospitalization through predictive modeling, and to intervene through care coordination with the patient's physicians and/or direct contact methods.
My role within this process is to work directly with new clients (typically healthcare insurance organizations) to establish data connectivity, align on marketing to patients and providers to introduce the program, confirm care coordination setup between our clinical teams and the insurance payor's care management entities, and much more.
What is something fascinating happening in your industry right now?
Value based care is becoming more and more the norm within the healthcare world. VBC entails payment to healthcare entities based on necessity and quality of services being provided to patients, rather than the historical norm of the "fee for service" model. Fee for service has meant that there is a rate for any particular medical service - i.e. an ACL repair is $5,000 - however, with VBC models the payment would take into account whether or not the procedure performed was appropriate, and the success of the procedure. This could mean a provider in a VBC model contract may receive $0 or $10,000 depending on the evaluation of the care provided. This will offer a more broad definition of what a provider and insurer will provide within their scope of care - one thing specific to the work that I do is the need for transportation to dialysis treatments to avoid hospitalizations due to barriers seen in many communities. Insurance companies, including Medicaid carriers, are offering more robust transportation benefits to patients to ensure care is being met in the most basic sense.
How did you end up in your current position?
I had been working in the healthcare world in corporate roles when I found out I had kidney disease and would eventually need dialysis or a transplant to live. I was lucky enough to get a pre-emptive kidney transplant through a living donation from my cousin. Through that process I made the choice to seek out employment opportunities that would allow me to do more meaningful work, and I was fortunate to find my current employer at the time of my transplant (CVS Health) had launched a kidney care organization. While CVS Health is doing great things in this area, it was one product/service in a portfolio any many. I learned about Cricket Health (now Interwell Health) through kidney care industry research, which is solely focused on the improvement in care and slowing of kidney disease. As a startup company it has allowed me to utilize my personal kidney disease experience, and my prior project management and program design history with a kidney care organization, to support the growth within this healthcare niche.
In what ways has your Mizzou education/affiliation impacted your life since graduation?
I believe having had the opportunity to move to an area of the country and a community like Columbia provided a great change in the way I see and interact with people of different backgrounds. Having grown up in the Northwest and spent time in the Southwest prior to enrolling at Mizzou, I will admit my perspectives in many areas where quite narrowly focused. Mizzou offered a midwest point of view that has since allowed me to better relate to and build relationships in my professional (and personal) life that might have been more difficult otherwise. There are also numerous Crosby MBA Alumni from my time there that have gone on to do amazing and brilliant work in different areas that I continue to follow and support, which is amazing to say I have that connection to through my graduate experience.
Why did you choose Mizzou—what makes Mizzou special? Why should someone consider Mizzou?
Candidly, Mizzou offered great financial incentives to come to a University that was outside my geographical comfort zone. They also offered a chance to work within the University as a teacher and/or a teaching assistant, both of which gave me the change to enjoy the graduate school experience free of full time employment burdens.
Now that it is a decade later I have more perspective into what makes Mizzou special to me. Having completed my undergraduate degree at Arizona State University, which is more or less situated in one of the largest metro areas in the county, the beauty of the college town personality and lifestyle is something I hope all college attendees get to experience. Living in a community that is so driven by the University and events related to it, the pride of those who support the educational institution, all without the distractions of "big city" life was amazing and unforgettable.
Going to Mizzou allows you to focus on the experience of college, getting to know your fellow classmates, and to have a sole purpose - getting an education.
Fondest memories while a student or faculty member here?
There are many...the facilities throughout campus are top notch. Cornell Hall was new when I was there and is quite impressive. But the campus as a whole is amazing to walk through daily. The friendships I made while at Mizzou still carry on even a decade later. And I was able to experience a study abroad program base in Ireland that brings with it memories that I talk about frequently.
In your spare time, what do you like to do?
I am lucky enough to have a wife of nine years now, along with three children; Harrison 7, Eloise 5, and Archer 1. The kids and their activities do occupy much of my free time. However, I do get out to the golf course when possible and we have been on some great vacations in the last year resuming our traveling spirit.