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Lisa Wright takes the helm at Community Health Choice at a pivotal time

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Lisa Wright, a former executive at Tampa, Fla.-based WellCare and UnitedHealthcare’s Texas division, joined Community Health Choice in May as the local insurer’s new president and CEO, two years after executive Ken Janda stepped down from the role.

She tales over as the healthcare landscape is in the midst of an evolution: insurers and hospitals are at odds over rising costs and network contracts, and the coronavirus pandemic has challenged the limits of traditional healthcare.

In her new role, Wright will oversee the day-to-day operations of Community Health Choice, a local nonprofit health plan with nearly 400,000 customers in southeast Texas. The plan, designed in the late 1990s to serve pregnant women as well as children covered by Medicaid and CHIP, expanded greatly under the Affordable Care Act.

Wright spoke with the Houston Chronicle about what the future holds for the organization. The following interview has been lightly edited.

Q: What are your main goals for Community Health Choice this year?

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Hometown: Houston

Education: Bachelor of Arts in Journalism from the University of Kentucky, MBA from the University of Maryland, College Park

Career: President, Medicare at WellCare; President, DSNP, MMP, and Nursing Facilities at UnitedHealth Group

Hobbies: Volunteering with foster kid organizations; spending time with her four-year-old

A: This is a really complex and complicated year. One: how do we deliver healthcare, considering that we’re in the middle of a pandemic? How do we take a community that’s used to going into the doctor and visiting the dentist, and get them more comfortable with telehealth, as opposed to face-to-face visits? Second, I would say Community is Community not just because of what we do in the actual community, but because of the team and the culture that we’ve built within. There’s a team here that is used to having that direct contact with one another. How do we continue to keep up with making certain that we’re connected and we’re having those conversations and doing it in a way that’s still engaging to the team, and still inspires them want to continue to do more around healthcare?

I think about not just for the end of 2020, but just into the future for all of healthcare. This pandemic has taught us a lot. It’s taught us that some of the ways we traditionally deliver healthcare may not be the same in the future. How do we do more around using data and being able to move from ill patients and sick visits to how do we sustain the well-being of our members?

HEALTH CARE PIVOTS: Houston’s healthcare systems turn to telemedicine to meet medical needs

Q: What are some of the lessons you’ve taken away from your experience working with WellCare and UnitedHealthcare in Texas?

A: I’ve always worked in government programs, and working in government programs, you’re working with the most vulnerable populations. Being able to come to Community and continue that work and having those connections from being in Texas has proven to be very beneficial to me. It’s allowed me to move a little bit faster, and to just pivot into some of the conversations a lot easier.

One thing I was looking forward to in coming here is really being able to not just make a difference from a healthcare standpoint, but more from a social determinants standpoint. You’re trying to get to the whole self. It’s like with anything else — you can’t focus on healthcare if other things in your life are taking priority.

Q: What’s driving insurers to re-examine healthcare costs at hospitals?

A: One of our goals at Community Health Choice is to build the highest quality networks with the most affordable costs. Houston’s diversity of hospitals and providers often provides great flexibility to have both at the same time. Providers go in and out of networks fairly regularly, and while sometimes the decisions are around the balance of cost and quality, at times a provider wants to focus on a specific patient demographic and seeks out insurers who serve that demographic. When a provider goes out of network, insurers do everything to communicate with members as we always want members to understand they have a choice. Regarding Kelsey-Seybold or anyone else not currently in our network, we’re always open to this conversation. We always want the highest quality network of providers possible for our members.

Q: What’s the outlook for the health insurance market right now?

A: Utilization is down just due to the fact that elective procedures were halted as we had the shelter in place. As we start to open up, we start to see more people that had scheduled services prior go in to get their services. We have to make sure we are looking at the whole picture. Understanding that pent up demand is just going to be a part of our reality moving forward, and that we don’t know exactly when that’s going to hit. But we do recognize that will come back.

Really, it’s unknown what’s going to happen over the next six months. We’re just not sure how many people, because they’re afraid to go out, are going to continue to delay their healthcare because they’re afraid of going to the hospital. That isn’t a good place to be because we know that whatever disease and condition they have could get much worse.

Q: What’s a challenge Community Health Choice will face this year?

A: When we think about what we call integration (of behavioral health doctors with medical providers), that’s really looking at physical and mental health. In health care, you normally focus on physical. Mental health is a portion of it for some people, but not for all. I feel like as we go through the pandemic, mental health is continuing to be an increased focus. How are we going to start integrating those two together where they’re on parallel paths and so we continue to look at the whole person? The pandemic has really highlighted the true need for mental health for all of us.

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Q: How will you approach that?

A: We used to contract out for mental health services and we’ve recently brought that department back in. One of the factors is that we’ve got to work together — we have a psychiatrist on staff, we’re continuing to hire other mental health professionals so they can work in tandem with our medical directors and nurse case managers.

Q: Any plans for expansion down the road?

A: That’s always an option for us, whether the expansion is geographic or product. We already serve primarily women and children in these vulnerable populations; we should do more because we have a quality product and have something outstanding to offer.

We have this amazing career-ready program, where we focus on getting high school seniors, and even our pregnant mothers, through to college. We provide scholarships, mentors and coaches that teach them how to study, help them just navigate life while they’re trying to go to school and help them find jobs. When we’re thinking about social determinants of health and us being a leader, that for me just speaks volumes because we’re actually in the community. The program started in 2018 but we are continuing it.

gwendolyn.wu@chron.com

twitter.com/gwendolynawu

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Coronavirus: ‘Our mental health goes downhill in situations like this’ – BBC News

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Rock County health officials ‘strongly recommend’ mask wearing

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Stack of medical masks
Image by jardin from Pixabay

JANESVILLE, Wis. – Officials in the Rock County Public Health Department are “strongly recommending” everyone wear a mask both indoors and outdoors unless only with family.

In a memo released Friday, health officials say positive tests in Rock County increased 60% from the week prior. In the memo, health officials detail that COVID-19 is primarily spread through droplets, which a mask can prevent from spreading.

While Dane County’s mandatory mask policy will go into effect Monday, Rock County does not have a mandate currently. Still, some private businesses are requiring masks to be worn by all customers and staff.

“I was more surprised that I hadn’t done it sooner,” said Jackie Gennett, co-owner of Bushel and Peck’s in Beloit.  :I probably should have done it sooner. It just makes sense to do it.”

Bushel and Peck’s began its mask mandate on June 30. Since then, Gennett says the store has seen next to no issues with compliance.

“The people who don’t want to wear masks aren’t going to come into the store and cause any problems,” she said. “So that eliminates us having people be angry with us.”

The Rock County Public Health Department says while masks are not a substitute for social distancing and other preventative measures, wearing a mask could reduce your chances of spreading or catching Coronavirus.

Beloit has seen the biggest percentage of Rock County positive Coronavirus cases, totaling nearly half of the county’s cases overall.

Gennett says because of this, she and her employees will continue to wear masks.

“You may not like wearing a mask,” she said. “I know I don’t like wearing a mask. No one likes wearing a mask. But once you realize that you have to do it to get past this, it’s not that hard to put a mask on.”

 

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Health and racism’s impact – Lowell Sun

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LOWELL — David Turcotte and a team of collaborators have compiled and published the Greater Lowell Community Health Needs Assessment every three years since 2013.

The lengthy document probes factors influencing residents’ health, like housing, education and employment. It analyses public health data and identifies residents in the community with the highest risk.

And when you ask health care professionals in Lowell about the relationship between race, ethnicity and health, this document is often referenced.

“It’s clear that there is an aspect of institutional racism that is connected to worse health outcomes for communities of color,” said Turcotte, who is a research professor at the University of Massachusetts Lowell specializing in sustainable housing, conflict resolution and environmental justice.

In Boston and Somerville, officials have declared racism a public health crisis. A petition signed by over 1,000 people urges the city of Lowell to follow suit and institute other reforms.

The Lowell City Council is expected to discuss the matter on Tuesday, as it moves through a bevy of motions on racism and equity with differing approaches and language.

But what are the links between race and health?

Health officials point to the prevalence of certain medical conditions, which are higher among certain ethnic or racial minorities than white residents. This has been documented locally and nationwide for COVID-19 rates, but it is not a phenomenon limited to the ongoing pandemic, officials say.

Chief of Community Health & Policy at Lowell Community Health Center, Sheila Och, listed asthma, diabetes, and hypertension, as examples, referencing numbers reported in the 2019 Greater Lowell Community Health Needs Assessment.

Hispanic children four and under in Lowell were hospitalized for asthma at almost twice the rate as white children in the city between 2002 and 2014, according to the report.

Hospitalization for diabetes in Lowell is “substantially” higher than in surrounding communities, according to the report. The report cited state level numbers, indicating 12.3% of adults who identify as Black, 11.7% of adults who identify as Hispanic and 8.7% of adults who identify as white have diabetes.

“When we say Blacks and Hispanics are three times more likely to have x, y and z disease — whether that’s diabetes or hypertension or chronic heart conditions — we’re able to close that gap, but we have to put the systems in place to impact that disparity number,” Och said.

These rates are influenced by what health officials call “social determinants” of health. Dr. Wendy Mitchell, president of the Lowell General Hospital Medical Staff, listed a few examples of these determinants ranging from housing instability to insufficient wages to neighborhood walkability to food availability to access to higher education.

“The racial injustice affects all of the above,” she said.

She said many countries in Europe that spend more on addressing social determinants, spend less on medical care.

Turcotte focused on the lack of affordable housing as a public health issue.

People in Lowell, on average, spend a higher percentage of their income on housing than Westford residents, even if housing is cheaper in Lowell, according to Turcotte. He argues this makes Lowell the less affordable community. When more of residents’ money goes toward housing, this leaves less for other determinants of health, like nutritional food and quality of life activities.

“It doesn’t leave much for the other necessities,” he said, noting race and income is often interconnected in the U.S.

However, “one sliver bullet” won’t solve the issue, he said.

“It’s not that everyone is racist,” he said. “Racism and barriers of race for opportunities exist.”

Och said the experience of racism also has direct health impacts, especially to mental health.

“We hear these stories every single day: the emotional toll of racism and discrimination … and the lifelong accumulation of the related stress around discrimination and racism for many of our communities of color,” Och said. “And how that manifests biologically, physically in someones body over time.”

A survey of 1,355 local residents — part of the 2019 Greater Lowell Community Health Needs Assessment — had participants rank community safety issues, like domestic violence, drug trafficking and different types of discrimination. Among all participants, “discrimination based on race” was seventh out of sixteen options. Among only non-white participants, “discrimination based on race” was ranked second, behind “bullying.”

Och said employees hear a common story at the LCHC Behavioral Health Services department, which offers mental health and substance abuse services.

“One of the stories that feels like it’s woven throughout, is this sense that not being included in a community and being always out of that circle,” she said.

Beyond “upstream approaches” requiring wider policy changes, Mitchell said she believes providers need to screen patients for social determinants of health. She said other shifts may be less obvious. For example, she said patients sent home with conditions like congestive heart failure are provided a list of dietary recommendations, though this list may not take into consideration cultural dietary differences.

“It may not be the foods or the meals that people eat,” she said. For some patients, a list of low-sodium Cambodian meals may be more useful than the list that is typically provides, Mitchell said.

LCHC created the Metta program about two decades ago to meet the specific needs of the city’s Cambodian population.

“It’s a prime example of how a community takes care of another community,” said Susan Levine, the chief executive officer of LCHC.

The city’s Cambodian population experiences higher than average rates of diabetes, hypertension and asthma, according to Och. Some who settled in Lowell as refugees are survivors of torture and experience post traumatic stress disorder.

“There are disparities that exist within our Cambodian community that also need to be talked about … and there’s also the aspect of resiliency that despite all these negative odds that some people have faced in their lives, they continue to rise and they continue to have the energy to improve the communities in which they live,” Och said.

As well as bilingual services, Och said Metta takes a culturally sensitive and appropriate approach to health care for this population.

Last month, the 19-member board at LCHC unanimously supported a letter requesting the declaration of racism as a public crisis in Lowell, according to Levine. She said LCHC is a community health center based on a model that emerged from the civil rights movement. Eliminating health disparities is part of its mission statement.

“It goes back to why we exist as a community health center,” she said.

Lowell Board of Health Director JoAnn Keegan — who also served as Lowell’s acting health director for a few months earlier this year — said she has been on vacation and has not been keeping up with the debate on declaring racism a public health crisis. The board does not have a July meeting and will next meet in August.

She said she believes there are health disparities by race, which have been documented in the Greater Lowell Community Health Needs Assessment.

“That’s a document I left right on the top of the desk when I left,” she said.

Turcotte said, while he doesn’t think Lowell is unique, racism is a public health problem in Lowell.

“Declaring it is the easy thing to do,” he said. “But what are you going to do about it?”

 

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