The Health Initiative Senior Director, Health Plans

THE HEALTH INITIATIVE

SENIOR DIRECTOR, HEALTH PLANS

The Context

It is well-established that 80% of a person’s health is determined by factors outside the doctor’s office — healthy food, safe housing and a decent income. Yet our healthcare system is built backwards, with more than 99% of US healthcare dollars spent on medical care alone. The amount of money going toward healthcare is huge — with public and private payers spending over $11B on healthcare every day. This is projected to grow 6% annually through the next decade.

But what exactly do we get for all this healthcare spending? Right now, the US has some of the worst health outcomes across all high-income countries, including for preventable heart disease and obesity, which cost the system nearly $500B each year.  This is inefficient and leaves people behind, especially low-income children and families. 

Imagine a system designed to pay for health, not simply healthcare. What if it invested dollars more efficiently and effectively to pay for access to nutritious food or safe housing as key levers to prevent and manage disease and lower healthcare costs?

The result would be a win-win-win: Children and adults would have better access to healthy food and safe housing and, as a result, have better health outcomes. When healthier patients use less care, the government saves money – and insurance companies’ revenues increase – incentivizing both to pay for these basics.  

The Health Initiative Approach & Impact to Date

The Health Initiative (THI) is a national organization that crosses political divides, taps market forces and activates stakeholders to shift dollars toward health.

By providing strategic guidance and technical assistance, we activate healthcare institutions to redesign their policies and invest preventatively in nutritious food and safe housing— to improve health outcomes for those most at risk and reduce overall healthcare costs. To date, these institutions have spent nearly $1B in healthcare dollars on food, housing and other basics.

For example, THI supported North Carolina to use Medicaid dollars to provide patients with groceries, rental assistance and other basics, keeping them out of the hospital and saving the state a net $1,020 per person per year. CMS incorporated aspects of NC’s approach into its approval process for states to use Medicaid dollars for food and housing benefits and 22 states have enacted key elements of it.

Likewise, THI worked with CMS leadership to lay the foundation for its enacting the first-ever billing codes to pay healthcare providers to screen patients for food, housing, and other basics, and to pay community health workers to navigate patients to these resources.

Finally, with THI’s guidance, three major insurance companies invested over $300M in buying health for their patients and/or their low-wage employees. For example, THI advised a Fortune 50 insurance company on how to increase healthy food and housing benefits by $80M for high-risk patients and to design an evaluation which found that those receiving higher benefits have lower healthcare costs.

Job Purpose

The Senior Director - Health Plans is a key member of the THI Leadership Team and is responsible for engaging health plans with Medicare, Medicaid, Marketplace, and/or commercial members, with the goal of unlocking existing healthcare dollars to invest in healthy food, safe housing, and other drivers of health. This role will be both creative in envisioning how plans can achieve this goal as not just the right, but also the economic thing to do, and persuasive in communicating this approach to others.

The Senior Director - Health Plans may or may not have direct reports but will be responsible for leading a cross-functional team of both THI’s program staff and cross-cutting functions (including research and analytics, communications, and mobilization) to achieve these goals.

This role will also collaborate closely with their peers leading THI’s work to spur federal and state healthcare institutions to invest in drivers of health and to engage philanthropic partners who invest in and champion THI’s work. The position reports to the Chief Operating Officer on an interim basis, and works closely with the Co-Founders and Co-CEOs.

Key Responsibilities

• Lead THI’s work to activate health plans to invest in the drivers of health as a core part of the business, by engaging plan leaders to implement this approach, build the business case, and go on the record to build sector momentum.

• Engage directly – and support other THI leaders to engage – the health plans’ executive, product, actuarial, analytic, communications, government affairs, and drivers of health teams to achieve these goals.

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